Pediatrics for Nursing Exam 1

Immunizations at birth

1 Hep B

Immunizations at 2months

Hep B

STap

Hib

Polio

PCV

RV

Immunizations at 4 months

NO HEP B

DTaP

Hib

Polio

PCV

RV

Immunizations at 6months

Hep B

DTaP

Hib

Polio

PCV

RV

Immunizations at 12-18 months

MMR

DTaP (15-18 months)

Hib

PCV

Varicella

Hep A

Immunization for 4-6 year olds

DTaP

MMR

Polio

Varicella

Babies bodies are measured in

Centimeters

Frontanelle Closure Anterior is at

18 months

Frontanelle Closure Posterior is at

2 months

Babies weight doubles by

6 months

Babies weight triples by

12 months

Babies have how many teeth by what age

6-8 teeth by 12 months

Babies have lower central incisors by how many months

12 months

Head circumference is how many cm what month

gets bigger 2 cm a month then 1 cm a month then 0.5 cm a month

Fine motor Skills

are the abilities required to control the small muscles, especially in the hands and fingers, for tasks such as grasping and manipulating objects.

Gross Motor skills

are the skills that involve the larger muscles of the body, allowing for movements such as crawling, walking, running, and jumping.

2 months milestones motor and cognitive

Moves head side to side

Tracks with eyes

Makes noises such as coos

Smiles

Holds head up on tummy

4 months Milestones, motor and cognitive

Begins to play

Babbling

Holds and reaches for toys

Rolls over

At what age do you stop swaddling and why

4 months they start to roll

What age do infants do a front to back roll

5 months

6 months milestones motor and cognitive

Can sit up supported

Roll from back to front

Hold bottle to feed self

Recognize and responds to name

Likes looking at the mirror

8-9 months milestones and motor and cognitive

Sits without support

Pincer grasp

Object permanence

Crawling

Stand with pulling up

Moves object hand to hand

10-12 months milestones motor and cognitive

Begins walking

Follows simple commands

Puts objects in containers

Bangs objects together

Seperation anxiety

Says simple words MAMA and DADA

SIDS parent teaching

No co-sleeping

No toys or blankets

Shaken Baby syndrome parent teaching

Brain rattling from shaking baby

Causes brain injury

Car seat safety parent teaching

Rear facing

Rolling over parent teaching

NO MORE SWADDLING

Choking parent teaching

Bulb syringes for infants

6 months make sure to give appropriate sized foods, no popcorn, no grapes

Burn safety for parents

Fire safety

Hot coffee

Stove

Water heater set nothing above 120

Interventions for Infant

Consistency- same nurse if possible

Respond to crying- rock and swaddle

Keep parent near

Ericksons for infant

Birth - 1 year

Trust VS. mistrust

Basic needs are met

Eating plan for infants

Breastfeeding 2-3 hours

Iron at 4months if breastfeeding

No cow milk or honey for the first year!

Start solids at 6 moths RICE CERAL FIRST

Social stimulation for infants

Independent play

Observe- faces, high contrast items, and voices

Birth- 4 months

Interact with toys, blocks, push toys over 4months

Discharge teaching for Newborn and Infants

Jaundice

Follow up with PCP 2 days or sooner

Birth weight should double by 6 months and triple by 12 months

Nurse cannot put a carseat in the car when leaving

Baby must be in carseat when leaving the hospital

Umbilical cord care

Keep above diaper line

Make sure it falls off and is not infected

Circumcision care

Plastibell type- ring will fall of 7-8 days

Keep area moist to prevent diapers from sticking

Nursing care for circumcision

Consent/ Time out

Restraints

Give sweeting

Document first void

Monitor 30 min after for first 2 hours

Breast feeding how often

every 2-3 hours

Bottle feeding how often

every 3-4 hours

Wet and stool diapers

Urine Minimum 1 a day for the first 6 days

Stool 5-6 a day

What happens when a child is hospitalized

Impacts the whole family

Disrupts routines (bath and feedings)

Misbehaves because scared

Age depends on reaction

How does this impact normal growth and development

For acute illness no impact

Nice baby and long term admissions can delay

Family centered care helps all family

Can parents go in for a sterile lumbar puncture

YES parents can go in to any procedure or code, and treatment room

Just no in the OR

Infant birth- 12 months Ericksons disease

Trust VS Mistrust

Impact: Seperation from parents

Trust comes from providing basic needs like feeding them or changing them

Play is solitary alone

Nurses role during trust vs mistrust

Infant birth-12 months

Use treatment room for procedures

Minimize separation from parents

Continue breastfeeding

Support normal milestones

Change positions often

Toddler 1-3 years old Eriksons

Autonomy VS Shame

Independence starts to emerge

Impact- Fear, Regression (like wetting bed again)

Play parallel side by side not with each other

Nurses role during Autonomy VS Shame

Toddler 1-3 years old

Parental prescence and involvement

Utilize objects (lovey, toy)

Use treatment room

Provide true choices: If appropriate, which arm would you want BP token. What color bandage would you like pink or green

Preschool 3-5 years old Ericksons

Initiative VS Guilt

Interacts socially a bit more

Impact- Loss of control, feeling punished

Medical play(stethoscope with bear)

Nurses role during initiative VS guilt

Preschool 3-5 years old

Provide clear, simple, honest information about what you’re doing

Encourage participation in care

Explain things using the 5 senses

School Age children 5-11 Ericksons

Industry VS Inferiority

Starting to form friends

Becoming competitive

Impact- Loss of bodily control and function. Fear of waking during surgery

Nurse Role during Industry VS Inferiority

Actively involve child in care

Identify and correct misconception

Adolescents 12-18 years old Ericksons

Peers are important they want to fit in

Self esteem is important

Privacy is important

Rapid growth in changes

Privacy is important

Friends are more important friends are less important

Impact- Loss of personal identity

Nurse Role during Identity VS Role confusion

Adolescents 12-18 years old

Speak directly with patient

Respect privacy

Discuss discharge needs and school needs if applicable

Promote self care and independence

Child life specialists are

They bring life into the hospital

Bring toys, teach about procedure, prepare patient for procedure

Advocate and support nO

One voice coaching

One nurse talks during a procedure or task involving multiple nurses

Helps reduce stimulation

EMLA

Lidocaine numbing cream

Child life personal in Pediatric loss

Child life helps siblings and family cope at this time to help process

Example- Brother thought a baby was coming home. A mother passing in ICU child life would help the child cope and tell them

Family centered care- Role of pediatric nurse

Forming a relationship

Alot of teaching and prevention

Resources

CARETAKER OR PARENT ALWAYS INCLUDED

Advocacy for child

Family centered Care

Treat child and family as one

Families are the expert of the child they know that child way more than anyone else

Let them do the Childs care how they would at home as long as it’s safe

Head circumference

Reflects brain growth

Axillary temp

Is the most used route

Do this as last part of vitals

Infants should hold their heads up by

4 months old

Absence of eye eliciting the red reflex is a indication of

Cancer

Assessing abdomen you listen for

a full 5 minutes