EXAM 1 PEDS

Which statement by nursing student demonstrates correct understanding of mandatory reporting laws related to abuse and neglect?

report any suspected/known cases of neglect

Therapeutic Relationship

Something that is age-appropriate 

Which statement by caregiver demonstrates correct understanding of home safety for a toddler?

Keep meds locked up, use child locks, keep things at a higher level where they can't reach

Human Trafficking - Contact

Hospital law enforcement 

How can a nurse provide culturally competent care when a family's religious beliefs conflict with recommended medical treatment?

Explore and integrate beliefs to care, and understand and respect culture

16 y/o presents to the ED with a fractured arm, the accompying adult answers all questions and reports delayed care after previous MVA. What are the red flags?

Late response to care, control by the adult, and inconsistent history

Nurse is caring for a pt with gender identity different than sex assigned at birth, what shows respectful care?

Ask for pronouns and document preference

When assessing a adolescent's social health which areas should the nurse explore and how do these factors influence overall wellbeing?

Friends, home environment, school environment, and peer interactions using open-ended questions

What are some risks for adolescents with social media?

Bullying, depression, low self-esteem, sleep patterns/circadian rhythm disruption, anixety

What nursing strategies demonstrate atraumatic care in a child that is showing anxiety over getting an IV placed?

Offering them the choice of which arm, giving them some autonomy

What is some important education for caregivers regarding a child with newly diagnosed asthma?

Written rescue plan that explains emergencies with attack

Which ethical principles balance respect with advocacy for a child's best interest and also respecting caregivers choices?

Beneficence, nonmaleficence, and autonomy

A toddler is being hospitalized for chronic illness. What impact could this have on the child’s health?

Complaining about other manifestations, mental health, influences their recovery. 

How as the nurse could you address the emotional needs of a nonverbal child and family that just got distressing news about a medical condition?

Allow them time to process, and active listening, privacy,

What would be an example of a good way to reduce stress and enhance the child's coping mechanisms in a 1 year old?

Song, familiar, bringing happiness, singing familiar songs

What developmental milestones are expected from 12 months old?

Walker, pincer grasp, response to name, wave bye and hi, 1-3 words, separation anxiety from mom/dad they start notice

For 2-year old what is the dietary recommendation for intake?

1000-1600 calories

In infants and children what findings normal vs abnormal for lung/heart assessment

Normal: s1 and s2, murmur for first few days of life,

Abnormal: extra sounds (s3, s4), clicking sound

Can indicate a cardiovascular concern -  adventitious sounds 

6 month old, what tools should nurse use for pain assessment?

FLACC

For a 18 month old toddler, what developmental milestones:

follow 1 step direction

Normal head and neck assessment findings for the child:

12-24 months (1-2 yr old)

What is one way you can avoid or prevent spasmodic croup?

Avoid allergens 

What is most likely the cause of pneumonia in a two day old newborn

Rupture of the membranes 48 hours before 

How would the nurse have given Nirsevimab it's for asthma?

Child will receive in 1-2 injections, depending on their weight 

Pathophysiology of pertussis

Bacteria release of the toxin damages cilia, inflammation to the lungs, can’t cough secretions

What can be used for rapid diagnosis of pertussis

PCR test - 2 hrs results

SATA: How can you help teach a parent about addressing their newborns crying?

 Rock or walk, feed the baby, diaper changing, gentle massage or patting 

What are ways to keep a newborn safe during sleep?

No extra items in bed, firm mattress, flat on their back 

What can be done to help with a newborn that has colic and is formula fed?

Curved bottle

Newborn Assessment: Is erythema toxicum normal on a newborn

Yes

What can help a newborn with their vision development?

Contrast colors : Black and White

 Which newborn reflex can be tested while the newborn is asleep

Babinski 

Common manifestations in  a newborn with colic

High pitched crying 

What is the normal age for cooing and babbling?

By their end of one month

What is the importance of holding and talking to your newborn what does it facilitate?

Bonding

Which of the following reflexes has the appearance of mimicking the movements made when walking

The step reflex 

What is infectious endocarditis?

Infection of endocardium resulting from blood borne pathogen that adheres to endocardium

Can a child with a history of atrial septal defect with surgical repair play sports?

Yes, recommendation: 3-6 months after closure

What position can a nurse assist an infant and if they have tetralogy of fallot and they are turning a bluish discoloration of their oral mucous membranes?

Knee to chest

What are the clinical manifestations of atrial septal defect?

Frequent lung infections, poor growth, failure to thrive, hypertension, murmur, shortness of breath

What manifestations are consistent with large ventricular septal defect?

Murmur, fatigue with feeds, rapid breathing (tachypnea)

What would be signs that an infant's heart failure is getting worse?

Diaphoresis, poor weight gain, irritable baby, fast breathing (tachypnea), poor feedings

What is kawasaki disease?

Coronary arteries abnormal immune system response 

How would u explain dx of TOF?

4 heart defects that impact (PORV)

Pulmonary stenosis

Overriding aorta

Right Ventricular hypertrophy

Ventricular septum defect

CASE STUDY - Hypertension (Know the VS)

HR 60-110/min

RR 20-25/min

O2 above 95%

BP 96-106/55-62 in males

BP 94-105/56-62 in females

T 36.1-37.2 C (97-99 F)

What would suggest Coarctation of aorta in a newborn?

Upper extremities will have high SBP, lower extremities with have low SBP

What is a psychosocial milestone and what would be an example (infant)

Emotional and social development (Infant calms when spoken to)

Appropriate teaching for a parent providing care for a 5 month old that cries often

Infants stop crying when the caregiver speaks to them

What is true about attachment when discussing separation anxiety? 

Security, self-regulation, self-esteem

What is true about solid foods for 6 month old?

The foods should be pureed and thickened as the baby advances. Continue to breastfeed.

How should a 5-month-old be sleeping to practice safe sleep?

Sleep on the back to decrease the risk of SIDS

What does the American Academy of Pediatrics recommend how often should you soothe the baby that is trying to put themselves to sleep?

The parent should sooth a crying baby without picking them up every 2-5 minutes

What milestones are normal for growth and development for a 4-month-old?

Roll front to back

How can you reduce the risk of SIDS?

Firm mattress with no extras in the crib on their back

What are three critical qualities essential to help infants' growth and development?

Safety, Stability, meeting the infants' physical, emotional, and developmental needs

The nurses discussing fine motor development milestones with the caregivers of an infant what statement should the nurse make?

6 month - pincer grasp transfer one hand to other

7 months - radial palmer grasp

3 months - grab items within reach

What can help develop a 12-month-old's language what can the parent do to help increase the 12 months old language?

Reading to them

The nurse is discussing areas of growth that are essentially dependent on cognitive development with the caregivers of an infant.

When the infant develops cognitively what's positively impacted - Language skills, reason with  you, thinking skills 

What is essential in developing a feeling of security and self-confidence?

Sense of trust

How does cystic fibrosis affect sodium levels

Lowers them

Number 61 is going to be prioritizing care and which patient you would see first so it's going to give you four different scenarios you would pick which patient that you would pick first as priority 

Number 61 is going to be prioritizing care and which patient you would see first so it's going to give you four different scenarios you would pick which patient that you would pick first as priority 

if a patient has bronchitis and an x-ray is ordered why would that x-ray be ordered

Fever

What are manifestations of rheumatic fever - Streptococcal Pharyngitis?

Cardiac monitor (AFib), elevated BUN and Creatine, chest pain, Oliguria

an asthmatic we've given their rescue medication what would be a sign that that rescue medication is working on an asthma

Kid is talking

How do you know an infant is ready for solid foods

 They are able to open their mouth and push out their tongue, head and neck control

If a child is in the fifth percentile for height and weight, what does this mean?

Poor growth—not appropriate weight and height for growth and development

The 95 percent larger in weight and in height

Initial treatment for dyslipidemia

Diet

Risk factors for dyslipidemia

Family hx