Children

Question 1

Growth and Development of 12 Month Old

Answer 1

by 12 months,
- communicates 1-2 words
- begins to understand words, requests, phrases, instructions, etc.
- answers simple questions nonverbally
- recognizes familiar objects by name (ball, shoe, cup).

Question 2

Weight by 3 months

Answer 2

175 - 210g per week

Question 3

Weight by 5 months

Answer 3

double the birth weight

Question 4

Weight by 6 months and onward

Answer 4

gains 400g per month

Question 5

weight by 1 year of age

Answer 5

3x birth weight

Question 6

Weight by 2 years of age

Answer 6

4x birth weight

Question 7

weight by 3 years of age

Answer 7

5x birth weight

Question 8

Risk factors for child abuse

Answer 8

Risk factors for child abuse include -
➢ Children younger than four years of age
➢ Children with special needs that may increase caregiver burden (e.g., disabilities, mental health issues, and chronic physical illnesses)
Caregivers who perpetuate abuse have risk factors such as -
➢ Substance use
➢ Caregivers who were abused themselves
➢ High levels of socioeconomic stress
Source: CDC (2022)

Question 9

Impetigo Precautions

Answer 9

Impetigo is a skin condition caused by group A Streptococcus (GAS; Streptococcus pyogenes) or Staphylococcus aureus. The condition is highly contagious and spreads by contact with the vesicles. The vesicles should remain clean and dry, and swimming is prohibited because it allows for further disease transmission. Children can return to school 24 hours after beginning antimicrobial therapy if the affected area remains covered. Draining lesions should be kept covered. Linens are an effective way to transmit the bacteria, and they should not be shared and laundered daily to prevent reinfection.
✓ Impetigo is a contagious skin condition that is caused by Staphylococcus aureus or Streptococcus pyogenes

✓ This condition is commonly found in young children and typically presents around the face, mouth, and then on the hands, neck, and extremities

✓ The lesions have drainage and then begin to crust

✓ Medical treatment is antibacterial ointments that should be applied via a sterile cotton tip applicator

✓ Nursing care focuses on educating the client on hand hygiene, pain control with warm compresses to the affected area, preventing transmission by not sharing linens, etc.

✓ The individual with impetigo should not go into any pools, hot tubs, or saunas to prevent further transmission

✓ The child may return to school if the vesicles are covered and antibiotic treatment has been started for 24 hours

Question 10

Nursing intervention for child with epistaxis

Answer 10

The priority nursing action to take is to keep the child calm and quiet. If the child becomes distressed and is crying, it will exacerbate the bleed. Next, the nurse needs to sit the child up and lean them forward. Many parents think they should pinch the child’s nose and tilt their head backward, but this will not aid in stopping the bleed and can be an aspiration risk. Do not let the parent tilt the child’s head back. Next, begin applying pressure to the nose, and check to see if the bleeding continues after 10 minutes. If the nose is still bleeding, the next action would be to insert absorbent cotton into each nostril. If the nose continues to bleed after that, the following priority action is to apply ice to the bridge of the nose to aid in vasoconstriction thus stopping the bleed.

Question 11

The Denver Developmental Screening Test

Answer 11

The Denver Developmental Screening Test (DDST) was devised to provide a simple screening method for evidence of slow development in infants and preschool children. The test covers four functions: gross motor, fine motor adaptive, language, and personal-social. It has been standardized on 1,036 presumably healthy children (two weeks to six years of age) whose families reflect the occupational and ethnic characteristics of the population of Denver.

Question 12

Which stage of cognitive development does the nurse expect her 6-month-old patient to be in?

Answer 12

The first stage of Piaget’s Stages of Cognitive Development is the sensorimotor stage. This stage occurs between 0 and 2 years old. During this stage, the child learns to coordinate their senses with motor responses. They are curious about the world and use their minds to explore. They start to form language and use it for demands. They also develop object permanence.

Question 13

The preoperational stage

Answer 13

The preoperational stage occurs between 2 and 7 years old. In this stage, the child is a symbolic thinker. They can use language with proper grammar to express their thoughts. Their imagination and intuition are developing rapidly. They are not yet ready to think complex abstract thoughts.

Question 14

The concrete operational stage

Answer 14

The concrete operational stage occurs from 7 to 11 years old. In this stage, concepts are attached to specific situations. The ideas of time, space, and quantity begin to develop.

Question 15

The formal operational stage

Answer 15

The formal operational stage begins at age 11 and continues into adulthood. In this stage, children can use theoretical, hypothetical, and counterfactual thinking. They can reason and use abstract logic. Planning for future events and using strategy becomes possible. They can learn concepts in one area and apply them to another area.

Question 16

Sickle Cell Anemia Genetics Considerations

Answer 16

Sickle cell anemia is an autosomal recessive disease. In the above diagram, the normal gene is represented as S, and the sickle cell gene is expressed as s. Therefore, sickle cell anemia is characterized by ss, Ss as the carrier, and SS as the normal phenotype. The baby has no chance, a 0% chance, of having sickle cell anemia. Instead, the baby will be a carrier. Since the baby’s mother has the disease, she is ss, and because the father has tested that he is not a carrier, nor does he have the disease, he is SS. This means that the only combination possible for the baby is Ss (carrier).

Question 17

The nurse is assessing a child with intussusception. Which findings would be expected?

Answer 17

Red, currant jelly stool is a classic finding of intussusception. When the bowel telescopes into another portion of the intestine, it causes intestinal obstruction and subsequently red, currant jelly stools (Choice A). A palpable, sausage-shaped mass in RLQ is a classic finding of intussusception. This is due to the physical telescoping of the intestine, and the weight can sometimes be felt on palpation
✓ Intussusception is a bowel obstruction commonly occurring between children between 3 and 6 years old

✓ A proximal segment of the bowel telescopes into a more distal segment, pulling the mesentery with it, causing compression

✓ Manifestations of intussusception include abrupt abdomen pain, vomiting, lethargy, the passage of red, currant jelly-like stools (stool mixed with blood and mucus), abdominal distention, and palpable sausage-shaped mass in the upper right quadrant

✓ Passage of a normal brown stool usually indicates that the intussusception has reduced itself

✓ Nursing care includes hydrating the child, administering prescribed antibiotics and pain medications, and potentially preparing the child for surgery

Question 18

Which medication would cause a child to get Reye’s syndrome?

Answer 18

ASA
Reye syndrome (RS) is a disorder characterized by fever, profoundly impaired consciousness, and disordered hepatic function. A liver biopsy is used to confirm the diagnosis of RS and the client may experience dangerously high ammonia levels. By avoiding the child’s exposure to salicylates, the client may avert this syndrome.

Question 19

The nurse is caring for a 4-year-old client in respiratory distress. The nurse knows to assess for which complication that frequently occurs with respiratory distress?

Answer 19

Dehydration is a frequent complication of respiratory distress and the nurse must know to monitor for this. Tachypnea (rapid breathing) is often seen in children with respiratory distress. Additionally, mouth breathing is common in children due to nasal congestion, edema, and inflammation. As these children expire more and more frequently, significant insensible fluid losses occur. Since children with respiratory distress do not take enough fluids by mouth, their intake is rarely enough to keep up with their insensible losses. Therefore, dehydration frequently occurs in a child experiencing respiratory distress. If the child is receiving humidified oxygen, insensible losses from tachypnea are minimal. Otherwise, it’s important that the maintenance fluids include an additional 20-50% to the respiratory replacement in a child with tachypnea.