chamberlain college of nursing-Pediatric Nursing Exam 1Piaget's Theory of Psychosocial Development

chamberlain college of nursing-Pediatric Nursing Exam 1Piaget's Theory of Psychosocial DevelopmentPediatric Nursing Exam 1  Piaget’s Theory of Psychosocial Development Stage Age Characteristics Sensorimotor Birth- 2 years  Development through use of 5 senses and motor response  Egocentric: only see the world from their point of view  Object permanence: objects that are out of sight still exist  Seperation: infants learn to seperate themselves from other objects  Progress from reflexive, to simple repetitive, to imitative activities Preoperational 2-7 years  Symbolic thinking (objects with words and images) but lack logical reasoning  Develop social awareness and able to consider viewpoints of others  Magical thinking: thoughts are all powerful and can cause events to occur  Animism: giving inanimate objects lifelike qualities. → imagination, pretend play  Centration: focus on one aspect insead of consider all alternatives  Asks a lot of questions (intuition) Concrete Operational 7-11 years  Development of logical thought and conceptual thinking (sorting blocks in a certain order)  Master the concept of conservation (something can stay the same in quantity, but look different)  Conductive reasoning (mathematical advancements)  Able to see the perspective and views of others. Formal Operational Stage 11- adulthood  Abstract thought (ex. Love, freedom, beauty, failure)  Hypothetical thinking: think beyond current circumstances and into future  Engage in deductive reasoning, logic based problem solving.  Able to understand how the actions of an individual affect others  Eriksons Theory of Cognitive Development This study source was downloaded by from CourseH on 12-14-2022 17:33:55 GMT -06:00 Infancy Birth- 1 year Trust vs. Mistrust  trust is developed by meeting comfort, feeding, stimulation and caring needs  Achieving this task is based on the quality of the caregiver-infant relationship and the care received by the infant  Begins to learn delayed gratification. Failure to learn delayed gratification leads to mistrust. Toddler 1-3 years Autonomy vs. Shame and Doubt  Attempt independence and do everything themselves  Use negativism or negative responses to express independence  Egocentric  Child develops personal control over behavior and actions  Toilet training Preschool 3-6 years Initiative vs. Guilt  Ability of the child to take initiative and be assertive leads to a sense of purpose  Interact socially and initiates play activities  Guilt can occur when they think they misbehavior or unable to accomplish a task  Guide preschoolers to attempt activities within their capabilities while setting limits School Age 6-12 years Industry vs. Inferiority  Ability to learn and grow socially/academically (feeling competent)  Accomplishment is gained through ability to cooperate and compete with others  Child should be challenged with tasks that need accomplished and allowed to work through individual differences to complete task Adolescence 12-18 years Identify vs. Role Confusion  Develop a sense of personal identity and come to view themselves as unique  Group identity: become part of a peer group that greatly influences behavior Developmental Considerations  Communication Techniques o Early Childhood  focus on child (egocentric); explain what, how, and why; let them know procedures are never a form of punishment; allow them to touch, feel and hold things; keep them in parents’ lap This study source was downloaded by from CourseH on 12-14-2022 17:33:55 GMT -06:00 o School Age  explanations and reasons for everything; interested in the functional aspect of procedures, objects and activities; have heightened concern over body integrity; use play o Adolescent  be honest and aware of privacy needs; think about developmental regression; involve other teens their age; prepare up to one week prior for procedures; give them a chance to speak without parents present  Home safety o Car Seats  Rear-facing: birth – 2years  Front facing: 2-5 years  Booster seat: meet height requirement of 4’9 and seat belt fits properly. Usually around 8-12 years old. oDrowning  Fence of swimming pools  Ensure the child wears like jacket in and around bodies of water  Supervise the child in and around water sources including buckets, toilets, baths, and drainage areas  Close bathroom doors  Close toilet seat and do not leave child unattended in bathroom  If near drowning occurs, always bring child to hospital o Burns  When cooking use farthest burner possible and turn handles to the back of stove.  Set water temperature to 120 degrees  Test water before child goes in  Avoid heating food in microwave  Sunscreen  Install smoke alarms and have one on each floor and outside bedrooms oPoisoning  Lock up medications  Have poison controls number readily available. Always call them before doing anything else o Choking  Supervise child during meals  Clothing should be checked for safety hazards  Avoid choking hazards: anything round or requires lots of chewing – hot dogs, nuts, seeds, whole grapes, hard candy  Begin CPR if child becomes unconscious oSuffocation  Place baby on back for all sleep  Never share bed with baby  Use a firm, tight fitting mattress, covered by fitted sheet  Crib slate should be no wider than 6cm  Atraumatic care and family centered care oFamily Centered Care: recognizes that the family as the constant in the child’s life and support families in their natural caregiving and decision-making roles. Allow family to serve as experts regarding their child’s health care o Atraumatic Care: provision of therapeutic care that eliminates or minimizes the psychosocial and physical distress experienced by children and their family. Preparing child for any unfamiliar treatments, controlling/preventing pain, allowing privacy, This study source was downloaded by from CourseH on 12-14-2022 17:33:55 GMT -06:00 providing activities for expression of fear and aggression, providing choices, and respecting cultural differences  Coping Mechanisms- regression, separation anxiety  Dental care (common chronic issues, teaching)  Milestones oWeight doubles/triples o Newborn reflexes/infant milestones (2m, 6, 8, 10m, 12m) VS  Apical heart rate  Height and weight  Pain assessment scales  Respiratory pattern  Note key assessment in files for differences and how, what to measure Respiratory  Signs and symptoms of distress (neonate, infant, child  Asthma – oxygen if <95%, meds oWhat is it? Chronic inflammatory disorder of the airways that results in intermittent and reversible airflow obstruction of the bronchioles from inflammation or airway hyperresponsiveness. o Risk Factors: family history; exposure to smoke; low birth weight; being overweight; exposure to allergens – indoor: mold, cockroach antigen, dust; Outdoor: grass, pollen, trees, shrubs, molds, spores, air pollution, weeds; Irritants: smoke, odors, sprays; exercise; cold air or changes in weather or temperature; animal hair; medications; strong emotions (fear, anger, laughing, crying) oSigns & Symptoms: chest tightness, dyspnea, cough, audible wheezing, coarse lung sounds, wheezing throughout, possible crackles; mucus production; restlessness, irritability; anxiety; sweating; use of accessory muscles; low o2 saturation oDiagnostic:  Pulmonary Function Tests:  Peak Expiratory Flow Rates (REFR): measures the amount of air that can be forcefully exhaled in 1 sec.  Bronchoprovotion testing: exposure to methacholine, cold air, or histamine; exercise challenge  Chest Xray: showing hyper expansion and infiltrates o Nursing Care:  Assess airway patency, respiratory rate, symmetry, effort, use of accessory muscles  Monitor for SOB, dyspnea, and audible wheezing. An absence of wheezing can indicate severe constriction of alveoli  Position child to maximize ventilation  Administer oxygen therapy as ordered. Keep endotracheal equipment close by.  Maintain calm and reassuring demeanor  Observe oral mucosa for infection secondary to use of inhaled medication  Assess weight, bp, electrolytes, glucose, and growth with corticosteroid use oMedications:  Bronchodilators (inhalers)  Short-Acting Beta2 Agonists (SABA) – albuterol, levalbuterol, terbutaline o Used for acute exacerbations o Prevention of exercise induced asthma  Long- Acting Beta 2 Agonists (LABA) – formoterol, salmeterol This study source was downloaded by from CourseH on 12-14-2022 17:33:55 GMT -06:00 o Used to prevent exacerbations, especially at night and reduce use of SABA o Must be used along with anti-inflammatory therapy o Cannot treat acute exacerbations  Cholinergic Antagonists – atropine, ipratropium o Block the parasympathetic nervous system, providing relief of bronchospasm  Anti-inflammatory agents – decrease airway inflammation  Corticosteroids: methylprednisone (parental); prednisone (oral); fluticasone (inhalation) o Oral systemic steroids can be given for short term o Inhaled are administered daily as a preventative measure o Rinse out mouth after using inhaler  Leukotriene modifiers – zafirlukast, montelukast  Mast Cell Stabilizers – Cromolyn  Monoclonal antibodies – omalizumab o Used to treat moderate to severe persistent allergic asthma uncontrolled by inhaled corticosteroids in children 12yr and older oInterprofessional Care  Consult respiratory services for inhalers and breathing treatments  Contact nutritional services for weight loss or gain related to medications or diagnosis o Client education  Instruct family and child to identify triggers  Teach child and family how to use a peak flow meter and to use at same time each day  Encourage child to drink plenty of fluids  Encourage exercise as part of asthma therapy – promotes ventilation and perfusion, maintains cardiac health and enhances skeletal muscle strength. o Complications  Status Asthmaticus: life threatening episode of airway obstruction that is often unresponsive to common treatment. Manifestations: wheezing, labored breathing, nasal flaring, lack of air movement into lungs, use of accessory muscles, distended neck veins, and risk for cardiac and respiratory arrest.  Administer humidified oxygen  Administer three nebulizer treatments of beta2-agonist, 20-30in apart or continuously. Ipratropium bromide can be added to increase bronchodilation  Administer corticosteroid  Prepare for emergency intubation  Magnesium sulfate IV decreases inflammation and improves pulmonary function and peak flow rate among children who have moderate to severe asthma when treated in the emergency department or pediatric ICU  Heloix (a mix of helium and oxygen) can be administered via a nonrebreathing mask to decrease airway resistance and work of breathing  Respiratory failure: persistent hypoxemia related to asthma  Stridor- will improve with humidity, epiglottitis management  Bronchiolitis/ RSC and appropriate isolation and management  Bacterial pneumonia  CF  Tonsillectomy  Epiglottitis  Pharyngitis This study source was downloaded by from CourseH on 12-14-2022 17:33:55 GMT -06:00  Strep throat  Cough and deep breathing  Otitis media Immunization/ communicable diseases  Contraindications to administration  Schedule  Isolation  Pinworms  Varicella  Warning signs of abuse  Management of phototherapy  Night mares vs night terrors This study source was downloaded by from CourseH on 12-14-2022 17:33:55 GMT -06:00 Powered by TCPDF ()