Download Peds Final exam study guide and more Study notes Nursing in PDF only on Docsity!
Absolutely. We’re filling this in the right way, correcting the weak spots, tightening the confusing parts, and adding the missing high-yield details from your review sheet plus the PWPs we covered. Your concept review hits a lot of the right ideas, but there are a few places where I want to sharpen the wording so you don’t get trapped on exam day.
I’m going to keep this clear and organized, but I am going to be thorough so you can actually understand it, not just memorize random facts.
Peds Final Concept Review — Filled In
and Corrected
Child abuse
Your review is right that major red flags include:
● injury or complaint that does not match the story ● wounds or burns in different stages of healing ● injuries that are not developmentally appropriate ● delay in seeking care ● strange family dynamics or caregiver behavior
Forms of abuse
● physical ● sexual ● emotional ● neglect
Most prevalent
Neglect is very commonly tested as the most common form. It can include:
● lack of supervision ● lack of food ● lack of shelter ● lack of medical care ● emotional neglect
Nursing priority
If abuse is suspected:
● detailed history and physical ● mandatory reporting ● protect the child ● use multidisciplinary care
Exam clue
Do not try to “prove” abuse before reporting. If you suspect it, you report it.
Pain scales and pain management
Your review is right, but here is the tighter version:
Pain scales by age
● Infant/newborn: CRIES or NIPS ● 2 months to 7 years / nonverbal: FLACC ● Preschooler / late toddler and older: FACES ● Older child/adolescent: numeric 0–10 scale
Important reminder
Infants do feel pain. That is a huge myth professors like to test.
Nonpharmacologic pain interventions
● stretching ● distraction ● sucking for infants ● guided imagery for older children ● positioning ● elevation of injured extremity
Nursing pearl
No crying does not mean no pain.
Celiac disease
Cleft lip / cleft palate
Your review has the right concern, but let’s tighten it.
Why it matters
Main concerns:
● nutrition/feeding difficulty ● aspiration risk ● speech development ● otitis media ● dentition problems
Repair timing
● cleft lip: about 2–3 months ● cleft palate: about 6–9 months
Feeding support
● special nipples/bottles ● droppers or specialized feeders may help ● some infants need temporary tube feeding
Why catch it early
Speech development is a big long-term issue, especially with palate problems.
Asthma
Your review is good here.
Pathophysiology
Asthma involves:
● bronchospasm ● bronchoconstriction ● airway inflammation
● excessive mucus production
Peak flow meter
Have the child:
● take a deep breath ● seal lips around mouthpiece ● blow out hard and fast ● do it 3 times ● record the highest number
Rescue drug
Albuterol
● bronchodilator ● quick relief ● relaxes bronchioles ● used for acute symptoms
Preventive/controller drugs
Corticosteroids
● reduce inflammation ● used for long-term control, not rescue ● rinse mouth after inhaled steroids to prevent thrush
Triggers
● exercise ● environmental irritants ● animals ● allergies ● infections ● weather changes
Exam trap
If a child is using albuterol all the time, asthma is poorly controlled.
Milestones
● head control: about 4 months ● roll over: about 4–6 months ● sit unsupported/tripod around 6 months ● pull to stand / cruise: 9–12 months ● walk: around 12 months ● concerning if not walking by about 18 months
Weight
● doubles by 6 months ● triples by 1 year
Solids
● start around 4–6 months ● start slowly ● rice cereal often used first in basic teaching ● then fruits and vegetables ● wait a few days between new foods to watch for reactions
Antipyretics
● acetaminophen can be used in younger infants per provider guidance; your review notes around 4 months ● ibuprofen is for 6 months and older
Exam clue
No honey under 1 year old, and no cow’s milk as main milk before 1 year old are classic infant teaching pearls.
Burns
Your review is mostly right, but one correction:
1st degree
● red ● painful ● blanches
● like sunburn ● no blisters
2nd degree
● blisters ● pink/red ● painful ● moist ● blanches
3rd degree
● through epidermis/dermis into deeper tissue ● brown/black or waxy white ● usually not painful because nerve endings are destroyed ● often needs grafting
4th degree
● into muscle/bone/tendon ● severe tissue destruction ● often painless in deepest area due to nerve damage
Important correction
Your review says 4th degree is the one with no pain, but 3rd-degree burns also can be painless because nerves are destroyed.
Burn care reminder
Use cool running water , not ice.
Pediatric cardiac problems and heart failure
Your review has the right broad idea.
Kids with congenital/structural heart defects may have heart failure
symptoms
Examples:
What it is
Acute inflammatory vasculitis affecting blood vessels. Biggest complication is coronary artery aneurysm.
Signs/symptoms
● fever for 5 days ● red hands/feet ● strawberry tongue ● conjunctivitis without exudate ● rash ● irritability/crankiness ● lymphadenopathy ● later peeling/desquamation of fingers/toes
Treatment
● IVIG
● aspirin ● low stimulation / comfort ● fever control ● echo monitoring
Quick clue
5 days fever + strawberry tongue + red eyes + peeling = Kawasaki
Cerebral palsy
Your review is correct.
What it is
A non-progressive motor disorder due to early brain injury/development issue. It does not get worse over time, though symptoms can become more obvious as the child grows.
Common findings
● developmental delay ● poor suck/feeding issues ● poor head control
● tongue thrust ● abnormal posture ● spasticity ● contractures ● hyperreflexia ● seizures may occur
Management
Goal is to maximize function:
● PT ● OT ● speech ● feeding support ● medications for spasms/pain ● surgeries for symptom control if needed
Quick clue
CP = movement/posture problem that is non-progressive
Cystic fibrosis
Your review is strong.
What it is
Autosomal recessive disorder causing thick secretions in lungs, pancreas, and other organs.
Main issues
● thick mucus ● lung infections ● pancreatic insufficiency ● poor digestion/absorption ● greasy stools ● poor growth
Treatment
● pancreatic enzymes with everything they eat
● usually worn for months depending on severity
Important correction
Your review says 23 hours on / off only for shower. That is brace teaching for scoliosis, not the standard way to phrase Pavlik harness teaching. For the exam, focus more on:
● skin care ● proper fit ● keeping harness on as prescribed ● not removing or adjusting it casually
Diabetes insipidus
This section needs one important correction.
What it is
Deficiency of ADH , often involving pituitary/hypothalamic problems, sometimes tumor related.
Signs/symptoms
● polyuria ● polydipsia ● dehydration ● hypernatremia ● low urine specific gravity, very dilute urine
Important correction
Polyphagia is not the classic DI finding. That is more associated with diabetes mellitus. For DI, think pee a lot, thirsty a lot, dry out.
Treatment
● water replacement ● DDAVP ● strict I&O ● daily weights
Memory clue
DI dries you out.
Hypospadias vs epispadias
You’ve got the basic idea right.
Hypospadias
● urethral opening on the underside/ventral surface of penis
Epispadias
● urethral opening on the upper/dorsal surface
Nursing pearl
Do not circumcise a newborn with hypospadias because the foreskin may be needed for repair.
Pyloric stenosis
Your review is good.
What it is
Hypertrophy/narrowing of the pyloric sphincter causing gastric outlet obstruction.
Classic findings
● projectile nonbilious vomiting ● dehydration ● electrolyte imbalance ● weight loss ● hungry after vomiting ● olive-shaped mass in epigastric area ● usually young infant, around 3–6 weeks , often boys
Treatment
DKA
Your review is mostly right, but one correction.
It is usually associated with
Type 1 diabetes mellitus.
Why it happens
Not enough insulin, so the body breaks down fat for energy → ketones → acidosis.
Signs/symptoms
● fruity breath ● Kussmaul respirations ● hyperglycemia ● polyuria ● polydipsia ● polyphagia ● dehydration ● abdominal pain ● nausea/vomiting
Important correction
Your review says blood in urine. That is not a classic DKA hallmark. The urine finding you think of is ketones , not blood.
Treatment
● isotonic fluids first, usually normal saline ● regular insulin drip ● monitor potassium closely ● rehydrate gradually and safely
Memory clue
DKA = dry + ketones + acid
Duchenne muscular dystrophy
Your review is correct overall.
Key points
● X-linked recessive ● carried by mother, expressed in sons ● progressive neuromuscular decline ● presents around age 3 ● child starts losing skills ● wheelchair dependence later ● pseudohypertrophy from fat replacement ● supportive care only, no cure
Classic clue
Gower sign
Toddler development
You wrote Erikson correctly.
Toddler stage
Autonomy vs shame and doubt
Nursing/communication trick
Toddlers need controlled choices:
● “red shoes or blue shoes?” ● “medicine in cup or syringe?” ● “sit on mom’s lap or the bed?”
This supports autonomy without giving unsafe control.
Dermatitis / eczema
Your review only lists types, so let me fill it in.
Contact dermatitis
● surgery to remove aganglionic segment ● temporary colostomy may be used, then reconnect later
Memory clue
No ganglion, no go.
Hemophilia A
Your review is right.
What it is
● factor VIII deficiency ● X-linked ● usually seen in boys, mother may be carrier
Major risk
Bleeding into joints:
● knees ● ankles ● elbows ● swelling ● pain ● long-term loss of ROM/function
Treatment
● replace factor VIII ● protect joints ● avoid unnecessary trauma/IM injections when possible
Quick clue
Hemophilia = joint bleeding
Meningitis
Your review is strong.
What it is
Inflammation of meninges from viral or bacterial infection. Treat suspected cases seriously and quickly.
Signs/symptoms
● stiff neck in older child ● photophobia ● fever ● vomiting ● irritability ● seizures may occur ● bulging fontanel/high-pitched cry in younger child
Test
Lumbar puncture is definitive.
Nursing priorities
● assume bacterial until ruled out ● droplet precautions ● do not wait to start broad-spectrum antibiotics ● later narrow therapy when culture results come back
Acute glomerulonephritis
This section needs a correction.
Cause
Often follows beta-hemolytic streptococcal infection and causes immune-complex damage to the glomeruli.
Signs/symptoms
● hypertension ● oliguria ● dark, tea-colored urine
