Peds : Exam 1 Simplified

Why do we care about the culture of a pt? What do we do for a family of cultural differences?

Ask how the family wants to be cared for.

Collaborate and facilitate safe care.

Respect and honor cultural differences.

How do toddlers play with one another?

Parallel play (side-by-side). Imitates adults. Doesn't share well yet.

How do preschoolers play?

Associative play, dramatic play, imaginary friends.

Erikson's development theory for school aged kid. How do you involve them in their care?

Erikson: Industry vs Inferiority.

Success = competence/mastery.

Failure = inferiority, low self-esteem.

Involvement in care: Choices, touch equipment, simple explanations.

What do you do for parents when child is in hospital and wants/needs them with them?

Keep them inside unless disruptive

What are age appropriate toys for a 1 year old?

rattles, mirrors, teething toys, nesting blocks, push-pull at 12 mo.

How does a nurse help with stressors in toddler age patient?

Stressors:

Separation anxiety strong.

Regression during hospitalization (potty training).

Comfort item important.

Nursing care:

Caregiver present during procedures.

Exam with child in lap, do invasive procedures last.

Let child play with equipment (like stethoscope).

How do you promote a sense of industry for a school aged child?

Let them make choices

A child is in the ICU. The parents do not like care that they are receiving. What do you do about it?

Acknowledge- Ask what they are not happy about, don't validate.

2 two year olds are stacking blocks. What kind of play is this?

Parallel play

At what age can a caregiver tell a family that a child can manage a chronic illness that they have?

School age

A school aged child has a stomach ache every morning before school. why might this happen?

Anxious: Bullying: May cause "school stomachaches."

Erikson's school age info about failure to master projects- what can happen if you miss that step

Erikson: Industry vs Inferiority.

Success = competence/mastery.

Failure = inferiority, low self-esteem.

What do you do for a child that is 4 years old that has night terrors?

Routine and reassurance. Psychologist not needed.

What vaccines will be the first dose for 12 mo

First doses of MMR, Varicella, Hep A.

Sometimes kids think they are getting an injection - "that what you get from being mean"

Its not okay for caregivers to say they are getting it as a punishment

When are you supposed to get your first DTaP?

DTaP: First dose at 2 months.

If a child is not developing normally with sounds and normal speaking time frame, what could be the issue?

Hearing impairment

What should the nurse do for a chronic illness in a child?

Nurse should explain, guide, and prepare parents for expectations.

If an adolescent is sick in the hospital, they are fearing being away from ___.

Separation from peers, body image.

What is a newborn's normal growth and weight?

Double birth weight by 5-6 months.

Triple birth weight by 1 year.

Height increases ~1 foot in 1st year.

When putting a baby down for bed, you should focus on _____.

Safe sleep

What is safe sleep?

"Back to sleep" on firm mattress, no pillows/blankets.

What are Erikson's Psychosocial stages for the school age?

Erikson: Industry vs Inferiority.

Success = competence/mastery.

Failure = inferiority, low self-esteem.

The nurse has to give an injection to a 2.5 year old. What should the nurse tell them?

Be honest → "little pinch," "straw in hand," not punishment.

What age is the biggest risk for separation anxiety?

Toddlers (1-3 years old)

At what age does the fontanelle close?

Posterior closes at 2 mo.

Anterior closes at ~18 mo.

Nursing care/Distraction for toddler?

Let child play with equipment (like stethoscope).

What is developmental surveillance?

Assessing what the child can and cannot do at each visit/stage

What is the normal HR for a 8 month old?

HR: 100-160 (200 = too high).

What temperature is considered a fever in a 8 month old?

Temp: 99.9°F is normal, 100.4°F = fever.

What can a baby do at 7/8 months old?

7-8 mo: stranger anxiety, sits briefly unsupported, pincer grasp, scoots.

Babbling by 7 mo.

A toddler is getting an assessment. During what order should the assessment go in?

Exam with child in lap, do invasive procedures last.

How do preschool age children respond to death?

Sees it as temporary; may think they caused it.

At what age does a baby start saying "mama" and "dada?"

10 mo: mama/dada, sits independently, throws objects.

A child is having an invasive procedure. The mother has legal custody, but she is out of town. Who can give consent?

Consent: Whoever has proxy consent can authorize if the parent is unavailable.

What would a preschool age child need to reduce anxiety?

Use child life specialists (play therapy, art).

Explain rules and reinforce.

Let them walk around with comfort item. NOT just reading a story.

What age appropriate things for preschool age- what they want to do /play?

Play: Associative play, dramatic play, imaginary friends.

What encompasses family centered care?

Core principles:

Information sharing (clear, honest, timely).

Encouragement and family empowerment.

Partnership/collaboration with family in all decisions.

Negotiation with adult family members (not with children).

Understand cultural differences.

In a family centered care scenario, should you tell them what's best for the patient & the family?

No. The family should be able to make their own decisions for their child.

What should you ask an adolescent with a possible pregnancy test?

"What activities have you participated in that could lead this this situation?"

What is the nurse's priority action in a family assessment?

Build relationship first.

What could happen to a child that is potty trained that gets admitted into the hospital?

Regression

What are some developmental milestones for a preschooler?

Fine motor: uses scissors, draws shapes, ties shoes, uses utensils.

Gross motor: throws ball overhand, climbs well, tricycle/bike.

No sentences yet.

A child is in the hospital with physical injuries. What might arouse suspicion?

Inconsistent stories, blaming someone else.

Is it okay to use a safety gate at the top of stairs to prevent falls for a toddler?

NO- further education needed

Toddler stage injury prevention includues:

Choking, drowning, aspiration big risks.

Gates at bottom of stairs okay, NOT at top.

How can you effecively discipline a child?

Immediate, consistent, not physical.

Can a 7 year old understand death?

By 7 yrs → understands permanence, not their fault.

Can a 8 year old read a book?

Yes

Stages of Piaget's Developmental Theory:

1. Sensorimotor (0-2 yo)

2. Preoperational (2-7 yo)

3. Concrete operations (7-11)

4. Formal Operations (11 & up)

Sensorimotor Piaget Stage age

0-2

Preoperational Piaget Stage age

2-7

Concrete operations Piaget Stage age

7-11

Formal Operations Piaget Stage age

11 & up

What should a 15 year olds PR & RR be?

PR : 50-100/min

RR : 16-20 /min

What should a 15 year olds BP be?

S : 97-130

D : 63-94

What are the immunizations for a 12 month old child with a family?

MMR (Measles, Mumps, Rubella) - 1st dose

Varicella (Chickenpox) - 1st dose

Hepatitis A - 1st dose (2nd dose at least 6 months later)

PCV (Pneumococcal Conjugate) - 4th dose

Hib (Haemophilus influenzae type b) - 4th dose