Quiz 2 Study Guide

Normal HR for an infant?

100–160 bpm

Normal RR for a toddler?

22–40 breaths/min

What is the BEST early indicator of adequate hydration in children?

Urine output ≥1–2 mL/kg/hr

What is a late sign of shock in children?

Hypotension

Why must respirations be counted for a full minute in infants?

Breathing is irregular

Best way to assess an infant?

While calm/asleep, least invasive first

Key strategy for toddlers during assessment?

Use play and give choices

What fear do preschoolers have during exams?

Fear of body harm/mutilation

Priority when assessing adolescents?

Privacy and independence

How are pediatric medication doses calculated?

Weight-based (kg)

Best method for giving oral meds to infants?

Oral syringe into side of cheek

Why avoid pills in young children (<5–6)?

Aspiration risk

IM injection site for infants?

Vastus lateralis

How do you administer ear drops to a child <3 years?

Pull ear down and back

What is the 4-2-1 rule?

Maintenance IV fluid calculation method

Fluid bolus amount for children?

10–20 mL/kg

Best sign of improving hydration?

Increased urine output

Why are infants more prone to infection?

Immature immune system

What happens to maternal antibodies after birth?

They decrease over time

Define sepsis

Life-threatening systemic response to infection

Early signs of sepsis?

Tachycardia, tachypnea, lethargy

Late sign of sepsis?

Hypotension

First step in sepsis treatment?

Obtain cultures → give IV antibiotics

What is required for infants <60 days with suspected sepsis?

Full sepsis workup + IV antibiotics

Why are children often placed in isolation?

Poor hygiene and incontinence increase spread

What precautions are used for respiratory + GI infections?

Droplet + contact

When is ibuprofen contraindicated in children?

Under 6 months

Non-pharmacologic fever interventions?

Tepid bath, light clothing, cooling

Scarlet fever hallmark signs?

Sandpaper rash + strawberry tongue

What is diphtheria?

Airway-blocking bacterial infection (emergency)

What causes botulism in infants?

Honey ingestion

What is pertussis?

Whooping cough

Measles classic signs?

3 C’s + Koplik spots

Fifth disease appearance?

“Slapped cheek” rash

Hand-foot-mouth disease symptoms?

Oral ulcers + lesions on hands/feet

Pinworms symptom?

Nighttime anal itching

Scabies symptom?

Severe itching at night

Head lice symptom?

Itchy scalp

When is epilepsy diagnosed?

≥2 unprovoked seizures

What is an absence seizure?

Brief staring episode

What is a febrile seizure?

Seizure caused by fever in young children

Priority during a seizure?

Airway and safety

Proper positioning during seizure?

Side-lying

What should NEVER be done during a seizure?

Put anything in mouth or restrain

What is Cushing triad?

Bradycardia + hypertension + irregular respirations

Sign of dehydration in infants?

Sunken fontanel

What is hydrocephalus?

Excess CSF in brain ventricles

Treatment for hydrocephalus?

VP shunt

What is a VP shunt?

Device that drains CSF to abdomen

Why are children more prone to head injury?

Large head + weak neck

What is shaken baby syndrome?

Abusive head trauma

Normal newborn vision?

~20/400

What is strabismus?

Misaligned eyes

What is amblyopia?

“Lazy eye”

Why do children get more ear infections?

Short, horizontal Eustachian tube

Sign of hearing loss in infants?

No response to sound

Sign of hearing loss in toddlers?

Delayed speech

What communication technique ensures understanding?

Teach-back method

What reading level should instructions be?

4th–6th grade

What is the formula for LOW systolic BP in children?

70 + (2 × age in years)

Most accurate temperature method for neonates?

Rectal

When can tympanic temperatures be used?

≥6 months

When is oral temperature reliable?

≥5 years

What is the FIRST thing to assess in an infant physical exam?

Heart and lungs (before crying)

What should the nurse do if a toddler becomes uncooperative during exam?

Assess what you can and move on

How much medication should be given at a time to an infant?

0.2–0.5 mL

Why should the syringe remain in the infant’s mouth during administration?

Prevent spitting out medication

How can you stimulate swallowing in an infant?

Rub chin or gently blow on face

What is the alternative daily fluid calculation method?

100 mL/kg (first 10 kg) 50 mL/kg (next 10 kg) 20 mL/kg (remaining)

What skin finding indicates severe infection/sepsis?

Petechiae

What behavioral sign in infants suggests sepsis?

Weak cry

What neurologic sign suggests worsening sepsis?

Poor responsiveness

What is a key question to ask about infection exposure?

“Has the child been around anyone sick?”

Why is immunization history important?

Identifies risk for preventable diseases

What GI symptoms are important in infection assessment?

Vomiting and diarrhea

What is osteomyelitis?

Bone infection causing pain, fever, ↓ movement

Classic rash for Lyme disease?

Bullseye rash

Key feature of Rocky Mountain spotted fever?

Petechial rash

What is rabies prognosis once symptoms appear?

Almost always fatal

How are pinworms diagnosed?

Tape test

First-line treatment for scabies?

Permethrin

What must be measured regularly in children <3 years?

Head circumference

What symptom suggests increased ICP in children?

Vomiting

Cause of neural tube defects?

Folic acid deficiency

What is craniosynostosis?

Premature closure of skull sutures

What is Chiari malformation?

Structural brain defect affecting cerebellum

How can you differentiate absence seizure from daydreaming?

Child does NOT respond when name is called

What are infantile spasms?

Brief stiffening episodes in infants (serious)

What causes retinopathy of prematurity?

Excess oxygen exposure

What are PE tubes used for?

Chronic ear infections

What is a cochlear implant?

Device for sensorineural hearing loss

Why validate a child’s answers with caregiver?

Ensures accuracy

What must be explained to adolescents about confidentiality?

Limits when safety is at risk

What is the nurse’s legal responsibility in suspected abuse?

Mandatory reporting

Leading cause of death from child abuse?

Shaken baby syndrome

What is the 4-2-1 rule used for?

Calculating maintenance IV fluids in mL/hr

4-2-1 rule breakdown?

4 mL/kg/hr (first 10 kg) 2 mL/kg/hr (next 10 kg) 1 mL/kg/hr (remaining)

Daily maintenance fluid formula?

100 mL/kg (first 10 kg) 50 mL/kg (next 10 kg) 20 mL/kg (remaining)

How do you convert mL/day to mL/hr?

Divide by 24

What is the pediatric fluid bolus amount?

10–20 mL/kg