Exam 1 PEDS

What is the leading cause of death in children older than 1 year?

Unintentional injuries

What are the three major causes of infant death

Congenital anomalies, SIDS, and unintentional injuries

What injury-related factors should the nurse consider

The child’s age, developmental level, mobility, curiosity, judgement, and ability to recognize danger.

What is low birth weight?

Less than 2,500g

What are risk factors for infant mortality?

African American race, male sex, short or long gestation, younger or older maternal age, and maternal education level.

What is the central belief of family centered care?

The family is the constant in the child’s life.

What is enabling?

Providing opportunities and resources that help families develop and demonstrate their abilities.

What is empowerment?

Helping families gain or maintain control and recognize their strengths.

What are the three principles of atraumatic care?

Minimize separation, promote control, and minimize injury and pain.

How can a nurse give a hospitalized child a sense of control?

Offer developmentally appropriate choices.

What is the pediatric nurse’s role in ethical care?

Advocate for the family, participate in ethical decisions, and provide an enviornment where concerns can be discussed.

What is a nuclear family?

Parens and their children living as one household.

What is a blended family?

A family formed when adults with children from previous relationships create a new family.

What is an extended family?

The nuclear family plus relatives such as grandparents, aunts, and uncles.

What is authoritarian parenting?

Parents control behavior through strict, unquestioned rules.

What is permissive parenting?

Parents exercise little or no control.

What is authoritative parenting?

Parents combine firm expectations with flexibility and support.

What does discipline mean?

Teaching and establishing rules that govern conduct.

What are examples of discipline methods?

Reasoning, reinforcement, ignoring, behavior modification, and time-out.

What is culture

A pattern of beliefs, assumptions, and practices that guides a group’s way of life.

What is a primary social group?

A close, stable group with continuing contact and mutual support, such as family or peers.

What is a secondary social group?

A group with limited or intermittent contact, such as a professional or social organization.

What is cultural humility?

Openness, self-awareness, egolessness, self-reflection, and respectful interactions

What is growth?

A quantitiative increase in the number and size of cells.

What is development?

Qualitative advancement from a lower level to a more complex level.

What is maturation?

Increased competence, adaptability, and ability to function at a higher level.

What is differentiation?

Development from simple to complex.

What is cephalocaudal development?

Development from the head to toe.

What is proximodistal development?

Development from the center of the body toward the extremitites.

What is sequential trends?

Development follows a definite and predictable sequence.

What are sensitive periods?

Periods when enviornmental influences have an especially strong effect on development.

During which stage is growth most rapid?

Infancy

When does growth increase markedly again?

Puberty

What is Erikson’s stage from birth to 1 year?

Trust versus mistrust.

What is Erikson’s stage from 1-3 years?

Autonomy versus shame and doubt.

What is Erikson’s stage from 3-6?

Initiative versus guilt.

What is Erikson’s stage from 6-12?

Industry versus inferiority.

What is Erikson’s stage from 12-18 years?

Identity versus role confusion.

What is Piaget’s sensorimotor stage?

Birth-2 years; the child develops object permanence.

What is Piaget’s preoperational stage?

Ages 2-7; thinking is egocentric, intuitive, and transductive.

What is Piaget’s concrete operational stage?

Ages 7-11; reasoning is concrete and inductive (logical).

What is Piaget’s formal operational stage?

Ages 11-15; Abstract reasining develops.

What is Kohlberg’s conventional level?

Moral decisions emphasize conformity and loyalty.

What is the progression of social play?

Onlooker —> solitary —> parallel —> associative —> cooperative

What type of play involves watching others without joining?

Onlooker play

What type of play involves playing alone?

Solitary play

What type of play involves children playing beside one another without cooperating?

Parallel play

What type of play involves interaction without organized goals?

Associative play

What type of play involves organized acitivity and shared goals?

Cooperative play

What should the hospital playroom be caled?

Activity room

Should painful procedures occur in the playroom?

No

What should the nurse do while a child is warming up?

Interview the parent or caregiver

When should painful area be examined?

Last

How should the nurse communicate with an infant?

Mainly through nonverbal communication, touch, facial expressions, and tone.

How should the nurse communicate with toddlers and preschoolers?

Use simple words, focus on the child, remain consistent, and incorporate play.

How should the nurse communicate with school-age children?

Explain what, how, and why using concrete terms.

What situations may limit confidentiality?

Suspected abuse or neglect and danger to self or others.

What order should be used for an infant or toddler’s vital signs?

Respirations first, pulse next, and temperature last.

Through what age is head circumference measured at every visit?

Through 24 months

What are the major stressors of hospitalization?

Separation, loss of control, bodily injury, pain, and unfamiliar routines.

What is regression?

Returning to behaviors from an earlier developmental stage during stress?

What age group is most affected by separation anxiety?

6-30 months

What are the three phases of separation anxiety?

Protest, despair, and detachment.

What occurs during protest?

Crying, screaming, searching for parents, and rejecting strangers.

What occurs during despair?

Withdrawal, sadness, decreased activity, and loss of interest.

What occurs during detachment?

The child appears adjusted but may form superficial relationships and reject the parent.

How may preschoolers interpret hospitalization?

As a punishment for misbehavior.

What is a common hospital stressor for school-age children?

Fear of death, abandonment, permanent injury, and loss of control.

What is a major hospital stressor for adolescents?

Separation from peers and loss of independence.

What are the six core domains for measuring pediatric pain?

Pain intensity, treatment satisfaction, symptoms/adverse events, physical recovery, emotional response, and economic factors.

What is chronic pain?

Pain lasting 3 months or longer.

What does FLACC stand for?

Face, Legs, Activity, Cry, and Consolability.

What age range is FLACC used for?

2 months -7 years

Which pain scale may be used for children with cognitive impairment?

Revised FLACC, or R-FLACC

For whom is the COMFORT scale used?

Unconscious or ventilated children in critical care.

What pain scales may be used for neonates?

CRIES, PIPP, and NPASS

What age group can use as FACES scale?

Approximately ages 3-4 years and older.

If behavior and reported pain conflict, which should the nurse believe?

The child’s self-reported pain.

Who is especially helpful when assessing pain in a cognitively impaired child?

The primary caregiver

What must the nurse do after administering an opioid?

Reassess pain, respiratory status, sedation, effectiveness, and adverse effects.

What are the three chemical factors that stimulate newborn breathing?

Hypoxemia, hypercarbia, and low pH

What is surfactant’s function?

It lowers surface tension and keeps the alveoli expanded.

What three fetal shunts functionally close after birth?

Foramen ovale, ductus arteriosus, and ductus venosus

Which fetal shunt closes as left atrial pressure rises?

Foramen ovale.

Which fetal shunt gradually closes as oxygen rises and pulmonary resistance decreases?

Ductus arteriosus

Which fetal shunt functionally closes when the cord is clamped?

Ductus venosus.

What is the newborn’s main method of heat production?

Nonshivering thermogenesis using brown adipose tissue.

What are the four mechanisms of newborn heat loss?

Evaporation, radiation, conduction, and convection.

What could apparent shivering in a newborn indicate?

Seizure; obtain help

When is APGAR measured?

At 1 and 5 minutes after birth

What does APGAR stand for?

Appearance, PUlse, Grimace, Activity, and Respiration.

What does an APGAR score of 7-10 indicate?

Absence of difficulty

What does an APGAR score of 4-6 indicate?

Moderate difficulty

What does an APGAR score of 0-3 indicate?

Severe distress

Is APGAR used to determine whether resuscitation is needed?

No

What scale assesses a newborn’s gestationage?

The New Ballard Scale.

What is SGA?

Weight below the 10th percentile for gestational age.

What is AGA?

Weight between the 10th and 90th percentiles

What is LGA?

Weight above the 90th percentile.

What is a term for infant?

An infant born at 37-42 completed weeks (37 weeks or greater)