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31 Cards in this Set
- Front
- Back
First 3 causes of infant death. (<1yo)
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1. Congenital anomalies
2. Disorders related to short gestation and LBW 3. SIDS |
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Baby dies at 30 days of life. Is this considered a neonatal, infant, or childhood death?
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infant
- neonatal - first 28 days of life - infant - 1st year of life - childhood - >1yr |
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What is major determinant of neonatal/infant death?
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low birth weight
- lower birth weight, higher mortality - many birth defects associated with LBW |
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Describe death rates across races.
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- infant mortality much lower for caucasians than any other race
- a.a. infant mortality much higher than any other group - difference between cauc and noncaucasion (not incl a.a.) have decreased |
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Primary cause of death of children >1yo
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MV accidents
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three leading causes of death. 1-4, 5-9, 10-14, 11-19
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1-4 = accidents, congenital, cancer
5-9 = accidents, cancer, congenital 10-14 = accidents, cancer, suicide 15-19 = accidents, homicide, suicide |
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Problem with long gestation
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meconium (infant stool) is aspirated
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Top 3 acute conditions in children
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1. Respiratory illness
2. injuries 3. infections and parasites |
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How to provide atraumatic care?
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1. prevent or minimize separation from family
2. promote sense of control 3. prevent or minimize bodily injury or pain |
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Describe Sepearation Anxiety
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- occurs in 3 phases
1. protest - crying, screaming for parents, refuse any other attention 2. despair - stop crying - depressed, withdrawn 3. detachment - appears as if child is adjusted - actually, is detachment from parent to escape emotional pain - may reject parents or cling |
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When a child enters a hospital, what stressors may they experience?
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- separation anxiety
- a loss of control - bodily injury and pain |
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How to minimize loss of control for infants
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- establish trust by giving consistent loving care
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considerations for minimizing loss of control for toddlers
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- autonomy vs shame and doubt
- egocentric - see things from their own point of view only - negativism - no no no, don't ask yes no questions - ritualism - ask parents - regression |
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considerations for minimizing loss of control for preschoolers
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- initiative vs guilt - why replaces no. answering q's of preschoolers reinforces intellectual initiative.
- egocentrism and magical thinking with preoperational thinking - easily misinterpret. clarify as to not scare child. |
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preoperational thinking
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- only able to understand explanations in terms of real events
- no abstract thinking - can only think in terms of what senses tell them |
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considerations for minimizing loss of control for school age children
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- industry vs inferiority - opinions of peers, parents teachers becomes important. if praised for good work, industry and mastery of school work. no mastery of school work may lead to feelings of failure and inferiority.
- enforced bed rest and patient role is direct threat to security - give them work to do - make their own beds, choose schedule of activities - inc sense of control from feeling of usefulness and productivity |
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considerations for minimizing loss of control for adolescents
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- identity vs role confusion - struggle for independence and self assertion for quest for personal identity
- condescending manner of talking intimidates them - assess level of intelligence, and learn their language so more relatable |
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Minimizing fear of bodily injury
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- for inserting IVs, papooses may help to constrict, but inc anxiety. better to restrain with touch and talk to them
- toddlers and preschoolers may need a bandaid for reassurance - teens may be more concerned about resulting scar than procedure |
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minimize separation anxiety
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- transitional objects
- allow children to cry during protest - even if child rejects strangers, rn can provide support through presence - remind about parents when detached |
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minimize loss of control
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- maintain the child's routine
- make sure school work is continuted - promote freedom of movement |
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birth weight doubles by
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4-7 mo
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birth weight triples by
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first year
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quick way of determining adult height
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height at 2 yo x 2 = adult height
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piaget cognitive development for children
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1. sensorimotor (birth to 2) - object permanence - knowing that object exists even when not visible
2. preoperational (2-7) - egocentrism - inability to put oneself in place of another 3. concrete operations (7-11) - conservation - volume, weight, number is same even if change in appearance 4. formal operations (11-15) - abstract thought |
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determine kind of play. one child beads necklace. one beads bracelet.
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associative - engaged in similar activity, but not organized
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determine kind of play. children building clay castles together.
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cooperative play - organized group play
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kinds of play
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onlooker
solitary paralllel associative cooperative |
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erikson stages of development
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1. trust v mistrust (birth to 1 yr)
2. autonomy vs shame and doubt (1 -3 yr) 3. initiative vs guilt (3-6 years) 4. industry vs inferiority (6-12) 5. identity vs role confusion (12-18) |
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FLACC scale
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- behavioral pain scale
- five categories - face, legs, activity, cry, consolability - 0-2 for each category - 0-10, 10 being worst |
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NIPS scale
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- neonatal infant pain scale - behavioral
- from 0 to 7, 7 being worst |
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what are physiologic responses to pain
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- inc HR, BP, resp
- dec O2 - palmar sweating |