Class notes
Nur254 Peds Exam 3
- Course
- Institution
Nur254 Peds Exam 3 anything in yellow on exam
[Show more]
Seller
Follow
anallamosas
Reviews received
Content preview
Child Caring Exam #3 Study GuideNur-254 Pediatric Exam 3
Galen College of Nursing
Unit 6: Growth & Development
Growth and development
o Growth: physical “stuff”
Height, weight, size
Remember: * weight 2x birth weight @6 months; 3x birth weight @12m; 4x birth weight @ 30month aka 1.5 years
o Development: “skills”
How mature the neuro-system is
Learning and functioning
Nursing management
o Knowing if interventions are effective based on age-appropriate assessment tools
Pain management – based on both age and cognition
Pain scales
o NIPS (neonatal infant pain scale) less than 2 months
Gives scores according to the following: facial expression, cry, breathing pattern, arms
and legs, state of arousal
Used for neonates under 2 months old
o FLACC- more than 2month (to 7 years old)
Assesses face, lets, activity, cry, consolability
Used for infant older than 2 months
o Wong-Baker Faces (3-4 year old) preschooler
Used for 3 to 4 year olds
o Numeric scale (0-10)
8 years and older ( as young as 5 if they understand value of #)
Can be used earlier ONLY if the child can count and actually understand the value of
numbers
Non-pharmacological- USE first
o Containment – blanket (nest)
o Positioning- swaddle
o Sucking- pacifier
o Kangaroo care- skin to skin
o Distraction, relaxation,
o Music, pet, art therapy
Pharmaceutical
o Mild/ Moderate= acetaminophen, NSAIDS
o Moderate/ Severe= Opioids (morphine, diaudid, fentanyl)
o Adjuvant- OTC and lower dose of opioids ( premee)
o Age-appropriate plan of care development
Nursing considerations
0-2 years old mouth breathers; 2 and older nose breathers
Infants (0-1)– can recognize faces – use same nurse
Preschooler- (3-6)- Magical thinking= PAIN is punishment, others fault, disappear magically
School-age (6-12) WHY?
o Ask a lot of questions and want to be involved; WHY?
o Get their input when making a plan of care
o They WANT to make contributions
o Understand cause and effect
Adolescents-(12-18)- privacy, confidentiality encourage friends to come visit, establishing Identity
o Exceptions for visits – post op; immunocompromised; contagious
o Priority
Priority actions
1
, Interventions based on patient signs/symptoms
o RED FLAGS tell HCP
Posterior fontanelle open (triangle shaped) after 2m RED FLAG
Anterior Fontanelle open (diamond shape) after 18m Red flag
Weight gain at 6m should 2xbirth weight= if NOT red flag
Weight gain at12m should 4x birth weight= if NOT red flag
Should babble at 9m= if NOT red flag
If Fontanelles are bulging sign of menigitis, ICP= Tell HCP
If fontanelles sunken in= dehydration FVD= Tell HCP
o Patient care
Peds Assessment – 1. interact w/parents 2. sit on parent lap 3. equipment out of sight; 4. invasive LAST (BP, oral temp
ear exam)
Ear assessment-anatomy of Eustachian tube - UNDER 3= pinna down and back; 3 and OLDER- Pinna up & back
Age-appropriate nursing assessment
Infant-(0-1) recognize faces – use same NURSE
Toddler(1-3) Egocentric; least to most intrusive; (observe, auscultate, use parent lap)
Preschooler- (3-6)- magical thinking; Pain is punishment;
o Coloring, finger painting
School-age-(6-12) WHY?, explain
o puzzle
Adolescents (12-18)- (body image; ask patient) ; when asking separate from parents; invite friends to visit
o Psychosocial development
Identity vs role confusion
They are trying to figure out who they are – parents need to “back off”
o Nutritional assessment
Concerned with body image and possible eating disorders
Ask the patient specifically, what do you eat in a day?
Type of play being observed
o Unoccupied: infant; not mobile and has random movements; no purpose
o Solitary play – infant/toddler: play alone with their interest focused on their own activity
o Onlooker play – infant/toddler: watch what other children are doing but do not make any
attempt to enter the play
o Parallel play – toddler (1-3): play independently but next to each other
o Associative play – preschooler (3-6): children play together but with no group goal; kick ball
around
o Cooperative play – school-age (6-12): play is organized, play in a group with other children
working to complete a specific goal; soccer basketball; SPORTS
o Erikson’s Psychosocial Theories
Infants (birth – 1 year) Trust vs mistrust= = faith & optimism
o Cooing and crying ; respond to non verbal cues
o If not attained – not able to trust others
o Toys- rattle; small toy go in mouth
Early Childhood/ Toddlers-(1-3) autonomy vs shame = learn self control; will power vs impulse;
o a. EGOCENTRIC ; discuss how they will be effected
o b. Teach parents: Allow toddler to explore; NO!, give choices; impressionable
o c. Toys - vacuum
Preschool (3-6) initiative vs guilt= direction and purpose; Right vs wrong; start lying; imaginary friend
o Imaginary friends, coloring, finger painting
o Teach parents – give tasks they can actually accomplish
o If not accomplished tasks=Guilt – second guess themselves
School age ( 6-12) industry vs inferiority= Competence, contribute
o Engage in tasks that they can fully accomplish, understand cause and effect; Want explanations
WHY?; Puberty ; want to feel needed
o Community service; sports; friends' matter, peer pressure, bullying
2
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller anallamosas. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $8.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
76669 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now