Exam 1 Study Guide

What are the key components of weight-based calculations in nursing?

Medication dosage, IV rates, fluid maintenance, urine output, fluid replacements of GI/GU related output.

What is the focus of age-appropriate patient interactions?

Play activities and parent teaching tailored to the child's developmental level.

What are the steps in the nursing process?

Assessment, nursing diagnoses (NANDA), interventions, rationale, evaluation of interventions and outcomes.

What are potential complications associated with treatments?

Identifying signs and symptoms and managing these complications.

What is the first stage of Erik Erikson's psychosocial theory for infants?

Trust vs. Mistrust: Based on consistent care.

What cognitive development stage occurs in infants according to Piaget?

Sensorimotor: Learns via reflexes; object permanence at 9 months.

What is the psychosocial challenge for toddlers (2-3 years) according to Erikson?

Autonomy vs. Shame/Doubt: The 'No' stage; egocentric behavior.

What cognitive development stage occurs in toddlers according to Piaget?

Preoperational: Symbolic thought; domestic mimicry; fully developed object permanence.

What is the psychosocial challenge for preschoolers (3-6 years) according to Erikson?

Initiative vs. Guilt: Mastering skills and pretend play.

What cognitive development stage occurs in preschoolers according to Piaget?

Preoperational: Animism, artificialism, and imminent justice.

What is the psychosocial challenge for school-age children (6-12 years) according to Erikson?

Industry vs. Inferiority: Peer groups and striving for self-respect.

What cognitive development stage occurs in school-age children according to Piaget?

Concrete Operations: Understanding weight/volume as unchanging and simple analogies.

What is the psychosocial challenge for adolescents (12-18 years) according to Erikson?

Identity vs. Role Confusion: Peer support systems and body image concerns.

What cognitive development stage occurs in adolescents according to Piaget?

Formal Operations: Adult-level thinking; abstract and deductive reasoning.

When do the posterior and anterior fontanels close?

Posterior fontanel by 3 months; anterior fontanel by 18 months.

What motor skill development milestone is expected at 12 months?

Sits down from standing position without assistance and tries to build a two-block tower.

What motor skill development milestone is expected at 15 months?

Walks without help, creeps up stairs, and successfully builds a two-block tower.

What motor skill development milestone is expected at 18 months?

Assumes standing position, runs and falls easily, and manages a spoon without rotation.

What motor skill development milestone is expected at 2 years?

Walks up and down stairs and builds a tower of six or seven blocks.

What is a key strategy for age-appropriate pain assessment?

Use age-appropriate pain scales and incorporate distraction techniques.

How should specimen collection be approached with children?

Demonstrate on a doll first and let the child handle collection containers.

What is an important aspect of infection control with children?

Explain isolation gear using dolls and maintain normalcy through play activities.

What should be explained to a child regarding restraints?

Explain the purpose honestly and offer choices when possible.

What is the significance of red flags in pediatric assessments?

No single indicator alone diagnoses a problem; look for patterns or combinations.

What are signs of physical abuse in children?

Injuries inconsistent with developmental abilities, unusual bruising, and multiple injuries in various stages of healing.

What is Shaken Child Syndrome?

A serious form of physical abuse caused by violent shaking of infants, leading to brain injury.

What are classic findings in cases of child abuse related to head trauma?

Intracranial bleeding, bilateral retinal hemorrhages, rib and long bone fractures, usually no external signs of injury.

What symptoms may indicate mild head trauma in infants?

Vomiting, irritability, poor feeding, listlessness, flu-like symptoms.

What severe symptoms can arise from head trauma in infants?

Seizures, altered level of consciousness, posturing, apnea, bradycardia, death.

What are common causes of head trauma in infants?

Caregiver frustration with infant crying, maternal stress or depression.

What are some long-term outcomes of head trauma in infants?

Seizure disorders, visual impairments, developmental delays, hearing loss, cerebral palsy, mental or cognitive impairments.

What key nursing interventions can help prevent child abuse?

Parent education about normal infant crying, teaching abuse prevention, public education, addressing socioeconomic factors.

What are the 9-month developmental milestones for infants?

Developing crude pincer grasp, pulling to standing position, letting go of objects, manipulation of toys, object permanence, saying 'Dada' and 'no', obeying simple commands, showing stranger fear.

What are the 15-month developmental milestones for infants?

Walking independently, using 3-5 words with meaning, stacking 2 blocks, creeping up stairs, holding a cup well, attempting to run.

What is Erikson's first stage of development?

Trust vs. Mistrust (birth to 1 year) - Infants develop trust through consistent care.

What is Erikson's second stage of development?

Autonomy vs. Shame and Doubt (1-3 years) - Toddlers gain independence while balancing dependence on caregivers.

What is Erikson's third stage of development?

Initiative vs. Guilt (3-6 years) - Preschoolers engage in learning and activities, developing purpose while managing guilt.

What is Erikson's fourth stage of development?

Industry vs. Inferiority (6-12 years) - School-age children develop skills and strive for accomplishment.

What is Erikson's fifth stage of development?

Identity vs. Role Confusion (12-20 years) - Adolescents explore their identity and roles.

What is the significance of the Industry vs. Inferiority stage?

Children learn new skills and seek praise; failure leads to feelings of inadequacy.

What is Piaget's Preoperational stage?

Ages 2-7 years; characterized by egocentrism, magical thinking, and intuitive thought.

What are key characteristics of the Preoperational phase?

Symbolic thinking, centration, and inability to understand conservation.

What is Piaget's Concrete Operational stage?

Ages 6-11 years; children develop logical thought and understand conservation.

What is the role of egocentrism in child development?

It limits children's ability to see perspectives other than their own.

What triggers Freud's concept of regression in toddlers?

Stressful situations such as illness, hospitalization, or changes in routine.

What are common behaviors indicating regression in toddlers?

Accidents after being potty trained, wanting a bottle again, tantrums.

What is the impact of socioeconomic factors on child development?

Increased household income can reduce the risk of developmental issues.

What is the importance of developmental milestones?

They help track a child's growth and identify potential delays or issues.

What is the significance of parent education in preventing child abuse?

It helps caregivers understand normal infant behavior and coping strategies.

What are some examples of typical behaviors in toddlers during the Autonomy vs. Shame and Doubt stage?

Negativism, ritualism, rapid mood swings, and expressing will.

What does successful mastery in the Autonomy vs. Shame and Doubt stage require?

Opportunities for self-mastery, limit-setting, and delayed gratification.

What is the Flacc scale used for?

Pain assessment in infants and young children (neonate - 4 years) for short, sharp procedural pain.

What does the acronym FLACC stand for?

Face, Legs, Activity, Cry, Consolability.

What is the score range for the FLACC scale?

0 (no pain behaviors) to 10 (most possible pain behaviors).

What is Sudden Infant Death Syndrome (SIDS)?

The sudden death of an infant younger than 1 year that remains unexplained after a complete autopsy.

Which infants have higher rates of SIDS?

African-American, American-Indian, and Alaskan-Native infants.

What are intrinsic risk factors for SIDS?

Genetics, male gender, prematurity, and prenatal exposure to cigarette smoke or alcohol.

What are extrinsic risk factors for SIDS?

Prone sleeping, bed sharing, soft bedding, and exposure to cigarette smoke.

What protective factors reduce the risk of SIDS?

Breastfeeding, pacifier use, supine sleep position, and room-sharing without bed-sharing.

What does ALTE stand for?

Apparent Life-Threatening Event.

What are the components of an ALTE?

Apnea, color change, change in muscle tone, choking, gagging, or coughing.

What is the management for a child experiencing an ALTE?

Temporary home cardiopulmonary monitoring and CPR training for caregivers.

What constitutes child maltreatment?

Intentional physical abuse, emotional abuse, neglect, or sexual abuse of children.

What does the acronym TEN4 stand for in identifying child abuse?

Trunk, Ears, Neck, 4 years or younger.

What is the recommended care management for child maltreatment?

Protect the child, support the child and family, plan for discharge, and prevent further abuse.

What are common sources of ingestion of injurious agents?

Corrosive substances like cleaners, hydrocarbons, and medications like acetaminophen.

What is the antidote for acetaminophen poisoning?

N-acetylcysteine (NAC).

What are the classic symptoms of opioid poisoning?

CNS depression, respiratory depression, and pinpoint pupils.

What are the common sources of lead poisoning in children?

Lead-based paint, contaminated soil, lead dust, and cultural products containing lead.

What are the symptoms of lead poisoning?

Cognitive/behavioral problems, developmental delays, and physical effects like affected growth.

What is the treatment for severe lead poisoning?

Chelation therapy with BAL and Calcium EDTA, along with hydration.

What is the nursing goal for lead poisoning?

Prevent initial or further exposure to lead.

What is cleft lip?

A congenital condition resulting from embryonic developmental failures, characterized by a notched vermilion border.

What are the nursing interventions for a child with cleft lip?

Clean the lip repair site, apply ointment, use elbow restraints, and monitor for infection.

What special feeding equipment is used for infants with cleft lip?

A long nipple or syringe with rubber tips to facilitate feeding.

What is the post-operative care for a child with cleft lip repair?

Keep the child supine, nothing by mouth, and monitor for signs of infection.

What should parents do to support a child with cleft lip during feeding?

Support the child's cheek and burp frequently to reduce air swallowing.

What is the purpose of a feeding tube in infants with esophageal trauma?

To minimize trauma to the esophagus.

What is a cleft palate?

A condition resulting from the failure of the primary palatal shelves to fuse during 7-12 weeks of gestation.

What are the manifestations of a cleft palate?

Nasal distortion, midline or bilateral cleft, exposed nasal cavities.

How is a cleft palate diagnosed?

By observation and placing a gloved finger in the mouth to feel the defect or visual examination with a flashlight.

What are the post-operative care instructions for a child after cleft palate surgery?

Clean the lip repair site, apply ointment, use elbow restraints, avoid brushing teeth for 1-2 weeks, and observe for signs of infection.

What is pyloric stenosis?

A condition where the pyloric muscle is overdeveloped, causing obstruction of gastric emptying.

What are the common manifestations of pyloric stenosis?

Projectile vomiting after feeding, dehydration, and electrolyte imbalances.

What is the typical treatment for pyloric stenosis?

Pyloromyotomy, IV fluids, and NG tube for stomach decompression.

What is Hirschsprung Disease?

An aganglionic megacolon resulting in obstruction due to the absence of ganglion cells in the colon and rectum.

What are the signs of Hirschsprung Disease in newborns?

Failure to pass meconium within 24-48 hours after birth.

What is the diagnostic procedure for Hirschsprung Disease?

X-ray, barium enema, and confirmation with a rectal biopsy.

What are the manifestations of Inflammatory Bowel Disease (IBD)?

Chronic inflammation, damage, and ulceration in the gastrointestinal tract.

What distinguishes Ulcerative Colitis from Crohn's Disease?

Ulcerative Colitis affects the rectum and anus, while Crohn's Disease can affect any part of the gastrointestinal tract.

What are common risk factors for developing IBD?

Family history, low fiber diet, food intolerance, GI infections, and smoking.

What are the common medications used to treat IBD?

5-Aminosalicylic acid medications, corticosteroids, immune-modulating agents, and antibiotics.

What is the importance of patient teaching for children with gastrointestinal disorders?

To ensure proper management of symptoms, nutritional needs, and psychological support.

What are the signs of dehydration in infants with pyloric stenosis?

Dry mucous membranes, decreased skin turgor, and lethargy.

What is the recommended position for feeding infants with cleft palate?

At a 30-degree angle in a semi-Fowler's or upright position.

What should parents monitor post-operatively for a child with pyloric stenosis?

Vomiting, abdominal tenderness, fever, or signs of an infected incision.

What dietary modifications are recommended pre-operatively for Hirschsprung Disease?

Low fiber, high calorie, and high protein diet or TPN.

What is the role of psychosocial support in managing IBD?

To improve self-esteem and provide coping strategies for patients.

What is the typical age of onset for pyloric stenosis?

Typically presents 2 weeks after birth.

What are the common symptoms of Crohn's Disease?

Abdominal pain, diarrhea, weight loss, and fatigue.