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Summary NSG 4421 Peds Final Study Guide.

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Summary NSG 4421 Peds Final Study Guide.

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Summary NSG 4421 Peds Final Study Guide.
Chapter 1:
1. Top leading causes of death/age group
a. Infants= not safe in any environment. Crawling= putting objects in mouth= poisoning or
aspiration
b. Toddler= mobile. Run/climb= r/f falls, burns & collisions
c. 5-9 yrs= bike accident (no helmet) = head injuries. Accidental poisoning r/t meds
d. Adolescents= MVCs, drug/alcohol abuse/suicide= intentional poisoning
e. Others: drowning/burns/firearms
2. Family-centered care
a. Planning, delivery & evaluation of HC grounded in mutually beneficial partnership of HCP,
pts & fams
b. Consider the need of ALL fam members
c. Key elements= realize fam is constant in child’s life, facilitating fam professional
collaboration, exchanging unbiased info, honor culture preferences, encourage fam to fam
support, appreciate fam & child
d. 2 basic concepts for nurses:
i. Enabling= creating opportunities& means for fam to display abilities to meet the needs of
child
ii. Empowerment= help fam acquire sense of control over fam life; helping behaviors that
foster their own strengths, abilities & actions
3. Atraumatic Care  test question: don’t say a needle stick. Practice on a bear
a. Care to eliminate or minimize psych & physical distress of child & fam w/in the health system
b. Ex. Teddy bear in room- sit them down & explain procedure, foster parent-child
relationship, prepare child for unfamiliar procedure, dec pain, allow play time/ expressing
fear, privacy, respect culture, provide choices
c. Psych stress= anxiety, fear, stress, anger, disappointment, sadness
d. Physical= sleepiness, pain, temp immobile
e. 3 principles=
i. prevent or minimize child separation from fam
ii. promote a sense of control
iii. prevent body harm
f. Setting: anywhere, personnel: anyone


Chapter 2:
1. Family theories:
a. Describes fam unit & how they respond to events
b. Fam SYSTEM theory= affects all fam (circular casualty). Too little change & not enough to
hurt the fam balance btwn the two can initiate change & react to it. Focus on fam as a whole
(not individually) FOUCUS ON INTERATIONS!!!!
c. Fam STRESS theory= how fam responds to a stressful event. Predictable (parenthood) &
unpredictable (illness, divorce, unemployment). Multiple stressors in 1 yr can = breakdown.
Promote adaptation & structural change. Focus on +: cope, resources & social support FOCUS
ON ADJUSTMENT AND ADAPTATION
d. Developmental theory= address fam change overtime, usually use 1st child as maturational

, Summary NSG 4421 Peds Final Study Guide.
marker, fam changes in individual ways but similar, must all achieve individual time
specific changes as part of the cycle  TRANSITIONS HAVE DISEQULIBRIUM.
STAGES.
2. Family Structures:

, Summary NSG 4421 Peds Final Study Guide.
a. Nuclear= 2 parents & children (step, biologic, foster, adopted) & parents don’t have to
be married
b. Traditional nuclear = 2 parents and their children
c. Traditional blended= 2 parents & at least 1 step
d. Traditional extended= at least 1 parent, 1 child, 1 relative (grandparents)
e. Binuclear (single-parent) = assuming parent role but eliminating spouse role, divorced but joint
parenting- joint custody
f. Polygamous (single-parent) = multiple wives/ husbands. Sororal: vies are sisters, nonsororal
g. Communal=community
h. LGBT
3. Parenting Styles
a. Authoritarian (parent rules) = “bc I said so”. Control the child behavior & attitude
unquestionable. Rules & regulation are expected to be followed. Children are polite,
dependable, honest & can be defiant & antisocial  THE KID WILL BE SHY SENSITIVE AND
SELF CONSCIOUS
b. Permissive (child rules) = little to no control. Allow child to make own decisions. Parent is
a resource, not a role model. Rarely punish child (inconsistent)
c. Authoritative (combo of the two)= direct the child by giving them a reason as to why, respect the
child as a person & allow child to voice objections, control focus on issue & not withdrawal from
lover or fear of punishment. Inner directness (control behaviors based on guilt or shame).
Children have ^ self-esteem, resilienc & interactive, assertive & content
4. Discipline Styles e
a. Limit setting= help kids channel undesirable feelings, protect them from danger, learn socially
acceptable behavior, test limit of control, children NEED & WANT limits, help test
environment & know others are there to protect them *******make sure limits are made
CLEAR!!
b. Reasoning= explain why action is wrong, young may not understand, kids may be used to getting
attention (act up= lengthy discussion). Think bad attention is better than no attention – This
works for the older child but not necessarily for toddler/preschool
c. Scolding= combo w/ reasoning. Child may take “you are a bad kid” seriously
d. + and – reinforcement= if its rewarded, going to repeat behavior. No reward= no repeat.
Token/stickers= must explain desired action & reward, verbal approval always
~~~~~~ there was a test question abt how tokens/stickers go with the +/- reinforcements
e. Ignoring= eventually stop or minimize act, use when child does wrong for attention, watch for
response burst= ^ action to test parent
f. Consequence= natural- w/o intervention, no friend until room is clean. Logical- r/t problem,
can’t play w/ toy until others are cleaned up. Unrelated- time out. Must be planned & it will
happen. Public= time out when we get home. ~~~~ time out lasts 1 min per age in years of child
g. Corporal/physical punishment (spanking)- teaches kids violence is acceptable. Harms te child,
may become used to pain, child may misbehave when parent isn’t around due to behaving
well for their own sake
Chapter 10:
Biologic/Physical Growth
Infants

, Summary NSG 4421 Peds Final Study Guide.
• Weight= gain 5-7 oz q week. 1.5 lbs/qwk for first 5 mo. Double by 6 mo. Triple by 1 yr.
• Height= ^^ 1 in/mo for 6 mo. Grow in spurts & more in trunk. 6 mo= 65 cm. 1 yr= 74 cm
• Head circumference= demonstrates growth of brain. 6 mo= 43 cm. 1 yr= 46 cm.
• Chest circumference= closure of fontanelles at 6-8 wks and 18 mo. Equal to head at 1 yr
• Heart- doubles in size by 1 yr (slower).

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