Shared Flashcard Set

Details

Children
elderly and children
164
Nursing
Undergraduate 2
12/08/2010

Additional Nursing Flashcards

 


 

Cards

Term
adrenarche (begins with puberty)
Definition
adrenocortical maturation that signals onset of sebum production from sebaceous glands. Apocrine glands respond to emotional stimuli and result in body odor
Term
head growth
Definition
grows proportionately with body during infancy and is 90% developed by age 6
Term
facial bone growth
Definition
varies. toddlers have low nasal bridge and mandible and maxilla are small making the face seem too small compared to cranium. then around school age face grows much faster then cranium making teeth look too large.
Term
lymph tissue
Definition
well developed at birth but continues to grow rapidly till age 10 or 11 where it exceeds adult size and then atrophies after puberty.
Term
eyes
Definition
less spherical than adults and children remain farsighted until age 6 or 7
Term
ears
Definition
inner ear matures, eustachian tube lengthens, but still may be occluded by growth of lymph tissue (adnoids), and eventually canal shortens and straightens and pinna can be pulled up and back like adult
Term
deciduous teeth
Definition
there are 20 and they are lost between ages 6-12
Term
Permanent teeth
Definition

start formation at 6 months and replace deciduous teeth at age 6 usually starting with incisors.

They appear earlier in African americans than in causcasians

Term
nasal growth
Definition
starts at same time as secondary sex characteristics. growth starts at 12 and ends at 16 for girls and 18 for boys.
Term
sinuses
Definition
maxillary and ethmoid are present at birth, but too small to be examined until child is much older. Frontal sinuses develop at 7 yo and sphenoid sinuses develop later in pubery
Term
Lungs
Definition
continue development till 8 yo and by adolesence we have 300 million alveoli. children have smaller airway and are at higher risk for aspiration.
Term
Chest
Definition
Children have smaller chest wall, soft and pliable ribs, and a moveable xiphoid
Term
Respiratory rate
Definition
children age 7 and younger are abdominal breathers and respiratory rate is much faster. Age 8-10 respiratory rates lower and breathing becomes thoracic
Term
thelarche
Definition
growth of brests between ages 8 and 13 that is primarily result of fat deposits however duct system development grows as well. Tenderness and asymmetric development are common.
Term
gynecomastia
Definition
breast tissue growth in boys that takes place during adolescents but is normally temporary.
Term
palpable abdominal organs
Definition
Right kidney may be palpable in young children especially with inspiration and liver is palpable in small children 1-2 cm below costal margin.
Term
Heart
Definition
heart is more horizontal. Apical pulse felt at 4th ICS left of MCL until 7 yo when it becomes similar to adult. Heart sounds are louder, higher pitched and shorter. Split S2 is normal at 2nd left ICS. S3 may be heard at apex. Sinus arrhythmia is normal
Term
abdomen
Definition
circular and prominent (pot-belly) in toddlers when standing and changes to adult shape with adolescence. Visible perstaltic waves could indicate diseases or disorders.
Term
Male genitalia
Definition
develop in 2-5 year period. pubic hair is the onset of puberty. Pubic hair and penile enlargement concur with testicular growth. Yet axillary and facial hair devolop later in puberty.
Term
Prostate growth
Definition
grows rapidly during puberty to 2x as big as prepubertal state
Term
Female Genitalia
Definition
external genitals increase in size and sensitivity, internal genitals increase in weight and mass. Pubic hair grows early in puberty. Axillary hair procedes menarche which is in late puberty
Term
Menarche
Definition
Menarche beings 2.5 years after puberty begins and is irregular for the first 2 years because of physiologic anovulation
Term
Skeleton
Definition
mainly cartilage in toddlers, but bones begin to form through ossification beginning in gestational period and continuing rapidly through infancy and childhood.
Term
Adolescent growth spurt
Definition
correlated with tanner's stage 2 for girls and 3 for boys and growth continues till stage 5 for both sexes. The growth spurt peaks at age 12 for girls and 14 for boys
Term
Bone Growth
Definition
grows in diameter and length. diameter growth happens mainly in children. Growth in length is at epiphyseal plates.
Term
Bone growth is effected by
Definition
pituitary growth hormone and thyroid hormone
Term
Muscle growth
Definition
linked to underlying bone growth. and both bone and muscle growth are influenced by use of extremities for weight bearing activities
Term
Lumbar curvature
Definition
develops at 12 to 18 months when child starts walking
Term
Motor control
Definition
develops in head-to-neck to trunk-to-extremities sequence and varies in progression with every child
Term
Nurse-to-parent communication
Definition
use open ended questions. Ask "what do you see as the problem?" and also ask what they have found to be effective or ineffective in managing their child's problems.
Term
nurse-to-child communication
Definition
direct communication (open ended questions) mixed with indirect communication (drawings, play, and sentence completion) and make sure you are at eye level
Term
barriers with nurse-to-child communication
Definition
nurses tend to overestimate the understanding ability of younger children and underestimate the ability of older children/adolescents. Children are also sometimes completely excluded.
Term
adolescent communication
Definition
be aware of privacy issues especially with talk of sex, sexuality, drugs and other sensitive issues. Patient may perfer their parents step out of the room
Term
Biographical data
Definition
child's name, nickname, parent's names, primary health care provider, last well-child care appt., address, do parents live in the same residence, who else lives there, are parents married, single, divorced, homosexual, and what are parent's ages, child's age and bday, is childe adopted, foster, or natural, what is child's ethnicity and religion, what are parent's jobs
Term
Current Health Status
Definition
compare it to 1 and 5 years ago. Include chronic illness (asthma, cerebral palsy) and allergies. For allergies nurse needs to determine how child reacts especially with medications, because parents often confuse side effects with allergies. Finally look at medications (over the counter, prescription, and home remedies) and what they are being used for.
Term
To locate child's pain
Definition
ask them to point to where it hurts and to point to a face on the faces scale.
Term
Past health history (pregnancy)
Definition
planned pregnancy? prenatal care? parents general health during pregnancy? problems, accidents, meds during pregnancy? tobacco, alcohol, or drugs? where  was the child born? type of delivery? problems with delivery. child's apgar score, weight, height, head circumfrence and problems after birth.
Term
Past Health History (for child)
Definition
past illnesses, hopitalizations, major illnesses and injuries and immunizations
Term
family history
Definition
same as for adult patient except nurse must be understanding of children that are fostered or adopted
Term
Subjective Integumentary
Definition
Change in hair texture, scalp itching (infestations, allergies, ringworm, seborrhea), changes in nails, exposure to infectious diseases (chicken pox, measles, lice, ringworm, scabies...), rashes or acne, excessive bruising or burns, cosmetics, tattoos, piercings, birthmarks
Term
Subjective Head and Neck
Definition
head injury, headaches and frequency, swollen neck glands for any long period of time, or neck stiffness (sign of meningitis)
Term
Eyes subjective
Definition

is child: excessively cross eyed, frequently rubbing eyes or blinking repeatedly, strainin/squinting to see distant objects, tested for vision, or wearing glasses/contacts.

Do glasses help and is child using them as needed

Term
Ears subjective
Definition
Does child: appear to be paying attention when you speak (could indicate hearloss or neuro problem), can they speak, when did they start? listen to loud music? use hearing aids (does it help them communicate and understand) frequent ear infections? tubes in ears? how frequently is hearing tested (should be regularly)
Term
Mouth, throat, nose, sinuses subjective
Definition
difficulty swallowing/chewing? past history of strep, tonsilitis, or oral infections? frequent oral lesions? when did teeth erupt? when did you lose baby teeth? when did adult teeth erupt? dental problems or appliances? see dentist regularly? experience nosebleeds or sinus problems
Term
Thorax and lungs subjective
Definition
any cough, wheezing, shortness of breath, nocturnal dyspnea, if so when does it occur? recieved a flu shot? (children +6months and high risk of health conditions should recieve one) does child smoke, when did they start and how much? is child exposed to second hand smoke?
Term
Breast and Lymphatics
Definition
begin thelarche? when? is there any abnormal breast development in males or females?
Term
Heart Subjective
Definition
any chest pain, heart murmurs, congenital heart disease or hypertension? complaints of fatigue ( decreased cardiac output), fainting, or turning blue during activity? do parent's believe child is meeting normal growth requirements?
Term
Abdomen subjective
Definition
any excessive vomiting or abdominal pain? describe it. and digestive problems (bowel problems should be explored), trauma to abdomen or any henias?
Term
Genetalia subjective
Definition
how often does child urinate? Age they were toilet trained? at night? any wetting of the pants? any frequency, burning, pain during urination? any masturbation? any inappropriate touching by someone other than child or doctor? started puberty? who gives sex talk? Child know how to give self breast/testicular exam? any mental or physical discomfort with period? use tampon and change frequently?
Term
Sexual history
Definition
age of first intercourse, HPV vaccine? ever had pap smear? any pain or discomfort with sex? how many sex partners have you had? type of contraceptive being used? any STDs or pregnancies (what was the result of pregnancy)? ever had gynecologic exam?
Term
Anus and Rectum subjective
Definition
how often are bowel movements? what do they look like? when was child toilet trained (bowels)? ever soil pants? any bleeding, constipation, diarrhea, hemorroids (very abnormal in children) or rectal itching?
Term
Musculoskeletal subjective?
Definition
 any history of limited ROM, joint pain, stiffness, paralysis, or bone deformity? any fractures? corrective devices (scoliosis brace)? describe child's posture. child invoved in sports? what protective gear is used?
Term
Neuro subjective
Definition
any learning diabilities or attention problems at home or school? any memory problems? history of seizures or head injury? any motor coordinatioon problems?
Term
Toddler developmental growth
Definition
height and weight increase is steplike because of growth spurts and lags. Bow leggedness is normal in toddlers because of leg muscles bearting weight of relatively large top
Term
height at 2 years
Definition
is equal to 1/2 of their adult height
Term
Head circumfrence
Definition
reaches chest circumfrence by age 1 to 2 yrs. total increase at age 2 is 2.5 cm then the rate increases slowly at .5 cm per year until age 5
Term
Preschoolers developmental growth
Definition
slender, graceful, and agile. avg 4 yo is 101.21 cm tall and 16.8 kg in weight
Term
School aged developmental growth
Definition
Girls grow faster than boys. At age 10-13 children experience a rapid uneven growth. So where a 6yo is 112.5 cm tall and 21 kg. an avg. 12 yo is 147.5 cm and 40 kg
Term
Adolescent developmental growth
Definition
20-25% of adult height and 30-50% of adult weight is achieved. Girls grow 5-20cm until 16 or 17 yo. Boys grow 10-30 cm til 18-20 yo. Puberty begins for girls between 8-14 and is 3 years long and for boys they start at 9-16 yo and it lasts 3-4 years
Term
Toddler motor development
Definition
can children walk, play with blocks, go up and down steps, jump with both feet, and do they scribble spontaneously?
Term
Preschoolers motor development
Definition
preschoolers at 3 years should be able to go up stairs using different feet, stand on one foot, and can build relatively tall block towers. 4yrs can skip go downstairss on alternating feet, catch a ball. 5 yrs. jump rope, write their name, tie shoes, and balance on one foot with eyes closed.
Term
School aged motor development.
Definition
should be able to do more complex tasks such as ride a bike, rollerblade, and write in cursive
Term
adolescent motor development
Definition
does child have a job, hobby or interests that involve hand skills and do they play sports?
Term
Toddler sensory devolopment
Definition
Visual acuity & depth perception improve and they can recall images. Able to listen and comprehend slightly. Olfactory and gustatory senses are influenced by voluntary control so children wont eat anything that doesnt look pleasant to them
Term
Preschool sensory development
Definition
color & depth perception become fully developed. Hearing reaces max level and listening further develops
Term
Schoolaged sensory development
Definition
visual capacity reaches 20/20 by age 6 or 7 and hearing acuity is almost complete
Term
Adolescent sensory development
Definition
all senses have reached mature capacity
Term
Toddlers cognitive development
Definition
in sensorimotor phase (12-24 months) substage tertiary circular reactions (12-18 months) invlove trial and error and exploration and in substage mental combinations (18-24months) child devises new means for accomplishing tasks through mental calculations. at 15 months toddlers begin to speak and by 2 years they can say 300 words and 2-3 word phrases
Term
Preschoolers cognitive development
Definition
Preoperational thought (2-7 years) has 2 phases. Preconceptual phase (2-4 years) forms concepts that are not complete or logical. The intuitive phase (4-7) capable of classifying, quantifying, and realationg objects but they are unable to see viewpoints of others. by 5 child can say 2,100 words and they know 4 of 5 colors and the days of the week
Term
school aged cognitive development
Definition
7-11 years stage of concrete operations which is marked by inductive reasoning, logical operations, and shift from egocentric to objective thinking. They often seek validation and ask many questions. They like to collect and sort objects and enjoy electronic games
Term
adolescent cognitive development
Definition

11-15 years

substage 1: they see relationships involving the inverse of the reciprocal

substage 2: they develop the ability to order triads of propositions and relationships

substage 3: they develop the capacity for true formal thought.

they think beyond the present and form theories about everythign

Term
Nutrition requirements
Definition
Toddlers need less calories cus of slower growth and by 12 months they eat similar food to fam. but become picky eaters. Preschoolers are very similar to toddlers but they enjoy social aspects of the dinner table. school children need to develop good diet at home to stick with them at school. Adolescents food should be balance by food pyramid
Term
Sleep requirements
Definition
Toddlers sleep 12 hours a day with nap once a day. Preschoolers sleep 11-13 hours a day and need afternoon nap. but sleeping problems are normal with toddlers and preschoolers because of anxiety. school age children get 8-9.5 hours of sleep and adolescents go to bed and sleep late at every opportunity
Term
leading killer of young people
Definition

suicide

ask if child has ever thought of killing themselves

Term
toddlers physical assessment
Definition
allow toddler to sit on parents lap; enlist parents aid; use play; praise cooperation
Term
preschoolers physical assessment
Definition
use story telling; use doll and puppet play; give choices when able.
Term
school age physical assessment
Definition
maintain privacy, use gown, explain procedures, and equipment; teach about bodies
Term
adolescent physical exam
Definition
ensure privacy, provide option of having no parent present, emphasize normality, provide teaching
Term
General appearance
Definition
look for lack of eye contact, pained or axious faces, posture, hygiene (could show neglect), abnormal development to assess for mental retardation, abuse, neglect, or a psych disorder
Term
Cognitive function
Definition
there should be no lags for their age category
Term
Pulse
Definition

3 months-2 years = 80-150

2 years- 10 years = 70-110

10 years - adult = 55-90

Term
Respirations
Definition

6 months-2 years= 20-30

3 years-10 years= 20-28

10 years-18 years= 12-20

Term
Blood pressure- systolic
Definition

1-7 years= age in years X 90

8-18= (2x age in years) X 90

Term
Blood Pressure- Diastolic
Definition

1-5 years= 56

6-18 years= age in years +52

Term
5th- 95th percentile
Definition
the percent a childs blood pressure should fall between. If they are above the 95% for more than 3 readings in a row they are considered to have high BP
Term
Head Circumfrence
Definition
should be in 5th- 95th percentile and less then 5% may be microcephaly where greater than 95% may be macrocephaly. Increased HC in children older than 3 may be from seperation of cranial sutures from intracranial pressure
Term
Skin color
Definition
pallor in skin suggests anemia and redness can be from fever, irritation, or allergies
Term
Excessive piercings/homemade tattoos
Definition
may be from self abusive tendencies, and homemade tattoos could have been infected with Hep B or HIV from unsanitary needles
Term
Urine odor
Definition
suggests incontinence, dirty diapers, or uremia
Term
salty sweat
Definition
if mother notices skin is salty when kissing child, it may indicate cystic fibrosis
Term
Excessive Burns and Bruising
Definition
Strong sign of abuse, but may be cultural practices such as cupping and coining
Term
Normal skin variations
Definition
port wine stains, hemangiomas, cafe-au-lait spots(unless there are more thans cafe-au-lait spots, which could indicated neurovascular problem
Term
Petechiae, lesions, rashes
Definition
could indicate serious problems
Term
Excessive dry skin
Definition
poor nutrition, excessive bathing, or endocrine problem
Term
Flaking or scaling skin
Definition
indicates eczema or fungal infection
Term
edema
Definition
suggests renal or cardiac disorders
Term
Russels sign
Definition
abrasions or scarring on the joints of index and middle fingers from self induced vomiting
Term
dull dry brittle hair
Definition
poor nutrition, hypertension, or overuse of chemical hair products (often seen with teens)
Term
Infestations of the hair
Definition
Grey translucent flakes suggest lice nits or ova. Grayish brown bodies suggest ticks
Term
Alopecia (hair loss)
Definition
Suggests neglect, hair pulling, skin diseases, or chemo
Term
tufts of hair on the spine
Definition
could be from spina bifida occulta
Term
coarse body hair before puberty
Definition
usually suggests an endocrine problem
Term
Nail/ finger issues
Definition

white nails with scaly lesions = fungal infection

spoon nails (koilonychia)= iron deficiency anemia

macerated thumbs are seen with chronic thumb sucking

inflammation of nail base= paronychia

Term
Hydrocephalus
Definition
very large head and "sun setting" appearance of the eyes
Term
oddly shaped head
Definition
premature closure of the sutures
Term
Down syndrom
Definition
Third fontanelle, unusually proportioned face, and short webbed neck,short broad extremities, hyperextensible joints, palmar simian crease, wide set eyes (hypertelorism), upward slant, and thick epicanthal folds, and brushfield's spots on the sclera.
Term
Craniotabes
Definition
osteoporosis of outer skull. palpating firmly with thumbs with cause indentation on the skull
Term
Range of Motion in the neck
Definition
hyperextension suggests opisthotonos or serious menigeal irritatation. limited ROM in the neck can be from torticollis (wryneck), or rheumatoid arthritis (this is indicitave of decreased ROM anywhere)
Term
Unusual face proportions
Definition
can be hereditary or can be from certain syndromes (Down's or fetal alcohol)
Term
Unequal face movement
Definition
facial nerve paralysis
Term
Enlarged parotid glands
Definition
seen with mumps or bulemia
Term
Allergies
Definition
seen with crease across the nose, shiners, and mouth agape
Term
distended veins in the neck
Definition
indicated difficulty breathing
Term
Trachea shift away from midline
Definition
Serious lung problem
Term
Enlarged lymph nodes
Definition
Hodgkin's disease or HIV
Term
stomatitis
Definition

infection or immunodeficiency

Term
Kopliks spots
Definition
prodromal sign of measels
Term
Dental problems
Definition
caries may be from "bottle caries syndrome" and enamel erosion suggests bulemia
Term
Nasal polyps
Definition
seen with allergies and cystic fibrosis
Term
Eyelid inflammation
Definition
blepharitis, dacryocystis, hordeolum
Term
ptosis
Definition
CN III palsy, congenital syndrome, or familial trait
Term
Blue sclera
Definition
osteogenisis imperfecta (brittle bone disease)
Term
Miosis
Definition
iritis or overuse of narcotics
Term
mydriasis of eye
Definition
emotional factors, truma or drug use
Term
Corneal abrasions
Definition
common during childhood but normally not visible
Term
visual acuity
Definition
1 year= 20/200. 2 year= 20/70. 5 years= 20/30. 6 years= 20/20. Online difference between eyes, abnormal visual acuity, disability to distinguish colors should be referred
Term
Strabismus
Definition
seen when eye moves during cover test and when light is not aligned in both eyes when light is shined on pupils (hirshberg test)
Term
Papilledema
Definition
unusual in children under 3 because fontanells are open so there should be less intracranial pressure
Term
Disc blurring and hemmoragess of internal eye
Definition
needs to be referred immediately
Term
low set ears with greater than 10 degree angle
Definition
mental retardation or congenital syndrome
Term
abnorma ear shape
Definition
suggests renal disease
Term
immobility of tympanic membrane
Definition
acute otitis media
Term
Periods of apnea longer than 20 seconds and accompanied by bradycardia
Definition
cardiovascular or CNS disease
Term
Stridor and wheezes
Definition

stridor is narrowing of upper bronchial tree

wheeze is narrowing of lower bronchial tree

Term
Mastitis
Definition
redness, edema, and tenderness in prepubertal breasts
Term
Systolic Heave
Definition
suggests right ventricular enlargement
Term
Deviated apical pulse
Definition
cardiomyopathy, pneumothorax, or diaphragmatic hernia
Term
Scaphoid abdomen
Definition
seen with malnutrition and dehydration
Term
Rigid abdomen
Definition
emergent problem
Term
Discharge, redness or lacerations of male or female genitals
Definition
maybe from abuse, but could be from infections or foriegn bodies. Discharge in adolescents could indicate STDs
Term
Cryptorchidism
Definition
more frequently seen in premature babies, because testicles drop during the 8th month of gestation
Term
Hydrocele
Definition
common in infants and normally resolve themselves spontaneously
Term
Partial or complete adhesion of the labia minora
Definition
sometimes seen in girls under 4 and they need to be referred to have the adhesion disintegrated
Term
Forate hymen ( no central orifice)
Definition
not significant unless it persists into puberty
Term
Polycystic ovary disease
Definition
male pattern hair on females
Term
Imperforate anus
Definition
no anal opening. needs to be referrred
Term
Hemmoroids
Definition
very uncommon in children and may be seen with chronic constipation or abuse
Term
Pustules around anus and dark ring around anus
Definition
pustules may be from diaper rash or seborrhea and a dark ring indicates heavy metal poisoning
Term
Polydactyly (extra digits) or Syndactyly (webbing)
Definition
may be seen with mental retardation
Term
Fixed position of extremeties that do not return to normal with manipulation
Definition
seen with metatarsus varus which is inverted and adduction of forefoot
Term
talipes equinovarus (club foot)
Definition
adduction of forefoot, inversion of entire foot, and equinus (pointing downward) position of entire foot
Term
Talipes varus
Definition
adduction of forefoot and inversion of entire foot
Term
Abnormal posture
Definition
neuromuscular disorder like cerebral palsy
Term
Scoliosis or hip disease
Definition
cause extremities that are asymmetric in size, shape, and movement
Term
"Toeing in" or "toeing out"
Definition
indicates tibial torsion or club foot
Term
Limping
Definition
indicates congenital hip dysplasia (toddlers), synovitis (preschoolers), legg-calve-perthes disease (school-aged) or slipped capital femora epiphysis and scoliosis in adolescents
Term
Inadequate muscle strength
Definition
neuromuscular disorder or muscular dystrophy
Term
Unintelligible speech by age 3
Definition
seen with prolonged stuttering, slurring, and lisping indicates speech disorders and neuro problems
Term
slurrring
Definition
may be from drug abuse or conditions such as diabetic ketoacidocis
Term
Sustained ankle clonus
Definition
CNS disease
Term
Parasthesia
Definition
decreases sensitivity to pain and inability to determain sharp from dull in 2 point senstation test
Term
Cerebral palsy
Definition
gross and fine motor skills that have not reached the appropriate mark for that age group
Term
Paresis
Definition
Hand preference that has not been developed by preschool age
Term
Soft signs
Definition
short attention span, poor coordination, hypoactivity, impulsiveness, labile emotions, distractibility, no demonstration of handedness, language problems, or learning problems
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