Peds 2 quiz part 1

Pediatric Nursing Care

• Separation Anxiety: A significant concern for infants and toddlers, manifesting as protest, despair, and detachment.
• Transitional Objects: Familiar items (toys, blankets) offer comfort and security.
• Regression: Hospitalization can temporarily halt development, with children reverting to earlier behaviors. Patience and support are crucial.
• Healthcare Settings: Outpatient clinics, home healthcare, and hospital units. Pediatric units prioritize child-friendliness (playrooms, flexible routines).
• Preparing for Treatments/Procedures: Preparation's tailored to the child's age and involves parents. Honest explanations and emotional outlets are vital.
• Reactions to Hospitalization: Reactions vary based on age, preparation, home life, previous experiences, and support systems.
• Pain Management: Essential; use age-appropriate tools (FACES, FLACC, Neonatal/Infant Pain Scale). Pharmacological and non-pharmacological methods should be employed.
• Medication Administration: Dosages calculated precisely based on weight and developmental stage. Education for parents is paramount.
• Fear/Anxiety: Respect modesty, privacy, and address anxieties and fears from intrusive procedures.
• Cultural/Family Responses: Cultural sensitivity, understanding family dynamics and beliefs about health/illness, crucial for effective care. Cultural differences regarding personal space, smiling, eye contact, and touch should be acknowledged and addressed.
• Parental Reactions: Parents experience high stress; feeling guilt, helplessness, and anxiety. Provide support, clear communication, and involvement in the child's care.
• Sibling Support: Hospitalized children's siblings often experience emotional distress. Acknowledge their feelings and provide opportunities for involvement.
• Nurse's Role: Positive first impression is essential during admission. Detailed developmental history informs care planning. Nursing care plans individualized, including play and family involvement. Clinical pathways promote coordinated care. Understanding the impact of developmental stages on hospitalization experiences is critical. Discharge planning starts at admission. Education and support for a smooth transition home. Home healthcare service support is part of the role.
• Safety: Accidents are a significant risk for children; safety precautions must be implemented (crib safety, medication security, infection control).
• Developmentally Appropriate Care: Adjust care, assessments, procedures, and medication dosages to the child's developmental stage.
• Family-Centered Care: Informed consent, education, and active participation of parents are crucial.

Key Terms in Pediatric Nursing

• Communicable Disease: Transmissible between individuals.
• Fomite: Inanimate objects that transmit infections.
• Vector: Organisms (e.g., insects) that transmit diseases.
• Pandemic: Widespread disease outbreak across regions.
• Epidemic: Sudden increase in disease cases.
• Endemic: Constant disease presence in a region.
• Host Resistance Factors: Influence susceptibility to infection (age, sex, genetics, nutrition, emotional wellbeing).
• Natural Immunity: Innate defenses.
• Acquired Immunity: Developed through exposure or vaccination.
• Active Immunity: Body produces antibodies.
• Passive Immunity: Antibodies from another source.
• Direct Transmission: Immediate contact with an infected person.
• Indirect Transmission: Contaminated object/surface.

Infection Control

• Medical Asepsis: Prevents infection spread.
• Standard Precautions: Hand hygiene, PPE.
• Transmission-Based Precautions:
  • Airborne: Private rooms, N-95 masks for tuberculosis.
  • Contact: Gloves, gowns for direct/indirect contact.
  • Droplet: Masks, gowns for respiratory droplets.
• Protective Environment Isolation: For patients with impaired immunity.
• Hand Hygiene: Crucial for preventing infection transmission. Minimum 15-second scrub. Avoid artificial nails, treat skin lesions.
• Family Education: Crucial for infection prevention (vaccinations, food safety, hygiene).

Immunization

• Worldwide Immunization Programs: Healthy People 2030 goals and WHO/AAP recommendations. Vaccines maintain immunities.
• Nurse's Role: Vigilance for signs of communicable disease, education regarding vaccine importance. Parent consent is crucial; provide Vaccine Information Statements.
• Immunization Agents: Active (vaccines elicit antibody production) and passive (immune globulins immediate, short-term protection).
• Vaccination Administration/Storage: Proper schedules, storage (refrigerator center, no re-freezing after thawing). Avoid damage to inactivated vaccines, especially by freezing and damage to live vaccines.
• Vaccine Handling/Protocols: Original packaging, discard unused vaccine doses, check for allergies/assessments and epinephrine availability. Observation post-vaccination.
• Thimerosal and Safety: FDA confirmed no harm; single-dose and thimerosal-free options available on request.Address parental concerns.
• Immunization Schedules/Catch Up: Familiarity with schedules, catch-up guidelines for children starting vaccination late. Combination vaccines, separate vaccine administration schedules for effectiveness and precaution.

Common Childhood Communicable Diseases

• Specific Diseases and Management: Details like Chickenpox (Varicella), Smallpox, German Measles (Rubella), their incubation periods, contagious periods, symptoms, and nursing care.
  • Measles: Vitamin A for reduced morbidity, gamma globulin in exposure cases.
  • Pertussis (Whooping Cough): Vaccination (DTaP), antibiotics, rest.
  • Polio: Vaccination (IPV), respiratory support, physiotherapy.
  • Infectious Mononucleosis: Rest, no contact sports.
  • Hepatitis A/B: Vaccinations, hygiene, avoidance of blood contact.
  • Lyme Disease: Prevention (protective clothing), antibiotics.

Pediatric Nursing Procedures

• Gavage Feeding: Nutrition when oral intake is not possible.
• Gastrostomy Tubes: Long term nutritional support.
• Enemas: Isotonic solutions to prevent fluid shifts.
• Tracheostomy: Maintenance of airway patency, infection prevention.
• Oxygen Therapy: Method selection based on age and condition, safety precautions.
• Airway Obstruction Management: Appropriate technique based on age.
• Pre/Post-Operative Care: Preparation and attention to the child's developmental needs are vital.

Pediatric Nursing in Bioterrorism & Disaster

• Nurse's Role: Crisis preparedness, communication, coordination of care.
• Children's Vulnerabilities: Immature immune systems/physiology (e.g., larger body surface area, thinner skin) heighten their risk from biological agents.
• Emergency Preparedness: Families maintain essential supplies/emergency plan.
• Bioterrorism Specifics: Nurses must be knowledgeable about bioterrorism-related symptoms in children.

Sexually Transmitted Infections (STIs)

• STI Transmission/Impact: Prenatal transmission is possible, high risk for sexual abuse in prepubertal children.
• Nursing Care/Education: Emotional support, STI education and safe practices for adolescents. HPV vaccination.
• Treatment: Symptom management, potential recurring infections.
• Specific STI Details: HPV management (cryotherapy, electrocautery).

HIV/AIDS

• Transmission/Prevention: Transmission via contact with blood, sexual routes, or mother-to-child during birth; education for safe sex, counseling for pregnant women
• Nursing Care: Infection prevention, antiretroviral therapy, nutritional support, emotional support, community resources. Specific virologic testing may be necessary.

Appendices/Additional Notes

• Data Collection: Assessments in a warm/non-stimulating environment, minimizing initial touch. Apical pulses for children under 5. Accurate weight measurement is necessary for medication calculations.
• Specimens: Age-appropriate explanations/comfort measures during specimen collection.
• Medication administration: Age is the most important determinant in determining response to therapy.
• Important considerations in medication administration: Drug absorption, distribution, metabolism, and excretion are different in children than in adults.
• Procedures: Detailed information of different pediatric procedures like Gavage feeding, Gastrostomy tubes, Enemas, Tracheostomy, and Oxygen therapy.
• Pain Assessment: Use of pain scales tailored to different age groups.