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ATI > ATI flashcards Children > Flashcards

ATI flashcards Children

1
Q

Recommended immunizations for healthy infants at birth

A

*HepB

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2
Q

Recommended immunizations at 2 mos

A

*Hep B, Rota, DTap, Hib, PCV, IPV

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3
Q

Recommended immunizations at 4 mos

A

*Rota, DTaP, Hib, PCV, IPV

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4
Q

Recommended immunizations at 6 mos

A

*Hep B (6-12 mos), Rota, DTap, PCV, IPV (6-18 mos)

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5
Q

Recommended immunizations 12-15 mos

A

*Hib, PCV, IPV, MMR, Varicella

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6
Q

Recommended immunizations 12-23 mos

A

*Hep A, given at 2 doses at least 6 mos apart

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7
Q

Recommended immunizations 15-18 mos

A

*DTap

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8
Q

Children can receive a yearly TIV beginning at what age?

A

*6 mos

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9
Q

Recommended immunizations at 4-6 yrs

A

*DTap, IPV, MMR, Varicella

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10
Q

Recommended immunizations 11-12 yrs

A

*TDap, MMR, HPV, MCV4

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11
Q

Contraindications to MMR vaccine

A

During pregnancy, and children who are allergic to eggs, gelatin, and neomycin

  • In children who have a history of thrombocytopenia or thrombocytopenic purpura
  • Immunocompromised children
  • Children with advanced HIV
  • Children who recently received blood products or immunoglobulinseggs, gelatin, and neomycin
  • In children who have a history of thrombocytopenia or thrombocytopenic purpura
  • Immunocompromised children
  • children with advanced HIV
  • children who recently received blood products or immunoglobulins
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12
Q

Contraindications to DTap vaccine

A
  • -Severe febrile illness
  • A history of prior anaphylactic reaction to the DTaP vaccination
  • An occurrence of encephalopathy 7 days after the administration of the DTaP immunization
  • An occurrence of seizures within 3 days of the vaccination
  • Uncontrollable crying that cannot be consoled by parents/caregiver; can usually last more than 3 hr and occurs within 48 hr of vaccination
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13
Q

Contraindications to IPV vaccine

A
  • Allergy to neomycin (Mycifradin) and/or streptomycin

- Pregnancy usually a contraindication and must be decided on an individual basis

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14
Q

Contraindications to Hep A vaccine

A
  • -Allergy to aluminum
  • Pregnancy may be a contraindication
  • C14-pregnancy may be a contraindication
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15
Q

Contraindications to Hep B vaccine

A
  • Prior hx of anaphylactic reaction

- Allergy to Baker’s yeast

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16
Q

Contraindications to Varicella Vaccine

A

During pregnancy

  • Children with cancer, such as leukemia or lymphomas
  • Children with a hx of allergy to neomycin and/or gelatin
  • Immunocompromised children, such as with HIV
  • Children with congenital immunodeficiency
  • Children taking immunosuppressive meds
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17
Q

Contraindications to PCV vaccine

A

-Hypersensitivity to diphtheria toxoid

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18
Q

Contraindications to influenza vaccine

A
  • -acute febrile illness- vaccincation is deferred until symptoms resolve
  • Hypersensitivity to eggs
  • Immunocompromised children, such as with HIV
  • Children on antibicrobial therapy
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22
Q

Contraindications to MCV 4 vaccine

A

*Hypersensitivity to components of the vaccine (e.g., diphtheria toxoid, latex); moderate to severe illness

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23
Q

If a vaccine is reconstituted, it should be used within how many minutes?

A

*30

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24
Q

IM vaccines are given to infants and young children in what muscle?

A

*vastus lateralis

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25
Q

IM vaccines are given in which muscle on older children, adolescents, and adults?

A

*deltoid

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26
Q

Interventions that maintain comfort after immunization

A
  • -Use of nonopioid analgesic (acetaminophen or ibuprofen)
  • Cool compress to injection site
  • Gentle movement of involved extremity
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27
Q

There is a small risk of what vaccine virus being transmitted?

A

Varicella

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28
Q

parenting style in which parents try to control their children’s behaviors & attitudes through unquestioned rules & expectations

A

*dictatorial or authoritarian

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29
Q

parenting style in which parents exert little or no control over their children’s behaviors

A

*permissive or laissez-faire

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30
Q

parenting style inwhich parents direct children’s behavior by setting rules and explaining the reason for each rule setting; parents also negatively reinforce deviations from the rules

A

*authoritative or democratic

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31
Q

expected temp of infants

A

*T: 36.5 to 37.5 degrees C (97.7 to 99.5 degrees F)

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32
Q

expected pulse of infants

A

*P: 120-160/min

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33
Q

expected respiratory rate of infants

A

*R: 23-50/min

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34
Q

expected BP of infants

A

*BP: for the 90th percentile taken by oscillometry is 110/71 mm Hg

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35
Q

expected temp of children

A

*T: 36-38 degrees C (96.8 -100.4 degrees F)

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36
Q

expected pulse of children

A

*P: 75-100/min

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37
Q

expected respiratory rate of children

A

*R: 20-30/ min

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38
Q

expected BP of children

A

*BP:for ages 2-5, BP reading for the 90th percentile is 112/66. Normal BP is any reading that is less than the 90th percentile adjusted for ht & wt.

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39
Q

expected VS of adolescents

A

T: 36-38 degrees C (96.8-100.4 degrees F)

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43
Q

reflex in which the infant turns head to side when cheek of mouth is touched

A

*rooting

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44
Q

expected age for rooting reflex

A

*birth to 6 mos

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45
Q

relex in which infant will grasp object when palm is touched

A

*palmar grasp

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46
Q

expected age for palmar grasp reflex

A

*birth to 4 mos

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47
Q

reflex in which toes curl downward when sole of foot is touched

A

*plantar grasp

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48
Q

expected age for plantar grasp

A

*birth to 8 mos

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49
Q

reflex in which the legs flex, arms and hands extend when startled by loud noise

A

*moro

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50
Q

expected age for moro reflex

A

*birth to 6 mos

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51
Q

extension of the arm & leg on the side when the head is turned to that side with flexion of the arm and leg of the opposite side

A

*asymmetric tonic neck reflex (fencer position)

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52
Q

expected age for tonic neck reflex

A

*birth to 3-4 mos

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53
Q

What did Erikson, Freud, and Piaget name the stage of the development for infants?

A

*Erikson: Trust vs. Mistrust
Freud: Oral
Piaget: Sensorimotor

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54
Q

The infant’s posterior fontal closes at what age?

A

2-3 mos

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55
Q

How much wt does an infant gain?

A
  • -0.7 kg (1.5 lbs) per mo the 1st 6 mos

- 0.3 kg (0.75 lbs) per mo the last 6 mos

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56
Q

When does an infant triple his/her birth wt?

A

*end of the 1st yr

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57
Q

How tall does an infant grow?

A
  • 2.5 cm (1 in) per mo the 1st 6 mos

1. 25 cm (0.5 in) per mo the last 6 mos

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58
Q

The circumference of an infant’s head increases by how much during the 1st 6 mos?

A

*.25 cm (0.5 in) per mo

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59
Q

holds head up

A

3 mos)

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60
Q

rolls over

A

5-6 mos)

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61
Q

holds head steady when sitting
transfers object from one hand to the other
rakes finger food with hand

A

6 mos)

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62
Q

gets to sitting position alone & can pull up to standing position
uses thumb and forefinger to grasp item
bangs 2 toys together

A

9 mos)

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63
Q

stands holding on / alone

nests one object into another

A

12 mos)

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64
Q

stands alone

A

12 mos)

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65
Q

When will infants be able to distingush themselves as being separate from parents?

A

*by the end of the 1st year

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66
Q

The infant discovers that what part of his/her body is a pleasure producer?

A

*mouth

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67
Q

Piaget’s sensorimotor period for an infant is characterized by

A

*intial reflexes replaced by voluntary movements that are self-centered on having needs met.

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68
Q

what is object permanence?

A

*when the infant realizes that an obect still exists even when it is no longer in view

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69
Q

When does object permanance occur in an infant?

A

*b/t 6-12 mos

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70
Q

When does separation anxiety develop in an infant?

A

*the latter half of the 1st yr

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71
Q

Infants engage in what kind of play?

A

*solitary

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72
Q

What are appropriate toys for infants?

A
  • -rattles
  • mobiles
  • teething toys
  • nesting toys
  • playing pat-a-cake
  • playing with balls
  • reading books
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73
Q

Crib slats should be no further apart than

A

*6 cm (2.4 in)

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74
Q

Infants should be in rear facing car seats until

A

*they weigh 20 lbs and are 1 yr old

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75
Q

When can solids be introduced to an infant?

A

*when the infant doubles the birth wt (5-6 mos)

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76
Q

commonly caused by immaturity of the liver and is observed as jaundice

A

*hyperbilirubinemia

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77
Q

If left untreated hyperbilirubinemia can cause

A

*brain damage

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78
Q

How many teeth errupt in the infant’s mouth by the end of the 1st yr?

A

6 to 8

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79
Q

What did Erikson, Freud, and Piaget name the stage of the development for toddlers?

A
  • -Erikson: autonomy vs. shame
  • Freud: anal
  • Piaget: sensorimotor transitions to preoperational
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80
Q

The toddler’s anterior fontanel closes by what age?

A

*18 mos

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81
Q

At 30 mos, the toddler should weigh how many times his birth wt?

A

*4

82
Q

The toddler grow by how much per yr?

A

*7.5 cm (3 in)

83
Q

12 mos to 3 yrs

A

*toddler

84
Q

birth to 28 days

A

*neonate

85
Q

1 mo to 1 year

A

*infant

86
Q

3 to 5 yrs

A

*preschooler

87
Q

5 to 12 yrs

A

*Schoolage

88
Q

12 to 20 yrs

A

*adolescent

89
Q
  • development of steady gait
  • clinbing stairs
  • jumping & standing on one foot for short periods
  • stacking blocks in increasingly higher numbers
  • drawing stick figures
  • undressing & feeding self
  • toilet training
A

-development of steady gait

90
Q

Toddlers develop gender identity by what age?

A

*3 yrs

91
Q

Toddlers engage in what kind of play?

A

*parallel

92
Q

The toddler should drink how many glasses of cow’s milk per day?

A

*3 or 4

93
Q

What did Erikson, Freud, and Piaget name the stage of the development for the preschooler?

A
  • -Erikson: Initiative vs. guilt
  • Frued: Phallic
  • Piaget: Preoperational
  • Frued: Phalliciaget: Preoperational
94
Q

The preschoold should gain how much wt per yr?

A

*2.25 kg (5lbs)

95
Q

The preschooler should grow how much per yr?

A

*6.2 to 7.5 cm (2.5-3 in)

96
Q

The greatest fear of a preschooler

A

*bodily harm

97
Q

What two phases of preoperational thinking do preschoolers develop and at what ages?

A
  • preconceptual (2-4 yrs)

- intuitive (4 yrs)

98
Q

When may a child comprehend the days of the week?

A

*by the end of preschool yrs

99
Q

Preschoolers engage in what kind of play?

A

*associative

100
Q

age-appropriate activities for preschoolers

A

playing ball

  • putting puzzles together
  • riding tricycles
  • pretend and dressup activities
  • role play
  • painting
  • sewing cards and beads
  • reading books
101
Q

Laws mays vary from state to state and requirements for a child in a car/booster seat may be up to

A

*80 lbs and a ht of 4 ft 9 in

102
Q

A preschooler consumes ____ the amount of an adult.

A

*half

103
Q

Preschoolers may continue being picky eaters up to what age?

A

*5 yrs

104
Q

The average preschooler needs how many hrs of sleep a day?

A

*12

105
Q

What did Erikson, Freud, and Piaget name the stage of the development for school-age children?

A
  • Erikson: industry vs. inferiority
  • Freud: Latency
  • Piaget: Concrete operations
106
Q

The school-age child will gain how much per year?

A

*2 to 4 kg (4.4 to 8.8 lbs)

107
Q

The school age child will grow by how much per yr?

A

*5 cm (2 in)

108
Q

There is typically a wt gain b/w what ages prior to the changes in ht that come after this age.

A

*10 to 12 yrs

109
Q

School age children may rival which parent?

A

*same sex

110
Q

School age children engage in what kind of play?

A

*competitive and cooperative

111
Q

Children less than what age are safest in the back seat?

A

*13 yrs

112
Q

The child eats an adult poportions of food by the end of

A

*school-age years

113
Q

What did Erikson, Freud, and Piaget name the stage of the development for adolescents?

A
  • -Erikson: identity vs. role confusion
  • Freud: Genital
  • Piaget: Formal operations
114
Q

Females reach 95% of their adult ht by___ while males reach 95% of their adult ht by___.

A

*13 yrs, 15yrs

115
Q

Nutrients that tend to be deficient in adolescents

A

*iron, calcium, vitamin A&C

116
Q

Leading cause of death in adolescents

A

*motor vehicle crashes

117
Q

Homicides are the second leading cause of death among adolescents and most prevalent among male adolescent acquaintances with

A

*a firearm.

118
Q

Suicide is the 3rd leading cause of death among adolescents. Depressed and socially-isolated adolescents may demonstrate changes in behavior which include:

A
  • poor school performance
  • lack of interest
  • tearullness and not interacting with others
  • disturbances in sleep or appetite
  • expression of suicidal thoughts
119
Q

leading contributor to motor vecle fatalities among adolescents

A

substance abuse

120
Q

preterm infants and small for gestational age infants require how many kcal per day?

A
  • 50 to 60 kcal/kg per day (parenteral

- 75 kcal/kg per day orally

121
Q

Nutritional needs of infants -birth to 1 yr

A

breast milk or formula

122
Q

Nutritional needs of infants -4 to 6 mos

A

iron-fortified cereal

123
Q

Nutritional needs of infants -6 to 8 mos

A

yellow veggies, fruits

124
Q

Nutritional needs of infants -8 to 10 mos

A

meats

125
Q

What foods are usually delayed until after an infant is 12 mos?

A
  • whole milk
  • eggs
  • strawberries
  • wheat
  • corn
  • fish
  • nut products
126
Q

Nutritional needs of toddlers

A
  • -finger foods; 3 meals and 2 snacks per day

- limit fruit juice to 4 to 6 oz/ day due to sugar content

127
Q

Nutritional needs of preschoolers

A

-3 meals and 2 to 3 snacks per day from all areas of the food pyramid

128
Q

Nutritional needs of adolescents

A

*2,000 to 3,000 kcal/day

129
Q

Children express what through play?

A

*feelings and fears

130
Q

child observing others

A

*onlooker

131
Q

child playing alone

A

*solitary

132
Q

child playing independently, but among other children (characteristic of a toddler)

A

*parallel

133
Q

children playing together without organization (characterisitic of preschoolers)

A

*associative

134
Q

organized playing in groups (characterisitic of school-age children)

A

*cooperative

135
Q

Pediatric doses are based on what 3 things?

A
  • -body wt
  • BSA
  • maturation of body organs
136
Q

greatest factor that affects medication response in the pediatric ct

A

*organ system immaturity

137
Q

preferred route of med administration for children

A

*oral

138
Q

preferred measurement of meds for children

A

*mL

139
Q

When administering otic meds in children, you should pull the auricle

A

*down and back

140
Q

SQ and IM injections for children require using what size needle/gauge?

A

*3/8 to 5/8-in needle, 26 to 30 gauge

141
Q

up to how much med can be adminitered in a child?

A

*0.5 mL

142
Q

site usually recommended for adminitering IM injections for infants and children less that 2 yrs

A

*vastus lateralus

143
Q

After age 2, what site can be used of IM injections and can accomodate fluid up to 2 mL?

A

*ventrogluteal

144
Q

the deltoid site has a smaller muscle mass and can only accomodate up to how many mL of fluid?

A

*1

145
Q

FLACC (Face, Legs, Activity, Cry, Consolability) pain assessment tool can be used for children of what ages?

A

*2 mos to 7 yrs

146
Q

FACES pain scale can be used during what ages?

A

*3 yrs and older

147
Q

Visual Analog Scale (VAS) can be used for children during what ages?

A

*7 yrs and older

148
Q

The infant experiences stanger anxiety b/w what mos of age?

A

*6 to 18

149
Q

early clinical s/sx of hypoxemia

A
  • tachypnea
  • tachycardia
  • restlessness
  • pallor of the skin and mucous membranes
  • elevated BP
  • sx of respiratory distress
150
Q

late clinical s/sx of hypoxemia

A
  • confusion and stupor
  • cyanosis of skin and mucous membranes
  • bradypnea
  • bradycardia
  • hypotension
  • cardiac dysrhythmias
151
Q

Some illness states may allow for an oxygen saturation of

A

*85 to 89%

152
Q

Acceptable level of SaO2 may range from

A

*91 to 100%

153
Q

SaO2 levels less than ___% require nursing intervention to assist the child to regain normal SaO2 levels.

A

*91

154
Q

SaO2 results less than ___% are considered an emergency.

A

*86

155
Q

Life threatening SaO2 results may start at levelsl less that____%

A

*80

156
Q

Suction catheters should be ____ the size in diameter of a child’s tracheostomy tube.

A

*half

157
Q

When suctioning a child’s tracheostomy tube, how far should you advance the suction cath?

A

*To the end of the tracheostomy tube or no more than 0.5 cm beyond the end

158
Q

suction pressure for infants and children

A

*60 to 100 mm Hg

159
Q

suction pressure for infants who are premature

A

*40 to 60 mm Hg

160
Q

An oxygen hood is a small plastic hood that fits over the infant’s head to deliver oxygen with a flow rate of ____ to prevent carbon dioxide buildup.

A

*4 to 5 L/min

161
Q

An oxygen tent is a large plastic tent that fits over a crib or bed that can provide oxygen and humidity if prescribed and is used on children older than _____ mos.

A

*2 to 3

162
Q

S/Sx of oxygen toxicity

A
  • nonproductive cough
  • substernal pain
  • nasal stuffiness
  • N/V
  • fatigue
  • headache
  • sore throat
  • hypoventilation
163
Q

chronic inflammatory disorder of the airways that involves mast cells, eosinophils & T lymphocytes; intermittent and irreversible airflow obstruction that affects the bronchioles in which the child experiences wheezing, breathlessness, chest tightness, & coughing.

A

Asthma

164
Q

manifestations of asthma

A
  • mucosal edema
  • bronchoconstriction (from bronchospasm)
  • excessive secretion production
165
Q

Most accurate tests for diagnosing asthma and its severity

A

*pulmonary function tests (PFTs)

166
Q

bronchodilators given orally or by inhalation for asthma that may be used for short-term prophylaxis, relief of acute attacks, and long term control; act by selectively activating the beta2 receptors in the bronchial smooth muscle resulting in bronchodilation in which bronchospasm is relieved, histamine release is inhibited, and ciliary motility is increased.

A

*beta 2 adrenergic agonists

167
Q

beta 2 adrenergic agonist that is inhaled, short acting, and has therapeutic uses of:

A

*albuterol (Proventil, Ventolin)

171
Q

beta 2 adrenergic agonist that is inhaled, long acting, and has therapeutic uses of:

A

*salmeterol (Serevent)

175
Q

beta 2 adrenergic agonist that is oral, long-acting and has therapeutic uses of:

A

*terbutaline (Brethine)

178
Q

These meds prevent inflammation, suppress airway mucous production, & promote responsiveness of beta 2 receptors in the bronchial tree; they do not provide immediate effects, but rather promote decreased frequency & severity of exacerbations & acute attacks.

A

*Glucocorticoids

179
Q

Inhaled glucocorticoids for asthma

A
  • beclomethasone diproprionate (QVAR)
  • budesonide (Pulmicort, Turbuhaler)
  • fluticasone propionate (Flovent)
180
Q

SE of inhaled glucocorticoids

A
  • difficulty speaking
  • hoarseness
  • candidiasis
181
Q

Oral glucocorticoid used short-term (3-10 days following acute asthma attack)

A

prednisone (Deltasone)

182
Q

When a child is prescribed an inhaled beta 2 agonist and an inhaled glucocorticoid, the child should inhale the beta 2 agonist before the glucocorticoid because

A

*the betas agonist promotes bronchodilation & enhances absorption of the glucocorticoid

183
Q

When a child is asymptomatic, indicating that asthma is under control with current tx plan, what Percent of Personal Best PEFR and zone is he in?

A

*80 to 100% - green zone

184
Q

What sx and interventions are presented in a child showing 50 to 79 % of personal Best PEFR in the yellow zone?

A
  • aution
  • The child may be experiencing worsening of sx or an acute asthma attack.
  • increased maintanence therapy is needed.
  • carefully monitor the child
  • contact PCP if PEFR does not improve.
185
Q

What sx and interventions are presented in a child showing less than 50% of personal Best PEFR in the red zone?

A
  • Alert
  • Administer a short-acting bronchodilator
  • contact PCP if PEFR does no immediately improve
186
Q

life-threatening episode of airway obstruction that is often unresponsive to common tx

A

*status asthmaticus

187
Q

s/sx of status asthmaticus

A
  • extreme wheezing
  • labored breathing
  • use of accessory muscles
  • distended neck veins
  • risk for cardiac and/or respiratory arrest
188
Q

tonsils removed during a tonsillectomy

A

*palatine tonsils located on both sides of the oropharynx

189
Q

tonsils removed suring an adenoidectomy

A

*pharyngeal tonsils aka adenoids

190
Q

occurs when the tonsils become inflamed and reddened and small patches of yellowish pus may become visible

A

*acute tonsillitis

191
Q

S/Sx of tonsillitis

A
  • hx of otitis media and hearing difficulties
  • reports of sore throat with difficulty swallowing
  • presence of fever
  • tonsil inflammation with redness and edema
  • mouth odor
  • mouth breathing
  • snoring
  • nasal qualities in the voice
192
Q

symptomatic tx for viral tonsillitis

A
  • rest
  • fluids
  • warm salt-water gargles
  • acetaminophen or ibuprofem for pain
193
Q

A child who just had a tonsillectomy can have no swimming for how long?

A

*2 wks.

194
Q

Full recovery after a tonsillectomy usually occurs within how long?

A

*10 days to 2 wks

195
Q

Maternal antibodies offer protection to the infant up to around how many mos?

A

*3

196
Q

Viral infections are common in the _____ and ___, with the incidence of these infections decreasing by age 5.

A

*-toddler, preschooler

197
Q

Children with asthma have a greater incidence of respiratory infections during what type of weather?

A

*cold

198
Q

RSV and other common respiratory infections are more common in what seasons?

A

*winter and spring

199
Q

Infections caused by Mycoplasma pneumoniae are more frequent during what seasons?

A

*autumn and early winter

ATI (3 decks)

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