exam 1 peds
1. Therapeutic Play for Children
Helps children express feelings, cope with hospitalization, and reduce anxiety.
Examples:
Medical play (e.g., using dolls to demonstrate procedures)
Sensory play (e.g., water, sand, clay for stress relief)
Role-playing activities
2. Concept of Atraumatic Care & Approaches
Goal: Minimize physical and emotional stress during medical procedures.
Approaches:
Use non-threatening language
Encourage parental presence
Offer choices when possible
Utilize therapeutic play
Use numbing creams before injections
3. Medication Administration (Otic, Optic, Oral)
Otic (Ear):
<3 years: Pull pinna down and back
3 years: Pull pinna up and back
Optic (Eye):
Pull lower eyelid down, drop medication into conjunctival sac.
Oral:
Use oral syringe for infants; aim toward side of mouth.
Mix with small amounts of food if allowed.
4. Erikson’s Psychosocial Stages (Key Pediatric Stages)
Infant (0-1 yr): Trust vs. Mistrust (Needs consistent care)
Toddler (1-3 yrs): Autonomy vs. Shame & Doubt (Encourage independence)
Preschool (3-6 yrs): Initiative vs. Guilt (Encourage exploration)
School-age (6-12 yrs): Industry vs. Inferiority (Encourage achievements)
Adolescence (12-18 yrs): Identity vs. Role Confusion (Encourage self-identity)
5. Safe Sleep for Infants / SIDS Risks
Prevention:
Place infant on back to sleep
Use firm mattress, avoid loose bedding & toys in crib
No co-sleeping
Avoid overheating
Pacifier use during sleep may help reduce risk
6. Pain Scales by Age Group
Infants: FLACC (Face, Legs, Activity, Cry, Consolability)
Toddlers: FLACC or Faces Pain Scale
Preschoolers: Faces Pain Scale
School-age & older: Numeric or Visual Analog Scale
7. Anxiety Reactions to Hospitalization
Infants & Toddlers: Separation anxiety (crying, tantrums)
Preschoolers: Fear of punishment or abandonment
School-age: Fear of pain, body injury, and loss of control
Adolescents: Fear of missing out, privacy concerns
8. Car Seat Safety
Rear-facing until at least 2 years (or as per weight limits)
Forward-facing in car seat until 5 years
Booster seat until 4’9” and 8-12 years old
Back seat until 13 years old
9. Pain Responses by Age Group
Infants: Crying, facial grimacing
Toddlers: Aggression, withdrawal, clinging to caregiver
Preschoolers: Verbalizing pain, resisting procedures
School-age: Stoicism, bargaining
Adolescents: Verbalization, mood changes
10. Infant Growth Patterns
6 months: Weight doubles from birth
12 months: Weight triples from birth, length increases by 50%
11. HPV Vaccine
Purpose: Prevents HPV-related cancers & genital warts.
Recommended Age: 11-12 years (2 doses), but can start as early as 9.
12. Appropriate Toys by Age Group
Infants (0-12 mo): Rattles, mirrors, soft books, mobiles
Toddlers (1-3 yrs): Push-pull toys, blocks, stacking rings
Preschoolers (3-6 yrs): Dress-up, simple board games, tricycles
School-age (6-12 yrs): Board games, crafts, bikes
Adolescents (12+ yrs): Sports equipment, electronics, music
13. Fontanel Closure
Posterior fontanel: Closes by 2-3 months
Anterior fontanel: Closes by 12-18 months
14. Suicide / Self-Harm Signs
Sudden changes in behavior/mood
Social withdrawal
Giving away belongings
Expressing hopelessness
Increased risk in adolescents
15. Infant/Toddler Developmental Milestones (ATI p. 15)
6 months: Rolls both ways, sits with support
9 months: Crawls, pulls to stand
12 months: Walks with assistance, waves bye-bye
18 months: Walks alone, stacks 3 blocks
24 months: 2-word sentences, jumps
16. Growth Hormone (GH) Deficiency
Causes: Pituitary dysfunction
Teaching: Growth hormone injections, monitor height/weight
Medication: Somatropin (subQ)
17. Fungal Infections
Tinea capitis: Scalp ringworm
Tinea corporis: Body ringworm
Tinea pedis: Athlete’s foot
Tinea cruris: Jock itch
18. Lice Manifestation & Treatment
Signs: Itching, nits on hair shaft
Treatment: Permethrin shampoo, combing out nits
Precautions: Wash bedding in hot water, no sharing hair accessories
19. Care for Eczema
Keep skin moisturized
Avoid triggers (allergens, irritants)
Use mild soaps
Apply topical corticosteroids as prescribed
20. Care for Diaper Dermatitis
Frequent diaper changes
Barrier cream (zinc oxide)
Air drying
Avoid baby wipes with alcohol
21. Acne Treatment & Risks
Meds: Topical retinoids, benzoyl peroxide, antibiotics
Risks: Isotretinoin (Accutane) can cause severe birth defects—requires pregnancy tests and birth control.
22. SC / IM Injection Techniques
SC: 45-degree angle, fatty tissue (thigh, upper arm)
IM (infants <1 yr): Vastus lateralis (thigh) only
IM (older children): Deltoid or ventrogluteal
23. Signs/Symptoms of Hypo/Hyperglycemia
Hypoglycemia: Sweating, shakiness, irritability, confusion
Hyperglycemia: Increased thirst, frequent urination, fruity breath
24. Diabetes Mellitus (DM) Patient Teaching
Monitor blood glucose levels
Insulin administration techniques
Carbohydrate counting
Signs of hypo/hyperglycemia
25. I/O Calculations
1 oz = 30 mL
1 tsp = 5 mL
1 tbsp = 15 mL
Daily fluid maintenance formula:
1st 10 kg: 100 mL/kg
2nd 10 kg: 50 mL/kg
Each additional kg: 20 mL/kg
1. Birth Weight & Growth Patterns
Doubles by: 6 months
Triples by: 12 months
2. Fontanel Closure
Posterior fontanel: Closes by 2-3 months
Anterior fontanel: Closes by 12-18 months
3. Developmental Findings to Report (Abnormal for 15-Month-Old)
Not walking independently
No single words besides "mama" or "dada"
Inability to follow simple commands
Lack of pincer grasp
Persistent hand dominance (before 18 months)
4. Expected Findings for a 6-Month-Old
Rolls over in both directions
Sits with support
Transfers objects between hands
Begins to babble consonant sounds (e.g., "ba-ba")
Stranger anxiety may begin
5. Appropriate Toys for a 12-Month-Old (Hospitalized)
Soft stuffed animals
Board books
Nesting cups
Large, lightweight balls
Push-and-pull toys
6. Apical Pulse Assessment for Newborns
Always listen to the apical pulse for 1 full minute.
Normal newborn heart rate: 110-160 bpm
Best auscultation location: Left midclavicular line, 4th intercostal space