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Summary NSG 4421 Peds Final Study Guide.
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Summary NSG 4421 Peds Final Study Guide.Chapter 1:
1. Top leading causes of death/age group
a. Infants= not safe in any environment. Crawling= putting objects in mouth= poisoning or
aspiration
b. Toddler= mobile. Run/climb= r/f falls, burns & collisions
c. 5-9 yrs= bike accident (no helmet) = head injuries. Accidental poisoning r/t meds
d. Adolescents= MVCs, drug/alcohol abuse/suicide= intentional poisoning
e. Others: drowning/burns/firearms
2. Family-centered care
a. Planning, delivery & evaluation of HC grounded in mutually beneficial partnership of HCP,
pts & fams
b. Consider the need of ALL fam members
c. Key elements= realize fam is constant in child’s life, facilitating fam professional
collaboration, exchanging unbiased info, honor culture preferences, encourage fam to fam
support, appreciate fam & child
d. 2 basic concepts for nurses:
i. Enabling= creating opportunities& means for fam to display abilities to meet the needs of
child
ii. Empowerment= help fam acquire sense of control over fam life; helping behaviors that
foster their own strengths, abilities & actions
3. Atraumatic Care test question: don’t say a needle stick. Practice on a bear
a. Care to eliminate or minimize psych & physical distress of child & fam w/in the health system
b. Ex. Teddy bear in room- sit them down & explain procedure, foster parent-child
relationship, prepare child for unfamiliar procedure, dec pain, allow play time/ expressing
fear, privacy, respect culture, provide choices
c. Psych stress= anxiety, fear, stress, anger, disappointment, sadness
d. Physical= sleepiness, pain, temp immobile
e. 3 principles=
i. prevent or minimize child separation from fam
ii. promote a sense of control
iii. prevent body harm
f. Setting: anywhere, personnel: anyone
Chapter 2:
1. Family theories:
a. Describes fam unit & how they respond to events
b. Fam SYSTEM theory= affects all fam (circular casualty). Too little change & not enough to
hurt the fam balance btwn the two can initiate change & react to it. Focus on fam as a whole
(not individually) FOUCUS ON INTERATIONS!!!!
c. Fam STRESS theory= how fam responds to a stressful event. Predictable (parenthood) &
unpredictable (illness, divorce, unemployment). Multiple stressors in 1 yr can = breakdown.
Promote adaptation & structural change. Focus on +: cope, resources & social support FOCUS
ON ADJUSTMENT AND ADAPTATION
d. Developmental theory= address fam change overtime, usually use 1st child as maturational
, Summary NSG 4421 Peds Final Study Guide.
marker, fam changes in individual ways but similar, must all achieve individual time
specific changes as part of the cycle TRANSITIONS HAVE DISEQULIBRIUM.
STAGES.
2. Family Structures:
, Summary NSG 4421 Peds Final Study Guide.
a. Nuclear= 2 parents & children (step, biologic, foster, adopted) & parents don’t have to
be married
b. Traditional nuclear = 2 parents and their children
c. Traditional blended= 2 parents & at least 1 step
d. Traditional extended= at least 1 parent, 1 child, 1 relative (grandparents)
e. Binuclear (single-parent) = assuming parent role but eliminating spouse role, divorced but joint
parenting- joint custody
f. Polygamous (single-parent) = multiple wives/ husbands. Sororal: vies are sisters, nonsororal
g. Communal=community
h. LGBT
3. Parenting Styles
a. Authoritarian (parent rules) = “bc I said so”. Control the child behavior & attitude
unquestionable. Rules & regulation are expected to be followed. Children are polite,
dependable, honest & can be defiant & antisocial THE KID WILL BE SHY SENSITIVE AND
SELF CONSCIOUS
b. Permissive (child rules) = little to no control. Allow child to make own decisions. Parent is
a resource, not a role model. Rarely punish child (inconsistent)
c. Authoritative (combo of the two)= direct the child by giving them a reason as to why, respect the
child as a person & allow child to voice objections, control focus on issue & not withdrawal from
lover or fear of punishment. Inner directness (control behaviors based on guilt or shame).
Children have ^ self-esteem, resilienc & interactive, assertive & content
4. Discipline Styles e
a. Limit setting= help kids channel undesirable feelings, protect them from danger, learn socially
acceptable behavior, test limit of control, children NEED & WANT limits, help test
environment & know others are there to protect them *******make sure limits are made
CLEAR!!
b. Reasoning= explain why action is wrong, young may not understand, kids may be used to getting
attention (act up= lengthy discussion). Think bad attention is better than no attention – This
works for the older child but not necessarily for toddler/preschool
c. Scolding= combo w/ reasoning. Child may take “you are a bad kid” seriously
d. + and – reinforcement= if its rewarded, going to repeat behavior. No reward= no repeat.
Token/stickers= must explain desired action & reward, verbal approval always
~~~~~~ there was a test question abt how tokens/stickers go with the +/- reinforcements
e. Ignoring= eventually stop or minimize act, use when child does wrong for attention, watch for
response burst= ^ action to test parent
f. Consequence= natural- w/o intervention, no friend until room is clean. Logical- r/t problem,
can’t play w/ toy until others are cleaned up. Unrelated- time out. Must be planned & it will
happen. Public= time out when we get home. ~~~~ time out lasts 1 min per age in years of child
g. Corporal/physical punishment (spanking)- teaches kids violence is acceptable. Harms te child,
may become used to pain, child may misbehave when parent isn’t around due to behaving
well for their own sake
Chapter 10:
Biologic/Physical Growth
Infants
, Summary NSG 4421 Peds Final Study Guide.
• Weight= gain 5-7 oz q week. 1.5 lbs/qwk for first 5 mo. Double by 6 mo. Triple by 1 yr.
• Height= ^^ 1 in/mo for 6 mo. Grow in spurts & more in trunk. 6 mo= 65 cm. 1 yr= 74 cm
• Head circumference= demonstrates growth of brain. 6 mo= 43 cm. 1 yr= 46 cm.
• Chest circumference= closure of fontanelles at 6-8 wks and 18 mo. Equal to head at 1 yr
• Heart- doubles in size by 1 yr (slower).
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