Ch5 Concept of Health Promotion

Secondary

screening - identifying disease early to initiate treatment promptly (vision screening, substance use screening)

A middle school nurse is preparing an outline for a sex education class for 6 and 7th graders. Which of these statements represent important concepts to be covered in discussing this topic with this age group? Select all that apply.

A.Consider separating the boys and girls into same sex groups. B.Answer questions in a matter-of-fact manner and honestly as appropriate to the child's level of understanding. C.Discuss birth control.

Which foods are "choke" foods and should be avoided in the infant diet? Select all that apply.

A.Grapes B.Hard candy C.Nuts D.Nut butter

When discharging a newborn, which injury prevention instruction would be of highest priority to tell the parents?

A.Never leave the baby unattended on a raised, unguarded area."

School aged children are prone to accidental injury primarily because of:

A.Peer pressure and risk taking behaviors

Acetylcysteine

Acetaminophen

Which information is most important to give parents to prevent accidental poisoning of a 2 month old?

remove plants from playing area

initial first impression

respiratory rate and effort skin color response to environment

At what age do infants usually begin to hold objects in their hands and bang them together?

6-8mons

Primary

optimizing health and preventing disease (vaccination, dental care,

Naloxone

Opiates

· Poisonings

Assess the child first Assess ABC's and initiate appropriate interventions:CPR, IV, vital signs, treatshock. Ask questions about the ingestion (history)/ not (may not always be cocurate/unwitnessed ingetions) What? When? How much? Laboratory analysis in some cases may provide definitive diagnosis (testing serum lead levels provides the only accurate diagnosis) Treatment Activated charcoal Antidote

Flumazenil

Benzodiazepines

Glucagon

Beta blockers

Oxygen

Carbon monoxide

1Describe how to manage an obstructed airway in an infant and child >1 year old.

Infant - 5 back blows followed by 5 chest compressions · Child > 1 year - Heimlich maneuver (abdominal thrusts)

ingestion and aspiration

Ingestion - substance or object go through GI tract Aspiration - small object swallowed lodge in trachea

Deferoxamine

Iron salts

Characteristics of bullying include:

The infliction of repetitive physical, verbal, or emotional abuse upon another person with intent to harm.

What factors should the nurse consider when interviewing an adolescent patient?

ask open-ended questions

injury and death in adolescent

car accident

CPR/obstructed Airway management

determine responsiveness, breathing, pulse within 10sec infant: brachial artery

Tertiary

disease management (asthma education, diabetes education, obesity management)

violence prevention

don't use weapon control anger protect yourself

young children

drown, burnt, car seat, fall, damage body

therapeutic management

· First steps = assess ABCED and stabilize the child. Oxygen (bag-valve-mask ventilation device) Alter consciousness = endotracheal intubation · Child has ingested a sufficient amount of a substance to cause rapid deterioration in mental status = intubation equipment should be a the bedside · Shock or shows signs of compensated shock = IV fluid resuscitation is initiated, placement of a cardiac monitor and pulse oximeter · Activated Charcoal is most effective when administered within 60 minutes of ingestion. What medicine is administered concurrently to facilitate elimination of the substance? Sorbitol (cathartic laxative)

ABCDE

•A = airway •B = breathing •C = circulation •D = disability •E = exposure

sexual activity

•Abstinence •Safe sex •Condom use

Prevent Recurrences - EDUCATE

•Assess home for hazards at eye level of child •How to poison proof home •Poison Control number readily available •Mr. Yuk stickers on all toxic substances •Items locked and placed in high cabinets •Do not store products in drinking containers •Supervise small children - should NOT be left alone!

Management of Aspiration of Foreign Object

•Direct laryngoscopy or bronchoscopy •Observed for laryngeal edema and respiratory distress •Nursing interventions •Monitoring •Diet •Medications Teaching

teen safety

•Driving •Seatbelts •Follow speed limit •Never text while driving •Alcohol consumption •Water/sun safety •Protective gear •Learn CPR

Secondary Assessment

•F = full set of vital signs •G = give comfort •H = history and head-to-toe assessment •I = inspect posterior surfaces •Diagnostic tests •Weight

mental health

•Learn to feel good about yourself •Continue learning about yourself (what you believe in, what is important to you). •Depression

Management of Ingestion of Foreign Objects

•Removal by endoscopy •Some simply require serial x-rays to ensure smooth passage through GI tract ØInstruct parent to monitor stools for foreign object •Possible surgery if obstruction

Prevention of Substance Use/Abuse

•Substance use counselling •Cessation or treatment programs

immediately

•Violent coughing, vomiting, gagging, wheezing, apnea, cyanosis