fear

Purpose:
- Height and Weight comparison of a child to others of the same age and sex
- Evaluating the child’s present measurements against former growth rates and patterns

Birth to 36 months:
- Girls: Length-for-age and Weight-for-age percentiles
- Boys: Stature-for-age and Weight-for-age percentiles
Data Declarations:
- Parameters include age, weight, stature, and BMI calculations.
- Formula for BMI:
  - $BMI = \frac{Weight (kg)}{Stature (cm) \times Stature (cm)} \times 10,000$
  - or, $BMI = \frac{Weight (lb)}{Stature (in) \times Stature (in)} \times 703$

Culmination in old age includes:
- Acceptance of life cycles from integration to disintegration
- Developing humor, empathy, resilience, and humility
- Acknowledgment of unfulfilled hopes
- Understanding complex relationships and nurturing others with care and empathy

Importance of positive experiences and individualized care
Separation Anxiety: Three stages observed
- Protest
- Despair
- Denial or Detachment
Interventions are necessary to heal the parent-child relationship
Pain Management:
- Increased cortisol levels can compromise immune function and delay healing
- Recognition of pediatric pain is crucial; children may underreport pain due to fear of treatment options, such as injections.

Pain Indicators for Communicatively Impaired Children (PICIC):
- Indicators include facial expressions, tears, screaming, tense body language, and irritability to touch.
FLACC Scale for nonverbal children:
- Face: Grimace
- Legs: Kicking
- Activity: Quiet or arched
- Cry: Moan or scream
- Consolability: Touch or Inconsolable
Neonatal/Infant Pain Scale (NIPS):
- Designed for infants under 1 year

Infants:
- Involve parents, use familiar objects, distraction and soothing techniques
Toddlers/Preschoolers:
- Involve parents, simple explanations, offer choices, distraction techniques, and post-treatment hugs
School Aged (6-12 years):
- Incorporate all prior strategies plus allow examination of medical equipment, encourage verbalization of fears, and offer rewards post-procedure.
Adolescents:
- Ensure privacy, involve the adolescent in the process, explain procedures, and suggest coping techniques

Liver Enzyme System: Immature leading to prolonged drug elimination
Renal Clearance: May be increased in toddlers compared to older children and adults
Protein Binding Capacity: Reduced in small newborns, leading to higher active drug concentrations in the body
Dosages: Must be calculated based on weight

Physical Features:
- Body surface area large relative to weight making infants prone to hypothermia
- Anterior fontanel and open sutures palpable until about 18 months; posterior fontanel closes between 2 and 3 months.
Respiratory System:
- Short, narrow trachea in children under 5 years; higher risk for foreign body obstruction.
Cardiac Output Dynamics:
- In children, it is rate-dependent; higher heart rates necessary until late school age and adolescence.
Vulnerability to Trauma:
- Abdomen provides poor protection to the liver and spleen
Kidney Function:
- Ineffective concentration of urine until 12 to 18 months
Neurodevelopment:
- All brain cells present at birth; myelination progresses over the first year.
Proportionality Issues:
- Larger head proportion increases risk for head injury; high metabolic rate along with high oxygen and caloric demands.
Rib and Lung Characteristics:
- Ribs have a higher percentage of cartilage until puberty; therefore more flexible and compliant.
- Faster respiratory rates and lower tidal volumes until around age 10 years.

Age-Based Norms:
- <1 year: Respiratory rate 30-40, Heart rate 110-160
- 1-2 years: Respiratory rate 25-35, Heart rate 100-150
- 2-5 years: Respiratory rate 25-30, Heart rate 95-140
- 5-12 years: Respiratory rate 20-25, Heart rate 80-120
- >12 years: Respiratory rate 15-20, Heart rate 60-100

Immunity Development:
- Develops throughout a person’s lifetime
Types of Immunity:
- Active Immunity: Develops in response to infection or vaccination
- Passive Immunity: Acquired through transfer from one organism to another
  - Natural Passive Immunity: Antibodies received from mother (e.g., breast milk)
  - Artificial Passive Immunity: Antibodies received via medical intervention (e.g., gamma globulin injections)

Vaccination Schedule Overview:
- Comprehensive timeline with specific doses recommended from various vaccines based on age.
Catch-Up Vaccination Guidance:
- Mandated provisions for those who have fallen behind on immunizations, including actions advised for each specific age group from birth to 18 years.

Vaccines and Corresponding Diseases:
- Common diseases prevented by vaccines: Diphtheria, Tetanus, Pertussis, Hib, Pneumococcal disease, Polio, Measles, Mumps, Rubella, Varicella, HPV, RSV, and many others

Medication Administration Guidelines:
- Importance of accurate measurements and calculations in drug delivery
- Restrictions on leaving medications at the bedside to prevent accidental ingestion

Ensuring Safety:
- Must be calculated to confirm they fall within safe ranges as established in medical resources (e.g., Drug Handbook)
- Daily and safe range calculations mandatory for appropriate medication administration
Rounding Rules:
- Dosages below 1 rounded to the nearest hundredth; above 1 rounded to nearest tenth.
  - Examples given for rounding and its applications in calculations.

Conversion from Pounds to Kilograms:
- Practical examples given, detailing calculations required to convert weight for dosage calculations, ensuring no intermediate rounding occurs.
Safe Range Determination for Drug Orders:
- Determination of safe dosage ranges based on weight and specific calculations for a typical pediatric medication

Emphasis on understanding immunization contraindications and key considerations in vaccine administration pertinent to pediatric patients
- Example question context regarding immunization contradictions with fallback on practical scenarios to ensure thorough preparation for NCLEX testing.