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Pediatrics Notes- Notes from Peds
course Growth and Deveopment.
Helpful for Quizzes.
Pediatric nursing (San Joaquin Delta College)
Pediatrics
Chapter 1
• “Family centered care” -Connect with the family first and then with the child
• Do least invasive assessment first (Inspection, Auscultation, Palpation, Percussion)
• Do vital signs while implementing distractions
• Develop strategies to include parents and guardians. Pediatric nursing is a TEAM effort.
• Child life –Group of people who distract the child while doing a procedure
• Major goal is to improve the quality of health care for children and their families
• Millions of families lack of health insurance. Disparities are related to race, ethnicity,
socioeconomic status and geographic factors. Healthy people 2020: Increase quality of
life and eliminate disparities Leading health indicators:
1. Physical activity
2. Overweight and obesity
3. Tobacco use
4. Substance abuse
5. Responsible sexual behavior
6. Mental health
7. Injury and violence
8. Environmental quality
9. Immunization
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10. Access to healthcare
• Equal health opportunities and resources (Child Health Promotion)
• Developmental processes are unique to each stage of development.
• Erickson’s: Stages of Psychosocial development o Trust vs Mistrust (Infant) –Attend to
their needs to build trust
o Autonomy vs Shame & Doubt (Toddler) o Initiative vs Guilt (Pre-schooler)
o Industry vs Inferiority (Grade-schooler) –They think they know it all
o Identity vs Role Confusion (Teenager) –Self-esteem is very important
• Piaget: Stages of cognitive Development o Sensory Motor (Begins at birth)
Preoperational (At age 2)
Concrete Operational (At age 7) Kohlberg’s:
Stages of Moral Development
• Infant developmental stages:
o 2 months: Starts to smile, turn their head, hold head up (Some head support)
o 4 months: Smiles occasionally, total head control o 6 months: recognize familiar
faces, able to sit without support o 9 months: Stranger danger!, should be
crawling & stand with support
o 12 months: Cries when parents leave, take a few steps & try to stand without
support
• Nutrition in infancy o Breastfeeding is BEST! O Provides micronutrients, immunologic
properties, enzymes that enhance digestion and absorption
o Eating habits are established by age 3
o Obesity and Type 2 Diabetes: Defined as BMI at or greater than the 95 th
percentile for youth of the same age and gender. It is the MOST COMMON
nutritional problem among American children and is associated with type 2
diabetes.
• Oral Health o Dental caries is the most common chronic disease in children o Low
income families are most likely to develop tooth decay o Give them water!! No juice or
milk at nighttime since it causes caries
o Brushing should occur after meals and at bedtime
• Childhood injuries o Most common cause of death and disability to children in the U.S.
o Suicide surpassed motor vehicle accidents as the leading cause of injury
mortality
o No pillows in the crib and remove strings from clothing o Keeps toilet seats
closed o Proper car seat position is important. Rear facing until age 2.
• Violence o Nurses need to be aware of children who harm animals, start fires
• Mental Health Problems o Suicide is the third leading cause of death (Ages 10-19) o
Ask questions that need to be asked and address the problem
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• Immunizations: Role of Nurses o Go to www.cdc.gov/vaccines -MEMORIZE
VACCINES!!!!
o Review page 197
• Mortality o Leading cause of death is congenital conditions
• Goals of Atraumatic Care o Parents are welcome in the room, involve them in the
treatment, educate them. O Prevent or minimize separation from the family o
Promote sense of control o Promote & minimize injury and pain
• Ethical dilemmas o Determine the most beneficial or least harmful action within the
framework
Chapter 2
• Primary and secondary group influences o Family, religious,
ethnicity, peer influence
• Cultural Shock o Values and beliefs are different
O Language barriers o
Isolation, loneliness
• Communication Influences o Mass media, Reading
materials, Movies, TV
• Socioeconomic influences
• Health beliefs and practices (Page 35)
• Religious beliefs (Table 2-2)
• Hereditary factors (Table 2-4) o Genetic differences
Chapter 4
• Ask open-ended questions
• Parents know the child better than anyone else
• See Box 4-3 (Pg. 98-99) – Verbal communication techniques: Facilitate response,
storytelling, bibliotherapy, dreams, “What if” questions, three wishes, word association
game, sentence completion, pros and cons. –Nonverbal communication techniques:
Writing, drawing, magic and play.
• See box 4-6 (Pg. 103) –Sexual Hx for adolescents
• No order needed to do abdominal girth or head circumference measurement
• Growth measurements
Height/length
Weight
Skinfold thickness and arm circumference o Head
circumference o BMI
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