VERSION 6
NR 328 PEDIATRIC NURSING EXAM 1 STUDY GUIDE
Ways we can help keep children out of hospital
-Vaccines
-Nutrition
-Exercise
-Education
Dental Care: the single most common chronic disease of childhood.
-Candy
-Energy drinks
-Coffee (Starbucks)
-Soda
Immunizations
- Herd-Immunity: everyone in a class gets vaccinated besides one person
-More than likely that one person that did not get vaccinated will not get the virus
Obesity & Type 2 Diabetes
-Define as a body mass index at or greater than the 95 th percentile for youth of the same age
and gender
Causes: not enough exercise, kids don’t want to go outside anymore, eating bad, sedentary lifestyle, not
enough money for recreational activities
Childhood Injuries: are the most common cause of death and disability to children in the US
-Over 1 year of age: car accidents if the #1 case of death
Others causes include: drowning, bums, poisoning, firearms
Prevention methods: car seats, helmets
Neonatal period: <28 days of life
Postnatal period: 28 days to 1 yr
Lower birth wt=higher mortality
Risk factors for infant mortality: lower birth wt, African Americans, male gender, short or long gestation,
maternal age (younger or older), maternal education
Top 3 causes of infant death: congenital anomalies, disorders relating to short gestation & unspecified
low birth wt, sudden infant death syndrome
5 leading causes of death in children 15 to 19 yrs old: accidents, homicide, suicide, cancer, heart disease
Family centered care: family as the constant in a child’s life
-Concept of enabling & empowerment
-Family must be included in care for these pts
-Needs of all family members must be addressed
Atraumatic Care: Goal is do not harm!
-Cluster care
-We allowed, give them choices
-Minimize harm
-Promote a sense of control
-Leave children w/ parents at all time
Pain
Pain is subjective
-It is whatever the child says it is
, -Pain is the 5th vital sign
Pain Assessment: behavioral, physiologic, self-report
QUESTT: Question, Use, Evaluate, Secure, Take cause of pain, Take action
Signs/Symp of pain: skin flushing, diaphoresis, elevation of BP, tachycardia, tachypnea, decrease in O2,
restlessness, dilation of pupils
After pharmacologic intervention
-Assess 10-30 mins after parenteral therapy
-One hr after oral administration
Assessment of pain: you can have the child point to area
-FACES scale/BIERI
-OUCHER
-Poker chip tool
-Word-graphic rating
-Numeric scale
-VAS
-Color tool
FLACC pain scale: tool used for infants
Children will metabolize drugs faster than adults
-Reason is because they are growing, everything is maturing, and moving faster
-Always calculate drug dosage w/ kids’ wt
Opioid Side effects: resp. depression, constipation, pruritis, n/v, sedation, physical dependence,
withdrawal symp, tolerance
Prevention of pain is always better than treatment
-Around the clock pain management
Communication & Physical Assessment
Communicating w/parents:
1st: Establish a setting
2nd: Ensure privacy and confidentiality (HIPAA-Health Insurance Portability and Accountability Act, 2003)
3rd: Encourage talking
4th: Direct the focus
5th: Listening and cultural awareness
6th: Silence, empathy, and anticipatory guidance: Tell the parents what to expect
7th: Avoid communication block
Communicating w/children:
1st: Make communication developmentally appropriate: Do not only acknowledge the parent, talk to the
child as well
2nd: Get on child’s eye level
3rd: Approach child gently and quietly: Toddlers are usually scared when you approach them
4th: Always be truthful
5th: Give child choices as appropriate
6th: Avoid analogies and metaphors
7th: Give instructions clearly
8th: Give instructions in positive manner
9th: Avoid long sentences, medical jargon; think about “scary words”
10th: Give older child opportunity to talk without parents present
We use play as an assessment tool
Assessment: Inspection, auscultation, palpation, percussion
NR 328 PEDIATRIC NURSING EXAM 1 STUDY GUIDE
Ways we can help keep children out of hospital
-Vaccines
-Nutrition
-Exercise
-Education
Dental Care: the single most common chronic disease of childhood.
-Candy
-Energy drinks
-Coffee (Starbucks)
-Soda
Immunizations
- Herd-Immunity: everyone in a class gets vaccinated besides one person
-More than likely that one person that did not get vaccinated will not get the virus
Obesity & Type 2 Diabetes
-Define as a body mass index at or greater than the 95 th percentile for youth of the same age
and gender
Causes: not enough exercise, kids don’t want to go outside anymore, eating bad, sedentary lifestyle, not
enough money for recreational activities
Childhood Injuries: are the most common cause of death and disability to children in the US
-Over 1 year of age: car accidents if the #1 case of death
Others causes include: drowning, bums, poisoning, firearms
Prevention methods: car seats, helmets
Neonatal period: <28 days of life
Postnatal period: 28 days to 1 yr
Lower birth wt=higher mortality
Risk factors for infant mortality: lower birth wt, African Americans, male gender, short or long gestation,
maternal age (younger or older), maternal education
Top 3 causes of infant death: congenital anomalies, disorders relating to short gestation & unspecified
low birth wt, sudden infant death syndrome
5 leading causes of death in children 15 to 19 yrs old: accidents, homicide, suicide, cancer, heart disease
Family centered care: family as the constant in a child’s life
-Concept of enabling & empowerment
-Family must be included in care for these pts
-Needs of all family members must be addressed
Atraumatic Care: Goal is do not harm!
-Cluster care
-We allowed, give them choices
-Minimize harm
-Promote a sense of control
-Leave children w/ parents at all time
Pain
Pain is subjective
-It is whatever the child says it is
, -Pain is the 5th vital sign
Pain Assessment: behavioral, physiologic, self-report
QUESTT: Question, Use, Evaluate, Secure, Take cause of pain, Take action
Signs/Symp of pain: skin flushing, diaphoresis, elevation of BP, tachycardia, tachypnea, decrease in O2,
restlessness, dilation of pupils
After pharmacologic intervention
-Assess 10-30 mins after parenteral therapy
-One hr after oral administration
Assessment of pain: you can have the child point to area
-FACES scale/BIERI
-OUCHER
-Poker chip tool
-Word-graphic rating
-Numeric scale
-VAS
-Color tool
FLACC pain scale: tool used for infants
Children will metabolize drugs faster than adults
-Reason is because they are growing, everything is maturing, and moving faster
-Always calculate drug dosage w/ kids’ wt
Opioid Side effects: resp. depression, constipation, pruritis, n/v, sedation, physical dependence,
withdrawal symp, tolerance
Prevention of pain is always better than treatment
-Around the clock pain management
Communication & Physical Assessment
Communicating w/parents:
1st: Establish a setting
2nd: Ensure privacy and confidentiality (HIPAA-Health Insurance Portability and Accountability Act, 2003)
3rd: Encourage talking
4th: Direct the focus
5th: Listening and cultural awareness
6th: Silence, empathy, and anticipatory guidance: Tell the parents what to expect
7th: Avoid communication block
Communicating w/children:
1st: Make communication developmentally appropriate: Do not only acknowledge the parent, talk to the
child as well
2nd: Get on child’s eye level
3rd: Approach child gently and quietly: Toddlers are usually scared when you approach them
4th: Always be truthful
5th: Give child choices as appropriate
6th: Avoid analogies and metaphors
7th: Give instructions clearly
8th: Give instructions in positive manner
9th: Avoid long sentences, medical jargon; think about “scary words”
10th: Give older child opportunity to talk without parents present
We use play as an assessment tool
Assessment: Inspection, auscultation, palpation, percussion
