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Hev's cards
Heather's version of peds cards
636
Nursing
Undergraduate 3
12/03/2013

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Cards

Term
Family Systems Theory
Definition
- The family is seen as a whole
- If there is a change to one part of the family the whole family is affected
- The family unit as a whole is more important than the individual members
Term
Cephalocaudal growth
Definition
The head to tail directional trend in growth
Ex. infants get structural control over their heads before they get control of their trunk and extremities
Term
Erikson's psychosocial theories in chronological order
Definition
Trust vs. Mistrust
Autonomy vs. Shame, Self Doubt
Initiative vs. Guilt
Industry vs. Inferiority
Identity vs. Role Confusion
Term
What is the change in length from birth to 12 months?
Definition
Length will increase by 50%
Term
Contributors to childhood obesity
Definition
- Sugary drinks and less healthy food availability
- Advertising of less health foods
- Lack of PE in school
- No safe or appealing place to be active in the community
- Increasing portion size
- Lack of breastfeeding support
- Television and media
Term
FACES pain scale
Definition
Give the scale to a patient and have them point to the face and the place they are having pain
Ages 3-8
Term
3 ways to provide atraumatic care
Definition
Prevent or minimize separation from parent
Promote sense of control
Minimize or prevent bodily injury and pain
Term
Why are kids particularly vulnerable to the stress of hospitalization?
Definition
It is a change from the usual state of health and environmental routine.
Children have limited coping mechanisms to resolve stressors
Term
Separation Anxiety
Definition
From middle infancy throughout the preschool years.
3 stages:
Protest: aggressive reaction: crying and screaming
Despair: crying stops, depression, child less active
Detachment: superficially look adjusted but really a sign of resignation, not content
Term
Primary narcissism
Definition
When the child has not differentiated himself from the outside world and regards all sources of pleasure as originating within himself.
Term
When should solid food be introduced?
Definition
After 6 months of age
Term
What can develop is solid food is introduced too soon?
Definition
Excessive weight gain, increased predisposition to allergies, and iron-deficiency anemia
Term
When should dental cleaning by the primary care provider begin? And what should be used?
Definition
When the primary teeth erupt. They should be cleaned with a damp cloth.
Term
What are current recommendations for Vit D consumption for first year of life?
Definition
400 IU per day
Term
What disease is there no "maternal immunity?'
Definition
Whooping cough
Term
Which vaccines should not be administered to a person that is immunocompromised and why?
Definition
MMR, Varicella vaccine, and Rotavirus. Because these are live vaccines.
Term
When should children be placed in front facing car seats?
Definition
Keep toddlers in rear-facing seats until 2 years of age, or until they reach max height and weight for their seat. Studies have found that children under 2 yrs are 75 percent less likely die or be severely injured in a car crash.
Term
What are the 5 markers signaling a child's readiness to toilet train?
Definition
1. Bladder readiness
2. Bowel readiness
3. Cognitive readiness
4. Motor readiness
5. Psychological readiness
Term
What are the 7 main types of injuries associated with early childhood?
Definition
1. Motor vehicles
2. Drowning
3. Burns
4. Accidental poisoning
5. Falls
6. Choking and suffocation
7. Bodily injury
Term
What is the special form of tooth decay in infants and young children? And why does it occur?
Definition
Called early childhood caries or baby bottle tooth decay. It occurs when a child is routinely given a bottle of milk or juice at naptime or bedtime or uses the bottle as a pacifier while awake.
Term
What is the major gross motor skill acquired during toddlerhood.
Definition
Development of locomotion
Term
What is one of the most commonly used developmental screening tools?
Definition
Denver developmental screening test 2
Term
What are the significant changes that occur in regards to Moral Development during the school age years?
Definition
Children 6 to 7 years of age know the rules and behaviors expected of them, but do not understand reasons behind them. Older children are able to judge an act by the intention that prompted it rather than just its consequences.
Term
What is conservation?
Definition
Children learn that simply altering objects arrangement in space does not change certain properties of the environment.
Term
What is tanner staging?
Definition
A scale of physical development measured based on external primary and secondary sex characteristics
Term
What risk factors do children have to make them prone to vitamin D deficiency
Definition
1. Vitamin D poor diets
2. Breast fed infants
3. Obese children
4. Those with certain medical conditions (CF, DM, IBD)
Term
How much dietary calcium is absorbed in kids with vitamin D deficiency?
Definition
15%
Term
What conditions result from low calcium levels?
Definition
Seizures
Heart rhythm abnormalities
Term
What is Rickets?
Definition
A disease in children caused by vitamin D deficiency. Characterized by imperfect calcification, softening, and distortion of the bones typically resulting in bowed legs
Term
What foods can you get vitamin D from?
Definition
Fish, milk, fortified cereals, pork, eggs, mushrooms, ricotta cheese
Term
Children who are vegetarians are more likely to suffer from what?
Definition
Professor stressed: protein deficiency
The book said: inadequate growth, poor digestibility of bulky, natural foods, deficiencies in vitamin B6, nacin, riboflavin, vitamin D, calcium, and zinc
Term
Kwashiorkor
Definition
A deficiency of protein with an adequate supply of calories leading to thin, wasted extremities and a prominent abdomen from edema
Term
Marasmus
Definition
General malnutrition of calories and protein leading to a gradual wasting and atrophy of body tissues, especially subcutaneous fat
Term
What are the 4 types of allergic reactions
Definition
Systemic
GI
Respiratory
Cutaneous
Term
How long does a food allergy take to occur?
Definition
After the food has been ingested one or more times. It can come on immediately (minutes to hours) or be delayed (2-48 hours)
Term
What are the 3 most common food allergies?
Definition
Peanuts, milk, eggs
Term
How to use an epipen
Definition
1. Remove from plastic tube, grasp unit with dominant hand, black tip down
2. Jab it at a 90degree angle against thigh (even through clothes) and hold it there for 10 seconds
3. Massage the area for 10 seconds
Term
What is colic?
Definition
Characterized by unconsolable and excessive crying in otherwise health infants
Usually a benign condition that resolves on its own in 4-5 months
Term
What are the symptoms of colic?
Definition
Crying that lasts at least 3 hours a day on at least 3 days a week over at least 3 months
Term
Theories of causes of colic
Definition
1. Gut problem associated with cow's milk allergy
2. Behavioral problems
3. Excessive crying in an extreme of the normal
4. Collection of different entities
Term
What are the 2 different types of failure to thrive?
Definition
Organic: something physiologically wrong with the body not allowing them to take in the nutrients they need
Inorganic: psychosocial factors
Term
What is SIDS?
Definition
The sudden death of an infact younger than 1 year that remains unexplained after a complete postmortem exam.
The third leading cause of infant death and the leadign cause of postneonatal deaths

Kids sleep on their backs now to prevent
Term
What are do children get the chickenpox and MMR vaccine?
Definition
1 year-15 months
Term
Viral conjunctivitis
Definition
- Occurs in response to upper respiratory tract infections
- Serous (watery) drainage, inflamed conjunctiva, swollen eyelids
- Self limiting, removal of accumulated secretions
Term
Bacterial conjunctivitis
Definition
- Accounts for most cases in children
- Purulent drainage, crusting of eyelids, inflmed conjunctiva, swollen eyelids
- Treated with topical antibiotics
Term
Which category of drug is responsible for the most fatalities?
Definition
Analgesics
Term
What is IPECAC and what are the current recommendations for use?
Definition
It's an emetic (makes you vom). Not recommended for routine treatment of poison ingestion bc some poisonings can be made worse by vomiting
Term
Why is lead poisoning a problem in the U.S.?
Definition
Lead used to be added to paint. There's still some in older homes and in lead-contaminated soil. Kids put everything in their mouth.
Term
What are the symptoms of lead poisoning?
Definition
- Abdominal pain, vomiting, constipation
- Headaches
- Difficulty thinking, concentrating, making decisions
- Loss of appetite and weight loss
- Pale skin, fatigue, muscle weakness
- Slow or delayed growth in kids
- Personality changes, mood swings, trouble sleeping
- Seizures or coma
Term
Risk factors of child abuse: parental characteristics
Definition
Younger parents, single-parent families, socially isolated with few supportive relationships, additional stressors such as low-income with little education, substance abuse, low self-esteem
Term
Risk factors of child abuse: characteristics of child
Definition
Age: birth to 1 year
Unwanted, brain-damaged, hyperactive, physically disables, premature infants (failure to bond at birth), increased physical needs, irritability
Term
What is enuresis and how do you manage it?
Definition
Bedwetting
Manage with medications, complementary and alternative therapys, restriction of fluids near bedtime, avoiding caffeine, purposeful interruption of sleep to void, motivational therapy, devices designed to awaken child at initiation of voiding
Term
What is encopresis
Definition
Repeated voluntary or involuntary passage of feces of normal consistency in inappropriate places
Must not be caused by a physiologic affect
Term
Why does encopresis happen?
Definition
Constipation, abnormalities in digestive tract, voluntary retention of stool, emotional problems
Term
Primary vs. secondary amenorrhea
Definition
Primary: it never happened when it should have
Secondary: it stopped when it shouldn't have
Term
American Cancer Society and USPSTF pap smear guidelines
Definition
Testing begins at 21
Ages 21-29 pap smear every 3 years
Ages 30-65 pap smear plus HPV test every 5 years
65: no more testing
Term
Signs of autism
Definition
- No big smiles or other warm, joyful expressions by 6 months or after
- No back and forth sharing of sounds, smiles, or other facial expressions by 9 months
- No babbling by 12 months
- No back and forth gestures by 12 months
- No words by 16 months
- No meaningful, 2-work phrases by 24 months
- Any loss of speech, babbling, or social skills at any age
Term
What causes autism?
Definition
- 15% of cases a specific gene cause identified
- Environmental influences: advanced paternal age, maternal illness during pregnancy, extreme prematurity, certain difficulties during birth
Term
Common behaviors of Asperger syndrome
Definition
- Limited or inappropriate social interactions
- Robotic or repetitive speech
- Challenges with nonverbal communication
- Tendency to discuss self rather than others
- Inability to understand social/emotional issues or nonliteral phrases
- Lack of eye contact or reciprocal conversation
- Obsession with specific, often unusual topics
- One-sided conversations
- Awkward movements or mannerisms
Term
How is Aspergers diagnosed
Definition
Can remain undiagnosed until child or adult begins to have serious difficulties in school, workplace, or social lives
Term
What are the current reported rates of youth suicide
Definition
For ages 10-24 suicide is the 3rd lead cause of death
Results in 4600 deaths a year
Term
What accounts for the majority of acute illnesses in children?
Definition
Respiratory tract infections
Term
The etiology and course of respiratory infections are influenced by what 4 things:
Definition
a. Age
b. Size
c. Resistance
d. Seasonal Variations
Term
Major anatomic and physiologic differences between the adult and young child with regards to the resp tract:
Definition
-The diameter of the airways in young children and subject to considerable narrowing from edematous mucous membranes and increased production of secretions
-The relative short and open Eustachian tube in infants and young children allows pathogens easy access to the middle ear
Term
An example of a seasonal respiratory infection:
Definition
Mycoplasmal infections occur more often in autumn and early winter.
Ex/ flu vaccine
Term
What is respiratory distress?
Definition
Respiratory distress is difficulty breathing and the psychological experience associated with such difficulty, even if there is no physiological basis for experiencing such distress
Term
5 signs of respiratory distress in an infant
Definition
1. Tachypnea
2. Abdominal breathing
3. Intercostal and subcostal retractions
4. Cyanosis
5. Head bobbing
Term
4 physiological differences that infants have in regards to airway and breathing:
Definition
1. More compliant chest wall
2. Greater reliance on diaphragm over intercostal muscle
3. Smaller and fewer alveoli than adults
4. Smaller and collapsible intrathoracic airways
Term
80%-90% of all cases of pharyngitis are caused by this?
Definition
A virus (but we treat with an antibiotic; important to treat because don’t want it to get into the blood. Don’t want to get rumatic fever and scarlett fever; and acute glamerial nephritis.)
Term
Would you recommend over the counter cough medicine for a child?
Definition
I would recommend that they not administer over-the-counter cough and cold medications (OTC-CCM) to children under 2 years of age because serious and potentially life-threatening side effects can occur
**Don’t want to suppress expectorants of mucus – best not to treat
Term
3 nursing interventions post a child's tonsilectomy:
Definition
a. Until the child is fully awake place him on his abdomen or side to faciltate drainage of secretions
b. Restrict foods and fluids until the child is fully alert and there are no signs of hemorrhage
c. Provide pain relief by administering analgesics at regular intervals even during the night. Can give them rectally or through IV
Term
clinical manifestations of otitis media:
Definition
- Crying
- Fussiness, restlessness, irritability especially on laying down
-Tendency to rub, hold, or pull affected ear
-Rolling head from side to side
-Difficulty comforting the child
-Loss of appetite, refusal to feed
Term
What is the safe dose of oral amoxacillin?
Definition
80-90 mg/kg/day divided twice daily.
Term
Why is croup so much more predominant in infants and small children?
Definition
Small diameter of airway and more at risk for significant narrowing with inflammation
Term
What is croup?
Definition
a general term applied to a symptom complex characterized by hoarseness, a resonant barking cough, varying degrees of inspiratory stridor, and varying degrees of respiratory distress resulting from swelling or obstruction in the region of the larynx
Term
Which of the 4 types of croup syndromes is predominantly caused by a bacterial infection?
Definition
Acute epiglottis
Term
Why are fluids a treatment for croup?
Definition
IV fluids are given in order to maintain adequate hydration of the child because they may be unable to take oral fluids.
Term
What is the only product available in the U.S. for the prevention of RSV?
Definition
Palivizumab (Synagis), a monoclonal antibody given monthly in an IM injection to prevent hospitalization associated with RSV.
Term
Do all children receive the treatment available for RSV?
Definition
No they do not because it has to be received in a monthly IM injection.
Term
Who are candidates for RSV treatment?
Definition
infants born before 32 weeks gestation, infants with chronic lung disease, infants born at less than 35 weeks gestation who attend day care or have a sibling under 5 years, children younger than 2 who have hemodynamically significant congenital heart disease, and children with severe immunodeficiencies
Term
What is RSV?
Definition
Respiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children.
Term
How is RSV spread?
Definition
RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so it can be easily spread when a person touches something contaminated.
Term
3 main changes that occur within the airway in individuals having asthma:
Definition
a. Inflammation – Makes airway tissue irritated, red, swollen
b. Bronchoconstriction/spasm – Tightening of muscles that surround airways reduced
c. Increase in secretion of mucus - further blocks the airway
Term
What is a peak flow meter?
Definition
a portable, inexpensive, hand-held device used to measure how air flows from your lungs in one “fast blast.” In other words, the meter measures your ability to push air out of your lungs.
Term
What is/are the pathophysiology of Cystic Fibrosis?
Definition
a. Increased viscosity of mucous gland secretions
b. a striking elevation of sweat electrolytes
c. an increase in several organic and enzymatic constituents of saliva
d. abnormalities in autonomic nervous system function
Term
What is the primary factor that is responsible for many of the clinical manifestation of Cystic Fibrosis?
Definition
Mechanical obstruction caused by the increased viscosity of mucous gland secretions.
Term
Why do children with Cystic Fibrosis need to take pancreatic enzymes?
Definition
Because in the pancreas, the thick secretions block the ducts, eventually causing pancreatic fibrosis. This blockage prevents essential pancreatic enzymes from reaching the duodenum, which causes marked impairment in the digestion and absorption of nutrients.
Term
When are pancreatic enzymes taken with regards to eating?
Definition
The pancreatic enzymes are administered with meals and snacks to ensure that digestive enzymes are mixed with food in the duodenum.
Term
The influenza virus has a peculiar affinity for what type of cells and where?
Definition
Epithelial cells of the respiratory tract mucosa
Term
What is McBurney point?
Definition
A point midway between the anterior superior iliac crest and the umbilicus. Where the most intense point of pain r/t appendicitis is located.
Term
Difference between Ulcerative Colitis and Crohn’s Disease
Definition
The inflammation found with UC is limited to the colon and rectum with the distal colon and rectum the most severely affected, while in Crohn’s Disease the chronic inflammatory process involves any part of the GI tract from the mouth to the anus but most often affects terminal ileus.
Term
4 goals of therapeutic management of Ulcerative Colitis and Crohn’s Disease:
Definition
1) Control the inflammation
2) obtain long-term remission
3) promote normal growth and development
4) allow as normal a lifestyle as possible.
Term
How does mesalamine work in treating CD or UC?
Definition
The exact mechanism of action is not nknown but is believed to work by blocking the activity of cyclooxygenase and lipoxygenase, thereby, reducing the production of prostaglandins which decreases inflammation in the colon and symptoms associated with ulcerative colitis.
Term
Problems children with cleft palate/ cleft lip have prior to surgery?
Definition
She swallows air when she drinks, cries, suckles on anything
Term
Problems associated problems with Cleft lip or Palate?
Definition
The infant is unable to create suction in the oral cavity that is necessary for feeding. Speech impairment, recurrent otitis media leading to hearing loss, and improper tooth alignment can also occur.
Term
Clinical manifestations of hypertrophic pyloric stenosis?
Definition
usually develops in the first 2 to 5 weeks of life, causing projectile nonbilious vomiting, dehydration, metabolic alkalosis, and growth failure
Term
why do children die as a result of pyloric stenosis?
Definition
Dehydration since the child cannot digest food and is constantly vomiting.
Term
What is intussusceptions?
Definition
The most common cause of intestinal obstruction in children between the ages of 3 months and 3 years, and it occurs when on segment of bowel telescopes into another segment, pulling the mesentery with it.
Term
Classic triad of intussusception symptoms?
Definition
Abdominal pain, abdominal mass, bloody stools
Term
What is Short Bowel Syndrome?
Definition
A malabsorptive disorder that occurs as result of decreased mucosal surface area, usually because of extensive resection of the small intestine.
Term
Most important component of nursing care for a child having Short Bowel Syndrome?
Definition
Administration and monitoring of nutritional therapy.
Term
Respiratory Distress
Definition
Compensated state that may precede respiratory failure, the patient is able to maintain adequate gas exchange by increasing breathing rate and depth
Term
Signs/Symptoms of Resp Distress
Definition
-Diaphoresis
-Pallor/cyanosis
-Nasal Flaring
-Tachypnea
-Noisy Breathing
-Retracting
-Grunting
Term
Examples of obstructions that cause respiratory failure?
Definition
-Foreign body (vomitus)
-Infection (i.e. epiglottitis)
-Tonsils/adenoids
-Laryngospasm
Term
Restrictive causes for respiratory failure?
Definition
-Thick secretions, foreign body
-Infection (Pneumonia)
-Alveolar rupture (pneumothorax)
-Chemical pneumonitis
-Pleural effusion
-Near-drowning event
Term
What comes after respiratory failure?
Definition
cardiac arrest!
Term
Upper Respiratory Tract Illnesses:
Definition
-URI or URTI
-Nasopharyngitis
-Pharyngitis
-Tonsillitis
-Influenza
-Otitis Media
-Infectious Mononucleosis
Term
Retraction
Definition
A retraction is a medical term for when the area between the ribs and in the neck sinks in when a person with asthma attempts to inhale. Retractions are a sign someone is working hard to breathe.
Term
Respiratory Excursion
Definition
a technique that assesses the extent and symmetry of chest movement
Term
Steeple Sign
Definition
a radiologic sign found on a frontal neck radiograph where subglottic tracheal narrowing produces an inverted "V" shape within the trachea itself. The presence of the steeple sign supports a diagnosis of croup.
Term
Outpatient treatment for patient with LARYNGEOTRACHEOBRONCHITIS?
Definition
-antipyretic
-hydration
-humidified air
-oral corticosteroids
Term
Inpatient treatment for patient with LARYNGEOTRACHEOBRONCHITIS?
Definition
-racemic epinephrine (bronchodilator)
-humidified air
-oral corticosteroids
Term
treatment for patient with severe LARYNGEOTRACHEOBRONCHITIS?
Definition
-endotracheal intubation for patient's with PaCO2 levels >45
Term
Are antibiotics used to treat croup?
Definition
usually not because most are caused by viruses, not bacteria.
Term
Symptoms of croup?
Definition
-barking cough
-inspiratory stidor
-hoarseness
Term
3 clinical observations that are predictive of epiglottitis?
Definition
1. abscess of spontaneous cough
2. drooling
3. agitation

*Can also see fever, sore throat, strider, chills, shaking, cyanosis
Term
A common cause of swelling of the epiglottis?
Definition
H. influenzae bacteria
*Can also be caused by other bacteria or viruses
Term
What vaccine has reduced the incidences of epiglottitis?
Definition
Due to the H. influenzae type B vaccine which children routinely receive at a young age.
Term
For those not receiving Synagis, what is the treatment for patient's with RSV receive?
Definition
Airway management and fluids
Term
Reactive Airway Disease
Definition
-Inflammatory response initiated in airways
-Involves mast cells, eosinophils and T lymphocytes
-End result means increased mucous production, inflammation to lower airways and bronchospasm
Term
Symptoms of Reactive Airway Disease?
Definition
RAD = Asthma
-Wheezing
-Dry cough (tight)
-Prolonged expiratory phase
-Restless
-Fatigue
-Tachypnea
Term
Long term asthma medications
Definition
-Corticosteroids-(inhaled) pulmicort
-Cromolyn sodium (Intal)
-Mast Cell Stabalizer
-Immunomodulators-(Xolair) decrease IgE response
-Leukotriene modifiers-(Accolate)
-LABA’s (long acting bronchodilator) -Serevent or Salmeterol (12 hours)
-Methylxanthines-theophylline
Term
Eosinophils
Definition
In chronic, more severe cases of asthma, general bronchial hyperreactivity (or smooth muscle twitchiness) is largely caused by eosinophils
Term
Examples of medications for quick relief for asthma relief
Definition
-Anticholinergics(Atrovent) –blocks constriction (parasympathetic)
-SABA-Short acting bronchodilators (Albuterol)-stimulates dilation (sympathetic) RESCUE
-Systemic corticosteroids-> Methylprednisolone/Solumedrol
Term
What is Cystic Fibrosis?
Definition
Inherited autosomal recessive trait
Cystic Fibrosis Transmembrane Conductance Regulator
critical loss of chloride ion transport
upsets the sodium and chloride ion balance
disrupts the normal, thin mucus layer that is easily removed by cilia lining the lungs and other organs
thick, sticky secretions
pool in bronchioles = atelectasis
clogs pancreatic ducts, impairs digestion & absorption of nutrients
leads to biliary cirrhosis
retarded G & D, delayed puberty
Terminal, median age is 37
Term
Cystic Fibrosis Management/Treatment
Definition
Mucolytics, bronchodilators, kalydeco
Antibiotics for infections
Chest PT
Avoid pulmonary Txs after meal
Term
Management of GI problems
Definition
Assess nutritional status
Provide high protein & calorie diet
Administer pancreatic enzymes
Vitamins (esp. fat soluble)
Term
Causes of vomiting
Definition
Allergies to foods
Over-eating
Persistent coughing
Intestinal obstruction
Viral illness
Term
What is dehydration?
Definition
output>input
Term
Rotavirus
Definition
Fever, Nausea, Vomiting, Freq diarrhea
**Very contagious - passed through fecal oral route or indirect contact
Symptoms appear 1-3 days post contact
Between Nov and April most commonly seen - seasonal
Monitor for dehydration!!
Give electrolytes as treatment and may need IV!
No specific tx- usually recover on their own
Lasts roughly for 3-7 days
Term
Hirschsprungs Disease
Definition
-Congenital Aganglionic Megacolon
Absence of ganglion cells in one or more segments of the colon
-Etiology not fully understood
Term
Symptoms of Hirschsprungs Disease
Definition
Symptoms
-Don’t pass meconium
-Distention
-Ribbon like stools
Term
G.E. Reflux Disease
Definition
-relaxation or incompetence of the lower esophageal sphincter
Term
Symptoms of G.E. Reflux Disease
Definition
Signs and symptoms:
Vomiting
Weight loss
Respiratory Problems (RAD)
GI Bleeding
Term
Appendicitis
Definition
Signs and symptoms:
-abdominal pain-per umbilical to right lower quadrant
-local rebound tenderness
-vomiting
-constipation or diarrhea
Term
Pyloric Stenosis
Definition
Muscle around the pylorus enlarges and leads to obstruction during the first three months of life
Term
S/S of Pyloric Stenosis
Definition
Signs and Symptoms
Projectile Vomiting-No Bile
Hunger
Weight Loss
Dehydration with F/E Disturbances
Increased Abdominal distention with peristaltic waves
Palpable Olive Shape Tumor in Epigastric Area
Term
Pre/Post Operative Problems for Pyloric Stenosis
Definition
Pre-op Problems
-Emphasis is on restoring and correcting fluid and electrolyte problems

Post-op Problems
-Infant may still vomit
-Advancing diet as tolerated
-Rare to have complications
**Diagnosed usually by ultrasound
Term
Diagnosing Intussusception
Definition
-made by x ray, ultrasound, or barium enema (Using Air enema currently), which may also un-telescope the bowel
-Surgery if b.e is not successful
Term
4 Pituitary Disorders
Definition
**Disorders of the pituitary gland depend on the location of the lesion or physiologic abnormality.

-Growth hormone deficiencies
-Precocious Puberty
-Diabetes Insipidus
-SIADH
Term
Growth Hormone Replacement
Definition
-GH products are currently labeled for use in “children who have growth failure due to an inadequate secretion of normal endogenous growth hormone”
-Administered at night to correspond with normal release time of GH
Term
Management of Growth Hormone Deficiency
Definition
-GH Replacement
-Children should be managed by a pediatric endocrinologist
-Height and weight is obtained every 3 months and plotted on the growth chart
-Bone age study yearly
Term
Precocious Puberty
Definition
-Development of sexual characteristics before the usual age of onset of puberty.
Girls
-Breast development, pubic hair, and/or menses before 8 years
Boys
-Secondary sexual characteristics before age 9
**Tanner Scale: true precocious puberty is characterized by 2 signs of puberty
Term
Diabetes Mellitus / Type 1
Definition
Lack of insulin production in the pancreas.
Under 20 years of age
Peak incidence between 10 and 14 years.
Term
Assess of DM Type I
Definition
Elevated blood glucose leads to osmotic diuresis. (polyphagia, polyuria and polydipsia)
Protein and fat breakdown lead to weight loss- as much as 30%
Accumulation of ketones causes a drop in pH. (metabolic acidosis) and spilling of ketones in the urine
Term
Diagnostic Tests for DM Type I
Definition
Blood glucose levels greater than 200 mg/dL
Urine sample reveals glucosuria and possible ketonuria.
Glucose tolerance test would reveal low insulin levels in the face of elevated glucose levels.
Term
Interventions for DM Type I
Definition
Administration of insulin
Blood glucose levels
Initially before every meal
Every am when diabetes under control
Dietary management / refer to nutritionist
Glycosylated hemoglobin / reflects average glucose concentration for preceding 2 to 3 months. (A1C)
Term
Glycosylated hemoglobin A1C
Definition
HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes.
Term
Target Blood Glucose Levels
Definition
Target levels
Toddler and preschool: 100 to 180 mg/dL
School-age: 90 to 180 mg/dL
Adolescents (13 to 19 years): 90 to 130 mg/dL
Term
Insulin
Definition
Short acting – often used to cover extra carbohydrate consumption
Combination of regular and intermediate-acting insulin
Morning and evening dosing
Children on mixed insulin dosage schedules tend to experience hypoglycemic episodes at 11:30 and 2:30 as peaking of insulin occurs.
Term
Hypoglycemia Symptoms
Definition
Rapid onset
Shaky feeling, hunger
Dizziness
Headache
Vital signs
-Shallow respirations
-tachycardia
Tremors
Term
Lab values for Hypoglycemia
Definition
Glucose = low, below 60
Ketones = negative
Urine output
Normal
sugar negative
negative ketones
Term
Treatment of Hypoglycemia
Definition
Simple concentrated sugars such as honey by mouth(older than 1 year), hard candy, sugar cubes, or glucose tablets will elevate the blood sugar immediately. Orange juice or sugar containing soda or fruit drink. (Blood Glucose less than 70 mg/dL)
Term
Hypoglycemia Prevention
Definition
-Using rapid-acting or Lispro insulin
-Infusion pump (8 to 10 years of age)
-Night time snack
-Check blood glucose before bedtime. -Make sure the blood glucose is 100 – 120 mg/dL before going to bed
-Do not skip snacks
-Eat an extra snack on days of strenuous exercise
Term
Symptoms of Hyperglycemia and DKA
Definition
Symptoms:
-Onset = gradual
-Lethargic, confused, weak
-Thirsty
-Abdominal pain often with nausea and vomiting
-Signs of dehydration
-Vital signs: deep, rapid respirations, fruity acetone breath, and weak pulses
Term
Symptoms of Diabetes KetoAcidosis
Definition
Altered level of consciousness
Dehydration
Electrolyte disturbances
Dysrhythmias
Shock
Complete vascular collapse
Term
Type 2 Diabetes
Definition
-85% of children with Type 2 are obese
-Age of onset is middle to late puberty- around 13 years
-Minority populations have an especially high rate of type 2 diabetes
-Strong family history
Term
Type 2 Diabetes Assessment
Definition
Obesity: BMI greater than 30 (normal range is 15 to 17 in the pediatric population)
Waist to hip ratio: apple shape
Acanthosis nigricans: hyper-pigmentation and thickening of the skin into velvety irregular folds in the neck and flexural areas
Hypertension
+ family history of type 2 diabetes
Ethnicity
Term
Glucophage (Metformin)
Definition
Glucose-lowering agent: drugs that improve insulin sensitivity
**Used with diet and exercise to control blood sugar in patients with type 2 diabetes. May be used alone or with other medicines.
Term
Examples of Age-Related Skin Manifestations
Definition
Infants: “birthmarks”
Early childhood: atopic dermatitis
School-age children: ringworm
Adolescents: acne
Term
Impetigo
Definition
Common peds skin problem
Treated with topical antibiotic if localized to small area
Bacterial: strep or staph
Wash crust off with soap and water and apply topical antibiotic
May be treated with oral antibiotics
if it has spread (still wash lesions)
Very contagious!!!!!!!
Term
Fungal Skin Infections
Definition
Superficial infections that live on the skin
AKA dermatophytoses, tinea
Transmission from person to person or from infected animal to human
Examples: tinea capitis, tinea corporis, tinea pedis, candidiasis
Term
Contact Dermatitis
Definition
Inflammatory reaction of skin to chemical
Initial reaction in the exposed region
Characteristic sharp delineation between inflamed and normal skin
Primary irritant
Sensitizing agent
Examples: diaper dermatitis, reaction to wool, reaction to specific chemical
Term
Atopic Dermatitis
Definition
A type of pruritic eczema that begins during infancy
Hereditary tendency
Often associated with history of food allergies, allergic rhinitis, and asthma
Term
Diaper Dermatitis
Definition
Pathophysiology and clinical manifestations
Usually from irritation of urine and feces
Detergents inadequately rinsed from clothing
Chemical irritation (especially from diaper wipes)
Nursing considerations: alter wetness, pH, and fecal irritants
Differentiate from Candidiasis of diaper area (Candidiasis has characteristic excoriated red papules with satellite lesions
Term
Burns
Definition
Toddlers: hot water scalds
Older children: flame-related burns
Child abuse
Child with matches or lighters accounts for 1 in 10 house fires
Term
Lyme Disease
Definition
Lyme disease is caused by infection with a spiral-shaped bacterium called Borrelia burgdorferi.
Term
Symptoms of Lyme Disease
Definition
Between three days to several weeks after being bitten by an infected tick, 70-90% of people develop a circular or oval rash, called erythema migrans (or EM), at the site of the bite. To qualify as an EM, the rash must be at least two inches in diameter.
The EM rash does not itch or hurt so if it is not seen, it may not be noticed.
"bulls eye" appearance
Term
Complications of Lyme Disease
Definition
Lyme disease may cause headache, fever, muscle and joint aches, and a feeling of tiredness. If left untreated, Lyme disease may progress to affect the joints, nervous system, or heart several weeks to months after the tick bite
Term
What is respiratory distress?
Definition
Respiratory distress is difficulty breathing and the psychological experience associated with such difficulty, even if there is no physiological basis for experiencing such distress
Term
5 signs of respiratory distress in an infant
Definition
1. Tachypnea
2. Abdominal breathing
3. Intercostal and subcostal retractions
4. Cyanosis
5. Head bobbing
Term
4 physiological differences that infants have in regards to airway and breathing:
Definition
1. More compliant chest wall
2. Greater reliance on diaphragm over intercostal muscle
3. Smaller and fewer alveoli than adults
4. Smaller and collapsible intrathoracic airways
Term
80%-90% of all cases of pharyngitis are caused by this?
Definition
A virus (but we treat with an antibiotic; important to treat because don’t want it to get into the blood. Don’t want to get rumatic fever and scarlett fever; and acute glamerial nephritis.)
Term
Would you recommend over the counter cough medicine for a child?
Definition
I would recommend that they not administer over-the-counter cough and cold medications (OTC-CCM) to children under 2 years of age because serious and potentially life-threatening side effects can occur
**Don’t want to suppress expectorants of mucus – best not to treat
Term
3 nursing interventions post a child's tonsilectomy:
Definition
a. Until the child is fully awake place him on his abdomen or side to faciltate drainage of secretions
b. Restrict foods and fluids until the child is fully alert and there are no signs of hemorrhage
c. Provide pain relief by administering analgesics at regular intervals even during the night. Can give them rectally or through IV
Term
clinical manifestations of otitis media:
Definition
- Crying
- Fussiness, restlessness, irritability especially on laying down
-Tendency to rub, hold, or pull affected ear
-Rolling head from side to side
-Difficulty comforting the child
-Loss of appetite, refusal to feed
Term
Why is croup so much more predominant in infants and small children?
Definition
Small diameter of airway and more at risk for significant narrowing with inflammation
Term
Which of the 4 types of croup syndromes is predominantly caused by a bacterial infection?
Definition
Acute epiglottis
Term
Why are fluids a treatment for croup?
Definition
IV fluids are given in order to maintain adequate hydration of the child because they may be unable to take oral fluids.
Term
What is the only product available in the U.S. for the prevention of RSV?
Definition
Palivizumab (Synagis), a monoclonal antibody given monthly in an IM injection to prevent hospitalization associated with RSV.
Term
Do all children receive the treatment available for RSV?
Definition
No they do not because it has to be received in a monthly IM injection.
Term
Who are candidates for RSV treatment?
Definition
infants born before 32 weeks gestation, infants with chronic lung disease, infants born at less than 35 weeks gestation who attend day care or have a sibling under 5 years, children younger than 2 who have hemodynamically significant congenital heart disease, and children with severe immunodeficiencies
Term
What is RSV?
Definition
Respiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children.
Term
3 main changes that occur within the airway in individuals having asthma:
Definition
a. Inflammation – Makes airway tissue irritated, red, swollen
b. Bronchoconstriction/spasm – Tightening of muscles that surround airways reduced
c. Increase in secretion of mucus - further blocks the airway
Term
What is a peak flow meter?
Definition
a portable, inexpensive, hand-held device used to measure how air flows from your lungs in one “fast blast.” In other words, the meter measures your ability to push air out of your lungs.
Term
What is/are the pathophysiology of Cystic Fibrosis?
Definition
a. Increased viscosity of mucous gland secretions
b. a striking elevation of sweat electrolytes
c. an increase in several organic and enzymatic constituents of saliva
d. abnormalities in autonomic nervous system function
Term
Why do children with Cystic Fibrosis need to take pancreatic enzymes?
Definition
Because in the pancreas, the thick secretions block the ducts, eventually causing pancreatic fibrosis. This blockage prevents essential pancreatic enzymes from reaching the duodenum, which causes marked impairment in the digestion and absorption of nutrients.
Term
When are pancreatic enzymes taken with regards to eating?
Definition
The pancreatic enzymes are administered with meals and snacks to ensure that digestive enzymes are mixed with food in the duodenum.
Term
The influenza virus has a peculiar affinity for what type of cells and where?
Definition
Epithelial cells of the respiratory tract mucosa
Term
What is McBurney point?
Definition
A point midway between the anterior superior iliac crest and the umbilicus. Where the most intense point of pain r/t appendicitis is located.
Term
Difference between Ulcerative Colitis and Crohn’s Disease
Definition
The inflammation found with UC is limited to the colon and rectum with the distal colon and rectum the most severely affected, while in Crohn’s Disease the chronic inflammatory process involves any part of the GI tract from the mouth to the anus but most often affects terminal ileus.
Term
4 goals of therapeutic management of Ulcerative Colitis and Crohn’s Disease:
Definition
1) Control the inflammation
2) obtain long-term remission
3) promote normal growth and development
4) allow as normal a lifestyle as possible.
Term
How does mesalamine work in treating CD or UC?
Definition
The exact mechanism of action is not nknown but is believed to work by blocking the activity of cyclooxygenase and lipoxygenase, thereby, reducing the production of prostaglandins which decreases inflammation in the colon and symptoms associated with ulcerative colitis.
Term
why do children die as a result of pyloric stenosis?
Definition
Dehydration since the child cannot digest food and is constantly vomiting.
Term
What is intussusceptions?
Definition
The most common cause of intestinal obstruction in children between the ages of 3 months and 3 years, and it occurs when on segment of bowel telescopes into another segment, pulling the mesentery with it.
Term
Classic triad of intussusception symptoms?
Definition
Abdominal pain, abdominal mass, bloody stools
Term
What indicates that the intussusception has reduced itself?
Definition
Passage of normal brown stool.
Term
What is Short Bowel Syndrome?
Definition
A malabsorptive disorder that occurs as result of decreased mucosal surface area, usually because of extensive resection of the small intestine.
Term
Respiratory Distress
Definition
Compensated state that may precede respiratory failure, the patient is able to maintain adequate gas exchange by increasing breathing rate and depth
Term
Signs/Symptoms of Resp Distress
Definition
-Diaphoresis
-Pallor/cyanosis
-Nasal Flaring
-Tachypnea
-Noisy Breathing
-Retracting
-Grunting
Term
Respiratory Excursion
Definition
a technique that assesses the extent and symmetry of chest movement
Term
Steeple Sign
Definition
a radiologic sign found on a frontal neck radiograph where subglottic tracheal narrowing produces an inverted "V" shape within the trachea itself. The presence of the steeple sign supports a diagnosis of croup.
Term
Outpatient treatment for patient with LARYNGEOTRACHEOBRONCHITIS?
Definition
-antipyretic
-hydration
-humidified air
-oral corticosteroids
Term
treatment for patient with severe LARYNGEOTRACHEOBRONCHITIS?
Definition
-endotracheal intubation for patient's with PaCO2 levels >45
Term
Symptoms of croup?
Definition
-barking cough
-inspiratory stidor
-hoarseness
Term
3 clinical observations that are predictive of epiglottitis?
Definition
1. abscess of spontaneous cough
2. drooling
3. agitation

*Can also see fever, sore throat, strider, chills, shaking, cyanosis
Term
A common cause of swelling of the epiglottis?
Definition
H. influenzae bacteria
*Can also be caused by other bacteria or viruses
Term
What vaccine has reduced the incidences of epiglottitis?
Definition
Due to the H. influenzae type B vaccine which children routinely receive at a young age.
Term
For those not receiving Synagis, what is the treatment for patient's with RSV receive?
Definition
Airway management and fluids
Term
Reactive Airway Disease
Definition
-Inflammatory response initiated in airways
-Involves mast cells, eosinophils and T lymphocytes
-End result means increased mucous production, inflammation to lower airways and bronchospasm
Term
Symptoms of Reactive Airway Disease?
Definition
RAD = Asthma
-Wheezing
-Dry cough (tight)
-Prolonged expiratory phase
-Restless
-Fatigue
-Tachypnea
Term
Long term asthma medications
Definition
-Corticosteroids-(inhaled) pulmicort
-Cromolyn sodium (Intal)
-Mast Cell Stabalizer
-Immunomodulators-(Xolair) decrease IgE response
-Leukotriene modifiers-(Accolate)
-LABA’s (long acting bronchodilator) -Serevent or Salmeterol (12 hours)
-Methylxanthines-theophylline
Term
Eosinophils
Definition
In chronic, more severe cases of asthma, general bronchial hyperreactivity (or smooth muscle twitchiness) is largely caused by eosinophils
Term
Examples of medications for quick relief for asthma relief
Definition
-Anticholinergics(Atrovent) –blocks constriction (parasympathetic)
-SABA-Short acting bronchodilators (Albuterol)-stimulates dilation (sympathetic) RESCUE
-Systemic corticosteroids-> Methylprednisolone/Solumedrol
Term
What is Cystic Fibrosis?
Definition
Inherited autosomal recessive trait
Cystic Fibrosis Transmembrane Conductance Regulator
critical loss of chloride ion transport
upsets the sodium and chloride ion balance
disrupts the normal, thin mucus layer that is easily removed by cilia lining the lungs and other organs
thick, sticky secretions
pool in bronchioles = atelectasis
clogs pancreatic ducts, impairs digestion & absorption of nutrients
leads to biliary cirrhosis
retarded G & D, delayed puberty
Terminal, median age is 37
Term
Cystic Fibrosis Management/Treatment
Definition
Mucolytics, bronchodilators, kalydeco
Antibiotics for infections
Chest PT
Avoid pulmonary Txs after meal
Term
Rotavirus
Definition
Fever, Nausea, Vomiting, Freq diarrhea
**Very contagious - passed through fecal oral route or indirect contact
Symptoms appear 1-3 days post contact
Between Nov and April most commonly seen - seasonal
Monitor for dehydration!!
Give electrolytes as treatment and may need IV!
No specific tx- usually recover on their own
Lasts roughly for 3-7 days
Term
Symptoms of Hirschsprungs Disease
Definition
Symptoms
-Don’t pass meconium
-Distention
-Ribbon like stools
Term
Symptoms of G.E. Reflux Disease
Definition
Signs and symptoms:
Vomiting
Weight loss
Respiratory Problems (RAD)
GI Bleeding
Term
S/S of Pyloric Stenosis
Definition
Signs and Symptoms
Projectile Vomiting-No Bile
Hunger
Weight Loss
Dehydration with F/E Disturbances
Increased Abdominal distention with peristaltic waves
Palpable Olive Shape Tumor in Epigastric Area
Term
Pre/Post Operative Problems for Pyloric Stenosis
Definition
Pre-op Problems
-Emphasis is on restoring and correcting fluid and electrolyte problems

Post-op Problems
-Infant may still vomit
-Advancing diet as tolerated
-Rare to have complications
**Diagnosed usually by ultrasound
Term
Diagnosing Intussusception
Definition
-made by x ray, ultrasound, or barium enema (Using Air enema currently), which may also un-telescope the bowel
-Surgery if b.e is not successful
Term
4 Pituitary Disorders
Definition
**Disorders of the pituitary gland depend on the location of the lesion or physiologic abnormality.

-Growth hormone deficiencies
-Precocious Puberty
-Diabetes Insipidus
-SIADH
Term
Growth Hormone Replacement
Definition
-GH products are currently labeled for use in “children who have growth failure due to an inadequate secretion of normal endogenous growth hormone”
-Administered at night to correspond with normal release time of GH
Term
Management of Growth Hormone Deficiency
Definition
-GH Replacement
-Children should be managed by a pediatric endocrinologist
-Height and weight is obtained every 3 months and plotted on the growth chart
-Bone age study yearly
Term
Precocious Puberty
Definition
-Development of sexual characteristics before the usual age of onset of puberty.
Girls
-Breast development, pubic hair, and/or menses before 8 years
Boys
-Secondary sexual characteristics before age 9
**Tanner Scale: true precocious puberty is characterized by 2 signs of puberty
Term
Diabetes Mellitus / Type 1
Definition
Lack of insulin production in the pancreas.
Under 20 years of age
Peak incidence between 10 and 14 years.
Term
Assess of DM Type I
Definition
Elevated blood glucose leads to osmotic diuresis. (polyphagia, polyuria and polydipsia)
Protein and fat breakdown lead to weight loss- as much as 30%
Accumulation of ketones causes a drop in pH. (metabolic acidosis) and spilling of ketones in the urine
Term
Diagnostic Tests for DM Type I
Definition
Blood glucose levels greater than 200 mg/dL
Urine sample reveals glucosuria and possible ketonuria.
Glucose tolerance test would reveal low insulin levels in the face of elevated glucose levels.
Term
Interventions for DM Type I
Definition
Administration of insulin
Blood glucose levels
Initially before every meal
Every am when diabetes under control
Dietary management / refer to nutritionist
Glycosylated hemoglobin / reflects average glucose concentration for preceding 2 to 3 months. (A1C)
Term
Glycosylated hemoglobin A1C
Definition
HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes.
Term
Target Blood Glucose Levels
Definition
Target levels
Toddler and preschool: 100 to 180 mg/dL
School-age: 90 to 180 mg/dL
Adolescents (13 to 19 years): 90 to 130 mg/dL
Term
Insulin
Definition
Short acting – often used to cover extra carbohydrate consumption
Combination of regular and intermediate-acting insulin
Morning and evening dosing
Children on mixed insulin dosage schedules tend to experience hypoglycemic episodes at 11:30 and 2:30 as peaking of insulin occurs.
Term
Hypoglycemia Symptoms
Definition
Rapid onset
Shaky feeling, hunger
Dizziness
Headache
Vital signs
-Shallow respirations
-tachycardia
Tremors
Term
Lab values for Hypoglycemia
Definition
Glucose = low, below 60
Ketones = negative
Urine output
Normal
sugar negative
negative ketones
Term
Treatment of Hypoglycemia
Definition
Simple concentrated sugars such as honey by mouth(older than 1 year), hard candy, sugar cubes, or glucose tablets will elevate the blood sugar immediately. Orange juice or sugar containing soda or fruit drink. (Blood Glucose less than 70 mg/dL)
Term
Hypoglycemia Prevention
Definition
-Using rapid-acting or Lispro insulin
-Infusion pump (8 to 10 years of age)
-Night time snack
-Check blood glucose before bedtime. -Make sure the blood glucose is 100 – 120 mg/dL before going to bed
-Do not skip snacks
-Eat an extra snack on days of strenuous exercise
Term
Symptoms of Hyperglycemia and DKA
Definition
Symptoms:
-Onset = gradual
-Lethargic, confused, weak
-Thirsty
-Abdominal pain often with nausea and vomiting
-Signs of dehydration
-Vital signs: deep, rapid respirations, fruity acetone breath, and weak pulses
Term
Hyperglycemia associated with diabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than:
Definition
330 mg/dl
Term
Symptoms of Diabetes KetoAcidosis
Definition
Altered level of consciousness
Dehydration
Electrolyte disturbances
Dysrhythmias
Shock
Complete vascular collapse
Term
Life management of Diabetes
Definition
Management by endocrinologist
Insulin
Blood sugar monitoring
Diet
Exercise
Screen for retinopathy: ophthalmologic exam annually
Term
Type 2 Diabetes
Definition
-85% of children with Type 2 are obese
-Age of onset is middle to late puberty- around 13 years
-Minority populations have an especially high rate of type 2 diabetes
-Strong family history
Term
Type 2 Diabetes Assessment
Definition
Obesity: BMI greater than 30 (normal range is 15 to 17 in the pediatric population)
Waist to hip ratio: apple shape
Acanthosis nigricans: hyper-pigmentation and thickening of the skin into velvety irregular folds in the neck and flexural areas
Hypertension
+ family history of type 2 diabetes
Ethnicity
Term
Glucophage (Metformin)
Definition
Glucose-lowering agent: drugs that improve insulin sensitivity
**Used with diet and exercise to control blood sugar in patients with type 2 diabetes. May be used alone or with other medicines.
Term
Examples of Age-Related Skin Manifestations
Definition
Infants: “birthmarks”
Early childhood: atopic dermatitis
School-age children: ringworm
Adolescents: acne
Term
Impetigo
Definition
Common peds skin problem
Treated with topical antibiotic if localized to small area
Bacterial: strep or staph
Wash crust off with soap and water and apply topical antibiotic
May be treated with oral antibiotics
if it has spread (still wash lesions)
Very contagious!!!!!!!
Term
Fungal Skin Infections
Definition
Superficial infections that live on the skin
AKA dermatophytoses, tinea
Transmission from person to person or from infected animal to human
Examples: tinea capitis, tinea corporis, tinea pedis, candidiasis
Term
Contact Dermatitis
Definition
Inflammatory reaction of skin to chemical
Initial reaction in the exposed region
Characteristic sharp delineation between inflamed and normal skin
Primary irritant
Sensitizing agent
Examples: diaper dermatitis, reaction to wool, reaction to specific chemical
Term
Atopic Dermatitis
Definition
A type of pruritic eczema that begins during infancy
Hereditary tendency
Often associated with history of food allergies, allergic rhinitis, and asthma
Term
Diaper Dermatitis
Definition
Pathophysiology and clinical manifestations
Usually from irritation of urine and feces
Detergents inadequately rinsed from clothing
Chemical irritation (especially from diaper wipes)
Nursing considerations: alter wetness, pH, and fecal irritants
Differentiate from Candidiasis of diaper area (Candidiasis has characteristic excoriated red papules with satellite lesions
Term
Burns
Definition
Toddlers: hot water scalds
Older children: flame-related burns
Child abuse
Child with matches or lighters accounts for 1 in 10 house fires
Term
Lyme Disease
Definition
Lyme disease is caused by infection with a spiral-shaped bacterium called Borrelia burgdorferi.
Term
Symptoms of Lyme Disease
Definition
Between three days to several weeks after being bitten by an infected tick, 70-90% of people develop a circular or oval rash, called erythema migrans (or EM), at the site of the bite. To qualify as an EM, the rash must be at least two inches in diameter.
The EM rash does not itch or hurt so if it is not seen, it may not be noticed.
"bulls eye" appearance
Term
Complications of Lyme Disease
Definition
Lyme disease may cause headache, fever, muscle and joint aches, and a feeling of tiredness. If left untreated, Lyme disease may progress to affect the joints, nervous system, or heart several weeks to months after the tick bite
Term
What is Immune-mediated DM?
Definition
results from an autoimmune destruction of the beta cells. Typically starts in children or young adults who are slim, but it can arise in adults of any age.
Term
Type of onset for type I and type II diabetes?
Definition
Type 1 onset: abrupt
Type 2 onset: gradual
Term
Presenting symptoms of type I and type II diabetes?
Definition
Type 1: 3 common Ps: polyuria, polydipsia, polyphagia
Type 2: May be related to long term complications: kidney damage, blurred vision, etc
Term
Nutritional Status for type I and type II diabetes?
Definition
Type 1: underweight
Type 2: overweight
Term
Insulin (natural) for type I and type II diabetes?
Definition
Type 1: pancreatic content: usually known
Serum insulin: low to absent
Primary resistance: 80-85%
Type 2: pancreatic content: >50% normal
Serum insulin: high or low
Primary resistance: <5%
Term
Therapy - type I and type II diabetes?
Definition
Type 1: insulin therapy always effective, diet and oral agents ineffective
Type 2: Insulin used in 20-30% of patients, oral agents and diets are often effective
Term
Difference between onset of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Rapid (minutes)
Hyperglycemia: Gradual (days)
Term
Difference between mood of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Labile, irritable, nervous, weapy
Hyperglycemia: Lethargic
Term
Difference between Mental Status of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Difficulty concentrating, speaking, focusing, coordinating; nightmares
Hyperglycemia: Dulled sensorium, confusion
Term
Difference between inward feeling of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Shaky feeling, hunger, headache, dizziness
Hyperglycemia: Thirst, weakness, nausea & vomiting, abdominal pain
Term
Difference between skin of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Pallor, sweating
Hyperglycemia: Flushed, signs of dehydration
Term
Difference between Mucous membranes of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Normal
Hyperglycemia: Dry, crusty
Term
Difference between Respirations of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Shallow, normal
Hyperglycemia: Deep, rapid
Term
Difference between pulse of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Tachycardia, palpitations
Hyperglycemia: Less rapid, weak
Term
Neurologic differences between hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Tremors
Hyperglycemia: Diminished reflexes, paresthesia
Term
Difference between Ominous signs of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Late – hyperreflexia, dilated pupils, seizure, shock, coma
Hyperglycemia: Acidosis, coma
Term
Difference between Blood glucose of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Low <60 mg/dl
Hyperglycemia: High >= 250 mg/dl
Term
Difference between urine output of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Normal
Hyperglycemia: Polyuria (early) to oliguria (late)
Term
Visual Differences between urine output of hypoglycemia and hyperglycemia?
Definition
Hypoglycemia: Diplopia
Hyperglycemia: Blurred vision
Term
What causes impetigo?
Definition
Staphylococcus
Term
What is the nursing management for lyme disease?
Definition
The major thrust of nursing care should be educating parents to protect their children from exposure to ticks. Children should avoid tick-infested areas or wear light-colored clothing so that ticks can be spotte easily, tuck pant legs into socks, and wear a long-sleeved shirt tucked into pants when in wooded areas. Products with DEET should be applied sparingly
Term
What are the three nursing interventions at altering in regards to diaper dermatitis?
Definition
Nursing interventions are aimed at altering the three factors that produce dermatitis: wetness, pH, and fecal irritants.
Term
What is Sickle Cell?
Definition
Sickle cell anemia is a genetic disease that affects hemoglobin. Under low oxygen conditions the hemoglobin sticks together causing long fibers that make the red blood cells change to a sickle shape. This causes them to get stuck in blood vessels causing parts of the body to not receive the oxygen they need.
Term
Problems of Sickle Cell
Definition
The red blood cells change shape causing the bone marrow to try to make more cells to make up for the loss, but it cannot keep up which causes anemia. The shape causes the cells to clump and cut off block flow in the vessels. As a result children’s growth is delayed, they are fatigued, and they have extreme pain.
Term
What causes pain in patients with SCA?
Definition
Because of the blockage the tissues are not getting enough oxygen. They must switch to anaerobic respiration. The fatigue is because anaerobic respiration does not produce as much energy as the cells normally would. The pain is because of the lactic acid that is a byproduct of anaerobic respiration. This pain is made worse because the reduced circulation means that the lactic acid remains in the tissues.
Term
SCA: Vasocclusive Crisis
Definition
Characterized by ischemia that causes mild to severe pain that can last from minutes to days
Term
SCA: Sequestration crisis
Definition
The pooling of a large amount of blood usually in the spleen and infrequently in the liver that causes a decreased blood volume and ultimately shock.
Term
Aplastic Crisis
Definition
Diminished RBC production usually caused by viral infection that may result in profound anemia
Term
SCA: Hyperhemolytic crisis
Definition
An accelerated rate of RBC destruction characterized by anemia, jaundic, and reticulocytosis
Term
SCA: Acute chest syndrome
Definition
Clinically similar to pneumonia. It is presence of new pulmonary infiltrate and may be associated with chest pain, fever, cough, tachycardia, wheezing, and hypoxia
Term
Thalassemia
Definition
Common genetic disorder where there is a deficiency in the rate of production of specific globin chains in hemoglobin. When it disintegrates it damages RBCs causing severe anemia.
Term
B-Thalassemia: Goals of treatment and nursing care
Definition
Goals: Provide therapy to maintina Hgb high enough to have enough RBCs to support normal normal growth and development. Do this by giving frequent blood transfusions.
Nursing care: Promote compliance with transfusion treatment, assist the child with their anxiety, help the parents adjust, and monitor for transfusion reactions.
Term
Aplastic anemia
Definition
Type of bone marrow failure where the formation of formed elements of the blood (leukocytes, thrombocytes, and Hgb) are all depressed. It can be primary (congenital, autosomal recessive) or secondary (acquired). Goal of therapy is to restore function of the bone marrow.
Term
Goal of therapeutic treatment of hemophilia
Definition
Replace missing clot factor.
Term
2 most common misconceptions about pathophysiology of leukemia
Definition
-In the acute form of leukemia, the leukocyte count is low, even though leukemia is an overproduction of WBCs
-There is a misconception that the immature cells deliberately attack and destroy the normal blood cells or vascular tissue, but in fact cellular destruction happens by infiltration and subsequent competition for metabolic elements
Term
Nursing care of child with leukemia
Definition
Therapeutic regime itself causes a lot of unpleasant and dangerous symptoms for the child. These symptoms must be managed to make the child more comfortable and as safe as possible.
Term
Absolute Neutrophil Count
Definition
-The number of neutrophil granulocytes present in the blood.
-To calculate the total percent of neutrophils you multiply the WBC count by the percent of neutrophils.
Term
Most common pediatric cancer
Definition
Leukemia (about 1/3 of cases of cancer in children)
Term
Which cancer has the best and worst prognosis?
Definition
-AML has the worst prognosis
-Hodgkin Lymphoma has the best prognosis
Term
Iron Deficiency Anemia
Definition
-Inadequate supply of dietary iron
-Children 12-36 months at greatest risk
Term
Sickle Cell Anemia Etiology
Definition
-Inherit the HgbS gene from each parent
-If only one gene for Hgbs then have sickle cell trait
-Normal adult hemoglobin partially or completely replaced by hemoglobin S
Term
Sickle Cell Anemia
Definition
Hereditary, chronic, hemolytic disorder. It predominately affects African-Americans but also people of Mediteranean decent. Under certain conditions, RBCs will assume a crescent or sickle shape
Term
Signs and symptoms of a patient with sickle cell anemia (not in crisis)
Definition
-Growth retardation
-Chronic anemia
-Delayed sexual maturation
-Marked susceptability to infection and sepsis
Term
Signs and symptoms of sickle cell anemia (in crisis)
Definition
-Severe pain
-Muscle spasms
-Hot, swollen joints, fever
-Hematuria
-Paralysis, seizure, coma
-Severe abdominal pain and distension
-Later jaundice d/u hemolysis
-Crisis may be fatal r/t cerebral infracting & cardiac complications
Term
Vasoocclusive crisis
Definition
Enmeshing of sickling cells block microcirculation intermittenly
-Hypoxia results then tissue edema then ischemia and possible tissue death
--Extremities-swollen
--Cerebrum stroke
Term
Acute Chest Syndrome
Definition
-High mortality rate
-Cause usually result of lung tissue damage from vasoocclusion
-Infiltrates develop appears as Respiratory Distress
-Poor oxygenation to tissues-cell death results
Term
Diagnosing and treatment of sickle cell disease
Definition
-Most states mandatory newborn screening
-Sickledex-screening test
-Electrophoresis
Treatment:
-Aimed at preventing sickling
-Short term O2 therapy
-Analgesics
-Bedrest
-Bone marrow transplant
-Hydration
Term
Nursing care for sickle cell
Definition
Educate parents about disease
-Don't fly in under-pressurized planes
-Don't exercise in high altitudes
-May use PCN G prophylactically
Term
Thalassemia and treatment
Definition
Problem with production of Hemoglobin in RBC. Do not have enough hemoglobin or RBCs to transport O2 throughout the body.
-Frequent blood transfusions
-Hemosiderosis can result: defective RBCs stored in various organs
Term
Hemosiderosis
Definition
Form of iron overload disorder. It is an accumulation of iron in the liver and/or heart but also endocrine organs, in patients who receive frequent blood transfusions (such as those with Thalassemia, Sickle cell disease, anemia, or myedysplastic syndrome)
Term
ITP (Idiopathic thrombocytopenic purpura)
Definition
-Idiopathic: cause is unknown; Thrombocytopenic: blood does not have enough platelets; Purpura: excessive bleeding/bruising
Term
Relationship between ITP and immune system
Definition
-Antibodies destroy platelets
-Antibodies see platelets as bacteria and work to eliminate them
-ITP is preceded by a viral illness (URI, varicella, smallpox/measles vaccine, mononucleosis, flu)
Term
Types of hemophilia
Definition
Hemophilia A: classic
Hemophilia B: Christmas disease
Von Willabrands Disease
Term
S&S of hemophilia
Definition
-Spontaneous bleeding
-Bleeding into joints and associated pain adn swelling
-Gastrointestinal tract and urinary tract hemorrhage
-Blood in the urine or stool
-Prolonged bleeding from cuts, tooth extraction and surgery
Term
Interventions for Hemophilia
Definition
-Replace the factor as ordered by physician
-Manage pain utilizing analgesics as ordered: no salicylate products.
-Maintaining joint intergrity during acute phase: immobilization, elevation, ice.
-Physical therapy to prevent flexion contraction and to strengthen muscles and joints
-Provides opportunities for normal growth and development
Term
2 clinical consequences of congenital heart defects in pediatrics
Definition
1. Heart failure: inability for the heart to pump an adequate amount of blood to the systemic circulation
2. Hypoxemia: Referes to an arterial oxygen tension that is less than normal and can be identified by a decreased arterial saturation or a decreased PaO2
Term
What are some factors of acquired cardiac disorders in pediatrics?
Definition
-Infection
-Auto-immune responses
-Environmental factors
-Famial tendencies
Term
Which heart defect has the worst prognosis?
Definition
Hypoplastic left heart syndrome--some centers reporting mortality rates of about 10%, but a lot mulitcenter series reports a mortality rate of about 30%
Term
Those with chronic hypoxemia develop what two physiologic changes?
Definition
1. Polycethemia: an increased number of RBCs, increased the oxygen carrying capacity of the blood. It increases of the blood and crowds out clotting factors.
2. Clubbing: a thickening and flattening of the tips of the fingers and toes
Term
What is "Blue spell" or "tet spell"
Definition
Hypercyanotic spells, and they may occur in any child whose heart defect includes obstruction to pulmonary blood flow and communication between the ventricles. The infant becomes acutely cyanotic and hyperpneic because sudden infundibular spasm decreases pulmonary blood flow and increases right-to-left shunting.
Term
2 types of cardiovascular dysfunction in children
Definition
-Congenital: monitor for heart failure, hypoxemia
-Acquired: Occurs after birth, seen in normal heart or abnormal heart
Term
Classification of heart defects
Definition
1. Acyanotic:
-Raised pulmonary blood flow (Atrial septal defect, ventricular septal defect, patent ductus arteriosus, atrioventricular canal)
-Obstruction to blood flow from ventricles (Coarctation of aorta, Aorta stenosis, pulmonic stenosis)
2. Cyanotic
-Lowered pulmonary blood flow (Tetralogy of fallot, tricuspid atresia)
-Mixed blood flow (Transposition of great arteries, total anomalous pulmonary venous return, truncus arteriosus, hypoplastic left heart syndrome)
Term
Symptoms of cardiac dysfunction in child/infant
Definition
-Heart murmur
-tires while eating
-FTT, low weight for height
-Sweats while eating (diaphoretic)
-Cyanosis, worsens with feeding or activity level, pallor
-Irritable weak cry
-Clubbing
-Difference in peripheral pulses
Additional symptoms in the older child:
-Chest pain
-Decreased activity level
-Syncope
-Abnormal growth chart pattern
Term
Vital signs in the child with cardiac dysfunction
Definition
-HR: tachycardia in the absence of fever, crying, or stress
-Tachypnea, even with rest, chest retractions indicate respiratory distress, possibly resulting from congestive heart failure
Term
Left to right shunt
Definition
-Pressures on the left side of the heart are normally higher than pressures in the right side of the heart
-If there is an abnormal opening in the septum between the right and left sides, blood flows from left to right
Term
Clinical manisfestations of left to right shunt
Definition
-The infant is not cyanotic
-Tachycardia due to pushing increased blood volume
-Cardiomegaly due to increased workload of the heart
-Dyspnea and pulmonary edema due to the lungs receiving blood under high pressure from the right ventricle
-Increased number of respiratory infections due to blood pooling in the lungs promoting bacterial growth
Term
Right to left shunts
Definition
-Occurs when pressure in the right side of the heart is greater than the left side of the heart (resistance of the lungs is abnormally high; pulmonary artery is restricted)
-Deoxygenated blood from the right side shunts to the left side
-Hole in septum + obstructive lesion = deoxygenated blood from the right side of the heart shunts to the left side of the heart and out into the body
Term
Clinical manisfestations right to left shunts
Definition
-Hypoxemia: the result of decreased tissue oxygenation
-Polycythemia: increased RBC production due to the body's attempt to compensate for the hypoxemia
-Increase viscosity of the blood = heart has to pump harder
-Potential complications include thrombus formation due to sluggish circulation, or brain abscess or stroke due to un-oxygenated blood bypassing the filtering system of the lungs
Term
Examples of diagnosis r/t shunts
Definition
-Left to right shunts: Atrial septal defect, ventricular septal defect
-Right to left shunts: Pulmonary stenosis; tetralogy of fallot
Term
Heart failure
Definition
-Major manifestation of cardiac disease
-Under 1 yr of age due to congenital anomaly
-Over 1 yr with no congenital anomaly may be due to acquired heart disease
Term
Clinical manifestations of Heart Failure
Definition
-Systemic venous congestion: weight gain, hepatomegaly, edema, jugular vein distension
-Pulmonary venous congestion: tachypnea, dyspnea, cough, wheezes
-Compensatory response: tachycardia, cardiomegaly, diaphoretic, fatigue, failure to grow
Term
Nursing interventions for Heart failure
Definition
-Fluid restriction
-Diuretics: Lasix (potassium wasting) or Aldactone (potassium sparing)
-Bed rest
-Oxygen
-Small frequent feedings: soft nipple with supplemental NG for adequate calorie intake
-Pulse oximeter
-Sedatives if needed
Term
Digoxin therapy
Definition
-Digoxin increases the force of the myocardial contraction
-Take an apical pulse before every dose of digoxin. If bradycardia is detected. General rule is: <90-110 beats/min for infant and toddler; <70 beats in the older child (toddler-adolescent); <60 beats in the adolescent
-Call physician before administering the drug
Term
Signs of Digoxin Toxicity
Definition
-Bradycardia/Dysrythmia
-Arrhythmia
-Nausea, vomiting, anorexia
-Dizziness, headache
-Weakness and fatigue
Term
Ventricular septal defect
Definition
-Opening in the ventricular septum
-Left-to-right shunt
-Right ventricular hypertrophy
-Deficient systemic blood flow
Term
Coarctation of Aorta
Definition
-Congenital narrowing of the descending aorta
-80% have aortic-valve anomalies
-Difference in BP in arms and legs (severe obstruction)
Term
Pulmonary stenosis
Definition
-Obstruction of blood flow from right ventricle
-Hypertrophy of right ventricle
-If severe cyanosis due to right-to-left shunt
Term
Tetralogy of Fallot
Definition
-Most common cardiac malformation responsible for child over 1 year
-4 Components
1. VSD
2. Pulmonary stenosis: narrowing of pulmonary valve
3. Overriding of the aorta: aortic valve is enlarged and appears to arise from both the left and right ventricles instead of the left ventricle
4. Hypertrophy of right ventricle: thickening of the muscular walls because of the right ventricle pumping at high pressure
Term
Clinical manisfestations of tetralogy of fallot
Definition
-Dependent on degree of right ventricular outflow obstruction
-Right-to-left shunt
-Clubbing of digits
-"Tet" spells: treated by flexing knees forward and upward
-Severe irritability due to low oxygen levels
Term
Kawasaki Disease
Definition
-Unknown origin; inflammation of vascular system
Symptoms:
-High fever
-Conjunctivitis: no drainage
-Strawberry tongue
-Edema of hands and feet
-Reddening of hands and feet
-Reddening of palms and soles
-Lymph node swelling
Term
Interventions for Kawasaki diseas
Definition
-Intravenous gamma globulin
-High dose of ASA while in hospital
-Low dose of ASA upon discharge
-Base-line echocardiogram to assess coronary artery status
Term
Rheumatic fever
Definition
-Poorly understood inflammatory disease
-Most often late school age children and adolescents
-Involves joints, skin adn heart (specifically mitral valve)
-If we can treat strep throat, we can treat
Term
Leggs Calve Perthes
Definition
-Self-limiting disorder where there is aseptic necrosis of the femoral head. Cause is unknown.
-Children 2-12 years, but most common in boys between 4-8 years. Most affected kids have a skeletal age below their chronological age.
-Has an insidious onset. May have limp on affected side or hip soreness, ache, or stiffness
-4 radiographic stages
Term
Hip spica cast
Definition
-Cast that immobilizes the hip
-Complete evaporation of water froma hip spica cast made with older type plaster materials can take 24-48 hours while fiberglass dries in minutes.
Term
Interventions for hip spica cast
Definition
-Turn the child at least every 2 hours to help cast dry evenly
-Body part should be elevated to prevent compartment syndrome
-Sensation and movement should be checked below the cast
-The prone position should be used for self-feeding from a small table placed next to dining room table
Term
What is causing a marked increase in skeletal injury in school age and adolescent children?
Definition
-Increased amount of training done by young athletes leads to overuse injuries. Overuse injuries account for nearly half of all injuries evaluated in pediatric sports medicine.
Term
Major differences in pediatric MSK system
Definition
-Children's bones are less dense, more porous and pliable (bones break easier, and will bow and cause torus or buckle fractures)
-Childrens bones grow from an epiphyseal plate (damaging growth plate can affect growth)
-Ligaments and tendons are stronger than bones until puberty (broken bones more common than sprains)
-Fractures heal much quicker in children than adults
-Normal bone remodeling process can correct malalignment making near anatomic reductions less important in children than adults
Term
Treatment for developmental dysplasia of the hip in infants to 6 months
Definition
The hip joint is maintained by dynamic splinting in a safe position with the proximal femur centered on the acetabulum in an attitude of flexium. Pavlik harness is most widely used. It is worn continuously and works the hip into a more abducted, reduced position. If it difficult to maintain stable reduction then a hip spica cast is applied.
Term
What is the treatment for developmental dysplasia of the hip in infants greater than 6 months to 18 months
Definition
Dislocation is usually not recognized until child stands and walks. A surgical closed reduction is performed and the child is placed in a spica cast for 12 weeks.
Term
Club foot
Definition
Common birth defect, occurs in males twice as much as females. Can involve one foot or both. Affected foot looks as though it has been turned inward at the ankles.
Term
Hematogenous osteomyelitis
Definition
When a bloodborne bacterium causes an infection in the bone. Most often occurs due to infected lesions, upper respiratory tract infections, otitis media, tonsilitis, abscessed teeth, pyelonephritis, and infected burns.
Term
Cerebral palsy
Definition
Group of permanent disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.
Term
Most common type of cerebral palsy
Definition
"Spastic CP": represents an upper motor neuron muscular weakness. Characteristic physical signs are increased stretch reflexes, decreased muscle tone, and weakness.
Term
Cerebral palsy is defined as being non-progressive. What does this mean?
Definition
A chronic, nonprogressive disease is considered a static condition. The neurological disturbances occurred in the developing fetus and are not acquired otherwise. CP itself can be considered non-degenerative.
Term
What is the prognosis for children having cerebral palsy?
Definition
Depends on type and severity of the condition.
-Children with mild-moderate involvement (85%) have the capability of achieving ambulation between the ages of 2 and 7 years.
-30-50% of children with CP have significant cognitive impairments, and an even higher percentage have mild cognitive impairments, and an even higher percentage have mild cognitive and learning deficits.
Term
When a clinician states that the child has spina bifida, what are they referring to?
Definition
Spina bifida myelomeningocele
Term
Difference between meningocele and myelomeningocele spina bifida?
Definition
Spina bifida meningocele is a visible defect defect involving the failure of the osseous spine to close due to an external saclike protrusion that encases the meneges and spinal fluid but no neural elements. Spina bifida myelomeningocele has the same definition except the saclike protrusion contains the meninges, spinal fluid, and nerves.
Term
Arnold Chiari Malformation
Definition
It is a consolation of neurologic findings, the most important of which is herniation of the hindbrain down into the cervical portion of the neck. This interferes with cerebrospinal fluid circulation and is the principle driver in the cause for hydrocephalus.
Term
Ventroperitoneal shunt
Definition
If hydrocephalus is causing the baby to be symptomatic, a neurosurgeon will put a shunt in through the skull into the ventrical of the brain to decompress the fluid in the brain caused by hydrocephalus. The shunt will then be threaded under the skin, over the chest and down to the abdomen.
Term
Nursing care of the unconcious child
Definition
Respiratory
-Adequate airway always priority
-CO2 potent vasodilating effect
-Positioning to prevent aspiration
-Frequent suctioning
Nutrition and hydration
-Ensure not to overhydrate
Medications
-Cause of unconsciousness depends on drugs: seizure-anti epileptics; cerebral edema-osmotic diuretics
Thermoregulation
-Medically induced hypothermia decreases metabolic demands
Term
3 major causes of brain damage in children
Definition
-Falls
-Motor vehicle accidents
-Bicycle injuries
Term
Bacterial meningitis
Definition
-Lumbar puncture to diagnose
-Pain managment especially in first 24 hours, Tylenol with codeine often given
-Safety measures I.e. seizure precautions
-Very specific and focused Neurological assessments to including vital signs
-Fluid and nourishment determined by child's status
Term
Seizures
Definition
-Most common and treatable disorder in children and can occur with a wide variety of conditions involving the CNS
-Epilepsy: a condition with two or more unprovoked seizures
-Seizures: symptom of underlying disease, head trauma, meningitis, hypoxia
Term
Diagnosing and treatment of seizures
Definition
-EEG: most useful diagnostic tool
-Drug therapy: raise the threshold for neuronal excitability
-Other treatments: Diet changes, nerve stimulation, surgery
Term
Febrile seizures
Definition
-Cause uncertain
-Most often seen in children 12-30 months
-Occur during temperature rise
-Usually do not last long
-Usually no antiepileptic medication but rather antipyretic therapy
Term
Hydrocephalus
Definition
-Imbalance of production and absorption of CSF in the ventricular system
-Dandy-Walker and Arnold-Chiari malformations: complex disorders that have difference causes and mechanisms and begin at different times in the embryonic period.
Term
Dandy-walker syndrome
Definition
Congenital brain malformation involving the cerebellum
Term
Nursing care management of ventralperitoneal shunt
Definition
-Monitoring for increased intracranial pressure
-Positioned on unoperative side of shunt
-Often kept flat to avoid too rapid reduction of intracranial fluid
-Observe for abdominal distension
-Accurate I&O
-Teaching
Term
What are Piaget's developmental theories about?
Definition
Cognitive
Term
What are the 4 parts of Piaget's theory?
Definition
-Sensorimotor
-Preoperational thought
-Concrete Operational
-Formal Operations
Term
Sensorimotor
Definition
-Ages birth-24 months
-Experiences world through senses and interactions
-Lacks object permeance
-Stranger anxiety
Term
Object permanence
Definition
The object exists even when it is no longer visible
Term
Stranger anxiety
Definition
When a child is exposed to an individual who is unfamiliar to them
Term
Preoperational thought
Definition
-24 months- age 7
-First use of representational thoughts and symbols
-Ability to pretend
-Lacks logical reasoning
-egocentrism
-transductive
Term
Egocentrism
Definition
The inability to put oneself in place of another
Term
Transductive
Definition
"All women with big bellies have babies"(reasoning from specific cases to general)
Term
Concrete Operational
Definition
-Age 7-11
-Increased logic (reasoning and thinking)
Ex/ Reasoning- the girl shares her doll with her friend since she has 2 dolls and her friend has none
Ex/ Thinking - the apple is still an apple even when it is cut in half
Term
Formal operations
Definition
age 11- young adult (adulthood)
-ex/ Thinking - if all dogs back, then the adolescent can deduce that his dog will bark too
-Ex/ Problem solving - If Adam had more money than Ben, and Ben had more money than Cara, then the adolescent would conclude that Adam has more money than Cara
Term
What are Freud's development theories about?
Definition
Psychosexual
Term
What are the 5 parts of Freud's theory?
Definition
-Oral
-Anal
-Phalic
-Latency
-Genital
Term
Oral (Freud)
Definition
-Birth to 1 year
-A child's primary source of pleasure is through the mouth: Sucking, biting, chewing, vocalizing
Term
Anal (Freud)
Definition
- ages 1-3 years
-Children gain a sense of mastery and competence by controlling bladder and bowel movements
-Climate of potty-training can have lasting effects on children's personality
Term
Phalic (Freud)
Definition
-Ages 3-6 years
-The libido's energy is focused on the genitals. Children begin to identify with their same-sex parent.
-Genitals, Exploration, opposite sex parent, curious of dissimilarities in opposite sex
Term
Latency (Freud)
Definition
-Age 6-12 years
The libido's energy is suppressed and children are focused on other activities such as school, friends and hobbies
-More interest in same sex parent
-Same gender play "boys have cooties"
-Ex/ child begins to elaborate on previously acquired traits and skills
-Ex/ The child focuses his/her energy into acquiring more knowledge
Term
Genital (Freud)
Definition
-Age 12-18 years
-Children begin to explore romantic relationships.
-Sexual interest
-Genitals are major source of sexual tensions and pleasures
-Energy towards friendships and preparing for marriage
Term
What are Erikson's developmental theories about?
Definition
Psychosocial
Term
What are the 8 parts of Erikson's theory?
Definition
-Trust vs Mistrust
-Autonomy vs Shame, Self doubt
-Initiative vs guilt
-Industry vs inferiority
-Identity vs role confusion
-Intimacy vs isolation
-Generativity vs stagnation
-Ego integrity vs despair
Term
Trust vs Mistrust
Definition
-Birth - 1 year
-Children learn to either trust or mistrust their caregivers.
-Faith in the environment vs suspicion, fear of future
-GOAL: Faith and optimism
Term
Autonomy vs Shame, Self-Doubt
Definition
-Age 1-3 years
-Children develop self-sufficiency by controlling activities such as eating, toilet training and talking.
-Independence driven, realize can control self, environment, body; encouragement of decision-making whether good or bad vs shame and doubt when made to feel inadequate or self-conscious
GOAL: Self control and will power
Term
Initiative vs Guilt
Definition
-Ages 3-6 years
-Children begin to take more control over their environment.
-Strong imagination, exploration; encourage self-established activities while teaching limitations
GOAL: Direction and purpose
Term
Industry vs Inferiority
Definition
-Age 6- 12 years
Children develop a sense of competence by mastering new skills.
-Ability to carry out tasks to completion, learn to compete and cooperate, learn rules, need real achievements
GOAL: Competence
Term
Identity vs Role confusion
Definition
-Age 12-18 years
-Children develop a personal identify and sense of self.
-Changes in body instigate mistrust in their bodies, overly concerned of how others see them, struggle to fit in
GOAL: Devotion to values and fidelity to others
Term
Intimacy vs Isolation
Definition
Young adults seek out romantic love and companionship.
Term
Generality vs Stagnation
Definition
Middle-aged adults nurture others and contribute to society.
Term
Ego integrity vs Despair
Definition
Older adults reflect on their lives, looking back with a sense of fulfillment or bitterness.
Term
What are Kohlberg's developmental theories about?
Definition
Moral
Term
What are the 3 parts of Kohlberg's theory?
Definition
-Preconventional level
-Conventional
-Post Conventional
Term
Preconventional level (Kohlberg)
Definition
-Ages 1-6 years
-Punishment and obedience
-At first bad behavior is determined by it's consequences.
-Later, children figure out that good behavior consists of which satisfied their own needs
Term
Conventional level (Kohlberg)
Definition
Ages 6-12 years
1st Moral = praise from teachers, peers, parents, etc
2nd Moral = conforming to rules and norms of society
-Obeys authority figures

Ex/ Child listens to parent when parents says to go to bed
Ex/ Child raises his/her hand to speak in class
Term
Post Conventional level (Kohlberg)
Definition
Ages 12-18
Individual judges own moral standards
-Justice and human rights with respect for the dignity of persons as individuals
-Emphasis on changing law in terms of societal needs and rational considerations
Term
Sequence for assessing an infant?
Definition
Check least traumatic to most traumatic last
Term
Appropriate techniques for assessing a preschooler?
Definition
-Make yourself "small" to interact on their eye level
-Keep a safe distance from the child to allow them to evaluate them
-Approach should be slow and smooth
-Allow the child to assess the equipment prior to being examined
Term
Difference between an adult and preschool assessment?
Definition
-Communicate with both parent and patient
-Assessment can be done on parent's lap rather than on table
-Allow the child to be fully clothed to protect modesty
-Perform exam distally (Hands, then arms etc.)
-Pull ear up and back when checking ears of children ages 3 and up.
Term
What communication techniques should be used for a school age assessment?
Definition
Explain the purpose of the equipment and the significance of the procedure. Teach about body function and care.
Term
Examinations techniques for an infant?
Definition
-Examine with the infant in the parent's lap before ages 4-6 months, after able to sit alone, try to have patient in parents lap whenever possible.
-Completely underdress if the room temperature permits. Leave diaper on male infant. Gain cooperation with distraction, bright objects, rattles, talking.
-Proceed in usual head-to-toe direction. Perform traumatic procedures last (eyes, ears, mouth).
Term
Examinations techniques for a toddler?
Definition
-Sitting or standing on or by parent. Prone or supine in parent’s lap.
-Have parent remove outer clothing. Remove underwear as body part is examined. Allow to inspect equipment- demonstrating use of equipment is usually ineffective.
-Inspect body area through “count fingers”, “tickle toes”. Use minimum physical contact initially. Introduce equipment slowly.
Term
Examinations techniques for a preschooler?
Definition
-Prefer standing or sitting. usually cooperative prone or supine. Prefer parent’s closeness.
-Request self-undressing. Allow to wear underpants if shy. Offer equipment for inspection, briefly demonstrate use. Make up story about procedure (“im doing to see how strong your muscles are, [blood pressure]). Give choices whenever possible.
-If cooperative, proceed in head-to-toe direction. If uncooperative, proceed as with toddler.
Term
Examinations techniques for a school age child?
Definition
-Prefer sitting.
Cooperative in most positions. Younger child prefers parent’s presence. Older child may prefer privacy.
-Respect need for privacy. request self-undressing. Allow to wear underpants. Give gown to wear. Explain purpose of equipment and significance of procedure, such as otoscope to see eardrum. Teach about body function and care.
-Proceed in head-to-toe direction. May examine genitalia last in older child.
Term
Examinations techniques for an adolescent?
Definition
-Same as for school-age child. Offer option of parent’s presence
-Allow to undress in private. Give gown. Expose only to area to be examined. Respect need for privacy. Explain findings during examination. Matter of factly comment about sexual development. Emphasize normalcy of development.
-Same as older school-age child. May examine genitalia last.
Term
Verbal vs Non-Verbal techniques
Definition
Non-Verbal = a patient writing in a journal, a sony play station is brought into a 12 yr olds room, an 8 yr old draws a picture of himself in the hospital
Verbal = "sometimes when kids come into the hospital, they get very sad. does that ever happen to you?", "I want you to feel better so you can play outside today, but I am worried that without taking the medicine you won't be able to"
Term
10 benefits of Comfort Positioning:
Definition
1.Requires fewer staff to be present
2.Helps prevent sharp incidents
3.Allows effective access to virtually all body parts
4.Can be adapted to suit the child and the procedure
5.Reduce emotional stress of the patient and the family by promoting physical contact with the caregiver
6.Provide the caregiver with an active role in supporting their child in a positive way
7.Facilitate a child’s feeling of control and ability to cooperate
8.Creates an environment for the staff to have a better frame of mind for accuracy
9.Establish a quicker recovery rate for the patient following the procedure
10.Allows for procedures to be done in an easier manner
Term
Goal of the nurses on the pain management unit at the Children's Hospital in LA?
Definition
To improve patient care while understanding and managing children's pain
Term
Goal of pain management?
Definition
To provide relief with minimal side effects
Term
Difference between pain in pediatric and adult populations?
Definition
Children experience more pain than adults
Term
Subjective and objective data used to establish pain in infants?
Definition
a. Subjective: Information from parent
b. Objective: Increased heart rate, increased respiratory rate, Furrowed eyebrow, Pulling eyebrows in, Crying, Inconsolable
Term
Biggest change in pain management?
Definition
Alternate therapies are used for pediatric patients
Term
Alternate therapies for pediatric patients?
Definition
Very few children receive a needle today now use patches and give drugs orally and through IV. These alternatives reduce medications and increase comfort.
Term
3 examples of alternative distraction therapies for pediatric patients?
Definition
1. Distraction - Bringing in a dog
2. Massage
3. Acupuncture
Term
2 most concerning memories pediatric patients remember from their hospitalization?
Definition
1. Pain
2. Abandonment
Term
How to address the concerning memories of pediatric patients as a nurse?
Definition
Goal is to eliminate them. Keep the parents close to the child as much as possible.
Term
Most reliable tool for measuring small doses?
Definition
Plastic disposable syringe/ tuberculin syringe
Term
4 ways to encourage a pediatric patient to take their oral medication?
Definition
a.Give the child a flavored ice pop or small ice cube to suck to numb the tongue before giving the drug
b.Mix the drug with a small amount (~1 tsp) of sweet-tasting substance, such as honey (except in infants), flavored syrups, jam, fruit purees sherbert, ice cream.
c.Give a “chaser” of water, juice, soft drink, or ice pop after the drug
d.When the medication has an unpleasant taste, have the child pinch the nose and drink the medicine through a straw.
IM injections
Term
3 sites for giving an IM injection to a pediatric patient?
Definition
a. Vastus Lateralis
b. Ventrogluteal
c. Deltoid
Term
1 gram of wet diaper equals how much urine?
Definition
1 mL of urine
Term
IV's should be placed where it allows the children the least amount of _____?
Definition
Restriction
Term
Foot veins should only be used for children who are not _______?
Definition
Learning to walk
Term
Scalp veins should only be used in children younger than _____ and only when other sites have been exhausted.
Definition
9 months
Term
What is an Intraosseous infusion?
Definition
Provides a rapid, safe, and lifesaving alternate route for administration of fluids and medications until intravascular access can be attained, especially in children who are 6 years of age and younger.
Term
What is LMX and EMLA Cream? When are they used?
Definition
1. Numbing Cream - LMX is faster acting (30 min vs 1 hour for EMLA), Darker skin will take longer for it to work.
2. Used for IVs, PICC lines, LPs
Term
3 distraction techniques for a pediatric patient?
Definition
Toys, books, Ipad, smart phone
Term
What is a wheeze?
Definition
Adventitious breath sound
Term
5 Signs of increased work of breathing?
Definition
1. Accessory muscle use
2. Nostril flaring
3. Grunting
4. Skin color
5. O2 Sat
Term
How does albuterol work?
Definition
Bronchodilator
Term
One very common side effect of Albuterol?
Definition
Tachycardia
Term
3 symptoms of dehydration for an infant?
Definition
Sunken fontanels (or flat), dry mucus membranes, higher pulse/lower BP
Term
Why are infants more at risk for dehydration?
Definition
Kidneys are under-developed, increased surface area, higher % of body is water
Term
What education can you teach to a parent of a school-age child about MRSA and strep throat?
Definition
They are contagious. Keep small kids away. Have another family member stay with the other kids at home.
Term
Immunization for a toddler:
Location? Needle insertion angle? Size of needle? Explanation offered to child?
Definition
Vastus lateralis, 90 degrees, 25GX5/8, "You might feel a small pinch but we need to give you this so you won't get the flu"
Term
What is TIV?
Definition
Inactivated vaccine
Term
Documentation of an injection?
Definition
Type of vaccine
Date given
Site
Funding source
Vaccine lot #
Date on vaccine
Initials
Term
Developmental Stages: Birth to 6 months
Definition
-Nonverbal communication is key
a. Facial expressions
b. Tone of voice

- Appropriate toys:
a. Toys with noise like rattles, squeaky toys
b. Musical toys like mobiles
c. Toys with texture they can touch
Term
Developmental Stages: 6 to 18 months
Definition
-Stranger anxiety
-Try to keep child with a caregiver
-Communication is mostly nonverbal but speak to the child anyway
-Use stimulating objects to catch attention for distraction or assessment
-Use head to toe approach

Appropriate toys:
a. Musical and noisy toys
b. Push pull toys
c. Stacking blocks
d. Books with rhymes
Term
Developmental Stages: 18 months to 3 years
Definition
-More explorative but still shelter with parents
-Will understand more words than can say
-Constantly moving
-Play and curiousity are big motivators
-Use your tools and toys
- Toe to head approach
- Toilet training often includes lessons about modesty and improper touching. Respect these lessons; uncover child selectively for exam.

Appropriate toys:
a. wagons/tricycles
b. large crayons
c. stuffed animals/dolls
d. finger paints
Term
Developmental Stages: 3 years to 6 years
Definition
- the "Disney" syndrome (Mrs. Shanley's term)
-Learning to explore and be independent, very curious!
-Can be talkative and enthusiastic
-Like to have choices
-Have "magical thinking" - play pretend

Appropriate toys:
a. kitchen sets
b. domestic items like phone, clock
c. small trucks, cars
d. building toys
e. felt markers
f. story books
g. paint and brushes
Term
Developmental Stages: 6 years to 12 years
Definition
-Fear failure, inferiority
- want to be treated like a "big kid"
-body conscious and modest
-may feel pain intensely
-feel comfort with touching
- dont you babyish terms
-use common interests to build trust
-offer limited choices
-dont tell them not to cry
-"I have to pee" years,

Appropriate toys:
a. love a challenge and skill - board games, video games, puzzles
b. bigger bikes, roller skates, scooters
c. costumes, doll houses, fashion
Term
Developmental Stages: 12 years and up
Definition
-Indentity and peer relationships are the key issues at this age
-Body image and future deformities and dysfunctions are very important
-Can be very dramatic
-Regressive behavior is common
-Respect modesty and privacy
-Direct yourself to the child as you would an adult
-Make eye contact
-Dont lie

Appropriate toys:
a. advanced board & card games, video games, DVDs
b. water gun
Term
What parents like and want:
Definition
-Treat children as people
-Keep children as physically and emotionally comfortable as possible
-Treat every child as if they are the most special, beautiful, smartest child in the world
-A compliment to the child is a compliment to their parents
Term
Non Verbal Communications
Definition
-What your face and body say are every bit as important as what your mouth says
-Make eye contact but dont hold it in a challenging manner
-Use eyebrows to exaggerate your expressions, especially for babies through elementary-age kids
-"High five" and tickling
Term
What is health promotion?
Definition
The process of enabling people to increase cover over, and to improve, their health. To reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment
Term
Primary Prevention
Definition
Activities that decrease the opportunity for illness and injury
EX/ immunizations, teaching about car safety seats
Term
Secondary Prevention
Definition
Early diagnosis and treatment of a condition to lessen severity
EX/ Developmental screening, vision and hearing
Term
Tertiary Prevention
Definition
Restoration to optimum function
Term
"Bright futures"
Definition
A national health promotion initiative dedicated to the principle that every child deserves to be healthy and that optimal health involves a trusting relationship between the health professional, the child, the family, and the community as partners in health practice
Term
Which diseases have been eradicated due to immunizations?
Definition
Smallpox, polio
Term
Nurses role in health promotion pediatrics:
Definition
-Guide to activities
-To promote development
-Keeping safety in mind
Term
FLACC Scale
Definition
-Measurement used to assess pain for children between the ages of 2 months–7years or individuals that are unable to communicate their pain. The scale is scored between a range of 0–10 with 0 representing no pain. The scale has 5 criteria which are each assigned a score of 0, 1 or 2.
-Stands for Face, Legs, Activity, Cry, Consolability
Term
Faces Scale or Color Scale
Definition
-Children between the ages of 3 and 8
-Usually have a word for pain
-Can articulate more detail about the presence and location of pain; less able to comment on quality or intensity
(Color scale assigns colors as mild, moderate, severe)
Term
Standard analog scale rating pain scale of 0 - 10.
Definition
For children older than 8 years
Same as used in adutls
Term
Uses of sucrose for infants:
Definition
-Can be used for procedures such as heel stick, venipuncture, catherization
-Effective analgesic in preterm and term infants (not effective beyond 3 months old)
-Dip pacifier in sucrose solution or give 0.2 mL to buccal area (May repeat but be cautious with many doses to younger infants
Term
Non noxious routes:
Definition
-Administer analgesia through most painless route
-Avoid IM Injections
-Oral and intravenous routes are preferred
a. Oral route for mild to moderate pain
b. Intravenous route for immediate pain relief and severe pain
Term
Organ systems to consider for med administration:
Definition
Respiratory
Liver and kidney
Term
Non-Opioid Analgesics
Definition
-Mild to moderate pain
-No side effects of respiratory depression
-Highly effective when combined with opioids
-Acetaminophen
-NSAIDS
-Aspirin (No longer used in pediatrics bc of Reyes Syndrome)
Term
Acetaminophen
Definition
-Antipyretic
-Mild analgesic
-Administer PO or PR
-Pediatric oral dose 10-15mg/kg/dose every 4 hours
-Onset 30 minutes
-Causes hepatic failure in overdose
a. Infant drops are MORE concentrated than the children's suspension
- Infant's Acetaminophen 80 mg/0.8mL
- Children's Acetaminophen 165 mg/5mL
Term
NSAIDs
Definition
-Antipyretic
-Analgesic for mild to moderate pain
-Anti-inflammatory
-COX Inhibitor-> Prostaglandin inhibitor
-Platelet aggregation inhibitor
Term
NSAIDs: Ibuprofen Antipyretic Dosing
Definition
Dose 10 mg/kg/dose eery 6 hours
Onset 30-45 mins
Term
NSAIDs: Ketorolac (Toradol) Antipyretic
Definition
-Intravenous NSAID (available PO)
-Onset 10 Minutes
-Monitor renal function
-Do not use more than 5 days
- Significant increase in side effects after 5 days
Term
Side effects of NSAIDs
Definition
-Gastritis
- Prolonged use increases risk of GI bleed
- Still rare in pediatric patients compared to adults
-Nephropathy (ATN)
-Bleeding from patient anti-coagulation
-NSAID use contraindicated in active bleeding
Term
Opoids Analgesics
Definition
-Moderate to severe pain
-Various routes of administration
-Different pharmacokinetics for different age groups
-Infants younger than 3 months have increased risk of hypoventilation and respiratory depression
-Low risk of addiction among children
Term
Side effects of Opioids
Definition
All opioids have side effects that should be anticipated and managed:
Respiratory depression
Nausea, vomiting
Constipation
Pruritis
Urinary retention
Term
Patient Controlled Analgesia (PCA)
Definition
-Control of the button rests solely with the patient, NOT the parent
Term
Chickenpox symptoms
Definition
Rash, tiredness, headache, fever
Term
Diphtheria
Definition
Sore throat, mild fever, weakness, swollen glands in neck
Term
Hib
Definition
May be no symptoms unless bacteria enter the body
Term
Hepatitis A
Definition
May be no symptoms, fever, stomach pain, loss of appetite, fatigue, vomiting, jaundice, dark urine
Term
Hepatitis B
Definition
May be no symptoms, fever, headache, weakness, vomiting, jaundice, joint pain
Term
Flu
Definition
Fever, muscle pain, sore throat, cough, extreme fatigue
Term
Measles
Definition
Rash, fever, cough, runny nose, pinkeye
Term
Mumps
Definition
Swollen salivary glands (under the jaw), fever, headache, tiredness, muscle pain
Term
Pertussis
Definition
Severe cough, runny nose, sore throat, fever, nausea, vomiting
Term
Polio
Definition
May be no symptoms, sore throat, fever, nausea, headache
Term
Pneumococcal
Definition
May be no symptoms, pneumonia
Term
Rotavirus
Definition
Diarrhea, fever, vomiting
Term
Rubella
Definition
Children infected with rubella virus sometimes have a rash, fever, swollen lymph nodes
Term
Tetanus
Definition
Stiffness in neck and abdominal muscles, difficulty swallowing, muscle spasms, fever
Term
Gross Motor Skills
Definition
Walking, running, climbing, jumping
Term
Fine Motor Skills
Definition
Include refined eye-hand and muscle coordination
-Drawing, dressing, artwork, skillful manipulation
Term
2 stages of the Preoperational Phase
Definition
1. Preconceptual phase - 2 to 4 years
2. Intuitive thought phase - 4 to 7 years
Term
Preschool Psychosocial Development
Definition
Erikson - Developing a sense of intiative
-Chief psychosocial task of the preschool period
-Feelings of guilt, anxiety, and fear may result from thoughts that diff from expected behavior
-Development of superego (conscience)
-Learning right from wrong: moral development
Term
Preschool Cognitive Development
Definition
-Readiness for school
-Readiness for scholastic learning
-Successful achievement of cognitive goals at this stage is needed for learning, which is among the reasons children enter school at 5-6 years old
-Shifts from egoentric thought to social awareness
-Able to consider other viewpoints
-Egocentricity is still evident
Term
Preschool Moral Development
Definition
-Basic level of moral judgement
-Punishment and obedience orientation
-Naive instrumental orientation: actions to satisfy one's own needs and less concern about the needs of others
-Concrete sense of justice and fairness
Term
Preschool Development of Body Image
Definition
-Increasing comprehension of "desirable" appearances
-Aware of racial identity, differences in appearances, and biases
-Poorly defined body boundaries
a. Fear that if skin is "broken", all one's blood and "insides" can leak out
b. Frightened by intrusive experiences
Term
Preschool Development of Sexuality
Definition
-Forms a strong attachment to the opposite-sex parent while identifying with the same-sex parent
-Become concerned with modesty
-Sex role limitation: "dressing up like Mommy or daddy"
-Sexual exploration is more pronounced
Term
Preschool Social Development
Definition
-Individuation- separation process is completed
-Overcomes stranger anxiety and fear of separation from the parents
-Still needs parental security and guidance
-Security from familiar objects
-Play therapy is beneficial for working through fears, anxieties, and fantasies
Term
Preschool 4 different types of play
Definition
-Associative play
-Imitative play
-Imaginative play and imaginative playmates
-Dramatic play
Term
Associative play
Definition
a form of play in which a group of children participate in similar or identical activities without formal organization, group direction, group interaction, or a definite goal. The children may borrow or lend toys or pieces of play equipment, and they may imitate others in the group, but each child acts independently, as on a playground or among a group riding tricycles or bicycles.
Term
Dramatic play
Definition
an imitative activity in which a child fantasizes and acts out various domestic and social roles and situations, such as rocking a doll, pretending to be a doctor or nurse, or teaching school. It is the predominant form of play among preschool children.
Term
Fears of Preschoolers
Definition
-Dark, being left alone, animals, ghosts, objects or persons associated with pain, technique of desensitization to overcome fears
Term
Aggression in preschoolers
Definition
Behavior that attempts to hurt another person or destroy property
May be influenced by biologic, sociocultural and familial variables
Factors that increase aggressive behavior include gender, frustration, modeling, reinforcement
Term
Age of school age children?
Definition
Ages 6- 12 years
Term
Height and Weight changes in school age children?
Definition
Height increases by 2 inches per year
Weight increases by 2-3 kilograms per year
Males and females differ little in size
Term
School age: Maturation of body systems
Definition
-Bladder capacity increases
-Heart is smaller in relation to the rest of the body
-Immune system is increasingly effective
-Bones increase in ossification
-Physical maturity is not necessarily correlated with emotional and social maturity
Term
Prepubescence
Definition
-2 years preceding puberty
-Typically occurs during preadolescence
-Varying ages from 9-12 years (in girls, it occurs about 2 years earlier than in boys)
-Average age of puberty is 12 years in girls and 14 years in boys
Term
School age Psychosocial development
Definition
-relationships center around same-sex peers
-Freud described it as the latency period of psychosexual development
Term
School age: Erikson - Developing a sense of industry
Definition
-Eager to develop skills and participate in meaningful and socially useful work
-Acquires a sense of personal and interpersonal competence
-Growing sense of independence
-Peer approval is a strong motivator
Term
School age: Erikson- Inferiority
Definition
-Feelings may derive from self or the social environment
-may occur if incapable or unprepared to assume the responsibilities associated with developing a sense of accomplishment
-all children feel some degree of inferiority regarding skills they cannot master
Term
School age Piaget: Cognitive Development (Concrete operations)
Definition
-Use thought processes to experience events and actions
-Develop an understanding of relationships between things and ideas
-Able to make judgements based on reason (conceptual thinking)
Term
School age Kohlberg: Moral Development
Definition
-Development of conscious and moral standards
-In a child ages 6-7 years, reward and punishment guide choices
-Older school-age child is able to judge an act by the intentions that prompted it
-Rules and judgements become more founded on the needs and desires of others
Term
School age: Social development
Definition
-Importance of peer group
-Identification with peers is a strong influence in a child gaining independence from parents
-Sex roles are strongly influenced by peer relationships
Term
School age: Relationship with Families
Definition
-Parents are the primary influence in shaping a child's personality, behavior, and value system
-Increasing independence from parents is the primary goal of middle childhood
-Children are not ready to abandon parental control
Term
School age: Play
Definition
Involves physical skill, intellectual ability, and fantasy
-Form groups, cliques, clubs, secret societies
-Rules and rituals
-See the need for rules in games they play
Ex/ Team play, quiet games and activities, ego mastery
Term
What is self-concept?
Definition
A conscious awareness of a variety of self-perceptions (ex/ abilities, values, appearances)

*Positive self-concept leads to feelings of self-respect, self-confidence, and happiness
Term
School age: Body image
Definition
-Children like their physical selves less as they grow older
-body image is influenced by significant others
-increased awareness of "differences" may influence feelings of inferiority
Term
Latch-key children
Definition
A child who returns from school to an empty home because his or her parent or parents are away at work, or a child who is often left at home with little or no parental supervision.
Term
School age: Dental health
Definition
-Stage begins with the shedding of the first deciduous teeth
-Eruption of permanent teeth
Term
School age: Sex Ed
Definition
-Middle childhood is the ideal time for formal sex education
a. life span approach
b. information on sexual maturity and process of reproduction
c. effective communication with parents
Term
Most common cause of severe injury and death in school-age children?
Definition
Motor vehicle crashes- pedestrian and passenger
Bicycle injuries - benefits of bike helmets
Term
Puberty
Definition
Sexual maturity is achieved
Term
Postpubescence
Definition
1-2 years after puberty; skeletal growth is complete and reproductive functions become established
Term
Adolescence
Definition
The time of growing into psychological, social, and physical maturation
Term
Adolescent: Sexual maturation
Definition
-Tanner stages of sexual maturity
(Stages of development of secondary sex characteristics and genital development)
*Guide for estimating sexual maturity
Term
Adolescent: Physical growth
Definition
-Dramatic increase in growth accompanies sexual maturation
-Adolescent growth spurt
a. 20% to 25% of total height is achieved during puberty
b. usually occurs within a 24-36 month period
Term
Adolescent: Physical changes
Definition
-Size and strength of heart, blood volume, and systolic blood pressure increase
-Pulse rate and basal heat production decrease
-Adult valves for all formed elements of blood
-Respiratory volume and vital capacity increase
-Increased performance capabilities
Term
Adolescent: Psychosocial development - Sense of Identity (Erikson)
Definition
-Early adolescent - group identity vs alienation
-development of personal identity vs role diffusion
-sex role identity
-emotionality
Term
Adolescent: Cognitive Development (Piaget)
Definition
Formal operations period
Abstract thinking
a. think beyond present
b. mental manipulation of multiple variables
c. concerned about others thoughts and needs
Term
Adolescent: Moral development (Kohlberg)
Definition
-Internalized set of moral principles
-Questioning of existing moral values and relevance to society
-Understand duty and obligation, reciprocal rights of others
-Concepts of justice, reparation
Term
Adolescent: Social development
Definition
-Goal is to define one's identity independently from parental authority
-much ambivalence
-intense sociability; intense loneliness
-acceptance of peers
Term
Adolescent: Relationship with parents
Definition
-role changes from "protection-dependency" to "mutual affection and equality"
-process involves turmoil and ambiguity
-struggle of privileges and responsibility
-Emancipation from parents may begin with the rejection of parents by the teenager
Term
Adolescent: Relationship with peers
Definition
-Peer assume an increasingly significant role in adolescence ("best friend")
-Peers provide a sense of belonging and a feeling of strength and power
-Peers form a transitional world between dependence and autonomy
-Role of social media and advanced technology
Term
Adolescent: Development of Self Concept and Body Image
Definition
-Feelings of confusion in early adolescence
-acute awareness of appearance, comparison of appearance with others
-blemishes and defects are magnified out of proportion
-matures to self-concept based on uniqueness and individuality
Term
Greatest cause of serious and fatal injuries in teens?
Definition
Motor vehicle crashes
Term
Infant colic
Definition
A benign condition in which the infant is inconsolable and excessively cries
Term
What can infant colic lead to?
Definition
maternal stress, child abuse, or neglect
Term
4 possible causes of colic?
Definition
1. a gut problem associated with cow's milk allergy, lactose intolerance, intestinal flora, gut motility dysfunction
2. a behavioral problem due to inadequate parent infant interaction or to a difficult temperament of the infant
3. the notion that the excessive crying is the extreme limit of normal
4. a collection of different entities
Term
When does infant colic typically resolve?
Definition
4-6 months
Term
Respiratory distress
Definition
Compensated state that may precede respiratory failure, the patient is able to maintain adequate gas exchange by increasing breathing rate and depth.
Term
Signs and symptoms of respiratory distress
Definition
-Diaphoresis
-Pallor/Cyanosis
-Nasal flaring
-Tachypnea
-Noisy breathing
-Retracting
-Grunting
Term
What is the difference in respiratory distress in a small child?
Definition
-Smaller and shorter airways
-Airways easily blocked
-Hyper-reflexive = spasms
-Easily fatigued decreases cough
-Immune unsophisticated
-Limited alveolar surface area
-Poor/weak respiratory muscles
-Poor fluid volume control
Term
What are possible causes of obstructive respiratory failure?
Definition
-Foreign body (vomitus)
-Infection (epiglottis)
-Tonsils/adenoids
-Laryngospasm
Term
What are possible causes for restrictive respiratory failure?
Definition
-Thick secretions, foreign body
-Infection (Pneumonia)
-Alveolar rupture (pneumothorax)
-Chemical pneumonitis
-Pleural effusion
-Near-drowning event
Term
What are possible causes of primary ineffecient gas transfer respiratory failure
Definition
-Anemia
-Hemorrhage
-Over-sedation
-Cerebral trauma
Term
Upper Respiratory Tract Illnesses
Definition
-URI or URTI
-Nasopharyngitis
-Pharyngitis
-Tonsilitis
-Influenza
-Otitis Media
-Infectious mononucleosis
Term
Croup- what do we do?
Definition
Treat with cool mist or steam therapy
-Can usually be treated at home
Term
Respiratory Syncitital Virus
Definition
-80%-90% cause of bronchiolitis seen in infants
-Seasonal
-Treatment airway management and fluids
-Frequent hospitalization for infants (at risk infants receive Synagis)
Term
Reactive Airway Disease
Definition
Inflammatory reponse initiated in airways
-Involves mast cells, eosiniophils, and T lymphocytes
-End result means increased mucous production, inflammation to lower airways and bronchospasm
-When it keeps reocurring is means Asthma
Term
Asthma
Definition
-Chronic inflammatory disorder of airways
-Bronchial hyperresponsiveness
-Episodic
-Limited airflow or obstruction that reverses spontaneously or with treatment
Term
Asthma triggers
Definition
-Inhalants
-Airborne pollens
-Stress
-Weather changes
-Exercise
-Biral or bacterial agents
-Food additives
-Lots of other things . . .
Term
Reccomendations for asthma care and management
Definition
-Obtain objective tests, physical examination, patient history and patient report, to diagnose and assess the characteristics and severity of asthma and to monitor whether asthma control is achieved and maintained.
-Education for a partnership in asthma care
-Control of environmental factors and comorbid conditions that affect asthma
-Pharmacologic therapy
Term
Long term medications
Definition
-Corticosteroids-(inhaled) pumicort
-Cromlyn sodium (intal)-Mast cell stabilizer
-Immunomodulators-(Xolair) decrease IgE response
-Leukotreine modifiers-(Accolate)
-LABA's (long-acting bronchodilator) Serevent or Salmeterol (12 hours)
-Methylxanthine-theophyline
Term
Quick relief for asthma
Definition
-Anticholinergics (Atrovent)-blocks constriction (parasympathetic)
-SABA: short-acting bronchodilators (Albuterol)- stimulates dilation (sympathetic)
-Systemic corticosteroids-Methylprednisone/Solumedrol
Term
Cystic Fibrosis
Definition
Inherited autosomal recessive trait
-Cystic fibrosis transmembrane Conductance Regulator
--Critical loss of chloride ion transport
--Upsets the sodium and chloride ion balance
--Disrupts the normal, think mucus layer that is easily removed by cilia lining the lungs and other organs
Term
Problems associated with Cystic Fibrosis
Definition
-Thick sticky secretions
-Pool in bronchioles = atlectasis
-Clogs pancreatic ducts, impairs digestion & absorption of nutrients
-Leads to biliary cirrhosis
-Retarded G & D, delayed puberty
-Terminal, median age is 37
Term
Respiratory management for cystic fibrosis
Definition
-Large amounts of mucous and increased viscosity increase likelihood of respiratory tract infections
-Recurrent pulmonary infection in the child with CF results in damage to the airways. (bronchiectasis)
-Mucolytics, brocnhodilators, kalydeco
-Antibiotics for infections
-Chest PT
-Avoid pulmonary treatments after meal
Term
GI management for Cystic Fibrosis
Definition
-Assess nutritional status
-Provide high protein & calorie diet
-Administer pancreatic enzymes
-Vitamins (esp. fat soluble)
Term
Reasons for vomiting in children
Definition
-Allergies to foods
-Over-eating
-Persistent coughing
-Intestinal obstruction
-Viral illness
Term
Rotavirus
Definition
Rotavirus is very common, especially in children under the age of 2
-Watery diarrhea most common symptom
-Other symptoms include vomiting and fever
-Passed through fecal-oral route
-Also can be passed through indirect contact such as child touches toy or if someone doesn't wash hands after changing a diaper
-Usually develops symptoms 1-3 days after contact
-No specific tx, children usually recover on own
-Can detect antigens in stool
-Diarrhea usually lasts 3-7 days
-Treatment with flavored oral rehydration
-May need IV
-Start back slow with diet (BRAT)
Term
Hirschsprungs Disease
Definition
Congenital Aganglionic Megacolon
-Absence of ganglioncells in one or more segments of the colon
-Etiology not fully understood
-Symptoms: Dont pass menium; Distension; Ribbon like stools
Term
G.E. Reflux Disease
Definition
Relaxation or incompetence of the lower esophageal sphincter
-Vomiting
-Weight loss
-Respiratory problems (RAD)
-GI bleeding
Term
3 Inflammatory GI Disorders
Definition
1. Appedicitis
2. Ulcerative Colitis
3. Crohn's disease
Term
Appendicitis
Definition
Signs and symptoms:
-Abdominal pain-per umbilical to right lower quadrant
-Local rebound tenderness
-Vomiting
-Constipation or diarrhea
Term
Hepatic disorders
Definition
Acute hepatitis
Cirrhosis
Biliary atresia
-Etiology unknown
-Healthy infant at birth
-Jaundice occurs within 2wk-2mo
-Alcohlic stools (puttylike, clay)
-Increased bilirubin levels
Term
3 Structural defects in children (GI)
Definition
-Cleft lip and palate
-Esophageal atresia
-Hernias
Term
Structural defects: Cleft lip and cleft palate
Definition
Failure of the premaxillary adn maxillary processes to come together in fetal life
-Cleft lip surgery (first 3 months)
-Cleft palate repair (6mos to 5 yrs)
Term
Esophageal atresia with tracheoesophageal fistula
Definition
-Esophageal atresia: the esophagus ends in a blind pouch or stops; does not connect with the stomach
-Tracheoesophageal fistula: a fistula is present connecting the esophagus with the trachea
Term
3 GI Obstructive Disorders
Definition
1. Hypertrophic pyloric stenosis
2. Intussusception
3. Malrotation
Term
Obstructive Disorders: Pyloric Stenosis
Definition
Muscle around the pylorus enlarges and leads to obstruction during the first three months of life
-Projectile vomiting
-hunger
-Weight loss
-Dehydration with F/E Disturbances
-Increased Abdominal distention with peristalsic waves
-Palpable Olive Shape Tumor in Epigastric Area
-Diagnosed by ultrasound
-Emphasis on restoring and correcting fluid and electrolyte problems
-POst-op: Infant may still vomit, advance diet as tolerated, rare to have complications
Term
Intussusception
Definition
Telescoping of one portion of the intestine into another
-Frequent cause of intestinal obstruction
Signs and Symptoms:
-Acute abdominal pain with tender abdomen
-Vomiting
-Normal stool to red currant jelly like stool (lovely!)
-Abdominal distention
-Sausage shape mass in riq
-Child can become acutely ill with fever and S&S fo peritonitis
-Dx is made by xray, ultrasound, or barium enema
-Surgery if b.e. is not successful
Term
Examples of age-related skin mansifestations
Definition
-Infants: birthmarks
-Early childhood: atopic dermatitis
-School-age children: ringworm
-Adolescents: acne
Term
Impetigo
Definition
-Common peds problem
-Treated with topical antibiotic if localized to small area
-Bacterial: strep or staph
-Wash crust off with soap andwater and apply topical antibiotic
-May be treated with oral antibiotics if has spread (still wash lesions)
-Very contagious
Term
Viral skin infections
Definition
-Most communicable diseases of childhood have characteristic rash (rubeola, rubella, chicken pox)
-Other ex: verruca (warts), herpes simplex type
Term
Fungal skin infections
Definition
Superficial infections that live on the skin
-AKA dermatophytoses
-Transmission from person to person or from infected animal to human
-EX: tinea capitis, tinea corporis, tinea pedis, candidiasis
Term
Contact dermatitis
Definition
-Inflammatory reaction or skin to chemical
-Initial reaction in the exposed region
-Characteristic sharp delineation between inflamed and normal skin
-Primary irritant
-Sensitizing agent
-Ex: Diaper dermatitis, reaction to wool, reaction to specific chemical
Term
Atopic dermatitis
Definition
A type of pruritic eczema that begins during infancy
-Hereditary tendency
-Often associated with history of food allergies, allergic rhinitis, and asthma
Term
Diaper Dermatitis
Definition
Pathophysiology and clinical manisfestations
-Usually from irritation of urine and feces
-Detergents inadequately rinsed from clothing
-Chemical irritation
-Nursing considerations: alter wetness, pH, and fecal irritants
-Differentiate from Candidiasis of diaper area (candidiasis has characteristic excoriated red papules with satellite lesions)
Term
Drug reactions
Definition
-Adverse drug reactions are most often seen in skin (rashes most common reaction)
-May be immediate or delayed following administration of drug
-Treatment: discontinue drug, antihistamines, corticosteroid therapy if very severe
Term
Acne
Definition
-Predominately in adolescents
-Pathophysiology
--Involves hair follicles and sebaceous glands
--Black heads
-Therapeutic management
--General measures/overall health
--Medications
Term
Burns
Definition
-Toddlers: hot water scalds
-Older children: flame-related burns
-Child abuse
-Child with matches or lighters accounts for 1 in 10 house fires
Term
Growth hormone deficiency
Definition
-Hypopituarism
--Failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children.
-Familial patterns
-Review growth charts
-GH products are currently labeled for use in children who have growth failure due to an inadequate of normal GH.
-Administered at night to correspond with normal release time of GH
Term
Growth hormone replacement management
Definition
-Children should be managed by a pediatric endocrinologist
-Height and weight is obtained every 3 months and plotted on the growth chart
-Bone age study yearly
Term
Precocious puberty
Definition
-Development of sexual characteristics before the usual age of onset of puberty.
Girls: Breast development, pubic hair, and/or menses before 8 years
Boys: Secondary sexual characteristics before age 9
-Tanner scale: true precocious puberty is characterized by 2 signs of puberty
Term
Pediatric blood glucose target levels
Definition
-Toddler and preschool: 100 to 180 mg/dL
-School-age: 90-180 mg/dL
-Adolescents (13 to 19 years): 90 to 130 mg/dL
Term
Insulin
Definition
-Short-acting: often used to cover extra carbohydrate consumption
-Combination of regular and intermediate-acting insulin
-Children on mixed insuling dosage schedules tend to experience hypoglycemic episodes at 11:30 adn 2:30 as peaking of insulin occurs.
Term
Hypoglycemia
Definition
Symptoms:
-Rapid onset
-Shaky feeling, hunger
-Dizziness
-Headache
-Vital signs-shallow respirations, tachycardia
-Tremors
-Glucose = low, below 60
-Ketones = negative
-Urine output: normal, sugar negative, negative ketones
Term
Treatment of hypoglycemia
Definition
Day time hypoglycemia:
-Simple concentrated sugars such as honey by mouth (older than 1 year), hard candy, sugar cubes, or glucose tablets will elevate the blood sugar immediately. OJ or sugar containing soda or fruit drink.
-Identify reason for hypoglycemia. In children it is often increase in activity without increase in food intake.
Term
Hypoglycemia prevention
Definition
-Using rapid-acting or Lispro insulin
-Infusion pump (8 to 10 years)
-Night time snack
-Check blood glucose before bedtime. Make sure the blood glucose is 100-120 mg/dL before going to bed.
-Do not skip snacks.
-Eat an extra snack on days of strenuous exercise.
Term
Hyperglycemia and DKA
Definition
Symptoms: Lethargic, confused, weak
-Thirsty
-Abdominal pain often with nausea and vomiting
-Signs of dehydration
-Vital signs: deep, rapid respirations, fruity acetone breath, and weak pulses
Term
DKA symptoms
Definition
-Altered LOC
-Dehydration
-Electrolyte disturbances
-Dysrrhythmias
-Shock
-Complete vascular collapse
Term
Life management of patients with DM
Definition
-Management by endocrinologist
-Insulin
-Blood sugar monitoring
-Diet
-Exercise
-Screen for retinopathy: opthalmologic exam annually
Term
Exercise for those with Diabetes Mellitus
Definition
-Vital component to management of child with diabetes
-May decrease the amount of insulin required.
-Enhances insulin absorption.
-Important for normal growth and development
Term
Type 2 diabetes
Definition
-85% of children with Type 2 are obese
-Age of onset is middle to late puberty-around 13 years
-Minority populations have an especially high rate of type 2 diabetes
-Strong family history
-The rate of new cases among youth was 5.3 per 100,000 for type 2 diabetes
Term
Assessment of children with type 2 diabetes
Definition
-Obesity: BMI greater than 30 (normal range is 15 to 17 in the pediatric population)
-Waist to hip ratio: apple shape
-Acanthosis nigricans: hyper-pigmentation and thickening of the skin into velvety irregular folds in the neck and flexural areas
-HTN
-+ family history of type 2 diabetes
-Ethnicity
Term
Interdisciplinary Interventions for children with DM type 2
Definition
-Comprehensive education on importance of regular exercise and how to self-monitor for blood glucose levels.
-Dietary management
-Glucose-lowering agent: drugs that improve insulin sensitivity such as Glucophage (Metformin)
-A few may need Insulin to initiate control
Term
Infant age range
Definition
Birth to one year
Term
Biological development of infant
Definition
- By year end grow ~1 foot and triple weight
- Develop 6-8 teeth
- Increased control over body
- Can discriminate sounds, images, and tastes
Term
Motor development of infant
Definition
- Fine motor: develops pincer grasp
- Gross motor: can stand and walk
Term
Psychosocial development of infant
Definition
- Trust vs. mistrust
- Primary narcissism
Term
Trust vs. mistrust
Definition
- Faith in the environment vs. suspicion
- Goal: faith and optimism
Term
Primary narcissism
Definition
Child has not differentiated himself from outside world. Don't recognize their surroundings besides how it affects them
Term
Cognitive development of infant
Definition
- Sensorimotor stage
- Lacks object permanence
- Stranger anxiety
Term
Sensorimotor stage
Definition
Experiences world through senses and interaction
- Occurs from birth to 24 months
Term
Object permanence
Definition
Objects that leave the visual still exist
- Develops around 9-10 months
Term
Stranger anxiety
Definition
- Develops between 6-8 months
- Related to infants ability to distinguish between familiar and unfamiliar people
Term
Infant psychosexual development
Definition
Oral: sucking, biting, chewing, vocalizing
Term
Toddler age range
Definition
12 months to 36 months (1-3 years)
Term
Biological development of toddler
Definition
- Proportional changes: chest circumference exceeds head circ
- Integrated function of senses: taste preferences
- Ability to control elimination patterns
Term
Motor development of the toddler
Definition
- Major motor skill acquired: locomotion
- Increased manual dexterity: can draw circles by age 3
- General mastery of skills: dressing, playing, eating
Term
Psychosocial development of the toddler
Definition
- Autonomy vs. shame and guilt
- Ritualism provides sense of comfort
- More comfortable in asserting autonomy
Term
Autonomy vs. shame and guilt
Definition
- Independence driven
- Realize they can control environment, body
- Encouragement of decision making whether good or bad
- Shame and doubt: made to feel inadequate or self-conscious
- Goal: self control and will power
Term
Cognitive development of the toddler
Definition
- 2-24 months: sensorimotor
- 2-7 years: preoperational
Term
Preoperational stage
Definition
- First use of representational thoughts and symbols
- Ability to pretend
- Lacks logical reasoning
- Egocentrism: inability to put oneself in the place of others
- Transductive: "all women with big bellies have babies"
Term
Social development of toddler
Definition
Play
- Gross and fine motor development through play
- Parallel play
- "No!"
Term
Moral development of toddler
Definition
Preconventional: bad behavior determined by the consequence of the action
Term
Psychosexual development of toddler
Definition
Anal: sphincter control-toilet training
Term
Preschool age range
Definition
3-5 years
Term
Motor development of preschool
Definition
- Strength and refinement of previously learned skills
- Locomotion further develops: running, jumping
- Increased manual dexterity: dressing, drawing
Term
Psychosocial development of preschool
Definition
- Initiative vs. guilt
Term
Initiative vs. guilt
Definition
- Strong imagination, exploration, encourage self-established activities while teaching limitations
- Goal: direction and purpose
Term
Cognitive development of preschool
Definition
- Preoperational
- Symbols or words used to represent objects or people
- Magical thinking: believe their thoughts are all powerful
- Don't have much understanding of causality
Term
Social development of preschool
Definition
- Play: associative play, imitative, dramatic, imaginative play most common
- Vocab increases dramatically
Term
Associative play
Definition
Group play in similar or identical activities but without rigid organization or rules
Term
Moral development of the preschooler
Definition
Preconventional: know an action is wrong because its consequences are bad, don't understand why logically
- Internalize parents morals
Term
Psychosexual development of preschooler
Definition
Phallic: exploration, curious of dissimilarities of opposite sex
Term
School age: age range
Definition
6-12 years
Term
Biological development of school age
Definition
- Slow and steady pace of physical growth
- Respiratory and heart rate steadily decrease
Term
Motor development of school age
Definition
- Strength and refinement of previously learned skills
- Locomotion continues to develop: riding a bike
- Prepubescense
Term
Psychosocial development of school age
Definition
- Industry vs. inferiority
- Growing sense of independence
- Sense of accomplishment involves ability to cooperate, compete with others, and cope effectively with people
Term
Industry vs. inferiority
Definition
- Achieve a sense of interpersonal competence
- Intrinsic motivation
- Acquisition of skill a means for achieving personal success
- Goal: compentence
Term
Cognitive development of school age
Definition
Age 6-10: concrete operational
Age 11-adolescent: formal operations
Term
Concrete operational
Definition
- Increased logic
- Thinking becomes socialized, can see other people's view points
- Reasoning is inductive, can solve concrete problems in a systematic fashion based on what they perceive
Term
Formal operations
Definition
- Thinking is adaptable and flexible
- Can think in abstract terms and use abstract symbols
- Draw logical conclusions
- Can make hypotheses and test them
Term
Social development of school age
Definition
- Cooperative play
- Peer group is very important, important in gaining independence from parent
Term
Moral development of school age
Definition
6-10: conventional
11-12: Post conventional
Term
Conventional
Definition
Morals come from knowing what is expected of them, don't understand the concepts behind them
Obey authority figures
Term
Post conventional
Definition
- Judge an act by its intentions, not just consequences
- Individual judges own moral standards
- Correct behavior defined by standards agreed on by society
Term
Psychosexual development of school age
Definition
Latency
- More interest in same sex parents
- Same gender play "boys have cooties"
Term
Adolescence
Definition
Transition between childhood and adulthood
Term
Biological development of adolescent
Definition
- Puberty
- All body organs now mature
Term
Psychosocial development of adolescent
Definition
- Role identity vs. role confusion
- Group identity
Term
Role identity vs. role confusion
Definition
- Develop a stable, coherent picture of oneself
- Establish a meaningful identity
- Take responsibility for ones actions
- Resolve questions of peer group first then individual identity
- Goal: devotion to values and fidelity to others
Term
Cognitive development of adolescent
Definition
Formal operations
Ability to reason abstractly
Ability to think independently can lead to rebellion
Term
Social development of adolescent
Definition
Less time with parents, more time with peers
Peer group very important
- From group they gain support in learning about themselves, consideration for the feeling of others, and increased ego development and self reliance
Term
Psychosexual development of adolescents
Definition
- Sexual interest
- Genitals are major source of sexual tensions and pleasures
- Energy towards friendships and preparing for marriage
Term
Moral development of adolscents
Definition
Post conventional
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