Professional Documents
Culture Documents
Pediatric Nursing
Pediatric Nursing
Nursing
Joshua W. Atienza, USRN
Developmental Theories
Theory of
libido = Natural drive
Sigmund Freud →
* Psychosexual =
How you deal with it
psychological crisis =
Erik Erikson
→ Theory OF
* Psychosocial =
* =
↳ can
↳ can cause Paranoia
cause Gullible
•
play solitary play:
• , ,
•
Fear : stranger Anxiety
•
Important Mom :
person
* Erikson Autonomy = vs -
Shame and doubt Guided by parents 2. can delay impulses
↳ Sense Can control sphincters
of independence •
strict = OCD 3-
•
Play Parallel play
:
•
Lax = Antisocial 4- has an idea
•
Toys : Building blocks push ,
and pull toys
•
Fear : Separation anxiety
management :
Orientation
•
Important : Mom 1- Dad
person
Temper tantrums * Ritualism
•
special Traits :*
-
Objects
Management :
-
timeout
but not the toddler
Ignore the condition
-
* Negativism
management :
-
Offer choices
(Development of conscience)
school (3-6410)
3. Pre
-
↳ cant ↳ Can t,
creativity self esteem
: Cooperative play
•
Play
puzzle Board games
Kit , Teacher Kit ,
Toys : Play house Doctors
,
•
,
•
Fear Body
mutilation
:
"
Why ?
"
* Ask question
+ siblings (Immediate Family)
•
Important person :
mom + Dat
↳ Role model
puppet and toys
* During Hospitalization = use
4. School Age ( 6- yrs )
12 old
↳ sense ↳ Iv self
esteem
OF competition
•
Play Competitive play
:
"
rules
Sports By the
"
•
Toys : ,
•
Important : teacher
person
Achiever oriented mindset
Special Traits
• : *
* Collections
* sensitive to humiliation
* concept of Death
Irreversible
* During hospitalization
↳ simple diagrams /pictures / illustration
5. Adolescent (12-19410)
* Freud Genital stage
=
- 1> T Libido toward other person
* Erikson = Identity Role confusion
us .
↳ ↳ Emotional
Immaturity
Emotional
Maturity -
short term goals
-
: * promote privacy
•
Special traits
Milestones
Developmental
skills
Fine Motor Gross motor
months head lag
reflex grasp
=
o months = o
5 months =
palmar grasp 4 months =
Full head control
7- months
= transfer object g- months = Roll over
to months =
3 yrs old
= unbutton
Cruising
6 yrs old = Tie shoelace 12 months =
stand without support
3410 = Tricycle
4410 =
bicyle
Live vaccines
Immunization schedule
MMR
1st stanza
:
× ) varicella
↳ Birth to 1
month Hepa B
polio
↳ Happ baby gelatin and
* Allergic eggs
2nd stanza :
* No to pregnant
and Immunocompromised
DR HIP
4,6 month
.
↳ 2,
Hemophilvs Influenzae
- Inactivated polio vaccine
-
Pneumococcal vaccine
Bridge :
12-15 months MMR
[3×3
Varicella t Hepa A
Nutrition principles
Breastfeeding ( E.
0.51)
Exclusive
6 months / pvrae
→
I '
mashed
Introduce solid Foods prep
:
6 months →
cerials Iron
fortified
{
=
2. "
Sma
and dates
veggies meat
•
quantity Fruits , ,
•
One Food
3- her old group
↳ egg yolk
2¥ Albumin
Sippy WP egg while
-
,>
↳ weaning OF
eggshell
bottle feeding
-
First visit to dentist
Disease
Pediatric
1. Tonsil itis
tonsils
-
Inflammation OF
cause : GABHS /
Staphylococcus
-
Infectious disease
Precaution Droplet :
Fever
-
sore throats
odor
Foul breath
-
-
Dysphagia
Management tonsils
-removal of
-
acid)
Vita Bq (Folic
-
types
ocoulta
spina bifida
•
Types :
a) Meningocele -
Not painful
b) Myelomeningocele
-
painful
management -
Do not touch
affected part
maneuver
prone No valvalra
-
-
standard precaution -
cover with
sterile gauze
-
WOF : latex allery
-
WOF : T ICP - ☐ If not resolved HydwcephaWs__
3- Hydrocephalus
-
T accumulation OF Fluids in the brain
Risk Factors :
•
Infection
• Neural tube defects Management :
ventriculi peritoneal shunt
•
Autoimmune
-
• Heriditary
slsx : ( VP shunt )
triad)
- 1^1 CP ( Cushing
-
projectile vomiting
-
Nuchal rigidity
-
photophobia
Hallmark sign : Sunset eyes
other Hallmark
:
Macewen sign
sign
Pediatric Nursing
Neurological problems
school
1- Cerebral Palsy =
age
cause : Multifactorial
motor movement
main problem : Abnormal
slsx :
-
Unstable gait
-
Respiratory problem
-
Dysphagia
Management :
1. Assistive Devices : wheelchair
2. Muscle relaxant
Doc: Multiple sclerosis
-
Baclofen
-
Flexiril
2. Seizure
cause : multifactorial
*
High grade fever
* meningitis
* Head trauma
* Genetics
* sodium imbalance
* too much exposure to flasher of light
stages :
1. Aura
lead to
feelings that
seizure
-
unusual may
common : • smell OF a burning wire
metallic taste
•
of
•
GI upset
rails
2. Unwusuousness 1 Raise side
at bedside
.
priority :
place the client in side lying g. suction machine
3- Tonic stage 3 Oxygen
.
muscle stiffness 4 .
note the duration of seizure
4. clonic stage
involuntary muscle jerking or twitching
5- Post total
reorientation
management :
medications :
I. Levetiracetamckeppra )
↳ maintenance
2. Carbamazepine = SIE : agranulocytosis 4. Diazepam ( Valium)
maintenance Administered Rectal route
phenytoin C. Dilantin )
= :
3.
therapeutic level : 10
-
aomcgldl
Anemia Pancytopenia
Toxicity effect : Aplastic
=
↳ Bone mamrw
:slsx =
Hematopoiesis
suppression
-
Infection ↳ Blood creation
gwmponents
* oxygenation
-
= 5- I
-
6m
-
RBC
" K
-
Bleeding - W Bc
= 5k -
150K 450K
platelets
-
-
=
SIE :
Gingival hyperplasia
-
oral care
Musculoskeletal Problems
1- Scoliosis
-
standing shape S
-
uneven heam line
-
U heron shoulder
Management
1. milwakie Brace
-
to correct deformity
0h : 23hm
of the
Hip
2. Developmental Dysplasia
dysplasia
congenital Hip
cause :
inborn
Hip fracture
slsx
- movement [ early sign)
limited
-
gwtial Folds
Assy metrical Galea2- zi Sign
shortening of the affected leg
=
-
Management :
1 .
Pavlik harness
Diaper rash
-
-
check time to time
-
sponge bath on
3- Osteomyelitis
-
Infection of the
bone
cause : bacteria
slsx :
-
vomiting
-
Body malaise
-
4 '
Duchenne muscle Dystrophy
Rtt X linked recessive disorder
Management
-
- :
slsx I '
in bone
-
problem
-
easily b. wishing
-
Oto sclerosis
Laboratory Test
DEXA ( Dual energy x-ray Absorption etry )
check bone density
=
>
Damaged bones
>
Roentgenograms
=
Management :
-
NO core
-
mosaic -
like appearance
osteoblast = bone building weak skeletal system
skeletal muscle pain
management :
Bi phospho nates
-
Normalized osteoclast =
Giving -
Alendwnate ( Fosamax)
- Pain medication
-
No cold compress
-
Assistive Devices
Platy basia Imagination of the skull
WOF :
=
test
New born screening ( Guthrie test)
Specimen : Blood in the heel prick
Ip treated
IF not screened
Table Disorder normal
severe mental retardation
1. cretinism norma ,
Adrenal
2. Congenital Death
but mild Altered too
hyperplasia normal
severe mental retardation and
g. pku
normal but mild delayed gtrwth
bilirubin in the brain)
severe anemia ( Kern icterus T
4- GUPD daewpment
Poisoning
Commonly occurs Toddlers and preschool
-
:
Abd pain oral mucosa
whitish plaques on
-
-
-
Fruity = Acetone
1. medications -
Anorexia cyanide
soethwath WW"° Bitter almonds =
-
* =
a. bleach
-
meds
3. muriatic acid -
Nausea / wmiting * RUQ =
4. Cosmetics
-
swelling of lips
level
more than 20
report
Lead poisoning
=
5- mothballs
*
6- Pestesides Management :
Decontamination 2 .
:
spices
lavage
'
> Gastric
crayons sewage system
-
-
water
paints cosmetics
-
-
Toys
-
-
Thinners
4. Pyloric stenosis
Distended
-
narrowing *
P¥¥¥n%?¥¥¥
abdominal ↓ Abnormal signs during palpation
" Distention →
Vein
severe abdominal ↳ Olive shaped mass
String sign
-
↓
Projectile Vomiting
←
HCL acid ↓ Hypokalemia = V wave
out
Dehydration
↓ loss
weight
-
Metabolic -
Thrist
Alkalosis
-
Hemo concentration
-
Sunken fontanels and eyeball
Management :
¥¥¥÷y
Sx : Fredet -
Ramstedt
↳ repair OF pyloric sphincter
Tips :
-
140
-
weight monitoring
5- Intussusception
-
telescoping
$"
OF the intestine ,
-
Blood t mucus stool ☆ Currant jell stool 7
:
-
Sausage shape mass
-
Severe abdominal pain
↳ Knees
drawing up to the chest
Management :
-
Air enema
↳ sign OF effectiveness normal bowel movement
6- Hirschprongs Disease
and absorbs water
ftp.rgqie.inntegyin#--
-
Abnormalities in the anatomical structure To mobilize stool
Basic unit
↓
Decreased ganglionic cell Function
Bite
V°m"" ↓
severe constipation → severe abdominal distension
← ↓
Fecaloid
vomiting Ribbon like stool
( Red)
Management :
-
resection OF colon (endorectal pull)
WOF : severe abdominal 1- Fever
pain
Phenylketonuria
-
T production of phenylalanine
pathophysiology :
When T toxic
to the Body → Kidney Damage =
Mvstyodorvrine
phenylalanine (④ 1.2 -3.4mg D=
Id
)
f - averting Enzyme
Phenylalanine : *
will disapeare ! ! !
Normal GI Function hydroxylase
Tyrosine =
• lntvssvceptioh
↳ No normal GI function Hirspwngs Disease
Development ( DHA )
•
Brain
↳
t
3- 4 Dioxy phenylalanine
Albinism
-
→
↳ ⑧ skin color
Management :
•
T intake of Foods high in tyrosine
but not :
Anything
-
red meat
-
beans
-
Dairies
•
special Formula : Milk * Wfenalau
Disease :
Pedi a cardio
Kawasaki Disease
Cause : I do phatic
Risk factors :
• related to Hereditary
•
Autoimmune
Dry skin
↳ can lead to seizure
-
Conjunctivitis
Hallmark sign : Strawberry
Tongue
Management :
-
Corticosteroids
-
IV Immunoglobulin
-
Interferone bets
-
Immunosuppressant / Cyclosporine
Tonsillitis
endocarditis
AGN
Impetigo
SISX -
Fever
-
sore throat
-
Body pain
-
Joint pain ( poly arthritis)
Management :
• Non pharmacologic " "
superior Pulmonary →
vena cava
→ Right → Right → Lungs
ventricle Artery
!
Inferior vena cava Atrium
Left Left
Aorta ←
ventricle ← Atrium
← Pulmonary Vein
G OXYGENATED
> Systemic Circulation
coartmtion of Aorta
=
Extremities
•
1st collection
VN OXYGENATED
Pulmonary
superior vena cava
→ Right → Right -1> - ☐ Lungs
Inferior vena cava Atrium
-
ventricle Artery
'֥
•
2nd Collection
Backflow in the heart
Left Left
Aorta ←
ventricle ← Atrium
← Pulmonary
G OXYGENATED
> Systemic circulation
Tetralogy OF Fallot
CHF Carano )
to =
Right shunting
=
-
crying
-
* management :
Knee chest position / Squat
positioning =
Polycythemia Report
* TRBC expected =
VN OXYGENATED
•o••
•••
Left Left
Aorta ←
ventricle ← Atrium
← Pulmonary Vein
G
OXYGENATED
> Systemic circulation
Fibrosis
Cystic
-
Autosomal disorder
vision
problem : T mucus production powered Pruritus
to I →
Decreased ADEK → Bleeding
Lungs ← Thick
mows dislodgement → Liver →
t
f
↳
|
weak
t Bones
pancreas -y small
Emphysema intestine
y
t NO pancreatic Juice
y
t, Insulin
t
pneumonia d malnutrition
Malabsorption f
Diabetic f
V Mellitus
Kwashiorkor
Marasmus
Repro system
-
Delayed
growth and development
-
Infertility
Management :
-
Flutter mucus device
-
Teal , 'T Chon Tcho
,
Oz
-
with meat
-
pancrealipasegie
Abuse
-
Intentional act of physical neglect
* Associated factors
victims abused
1. parents / guardians were of
2. Lack OF parenting skills
*
child characteristics
1- Aloof merit
2. withdrawn
3. Habitual absentism
4. unusual injuries
Types of Abuse
1. Physical Abuse
adequate needs
-
failure to provide
-
Neglect
manifestations :
Inadequate weight
•
how
•
poor hygiene
•
Lack OF immunization
manifestation
•
shaming
•
Embarrassment
•
a self esteem
•
Guilt
3- Sexual Abuse
Management :
Safety
services
Report to child protective
heedv
physiologic
Complication of
Abuse
t Failure to thrive
2. Antisocial
3. Substance Abuse