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NSG 3600 Pediatric Actual
Exam 1 Questions and
Answers Galen College Of
Nursing
Turned head toward sounds 2 months Begins to follow things with eyes 2 months Tummy time 2 months Copies facial movements like smiling or frowning 4 months Begins to pass things from one hand to the other 4 months Cries in different ways to show hunger, pain, or being tired 4 months Reaches for you with one hand 4 months Holds head stead, unsupported 4 months Brings hands to mouth 4 months When on stomach, pushes up to elbows 4 months Likes to look at self in mirror 6 months Responds to name 6 months Begins to pass things from one hand to the other 6 months Rolls over in both directions (front to back, back to front) 6 months rocks back and forth 6 months
Sits without support 6 months afraid of strangers 9 months clingy with familiar adults 9 months Understands "no" 9 months Makes sounds like "mama", "baba", "dada" 9 months Uses finger to point at things 9 months Looks for things that are hidden (object permanence) 9 months Pulls to stand 9 months Crawls 9 months Moves things from one hand to the other 9 months Puts arm/leg out to help with dressing 12 months Responds to simple spoken requests 12 months Uses simple gestures, like shaking head "no" or waving "bye-bye" 12 months Tries to say words you say 12 months Can take steps without holding on 12 months May start experiencing temper tantrums 18 months Shows affection to familiar people 18 months Plays simple pretend, such as feeding a doll 18 months Clings to caregivers in new situations 18 months Says several 18 months
Talks about what she likes and what she is interested in 4 years Sings a song or says a poem from memory such as the "Itsy Bitsy Spider" or the "Wheels on the Bus" 4 years Names some colors and some numbers 4 years Understands the idea of counting 4 years Starts to understand time 4 years Remembers part of a story 4 years old Understands the idea of "same" and "different" 4 years Draws a person with 2 to 4 body parts 4 years Uses scissors 4 years Starts to copy some capital letters 4 years plays board games 4 years Can stand on one foot 4 years old Wants to be like friends 5 years More likely to agree with rules 5 years Is aware of gender 5 years Can tell what's real and make believe 5 years Counts 10 or more things 5 years old Can use the toilet on her own 5 years Swings and climbs 5 years Hepatitis B vaccination
1st at birth 2nd at 1-2 months 3rd at 6-18 months DTaP vaccine diptheria, tetanus, pertussis 2 months 4 months 6 months 18 months 4 - 6 yo Rotavirus vaccine schedule 2 months 4 months Hib vaccine schedule 2 months 4 months 12 - 15 months Tdap vaccine 11 - 12 years Pneumococcal vaccine 2 months 4 months 6 months 12 - 15 months IPV 2 months 4 months 6 - 18 months 4 - 6 years Influenza vaccine Annually for over 6 months old MMR vaccine 12 - 15 months 4 - 6 years Varicella 12 - 15 months 4 - 6 years Hepatitis A vaccine 2 doses 12-23 months HPV vaccine
- rapid growth
- double birth weight at 6mo and triple by 12mo
- Gross motor: raise head and chest while on belly, roll side to side (3m), turn over (6m), crawl and pull up (8m)
- Fine motor: transfer objects between hands, scribble, stack large object (6- 12 months)
Freud Oral Stage Birth - 1 year
- oral curiosity (pacifiers, thumbs) Freud Anal Stage 1 year - 3 years
- potty training Freud Phallic Stage 3 - 6 years
- difference in genders noticed Freud latency stage 6 - 12 years
- focus on other aspects of growth Freud Genital stage 12 - 18 years
- puberty, dating Erickson: Trust v. Mistrust Birth - 1 year
- recognize that there are people that will meet their basic needs Erickson: Autonomy vs. Shame and Doubt 1 - 3 years
- balance independence and self-sufficiency against sense of uncertainty Erickson: Initiative vs Guilt 3 - 6 years
- develop resourcefulness to achieve and learn new things without receiving self-reproach Erickson: Industry vs. Inferiority 6 - 12 years
- develop a sense of confidence through mastery of task
- can be hindered by a sense of inadequacy or inferiority Erickson: Identity vs. Role Confusion 12 - 18 years
- acquiring a clear sense of self and purpose Piaget: Sensorimotor Stage
Birth to Age 2
- primary means of cognition is through senses Piaget Preoperational Stage 2 - 7 years
- takes into account the development of motor skills
- divided into preconceptual and intuitive Piaget Concrete Operational Stage 7 - 11 years
- able to organize thoughts into a logical order Piaget: Formal Operational 11 - 15 years
- uses abstract thinking to handle difficult concepts and can analyze both sides of an issue Breast milk or formula birth - 1 year introduce solid foods 4 - 6 months encourage self-feeding and finger foods infants ween to cup 9 - 12 months introduce whole milk 1 year allow self feed and to use cup toddle 2 - 3 snacks per day toddler do not force eating toddler 3 meals and 2 snacks per day toddler 3 meals and 2-3 snacks per day school age manage weight through exercise and healthy choice school age Numeric scale ages 12 and up Wong-Baker faces scale ages 3- 12 FLACC
Separation anxiety Regression Tantrums Reaction to Hospitalization: Preschooler Views hospitalization as punishment Simple explanation and choices Encourage child to ask questions Reactions to Hospitalization: School age Questions identity Increased need for attention Regression Fears bodily mutilation Simple explanations and choices Respect privacy Encourage verbalization of fears Alleviate fears about changes in body image when possible) Reactions to Hospitalization: Adolescent Body image concerns Loss of independence, Separation from peers, Decreased socialization: encourage peer visits, use of teen room Be honest, explain in understandable terms, allow questions/ verbalization of fears/ choices Respect privacy Encourage parental involvement Recognize tendency to reject authority Functions of play Sensorimotor development Intellectual development Creativity Self-awareness Therapeutic value distraction with toys, music, games let child handle equipment and simulate the procedure guided imagery Moral value Infant Play Solitary play
- books, blocks, musical toys, mobiles, finger/hand games Toddler Play
parallel play
- push-pull toys, books/movies, matching games, ride on toys, imitative toys such as dishes, playhouse, blowing bubbles Preschool Play associative play
- role playing, simple board games, alphabet or color games, simple computerized games School age play cooperative play
- music, books, crafts, team sports, bike, skateboard, card or board games, video movie or games, puzzles Adolescent Play cooperative play
- team sports, video/computer games, card or board games, art, concerts, "hanging out", social events with friends Common Infant injuries head injury, fracture from falls, burns from sun/stove/cigarette/water/outlets, mva/improperly installed car seat, choking, suffocation by cord/string Injury prevention: Infants child proofing house, smoke and carbon monoxide detectors, fire extinguisher, safety locks, recommended crib model, properly installed car seat, warming bottles, keep hot food and liquids away from baby, close supervision, no walkers, caution with powder and lotion, no long cords or removable parts on toys, safety gates/latches, test water temp (<120⁰F) Common Injuries: Toddler head injury, fracture, sprain from falls, mva, drowning, poisoning, burns from sun/stove/cigarette/water/outlets Injury Prevention: Toddlers constant supervision, kitchen and bathroom off limits, turn pot handles on stove, hot items out of reach, toxic chemicals put away, refrigerator/attic/ basement locked or sealed, fenced in yard Common Injuries: Preschooler head injury, fracture, sprain from falls, mva, poisoning, firearms, burns from sun/stove/cigarette/ water/outlets Injury Prevention: Preschooler teach about stranger danger and inappropriate touching (could be known person), fire safety, check playground for unsafe objects, wear helmet Common Injuries: School Age head injury, fracture, sprain from falls, being struck by another person or object, animal or insect bites, overexertion
IPV
DTaP MMR Varicella Immunizations: 7-18 years old Don't Have Money DTap HPV Meningicoccal Immunizations in pregnancy Live virus vaccines are contraindicated during pregnancy NO: MMR, Polio, Varicella Varicella Etiology: varicella zoster virus Varicella Clinical Manifestations: rash on trunk and face, lesions begin as macule and progress to vesicle then crust, pruritic Varicella Isolation: contact & airborne precautions Varicella Nursing care: Supportive (anti-pruritic lotions, baths, antihistamines) Oral acyclovir to shorten duration No aspirin Rubella Etiology rubeola virus, Rubella Clinical Manfestations sore throat, lymphadenopathy, mild fever, fine light pink maculopapular rash face to chest to body Rubella Isolation droplet and contact Rubella Nursing Care Supportive care (antipyretics) Educate on isolation while active (1 week after rash starts) Rubeola Etiology caused by morbillivirus Rubeola Clinical Manifestations moderate fever, cough, conjunctivitis, photophobia, Koplick's spots appear 2 days before rash, rash 3-4 days, fever to 105⁰, rash fades and temperature drops 4-7 days Rubeola Isolation airborne and contact
Rubeola Nursing care supportive (antipyretics, bedrest, fluids) Haemophilus Influenza Type B Etiology Haemophilus influenza type b bacteria Haemophilus Influenza Type B Clinical Manifestations upper respiratory infection, OM, sinusitis Haemophilus Influenza Type B Isolation droplet and contact Haemophilus Influenza Type B Nursing Care antibiotic as prescribed Influenza Etiology influenza virus A, B, or C, Influenza Clinical Manifestations rapid onset of high fever, myalgia, headache, sore throat, nonproductive cough Influenza Isolation droplet and contact Influenza Nursing care Supportive (antipyretics, bedrest), Isolated until sx subside, No aspirin Mumps Etiology paramyxovirus Mumps Clinical Manifestations mild and systemic-low-grade fever, malaise, anorexia, ear pain, headache, parotid glands enlarge Mumps Isolation droplet and contact Mumps Nursing care supportive Pertussis Etiology Bordatella pertussis bacteria Pertussis Clinical Manifestations mild respiratory illness with "whooping" cough Pertussis Isolation droplet and contact Pertussis Nursing Care antibiotics as prescribed, keep open airway, monitor oxygen saturation Tetanus Etiology Clostridium tetani, occurs in cut or deep puncture wound Tetanus Clinical Manifestations
