Pediatric Nursing: Growth, Development, Hospitalization & Med-Surg Care

What developmental pattern proceeds from head to toe?

Cephalocaudal development.

What developmental pattern proceeds from the centre of the body outward?

Proximodistal development.

When does birth weight usually double and triple?

Doubles by about 4 months and triples by about 1 year.

When does the anterior fontanelle usually close?

By about 18 months.

What is a typical 3-month motor finding?

Reaches for objects but may miss; holds head steadily.

What is a typical 6-month developmental finding?

Sits briefly/with support, turns over, transfers/bangs objects, begins complementary foods.

What is common at 9 months when a caregiver leaves?

Separation anxiety.

What bedtime advice is appropriate for a healthy 10-month-old?

Use a predictable, calming bedtime routine.

What is an expected gross motor skill for many 2-year-olds?

Jumping with both feet.

What Erikson task is supported when a toddler chooses between two shirts?

Autonomy.

What is parallel play?

Toddlers play beside one another without organizing a shared activity.

What is cooperative play?

Children organize a shared activity and roles, such as playing house.

A preschooler believes a bandage will stop all blood from escaping. What type of thinking is this?

Magical thinking.

What is the preschooler's Erikson task?

Initiative versus guilt.

What is the school-age child's Erikson task?

Industry versus inferiority.

What is the adolescent's Erikson task?

Identity versus role confusion.

What statement demonstrates adolescent identity development?

"I am exploring my career options."

What response supports an adolescent worried about puberty timing?

Variation in timing and pattern of puberty is common.

What is an important sign of toilet-learning readiness?

Staying dry for about 2 hours and reporting wetness.

What is an appropriate early complementary food at about 6 months?

Iron-fortified infant cereal or another iron-rich food.

How should a toddler's meals be structured?

Offer small portions; caregiver chooses what/when/where, child decides whether/how much.

What should the nurse do first when an adolescent starts a vegan diet?

Assess current food choices and understanding of nutrient needs.

What nutrients deserve attention in a vegan adolescent?

Protein, iron, calcium, zinc, vitamin B12, vitamin D, energy, essential fatty acids.

What is therapeutic play?

Play used to reduce anxiety, teach, distract, express feelings, or support a procedure.

What does infant trust develop from?

Consistent, responsive, affectionate caregiving.

What are the three major stressors of hospitalization for children?

Separation, pain/physical discomfort, and fear of body intrusion.

What are the three stages of separation anxiety?

Protest, despair, and denial/detachment.

What does the protest stage of separation anxiety look like?

Loud crying, searching, calling, resisting strangers, and watching the door.

What does the despair stage of separation anxiety look like?

Sadness, quiet withdrawal, listlessness, and decreased play.

What does the detachment stage of separation anxiety look like?

The child appears uninterested in the caregiver and focuses on surroundings or toys.

A toddler stops crying when the parent leaves and seems uninterested on return. What stage is this?

Detachment/denial.

What should a parent do before leaving a hospitalized toddler?

Say goodbye and give a predictable plan for returning; do not leave secretly.

A parent thinks a toddler's crying during visits means visits should stop. What is the best response?

Crying is a normal response to separation and attachment; do not stop visiting.

What is the central principle of family-centred care?

Family and health-care providers are partners; family is not merely a visitor.

What item often comforts a hospitalized toddler?

A familiar blanket or other object from home.

How should the nurse respond to temporary regression in a hospitalized child?

Recognize it as a stress response and respond without punishment.

What intervention supports a sibling of a hospitalized infant?

Prepare the sibling for a supervised visit when appropriate and allow questions.

What concerns are especially common for hospitalized adolescents?

Privacy, body image, independence, peers, school, and identity.

How should the nurse support an adolescent's health interview?

Provide private time and explain confidentiality and its limits.

What demonstrates culturally safe pediatric care?

Ask permission before touching and ask about family preferences rather than assuming.

What is the purpose of rooming-in?

Reduce separation and help caregivers practise care while providing security and familiarity.

When should discharge planning begin?

At admission.

What pain scale is useful for a nonverbal/preverbal child?

FLACC: face, legs, activity, cry, consolability.

What is the best general rule for assessing pediatric pain?

Use self-report when possible; combine behaviour, physiology, and caregiver report when not.

A preschooler is anxious after a procedure while parents are away. What can help?

Stay with the child; use puppets, simple play, distraction, and concrete reassurance.

What is the priority problem in acute asthma exacerbation?

Impaired gas exchange.

What signs indicate increased work of breathing in a child?

Nasal flaring, retractions, grunting, tachypnea, or fatigue.

A child has SpO₂ 89% on room air with retractions. What is the priority action?

Administer oxygen as ordered and escalate/continue urgent respiratory assessment.

What breath sound is commonly associated with acute asthma?

Expiratory wheezing.

What are classic croup findings?

Barking cough, hoarseness, and inspiratory stridor.

Why is epiglottitis considered a medical emergency?

Airway swelling can rapidly obstruct the airway.

What should the nurse avoid if epiglottitis is suspected?

Agitating the child or inspecting the throat with a tongue blade.

What is the priority danger in pediatric diarrhea/gastroenteritis?

Dehydration and electrolyte/acid-base imbalance.

What findings suggest dehydration in a pediatric patient?

Poor intake, dry mucosa, sunken eyes/fontanelle, decreased urine, weight loss, tachycardia, delayed capillary refill.

How should oral rehydration solution (ORS) be administered?

In small, frequent amounts using a spoon, dropper, syringe, cup, or bottle.

When is IV fluid preparation indicated in pediatric dehydration?

When oral fluids are not tolerated or dehydration is severe.

What must be established before IV potassium is administered?

Adequate urine output and a verified order.

What finding suggests Candida diaper dermatitis?

Beefy-red rash with satellite lesions.

What are the basic goals of atopic dermatitis care?

Hydrate/lubricate skin, control itch and inflammation, avoid triggers, and prevent infection.

What is appropriate care after cleft lip repair?

Protect suture line, prevent scratching, follow prescribed feeding method, provide analgesia.

What should be avoided after cleft palate repair when prohibited by the surgical plan?

Straws, hard objects, touching the palate, hot foods/liquids, and oral suctioning.

What finding after a concussion requires prompt reassessment?

Repeated vomiting.

What is cerebral palsy?

Permanent, nonprogressive movement/posture disorder from brain injury/abnormal development.

What should be assessed when screening for scoliosis?

Posture, shoulder/hip symmetry, spinal alignment, gait, and forward-bend appearance.

What goal supports a school-age child with a chronic condition?

Participation in age-appropriate school, play, and peer activities.

What is an essential intervention for a family with a dying child?

Provide time to listen, remain present, acknowledge grief, and support comfort/family goals.

What takes priority in pediatric nursing care over routine tasks?

Airway and breathing assessment and interventions.

What should the nurse clarify before making assumptions about a child's status?

Baseline, developmental level, symptom severity, intake/output, pain, and caregiver observations.

How should hydration be protected in pediatric patients?

Offer small, frequent oral rehydration and monitor urine, weight, mucosa, and capillary refill.

How does developmental stage influence interventions for toddlers?

Provide choices to support autonomy and control.

What key principle guides family involvement in pediatric care?

Invite participation and respect culture without assuming a parent can stay continuously.

What actions help protect surgical repairs in pediatric patients?

Prevent touching or scratching, follow feeding restrictions, control pain, and monitor for bleeding or infection.

Why should regression in a hospitalized child not be punished?

It is a common temporary response to stress or hospitalization.

When is immediate reassessment required in pediatric care?

After every intervention, especially oxygen, analgesia, fluids, respiratory treatments, and procedures.