Pediatric Nursing Immunization Assignment
Pediatric Nursing Immunization Assignment
Respond to the questions below using the cdc link the attached books and at least three evidence-based articles.
https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html
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1. in 200 words. Which vaccines protect against Meningitis (you need to look at your PowerPoint and read about the vaccines in your book to properly answer this). What is the benefits of taking this vaccine? Who should receive this vaccine and at what age are they typically give? What is the route of administration?
2. In 200 words. Why would you wait to vaccinate a child who is immunosuppressed or acutely ill? (this is not a little runny nose and low-grade temp). What happens if you do not wait to administer the vaccine to a client that is immunosuppressed? Review one evidence-based practice article that speaks on this topic.
3. In 200 words. Name at least three vaccines that are given Subcutaneous? What is rationale for given vaccination subcutaneous vs IM? What happens if you give a vaccine by the incorrect route of administration (example subcutaneous vs IM) what impact does it have on the efficacy and absorption? What are the benefits of giving a vaccine subcutaneous and intramuscularly?
4. In 200 words. name at least 4 allergies that a patient have that would be contraindicated to give a vaccine? What reaction would the client have if the medication was given, provide data on the frequency of this occurrence. Review one evidence-based practice article that speaks on this topic. Pediatric Nursing Immunization Assignment
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PedsATIbook.pdf -
MaternalChildNursingCare-E-Book.pdf
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N317PPT_Chapter_30.pptx
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PPT_Chapter_31.pptx
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N371Chapter29.pptx
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N371PPT_Chapter_28.pptx
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N371PPT_Chapter_27.pptx
Chapter 27 Growth and Development of the Preschooler
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Physical Growth Developments of the Preschooler
Average growth of 2.5 to 3 in per year
Average weight gain around 5 lb per year
Loss of baby fat and growth of muscle
Length of skull increases slightly; lower jaw more pronounced; upper jaw widens
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Motor Skill Development
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Question #1
The nurse is assessing a 4-year-old for gross motor skill development. Which would the nurse expect this preschooler to have accomplished?
a. hopping on one foot
b. standing on one foot for 10 seconds
c. skipping
d. swimming
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Answer to Question #1
a. hopping on one foot
The 4-year-old should be able to hop on one foot.
At age 4, the preschooler hops on one foot and stands on one foot up to 5 seconds. At 5 years old the preschooler stands on one foot for 10 seconds, may skip, and may learn to skate and swim. Pediatric Nursing Immunization Assignment
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Maturation of the Organ System (Preschooler)
Myelination of the spinal cord allows for bowel and bladder control to be complete; small intestine grows in length.
Respiratory structures continue to grow in size; number of alveoli increase.
Eustachian tubes remain short and straight.
Heart rate decreases; blood pressure increases slightly; innocent heart murmur may be heard.
20 deciduous teeth should be present.
Urethra remains short in children, making them susceptible to urinary tract infections.
Bones increase in length and muscles strengthen and mature.
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Psychosocial Development of the Preschooler
In Erikson’s stage of development: initiative versus guilt
Preschooler is an inquisitive and enthusiastic learner
Feels sense of accomplishment by succeeding in activities
Feeling pride in accomplishment stimulates initiative
Overextending self can result in sense of guilt
Superego (conscious development) is completed and is basis for moral development
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Social Skills Developed by the Preschooler
Cooperation
Sharing (of things and feelings)
Kindness
Generosity
Affection display
Conversation
Expression of feelings
Helping others
Making friends
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Emotional and Social Development of the Preschooler
Friendships
Preschoolers learn how to make and keep a friend
Temperament
Indicator of parent’s expectation of child’s behavior
Determines child’s task orientation, social flexibility, and reactivity
Fears
Preschoolers exhibit variety of fears
Parents should acknowledge child’s fears
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Cognitive Development of the Preschooler
Piaget’s theory
Preoperational stage
Magical thinking
Believes thoughts are all-powerful
Imaginary friend
Creative way to sample activities and behaviors and practice conversation skills
Transduction
Extrapolates from one situation to another
Animism
Attributes life-like qualities to inanimate objects
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Psychosocial Preschool-Aged Child
Kohlberg’s theory
Preconventional stage
Punishment and obedience orientation
Religion
Diet
Mode of discipline
View of children
Prayer or meditation
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Language Development
Symbolic thought
Do not understand the concept of death
Acquisition of language allows for child to express thoughts and creativity
Transition in this period from the use of telegraphic speech at age 3 years to the adult-like structure of sentences at age 5 years
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Sample Nursing Diagnoses for Issues Related to Growth and Development
Delayed growth and development
Imbalanced nutrition, less than body requirements
Interrupted family processes
Readiness for enhanced parenting
Risk for caregiver role strain
Risk for delayed development
Risk for disproportionate growth
Risk for injury
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Issues Involved in Promoting Growth and Development of the Preschooler
Building self-esteem
Maintaining routine and ritual
Setting limits and remaining consistent with them
Knowing signs of developmental delay
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Question #2
The nurse is assessing a 5-year-old child for signs of developmental delay. Which would alert the nurse to a potential problem?
a. the child can build a tower of six blocks
b. the child does not play with other children
c. the child engages in fantasy play
d. the child separates from parent easily
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Answer to Question #2
b. the child does not play with other children
This is a sign of a potential developmental delay.
Signs of developmental delay in preschool-aged children include not playing with other children, not being able to build a block tower of six to eight blocks, not engaging in fantasy play, and not separating from the parent without major protest.
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Focus of Nursing Care Plan to Promote Growth and Development of Preschooler
Promoting growth through play
Promoting early learning
Promoting language development
Choosing a preschool/starting kindergarten
Promoting safety
Promoting nutrition
Promoting healthy sleep and rest
Promoting appropriate discipline
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Question #3
Is the following statement True or False?
The nurse should recommend that parents of a 3- to 5-year-old receive 500- to 800-mg calcium and 10-mg iron daily.
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Answer to Question #3
True.
The preschool child needs 500- to 800-mg calcium and 10-mg iron daily.
Preschool children need 500- to 800-mg calcium and 10-mg iron daily. Parents should be aware that drinking excess amounts of milk may lead to iron deficiency as the calcium in milk blocks iron absorption.
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Daily Nutritional Requirements of the Preschooler
500- to 800-mg calcium
10-mg iron
19-mg fiber
Fat intake no less than 20% and no more than 30% daily calories
Saturated fats less than 10%
Diet high in nutrient-rich foods
Limited amounts of poor, high-calorie foods
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Risks of Overweight and Obesity
Hypertension
Hyperlipidemia
Insulin resistance
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Developmental Issues for Preschoolers
Lying
Sex education
Masturbation
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Question #4
Tell whether the following statement is True or False.
The nurse is counseling parents of a 5-year-old who are concerned that their child is masturbating. The recommended intervention for this situation is to advise parents to discourage their child from this practice using firm discipline.
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Answer to Question #4
False.
The recommended intervention for a 5-year-old child who is masturbating is to treat it in a matter-of-fact way, making sure the child knows nudity and masturbation are not acceptable in public.
If parents overreact to this behavior, it may occur more frequently. The child should also be taught that no other person can touch his or her private parts.
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Focus of Health Care Visits Throughout Childhood
Expected growth and development
Anticipatory guidance
Preparation for school entry
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Hospitalization
Explore the environment
Engage in make-believe play
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N371PPT_Chapter_25.pptx
Chapter 25 Growth and Development of the Newborn and Infant
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Developmental Changes in the Newborn and Infant
Growth
Increase in physical size
Development
Sequential process by which infants and children gain various skills and functions
Maturation
Increase in functionality of various body systems or developmental skills
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Assessing Newborns and Infants for Developmental Milestones
The nurse may ask the parent if the skill is present or the infant may demonstrate the skill during the interview.
The nurse may elicit the skill from the infant.
Screening tools may be used to assess development.
Denver II Developmental Screening Test
Prescreening Developmental Questionnaire (PDQ II)
Ages and Stages Questionnaire (ASQ)
Infant–Toddler Checklist for Language and Communication
Infant Development Inventory
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Assessing Growth and Development of a Premature Infant
Use the infant’s adjusted age to determine expected outcomes.
Subtract the number of weeks that the infant was premature from the infant’s chronologic age.
Plot growth parameters and assess developmental milestones based on adjusted age.
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Question #1
The nurse is assessing developmental milestones for a 7-month-old premature infant born at 28 weeks’ gestation. What would be the adjusted age upon which the nurse would base the assessment?
a. 2 months
b. 3 months
c. 4 months
d. 5 months
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Answer to Question #1
c. 4 months
The nurse assessing developmental milestones for a 7-month-old premature infant born at 28 weeks’ gestation would adjust the age to 4 months.
The infant was born 12 weeks early (3 months); therefore, the nurse would subtract 3 months from the chronologic age of 7 months to obtain an adjusted age of 4 months. Healthy growth would be demonstrated if the infant were the size of a 4-month-old and achieved the developmental milestones of a 4-month-old.
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Question #2
Is the following statement True or False?
The nurse is assessing a 6-month-infant and obtains the following measurements: weight: 15 lb; length: 26 in; head circumference: 17 in. It has been determined that these are average measurements for a 6-month-old infant.
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Answer to Question #2
True.
The following measurements: weight: 15 lb; length: 26 in; and head circumference: 17 in are average measurements for a 6-month-old infant.
The average weight for a 6-month-old infant is 15 lb, the average length is 25 to 27 in, and the average head circumference is 16.5 to 17.5 in. Pediatric Nursing Immunization Assignment
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Infant Organ System Maturation
Neurologic system
Cardiovascular system
Respiratory system
Gastrointestinal (digestive) system
Renal system
Hematopoietic system
Immunologic system
Integumentary system
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Newborn States of Consciousness
Deep sleep: infant lies quietly without movement.
Light sleep: infant may move a little while sleeping and startle to noises.
Drowsiness: eyes may close; the infant may be dozing.
Quiet alert state: infant’s eyes are open wide and body is calm.
Active alert state: infant’s face and body move actively.
Crying: infant cries; body moves in disorganized fashion.
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Newborn Primitive Reflexes
Moro
Root
Suck
Asymmetric tonic neck
Plantar and palmar grasp
Step
Babinski
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Respiratory System of the Infant Versus Adult
The nasal passages are narrower.
The trachea and chest wall are more compliant.
The bronchi and bronchioles are shorter and narrower.
The larynx is more funnel shaped.
The tongue is larger.
There are significantly fewer alveoli.
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Maturation of the Cardiovascular System of the Infant in First Year of Life
The heart doubles in size.
The average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1-year-old.
Blood pressure steadily increases, from an average of 60/40 in the newborn to 100/50 in the 12-month-old.
The peripheral capillaries are closer to the surface of the skin, making the newborn and young infant more susceptible to heat loss. Pediatric Nursing Immunization Assignment
Thermoregulation becomes more effective.
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First Year of Life Changes
Eruption of teeth
Consistency and frequency of stools change over the first year of life
Acrocyanosis is normal in newborns and that they often experience mottling of the skin
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Immunologic System of the Infant
Newborns receive large amounts of immunoglobulin G (IgG) through the placenta from their mothers.
This confers immunity during the first 3 to 6 months of life for antigens to which the mother was previously exposed.
Infants then synthesize their own IgG, reaching approximately 40% of adult levels at age 12 months.
Immunoglobulin M (IgM) is produced in significant amounts after birth, reaching adult levels by 9 months of age.
Immunoglobulin A (IgA), immunoglobulin D (IgD), and immunoglobulin E (IgE) production increases very gradually, maturing in early childhood.
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Psychosocial Development
Erik Erikson theory
Crisis of infancy as trust versus mistrust
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Jean Piaget’s Theory of Cognitive Development
Sensorimotor stage: birth to 2 years
Four stages
Reflexes
Primary circular reaction
Secondary circular reaction
Coordination of secondary schemes
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Gross and Fine Motor Skills
Phenomenal increases
First 12 months
Development in this stage in a cephalocaudal fashion
Fine motor development includes maturation of hand and finger use and develops in proximodistal fashion
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Question #3
Is the following statement True or False?
Fine motor skills develop in a cephalocaudal fashion (from the center to the periphery).
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Answer to Question #3
False.
Fine motor skills develop in a proximodistal fashion (from the center to the periphery).
Gross motor skills develop in a cephalocaudal fashion (from the head to the tail).
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Warning Signs Indicating Problems With Sensory Development
Young infant does not respond to loud noises.
Child does not focus on a near object.
Infant does not start to make sounds or babble by 4 months of age.
Infant does not turn to locate sound at age 4 months.
Infant crosses eyes most of the time at age 6 months.
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Warning Signs Indicating Problems With Language Development
Infant does not make sounds at 4 months of age.
Infant does not laugh or squeal by 6 months of age.
Infant does not babble by 8 months of age; infant does not use single words with meaning at 12 months of age (mama, dada).
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Social and Emotional Development of the Infant
Stranger anxiety
Indicates infant recognizes self as separate from others
Separation anxiety
Infant becomes distressed when parent leaves
Temperament
Ranges from low to moderately active, regular, and predictable, to highly active, more intense, and less adaptable
Cultural differences
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Nutritional Requirements
Essential for growth and development
Breast-feeding and bottle-feeding of infant formula are both acceptable
Needs related to the tremendous growth
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Exceptions to Recommended Breast-feeding
Infants with galactosemia
Maternal use of illicit drugs and a few prescription medications
Maternal untreated active tuberculosis
Maternal HIV infection in developed countries
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Breast-feeding
Advantages
Teach new mother proper techniques
New mothers should be assessed for pain upon breast-feeding
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Bottle-Feeding
Proper preparation
Proper storage of formula
Care of bottles
Only formulas that are fortified with iron should be used
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Nutritional Plan First Year of Life
Optimal feeding pattern
Infant feeding opportunity to establish good eating behaviors
Special formulas have been developed to meet the nutritional needs of infants with allergies or disorders
After 6 months
Nutrients available in solid foods in addition to breast milk or formula
Introduce one new food every 4 to 7 days for identification of food allergies
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Role of Nurse
Promote early learning, safety, proper nutrition, healthy sleep and rest, healthy teeth and gums, and appropriate discipline techniques. Pediatric Nursing Immunization Assignment
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Common Developmental Concerns in Infancy
Colic
Spitting up
Thumb sucking, pacifiers, security items
Teething
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Anticipatory Guidance
Parents need tools to support their infant’s development in a safe fashion
Parents can promote growth and development of an infant through solitary play
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N371PPT_Chapter_26.pptx
Chapter 26 Growth and Development of the Toddler
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Physical Growth of the Toddler
Height and weight increase steadily in spurts at a slower rate than the infant
Generally reach half adult height by age 2
Average weight gain is 3 to 5 lb per year
Height increases an average of 3 in per year
Fontanels close by 18 months
Head size more proportional to body by age 3
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Organ System Maturation #1
Neurologic system
Brain reaches about 90% of size by age 2
Respiratory system
Alveoli increase in number until age 7; trachea and airways small compared to adult
Cardiovascular system
Heart rate decreases; blood pressure increases
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Organ System Maturation #2
Gastrointestinal system
Stomach increases in size; small intestine grows in length; stool passage decreases.
Genitourinary system
Bladder and kidney reach adult function by 16 to 24 months; bladder capacity increases; urethra remains short.
Musculoskeletal system
Bones increase in length; muscle matures; swayback and pot belly appear due to weak muscles until 3 years old.
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Growth Theories
Freud’s theory focuses on the satisfaction and/or frustration of expelling feces (anal stage).
Piaget’s theory focuses on development of the senses of the toddler.
Erikson’s theory focuses on achievement of autonomy and self-control.
Kohlberg’s theory focuses on the moral development of the toddler.
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Question #1
The nurse praises a 3-year-old child for using the potty. Which of the following theorists focuses on the satisfaction/frustration of expelling feces?
a. Piaget
b. Freud
c. Erikson
d. Kohlberg
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Answer to Question #1
b. Freud
Freud’s theory focuses on the satisfaction and/or frustration of expelling feces (anal stage).
Piaget’s theory focuses on development of the senses of the toddler; Erikson’s theory focuses on achievement of autonomy and self-control; Kohlberg’s theory focuses on the moral development of the toddler. Pediatric Nursing Immunization Assignment
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Motor Skill Development (Toddler)
Gross motor skills
Include running, climbing, jumping, pushing or pulling a toy, throwing a ball, and pedaling a tricycle
Fine motor skills
Progress from holding and pinching to the ability to manage utensils, hold a crayon, string a bead, and use a computer
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Speech Development (Toddler)
Receptive language development: the ability to understand what is being said or asked
Typically far more advanced than expressive language development (ability to communicate desires and feelings)
Common occurrences
Echolalia: repetition of words and phrases without understanding
Telegraphic speech: speech that contains only the essential words to get the point across
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Sensory Development
Use all senses to explore the world
Vision progresses
Depth perception matures
Hearing at adult level
Sense of smell matures
Taste discrimination not completely developed
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Emotional and Social Development of the Toddler
Focus
Separation
Seeing oneself as separate from the parent
Individuation
Forming a sense of self and learning to control one’s environment lead to emotional lability.
Egocentrism
Focus on self
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Typical Behaviors of the Toddler
May rely on a security item
Becomes aware of gender differences
May display aggressive behaviors
May show fear of loss of parents and of strangers
Becomes more self-aware; does not have clear body boundaries
Separation anxiety may reoccur
May resist invasive procedures
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Promoting Growth and Development of the Toddler Through Play
Play is the major socializing medium for toddlers.
Toddlers need 30 minutes of structured physical activity and 1 to 3 hours of unstructured physical activity per day.
Parents should limit television and encourage creative and physical play instead.
Toddlers engage in parallel play (playing alongside another child) instead of cooperative play.
Toddlers are egocentric and do not like to share.
The short attention span of toddlers will make them change toys frequently.
Toddlers do not need expensive toys.
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Question #2
Is the following statement True or False?
The best type of toys for toddlers is store-bought interactive electronic toys.
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Answer to Question #2
False.
Toddlers do not need store-bought expensive toys.
The best toys for toddlers are familiar household items, child-sized household items, blocks, cars, plastic figures, stuffed animals, dolls, doll beds, and carriages. Manipulative toys with knobs and buttons that make things happen, shapes to insert into matching holes, puzzles, chalk, buckets and shovels, and floating toys are also recommended. Appropriate gross motor toys include gyms, tricycles, pull toys, and wagons. Pediatric Nursing Immunization Assignment
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Promoting Safety for the Toddler
Provide a childproof environment
Use a safe car seat in back of car
Provide a safe home environment
Avoid exposure to tobacco smoke
Prevent injury
Prevent poisoning
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Sleep and Dental Health Requirements for the Toddler
18-month-old: 13.5 hours of sleep per day
24-month-old: 13 hours of sleep per day
3-year-old: 12 hours of sleep per day
A typical toddler should sleep through the night and take one daytime nap
Most children discontinue daytime napping at around 3 years of age
30 months toddler has full set of primary teeth
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Nutritional Plan
Lay foundation
High in nutrient-rich foods
Toddlers who consume a strictly vegan diet (no food from animal sources) are at risk for deficiencies in vitamin D, vitamin B12, and iron. Supplementation with these nutrients should occur to promote adequate nutrition and growth.
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Question #3
The nurse is planning a diet for a toddler that is rich in vitamin A. Which of the following foods might the nurse include?
a. avocados
b. corn
c. strawberries
d. spinach
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Answer to Question #3
d. spinach
Spinach is rich in vitamin A.
Avocados are rich in folate, corn is rich in fiber, and strawberries are rich in vitamin C. Other foods rich in vitamin A include apricots, cantaloupe, carrots, mangoes, dark greens, and sweet potatoes. Pediatric Nursing Immunization Assignment
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Promoting Self-Feeding in Toddlers
Use a child-sized spoon and fork with dull tines
Seat the toddler in a high chair or at a comfortable height in a secure chair
Never leave the toddler unattended while eating
Minimize distractions during mealtime
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Common Developmental Concerns of the Toddler
Toilet teaching
Negativism
Temper tantrums
Thumb sucking and pacifiers
Sibling rivalry
Aggression
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Signs a Toddler Is Ready for Toilet Teaching
Regular bowel movement
Expresses knowledge of need to defecate or urinate
The diaper is not always wet
The toddler is willing to follow instructions
The toddler walks well alone and can pull down pants
The toddler follows caregiver to bathroom
The toddler climbs onto potty chair or toilet
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Teaching Strategies to Minimize Issues With Sibling Rivalry
Attempt to keep the toddler’s routine as close to normal as possible
Spend individual time with the toddler on a daily basis
Involve the toddler in the care of the baby
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Focus of Discipline for the Toddler
Limit setting
Negotiation
Techniques to assist the toddler to learn problem solving
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Role of Parent
Talk and sing to child to encourage conversation and promote language development
Read to toddler every day
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Guidelines for Choosing a Preschool for a Toddler
Parents agree with goals and an overall philosophy.
Teachers and assistants are trained in early childhood development as well as CPR.
Classes are small with an appropriate adult-to-child ratio.
Disciplinary procedures are consistent with the parents’ values.
Parents are able to visit at any time.
School is childproofed inside and out.
Appropriate hygiene procedures are in place. Pediatric Nursing Immunization Assignment
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