Test 1: Chapters 5, 7, 25, 8-13
Test 1: Chapters 5, 7, 25, 8-13 NBSN3010C
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This 17 page Study Guide was uploaded by Trisha Riley on Friday October 2, 2015. The Study Guide belongs to NBSN3010C at University of Cincinnati taught by Butts in Fall 2015. Since its upload, it has received 24 views. For similar materials see Continuum of Care for Children and Families in Nursing and Health Sciences at University of Cincinnati.
Reviews for Test 1: Chapters 5, 7, 25, 8-13
Clutch. So clutch. Thank you sooo much Trisha!!! Thanks so much for your help! Needed it bad lol
-Erica Ebert DDS
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Date Created: 10/02/15
Chapter 5 Concepts of Growth amp Development Wednesday August 26 ZDlS 839 AM Growth and development is a pattern and not all children will reach certain points at the same time but if they are behind we need to discover why and if they are ahead great Erikson39s Trust vs Mistrust o Newborns quottrustquot their needs will be met 0 They cannot advance to the next stage of development when their needs are not met Each age group has developmental tasks they should meet Growth physical size and quantitative changes numbers Generally babies double their weight by 6 months and triple their weight at 1 year Development capabilities or functions Cephalocaudal head to tail moves head arms then legs and feet Proximodistal center to distant parts shoulders before hands Common Defense Mechanisms Used by Children Regression return to an earlier behavior previously toilet trained child becomes incontinent when separated from parents at hospital Repression involuntary forgetting of uncomfortable situations commonly abused children who cannot recall episodes of abuse Rationalization attempt to make unacceptable feelings acceptable hitting another because quothe took my toyquot Fantasy creation of the mind to help with unacceptable fear hospitalized child who is weak pretends to be Superman 36 years old Erikson39s psychosocial stages Toddlers autonomy parallel play 2 to 3 years old each one is playing with something near each other but not playing together Preschoolers initiate activities with planning and carrying out imaginative School age industry they want to be involved and participate in activities Erikson39s Stages of Infant Childhood and Adolescent Development Trust vs mistrust birth to 1 year needs must be met to progress Autonomy vs shame and doubt 1 to 3 years children want to be independent pottytraining praise for trying do not yell at for going in pants Initiative vs guilt 3 to 6 years initiates new activities and considers new ideas interest in exploring the world creates a child who is involved and busy Industry vs inferiority 6 to 12 years they want to do well and if they don39t they want be taught don39t bring them down because they are not doing well the child gains a sense of selfworth from involvement in activities Identity vs role confusion 12 to 18 years teenagers discovering themselves they want their friends and usually begin experimenting to fit in search for independence from parents and reliance from peers Piaget Object permanence ability to understand that when something is out of sight it still exists Egocentrisim ability to see things only from one39s own point of view Transductive reasoning connecting two events as cause and effects because they occurred together Centration focusing only on one particular aspect of a situation Animism giving lifelike qualities to nonliving things Magical thinking belief that events occur because of one39s thoughts or actions Conservation knowledge that matter is not changed when its form is altered Young infants display primary circular reactions when a reflexive response results in pleasure and is repeated shaking a rattle As infants become toddlers tertiary circular reactions occur when the child experiments with objects turning them placing them in mouth and banging them Toddlerspreschoolers demonstrate mental combinations as they increasingly use language to describe and understand their worlds Sensorimotor period Birth to 2 Years 0 Reflexive birth to 1 month sucking rooting and grasping by using these infants receive stimulation via touch sound smell and vision 0 Primary circular reactions 1 to 4 months repetition of behavior ie if a toy grasped make a noise and is interesting the infant with grasp it again 0 Secondary circular reactions 4 to 8 months awareness of environment grows as the infant begins to connect cause and effect ie sound of bottle preparation will lead to excitementif item is partially hidden the infant will try to uncover and retrieve 0 Coordination of secondary schemes 8 to 12 months object permanence intentional behavior using learned behavior to obtain objects sounds or engage in other pleasure activities 0 Tertiary circular reactions 12 to 18 months curiosity experimentation and exploration predominate as the toddler tries out actions to learn results ie objects are put in mouth banged put in containers etc 0 Mental combinations 18 to 24 months language provides a new tool object permanence is fully developed Preoperational period 2 to 7 Years 0 Preconceptual substage 2 to 4 years 0 Egocentrism ability to understand that when something is out of sight it still exists 0 Intuitive substage 4 to 7 years 0 Transductive reasoning connecting 2 events in a causeandeffect relationship simply because they occur together 0 Magical thinking belief that events occur because of one39s thoughts or actions 0 Centration ability to consider only one aspect of a situation at a time o Animism giving life to inanimate objects because they move make noise or have certain other qualities Concrete operational period 7 to 11 Years 0 Cause and effect thinking 0 Reasoning tied to concrete experiences 0 Conservation matter does not change when its form is altered Formal operational period 11 Years and older 0 Mature thought 0 Abstract thinking 0 Alternative outcomes to problems 0 Idealism Patterns of Temperament o The quoteasyquot child about 40 generally moderate in activity usually positive in mood and when subjected to new stimuli o The quotdifficultquot child about 10 adapts slowly to new situations and persons display a predominantly negative mood intense reactions are common 0 The quotslowtowarmupquot child about 15 mild intensity reactions and slowly adapt to new situations Resiliency Model 0 Developmental and situational stresses 0 Healthy functioning even with significant stress and adversity 0 Protective factors provide strength and assistance in dealing with crises 0 Risk factors promote or contribute to their challenges 0 Adjustment 0 Adaptation Developmental Periods o Newborn O to 1 month old 0 Prenatal influences on growth and development 0 Prenatal maternal and paternal influences 0 Physical growth and development 0 Reflexes help infant receive input nourishment comfort 0 Cognitive development 0 Learns through reflexes grasping eating 0 Psychosocial 0 Attachment 0 Touchpoints 0 Application to nursing care 0 Promote attachment strong emotional bond between people it can begin in the newborn period 0 Support parents 0 Provide education 0 Physical growth 0 Gains 57 ozweek o Grows 15cm in first month 0 Head circumference increase 15cmmonth 0 Fine motor ability 0 Holds hand in fist o Draws arms and legs to body when crying 0 Gross motor ability 0 nborn reflexes such as startle and rooting are predominant activity 0 May life head briefly if prone o Alerts to highpitched voices o Comforts with touch Sensory ability 0 Prefers to look at faces and blackandwhite geometric designs 0 Follows objects in line of vision 0 Infant 1 to 12 months 0 2 to 4 months 0 Physical growth I Gains 57ozweeks I Grows 15cmmonth I Head circumference increases 15cmmonth I Posterior fontanel closes I Ingests 120mlkg24hr 0 Fine motor ability I Holds rattle when placed in hand I Looks at and plays with own fingers I Brings hands to midline 0 Gross motor ability I Moro reflex fading in strength I Can turn from side to back and then return I Decrease in head lag when pulled to sitting sits with head held in midline with some bobbing I When prone holds head up and supports weight on forearms o Sensory ability I Follows objects 180 degrees I Turns head to look for voices and sounds O 4 to 6 months 0 Physical growth I Gains 5 to 7 ozweeks I Doubles birth weight at 56 months I Grows 15cmmonth O I Head circumference increases 15cmmonth I Teeth may begin erupting by 6 months I Ingests 100mlkg24hr 0 Fine motor ability I Grasps rattles and other objects at will drops them to pick up another offered object I Mouths objects I Holds feet and pulls to mouth I Holds bottle I Grasps with whole hand palmar grasp I Manipulates objects 0 Gross motor ability I Head held steady when sitting I No head lag when pulled to sitting I Turns from abdomen to back by 4 months and then back to abdomen by 6 months I When held standing supports much of own weight 0 Sensory ability I Examines complex visual images I Watches the course of a falling object I Responds readily to sounds O 6 to 8 months 0 Physical growth I Gains 35 ozweek I Grows 1 cmmonth I Growth rate slower than first 6 months 0 Fine motor ability I Bangs objects held in hands I Transfers objects from one hand to the other I Beginning pincer grasp at times 0 Gross motor ability I Most inborn reflexes extinguished I Sits alone steadily without support by 8 months I Likes to bounce on legs when held in standing position 0 Sensory ability I Recognizes own names and responds by looking and smiling I Enjoys small and complex objects at play 0 8 to 10 months 0 Physical growth I Gains 35 ozweek I Grows 1cmmonth 0 Fine motor ability I Picks up small objects I Uses pincer grasp well 0 Gross motor ability I Crawls of pulls whole body along floor by arms I Creeps by using hands and knees to keep trunk off floor I Pulls self to standing and sitting by 10 months I Recovers balance when sitting o Sensory ability I Understands words such as quotnoquot and quotcrackerquot I May say one word in addition to quotmamaquot and quotdadaquot I Recognizes sound without difficulty 0 10 to 12 months 0 Physical growth I Gains 3502week I Grows 1 cmmonth I Head circumference chest circumference I Triples birth weight by 1 year 0 Fine motor ability I May hold crayon or pencil and mark on paper I Places objects into containers through holes 0 Gross motor ability I Stands alone I Walks holding onto furniture I Sits down from standing 0 Sensory ability I Plays peekaboo and patty cake 0 Toddler 1 to 3 years of age 0 1 to 2 years 0 Physical growth I Gains 802 or moremonth I Grows 355 in during this year I Anterior fontanel closes 0 Fine motor ability I By end of 2nd year builds a tower of four blocks I Scribbles on paper I Can undress self I Throws a ball 0 Gross motor ability I Runs I Shows growing ability to walk and finally walks with ease I Walks up and down stairs a few months after learning to walk with ease I Likes push and pull toys 0 Sensory ability I Visual acuity 2050 0 2 to 3 years 0 Physical growth I Gains 1423kgyear I Grows 565cmyear 0 Fine motor ability I Draws a circle and other rudimentary forms I Learns to pour I Learning to dress self 0 Gross motor ability I Jumps 39 Kicks ball I Throws ball overhand o Preschooler 3 to 6 years of age 0 Physical growth 0 Gains 1525kgyear o Grows 46cmyear 0 Fine motor ability 0 Uses scissors o Draws circle square cross 0 Draws at least a sixpart person 0 Enjoys art projects ie pasting stringing beads using clay o Learns to tie shoes at end of preschool years 0 Buttons 0 Brushes teeth 0 Uses spoon fork knife 0 Gross motor ability 0 Throws ball overhand o Climbs well 0 Rides tricycle O Sensory ability 0 Visual acuity continues to improve 0 Can focus on and learn letters and numbers 0 Schoolage child 6 to 12 years of age 0 Physical growth 0 Gains 1422kgyear o Grows 46cmyear 0 Fine motor ability 0 Enjoys craft projects 0 Plays card and board games 0 Gross motor ability 0 Rides twowheeler 0 Jumps rope 0 Roller skates or ice skates O Sensory ability 0 Can read 0 Able to concentrate for longer periods on activities by filtering out surrounding sounds o Adolescence 12 to 18 years of age 0 Influences on growth and development 0 Physical growth 0 Variation in age of growth spurt 0 During growth spurt girls gain 725kg and grow 2520cm boys gain approx 7295kg and 1130cm 0 Fine motor ability 0 Skills are well developed 0 Gross motor ability 0 New sports activities are attempted and muscle development continues 0 Some lack of coordination common during growth spurt O Sensory ability 0 Fully developed NLCEXRN Review l 0095 Iquot 0095 S 0095 P 0095 The nurse notes that a 6 month old infant boy who weighed 7 pounds at birth now weighs 15 pounds Based on the evaluation of the infant39s current weight what is the nurse39s next action Ask the parent why the child does not eat enough Immediately inform the physician Teach how not to overfeed the baby When planning nursing care for a hospitalized 9 year old child which intervention is most developmentally appropriate Provide a separate recreation room for activities Encourage the child to brush teeth twice a day Offer medical equipment for play The nurse is caring for an 8 year old child who is hospitalized following a motor vehicle accident Based upon what the nurse knows about this child39s development what is the most appropriate nursing interventions Using toys for distraction from painful medical procedures Offering medical equipment for play to decrease anxiety Providing information on sexuality During a developmental assessment a parent complains that she has a quotdifficultquot toddler What advice would the nurse offer to the parent quotToddlers are flexible Accepting new rules will occur quicklyquot quotEncourage associative play and this will get betterquot quotSpanking your child will make the difficult behavior improvequot Chapter 7 Pediatric Assessment Wednesday September 2 2 15 9633 AM Physical VSLOCPain Incisions IV site Oxygen delivery Avoid honey until age 1 risk for botulism Avoid eggs wheat strawberries until age 1 risk for allergies Premies often require oxygen if they get too much 100 oxygen for long term retinopathy of prematurity ROP can occur may need to have combination of oxygen and room air less than 100 Test questions Vital signs normal values HR slows down with age higher in newborn Normal Temperature Bv Agg Age Celsius Fahrenheit Newborn 36372 axillary 968990 axillary 3 Years 364370 axillary 975986 axillary 10 Years 364370 oral 975986 oral 16 Years 364370 oral 975986 oral Normal Vital Signs Parameters Bv Agg Age Avg HR at rest Avg RR at rest Avg systolic BP Avg diastolic BP Premature 120170 4070 5575 3545 Birth1 month 100180 4060 6585 4555 112 months 100180 3540 70100 4565 13 months3 years 70110 2530 80105 5570 46 years 70110 2123 95110 6075 712 years 70110 1921 100120 6075 1319 years 5590 1618 90120 6585 Adult 60100 1218 90120 6080 Pediatrics Exam 1 Page 1 Chapter 19 Nutrition Friday August 28 2 15 234 AM Premature Infants 0 Before feeding consider gestational age weight and any congenital defects that prohibit oral feeds ie GI cardiac respiratory etc 0 When okay to feed PO watch for SampS of not tolerating food 0 Bloody stools 0 NEC necrotizing enterocolitis I Serious complication can spread in nurseries 0 Neosure is common formula used contains extra calories per ounce and easier for premies 0 Standard caloriesounce22cal can also come in 24cal NORMAL FORMULA 20caloz Max that can be given is 30caloz 0 Very expensive 0 Dietician makes quotrecipequot to make the desired caloriesounce and how long to continue formula 0 To increase calories without increasing volume increase calories per ounce To maintain weight give 100calkgday TPN is very hard on the liver Continuous TPN will lead to liver failure after about 18 months only treatment is liver transplant SGA Small for gestational age 0 Can happen from poor nutrition from mom 0 Going to need more caloz 0 Consider consistency in growth not necessarily the average percentile but continuing to grow Congenital defects 0 GI O TEF trachea and esophagus can have a hole in it during feeding can cause choking and food to enter lungs O CDH GI and respiratory o Biliary atresia there is no bile duct going into the liver 0 Cleft palate need a special nipple to create the suction sometimes requires squeezing 0 How to get nutrition 0 Artificial nutrition fed through an IV may be indicated TPN or hyper alimentation TPN is light sensitive TPN is based on off CD or QOD labs Watch glucose closely when on TPN When initiated start slow and increase If it is not continuous taper on and off Expensive Lipids have to be given in separate bottlebag Very hard on organs especially liver NG NJ Gtube Jtube types of delivery based on formula and pt needsbest way to deliver Sometimes tube feedings are supplemental Children with structural problems avoid upper GI tract OOOOOOOOOO Special diets 0 Type 1 diabetes let them eat and then determine the amount of insulin more active less insulin Pediatrics Exam 1 Page 1 Renal patients may have restrictions on volume and components of feeding Metabolic syndrome patients can require very specific amounts and types of protein GI patients with absorption problems ie CF need enzymes to aid digestion Celiac patients need to avoid wheats and oats barley is controversial EE patients esophagus is allergic to eating and drinking Pediatrics Exam 1 Page 2 Chapter 25 Alterations in Respiratory Function Friday August 28 2 15 92 3 AM The pediatric respiratory tract constantly grows and changes until about 12 years of age Young child39s neck is shorter than an adult39s resulting in airway structures that are closer together Lower Airway Differences Gas exchange cannot occur in preterm infants before 24 weeks gestation because lung sacs have not yet developed After 8 years of age the alveoli begin increasing in size and complexity and increases from 25 million fullterm newborns to 300 million by adulthood By 5 months of age infants have sufficient muscles to react to irritants by bronchospasm and muscle contraction Children under 6 years use the diaphragm to breathe because the intercostal muscles are immature by 6 years the child uses the intercostal muscles more effectively Retractions occur when the child is in respiratory distress sunken areas between the ribs during inspiration Coordinated chewing and swallowing does not fully develop until 4 years of age Children also have a cough that is less effective at removing foreign bodies when aspirated 0 Hot dogs nuts popcorn hard candy meat bones or small raw vegetable pieces and fresh fruits are common aspirated items 0 Small loose toy parts such as small wheels bells and latex balloons 0 Household objects and substances such as beads safety pins coins buttons batteries and colorful liquids in enticing packages Hypoxemia lower than normal blood oxygen level Hypercapnia an excess of carbon dioxide in the blood Hypoxia lower than normal oxygen level in the tissues Croup syndrome sounds like a seal due to stridor in the airway upper airway hoarseness Inflammation swelling of epiglottis and larynx L larynx T trachea B bronchioles most common Epiglottis and bacterial tracheitis are more serious Tends to be worse at night Cold air best treatment DO NOT APPLY HEAT If they have to go the ER get IM steroid injection to reduce swelling f croup is still bad they may receive racemic epinephrine if they receive this they should be admitted Antibiotic is not necessary because it is usually viral Bacterial croup syndromes include bacterial tracheitis and epiglottis Can become an emergency situation if the swelling becomes severe enough less stridoremergency Tracheitis bacterial infection of the trachea Severe resp emergency Needs to be treated with antibiotics Secondary infection of the upper trachea following an initial viral LTB SampS viral croup for several days before a productive cough high fever and a toxic appearance Child can lay flat Dysphagia and drooling are rarely present Pediatrics Exam 1 Page 1 Sometimes misdiagnosed as LTB condition worsens with nebulized epinephrine Antibiotics are given 10 to 14 days Asthma Reactive airway disease asthma in infants Not considered asthma until they are about 34 or have many attacks Two components of asthma inflammation in the airways and constriction in the lungs Bronchodilator treat constriction of lungs want something quick steroids treat inflammation 1 minute between puffs Ventolin increases HR drastically Xopenex is not as severe of an increase Blood gas RR shallow and fast Status asthmaticus no relief after using aerosol or inhaler usually sent to ICU and put on continuous aerosol treatments true emergency Exercise induced asthma or bronchospasm use inhaler 30 minutes before physical activity Home management use peak flow meter schoolage children are able to monitor their own peak flow and medication Epiglottitis Severe bacterial infection happens to children about 34 up to age 6 SampS drooling not being able to swallow or talk looking very anxious sitting in tripod position their throat is cherry red DO NOT LEAVE CHILD AND DO NOT PUT ANYTHING INTO THEIR MOUTH Bring everything to them scalexray Prepare for emergency trach Rhino Syntical Virus Nasal swab is the only way to diagnose Certain infants it can be fatal 0 Premies 0 Kids with underlying resp disease Cough is severe Generally what causes bronchiolitis NPO frequent resp status Pertussis quotwhooping coughquot Face gets very red and coughing continuously Spasmodic coughing then takes a breath that sounds like a whoop Can last up to 6 weeks Adult vaccine Tdap Cystic Fibrosis Each parent has to have the gene Each pregnancy has a 1 in 4 chance Exocrine glands that discharges secretions usually through a tube or a duct onto a surface Produce gallons of mucous and drown in her own mucous they get coughing fits and end up swallowing a ton of mucous Have to take enzymes when they eat IV therapy Meconium ilias not passing within 48 hours is a sign neonate Sweat chloride test determines how much salt and chloride is on their skin 4060 questionable Pediatrics Exam 1 Page 2 and gt60 is a sign 0 Rectal prolapse bulky stools difficulty going older children 0 Small for their age repeated resp infections stool steatorrhea 0 Cannot absorb water soluble vitamins A D and K have to be taken my mouth 0 Resistant to a lot of antibiotics usually in isolation o CPT chest physio therapy Other resp conditions Pneumothorax hole in lung Near drowning Smoke inhalation o Pneumonia crackles Premies can have chronic lung problems Bronchio Pulmonary Dysplasia Pulmonary hypertension high blood pressure in the lungs 0 Can be primary Dx 0 Secondary Dx caused from another problem 0 Treatment diuretic IV meds to reduce fluid in lungs 0 Gets worse cough up blood 0 Can cause systemic high blood pressure 0 Diagnosed through cardiac catheterization 0 Chronic 0 ND develops over time Congenital diaphragmatic hernia 0 Hole where diaphragm is and stomach content push up into lungs They will need to be intubated right after birth Unable to use diaphragm Prenatal ultrasounds can diagnose this before birth Important parameter in assessing respiratory status 0 Rate 0 Rhythm 0 Symmetry o Retraction 0 Sounds 0 LOC 0 Patient color cyanotic normal baseline 0 Hypoxia normally fine shortterm o Hypoxemia long term 0 What do they look like 0 How are they sitting o Coughing is good not coughing is bad 0 Wheezing Central apnea vs obstructive apnea 0 Central apnea something in the brain neurological where they will stop breathing periodically some kids may be on a trachea o Obstructive apnea tonsils sleep apnea o Monitors are set at 15 to 20 seconds Pediatrics Exam 1 Page 3 Tongue is where to check for status slight blueness around mouth and eyes can be normal ALTE apparent life threatening event tell parents to try to stimulate them Choking and aspiration Every respiratory situation can turn into an emergency SIDS any infant can be at risk cause unknown NCLEXRN Review POP Iquot 93 1119090 POP The nurse is caring for an infant who was admitted to the hospital for the treatment of RSV bronchiolitis What assessment item would the nurse report immediately to the healthcare provider Increased temperature Increased heart rate Decreased bowel sounds The neonatal nurse is giving discharge instructions to parents of an infant diagnosed with bronchopulmonary dysplasia BPD Teaching was ineffective if which statement is made by one of the parents quotI can expect my baby to require diuretic therapyquot quotI can expect my baby to receive respiratory treatments at least once dailyquot quotI can expect to come to the office monthly during winter months for at least 1 yearquot An 8 year old is diagnosed with viral pneumonia and sent home from the clinic without an antibiotic prescription The symptoms worsen and the child returns to the clinic a week later with signs of a higher fever listlessness and a harsh productive cough The mother states quotI knew a prescription for antibiotics was neededquot Which indicates the nurse39s most appropriate response quotIt is better to wait to make sure so we don39t use antibiotics unnecessarily This approach also saves healthcare dollarsquot quotSometimes we just do not know I39m glad you came back inquot quotYou do not want to expose your child to medication unnecessarily Now it is necessary because it is bacterial pneumoniaquot The nurse is caring for a pediatric patient who may be experiencing obstructive sleep apnea syndrome What questions are appropriate to include in the history assessment for this child select all that apply quotDoes your child sleep on hisher backquot quotDoes your child complain of evening headachesquot Pediatrics Exam 1 Page 4 Family Centered Care Wednesday September 2 2 15 849 AM Mutual pretense child knows but parent wants to act like all is well Ascent child or adolescent agrees with care Stages of Grief Stage Denial shock numbness Anger hostile reactions Bargaining yearning pining Depression disorganizatio n or despair Acceptance recovery Behavioral Responses Disbelief it seems like a bad dream Unable to process information about the death Questions the reality of the death Unable to believe that the child will not come home again may say quotThis can39t be happeningquot or quotThis can39t be truequot May direct anger at physicians and nurse who could not save the family member May express anger at God or supreme being May be angry about the bad things that have happened to a loved one or the inability to control what happened Yearns for life to return to the way it was Expresses guilt focusing on quotwhat ifquot or quotif onlyquot scenarios May bargain for life to return to the way it was or to see the loved one in heaven Has sadness and lethargy Daily activities seem pointless May withdraw from social and life activities Comes to terms with the death of the child and learns to live with the loss of the loved one Accepts the reality that the loved one is physically gone Eventually starts reaching out to others Stages of Sepa tion Anxietv Protest Despair Nursing Management Be verbally supportive Do not reinforce denial Don t argue allow the child or parents to come to terms in their own time Recognize that anger is a normal response to feeling of loss and powerlessness Avoid withdrawal or retaliation Do not take anger personally Remain with the child or parents even though they express anger Actively listen using eye contact and stillness Encourage survivors to identify and express their feelings Offer spiritual support if appropriate Make follow up phone call at regular intervals to the survivors 1 month 3 months 6 months and 1 year Assist family and friends to understand the grieving process Encourage friends and family to continue making contact Encourage the family to create memories Allow the individual to progress through the tasks or stages on his or her own timeline Encourage participation in activities that have meaning to the family member Denial Detachment Pediatrics Exam 1 Page 1 Screaming crying Sadness Lack of protest when parents leave Clinging to parents Quiet appear to have Appearance of being quotsettled inquot happy and content with everyone May resist attempts by Withdrawal or compliant Show interest in other adults to comfort behavior surroundings them Crying when parents Close relationships not return established Siblings 0 Worry about their siblings 0 Disruption in their routine 0 Getting quotshuffledquot about from relative to relative 0 Worry they may quotcatchquot what sibling has 0 Wondering if they will also be in the hospital Promoting Growth and Development while in the hospital 0 Find out from patientparentcaregiver about daily activities food preferences how to make child as comfortable as possible 0 Help the child cope using strategies that work finding out what does no work and communicating that with other staff Preparing for Discharge 0 Give instruction verbally using effective communication 0 Giver clearly written instructions and verify these are understood 0 Use demonstration and return demonstration techniques 0 Allow time for expression of fears hope and questions Pediatrics Exam 1 Page 2
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