NUR 113 STUDY GUIDE EXAM 4

Implanon a contraceptive method when does it need replaced

It must be removed and replaced every 3 yrs if continued contraception is desired

age group would you observe for pain rather than trying to use verbal report?

(It was hard for me to find this one) I would think it would be between the ages of 0-3 years.

AT WHAT AGE WOULD THERE BE CONCERN IF GIRL HAS NOT STARTED MENSTRUAL CYCLE? ~

...15

ZOLOFT 50 MG, WHAT SHOULD THE CLIENT BE TAUGHT ABOUT THE MEDICATION?

...SSRI, contraindicated in breastfeeding, MAOIs, hepatic or renal dysfunc, alchol, hx of suicide attempts

WHICH CULTURE WOULD BE MOST LIKELY TO USE FOLK MEDICINE?

...indian and hispanics

What does the CDC recommend concerning physical activity for school children, how long and how many times a week?

1 hour or more of physical activity a day

Common time for infant to roll over

4mths rolls from back to side,5mths rolls from front to back, 6mths rolls from back to front ati pg24 Can turn over by 8-9 mths of age. Pg 653 ward

Which assessment would you perform first on an infant?

APGAR if a newborn If this is an infant coming in for a checkup make sure that the reflexes(rooting,sucking,moro, grasping,babinksi) are present, and the child is neurologically intact. Measure the head circumference, length, weight, and BMI. As always AIRWAY is most important.

WHICH AGE GROUP BENEFITS FROM READING AS PART OF THERAPEUTIC PLAY?

Adolescent

Appropriate stage for teaching children names and functions of sexual organs

Age 6-12 ati pg 48

PAXIL TO PREVENT DRUG/FOOD INTERACTIONS WHAT WOULD YOU TEACH CLIENT TO AVOID:

Alcohol

What site would you use to administer immunizations in an infant?

Anterolateral thigh muscle

Which contraceptive would be appropriate for a lactating woman?

Appropriate candidates for intrauterine contraception (IUD) include nulliparas, women with previous ectopic pregnancies , women receiving treatment for PID, LACTATING WOMEN, women testing positive for HIV, and women immediately postpartum or postabortion pg 152

DENVER II SCREENING TEST IS USED TO ASSESS WHAT?

Assesses personal-social, fine motor-adaptive, gross motor, and language skills. Nurse also documents behaviors during administration of the test.

Signs and symptoms of toxic shock syndrome

Common signs of TSS include fever of sudden onset greater than 101.1F, rash, hypotension with a systolic BP less than 90mm Hg. Pg 147

KUBLER-ROSS'S STAGES OF GRIEF:

Denial and Isolation, Anger, Bargaining, Depression, Acceptance

DESCRIBE DESPAIR:

Developmental regression, withdrawn, quiet.

ADVANTAGES OF HAVING A PRIMARY HEALTH CARE PROVIDER:

Reasonable cost of care, continuity of care by remaining in a medical home, and the fact that the child remains in the care of the family. Can decrease the risk of exposure that the child may have to other infectious or communicable conditions.

Describe who makes up the extended family?

Extended family is grandparents, aunts, uncles, cousins, who are outside of the nuclear family.

Appropriate toys and activities for toddler

Filling and emptying containers, playing with blocks, looking at books, toys that can be pushed or pulled, tossing balls. Ati pg33

Typical height for adolescent is?

Final 20-30% of height is achieved durning puberty, girls grow up 2-8 inches, and boys 4-8, ati pg55

What is definition of growth ? Definition of development

Growth refers to physical change and increase in size, Development is an increase in the complexity of function and skill progression. Ppt development

A toddler hospitalized what stressors would you anticipate for the child and family?

If hospitalized a toddler may experience: regression, separation anxiety, negative behavior, increase in tantrums, or fearfulness. Allowing family to room in, bringing things from home, and encouraging play(movies, drawing, etc), guided imagery, and role modeling are all ways to help the child feel more at home and decrease anxiety. Ways to help the parents may be: before admission for them to visit the hospitial to see where the child will be staying, give constant and open communication, encourage visitors, perform ongoing assessment to ensure that the nurse fully understands any changes in plan of care for child, observe for the need for crisis intervention, encourage parents to participate in the child's care.

The basic task for Erickson's Industry vs Inferiority stage is?

Industry versus Inferiority - 6 to 12 years - Child develops sense of confidence through mastery of tasks. This is counterbalanced by sense of inadequacy or inferiority that comes from not succeeding. Realizing competency is important building blocks in development of self-esteem. If child cannot accomplish realistic expected tasks, the feeling of inferiority may result. ppt development

Latent stage of development according to Freud

LATENCY (6 years to puberty) - Freud believes child "takes a break". Allows child to focus more intently on other aspects of growth and learning. Sexual impulses are repressed, relationships between peers of same sex develop, time for sports, and video games. ppt development

HOW DO YOU ASSIST FAMILY DEALING WITH GRIEF? IS THERE A SET TIME TO GRIEVE

Listen empathetically to the family and encourage them to take it one day or moment at a time, help the family understand that there will be good days and bad days. Can give family hope over that over time the emotional pain may dissipate, and that they can better understand the experience of their child's death

TYPICAL REACTION TO SEPARATION FROM FAMILY FOR A TODDLER IS?

Separation anxiety. May exhibit an intense reaction to any type of procedure due to the intrustion of boundaries. The three reactions are protest (screaming), despair (developmental regression), and detachment (lack of interaction with unfamiliar people)

CLOMID FOR INFERTILITY, WHAT DO YOU NEED TO TEACH CLIENT?

May increase the risk of multiple births, may need daily ultrasounds or ck serum estrogen levels if combined with other medications, can have "ovarian hyperstimulation" which pt may need to have a rest period and postponement of treatment until following cycle.

How do you assess adolescents for pain?

Most people of this age can tell you how they are feeling, and where their pain is. Pain is ALWAYS what the patient says it is. The numeric pain school (0-10) are best used on patients older than 12. The Wong-Baker Faces pain scale is good for preschool through school age. Another thing to measure pain is the FLACC scale. This scale consists of 5 categories: Face, Legs, Activity, Cry, Consolability. All of these categories are scored from 0-2. This is on page 693.

Difference between nature and nurture

Nature describes the traits inherent in the infant: biologically imposed idiosyncratic factors that create what and how each person "is". Nurture refers to the influence of external events such as parenting received , culture, or the time in which a child lives. Pg 642

SERVICES PROVIDED BY PEDIATRIC COMMUNITY NURSE?

Nurse provides health screening and education, emphasizing health promotion and disease prevention. Focus is on early identification, assessment, and referral

What interventions would you use to support child and family during the dying process?

Once the child is in the dying process it is important for the nurse to move her focus to care that helps the child move toward death. Comfort measures are always important for the dying patient. When it comes to family the nurse needs to convey genuine feelings for kindness and sympathy to the family. Physical contact is also important for the child and the family. The nurse also needs to be aware of the families that do not respond to touch and may stiffen or draw back. During this....the nurse needs to just step back and withdraw her hand. The nurse also needs to refrain from sharing any personal stories about his/her personal loss. As a nurse we need to give the family choice about what is possible during the dying process. The family may want to hold the child or climb in bed with them. An important thing for these situations is offering presence. Just being there in the room (if wanted) and providing emotional support are important.

Effective way to encourage good nutritional habits for preschoolers?

One way is to set a good example by eating healthy yourself. You can bring healthy snacks for your child, with you when you leave the house and teach them about the healthy choices that they can make outside of the home. Also, you can cut foods into shapes or present them in different ways so the food looks more appealing to the child.Include your child in preparation and purchasing of foods. Have one family meal at the table to introduce your child to new foods and if they don't like them don't force them to eat it.

How do you modify a toddler's behavior?

Parents and caregivers should know that tantrums for children of this age are normal. It may be possible to avoid such tantrums if the parent recognizes certain things that may "set the child off" like being too tired, or hungry. There are a few things that he nurse can teach the parents on how to help with discipline. 1. If the child is thrashing and crying and is not hurting themselves or anyone else...you can just leave them alone. 2. Distraction: Give the child a toy to divert their attention 3. Time-out: So the child can calm down 4. Removal of privileges: Withhold a favorite toy until the child's behavior is appropriate. 5. Verbal reprimands: Give spoken warning or disapprovals without judging the child as "bad" 6. Corporal punishment: Like spanking, swatting, grabbing....are NOT recommended (p.657) It is important for the parents to remember to never use name calling or yelling, to be clear, and firm. Also, they need to speak to the child as they would want to be spoken to if someone were reprimanding them.

Conflict resolution strategies

Parents should: allow adolescent to develop social relationships outside of the family in order to mature and define their identity; --set limits to adolescent behavior, -maintain open and honest communication on problem solving , allow adolescent to evaluate options to conflict resolution in passive, yet assertive ways. Conflict resolution strategies enable adolescent to remain calm in a potentially violent situation.

Cyanosis of skin is indicative of ?

Poor oxygenation, circulation, cold ...idk

WHAT STRATEGY USES REWARD TOINCREASE POSITIVE BEHAVIOR?

Positive reinforcement

What are the stages and signs of grief?

S/S: tightness in the chest and throat, weakness, SOB, inability to focus, feelings of guilt, feeling responsible for the loved ones death, hostile reactions, inability to complete daily tasks, preoccupation with the image of the deceased, searching for what they could have done differently. Grief theories: • Elisabeth Kubler-Ross- Denial, anger, bargaining, depression, acceptance. • Miles and Perry's Stages of Grief- Phase 1: state of numbness and shock Phase 2: period of intense grief Phase 3: period of reorganization (p.1149) • Epperson's Theory of Grieving- High anxiety, Denial, anger, Remorse, Grief, Reconciliation. • Pathological Grief- When the person deviates from a healthy way of dealing with grief to a not so healthy way (violence, addictions, poor decision making)

What safety concerns would you have for a school age child?

Safety is important for school-age children. • School-age children are highly active. They need physical activity and peer approval, and want to try more daring and adventurous behaviors. • Children should be taught to play sports in appropriate, safe, supervised areas, with proper equipment and rules. Bicycles, skateboards, in-line skates, and other types of recreational sports equipment should fit the child. They should be used only while following traffic and pedestrian rules, and while using safety equipment such as knee, elbow, wrist pads/braces, and helmets. Sports equipment should not be used at night or in extreme weather conditions. • Swimming and water safety lessons may help prevent drowning. • Safety instruction regarding matches, lighters, barbecues, stoves, and open fires can prevent major burns. • Wearing seat belts is the most important way to prevent major injury or death from a motor vehicle accident.

WHAT SHOULD CLIENT AVOID WHILE TAKING ORAL CONTRACEPTIVES?

Smoking

Which developmental domain is assessed for language development?

Social theory: Lev Vygotsky--emphasized that culture and certain factors within the child's environment have a dramatic impact on language development. (pg 646)

Signs of readiness for finger foods

Solids introduced at 4-6 mths, indicators for readiness include interest in solid foods, voluntary control of the head and trunk, and hunger less than 4hrs after nursing, veggies and fruits at 6-8mths, weaning can be accomplished after infant is able to drink from cups with handles sometime after 6thms. Ati pg26

What play is appropriate for a 6-9 month old?

Solitary play phase: They like to play patty cake, pee a boo, itsy-bitsy spider, finger painting, ball rolling, songs, high chair fishing.

. An adolescent is likely to take risks because?

They are still developing formal thought operations, and they may not have the cognitive abilities to make appropriate decisions regarding safety. Safety issues in adolescents differ from those who are younger. In the adolescent stage safety concerns such as safe sex, substance abuse, violence, and suicide are of concern. It's normal for adolescents to engage in risk-taking behaviors. However, these risks need to be healthy ones like: camping, team sports, horseback riding, etc. These need to be encouraged by the parents.

Hospitalized adolescent what stressors would you anticipate?

They may have concerns about their body image, separation from their peers, loss of independence, and decrease in socialization.

Nursing interventions and information for school-age child with terminal illness?

This child takes pride in the ability to assume some new responsibility, and their friends are important to them. Separation from these friends and an interruption in the child's independence can cause the child to display anger by refusing to comply with certain treatments are eat the special diet that they have ordered. This child can listen attentively but sometimes they don't completely understand all that the nurse is telling them. They may be scared to ask questions. It is also possible for the child to misinterpret medical information. Nursing intervention: The nurse needs to remember that the child has an increased awareness about the significance of their sickness and they may understand the lifelong consequences of their condition. A priority for the nurse is to assess the child's pain(numeric, FLACC, Wong-Baker scales). The child needs to be reassured that their behavior did not cause their illness, and the nurse needs to answer any questions the child may have about their treatments, condition, etc. Play may help the child cope with their illness. The nurse needs to teach parents that it may help the child regain some independence is they let him/her go to school, play with friends, choose activities, etc. The nurse also needs to tell the parents that the child can pick up on nonverbal cues and that they understand more than the parents may think. For this reason there needs to be open communication among all parties involved.

What activities to adolescents participate in?

This is the cooperative play stage. They like to play video games, computer games, board games, sports, card games, charades, etc.

OLD CAT

Used to clarify childs health history. Onset, Location, Duration, Character, Aggravating/ Alleviating, Timing pg666

How many regular menstrual cycles should one have before initiation of birth control pills?

Waiting until 2 years of menstrual cycles reduces the chance of suppression of the pituitary regulating centers. Pg 148

DESCRIBE DEPRESSION:

When illness can no longer be denied or bargained away, the family and child may begin to feel a profound sadness. (insomnia or excessive sleeping, nightmares, weight gain or weight loss, loss of concentration that interferes with ability to function normally, overwhelming anger, constant fear or worry about the physical wellness of other family members.

AMBULATORY SURGERY-DESCRIBE SERVICES:

a place where children receive minimal treatment, recover from the procedure, and then are discharged home soon after the surgery. Minimizes separation between child and family. Some recovery takes place in the surgery center, but longer process continues at home. Assess knowledge in order to determine their ability to care for child independently at home or if additional support is needed.

PRIORITY MEASURE FOR CHILD SAFETY IN HOSPITAL SETTING:

keeping toxic materials out of reach, identifying children with name bands, and knowing the whereabouts of children on the unit. Nurse must also provide a safe environment inside the room and in the transport of children from their room to other parts of the hospital.