Exam 4

toddlers and preschool childrne med administartion

•Support: siblings, parents

•Child life therapist – distraction, toys

•Choices

•Ear drops – side lying and pull ear up and back if 3+

•

•PO – cup if they can hold it and are willing

•IM – deltoids, 25 gauge and 5/8 of an inch-1 inch

•IV – don’t put in foot

developmental domain and behaviors for a 3 year old

gross motor- kick/throw ball, run up stairs, jump

fine motor- scribble

language- cant express themselves and get frustrated, don’t know right from wrong

social(play)- associative play (acknowledge others presence) , imaginative play

also able to- believe their thoughts produce consequences(magical thinking), only knows behavior is bad if they are punished, differentiate gender, speak to pretend friends, experience night terrors

unable to- understand yesterday and tomorrow, collect objects like cards or stickers

ceebreal palsy

concept	expected findings	interventions/actions
intracranial regulation	at an increase risk for seizures, change in consciousness, nausea, vomiting,	do frequent neuro checks, avoid triggers, cluster care, keep head of bed up, padded side rails, suction at bedside
functional mobility	delayed motor milestones such as walking, decreased muscle tone, stiff, spastic moveements	assistive devices like walkers, wheelchairs, or special crutches
sensory perception	hypo/hypersensitivity, balance difficulty, visual impairment, hearing impairment communication and speech difficulty	speech therapist, OT, audiologists for hearing, ophthalmologists for vision, safety, help with daily function/ADLs
growth and development	developmental delays, delayed fine motor skills like rolling and crawling	IEP, OT, PT
elimination	chronic constipation which can lead to fecal impaction, over active bladder with incomplete emptying which can lead to UTI	change wet pads/diaper
gas exchange	aspiration risk, secretions increased	position head of bed high, monitor rr and o2
nutrition	difficulty chewing, sucking, and swallowing which leads to vitamin inefficacy and malnutrition (weight loss)	high calorie foods, soft puree foods, thicken liquids, ng tube with fortified formula if they cant have oral intake, speech therapy for dysphagia
tissue integrity	more likely to have skin breakdown and dry skin since they might be bound to a wheelchair	rotate every 2 hours, different cushions/pads
cognition	learning disabilities	IEP
psychosocial	stressful, relationships can be difficult to build in school, etc.	provide resources and support groups

-can be born with it or from an episode where there is no oxygen going to the brain (umbilical cord going around neck, APGAR is low, can’t breathe properly,

-not progressive

-always elevate head of bed if they have increased intracranial pressure

treatments- baclofen(for muscle rigidity), gabapentin (for seizures)

While in the health office, the child with autism continues attempting to bang his head. Which action should the nurse implement first?

A. Apply soft wrist restraints
B. Hold the child firmly until calm
C. Position a pillow between the child and wall
D. Administer PRN anxiolytic medication

Position a pillow between the child and wall

Which communication technique is most appropriate when interacting with a child with autism?

A. Use open-ended questions
B. Provide lengthy explanations to improve understanding
C. Use short, simple, one-step directions
D. Maintain continuous eye contact

Use short, simple, one-step directions