NUR3503 Exam - Paediatrics Study
Guide
How are children physically different to adults? - Answer - Head is large compared to
the adult
- Often in newborns it exceeds the circumference of the chest
- Anterior and posterior fontanelles
- Muscles lack tone, power and coordination
- Arms and legs are shorter and underdeveloped at birth
- Midpoint in length on a child is umbilicus
- Midpoint in length on an adult is the symphysis pubis
- Disproportionate abdomen is due to the large liver and small pelvis
What are musculoskeletal system differences between the adult and child? - Answer -
Skeletal strength and endurance increases with age
- Protuberant abdomen
-At birth spinal column has only the anterior curvature
- Cervical and lumbar curvature begin with holding head up and walking
- Small facial sinuses (10-12 years)
What are Central Nervous System differences between the adult and child? - Answer
The brain of the neonate is relatively large
- 1/10 of the weight as compared to 1/50 of adult
- The brain grows rapidly commensurate with age
- Fontenelle's close at 18 months to 2 years as the brain grows
Spinal Cord
- Neuronal development finishes at age 12
- Myelination is not complete until age 3
- Primitive reflexes (Moro, grasp) disappear with myelination
*THEY HAVE Higher metabolic rate, higher oxygen needs, higher calorie need
,What are Integumentary system differences between the adult and child? - Answer
Growth is regulated and adjusted to variations in surface area
Thin structure - 1mm thick at birth
4% of Total Birth Weight in the newborn
Body Surface Area measurement important in children -why?
- Functionally matures during early childhood
- Production of sebum is minimal
- Eccrine glands are functional but immature
Cardiovascular differences - Answer At birth the right & left ventricles are essentially
the same in size & wall thickness
During the 1st month of life Right Ventricle dominant
4-6 months Left Ventricle dominant
• By four weeks the LV weighs more than the RV (2 months twice the weight)
• Cardiac muscle fibres increase over childhood
• Cardiac Output is related to Heart Rate not only Stroke Volume
• Blood pressure rises
• Total blood volume 70-80mls/kg
Respiratory system differences - Answer Trachea is short and soft
Large tongue
Airway resistance is high
Epiglottis is horseshoe shaped, posterior at 45 degree angle
Infants <6 months - obligate nasal breathers
Rely on diaphragm
Compliant chest wall
Outward recoil of the thorax is very low
5 yrs to puberty lung weight increases three fold
Lung and alveolar growth and size and maturation of tissues by 8 yrs
Why is fluid homeostasis important? - Answer Newborn 70 - 80 % Water
,Full term infants have a large % of TBW (total body water) & Extra Cellular Fluid
TBW decreases with age mainly as a result of loss of water in ECF fluid
Fluid turnover is 7 times greater than that of an adult
Altered fluid balance can have catastrophic consequences
Organ perfusion and metabolism count on adequate hydration
Infants and children are at a much higher risk for developing rapid dehydration
Childhood Immunisations - Answer diphtheria
tetanus
pertussis (whooping cough)
poliomyelitis (polio)
measles
mumps
rubella
haemophilus influenzae type b infections HIB
HPV
Hepatitis
Herpes Zoster
Answering Concerns about vaccinations - Answer Listen, most questions answered by
nurses, access information sites
Don't push
Keep up to date
Anticipated reactions
- Links to Autism, asthma
- Developmental delays
- Unanticipated adverse reactions
Maslow's Hierarchy of Needs - Answer (level 1) Physiological Needs, (level 2) Safety and
Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self
Actualization
, What do children need for health development?
Common age groups terminology - Answer Neonate: 0-4weeks
Infancy : 0-1year
Toddler : 1-3 years
Early childhood: 1-5 years
Pre-schooler : 4-6 years
School-aged : 6-11 years
Childhood : 5-13 years
Adolescence (varies) : 12-19 years of age
What is the full gestational age? - Answer 40 weeks
Less than 38 week is pre-term
Child resuscitation above 6 weeks - Answer 15:1 compressions to breaths
Child resuscitation below 6 weeks - Answer 3:1 compressions to breaths
Principles of Child and Family Centered Care - Answer - Respect
- Dignity
- Active engagement and involvement
- Information sharing
- Open and honest communication
- Collaboration
- Therapeutic relationships
Developmental Milestones - Answer Physical
Social
Emotional
Cognitive
Language
Functions of the gastrointestinal tract - Answer digestion, absorption, elimination
Children have a compromised/immature GI system
Guide
How are children physically different to adults? - Answer - Head is large compared to
the adult
- Often in newborns it exceeds the circumference of the chest
- Anterior and posterior fontanelles
- Muscles lack tone, power and coordination
- Arms and legs are shorter and underdeveloped at birth
- Midpoint in length on a child is umbilicus
- Midpoint in length on an adult is the symphysis pubis
- Disproportionate abdomen is due to the large liver and small pelvis
What are musculoskeletal system differences between the adult and child? - Answer -
Skeletal strength and endurance increases with age
- Protuberant abdomen
-At birth spinal column has only the anterior curvature
- Cervical and lumbar curvature begin with holding head up and walking
- Small facial sinuses (10-12 years)
What are Central Nervous System differences between the adult and child? - Answer
The brain of the neonate is relatively large
- 1/10 of the weight as compared to 1/50 of adult
- The brain grows rapidly commensurate with age
- Fontenelle's close at 18 months to 2 years as the brain grows
Spinal Cord
- Neuronal development finishes at age 12
- Myelination is not complete until age 3
- Primitive reflexes (Moro, grasp) disappear with myelination
*THEY HAVE Higher metabolic rate, higher oxygen needs, higher calorie need
,What are Integumentary system differences between the adult and child? - Answer
Growth is regulated and adjusted to variations in surface area
Thin structure - 1mm thick at birth
4% of Total Birth Weight in the newborn
Body Surface Area measurement important in children -why?
- Functionally matures during early childhood
- Production of sebum is minimal
- Eccrine glands are functional but immature
Cardiovascular differences - Answer At birth the right & left ventricles are essentially
the same in size & wall thickness
During the 1st month of life Right Ventricle dominant
4-6 months Left Ventricle dominant
• By four weeks the LV weighs more than the RV (2 months twice the weight)
• Cardiac muscle fibres increase over childhood
• Cardiac Output is related to Heart Rate not only Stroke Volume
• Blood pressure rises
• Total blood volume 70-80mls/kg
Respiratory system differences - Answer Trachea is short and soft
Large tongue
Airway resistance is high
Epiglottis is horseshoe shaped, posterior at 45 degree angle
Infants <6 months - obligate nasal breathers
Rely on diaphragm
Compliant chest wall
Outward recoil of the thorax is very low
5 yrs to puberty lung weight increases three fold
Lung and alveolar growth and size and maturation of tissues by 8 yrs
Why is fluid homeostasis important? - Answer Newborn 70 - 80 % Water
,Full term infants have a large % of TBW (total body water) & Extra Cellular Fluid
TBW decreases with age mainly as a result of loss of water in ECF fluid
Fluid turnover is 7 times greater than that of an adult
Altered fluid balance can have catastrophic consequences
Organ perfusion and metabolism count on adequate hydration
Infants and children are at a much higher risk for developing rapid dehydration
Childhood Immunisations - Answer diphtheria
tetanus
pertussis (whooping cough)
poliomyelitis (polio)
measles
mumps
rubella
haemophilus influenzae type b infections HIB
HPV
Hepatitis
Herpes Zoster
Answering Concerns about vaccinations - Answer Listen, most questions answered by
nurses, access information sites
Don't push
Keep up to date
Anticipated reactions
- Links to Autism, asthma
- Developmental delays
- Unanticipated adverse reactions
Maslow's Hierarchy of Needs - Answer (level 1) Physiological Needs, (level 2) Safety and
Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self
Actualization
, What do children need for health development?
Common age groups terminology - Answer Neonate: 0-4weeks
Infancy : 0-1year
Toddler : 1-3 years
Early childhood: 1-5 years
Pre-schooler : 4-6 years
School-aged : 6-11 years
Childhood : 5-13 years
Adolescence (varies) : 12-19 years of age
What is the full gestational age? - Answer 40 weeks
Less than 38 week is pre-term
Child resuscitation above 6 weeks - Answer 15:1 compressions to breaths
Child resuscitation below 6 weeks - Answer 3:1 compressions to breaths
Principles of Child and Family Centered Care - Answer - Respect
- Dignity
- Active engagement and involvement
- Information sharing
- Open and honest communication
- Collaboration
- Therapeutic relationships
Developmental Milestones - Answer Physical
Social
Emotional
Cognitive
Language
Functions of the gastrointestinal tract - Answer digestion, absorption, elimination
Children have a compromised/immature GI system
