Final Exam: PRN 1831/ PRN1831 (Latest 2024/ 2025 Update) Principles of Maternal Child Health Nursing Review| Questions and Verified Answers|100% Correct| Grade A- Rasmussen
Final Exam: PRN 1831/ PRN1831 (Latest
2023/ 2024 Update) Principles of Maternal
Child Health Nursing Review| Questions and
Verified Answers|100% Correct| Grade ARasmussen
Q: SIDS and prevention
Answer:
- teach the parent about the importance of the “back-to-sleep” concept to prevent SIDS
- Infants should be positioned for sleep on their backs on a firm, flat mattress in a crib, both for
their safety - Bed sharing with young infants is a dangerous practice and should be discouraged.
- The use of pacifiers during sleep has a protective effect on preventing SIDS
Q: Safety: Adolescents Cyberbullying
Answer:
mean texting posting on social media ect
Q: Goals in the primary management of poisoning
Answer: - Remove access to the poison.
- Prevent further absorption.
- Call the poison control center.
- Provide supportive care and seek medical help.
Q: How to soothe a fussy premature infant?
Answer:
Keep light low, provide quiet environment, swaddle and make eye contact
Q: Signs of abuse in children
Answer:
Multiple bruises (green, yellow brown…variation in color indicates different ages of the bruising)
Q: Preventing burns in infants
Answer:
DO NOT use microwave to heat up food or drinks, check temperature of water. Water heart need
to be at 120, keep boiling liquid handles at the back burner and handles turn in
Q: Risk factors for abuse in parents
Answer:
Experienced abuse as a child
Drug or alcohol abuse
Low self esteem
High levels of stress
Poor parenting skills
Q: care of pediatric abuse victims
Answer:
Trusting relationship is key
Q: Industry VS infirmity
Answer:
mastering skills in math reading playing sport- don’t lie to them- logical thinkers
Q: Initiative vs. Guilt (Erikson)
Answer:
preschooler magical thinking, sexual curiosity is normal
Q: Piaget’s theory
Answer:
4 stages of cognitive development to process from one period to the next, children reorganize
their thinking processes to bring them closes to adult thinking”
Q: Identity- adolescents- teenagers
Answer:
hero worship normal, sleep more and eat more growing spurts, Establish trust with them
Q: Sensorimotor (ages 0-2)
Answer:
Developed through reflexes, environmental and exploration and interaction, and first forms of
communication.
Q: Preoperational (ages 2-7)
Answer:
peekaboo Developed through increased ability to communicate and reason but still egocentric
Q: Concrete Operations (ages 7-11):
Answer:
Developed through logic, cause and effect, seeing other points of view.
Q: Formal Operations (ages 11-16)
Answer:
Developed through ability to think abstractly and using problem solving.
Q: Development Patterns of Direction Cephalocaudal
Answer:
- development proceeds from head to toe.
- The infant is able to raise the head before being able to sit, and he or she gains control of the
trunk before walking.
Q: Patterns occur bilaterally Development Patterns of Direction
Answer: - development proceeds from the general to the specific.
- The infant grasps with the hands before pinching with the fingers.
Q: The first month of life, babies
Answer:
have minimal fine motor skills consist of having a “grasp reflect”.
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Infants
0 to 12 months
Toddlers
1 to 3 years
Preschoolers
4 to 6 years
School age
6 to 11 years
Adolescents
12 to 20 years
Recognize foods that increase risk for choking:
Hot dogs, nuts, grapes, bagels , marshmallows, peanut butter, raw carrots, dried beans, tough meats , popcorn
Cold stress
Cold stress occurs most frequently in newborns born preterm, outside of a healthcare faculty, requiring resuscitation, or with congenital anomalies. Symptoms include a temperature below 97.3F, respiratory distress, hypoglycemia, and lethargy
Stage 1: Trust vs. Mistrust
-Birth to 18 months
-Can I trust?
-Is the world a safe place?
-Trust: warm, responsive, consistent caregiving
-Mistrust: unresponsive, harsh, neglectful, abusive
Stage 2: Autonomy vs. Shame and Doubt
-18 months – 3 years
-Can I do it?
-Exploration, Independence
-Autonomy: patience, encouragement
-Shame/Doubt: belittling, discouraging
Stage 3: Initiative vs. Guilt
-3 – 5 years
-WHAT can I do?
-Curiosity
-Free Play
-Initiative: allow child to try, encourage, guide
-Guilt: not allowing child to try, scolding
Stage 4: Industry vs. Inferiority (Erikson)
Age: 6-12 years
Important: life event: school
Outcome: children learn to cop with new social and academic demands. Success leads to a sense of ability and accomplishment. In contrast, failure leads to a sense of nagging inferiority.
Stage 5: Identity vs. Role Confusion
Erikson: a need to develop a strong sense of self, one’s role in society, and personal identity – often resulting in a personal struggle called an “identity crisis.”
Stage 6: Intimacy vs. Isolation (Erikson) 20-40
Intimacy versus isolation
Major Question: “Will I be loved or will I be alone?”
Basic Virtue: Love
Important Event(s): Romantic relationships
Stage 7: Generativity vs. Self-Absorption 40-65
Generativity vs. stagnation
Major Question: “How can I contribute to the world?”
Basic Virtue: Care
Important Event(s): Parenthood and work
SAFETY TEACHING- newborns and young infants
don’t shake the baby
Stage 8: Ego Integrity vs. Despair 65+
Integrity versus despair
Major Question: “Did I live a meaningful life?”
Basic Virtue: Wisdom
Important Event(s): Reflecting back on life
SAFETY: Car seats
center of rear seat, rear facing until 2 years
Safe toys for infants Birth to 3 months
colorful moving mobiles, music/sound boxes
Safe toys for infants 3 to 6 months
3 to 6 months: noise‑making objects, soft toys
Safe toys for infants 6 to 9 months
6 to 9 months: teething toys, social interaction
Safe toys for infants 9 to 12 months
large blocks, toys that pop apart,
push‑and‑pull toys
Toddlers safety
- toys with small parts are choking hazards
- safety locks on cabinets
- drowning risk
- electrical outlets- should be covered
- greater risk for sunburn related to thinner skin
Bodily harm prevention for a preschooler
● Firearms should be kept in locked cabinets or containers.
● Preschoolers should be taught stranger safety.
● Preschoolers should be taught to wear protective equipment (helmet, pads).
Burns prevention for a preschooler
● Hot water thermostats should be set at or below 49° C (120° F).
● Working smoke detectors should be kept in the home.
● Preschoolers should have sunscreen applied when outside.
Drowning prevention for a preschooler
● Preschoolers should not be left unattended in bathtubs.
● Preschoolers should be closely supervised when near the pool or any other body of water.
● Preschoolers should be taught to swim.
Motor-vehicle injuries prevention for a preschooler
● Preschoolers should use a federally approved car restraint according to the manufacturer recommendations.
School age safety Bodily harm
● Keep firearms in locked cabinets or boxes.
● Identify safe play areas.
● Teach stranger safety to children.
● Teach children to wear helmets and/or pads when roller skating, skateboarding, bicycling, riding scooters, skiing, and snowboarding.
School age safety Burns
● Teach fire safety and potential burn hazards.
● Keep working smoke detectors in the home.
● Children should use sunscreen when outside.
● Teach safety precautions for children to take while cooking.
School age safety Drowning
● Children should be supervised when swimming or when near a body of water.
● Children should be taught to swim.
● Check depth of water before allowing children to dive.
● Encourage breaks to prevent children from becoming over-tired.
School age safety Poisoning/substance misuse
● Cleaners and chemicals should be kept in locked cabinets or out of reach of younger children.
● Children should be taught to say “no” to substance misuse.
School age safety Motor-vehicle injuries
● Children should use an approved car restraint system until they achieve a height of 145 cm (4 feet, 9 inches).
Safety: Adolescents
most accidental deaths r/t auto accidents
Safety: Adolescents Bodily harm
● Keep firearms unloaded and in a locked cabinet or box.
● Reinforce teaching about the proper use of sporting equipment prior to use.
● Insist on helmet use and/or pads when roller skating, skateboarding, bicycling, riding scooters, skiing, and snowboarding.
● Be aware of changes in mood. Monitor for self‑harm in adolescents who are at risk.
Adolescents- Safety
Safety: Adolescents Burns
● Reinforce teaching about fire safety.
● Adolescents should apply sunscreen when outside.
● Adolescents should avoid tanning beds.
Safety: Adolescents Motor‑vehicle injuries
● Encourage attendance at drivers’ education courses. Emphasize the need for adherence to seat belt use.
● Insist on helmet use with bicycles, motorcycles, skateboards, roller skates, and snowboards.
● Discuss the dangers of using cell phones or texting while driving and enforce laws regarding use.
● Reinforce the dangers of combining substance use with driving.
● Role model desired behavior.
Safety: Adolescents Drowning
● Encourage adolescents to learn how to swim.
● Advise adolescents not to swim alone.
Safety: Adolescents Substance use disorder
● Monitor for indications of substance use disorder in adolescents who are at risk
SIDS and prevention
- teach the parent about the importance of the “back-to-sleep” concept to prevent SIDS
- Infants should be positioned for sleep on their backs on a firm, flat mattress in a crib, both for their safety
- Bed sharing with young infants is a dangerous practice and should be discouraged.
- The use of pacifiers during sleep has a protective effect on preventing SIDS
Safety: Adolescents Cyberbullying
mean texting posting on social media ect
Goals in the primary management of poisoning
- Remove access to the poison.
- Prevent further absorption.
- Call the poison control center.
- Provide supportive care and seek medical help.
How to soothe a fussy premature infant?
Keep light low, provide quiet environment, swaddle and make eye contact
Signs of abuse in children
Multiple bruises (green, yellow brown…variation in color indicates different ages of the bruising)
Preventing burns in infants
DO NOT use microwave to heat up food or drinks, check temperature of water. Water heart need to be at 120, keep boiling liquid handles at the back burner and handles turn in
Risk factors for abuse in parents
Experienced abuse as a child
Drug or alcohol abuse
Low self esteem
High levels of stress
Poor parenting skills
care of pediatric abuse victims
Trusting relationship is key
Industry VS infirmity
mastering skills in math reading playing sport- don’t lie to them- logical thinkers
Initiative vs. Guilt (Erikson)
preschooler magical thinking, sexual curiosity is normal
Piaget’s theory
4 stages of cognitive development to process from one period to the next, children reorganize their thinking processes to bring them closes to adult thinking”
Identity- adolescents- teenagers
hero worship normal, sleep more and eat more growing spurts, Establish trust with them
Sensorimotor (ages 0-2)
Developed through reflexes, environmental and exploration and interaction, and first forms of communication.
Preoperational (ages 2-7)
peekaboo Developed through increased ability to communicate and reason but still egocentric
Concrete Operations (ages 7-11):
Developed through logic, cause and effect, seeing other points of view.
Formal Operations (ages 11-16)
Developed through ability to think abstractly and using problem solving.
Development Patterns of Direction Cephalocaudal
- development proceeds from head to toe.
- The infant is able to raise the head before being able to sit, and he or she gains control of the trunk before walking.
Patterns occur bilaterally Development Patterns of Direction
- development proceeds from the general to the specific.
- The infant grasps with the hands before pinching with the fingers.
The first month of life, babies
have minimal fine motor skills consist of having a “grasp reflect”.
Development Patterns of Direction Proximodistal
- from midline to the periphery.
Development proceeds from the center of the body to the periphery
by The 9th month of life, babies are
able to walk while holding someone’s hand, they can sit from a standing position without anyone’s help, & able to stack blocks & turn book pages.
by The 4th month of life, babies
can grasp objects with both hands, raise their heads up, &roll from back to side.
Importance of developmental level in planning care
Understand the way that the child thinks- this allows you to communicate effectively and appropriately
- Understand the related fears and developmental tasks- allows the nurse to focus interventions and individualize care
When does separation anxiety appear? (Developmentally)
-Begins at 4 month and peaks at 8 months
-Infant protest when separated from parent which cause parents anxiety
-11 and 12 months infant recognize when mom is leaving by watching behaviors
12 month old language development- what do you expect?
- Has 3 to 5 word vocabulary and understand simple commands
3yr old gross motor skills
rides a tricycle
jumps off bottom step
stands on one foot for a few seconds
3yr old fine motor skills
builds tower of 9-10 blocks
copies a circle
imitates a cross when drawing
4yrs old gross motor skills
skips and hops on one foot
throws ball overhead
catches ball reliably
4yrs old fine motor skills
laces shoes
uses scissors to cut out a picture
5yrs old gross motor skills
jumps rope
walks backward with heel to toe
throws and catches a ball with ease
5yrs old fine motor skills
uses pencil and small tools well
prints simple words and first name
Interacting with toddlers- activities
play with the child using age appropriate toys and read to the child
Developmental milestones for preschoolers 3-6
jump off of chairs and stairs,
they can also ride a tricycle,
skip and hop,
throw and catch a ball,
jump rope and walk backwards
Takes turns when playing games
Toddlers 1-3 NUTRITION
- picky eaters
- observe choking hazards
- will finger feed
- observe growth curve to ensure adequate intake
Toddlers 1-3 DEVELOPMENTAL ACTIVITIEST
finger painting. Toddlers will grow almost three inches a year during this stage and should weigh four times their birth weight by the time they are three years old
Toddlers 1-3 Safety
- may be prone to falling because of distribution of body weight
- The normal gait of a toddler is wide and unstable. By 6 years of age, the gait resembles an adult walk.
Tantrums- who has them and why
- Toddlers- Temper tantrums result when toddlers are frustrated with restrictions on independence. Providing consistent, age-appropriate expectations helps toddlers to work through frustration.
Tantrums-Appropriate response
- Make sure the child is safe
- Give as little attention as possible so as to not positively reinforce the negative behavior
Activity/toy recommendations for toddlers :
finger painting, large puzzle, blocks, tossing ball,
● Cloth books, puzzles with large pieces
● Large crayons and paper
● Push‑and‑pull toys, balls
● Tricycles
● Educational and child-appropriate shows and videos
Preschooler 3-6 ERIKSON
- Initiative vs guilt
Preschooler 3-6 COGNITIVE
- Magical thinking
Preschooler 3-6 BEHAVIORS
- sexual curiosity is normal
Preschooler 3-6 COMMUNICATION
- answer questions in simple terms
Magical thinking examples
- child is angry at a sibling and the sibling becomes ill… the preschool aged child may believe that their negative thoughts caused the illness
Magical thinking
Thoughts are all powerful and can cause events to occur.
School Aged 6-11 Eriksons
- Industry vs. Inferiority
Major Question: “How can I be good?”
Basic Virtue: Competence
Important Event(s): School
School age 6-11 behavior
- mastering tasks like math, reading, playing a sport or an instrument
School age 6-11 characteristics of thinking
- Logical thinkers ‡ communicate honestly
Adolescents: Erikson
identity vs role confusion
- developmental task is identity
Adolescents BEHAVIOR & PERSONALITY CHARACTERISTICS
- hero worship is normal
- peers are important (be concerned if they do not have peer relationships)
- daydreaming is mentally preparing for real situations
Adolescents SLEEP & GROWTH
- may sleep more and have increased appetite due to growth spurts
Adolescents Education
- When teaching about a sensitive topic- be sure to establish trust via ensuring confidentiality
Infant growth in the first year (weight increase)
infants should Double their birthweight by 6 months
- 12 months an infant should weigh in at Triple its birth weight
Newborn: Assessment of the head Fontanelle
- wider area where sutures of the cranial bones meet;
- The anterior fontanelle, a diamond-shaped area formed by the intersection of four sutures (frontal, sagittal, and two coronal) ‡ closes by 12-18 months
- The posterior fontanelle, a tiny triangular depression formed by the intersection of three sutures (one sagittal and two lambdoid) ‡ closes by 2-3 months
Growth in adolescence
- girls have growth spurt earlier than boys
- Periods of rapid growth may require increase in caloric intake as well as increase in sleep
Hospitalization: meeting the child’s needs
Child Life Specialists-
- provide children with age-appropriate preparation for medical procedures
- Pain management and coping strategies
- Facilitate and self-expression activities. They also provide information, support, and guidance to parents, siblings, and other family members.
Growth in adolescence FULL HEIGHT EXPECTED
Females: 2 years after onset of menses
- Males: age 20
Impact of hospitalization
Impaired family processes
- promote rooming in for maintaining bond
- involve the parents in care such as bathing and feeding
What is every hospitalized child at risk for?
- Developmental regression
- Include activities in your care to promote development
Pain assessment 2 months to 7years
- FLACC- 2 months to 7 years -pain indicator that can be used with nonverbal children.
Each observation is rated on a scale of 0 to 2, and 10 is the highest level of pain:
Pain assessment – 5 years and older
Numeric Scale
Hospitalized adolescents- plan your care:
Body image is important: will have concerns related to scars, having body parts shaved for surgery, use of assistive devices that make them “different”
Developing a sense of self…figuring out who they are Peer interactions are highly valued
Pain assessment – 3 years and older
FACES
Contraindications to rectal medication administration
- Does the child have a bleeding disorder? If so no rectal medication causes injury/bleeding
- Is the child vomiting – cant give PO
- Is the child allergic to the medication
Priority reactions to report after medications
-how its tolerated
- effect of it
-adverse reactions- difficulty breathing hives
-Which one is the highest priority? adverse reaction – ABC
How do you select a needle to administer medications?
22- to 25-gauge, 1/2 to 1 inch
Age/ size of child
Depends on the Viscosity “thickness” of medication to be administered
High alert medications:
Safe dosage range, route, double check high alert mediation with other nurse like insulin
Administration of otic drops:
UNDER 3- pull ear down and back
OVER 3- pull ear up and back
Administration of liquid medications:
Measure the dose precisely
For larger volumes can use a medicine cup
For smaller volumes- should use a syringe for more precise measurement
Administering IM injection to toddlers, preschoolers
Vastus lateralis , deltoid, ventrogluteal
Have parent hold child , explain procedure in the child’s language
Administering oral medications to an infant
-Semi reclining position and upright to prevent aspiration
-Administer medication in the side of the mouth in small amounts
-Stroke under the chin while holding cheeks together
There are six rights of adult and pediatric medication administration:
- Right patient
- Right drug
- Right dose
- Right time
- Right route
- Right documentation
Infant feedings Caloric needs
105 to 108 kcal/kg/day (Term infant)
- 110 to 120 kcal/kg/day (Preterm infant)
Infant feedings Fluid requirements:
140 to 160 mL/kg/day (Term infant)
- 60 to 80 mL/kg/day (Preterm infant)
What types of infant formulas are recommended?
Iron fortified
Nutrition for toddlers
Require balance diet, excessive milk intake can interfere with iron absorption
Calcium interfere with iron absorption
Food jags are normal- they are picky eaters
Childhood obesity: contributing factors
Lifestyle, genetics (Prader-Willi, Downs, Turners), hormonal disorders
-Diet (fast food, high calories)
-Family History: the eating and exercise habits of the parents
Psychological Factors: Childhood obesity
Long Term Medications: antidepressants, anti-seizure, antipsychotics, corticosteroids can all cause weight gain
Childhood obesity Socioeconomic factors
children from lower-income families are at a higher risk of becoming obese because of the lower cost of high-calorie foods, and the inability to pay for many extracurricular activities such as sports.
Clear liquid:
Broth , JELL-O, ice pops, clear juices, ice chips
•Full liquid
cream soups, milk products, ice cream, liquid yogurt drinks without
Soft Diet:
mashed potatoes and other veggies, soft meats, pureed fruits, yogurt
most water in the body
Is extracellular “extracellular fluid means that it is easier for that fluid to leave the body”
Infant risk for dehydration- why is it increased?
Insensible water loss is water loss that is difficult to measure such as body sweat
Priority action in epiglottitis
Protect Airway
Priority action in epiglottitis DONT
put anything in mouth no throat culture tongue blade, Provide humidified oxygen, droplet isolation for the first 24 hours after iv antibiotics is given
epiglottitis treatment
normal start of iv antibiotics then transition to 10 days of oral antibiotics prepare for intubation, monitor oximetry, administer corticosteroids and iv fluids
Respiratory system: Respiratory distress signs :
rapid breathing (tachypnea), retractions (which are exaggerated chest movements), nasal flaring, a grunting sound with expiration, and cyanosis
Respiratory system Meconium aspiration
can lead to respiratory distress, respiratory arrest, and, respiratory infections
New born at risk for
respiratory problems- if mom used drugs & alcohol during pregnancy – also if pain mediation or respiratory depressant used labor
Respiratory system: premature
(BORN..Before 36 week of gestation) — lungs may not be fully developed- risk for asthma
What is an exacerbation?
It means to worsen of any condition or sudden increase in symptoms
Eg flare up of asthma
SBAR- what is contained in EACH part?
S- situation- what I am calling about
B- background, hx, assessment finding like vitals
A- Assessment- the nurse assessment of the situation
R- recommendation” what the nurse recommends”
What is Broselow’s tape?
tool used to determine the correct equipment and dosage of medication needed for children of various sizes during an emergency response
-The tape is recommended for use on any child under the age of 12 years.
How is Broselow’s Tape used?
Under emergency situations in which the child cannot be weighed, the color-coded resuscitation tape is used to determine the best estimate of the child’s weight based on the child’s length.
ADPIE
A- ASSESSMENT
D- Diagnosis
P-planning
I- Interventions
Post-op care for cleft lip/palate
Elbow restrain, pain management, positioning for comfort ‘ onside’ , protection of airway, providing nutrition NO pacifier
Principles of Family Centered Care
· Agreed-upon partnerships between families of children, nurses, and providers, in which the families and children benefit.
· Respecting cultural diversity and incorporating cultural views in the plan of care.
· Understanding growth and developmental needs of children and their families.
Signs of respiratory distress in children
- Nasal flaring
- Grunting
- Retracting
- Tachypnea
- Wheezing
- Decreased SaO2
Short acting beta agonists
- Albuterol, levoalbuterol
Inhaled corticosteroids
- Fluticasone, beclamethasone, budesonide
Long acting beta agonists
formoterol
Systemic corticosteroids (oral)
- Prednisone
- Dexamethasone
- prednisolone
Abdominal pain assessment-
Inspect – look at it
Ausculate- listen to bowl sounds and bruits
Palpate- for organomegaly, masses and discomfort
Assess- pain level
Inhaled corticosteroids: teaching
- Shake before using
- Take slow deep breaths
- Rinse and expectorate following administration: presence of steroid in the mouth can result in thrush (oral yeast infection)
What is enteral feeding?
a mixture of supplements that are given through an intravenous catheter
The placement of a nasogastric tube (NGT) is the primary means to administer nutrition for short-term requirements.
If a child needs extended feeds, a gastrostomy tube may be placed surgically, extending from the external abdominal wall to the stomach. This is called a PEG tube or percutaneous endoscopic gastrostomy tube.
Risks related to persistent vomiting
Aspiration, tooth decay from stomach acid eroding the enamel , electrolyte imbalance, weight loss, nutritional deficiency
Hypertrophic pyloric stenosis is
- the thickening of the pyloric sphincter, which creates an obstruction.
- Usually occurs the first few weeks of life.
- Vomiting that often occurs following a feeding, but can occur up to several hours following a feeding and becomes projectile as obstruction worsens
MANIFESTATIONS: Hypertrophic pyloric stenosis
- Constant hunger
- Olive‑shaped mass in the right upper quadrant of the abdomen and possible peristaltic wave that moves from left to right when lying supine
- Failure to gain weight and manifestations of dehydration (pallor, cool lips, dry skin and mucous membranes, decreased skin turgor, diminished urinary output, concentrated urine, thirst, rapid pulse, sunken eyes).
Diarrhea Typical etiology
Viral
Diarrhea treatment
- Treatment is supportive symptom management
- Goal of treatment is rehydration:
- Use oral rehydration solution such as pediatlyte
- Avoid fruit juices, caffeinated beverages, milk
Dehydration in pediatrics Cause of hypovolemic shock in children?
- Absence of tears
- Dry mucous membranes
- Sunken fontanel (infants)
- Dry eyes
- Decreased or absent urine output
- Tachycardia
- Sluggish capillary refill
Congenital heart defect in newborn: signs
- Poor feeding (tires out easily during feeds)- seen in newborns
- Poor weight gain
- Edema
- Frequent respiratory tract infections
Persistent Pulmonary Hypertension of the Newborn (PPHN)
fetal circulation routes persist after birth, the blood will continue to be shunted away from the lungs.
Emancipated minor
- generally refers to an adolescent younger than 18 years of age who is no longer under the parent’s authority.
- Married minors or minors in the military are automatically considered and may give consent for medical treatment for themselves and their children.
- Laws vary from state to state
Symptoms of heart problems
cyanosis, respiratory distress, tachycardia (rapid heart rate), tachypnea (rapid respiratory rate), difficulty feeding, and heart murmurs
•Physical indicators of Down Syndrome
Small ears with short pinna, possible congenital heart defect, enlarges anterior fontanel
High-arched narrow palate, plantar crease, short stature, incurved fifth finger, protruding tongue, hyperflexible, muscle weakness, hypotonia, transverse palmar crease, dry skin that cracks easily, short broad neck, upward outward slant eyes Small nose with depressed nasal bridge
What vaccine protects against pertussis?
- DTaP : given at 2, 4, 6, and 12 months
- TDaP: given at age 11 and to adults as booster
Best resource for immunizations
- CDC.gov
Benefits of vaccines
Protect against certain childhood illnesses
-Protect immunocompromised individuals by herd immunity
-Reduction of healthcare costs
Chickenpox (varicella) presentation
macules papules, vesicles, pustules and scabs. All stages of the lesion are present on the body at the same time
Chickenpox Varicella Incubation
2-3 wks
Chickenpox (varicella) Treatment
acyclovir – monitor for side effects or VZIG -immune globulin
Chickenpox Varicella contagious
6 days after appearance of rash- exclude from daycare until lesion are crusted and dry
Chickenpox (varicella) Nursing care
keep fingers trim to prevent scratching . removal of scabs can cause scaring. Calemine lotion may reduce itching.
Gardasil vaccine:
Can be given from ages 9 and up from 9 strains of HPV
The importance of adhering to recommended screening Preventive measures available (vaccine, safe sex, screening) The importance of follow-up for abnormal pap smears
Hpv cause
majority of cervical cancer
Polio vaccine
- IPV- inactivated polio vaccine: given at 2, 4, 6 & 12 months
- OPV (oral polio vaccine) was an active form that is no longer used
Immunizations for “whooping cough”Pertussis
Majority of pertussis related deaths are in infants <3mos
Causative organism: Bordetella pertussis
RISK FOR: ineffective airway clearance
“whooping cough” Pertussis s/s
Starts with 1-2 weeks of mild cough/cold sx, possible LG fever;
Then…Paroxysmal- 2-4 weeks, absent or LG fever, paroxysmal cough with inspiratory whoop, possible post tussive emesis
Chickenpox (varicella) Precation
airborne
Pertussis vaccine:
Infants and younger children-
Dtap given at 2, 4,6, and 15 months
For older children& adolescents
Tdapt given at 11 years
Immunizations for school age children-
TDAP and hpv
Infant feedings- how often should they eat each day
Usually about 8-12 times each day