Theory 210

A nurse in the teen clinic is using anticipatory guidance to educate parents about preventing suicide in teens. Which of the following responses by a parent would show the nurse that the teaching on suicide was effective?

"I will check for signs of depression and a lack of peers."

The school nurse has completed an educational program for parents at a local elementary school. Which statement by a parent would indicate the need for further education?

"It's okay for my 10-year-old to sit in the front seat of the car since he doesn't need a booster seat anymore."

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which statement made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child?

"My child sleeps between 11 and 12 hours a night."

During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be?

"Play helps children to develop cognitively, socially, physically, and emotionally."

Adolescent sleep hygiene

-7 to 8 hr per night -changes in circadian rhythm -bed 11pm -wake 9am -school start time=sleep deficit -sleep xtra on weekends to compensate

Complete health history

A comprehensive history of a patient's past and present health status, usually gathered during the patient's initial visit to a health care facility.

The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory?

A sense of competence, mastery, and worth.

Healthy People 2020 goals

Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups. Create social and physical environments that promote good health for all. Promote quality of life, healthy development, and healthy behaviors across all life stages.

Veracity

Devoted to the truth, truth telling to patients, clients, supervisor, coworkers

Beneficence

Doing good

secondary prevention

Efforts to limit the effects of an injury or illness that you cannot completely prevent.

primary prevention

Efforts to prevent an injury or illness from ever occurring.

objective

Factual, related to reality or physical objects; not influenced by emotions, unbiased

healthy people 2020 mission

Identify nationwide health improvement priorities. Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress. Provide measurable objectives and goals that are applicable at the national, State, and local levels. Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge. Identify critical research, evaluation, and data collection needs.

The nurse has just completed an assessment on a child who voices an interest in how things are made and who needs support when they are not successful. The child further reports he is involved in clubs and sports outside the home. The nurse is aware that this child is in which of Erikson's states of development?

Industry versus inferiority.

Tanner's Clinical Judgement Model

Noticing Interpreting Responding Reflecting

Which nursing action will best assist a 15-year-old client accomplish the developmental task according to Erikson?

Permit the client to make decision regarding one's car.

PICOT format

Population Intervention Comparison Outcome Time

Dignity

Respect for the inherent worth and uniqueness of others

When interviewed by the school nurse, a 13-year-old adolescent female states she has a boyfriend and that her parents do not talk about sex with her. She says is confused about the facts and wants to know the truth. Which approach would best address this adolescent's concerns?

Sit down with her and openly discuss her concerns and questions in an honest, straightforward manner.

Computer use at home and at school has increased adolescents' comfort in gaining access to and using the Internet. This has expanded their exposure to risks. What potential risks are there for an adolescent to be exposed to?

Teens can be exposed to inappropriate materials, harassment, threats, and potential for molestation.

The nurse is caring for adolescent athlete who is being seen for a fractured arm. The parent reports that this is the third sports injury in the past 2 years. The parent asks the nurse why the adolescent who is healthy overall continues to have injuries. How should the nurse respond?

The bones, joints and tendons of adolescents are vulnerable to injury due to their rapid state of growth.

health

The combination of physical, mental/emotional, and social well-being

Fidelity

The principle that we act in ways that are loyal. This includes keeping our promises, doing what is expected of us, performing our duties and being trustworthy

night terrors -preschool

a sleep disorder characterized by high arousal and an appearance of being terrified; unlike nightmares, night terrors occur during Stage 4 sleep, within two or three hours of falling asleep, and are seldom remembered

Integrity

acting in accordance with an appropriate code of ethics and accepted standards of practice

tertiary prevention

actions taken to contain damage once a disease or disability has progressed beyond its early stages

Nurse Practice Act

defines the legal parameters of professional and practical nursing

Nonmaleficence

do not harm to others; avoiding evil

Justice

fairness, equal access to care and treatment provided equally as divided amongst all

Focused Health History

involves questions that relate to the current situation

Maslow's Hierarchy of Needs

physiological safety love/belonging esteem self-actualization

PQRST

provocative/palliative quality region/radiation severity timing

Autonomy

self-determination; being independent and self-governing

Code of Ethics for Nurses

statements of the professionals' values and beliefs, which are based on ethical principles

Compassion

sympathetic consciousness of others' distress together with a desire to alleviate it

health equity

when all people have the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance

school age socialization

-ability to think about language/how its used -increase jokes/humor -ability to think/talk thru feelings

Infant pain assessment

-assess through observation/consolability -incorporate caregiver in pain assessment -FLACC Scale -NIPS

assessing toddler

-be flexible -gather info thru play -provide distraction -involve parent -allow toddler to touch medical equipment -explain procedure in simple, positive terms -positive reinforcement/praise -invasive procedures last

assessing preschoolers

-begin to involve the child -give choices through out exam -allow play with med equip. -invasive tx last -involve play

toddlers socialization

-believe world revolves around them -imitates behavior -temper tantrum -encourage choices -separation anxiety

toddler safety

-burns (lower hot water heat to 120) -falls (use gates @ top of stairs) -vehicles (ride backward 5 pt harness 0-2, right frontward 5 pt 2-4) -drowning (beware of buckets, small amt of water too)

FLACC scale

-face, legs, activity, cry, consolability -each domain score 0-2 -scores 0-10 -higher scores= more pain

preschool nutrition

-focus on a healthy diet -1200 to 1400 cal daily -avoid food high in fat/sugar -three meals/two snacks -involve child in meal prep/choices -do not fix separate meals -don't force feed if not hungry

subjective

-gathered from the patient -can't use 5 senses

gender dysohoria

-identifying with a gender -first seen ages 9-10 -short or long term -encourage caregivers to support child -remain non judgemental -be alert of s/s of depression, anxiety, bullying, low self esteem

Erisksons stage- Adolescent

-identity vs role confusion -self conscious about changing body -concern w/ attractiveness -body image stabilizes/identity forms in later adolescence

eriksons stage preschool

-initiative vs guilt -asserts self more -wants to please parents -plans/initiates activity

assessing the infant

-involve parents -access infant on parents lap -auscultate first while patient is quiet -most invasive tx last -explain everything in tx to parents

NIPS scale

-neonatal infant pain scale -facial expression, breathing pattern, cry, arms, legs state of arousal -scale of 0-1 except cry is 0-2 -max score of 7

School age safety

-protective gear in sports -prevent dehydration -never swim alone/teach how to swim -look both ways before crossing -firearm safety -fire safety plan -helmets

sleep hygiene toddler

-required for healthy growth/development -11 to 13 hr required -9 hr at night -2 naps until 18 months -develop bedtime routine

colic

-self limiting -increased business/inconsolable crying -peak: 6 weeks -resolve: 3-5 month -worse in evening -no tx -caregivers need support -encourage caregivers to lay infant in crib when frustrated

school age nutrition

-teach children about specific caloric needs -allow meal planning/assisting -families eat together -monitor Ca/vit D intake -avoid sugary drink/snacks -assist fam with food scarcity/limited resources

nightmares- preschool

Anxiety-arousing dreams that lead to awakening, usually from REM sleep.