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Pedi Exam 1
Intro to Pediatrics
70
Nursing
Graduate
02/08/2017

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Term
philosophy of care permeating all interactions between family and healthcare providers
Definition
family centered care
Term
Key Elements of Family Centered Care
Definition
1-Family at center; 2-Family to Provider Collaboration; 3-Open communication; 4-Family Centered Peer Support; 5-Cultural Diversity of Families; 6-Holistic Perspective
Term
Phase 1 of Crisis Theory
Definition
-Obstacles lead to increased tension
-Discomfort increases
-ie. increased stress on family from admission to hospital
Term
Phase 2 of Crisis Theory
Definition
-Unsuccessful attempts to cope with crisis
-Increased discomfort and disequilibrium
-ie. arguments among family
Term
Phase 3 of Crisis Theory
Definition
-Mobilization of resources to cope with crisis
Term
Phase 4 of Crisis Theory
Definition
-Phase of crisis in which equilibrium is restored in family dynamic OR continued disequilibrium requires outside intervention
Term
Concept for Transcultural Care Model
Definition
Centered around an individual as a unique cultural being. She is directly influenced by her Religion, Ethnicity and Culture. And more indirectly influenced by social norms, her environment, etc.
Term
Campinha-Bacote's Culturally Competent Model of Care
Definition
Accompanies ASKED Model
-States that culturally competent care requires cultural awareness, knowledge, skill and encounters
Term
ASKED Model
Definition
Awareness of personal biases; Skill to conduct a sensitive cultural assessment; Knowledge to understand cultural basics; Encounters/Experiences with various cultures; Desire to be culturally sensitive
Term
Autosomal Recessive Inheritance
Definition
Requires both parents to pass the mutation to offspring. One copy will result in carrier status, ie CF
Term
X-linked Recessive Inheritance
Definition
A recessive inherited condition passed only on the x-chromosome. In the case of female offspring, a carrier mother will always pass the X chromosome to a male and 50% of time to female. A carrier father will NOT spread to male child but 50% chance to female child.
Term
Genotype of Downs Syndrome
Definition
Trisomy 21, 47 chromosomes
Term
Phenotype of Downs Syndrome
Definition
1-Growth failure; 2-Developmental delay; 3-Epicanthal folds and slanted eyes; 4-Low-set ears; 5-Large tongue; 6-congenital heart disease; 7-hands w/ simean crease; 8-mottling skin; 9-ALL
Term
Genotype in Turner Syndrome
Definition
Only one sex chromosome, always an X
-45 chromosomes
-ID'ed as XO
Term
Phenotype of Turner syndrome
Definition
1-Small stature; 2-Androgenous appearance; 3-Poor breast development; 4-Ovarian dysgenesis; 5-bicuspid aortic valve and COA; 6-multiple pigmented nevi
Term
Order or Developmental Progression of Infant
Definition
Progresses head to toe and then midline to distal
Term
Bronfenner's Social-Ecological Model of Development
Definition
A child is the result of their environment therefore we must consider her microsystem, mesosystem, exosystem and macrosystem
Term
Bronfenner's Microsystem
Definition
1-Home, 2-Siblings, 3-Peers, 4-Parents, 5-Teachers
Term
Bronfenner's Mesosystme
Definition
1-House; 2-Neighborhood; 3-School; 4-Religious setting
Term
Bronfenner's Exosystem
Definition
1-Parents' workplace; 2-Local government; 3-School board; 4-Local industry
Term
Bronfenner's Macrosystem
Definition
dominant beliefs and ideologies
Term
Physiological Anorexia
Definition
a decrease in feeding at age 1 due to decrease in rapid growth
Term
the increase in the number and size of cells
Definition
growth
Term
increase in competence and ability
Definition
maturation
Term
age at which teething begins
Definition
6 months
Term
age at which object permanence begins
Definition
6 months
Term
ability to pincer grasp
Definition
prehension
Term
ability to walk upright without support
Definition
locomotion
Term
Freud's Theory
Definition
-a theory on personality development
-humans are driven by a need to resolve certain biologically determined drives that center around sexual drives
-without resolution, fixation will result
Term
Erikson's Theory
Definition
-a theory on personality development based upon epigenetic principle
-Personality develops based upon predetermined steps that are maturational
-In each stage of development, a child is presented with a crisis. If handled well, a positive outcome results. If not, a negative outcome results.
Term
Piaget's Theory
Definition
-Cognitive Intellectual development
-Humans are constantly absorbing information and processing it to form ideas and concepts (schemas).
-Each stage considers a new way of thinking achieved through maturation.
Term
the process of taking in info from the environment and incorporating it into one's existing knowledge
Definition
assimiliation
Term
when information is absorbed from the environment and this new knowledge is used to alter one's perception of the world or one's schema
Definition
accommodation
Term
Elkind's Theory
Definition
-a Cognitive Intellectual theory based upon Piaget
-discusses egocentrism in children
Term
age posterior fontanel closes
Definition
2-4 months
Term
age for first words
Definition
8-10 months
Term
Factors that Affect Distribution of Drugs in Children
Definition
1-Higher proportion of total body water; 2-lower proportion of body fat
3-Protein binding of meds is age-dependent
4-Neonates have immature BBB and decreased fetal albumin
Term
Factors that Affect Metabolism of Drugs in Children
Definition
1-Neonates have decreased enzymatic sx
2-Liver maturation varies
Term
Factors that Affect Elimination of Drugs in Children
Definition
1-Increased renal clearance
2-Kidneys are not matured until 1-2 yrs
Term
Age child first smiles
Definition
4-5 months
Term
Age at which strabismus is considered abnormal
Definition
6 months
Term
Age at which tracking to midline is normal
Definition
2 months
Term
Age at which tracking 180 degree is normal
Definition
4 months
Term
Age at which head lab disappears
Definition
4 months
Term
Age at which crawling begins
Definition
7 months
Term
Age at which walking begins
Definition
9-11 months
Term
Age at which child begins reaching
Definition
4 months
Term
Age at which object permanence begins
Definition
10-11 months
Term
Age at which teething begins
Definition
18-24 months
Term
Age at which child can follow directions
Definition
18 - 24 months
Term
Age at which child uses complete sentences
Definition
3-4 years old
Term
HEEADDSS Screen
Definition
Adolescent Screening: H-home environment; E-educational performance/employment; E-exercise, eating behaviors; A-activities; D-Drugs; D-depression; S-suicidal thoughts/attempts; S-sex hx
Term
CRAFFT Screening
Definition
Adolescent Screening Tool for Substance Use: C-car--use when driving?; R-use when Relaxing?; A-use when Alone?; F-are family/friends bringing it up as an issue?; T-Getting into trouble?
Term
Which patients do not get rectal temps?
Definition
<1 month or >1 year; thrombocytopenia; irritated rectum; occult blood in stool
Term
Skin tags are indicative of what?
Definition
renal issues
Term
Stages of Separation Anxiety
Definition
Ages 6 months to 4 years
1-Protest--hours or days--searches for parent, cries and rejects staff. Accepts parent on return
2-Despair--more sad but cries less, may or may not approach parent on return
3-Denial--child becomes cheerful and ignores parent upon their return
Term
Presentation of Croup
Definition
Barky cough and Inspiratory stridor; Onset over 1-3 days; XR reveals "steeple" sign; Affects children age 6 mos-6 yrs
Term
Treatment of Croup
Definition
Dexamethasone PO
Nebulized racemic epi
Term
Presentation of Bacterial Tracheitis
Definition
Cough (maybe barky with thick sputum) and inspiratory stridor
*Appears toxic
-viral prodrome for days then suddenly worse
Diagnosed by bronchoscopy
Affects children 3 mos-13 yrs (esp 3-5 yr)
Term
Treatment of Bacterial Tracheitis
Definition
OR for airway management and bronchoscopy

Ampicillin-Sulbactam or Cephalosporin / Clindamycin
Term
Presentation of Epiglottitis
Definition
Affects any age
-Presents with Drooling, Dysphagia, Muffled voice, Respiratory distress that is worse supine, no cough; TOXIC
-Onset is rapidly over hours
-Diagnosed by visualization or XR
Term
Treatment of Epiglottitis
Definition
OR for airway management or intubation
Abx--cephalosporin
May try nebulized racemic epi
Term
Causative agents in croup
Definition
1-Parainfluenza virus; 2-RSV; 3-Adenovirus; 4-Measles; 5-Mycoplasma pna (only one that is bacterial)
Term
Acute Spasmodic Croup vs Laryngotracheobronchitis (LTB)
Definition
Acute Spasmodic Croup is typically recurrent. While Laryngotracheobronchitis rarely occurs more than once.
Term
Laryngotracheobronchitis
Definition
Inflammation in trachea that extends all the way down into the bronchioles--complicated croup; less common and not recurrent
Term
Criteria for hospitalization of croup patient
Definition
1-Anxiety/restlessness; 2-stridor at rest; 3-Cyanosis or Hypoxia; 4-Retraction or respiratory distress
Term
Treatment for Croup
Definition
1-humidified O2; 2-close assessment of resp status; 3-Racemic epinephrine nebulizer; 4-steroids
Term
Causative organisms of Acute Epiglottitis
Definition
1-Haemophilus influenza type B
2-Strep pna
3-Strep pyogenes
Term
Clinical Presentation of Bronchiolitis
Definition
Usually <2 yrs; often viral etiology (RSV)
-trapping of mucus in bronchioles
-dry cough; URI symptoms; low grade fever; wheezing that does not resolve with meds; difficulty feeding
Term
Immunization against RSV
Definition
Synergis
-requires 5 doses
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