Interventions for Health Promotion

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Trisomy 21 (Down Syndrome)

-Broad flat nose -Protruding tongue -Single palmar crease -Low set ears -Mild-moderate cognitive deficits

Pediatric Health Promotion

-Developmental milestones -Nutrition -Physical activity: 60 minutes/day for kids 6 and older -Screen time: limit

Poisoning: Hydrocarbons (gasoline, kerosene, lighter fluid, paint thinner, turpentine)

-Do NOT induce vomit -Intubate before gastric decompression

Poison: Corrosives (household cleaners, batteries, bleach

-Do NOT induce vomiting or neutralize acid -Maintain airway

Finger & Table foods

-Finger foods: 9 months old -Consider: -Safety: keep things small enough that they do not choke on them, have toddlers sit down when they eat -DigestibilityL no seeds, grapes, etc. -Table foods: Cheese, graham crackers, cooked unseasoned vegetables, noodles

Poisoning: Acetylsalicylic acid (aspirin)

-Gastric lavage -Activated charcoal

Poisoning: Supplemental iron

-Gastric lavage -Chelation therapy

Infant Nutrition

-Human milk or iron fortified formula -Primary source of nutrition -No extra fluids needed -Excess intake of water -Wean to a cup -Vitamin D supplement -Iron supplement (At 4 months for breastfed babies)

Introduction of Solid Foods

-Interest -Voluntary control of head & trunk -Disappearance of extrusion (protrusion) reflex -Iron-fortified cereal -Observe for allergy intolerance (New baby food every 5-7 days) -Vegetable, fruits, meats: start about 8-10 months

Health Promotion: Health Screenings

-Lead Screening: 1 and 3 years of age -Scoliosis

Trisomy 13 (Patau Syndrome)

-Microencephaly -Eyes small or missing -Severe cognitive deficits -Rarely survive a year, sometimes not even 2 weeks

Adolescent: Health Promotion

-Nutrition -Rapid Growth -Sexuality -Comfortable asking questions -Education: -Abstinence/ safe sex practices -Sexually transmitted infections -Pregnancy -Need to watch for overeating and under-eating

Toddler Nutrition

-Physiologic anorexia: they get bored of foods -Picky eaters -Whole milk (Vitamin D): for a year -Lower fat milk -Limit juice: lots of sugar, empty calories, limit to 4oz a day -Fruit: Cup a day -Prefer finger foods -Avoid potential choking hazards

Preschool Nutrition

-Picky eaters: monkey see, monkey due a this age so watching someone else try something new can help them want to try something new -Portions: Half of what adults eat -Saturated fats: limit this -Fruits and vegetables: need 5 servings/day -Protein: increase, size of palm of hand

Heath Promotion: Genetic Disorders

-Risk Factors: -Genetic disorder/inborn error or metabolism -Closely related -Known carrier of a genetic disorder -Age -Exposure -Obtain a complete family history -Refer for genetic screening -Provide emotional support/guidance -Refer to support groups

Motor-Vehicle Injuries Prevention

-Safest: back seat -Rear-facing carseat: Need to face backwards until 2 years old -Forward facing seat: Stay in these until they have outgrown them =Booster seat: preschoolers who have outgrown their toddler seat. Need to stay in booster seat until they are 4ft 9 in. tall -Supervise children -Don't let them sit in the truck bed -Explain no cell phone use while driving -Role model behavior

Turner Syndrome

-Short stature -Smal nonfunctioning ovaries -Short webbed neck -Puberty--pubic hair

Trisomy 18 (Edwards Syndrome)

-Small for gestational age (SGA) -Low-set ears, small jaw -Misshapen digits -Severe cognitive deficits -Rarely survive a year, sometimes not even 2 weeks

Health Promotion: Dental Health

-Teeth eruption: about 6 to 10 months -Bottle/ breastfeeding: Do not prop bottles because milk can pool and cause cavities -Dentist -Brushing/flossing: age appropriate assistance/supervision; Will be about 7 before they can do dental care appropriately -Tooth trauma: needs assistance immediately by dentist -Primary "baby" teeth -Permanent teeth: start coming in around the age of 6

Klinefelter Syndrome (XXY)

-Testes remain small--sterility -Gynecomastia (enlarged breast tissue) -Elongated lower limbs

A nurse is providing education on SIDS risk reduction to a group of parents. Which comment by a parent supports an understanding of SIDs prevention? A. "I and my partner will begin a stop smoking program tomorrow" B. "I will avoid a pacifier use because it will interfere with breastfeeding" C. "To support bonding of my twins from the womb, they can share a crib." D. "We will dress our infant in extra layers of clothes to prevent chilling"

A. "I and my partner will begin a stop smoking program tomorrow"

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." B. Place safety locks on all medicine cabinets and household cleaning supplies" C. Transport the infant in the front seat when driving alone so you can see the baby." D. Place safety guards in front of any heating appliance, stove, fireplace, or radiator."

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

A nurse is providing injury prevention education to the parents of an 18 month old. What information should the nurse provide? Select All That Apply A. Cover electrical outlets B. Close all toilet lids C. Lock windows D. Encourage pet therapy E. Use forward facing car seat

A. Cover electrical outlets B. Close all toilet lids C. Lock windows

Poisoning: Acetaminophen

N-acetylcysteine orally

School Age: Health Promotion

Nutrition: -Portions: more adult sized portions

Poisoning: Lead

Chelation therapy

Interpreting

Cluster relevant information, determine additional information to collect, set priorities & collaborate with other healthcare team members

Responding

Communicate & teach

Which is the most appropriate teaching to the parents of a child in the emergency department after a near drowning if the child is awake, alert, and has no respiratory distress? A. "Your child will most likely be discharged, and you should watch for any cough or trouble breathing." B. Your child will need to have a preventive tube for breathing and ventilation to ensure the lungs are clear." C. "Your child will be fine but sometimes antibiotics are started as a prevention for pneumonia and ear infection." D. Your child will most likely be admitted for at least 24 hours and observed for respiratory distress or any swelling of the brain."

D. "Your child will most likely be admitted for 24 hours and observed for respiratory distress or any swelling of the brain."

Reflecting

Evaluate health promotion readiness & correct thinking if needed

Noticing

Gather accurate data & predict potential complications


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