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NUR3503 Exam - Paediatrics Study Guide

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NUR3503 Exam - Paediatrics Study Guide ...

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  • August 8, 2024
  • 34
  • 2024/2025
  • Exam (elaborations)
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  • NUR3503
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NUR3503 Exam - Paediatrics Study
Guide
How are children physically different to adults? - Answer - Head is large compared to
the adult

- Often in newborns it exceeds the circumference of the chest

- Anterior and posterior fontanelles

- Muscles lack tone, power and coordination

- Arms and legs are shorter and underdeveloped at birth

- Midpoint in length on a child is umbilicus

- Midpoint in length on an adult is the symphysis pubis

- Disproportionate abdomen is due to the large liver and small pelvis

What are musculoskeletal system differences between the adult and child? - Answer -
Skeletal strength and endurance increases with age

- Protuberant abdomen

-At birth spinal column has only the anterior curvature

- Cervical and lumbar curvature begin with holding head up and walking

- Small facial sinuses (10-12 years)

What are Central Nervous System differences between the adult and child? - Answer
The brain of the neonate is relatively large

- 1/10 of the weight as compared to 1/50 of adult

- The brain grows rapidly commensurate with age

- Fontenelle's close at 18 months to 2 years as the brain grows

Spinal Cord

- Neuronal development finishes at age 12

- Myelination is not complete until age 3

- Primitive reflexes (Moro, grasp) disappear with myelination

*THEY HAVE Higher metabolic rate, higher oxygen needs, higher calorie need

,What are Integumentary system differences between the adult and child? - Answer
Growth is regulated and adjusted to variations in surface area

Thin structure - 1mm thick at birth

4% of Total Birth Weight in the newborn

Body Surface Area measurement important in children -why?

- Functionally matures during early childhood

- Production of sebum is minimal

- Eccrine glands are functional but immature

Cardiovascular differences - Answer At birth the right & left ventricles are essentially
the same in size & wall thickness

During the 1st month of life Right Ventricle dominant

4-6 months Left Ventricle dominant

• By four weeks the LV weighs more than the RV (2 months twice the weight)

• Cardiac muscle fibres increase over childhood

• Cardiac Output is related to Heart Rate not only Stroke Volume

• Blood pressure rises

• Total blood volume 70-80mls/kg

Respiratory system differences - Answer Trachea is short and soft

Large tongue

Airway resistance is high

Epiglottis is horseshoe shaped, posterior at 45 degree angle

Infants <6 months - obligate nasal breathers

Rely on diaphragm

Compliant chest wall

Outward recoil of the thorax is very low

5 yrs to puberty lung weight increases three fold

Lung and alveolar growth and size and maturation of tissues by 8 yrs

Why is fluid homeostasis important? - Answer Newborn 70 - 80 % Water

,Full term infants have a large % of TBW (total body water) & Extra Cellular Fluid

TBW decreases with age mainly as a result of loss of water in ECF fluid

Fluid turnover is 7 times greater than that of an adult

Altered fluid balance can have catastrophic consequences

Organ perfusion and metabolism count on adequate hydration

Infants and children are at a much higher risk for developing rapid dehydration

Childhood Immunisations - Answer diphtheria

tetanus

pertussis (whooping cough)

poliomyelitis (polio)

measles

mumps

rubella

haemophilus influenzae type b infections HIB

HPV

Hepatitis

Herpes Zoster

Answering Concerns about vaccinations - Answer Listen, most questions answered by
nurses, access information sites

Don't push

Keep up to date

Anticipated reactions

- Links to Autism, asthma

- Developmental delays

- Unanticipated adverse reactions

Maslow's Hierarchy of Needs - Answer (level 1) Physiological Needs, (level 2) Safety and
Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self
Actualization

, What do children need for health development?

Common age groups terminology - Answer Neonate: 0-4weeks

Infancy : 0-1year

Toddler : 1-3 years

Early childhood: 1-5 years

Pre-schooler : 4-6 years

School-aged : 6-11 years

Childhood : 5-13 years

Adolescence (varies) : 12-19 years of age

What is the full gestational age? - Answer 40 weeks

Less than 38 week is pre-term

Child resuscitation above 6 weeks - Answer 15:1 compressions to breaths

Child resuscitation below 6 weeks - Answer 3:1 compressions to breaths

Principles of Child and Family Centered Care - Answer - Respect

- Dignity

- Active engagement and involvement

- Information sharing

- Open and honest communication

- Collaboration

- Therapeutic relationships

Developmental Milestones - Answer Physical

Social

Emotional

Cognitive

Language

Functions of the gastrointestinal tract - Answer digestion, absorption, elimination

Children have a compromised/immature GI system

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