Studied by 5 PeopleTags & Description
Cycle of Violence
Tenson → Battering → Honeymoon
When do you have a legal obligation to contact the police.
When the victim of abuse is a child.
ABCs of visual pediatric assessment
Appearance breathing circulation (colour)
Friedman’s Structure
Views famliy structure as acomplishing two things, it is affective (it provides affection), and it provides socialization and social placement
Calgary family assessment
Assesses family structure (losses, broad), developmental milestones (walking etc), family function (how well the family works)
Mcgill model
Assesses fmaily, health, collaboration, and learning
Medication reconciliation
The process of a patient informing the healthcare team of all their previous medication use prior to arriving in the hospital setting (prevents med errors)
Near miss
Potential error no harm
No harm event
Error, no harm
Medication error
Causes harm
Crtitical Incident
Causes serious harm
Dexamethasone
Long acting corticosteroid
Pregnisone
Short acting corticosteroid, can disrupt sleep patterns
Where is fluid kept
65% intercellular, 25% interstitial, 10% plasma
Magnesium
More important in pedes due to MALNUTRITION
HIT YOUR LYTES GOOD
Calculation for pediatric fluid balance.
100ml/Kg for first 10, 50ml/Kg for next 10, 20ml/kg for remaining weight.
Typical pediatric urine output
0.5-2.0ml/Kg
Dehydration s/s in neonate
Sunken fontanels, delayed cap refil, adult dehydration symptoms
Fluid overload s/s in neonate
Expanded fontanells, crackles, pulmonary/cerebral edema
Normal pCO2
35-45mmHg, Under 2 its 26-41
Normal HCO3
21-28mmol/L, Infant 16-26
Growth vs development
Growth=size, development=personhood
Freud’s Oral stage
B to 1yr - Sucking, biting, just kinda jamming stuff in there
Freud’s Anal Stage
1 to 3yrs - Potty training, bladder control
Freud’s Phallic Stage
3 to 6yrs - Relationship with parents forms, being away from trusted adults in school/daycare
Freud’s Latent stage
6 to 12yrs - Learning about gender roles
Freud’s Genital Stage
12 to Adult - I want to have sex
Piaget’s Sensory-Motor
B to 2yr - Reflexes, basic shit
Piaget’s Preoperational Stage
2 to 7yr - Egocentric, magical thinking, very creative
Piaget’s Concrete opperational stage
7-11yrs - Less self-centered, thinking more coherent, very curious
Piaget’s Formal Operational Stage
11-A - Thoughts more adaptable, flexible, abstraction possible
Eriksons Trust vs Mistrust Stage
B to 1y - Depends on the childs needs being met
Erikson’s Autonomy vs Shame/Guilt Stage
1 to 3y - Increased indepence, testing the limits of their role
Erikson’s Initiative vs Guilt Stage
3 to 6y - Playing, starting to express themselves
Erikson’s Industry vs Inferiority Stage
6 to 12y - Self worth linked to activities and social groups
Erikson’s Indentity vs Role Confusion Stage
13 to 17y - Problems assessing with the parents in the room due to increased independence, modesty, forming of a new identity
Infant Developmental Milestones
Holds head up without help, Voice recognition, Supports most of it’s own weight when held upward, supported walking
Toddlerhood Developmental Milestones
Throwing, Scribbling, Push and pull toys, Talking, Can undress and kinda dress
Parallel Play
Typicall engaged in by toddlers, playing beside someone else but not engaged with them directly
Preschool Aged Play
Want to emulate parents, whisks, trainers etc, safety scissors as motor skill develops
School Aged Play
Can do stuff that requires concentration like sports
Adolescent Play
Mostly social
Separation Anxiety Cycle
Fear → Despair → Withdrawl/Denial
Dealing with Seperation Anxiety
Look to the parents first, be firm about tasks
Coming methods of childhood coping
Regression, Repression, Rationalization, and Fantasy
Assessing a B to 6m
Usually fine, no stranger anxiety
Assessing 6m to 1y
Stranger danger, keep them with the parent, least invasive → most invasive
Assessing 1 to 3y
Assess quick as you can, usually anxious an hyperactive, still working least to most invasive
Assessing 3 to 6yr
Usually fine unless traumatized, more private, can start to integrate play into assessment. Involve positive feedback. “Thank you for staying still!”
Assessing 6 to 13yr
Usually willing to cooperate, modesty more and more important.
Assessing 13 to 18yr
Can take a more head to toe approach, modesty is very very important.
Thrush
White spots coating the back of the throat, common side effect of corticosteroid therapy
Tylenol Max Pediatric Dose
10-15mg/Kg daily max
APGAR
Apperance, Pulse, Grimace, Activity, Respirations
Egg and sperm viability window
Egg is viable for about 24 hours, sperm is viable for about 48
Due date calculation
The first day of the last menstrual period - 3 months + 7 days
Considered Term
After 37 weeks before 42 weeks
Recommended maternal assessment schedule pre-natal
Every 4 weeks for the first 28 weeks, every 2 weeks 28-36 weeks, once a week 36+
What is assessed at a prenatal visit
Vital signs, weight, uterine size, fetal heartbeat, urinalysis, blood tests, GBS status, psych
G TPAL
Gravita, Term, Preterm, Abortions, Living
Different between stillbirth and abortion
Stillbirth is part 20 weeks
What placental side is maternal and what side is fetal
Maternal = Red/fleshy, fetal = shiny/grey
Subjective signs of pregnancy
Morning sickness, “feeling” pregnant, subjective
Probable signs of pregnancy
A positive pregnancy test, objective tests that do not 100% confirm a pregnancy. Can be cause by other things.
Positive signs of pregnancy
Can only mean you’re pregnant, no other explanation. Ultrasound.
Fetal Development at 4th Week
Fetal Heart Beat Begins to Beat
Fetal Development at 8th Week
All Body Organs Formed
Fetal Development at 8-12th Week
Fetal heart rate can be detected
Fetal development at 16th Week
The sex of the fetus can be detected
Fetal development at 20th week
Heart beat can be detected, mother experiences quickening, baby develops a regular sleep/wake schedule, vernix and lanugo present, head hair, eyebrows, eyelashes present
Fetal development at 24th week
weighs 780g (1lb 10oz), increasingly active, respiratory movements begin, sucking movements
Fetal development at 28th week
Eyes open/close, baby can breathe, surfactant is develpoped, baby is 2/3 final lenght
Fetal Development at 32nd week
Fingernails and toenails form, subcutaenous fat is developing, less red and wrinkled
Fetal Development at 38+ weeks
Baby fills entire utereus, receiving antibodies from mother
Trimester 1 S/S
Extreme fatigues, N/V, Swolen Breasts, Taste changes, Heartburn, Mood Swings, Constipation, Urinary Frequency, Weight Changes
Trimester 2 S/S
Body aches, stretch marks, linea nigra, skin darkening around nipples, darker patches on face, carpal tunnel, ankel edema, insomnia, vivid dreams
Trimester 3 S/S
SOB, Heartburn, Swelling, Hemorrhoids, Tender breasts, colostrum excretion, Umbilical protrusion, Lightening, Braxton-hicks contractions
Safe sex and pregnancy
Sex safe 6 weeks after delivery, sex fine throughout pregnancy if no complications
Caffiene Limit Pregnant
1-2 Cups/Day
Foods to avoid when pregnant
Unpasturized dairy, raw fish/canned tuna, raw eggs, deli meat
Lightening timeframe pregnancy
2 weeks pre-pregnancy, baby moves down into pelvis
Normal fetal orientation
ROA or LOA (Right occipit anteroir or Left occipit anteroir)
4 P’s of labour
Pelvis, Passenger, Power, and Psyche