-
benefits of outpatient clinic
- child not separated from the family
- reduce the extent of treatment and the emotional impact of the illness
-
how should an infant be prepared for a treatment
- involve parents
- include familiar object
- soothe, distract and hug afterwards
-
how should toddlers and preschoolers be prepared for a treatment
- involve parents
- offer simple explanations
- give permission to express discomfort
- offer one distraction at a time
- allow for choices
- use distraction
- model desired behavior (i.e opening mouth)
- hug afterwards
-
how should a school age child be prepared for a treatment
- let child examine equipment
- encourage verbalization of fears
- offer small reward after treatment
-
how should an adolescent be prepared for a treatment
- provide privacy
- involve in treatment or procedure
- explain treatment or procedure and equipment
- suggest coping techniques
- involve in deciding who should be in the room
-
what are the major causes of stress for children of all ages?
- separation
- pain
- fear of body intrusion
-
at what age does separation anxiety normally occur
- infants at 6 months
- most pronounced in toddlers
-
what are the stages of separation anxiety
- protest: verbalize sense of abandonment
- despair: appears sad and depressed
- denial: Denies need for parents and becomes disinterested in their visits
-
how might a nurse misinterperet the stages of separation anxiety
- Protest = crying = bad
- Despair – adjusting
- Denial – well adjusted
-
should a parent be encouraged to "sneak out" while a child is distracted?
no it will damage the bond of trust
-
Four common pain assessment scales are
- Face scale: happy and sad faces
- poker chip scale: 4 poker chips; 0 is no pain, 4 is a lot of pain
- visual analog scale: pain thermometer
- descriptive word scale: child chooses word that describes pain
-
why is elimination of a drug prolonged in infants and toddlers
immature liver enzyme system
-
acetaminophen
- mild to moderate pain
- liver failure if not dosed correctly
- 15 mg/kg/dose
- max of 5 doses in 24 hrs
- toxicity can lead to liver failure
-
maximum time a child can be given NSAIDS and dosing schedule
- 5 days
- 8 - 10 mg/kg every 6 hrs
-
intramuscular injection sites
- vastus lateralis
- ventrogluteal
- deltoid
-
foods rich in iron
- boiled egg yolk
- liver
- leafy greens
- creaom of wheat
- dried fruits
- dry beans
- crushed nuts
- whole grain bread
-
how does sexual abuse manifest itself in children
- urinary frequency
- excessive masturbation
- encopresis (fecal soiling after 4 years of age)
- severe nightmares
- bedwetting
- irritation or pain in the genital area
- decrease in physical or emotional development
-
phimosis
narrowing of the foreskin which prevents it from retracting
-
hypospadias
- urethral opening on the lower shaft of the penis
- surgically repaired before 18 months
-
estimation of bladder capacity of a child
age in years + 2
-
why do girls get uti more often
- shorter urethra
- urethra closer to anus
- wear close fitting nylon underwear
- bubble baths
- retention of urine
- vaginitis
-
nephrotic syndrome
- kidney conditions distinguished by marked amounts of protein in urine, edema and hypoalbuminemia
- child has edema around eyes and ankles that later becomes generalized
-
nephrotic syndrome treatment
steroids
-
can a child with nephrotic syndrome or going through immunosuppressive therapy be vaccinated or immunized
no
-
signs and symptoms of acute glomerulonephritis
- occur 1 - 3 weeks after strep infection
- periorbital edema after waking
- smoky brown or bloody urine
- urine has high specific gravity
- BUN is elevated
- hypertension
-
wilms' tumor
- tumor of the kidney
- most found before child is 3
- found as a mass in the abdomen by doctor or parent
- do not palpate abdomen
-
should you palpate the abodomen of a pt with wilms' tumor
no, may cause tumor to spread
-
cryptorchidism
- undescended testicle
- common in 30% of low birth weight infants
- if both testes involved, sterility is likely
- doesn't affect testosterone production
-
does cryptorchidism affect testosterone production
no
-
seborrheic dermatitis (cradle cap)
- thick yellow, oily , adherent , crustlike scales on the scalp and forehead
- inflammation of skin that involves the sebaceous glands
- seen in newbors, infants and at puberty
-
cradle cap treatment
- shampooin on regular basis
- apply baby oil to the head in the evening and shampoo in the morning
- teens use dandruff control shampoo
-
eczema triad
- atopic dermatitis
- asthma
- hay fever
-
application of ointment
- apply after warm bath
- stroking in the direction of hair growth
- don't use topical steroids when a viral infection is present
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