PEDS Nursing Care of Children- exam #1

PEDS Nursing Care of Children- exam #1 a large body surface area for weight leaves the baby susceptible to? hypothermia anterior fontanel and open sutures are palpable up until... about 18 months posterior fontanel closes between? 2 and 3 months the tongue is large in relation to... a small nasal a oral airway passage a short narrow trachea in children under 5 years old makes them susceptible to? foreign body obstruction what makes the heart rate more rapid in late school aged children to adolescence cardiac output is rate dependent not stroke volume dependent abdomen offering poor protection for the liver and spleen causes a child to be susceptible to? trauma until 12 to 18 months of age the kidneys... do not concentrate urine effectively and do not exert optimal control over electrolyte secretion and absorption Until later school age, proportion of body weight in water is... larger with more water in extracellular spaces, daily water exchange rate is much higher what do muscles lack during infancy? tone, power and coordination muscles account for how much weight in infants vs adults 25% of weight in infants vs. 40% in adults until puberty the bones are softer and more easily bent and fractured primary breathing muscle the diaphragm what is not effectively expired when a child is under distress? causing them to become susceptible to? CO2 causing them to be susceptible to metabolic acidosis child have a faster? respiratory rate children have fewer/smaller and less? fewer and smaller alveoli and less lung volume tidal volume is proportional to? weight (7-10 mL/kg) until puberty the percentage of cartilage in ribs is? higher, making them more flexible and compliant children/infants require a higher (3) metabolic rate, oxygen need, higher caloric need the head is proportionately larger making the child susceptible to head injury true or false: all brain cells are present at birth? true myelinization and further development of nerve fibers in the brain occur when? during the first year RR and HR- newborn RR- 30-55 HR-100-170 RR and HR- 1 years RR- 25-40 HR- 90-140 RR and HR- 3 years RR- 20-30 HR- 80-120 RR and HR- 6 years RR- 16-22 HR-70-120 RR and HR- 10 years RR- 16-20 HR- 60-110 RR and HR- 17 years RR- 12-20 HR- 60-100 order to take vital signs in a child 1. RR 2. HR 3. BP 4. Temperature RR and HR need to be counted for how long? 60 seconds what is the last vital sign to change in a clinically decompensating child? BP when allowing parents to administer medications to their children in the hospital it is important that the parent... demonstrate the proper way to administer the medication toddlers experience what while being in the hospital? -separation anxiety -regression -injury and pain what can help a preschooler to learn about procedures and other things occurring while at the hospital? an intervention when about to do an assessment on this age group giving them hands on activities to help teach three phases of separation anxiety 1. protest (crying when the parent leaves) 2. despair (sad, withdrawn, cry when parent returns) 3. detachment (when parent leaves the child is not phased and is happy around other people but does not form any close relationships) nursing interventions for infants (trust vs. mistrust) -allow parents to stay in the room for procedures -teach parents things that they can perform -swaddle -pay attention to lights and sounds -keep scary objects out of sight -assign the same nurse nursing interventions for toddlers (autonomy vs. shame and doubt) -encourage the parents to stay at the hospital with their child -provide security objects (blanket, toy) -set limits but allow children to make small choices -teach parents that children can regress nursing interventions for preschoolers (initiative vs. guilt) -acknowledge fears -orient to surroundings -provide comfort and support -assess food likes -provide the child with a doll to help them understand what is going to happen -NEED TO WATCH WORDS WHEN DESCRIBING nursing interventions for school aged (industry vs. inferiority) -concrete thinkers (teach with books, hand outs, videos) -direct questions to the child -allow them to participate in the care -explain what is going to occur using correct terminology nursing interventions for adolescents (identity vs. role confusion) -encourage questions -encourage street clothes and other belongings from home -provide privacy -as few restrictions as possible define PEWS (pediatric early warning score) identifies patients at risk for clinical deterioration and provides needed interventions -based on behavior, respiratory and cardiovascular Green PEWS score 0-2 Yellow PEWS score 3 Orange PEWS score 4 Red PEWS score >5 IM injection is to be given vastus lateralis define Neonatal Abstinence Syndrome signs and symptoms infants may exhibit following delivery to a drug dependent mother