NURS 403 - Pediatrics Unit 1

anticipatory guidance

focuses on educational needs pertaining to growth and development

anticipatory guidance

involves educating parents and caregivers about what to expect as a child grows

Medicaid and the Child's Health Insurance Program (CHIP)

a decrease in the percentage of children without health insurance is largely attributed to the expansion of:

Child's Health Insurance Program (CHIP)

purpose is is to help insure low-income children who are ineligible for Medicaid, but cannot afford private health insurance

congenital and chromosomal abnormalities

leading cause of neonatal and infant mortality

unintentional injuries

leading cause of childhood mortality

respiratory illnesses

leading cause for childhood hospitalization

gastrointestinal illnesses

second leading cause for childhood hospitalization

positive reinforcement

type of discipline: key is to focus on the child's appropriate behaviors

positive reinforcement

type of discipline: can be in the form of smiles, praise, special attention, or rewards

extinction

type of discipline: focuses on reducing or eliminating the positive reinforcement for inappropriate behavior

extinction

type of discipline: ignoring the temper tantrums of a toddler

extinction

type of discipline: withholding or removing privileges

extinction

type of discipline: time-out

punishment

type of discipline: involves a negative or unpleasant experience or consequence for doing or not doing something

verbal punishment

type of discipline: commonly takes the form of reprimands or scolding (the use of disapproving statements)

corporal punishment

type of discipline: involves the use of physical pain as a means to decrease inappropriate behavior

depression

anxiety

obesity

children who come from low socioeconomic status are more likely to suffer negative physical and mental health outcomes, such as:

drop out of school

experience violent crimes

children living in poverty are more likely to:

have nutritional deficiencies

participate in behaviors such as illegal substance use

homeless children are more likely to:

< 1 hr

media should be limited to _____ per day for children 2-5 years

< 2 hr

media should be limited to _____ per day for children older than 5 years

unhealthy eating habits

decreased physical activity

principal causes of childhood obesity:

dental caries

the most common chronic illness seen in children

increased incidence of pain and infections

problems eating and playing

difficulty at school

sleep pattern disturbances

untreated dental caries lead to:

by the child's first birthday

when should dental care be established?

firearms

approximately 13 young people are victims of homicide each day, with the majority due to _____

suicide

the second-leading cause of death in people of ages 10-34 years

homicide

the third-leading cause of death for youth

depression

low self-esteem

anxiety

academic problems

dropping out of school

emotional distress

violence later in life

many cases of bullying go unreported, but bullying can affect school performance and social relationships and have long-lasting traumatic effects such as:

emancipated minor

an exception to informed consent and is considered to have the legal capacity of an adult and may make his or her own health care decisions

member of armed services

marriage

court-determined emancipation

financial independence and living apart from parents

pregnancy

mother less than 18 years of age

emancipation may be considered in any of the following situations:

pregnancy counseling

prenatal care

contraception

STD treatment

substance abuse

mental health counseling

health care may be provided to minors for certain conditions without including the parents. these instances may include:

resilience

qualities that enable a person to cope with significant adverse events or stresses and still function competently

family-centered care

refers to the collaborative partnership among the individual, family, and caregivers to determine goals, share information, offer support, and formulate plans for health care

atraumatic care

refers to the therapeutic delivery of care that minimizes or eliminates the psychological and physical distress experienced by children and their families in the healthcare system

decrease exposure to stressful events

prevent or minimize separation from family

provision of child-life specialist

minimize pain

promote a sense of control

principles of atraumatic care:

use touch, sight, and hearing

rock, cuddle, sing

effective communication for infants:

tell stories

use dolls

read books

use preferred words

effective communication for toddlers:

use imaginative play

utilize puppets

tell stories

use simple, concrete terms

effective communication for preschoolers:

read books

watch videos

use illustrations

be honest and straightforward

effective communication for school-age children:

respect privacy

remain nonjudgmental

use creativity and humor

use appropriate medical terminology

effective communication for adolescents:

8-12 years

peak ages of sexual abuse:

mandated reporter

local child protection agency

social services

risk management

SANE nurse

interprofessional team members for sexual abuse:

inappropriate sexual behavior for age

chronic sore throat, difficulty swallowing

STIs

genitals burning/itching

signs of possible sexual abuse in children:

rectal, oral, vaginal, or urethral specimen collection

prophylaxis and treatment of STIs

emergency contraception

treatment of injuries

follow up for medical problems with PCP or gynecologist

mental health counseling referral

interventions for sexual abuse in children:

neglect

the most common form of child abuse and maltreatment

parents or caregivers

the most frequent perpetrators of abuse against children

anxiety

depression

alcohol and drug use

suicidal ideation and attempts

developmental problems

a history of childhood abuse commonly leads to:

poverty

prematurity

cerebral palsy

chronic illness

intellectual disability

risk factors for abuse in children:

abused as a child

alcohol or substance use

extreme stress

risk factors for being an abuser:

burns in a stocking/glove pattern

burns only on the soles or palms

burns with a clear pattern/margin

injuries in various stages of healing

bruises on chest, head, neck, abdomen, or non-bony prominences

non-ambulatory children with fractures/bruising

indications of child abuse (red flags):

non-accidental head trauma

the leading cause of traumatic death and morbidity during infancy

9 months

the average victim of non-accidental head trauma (shaken baby syndrome) is younger than _____ of age

shaken baby syndrome

differs from many other forms of child abuse in that frequently there was no intent to harm the child

profound intellectual disability

spastic quadriplegia

severe motor dysfunction

blindness

death

poor outcomes of shaken baby syndrome:

poor feeding or sucking

vomiting

lethargy or irritability

failure to thrive

increased sleeping

difficulty arousing

common signs and symptoms in less severe cases of shaken baby syndrome:

seizure activity

apnea

bradycardia

decreased LOC

bulging fontanel

common signs and symptoms in more severe cases of shaken baby syndrome:

single parent

young parent

substance abuse

parental stressors

colicy infant

premature infant

ill infant

risk factors associated with shaken baby syndrome:

retinal hemorrhages

possible external head bruising

*often NO external trauma is evident

what may be found on a physical examination of a child with shaken baby syndrome?

retinal hemorrhages

classic presentation of non-accidental head trauma

CT scan

MRI

ophthalmologic exam

skeletal survey X-rays

labs and diagnostic tests for shaken baby syndrome:

Maintain and monitor ABCs

Monitor neuro status

Prevent and stop seizures

Treat other injuries

Assess for changes in LOC

Monitor for signs and symptoms of increased intracranial pressure

nursing management for severe head injury in children: