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What is the major goal for pediatric nursing?
To improve the quality of health care for kids
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What are the pedicatric age groups?
- Infant 0-1 yr
- Toddler 1-3 yr
- Preschooler 3-5 yr
- School Age 6-12 yr
- Adolescent 13-18 yr
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What are the key stressors of hospitalization?
- Seperation anxiety for both parent and child
- Loss control, bodily injury, and pain
- Loss of a loved one
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What are the stages of separation anxiety
- Protest-child reacts aggressively to the separation from the parent
- Despair-crying stops and depression is evident
- Detachment-denial, superficially it appears that child has finally adjusted to the loss
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Describethe expression of anxiety for early childhood
- Infants-mistrust and decreased sense of control
- Toddlers-negativism, temper tantrums, non-compliance, regression, enforced dependency
- Preschoolers-loss of control, interpret messages according to their particular past experiences
- School-age-concrete thinking, vulnerable to events that less their feeling of control and power
- Adolescent-concrete thinking, loss of control and threat to self-identity, withdrawal, uncooperativeness
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What are the cognitive influences of loss of control?
- Egocentrism-"it's all about me" (infants & toddlers)
- Magical Thinking-"I have the power" not logical (Preschoolers & some school-age)
- Concrete Thinking-understand logical thinking (Adolescence)
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What do we need to do to minimize loss of control?
- Lack of control increases the perception of threat and can affect the child's coping skills. The major areas of loss of control and physical restriction, altered routine or rituals, and dependency
- Freedom of movement
- Promote understanding
- Maintain routine
- Encourage independace
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Hospitalization and stress, what are some risk factors, sibling reactions, & parental reactions?
- Risk factors: difficult temperament, lack of fit between child and parent, age, male gender, below average intelligence, multiple and continuing stresses
- Siblings: experience lonliness, fear & worry, anger, resentment, =guilt, unequal attention
- Parents: feeling an overall sense of helplessness, questioning skills of the staff, accepting reality of hospitalization, needing to have info explained, dealing with fear, uncertainty
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What are some strategies to support parents during stressful times and hospitalization?
- Establish bond
- Promote trust in staff
- Encourage participation in care
- Encourage self-maintenance
- Provide info
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What is the #1 cause of death for older pediatric populations?
Accident
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What is child abuse?
- Intentional physical abuse of neglect
- Emotional abuse or neglect
- Sexual abuse of children
- *Neglect is most common form of maltreatment
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What is the nurse's responsiblity when it comes to abuse?
- Protect the child further abuse
- Support the family and child
- Report and document to local authorities
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Describe failure to thrive?
Weight that falls below the 5th percentile for a child's age. It is a sign of inadequate growth resulting from the inability to obtain or use calories required for growth
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What are the types of failure to thrive?
- Organic, non-organic
- 1. Inadequate caloric intake
- 2. Inadequate absorption
- 3. Increased metabolism
- 4. Defective utilization
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What are the potential drives for non-organic failure to thrive?
- Poverty
- Health or childbearing beliefs such as fad diet
- Family stress
- Feeding resistance
- Insufficient breastmilk
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What is ALTE (Apparent Life Threatening Event)?
- Refers to an event that is sudden and frightening to the observer
- Apnea, change in color, hypotonia, choking, gagging, sepsis, CPR, upper or lower airway infection
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What is SIDS and what are the risk factors?
- Sudden death of an infant younger than 1 year of age that remains unexplained
- 95% of deaths occur under 6 months
- Risk factors include: maternal smoking, co-sleeping, soft bedding, unintentional asphyxiation from adult intoxication, maternal obesity
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