Pediatric Nursing Exam 1 Study Guide

What is Family Centered Care in pediatric nursing?

It supports the presence and participation of parents in the care of hospitalized children, involving discussions with at least two individuals, the child and caregiver.

What are some barriers to Family Centered Care?

Work schedules, other children, frustration, stress, and grief.

What is anticipatory guidance in pediatric nursing?

It prepares caregivers for upcoming changes in their bodies and the infant/child's body, focusing on health promotion and disease prevention.

When should health promotion and disease prevention begin?

Before conception.

What are the leading causes of morbidity and mortality in infants?

Birth defects, preterm birth and low birth weight, pregnancy complications, Sudden Infant Death Syndrome (SIDS), and injuries (non-accidental trauma).

What are the leading causes of morbidity and mortality in children aged 1-4?

Accidents, congenital or chromosomal abnormalities, and assault (homicide).

What are the leading causes of morbidity and mortality in children aged 5-14?

Accidents, cancer, and self-harm (suicide).

What is the goal of Healthy People 2030?

To improve access to healthcare and providers, reduce health disparities, and focus on areas like dental health, injury prevention, nutrition, sleep, immunizations, mental health, and reducing bullying of LGBT.

What societal issues impact pediatric health promotion?

Societal and ethical dilemmas where family decisions or viewpoints may differ from healthcare providers.

What are the four domains of growth and development in children?

Physical, cognitive, social, and emotional.

What does growth refer to in pediatric development?

An increase in size.

What is cephalocaudal growth?

Development that occurs from head to tail.

What is proximodistal growth?

Development that occurs from near to far and midline to periphery.

What does development refer to in pediatric nursing?

Increased capabilities and the ability to adapt.

What is the touchpoint concept in pediatric nursing?

It refers to the dynamic variation of the family system from birth to 3 years, focusing on the caregiver's ability to model healthy coping strategies and lifestyles.

What are the stages of pediatric clients?

Infant (birth to 1 yr), Toddler (1 to 3 yrs), Preschool (3 to 5-6 yrs), School age (6 to 12 yrs), Adolescent (12 to 18 yrs).

What is the first stage in Erikson's Theory of Psychosocial Development?

Trust vs. Mistrust (Birth-1 yr), where basic needs must be met to learn trust.

What is the second stage in Erikson's Theory of Psychosocial Development?

Autonomy vs. Shame and Doubt (1-3 yrs), focusing on controlling body excretions and developing independence.

What is the third stage in Erikson's Theory of Psychosocial Development?

Initiative vs. Guilt (3-6 yrs), where children explore the world and learn resourcefulness.

What is the fourth stage in Erikson's Theory of Psychosocial Development?

Industry vs. Inferiority (6-12 yrs), where children engage in new activities and develop confidence.

What is a common phrase associated with the Trust vs. Mistrust stage?

"Hold me, feed me, take care of me."

What is a common phrase associated with the Autonomy vs. Shame and Doubt stage?

"I want to help you, I can do it too."

What is a common phrase associated with the Initiative vs. Guilt stage?

"Watch me do this myself."

What is the primary focus of role confusion during adolescence (12-18 years)?

Developing a new sense of identity and a clear sense of self.

What must be resolved at each stage of development according to Erikson's theory?

Each stage represents a crisis that must be resolved to move on to the next stage in a healthy manner.

What are the four stages of Piaget's Theory of Cognitive Development?

1. Sensorimotor (Infant-2 yrs), 2. Preoperational (2-6 yrs), 3. Concrete operational (7-11 yrs), 4. Formal operational (12 yrs-adulthood).

What characterizes the Sensorimotor stage of Piaget's theory?

Learns from sensory input and develops language skills through looking, hearing, touching, mouthing, and grasping.

What cognitive abilities develop during the Preoperational stage?

Increasing verbal skills, limitations in thought, and development of motor skills, including using words and images to represent things.

What is a key feature of the Concrete Operational stage?

Children organize thought in logical order, manipulate objects, and grasp concrete analogies.

What cognitive ability is developed during the Formal Operational stage?

Mature, abstract thought and reasoning to handle difficult concepts.

Why is play important in nursing for infants?

Play is necessary for health and illness and can be a part of teaching or therapy.

What are some general physical changes in infants during the first year?

Body organs are not fully mature, and growth is measured month to month.

What are the characteristics of a newborn (birth-1 month)?

No head control, flexed position, hands closed but with a strong grasp, communicates by crying, cooing, and babbling.

What developmental milestones are reached by 3-6 months?

Birthweight doubles, holds head erect, sits supported, rolls over, discovers self-play, and communicates through cooing and babbling.

What are the key milestones for infants by 9-12 months?

Birthweight triples, head and chest circumference are equal, creeps, pulls up on objects, takes steps with assistance, uses pincer grasp, and begins to say 'mama' and 'dada'.

What type of play do infants engage in?

Solitary play, where they play by themselves.

What types of toys are suitable for infants?

Toys that provide multisensory stimulation, such as music, noise-making objects, visual patterns, and toys that require fine/gross motor activities.

What physical changes occur in toddlers (1-3 years)?

Gains about 1.4kg-2.3kg per year and height increases about 3 inches per year.

What cognitive and sensory functions develop in toddlers?

Temper tantrums, enjoyment of pictures, and ability to follow commands based on age.

What is the psychosocial development stage of toddlers?

Parallel play, where they imitate behaviors and occasionally trade toys and words.

What communication skills do toddlers develop by age 1?

Use 1-word commands and can follow 1-step directions.

What communication skills do toddlers develop by age 2?

Use 2-word phrases and can follow 2-word commands.

What communication skills do toddlers develop by age 3?

Use 3-word phrases and can follow 3-word commands.

What types of play can toddlers engage in?

Imitative play, where they play side-by-side without direct interaction.

What are some physical changes observed in preschoolers (3-5/6 years)?

Gains about 1.5kg-2.5kg per year, height increases about 4-6cm (1.5-2.5in) per year, walks, climbs, runs, jumps easier, ties shoes, fastens buttons, draws stick figures, and can use scissors.

What cognitive and sensory functions develop in preschoolers?

Thinking becomes more logical, they can solve problems, transition from asking 'why' to 'how', visual acuity reaches 20/20, and vocabulary expands to 8,000 to 15,000 words.

What psychosocial developments occur in preschoolers?

Increased peer influence and development of gender identity, often leading to same-sex friendships.

What types of play can preschoolers engage in?

Cards and board games, puzzles, and reading.

What sports activities can preschoolers participate in?

Can concentrate longer, jump rope, ride a two-wheeler, but there is a decrease in active physical play due to technology.

What is cooperative play in preschoolers?

Goal-oriented play that involves winning and losing; if hospitalized, they may be separated from playmates but can integrate play into care.

What are the physical changes in adolescents (12-18 years)?

Girls gain about 15-55 lbs and increase in height by 2-8 inches; boys gain 15-66 lbs and increase in height by 4-12 inches; secondary sex characteristics develop, and endurance and coordination peak.

What cognitive abilities develop in adolescents?

Ability to think in abstract terms, hypothesize, use future time perspective, with a vocabulary of 50,000 words.

What psychosocial developments are typical for adolescents?

Guided mainly by peer influence, experiencing a push-pull dynamic with parental/caregiver units, and continuing cooperative play involving bargaining and negotiating.

What general health history should be assessed in pediatric patients?

Immunizations (up to date?), birth history, play/activity, sleep patterns, and developmental milestones.

What is the recommended approach for physical assessment in pediatrics?

Always begin with least invasive procedures to most distressful; vital signs should be taken when the child is not crying.

What are the steps to consider during a pediatric physical assessment?

1) Consider anxiety level and reduce fears, 2) Talk with parents first, 3) Go slowly, 4) Give control when and where possible.

What is the recommended order of procedures for infants during assessment?

Start with non-invasive procedures and save ears, throat, etc. for later.

How does play change for preschoolers when hospitalized?

They may be separated from playmates but can integrate play into their care.

What factors influence the development of fine motor skills in adolescents?

Fine dexterity sharpens, allowing for effortless manipulation of objects.

What activities are common among adolescents?

Sports, school activities, peer group interactions, games, reading, music, movies, video games, and dance.

What is the significance of peer influence during adolescence?

Peer influence becomes a central focus, affecting behavior and social interactions.

How do preschoolers' vocabulary skills develop?

Their vocabulary expands significantly, reaching between 8,000 to 15,000 words.

What changes occur in cooperative play as children grow?

Cooperative play evolves to include more complex interactions like bargaining and negotiating.

What is the role of technology in preschoolers' physical activity?

There is a noted decrease in active physical play due to increased technology use.

What should be done to help a child with separation anxiety during an exam?

Always keep the parent close and examine the child in the parent's lap as much as possible.

How should a toddler be positioned during an examination?

Allow the child to remain in the parent's lap and let them get comfortable in the room before starting.

What is the appropriate approach for examining preschool-aged children?

Use simple explanations, have the child participate, and use games.

What is the recommended position for school-age children during an examination?

The child should sit up on the table and be explained what is being done.

What are anthropometric measurements used for?

To assess growth and development in children.

How should length be measured in children under 2 years old?

Measure supine with hips and knees extended and flat using a stadiometer.

What is the procedure for measuring weight and BMI in children?

Use an infant scale until age 2, removing all clothes/diaper, and a standing scale for older children.

How should height and weight be documented?

Height is documented in cm and weight in kg.

What is the purpose of growth charts?

To plot growth until age 18, separated by sex and age.

What is the significance of head circumference measurements in infants?

It should be plotted for the first 2 years to identify potential problems.

What are Fenton charts used for?

To track growth in preemies until age 2, starting at 22 weeks and ending at 50 weeks.

What pain scale is appropriate for children aged 12 and older?

Numeric scale.

Which pain scale is used for preschool-aged children?

Wong-Baker scale.

What pain scale is used for newborns?

NPASS.

What pain scale is appropriate for infants up to 7 years old?

FLACC scale.

What are common pediatric coping mechanisms during hospitalization?

Regression, repression, rationalization, and fantasy.

What is Bowen's Family Systems Theory?

It posits that the family is an emotional unit.

What does a complete family assessment promote?

Family-centered care.

What are the three levels of prevention in health care?

Primary (prevention), Secondary (screening), Tertiary (treatment).

What health promotion behaviors should adolescents engage in?

Exercise, support systems, contraception, and sex education.

What is considered infertility in young adults?

Trying for 1 year without achieving pregnancy.

What is the only 100% effective method of preventing pregnancy?

Abstinence.

What are the advantages of barrier methods of contraception?

No medications required and easy to start and stop.

What are the disadvantages of hormonal combination methods of contraception?

Side effects like weight gain and mood changes, and contraindications such as smoking.

What are the advantages of progestin-only hormonal methods?

No estrogen side effects and fewer contraindications.

What is the purpose of clinical termination of pregnancy?

To deliberately end a pregnancy before the fetus reaches a viable age.

What are the two types of procedures for termination of pregnancy?

Medical (e.g., Mifeprex) and Surgical (e.g., vacuum aspiration).

What is important to assess after a termination of pregnancy?

Physical complications and the need for follow-up and family planning.

What is the average time for conception to occur?

6 months

After how long of active cycle monitoring is infertility considered?

More than 1 year

What is the role of prenatal vitamins with folic acid?

They prevent neural tube defects.

What is Azoospermia?

It is the absence of measurable sperm in semen.

What are some presumptive signs of pregnancy?

Amenorrhea, fatigue, enlarged and sore breasts, increased urination, fetal movement (quickening), emesis, and nausea.

What are probable signs of pregnancy observed by a provider?

Positive pregnancy test, fetal outline palpated, Braxton Hicks contractions, Goodell's sign, Chadwick's sign, Hegar's sign, and enlarged uterus.

What is the earliest biochemical marker of pregnancy?

hCG (human chorionic gonadotropin).

What confirms positive signs of pregnancy?

Fetal movements felt by the provider, detection of fetal heart sounds, delivery of the baby, ultrasound detecting the fetus, and visible fetal movement.