Exam 1 Review/Main Points

Question 1

AGE OF BINOCULARITY

Answer 1

3-4 months

Question 2

AGE IN AN OTOSCOPE EXAM WHERE PINNA IS PULLED DOWN AND BACK.

Answer 2

WHAT IS 3 AND YOUNGER

Question 3

AGE AT WHICH THE ANTERIOR FONTANEL CLOSES

Answer 3

WHAT IS 12-18 MONTHS?

Question 4

AGE AT WHICH THE POSTERIOR FONTANEL CLOSES

Answer 4

WHAT IS 2-3 MONTHS?

Question 5

ASSESSMENT OF SEXUAL GROWTH

Answer 5

WHAT IS TANNER STAGING?

Question 6

AGE AT WHICH INFANTS WILL BEGIN TO AUTOMATICALLY OPEN THEIR MOUTHS WHEN THEIR NOSE IS OCCLUDED

Answer 6

WHAT IS 6 MONTHS?

Question 7

ACCURATE PULSE ASSESSMENT IN CHILDREN

Answer 7

apical

Question 8

Know the components of Family-Centered care

Answer 8

Know the components of Family-Centered care.–BASED ON THE IDEA THAT FAMILY IS THE CHILD’S PRIMARY SOURCE OF SUPPORT AND STRENGTH-COLLABORATE WITH THE FAMILY, TREAT FAMILIES WITH DIGNITY AND RESPECT, BUILD ON THE FAMILIES STRENGTHS AND HELP THEM MAKE DECISIONS, UNDERSTAND THE FAMILIES CULTURE AND INDIVIDUAL NEEDS, SUPPORT THE CHILD IN LEARNING ABOUT THEIR CARE AND HELPING TO MAKE DECISIONS–THIS WILL LEAD TO IMPROVED CHILD OUTCOMES, INCREASED PT AND FAMILY SATISFACTION, AND REDUCED STRESS AND ANXIETY OF THE CHILD AND THEIR FAMILY MEMBERS.

Question 9

Erikson’s developmental stages: Know what they are and how to apply that knowledge–

Answer 9

TRUST VS MISTRUST(AGES 0-1) TRUST OR MISTRUST THAT BASIC NEEDS SUCH AS NOURISHMENT AND NUTRITION ARE MET–

AUTONOMY VS SHAME/DOUBT (AGES 1-3) DEVELOP A SOURCE OF INDEPENDENCE IN MANY TASKS–
INITIATIVE VS GUILT (AGES 3-6) TAKE INITIATIVE ON SOME ACTIVITIES BUT MAY DEVELOP GUILT IF THEY ARE UNSUCCESSFUL AT COMPLETING THE TASK OR BOUNDARIES ARE OVERSTEPPED–INDUSTRY VS INFERIORITY (AGES 7-11) DEVELOP SELF CONFIDENCE IN ABILITIES WHEN COMPETTENT OR A SENSE OF INFERIORITY IF NOT– IDENTITY VS CONFUSION (AGES 12-18) EXPERIMENT WITH AND DEVELOP IDENTITY AND ROLES– INTIMACY VS ISOLATION (AGES 19-29) ESTABLISH INTIMACY AND RELATIONSHIPS WITH OTHERS– GENERATIVITY VS STAGNATION (AGES 30-64) CONTRIBUTE TO SOCIETY AND BE A PART OF A FAMILY– INTEGRITY VS DESPAIR (AGES 65 AND OLDER) ASSESS AND MAKE SENSE OF LIFE AND MEANING OF CONTRIBUTIONS

Question 10

Developmental milestones: know them

Answer 10

BIRTH TO 1 MONTH= GAINS 5-7 OZ A WEEK, HOLDS HAND IN FIST, ALERTS TO HIGH PITCHED VOICES, COMFORTS WITH TOUCH, FOLLOWS OBJECTS IN LINE OF VISION
2-4 MONTHS= POSTERIOR FONTANELLE CLOSES, HOLDS RATTLE AND OTHER OBJECTS WHEN PLACED IN HAND, BRINGS HANDS TO MIDLINE, CAN TURN FROM SIDE TO BACK AND THEN RETURN, WHEN PRONE, HOLDS HEAD AND SUPPORTS WEIGHT ON FOREARMS
4-6 MONTHS= DOUBLES BIRTH WEIGHT AT 5-6 MONTHS, TEETH MAY BEGIN ERUPTING BY 6 MONTHS, HOLDS BOTTLE, GRASPS WITH WHOLE HAND (PALMAR GRASP), NO HEAD LAG WHEN PULLED TO SITTING, TURNS FROM ABDOMEN TO BACK BY 4 MONTHS AND THEN BACK TO ABDOMEN BY 6 MONTHS, WHEN HELD STANDING SUPPORTS MUCH OF THEIR OWN WEIGHT
6-8 MONTHS= GROWTH RATE SLOWER THAN FIRST 6 MONTHS, BEGINNING PINCER GRASP AT TIMES, INBORN REFLEXES EXTINGUISHED, SITS ALONE STEADILY WITHOUT SUPPORT BY 8 MONTHS, RECOGNIZES OWN NAME AND RESPONDS BY LOOKING AND SMILING
8-10 MONTHS= CRAWLS OR PULLS WHOLE BODY ALONG FLOOR BY ARMS, PULLS SELF TO STANDING AND SITTING BY 10 MONTHS, MAY SAY ONE WORD IN ADDITION TO MAMA AND DADA
10-12 MONTHS= TRIPLES BIRTH WEIGHT BY 1 YEAR, MAY HOLD CRAYON OR PENCIL AND MAKE MARKS ON PAPER, STANDS ALONE
1-2 YEARS= ANTERIOR FONTANELLE CLOSES, BY END OF 2ND YEAR BUILDS A TOWER OF 4 BLOCKS, SHOWS GROWING ABILITY TO WALK AND WALKS WITH EASE
2-3 YEARS= DRAWS A CIRCLE AND OTHER RUDIMENTARY FORMS, LEARNING TO DRESS SELF, JUMPS
1-3 YEARS= FACILITATES IMITATIVE BEHAVIOR BY PLAYING KITCHEN, GROCERY SHOPPING, OR WITH A TOY TELEPHONE, LEARNS GROSS MOTOR ACTIVITIES BY RIDING A BIG WHEEL, PLAYING WITH A SOFTBALL AND BAT, MOLDING WATER AND SAND, TOSSING BALL OR BEAN BAG, ENJOYS TALKING, LIKES CONTACT WITH OTHER CHILDREN
3-6 YEARS= BRUSHES TEETH, USES A SPOON, FORK, AND KNIFE, EATS 3 MEALS WITH SNACKS, RIDES A BICYCLE, ENGAGES IN ASSOCIATIVE PLAY SUCH AS GAMES, PUZZLES, AND NURSERY RHYMES, DRAMATIC PLAY WITH DOLLS AND DOLL CLOTHES, DRESS UP CLOTHES, AND PUPPETS, ENJOY PLAYING WITH OTHER CHILDREN, AND HEALTH CARE PROVIDERS CAN VERBALIZE AND EXPLAIN PROCEDURES, USE STORIES AND DRAWINGS TO EXPLAIN CARE, USE ACCURATE NAMES FOR BODY FUNCTIONS, AND ALLOW THE CHILD TO TALK, ASK QUESTIONS, AND PARTICIPATE IN THEIR CARE.
6-12 YEARS= SENSE OF INDUSTRY IS FOSTERED BY PLAYING A MUSICAL INSTRUMENT, STARTING HOBBIES, AND PLAYING BOARD AND VIDEO GAMES, AND HEALTH PROFESSIONALS CAN ASSESS THE CHILDS KNOWLEDGE BEFORE TEACHING, AND INCLUDE BOTH PARENT AND CHILD IN HEALTHCARE MAKING DECISIONS, AND SOME LACK OF COORDINATION IS COMMON DURING GROWTH SPURT
12-18 YEARS= INCREASING COMMUNICATION AND TIME WITH PEER GROUP WITH THINGS SUCH AS MOVIES, DANCES, DRIVING, EATING OUT, AND ATTENDING SPORTING EVENTS AS WELL AS APPLYING ABSTRACT THOUGHT AND ANALYSIS IN CONVERSATIONS AT HOME AND AT SCHOOL

Question 11

Normal VS for infants through adolescence

Answer 11

NEONATE- HR AWAKE 100-180 HR ASLEEP 80-160 RR 30-60, INFANT- HR AWAKE 100-160, HR ASLEEP 75-160, RR 30-60– TODDLER– HR AWAKE 80-110, HR ASLEEP 60-90, RR 24-40–PRESCHOOL- HR AWAKE 70-110, HR ASLEEP 60-90, RR 22-34– SCHOOL AGE- HR AWAKE 65-110, HR ASLEEP 60-90, RR 18-30– ADOLESCENT- HR AWAKE 60-90, HR ASLEEP 50-90, RR 12-16– NORMAL BP FOR CHILDREN OVER 1 YR= 90MMHG + (2X AGE IN YEARS)

Question 12

Common illnesses of infancy and possible causes–

Answer 12

COMMON COLD, EAR INFECTION, FLU, BRONCHITIS, RSV, HAND FOOT AND MOUTH, CRADLE CAP, DIAPER RASH, STREP THROAT, UTI

Question 13

Different temperaments of children and possible nursing intervention/parental teaching for each type–

Answer 13

THE EASY CHILD= APPROXIMATELY 40% OF CHILDREN…MODERATE IN ACTIVITY, REGULAR SLEEP AND EAT PATTERNS, POSITIVE MOOD, ADAPTS TO NEW SITUATIONS, ACCEPTS RULES, WORKS WELL WITH OTHERS…–
THE DIFFICULT CHILD= APPROXIMATELY 10%…IRREGULAR SCHEDULES FOR EATING AND SLEEPING, ADAPTS SLOWLY TO NEW SITUATIONS, PREDOMINANTLY NEGATIVE MOOD, INTENSE REACTIONS TO THE ENVIRONMENT ARE COMMON…
–THE SLOW TO WARM UP CHILD= APPROXIMATELY 15%…INITIAL WITHDRAWAL FOLLOWED BY GRADUAL, QUIET, SLOW INTERACTION WITH THE ENVIRONMENT…ADAPTS SLOWLY TO NEW SITUATIONS…MILD REACTIONS TO ENVIRONMENT…–
MIXED CHILD= APPROXIMATELY 35%…SOME OF EACH PERSONALITY TYPES SEEN…A LITTLE BIT OF EVERYTHING…
THE GOAL IS TO TRY AND IMPROVE THE GOODNESS OF FIT BETWEEN THE CHILD AND THE PARENT…IF THE CHILD IS EXTREMELY ACTIVE THEN PLAN PERIODS OF ACTIVE PLAY FOLLOWED BY RESTFUL PERIODS BEFORE BEDTIME TO FOSTER SLEEP…IF THE CHILD IS SHY THEN ALLOW TIME TO ADAPT AT THEIR OWN PACE TO NEW PEOPLE AND SITUATIONS…IF THE CHILD IS EASILY STIMULATED THEN HAVE A QUIET ROOM FOR SLEEPING AND HOMEWORK…IF THE CHILD HAS A SHORT ATTENTION SPAN THEN PROVIDE PROJECTS THAT CAN BE COMPLETED IN A SHORT PERIOD OF TIME AND THEN GRADUALLY ENCOURAGE LONGER PERIODS AT ACTIVITIES.

Question 14

How can we assist in making hospitalization less stressful on pediatric patients? Family?

Answer 14

USE DISTRACTION SUCH AS AGE APPROPRIATE ACTIVITIES, RELAXATION TECHNIQUES SUCH AS DIMMING THE LIGHTS AND LISTENING TO CALMING MUSIC, INVOLVING THE CHILD AS MUCH AS POSSIBLE IN DECISION MAKING, ESTABLISH RAPPORT, MAKING A FAMILY CENTERED ENVIRONMENT

Question 15

Appropriate responses of children to procedures and how to manage them.–

Answer 15

Coping mechanisms most often used in preschool aged children…–
REGRESSION= RETURN TO AN EARLIER BEHAVIOR…A CHILD WHO IS TOILET TRAINED MAY PEE THEIR PANTS…–
REPRESSION= INVOLUNTARILY FORGETTING UNCOMFORTABLE SITUATIONS..AN ABUSED CHILD CAN NOT RECALL AN EPISODE OF ABUSE..– RATIONALIZATION= AN ATTEMPT TO MAKE UNACCEPTABLE FEELINGS ACCEPTABLE…CHILD THINKS IT IS OKAY TO HIT ANOTHER CHILD BECAUSE THEY TOOK THEIR TOY…–
FANTASY= CREATION OF THE MIND TO HELP DEAL WITH UNACCEPTABLE FEAR….IMAGINARY FRIENDS OR A SICK CHILD PRETENDING TO BE SUPERMAN

Question 16

Know approximate growth patterns for Infants, Toddlers, preschool, and school age children.

Answer 16

(Example: Infant’s triple birth weight by one year.)
Infant: Triple birth weight by one year and height increases by 1 foot in 1 year.
Toddlers: Weight gain slows to 4 to 6 pounds per year.
Preschool: Weight gain of 3-5 pounds/year.
School Age Children: Fat gives way to muscle, child appears leaner.

Question 17

Assessment skills (tips and tricks) for toddler, preschool, and school age children.–

Answer 17

YOUNG CHILDREN START AND DO A FOOT TO HEAD ASSESSMENT THAT WAY YOU ARE NOT ALL UP IN THEIR FACE SCARING THEM AND OLDER CHILDREN YOU CAN DO A HEAD TO TOE APPROACH–FOR TODDLERS INVOLVE THE PARENTS, GIVE THE TODDLER CHOICES SUCH AS DO YOU WANT ME TO LISTEN TO YOUR HEART OR YOUR LUNGS FIRST?, DEMONSTRATE ON PARENT OR TEDDY BEAR WHAT YOU ARE GOING TO DO FIRST, AND EXAMINE EYES, EARS, AND MOUTH AT THE END OF THE EXAM. –PRESCHOOLERS- CAN DO THE PAPER DOLL TECHNIQUE, USE GAMES TO REDUCE ANXIETY, GIVE THEM POSITIVE FEEDBACK SUCH AS YOU ARE BEING SO BRAVE! AND ALLOW THE CHILD TO PLAY WITH THE EQUIPMENT FIRST SUCH AS THE STETHOSCOPE AND LET THEM LISTEN TO THEIR OWN HEART– SCHOOL AGE- ENSURE MODESTY AND PRIVACY, CONSIDER THE NEED FOR NON PARENT CHAPERONES, CAN DO A HEAD TO TOE EXAM, LOTS OF EDUCATION ESPECIALLY ON MVA’S, SAFE SEX,AND SUICIDE PREVENTION

Question 18

Piaget’s theory of cognitive development–

Answer 18

SENSORIMOTOR STAGE AGES 0-2 YEARS…INFANT HAS BASIC REFLEXES AND STARTS TO GAIN AN UNDERSTANDING OF THE WORLD BY COORDINATING SENSORY EXPERIENCES WITH PHYSICAL ACTIONS– PREOPERATIONAL STAGE AGES 2-7 YEARS…CHILD BEGINS TO REPRESENT THE WORLD WITH WORDS AND IMAGES AND HAS AN INCREASE IN SYMBOLIC THINKING– CONCRETE OPERATIONAL AGES 7-11 YEARS..CHILD CAN NOW REASON LOGICALLY ABOUT CONCRETE EVENTS- FORMAL OPERATIONAL STAGE AGES 11-15 YEARS…CAN REASON MORE WITH LOGICAL AND ABSTRACT THOUGHT

Question 19

Types of Play and examples of play ..-

Answer 19

SOLITARY PLAY= INDEPENDENT PLAY..BEGINS IN INFANCY AND IS COMMON IN TODDLERS..THEY PLAY ALONE EVEN THOUGH OTHER CHILDREN MAY BE AROUND…–PARALLEL PLAY= CHILDREN PLAY THE SAME THING SIDE BY SIDE BUT THERE IS NO INTERACTION BETWEEN THE TWO CHILDREN…BOTH BUILDING WITH BLOCKS BUT NOT INTERACTING WITH ONE ANOTHER…–ASSOCIATIVE PLAY= LEARNING THE RULES BUT STILL NOT PLAYING TOGETHER..BEGIN IN TODDLERHOOD AND CONTINUE THROUGH PRESCHOOL…BOTH SPLASHING IN A BUCKET OF WATER BUT NOT PLAYING TOGETHER…–COOPERATIVE PLAY= PLAY TOGETHER AND AS A TEAM…BEGINS IN LATE PRESCHOOL YEARS…TUG OF WAR, SOCCER, BASKETBALL ETC…–ONLOOKER PLAY= CHILD OBSERVES OTHER CHILDREN PLAYING THEN ASKS A LOT OF QUESTIONS ABOUT WHAT THE CHILD IS DOING…USUALLY STARTS IN THE TODDLER YEARS BUT CAN BE SEEN IN ANY AGE..

Tanner stages in both males and females- STAGE 1- HORMONES ARE ACTIVE BUT THERE ARE NO PHYSICAL SIGNS OF PUBERTY YET- STAGE 2- THE FIRST PHYSICAL SIGNS OF PUBERTY APPEAR SUCH AS BREAST BUDS FORMING AND THE AREOLA WIDENING- STAGE 3- THE GROWTH SPURT STAGE- STAGE 4- DEVELOPMENT CONTINUES- STAGE 5- THE FINAL STAGE WHERE CHANGES ARE USUALLY SLOW AND INCONSPICUOUS- BREAST DEVELOPMENT IN GIRLS ARE B1-B5…GENITAL DEVELOPMENT IN BOYS ARE G1-G5..AND PUBIC HAIR DEVELOPMENT FOR BOTH IS PH1-PH5 AND AXILLARY HAIR DEVELOPMENT FOR BOTH IS A1-A3.

Question 20

Styles of parenting

Answer 20

AUTHORITARIAN= HIGH CONTROL AND LOW WARMTH..CHILD MAY BECOME FEARFUL OR WITHDRAWN..GIRLS ARE OFTEN PASSIVE AND DEPENDENT AND BOYS ARE REBELLIOUS AND AGGRESSIVE…MY WAY OR THE HIGHWAY..DOESN’T PRAISE GOOD BEHAVIOR “CHILDREN TO BE SEEN AND NOT HEARD”…–AUTHORITATIVE= MODERATELY HIGH CONTROL AND HIGH WARMTH…CHILD TENDS TO BE WELL ADJUSTED, SELF CONTROLLED, AND SOCIALLY COMPETENT..CHILD’S SELF ESTEEM AND SCHOOL PERFORMANCE ARE GENERALLY GOOD–PERMISSIVE= LOW CONTROL AND HIGH WARMTH…CHILD MAY BECOME REBELLIOUS, AGGRESSIVE, SOCIALLY INEPT, IMPULSIVE OR CHILD MAY BE CREATIVE, ACTIVE, AND OUTGOING….LETS KIDS RUN ALL OVER AND DO WHAT THEY WANT…–INDIFFERENT= LOW CONTROL AND LOW WARMTH..CHILD MAY SHOW HIGH DEGREE OF SELF DESTRUCTIVE IMPULSES AND DELINQUENT BEHAVIOR..AKA A SOCIOPATH

Question 21

Pediatric stages of life

Answer 21

NEONATES= UP TO 28 DAYS…–INFANT= BIRTH TO 1 YEAR…–TODDLER= 1-3 YEARS…– PRESCHOOL= 3-6 YEARS…–SCHOOL AGE= 6-12 YEARS…–ADOLESCENT= 12-18 YEARS

Question 22

Growth and development principles:

Answer 22

Proximodistal= CENTER TO DISTANT PARTS..BABY WILL GAIN CONTROL OF THEIR ARMS FIRST AND THEN THEIR HANDS AND FINGERS
Cephalocaudal= HEAD TO TOE…CHILD WILL GAIN CONTROL OF HIS HEAD AND NECK BEFORE THE TRUNK AND LIMBS
Maturation= FINAL STAGE OF DIFFERENTIATION..QUANTITATIVE AND QUALITATIVE
Growth is quantitative (ht, wt, # of words)
Development is Qualitative: increase in developmental skills, increase in capacity