Pediatric Nursing and Development Practice Flashcards

Specific safety protocols must be followed when teaching about car seat safety for a child approximately $6\,months$ old: - Orientation: The car seat should remain rear-facing until the child is at least $2\,years$ old. - Strap Fit: Harness straps must be kept snug and flat against the child. - Buckle Placement: The chest clip/buckle must be positioned at the level of the child's armpits. - Clothing Warnings: Caregivers must ensure the infant is not wearing bulky clothing, as this interferes with harness effectiveness. - Warmth: If a blanket is required, it should be placed over the harness rather than underneath the straps.

When assessing a $9\,month$ old infant, several reflexes are evaluated to determine developmental maturity: - Doll's eye reflex: This reflex disappears as the infant's neurological system continues to mature. - Crawl reflex: This reflex normally disappears around $6\,weeks$ of age. - Babinksy reflex: In infants, this is observed when the big toe goes up and the other toes fan outward.
Assessment Approach for Infants and Children: - Modified Head-to-Toe: Healthcare providers should perform assessments from the least invasive to the most invasive procedures. - Final Procedures: Examination of the Ears, Nose, and Throat (ENT) and Blood Pressure (BP) measurement should be performed last. - Sensitivity: Areas identified as painful must be assessed at the very end of the examination.

Infant Vital Signs (Normal Ranges): - Temperature: Between $97.7\,^{\circ}F$ and $99.3\,^{\circ}F$ . - Fever Threshold: Any temperature exceeding $100.4\,^{\circ}F$ necessitates a clinical evaluation. - Heart Rate (HR): Between $109-164\,bpm$ . - Respiratory Rate (RR): Between $30-60\,breaths\,per\,minute$ . Brief periods of apnea (under $10\,seconds$ ) are considered a normal finding. - Blood Pressure (BP): Typically $64/41$ ; however, this is not a routine measurement for infants. - Oxygen Saturation ( $O_2$ ): Between $95-100\%$ .
Toddler Temperature Measurement Methods: - Axillary: Measured in the armpit; this is the most common site for toddlers. - Temporal: Measured on the forehead. - Tympanic: Measured via the ear. - Rectal: Noted as the most dangerous method of temperature measurement. - Preferred Methods: For children in a febrile or hypothermic state, tympanic or temporal sites are used. - Fever: A temperature reading over $100.4\,^{\circ}F$ constitutes a fever.

$3\,months$ : The infant lifts their head, coos, and displays a social smile.
$6\,months$ : The infant rolls over and can sit with external support.
$8-9\,months$ : The infant crawls, grabs objects, and begins developing the pincer grasp.
$12\,months$ : The child walks with support and can say between $1-3\,words$ .
$15\,months$ : The child walks independently and can stack $2$ small objects.
$18\,months$ : The child speaks $5$ or more words, climbs on and off furniture, scribbles, and uses $2\,syllable$ words.
$2\,years$ : The child runs, kicks a ball, uses gestures (e.g., blowing a kiss or waving), and forms $2\,word$ sentences.
$2.5\,years$ : The child can turn one page of a book at a time, jump with both feet, and twist a doorknob.
$3\,years$ : The child engages in play with other children, rides a tricycle, dresses independently, and forms $3\,word$ sentences.
$4\,years$ : The child can hop on one foot and speaks clearly.

Vaccinations for the $4\,year\,old$ Age Group: - tdap (Tetanus, diphtheria, and pertussis) - IPV (Inactivated Poliovirus Vaccine) - MMR (Measles, Mumps, and Rubella) - varicella
Erik Erikson’s Psychosocial Development (Toddlers ages $1-3$ ): - Stage: Autonomy vs. Shame and Doubt. - Characteristics: The child seeks independence, often characterized by the phrase "me do it." - Strategy: Provide the child with choices (e.g., "Do you want the red cup or blue cup?") to support autonomy.
Pain Assessment Tools: - Flacc scale (for infants): Monitors Face, Legs, Activity, Cry, and Consolability. - Faces scale: Utilized for older children who can point to facial expressions to represent their pain.

Hospice Care Parameters: - Eligibility: Strictly restricted to clients who are terminally ill. - Survival Prognosis: Typically for clients expected to live for approximately $2-3\,months$ . - Clinical Profiles for Hospice: Includes patients with terminal lung cancer who have discontinued all treatment, and patients with end-stage kidney disease who have ceased dialysis.
Failure to Thrive: - Clinical Indicators: Poor weight gain, delayed development, and a general lack of physical growth.