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NUR 514: Pediatrics > Exam 1 test review (02/04) > Flashcards

Exam 1 test review (02/04) Flashcards

1
Q

What is the normal heart rate range for infants (0-12 months)?

A

120-160 beats per minute

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2
Q

True or False: The normal respiratory rate for toddlers (1-3 years) is 20-30 breaths per minute.

A

False. Its 24-30

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3
Q

Fill in the blank: The normal systolic blood pressure for a 5-year-old child is approximately _____ mmHg.

A

100-110

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4
Q

What is the typical temperature range for children?

A

97°F to 100.4°F (36.1°C to 38°C)

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5
Q

What is the normal respiratory rate for adolescents (13-18 years)?

A

12-20 breaths per minute

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6
Q

Multiple choice: Which of the following is the normal heart rate for a toddler?

A

90-150

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7
Q

What is the normal heart rate range for infant

A

100-160

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8
Q

True or False: The normal blood pressure for infants is higher than that for adolescents.

A

False

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9
Q

Fill in the blank: The normal resp rate for a newborn is typically _____

A

30-60

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10
Q

What is the normal temperature range for infants?

A

97°F to 100.4°F (36.1°C to 38°C)

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11
Q

Multiple choice: What is the normal systolic blood pressure for adolescents? A) 90-110 B) 110-130 C) 120-140

A

B) 110-130

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12
Q

What is the normal respiratory rate for school age

A

18-30

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13
Q

True or False: A toddler’s normal heart rate can exceed 140 beats per minute.

A

True

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14
Q

What is the normal heart rate for a school-aged child (6-12 years)?

A

70-120 beats per minute

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15
Q

True or False: The normal heart rate for adolescents is lower than that for infants.

A

True

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16
Q

Fill in the blank: The normal respiratory rate for children aged 4-5 years is _____ breaths per minute.

A

22-34

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17
Q

Multiple choice: Which age group typically has a respiratory rate of 30-60 breaths per minute? A) Infants B) Toddlers C) Adolescents

A

A) Infants

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18
Q

What is the normal temperature for adolescents?

A

97°F to 100.4°F (36.1°C to 38°C)

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19
Q

Fill in the blank: The normal systolic blood pressure for toddlers is approximately _____ mmHg.

A

95-105

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20
Q

What is the first stage of Erik Erikson’s psychosocial development?

A

Trust vs Mistrust

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21
Q

During which age range does the Trust vs Mistrust stage occur?

A

Infancy, approximately 0-1 year

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22
Q

True or False: Successful resolution of the Trust vs Mistrust stage leads to a sense of security.

A

True

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23
Q

What is the second stage of Erik Erikson’s psychosocial development?

A

Autonomy vs Shame and Doubt

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24
Q

At what age does the Autonomy vs Shame and Doubt stage typically occur?

A

Early childhood, approximately 1-3 years

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25
Q

Fill in the blank: Successful resolution of the Autonomy vs Shame and Doubt stage results in a sense of _______.

A

independence

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26
Q

What is the third stage of Erik Erikson’s psychosocial development?

A

Initiative vs Guilt

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27
Q

During which age range does the Initiative vs Guilt stage take place?

A

Preschool age, approximately 3-6 years

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28
Q

True or False: Initiative vs Guilt involves children asserting control and power over their environment.

A

True

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29
Q

What can happen if a child does not successfully navigate the Initiative vs Guilt stage?

A

They may develop feelings of guilt or inhibition.

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30
Q

Which psychosocial crisis is associated with the Autonomy vs Shame and Doubt stage?

A

The crisis of self-control

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31
Q

Fill in the blank: The outcome of the Initiative vs Guilt stage can lead to a sense of _______.

A

purpose

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32
Q

What is a potential negative outcome of unresolved issues during the Trust vs Mistrust stage?

A

Fear and suspicion towards the world

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33
Q

How does successful resolution of the Initiative vs Guilt stage impact future development?

A

It fosters a willingness to take initiative and engage in activities.

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34
Q

What is the primary psychosocial conflict during the stage of industry vs. inferiority?

A

The primary conflict is between developing a sense of competence and feeling inferior.

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35
Q

True or False: The stage of identity vs. confusion occurs during adolescence.

A

True

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36
Q

Fill in the blank: In the industry vs. inferiority stage, children learn to work with others and develop skills in __________.

A

various tasks and activities

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37
Q

What are the two outcomes of the identity vs. confusion stage?

A

The outcomes are a strong sense of identity or role confusion.

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38
Q

Multiple Choice: At what age range does the industry vs. inferiority stage typically occur? A) 0-2 years B) 3-5 years C) 6-12 years D) 13-18 years

A

C) 6-12 years

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39
Q

What is a key factor that influences the development of identity during the identity vs. confusion stage?

A

Exploration of different roles and experiences.

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40
Q

True or False: Success in the industry vs. inferiority stage leads to feelings of self-worth.

A

True

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41
Q

What is the main challenge adolescents face during the identity vs. confusion stage?

A

Finding a personal identity and sense of self.

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42
Q

Fill in the blank: Failure to develop a sense of competence in the industry vs. inferiority stage can lead to feelings of __________.

A

inferiority

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43
Q

How do stages of development affect how we help patients with procedures?
-Toddler

A

Have child sit on their parents laps.
Allow them a little contol like keeping their shoes on.

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44
Q

How do stages of development affect how we help patients with procedures?
-Preschooler

A

Fear of pain “No needles”
Fear of mutilation
They love bandaids
avoid asking them to make a choice

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45
Q

How do stages of development affect how we help patients with procedures?
-School age

A

Fear of death
Fear of pain
Secondary gains
-involve them in their care
show necessary equipment

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46
Q

How do stages of development affect how we help patients with procedures?
-Teenager

A

worried about scars or visible signs they have to explain to peers.
Body image important
Loss of control and independence

Listen, be honest and open

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47
Q

Stages of development (9 months)

A
  • Physical Growth: Weight and length, gaining at a slower pace and growing slow and steady

*Fine Motor: Bangs objects together, crude pincer (3 fingers), waved ‘bye-bye’; holds an object in each hand; claps hands

*Gross Motor: Crawls, abdomen off of the floor, sits up unassisted, may
start to pull self up and may start walking.

*Cognitive Ability/Language: ‘Ma-ma’, ‘Da-da’, combines consonants and
vowels, object permanence, separation anxiety

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48
Q

Stages of development (6 months)

A
  • Birth weight is doubles
    Fine Motor: Releases objects I hand to take another

*Gross Motor: Sits in Tripod Position; Rolling over in both directions
- begins to sit unsupported

*Cognitive Ability/Language: Babbling, imitating sounds, belly laugh/giggle
-Examines objects, play mobiles, their toes
-Starts to respond to their name

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49
Q

Stages of development (10 months)

A

uses pincher grasp

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50
Q

What stage could ritualistic behaviors when a hospitalization difficult?

A
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51
Q

What toys would be appropriate for an infant? Which toys would be inappropriate?

up to 4 months

A

playmat with toys overhead, mobile, mirror, soft rattle, teething toy would not be appropriate until at least 4 months

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52
Q

What toys would be appropriate/inappropriate for a toddler? 30-36months

A

push and pull toys, bigger puzzles, books, toys that are musical, nesting toys, bright building blocks

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53
Q

What toys would be appropriate/inappropriate for preschool aged children?

A

coloring/arts and crafts, start of imaginative play – dress up, play kitchen, tricycle, scooter

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54
Q

What toys would be appropriate/inappropriate for school aged children?

A

– sports equipment, science kits, arts and crafts, bicycles, scooter, skate board, books, or board games

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55
Q

Piaget’s Pre-Operational Stage

A

Piaget’s pre-operational stage is a phase of cognitive development that occurs roughly between the ages of 2 and 7 years.
- During this stage, children acquire symbolic thinking and language skills but still lack the ability to perform operations:
– which are reversible mental actions (meaning that they can occur in more than one way, or direction.
– Adding (3 + 3 = 6) and subtracting (6 − 3 = 3) are examples of reversible actions, frozen ice cubes can return to thawed state and still be same volume)

Pre-operational is also when a child will draw stick figures

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56
Q

What stage of Piaget’s growth and development will children draw stick figures?

A

Preoperational stage

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57
Q

Piagets Formal operational stage

A

Piaget’s formal operational stage is the fourth and final stage
- which typically begins around adolescence (around 11 years old) and continues into adulthood.

During this stage, individuals develop the ability to think abstractly, engage in hypothetical reasoning, and use logical thinking to solve problems.

58
Q

Think through different types of emergencies: Prevent bodily harm

A

Use age-appropriate car seats and seat belts
Supervise children during playtime
Keep sharp objects and tools out of reach
Teach children to use playground equipment safely

59
Q

How will risk associated to various age groups impact nursing teaching?
Prevent infants for falling from high surfaces

A

Supervise children during playtime and while using stairs
Use safety gates at the top and bottom of stairs
Keep furniture away from windows
Use window guards on upper floors

60
Q

How will risk associated to various age groups impact nursing teaching?

SIDS risk factors and Prevention –Back to sleep

A
  • ensure the crib is properly assembled
  • always place baby on their back to sleep
  • keep a smoke-free zone around baby
  • remove everything other than the mattress and sheet from crib when baby is sleeping
  • use a blanket sleep; never loose blankets
  • once breastfeeding established, pacifier after
  • keep baby in mom’s room, but in a separate sleeping area
  • use a firm mattress with no more than two fingers width between crib and mattress
  • do not over-clothe baby while sleeping; baby should not be hot to the touch
  • there should not be more than a soda can width between bars
61
Q

How will risk associated to various age groups impact nursing teaching?

Prevention of toddler poisoning
Where/how should families store cleaning products or medications?
Discard empty containers?
Have poison control number posted?
What is a poison?
What are acceptable levels and when is care escalated

A

Keep medicines, cleaning products, and chemicals out of reach
Store toxic substances in locked cabinets
Use child-resistant packaging
Teach children not to eat or drink anything unless given by a trusted adult
- poison can be anything

62
Q

How will risk associated to various age groups impact nursing teaching?
-Prevent drowning

A

Never leave children unattended near water
Teach children to swim at an early age
Use appropriate safety equipment such as life jackets
Install fences around pools and secure pool covers

63
Q

How will risk associated to various age groups impact nursing teaching?
-Preventing Burns

A

set home’s water heater at a maximum of 120 F
- fill tub prior to child getting in and test temperature (never more than 104F)
- never let child touch the faucet
- turn the hot water on LAST and off FIRST
- faucet covers for safety
- stove covers
*Keep hot liquids and foods out of reach
Use stove guards and oven locks
Check water temperature before placing child in bath
Install smoke alarms and carbon monoxide detectors

64
Q

How will risk associated to various age groups impact nursing teaching?
-Assess teenage risk behavior

A

MVAs

65
Q

Postictal State of Tonic-Clonic Seizures

A

lasts about 30 minutes
- remains semiconscious but arouses with difficulty
- impairment of fine motor movements
- possible headache, vomiting, visual or speech difficulties
- confused for several hours
- lack of coordination
- sleeps for several hours, feels tired, may complain of sore muscles
- no recollection of the seizure

66
Q

What are the key differences between infantile spasms and other seizures?

A

Infantile spasms (West Syndrome)
- peak: 3-7 months
- sudden, brief, symmetric muscle contractions
- flexed head, extended arms drawn up
- possible nystagmus or eye deviation
- possible LOC
- treatment: adrenocorticotropic hormone (ACTH)

exam:
- chaotic brain activity on EEG
- poor development
- not meeting milestones

67
Q

What are the most important actions for the nurse or parent during a seizure?

A

Nurse:
- protect from injury
- position: maintain airway
- watch the clock
- note onset, time, and characteristics of seizure
- side-lying to prevent aspiration
- do not restrain child
- loosen restrictive clothing
- do not attempt to put anything in the child’s mouth
- prepare for oxygenation
- remove glasses
- remain calm and stay with the child

68
Q

Key features of tonic-clonic seizure

A

Is a generalized motor seizure
previously called grand-mal
most prevalent
​
consists of sudden stiffness (tonic) and repetitive jerking (clonic)
- muscle stiffness: rhythmic pattern of contraction and relaxation of muscles
Onset: without warning
​
- Tonic (10-20 seconds)
– Loss of consciousness
– Eyes roll upward
– tonic contraction of the entire body with arms flexed, legs and head extended
– possible piercing cry
– thoracic and abdominal muscles contract
– mouth snaps shut and tongue can be bitten
– flushing
– loss of swallowing reflux
– increased salivation
– apnea leading to cyanosis
- Clonic (30-50 seconds)
– violent jerky movements of the body
– can have foaming in the mouth
– trunk and extremities experience rhythmic contraction and relaxation
– can be incontinent of urine or feces
– gradual slowing of the movements until cessation

69
Q

Key features of absence seizure

A

Onset: 4-12 and ceases by teenage years

  • day dream appearance
  • staring off
70
Q

What are key nursing interventions for a child with a concussion?

A

ABCs
may have brief LOC, tonic posturing with clonic movements
immediate treatment:
– cervical spine stabilization until neuro-assessment of all 4 limbs and no reported neck pain or cervical tenderness
symptoms may not appear until several hours after concussive episode
athletes may not report symptoms for fear of losing playing time
monitor ICP, GCS
oxygen as prescribed
assess for CSF leakage
monitor for fluid overload

71
Q

What is nuchal rigidity and relation to meningitis?

A

Online response: Nuchal rigidity refers to a stiff neck, where the neck muscles resist bending forward, and is considered a key clinical sign that can indicate the presence of meningitis, a serious infection of the membranes surrounding the brain and spinal cord; essentially, when someone has meningitis, their neck muscles become tight and painful, preventing them from fully flexing their neck forward due to inflammation of the meninges.

72
Q

What are physical exam signs of meningitis?

A

nuchal rigidity
kernig sign
brudzinski sign

73
Q

What are the symptoms of meningitis in infants vs other age groups

(break into different flashcards)

A

Newborn:
- no illness at birth
- vague and difficult to diagnose
- poor muscle tone
- weak cry
- poor suck
- refuses feeding
- vomiting, diarrhea
- possible fever or hypothermia
- no nuchal rigidity
- late sign: bulging fontanel

3 months - 2 years
- bulging fontanels
- seizures
- high pitched cry
- purpuric/petechial rash
- fever
- irritability
- poor feeding/vomiting
- possible nuchal rigidity

2 years - adolescence:
- initial finding: nuchal rigidity
- fever/chills
- severe headache
- vomiting
- positive Kernig’s sign
- positive Brudzinski’s sign
- petechial/purpuric rash
- photophobia and irritability
- progresses to drowsiness, delirium, coma
- involvement of the joints (meningococcal and Hib)
- chronic draining ear (pneumococcal)

74
Q

Key features of febrile seizure

A
  • associated with a sudden spike in temperature: 38.9-40 (102-104)
  • 15-20 seconds

Treatment:
- acetaminophen or ibuprofen
- dress in light clothing
- administer tepid sponge baths

75
Q

What is second impact syndrome? How to prevent?

A

second hit before first concussion has resolved
more long term deficits

76
Q

What is Reye Syndrome?

A
  • life-threatening disorder
  • primarily affects the liver and brain
    – liver dysfunction
    – cerebral edema
  • peak incidence occurs when influenza is common
  • prognosis is best with early recognition and treatment
77
Q

What are key lab results indicative of Reye Syndrome?

A

elevated liver enzymes (ALT, AST, bilirubin)
- elevated blood ammonia level
- blood electrolytes
- extended coagulation times

78
Q

What is the reason for administering mannitol in certain conditions? in Reye syndrome?

A

osmotic diuretic; decrease intracranial pressure
reduce cerebral edema in Reye Syndrome
helps prevent seizures

79
Q

What are preventative strategies for Sudden Infant Death Syndrome (SIDS)?

A
  • ensure the crib is properly assembled
  • always place baby on their back to sleep
  • keep a smoke-free zone around baby
  • remove everything other than the mattress and sheet from crib when baby is sleeping
  • use a blanket sleep; never loose blankets
  • once breastfeeding established, pacifier after
  • keep baby in mom’s room, but in a separate sleeping area
  • use a firm mattress with no more than two fingers width between crib and mattress
  • do not over-clothe baby while sleeping; baby should not be hot to the touch
  • there should not be more than a soda can width between bars
80
Q

What are key nursing care interventions following a tonsillectomy?

A

Post-Op Care:
- assessment for excessive bleeding
– vital signs:
— tachycardia
— increased or decreased BP
— increased RR
- assess pallor
- frequent clearing of the throat or swallowing
- watch vomiting bright red blood
- restlessness
- blood on inspection of the throat

81
Q

What is the Brudzinski sign?

A

child laying flat and pull head up, their knees will come up too

82
Q

What is the Kernig sign?

A

when bending knee, head will pull up

83
Q

At what age do most girls begin to experience puberty?

A

Most girls begin to experience puberty between ages 8 and 13.

84
Q

True or False: Puberty starts earlier in boys than in girls.

A

False

85
Q

Fill in the blank: The average age for boys to start puberty is around ____ years old.

A

9 to 14

86
Q

What are the primary physical changes that occur during puberty?

A

Growth spurts, development of secondary sexual characteristics, and changes in body composition.

87
Q

Multiple Choice: Which of the following is a common sign of puberty in girls? A) Voice deepening B) Menstruation C) Facial hair growth

A

B) Menstruation

88
Q

What is the primary method for assessing pain in infants?

A

The primary method for assessing pain in infants is through behavioral observations, such as facial expressions, crying, and body movements.
FLACC

89
Q

Fill in the blank: The ______ scale is commonly used for assessing pain in children aged 3 to 7 years.

A

Wong-Baker FACES Pain Rating Scale

90
Q

What method do we use to measure pain in 3-12 year olds

look up

A

OUCHER

I believe the difference here from the FACES scale is that this uses real faces versus cartoon faces

91
Q

At what age do children typically begin to understand the concept of pain and can use a numeric scale to rate it?

A

Children typically begin to understand the concept of pain and can use a numeric scale to rate it around 8 years of age.

92
Q

Communicating with a hospitalized child
INFANT

A

crying
Be soft, cuddle, rock, eye contact
Safety

93
Q

Communicating with a hospitalized child
TODDLER

A

“control” - imitates parents
Short clear instructions
Give choices
Approach positively-praise after activity
Explain all procedures, objects, equipment
Comfort-cuddle, rock, drink
Uses expressive jargons-pointing

94
Q

Communicating with a hospitalized child
PRESCHOOLER

A

Literal meanings
Utilize concrete visual aids
Handle equipment
Teach in several short sessions
Strong imagination

95
Q

Communicating with a hospitalized child
SCHOOL AGE

A

Increased vocabulary
Respects authority-learns rules
Privacy
Hospitalization used for secondary gains

96
Q

Communicating with a hospitalized chil
-Adolescents

A

Slang is common

Acting out

Privacy

Sexuality information
Injury prevention

Body image control

Seeks independence

Peer Influenced

97
Q

What are the ages that have the highest hospitalization with RSV?

A

children under 1

98
Q

What are the risk factors for RSV?

A
  • male gender
  • birth within 6 months of RSV season
  • multiple birth (often are premature if multiples)
  • young mothers
  • young mothers who smoke during pregnancy or after
  • non-breast fed babies
  • low socioeconomic status and education
  • living in crowded conditions
  • older family can transmit infection, even if they have a cold
  • preterm birth
  • chronic lung disease
  • congenital heart disease
  • immunodeficiency
  • neuromuscular disease
99
Q

How is RSV transmitted?

A

Direct/indirect contact
Need frequent handwashing

highly contagious; transmitted from direct respiratory secretions
- can live on objects for hours
- can live on skin for 30 minutes

100
Q

Home care vs hospital care with RSV (I feel like this needs to be more specific)

A

apnea, hypoxia, dehydration

101
Q

What assessment do you never complete on a child with possible epiglottitis?

A

do not do a throat exam

102
Q

What are signs and symptoms of epiglottitis?

A

difficulty swallowing, drooling, high fever, stridor, tripod position, looking sick

ppt:
- appears sicker than clinical findings
- drooling
- tripod position
- fever
- irritable, anxious, restless
- retractions
- thickened or muffled voice
- throat is red and inflamed (don’t do throat inspection)

103
Q

Does epiglottitis have a rapid or slow onset?

A

onset is abrupt
- rapid
- usually goes to bed asymptomatic and awakens with sore throat and painful swallowing
is a medical emergency - can rapidly progress to severe respiratory distress

usually 2-6 y/o
high fever
severe dysphagia

104
Q

Signs and symptoms of pneumonia

A

Tachypnea with retractions

Bacterial:
- fever
- difficulty breathing
- chest pain
- tachypnea

Viral:
- seen more in children with viral URIs

105
Q

Treatment for pneumonia

A

Bacterial: antipyretics, IVF, antibiotics

Viral: treatment is symptomatic
- keep nose clear
- humidifiers
- nasal saline
- reduce fever
- hydration
- rest

106
Q

Home care vs hospital care of pneumonia

A

Home care:
- supportive
– rest, hydration, humidifier, keeping nose clear, administering medications - antipyretics

Hospital:
- IVF
- antibiotics

107
Q

What are signs and symptoms of croup?

A

barky cough, inspiratory stridor

  • varying degrees of inspiratory stridor
  • varying degrees of respiratory distress
    – resulting from obstruction in the larynx
    – resulting from swelling
  • may affect the trachea, larynx, bronchi
    laryngeal involvement often dominates the clinical picture
  • worse at night and with crying

usually 6 months - 3 years
gradual onset
low-grade fever

108
Q

Treatment for croup

A

Hospital:
- PO or IV fluids
- high humidity with cool mist (mist tent)
- nebulized treatments (racemic epinephrine)
- corticosteroids (dexamethasone)

Home:
- humidification (cool mist; outdoors, freezer)
- warm mist from hot running water in a closed bathroom

109
Q

What is the first intervention done with croup

A

cold air for 15 minutes

110
Q

Home care for croup

A
  • warm mist from hot running water in a closed bathroom
  • humidification: cool mist
    – outdoors
  • open freezer door
    10-15 minutes, stridor can resolve
111
Q

What is posturing with head injuries?

A

Flexion:
- severe dysfunction of the cerebral cortex
- demonstrates the arms, wrists, elbows, and fingers flexed and bent inward onto the chest
- legs extended and rotated internally

Extension (more severe):
- severe dysfunction at the level of the midbrain
- demonstrated a backward arching of the legs and arms, flexed wrists and fingers, extended neck, clenched jaw, possibly arched back

(pretty sure this is just decorticate vs decerebrate – flexion = decorticate; extension = decerebrate)

112
Q

What is the Glasgow Coma Scale - head injuries?

A

need to monitor this along with VS, LOC, neuro, ICP

The Glasgow Coma Scale (GCS) is a scoring system that measures a person’s level of consciousness. It’s used to assess the severity of brain injuries.
- lowest is 3
- highest is 15

113
Q

Complications of a tonsillectomy

A

Complications:
- hemorrhage
- dehydration
- chronic infection

114
Q

Bacterial vs viral meningitis

A

Viral: aseptic
- supportive care
- causative agents: viral illness
– CMV, HSV, enterovirus, HIV, abrovirus
- most common
- acute headache, fever, stiffness, N/V
- usually self-limiting with good prognosis

Bacterial: septic
- contagious
- prognosis depends on how quickly care is initiated; is serious
- causative agents: bacterial
– neisseria meningitidis, Hib, e. coli
– injuries –> CSF

115
Q

Treatment for meningitis: bacterial vs viral

A

Antibiotics: broad spectrum (bacterial)
Corticosteroids: can control cerebral swelling (bacterial)
- not indicated for viral
Analgesics:
- acetaminophen
- acetaminophen with codeine

116
Q

Meningitis: Nursing intervention - how do you help your patient with a headache?

A
  • dim lights
  • decrease environmental stimuli
  • provide comfort measures
  • analgesics
117
Q

What is the most important responsibility of a nurse with seizures?

A

Time!!!!
Record what you see

118
Q

When should a parent seek emergency help during a seizure?

A
  • when lasting longer than 5 minutes
  • after administering rectal diastat the family should call 911
119
Q

Seizures: Complex partial - features and characteristics

A
  • unaware
  • repetitive motor movements such as lip smacking
  • partial so focal
120
Q

What is gynecomastia? Is it normal?

A

yes; it is normal in early puberty development in boys
- short period: have an imbalance of estrogen and testosterone

early-mid puberty: can have more estrogen, leading to breast development
- seen more frequently in boys that are overweight
- are genetic disorders and medications
- alcohol and marijuana can cause breast development

about 50% of boys will have breast development during ages of 11-14 y/o
- will take 6 months to 2 years but will resolve

121
Q

What are key s/s of pneumonia?

A
122
Q

How do stages of development affect assessment: infant?

A

place on exam table and have the parent visible to the infant

123
Q

How do stages of development affect assessment: toddler?

A

have child sit on parent’s lap

124
Q

How do stages of development affect assessment: preschooler?

A

allow them a little control, like keeping their shoes on

125
Q

How do stages of development affect assessment: adolescent?

A

ask if they want their parent present

126
Q

Why do toddlers resist directions from others?

A

Because they are in the autonomy vs shame/doubt stage - they are trying to set their own autonomy

127
Q

When should an infant weight double their birth weight?

A

at 6 months

(length is rapid)

128
Q

When should an infant weigh triple their birth weight?

A

at 12 months

(length has increased by 50%)

129
Q

When should the posterior fontanel close by?

A

6 weeks (2 months)

130
Q

When should the anterior fontanel close by?

A

18 months (2 years)

131
Q

When should an infant be able to roll over by?

A

6 months

132
Q

Hospital care for croup

A
  • PO or IV fluids
  • high humidity with cool mist
    – mist tents
  • nebulized treatments
    – racemic epinephrine
  • corticosteroids
    – dexamethasone
133
Q

Treatment for RSV

A
  • mostly supportive care
  • pharmacological treatment
    – ribavirin (anti-viral)
    – synagis (monoclonal antibody used for prevention)
134
Q

Expected findings of meningitis

A
  • photophobia
  • irritability
  • vomiting
  • headache
135
Q

Meningitis physical assessment findings: newborns

A

Newborn:
- no illness at birth
- vague and difficult to diagnose
- poor muscle tone
- weak cry
- poor suck
- refuses feeding
- vomiting, diarrhea
- possible fever or hypothermia
- no nuchal rigidity
- late sign: bulging fontanel

136
Q

Meningitis physical assessment findings: 3 months - 2 years

A

3 months - 2 years
- bulging fontanels
- seizures
- high pitched cry
- purpuric/petechial rash
- fever
- irritability
- poor feeding/vomiting
- possible nuchal rigidity

137
Q

Meningitis physical assessment findings: 2 years - adolescence

A

2 years - adolescence:
- initial finding: nuchal rigidity
- fever/chills
- severe headache
- vomiting
- positive Kernig’s sign
- positive Brudzinski’s sign
- petechial/purpuric rash
- photophobia and irritability
- progresses to drowsiness, delirium, coma
- involvement of the joints (meningococcal and Hib)
- chronic draining ear (pneumococcal)

138
Q

Bacterial vs viral meningitis lab tests for spinal fluid

A

Bacterial:
- cloudy
- elevated WBC
- elevated protein
- decreased glucose
- POSITIVE gram stain

Viral:
- clear color
- slightly elevated WBC
- normal or slightly elevated protein
- normal glucose content
- NEGATIVE gram stain

139
Q

Increased ICP signs in newborns

A
  • bulging or tense fontanels
  • high-pitched cry
  • increased head circumference
  • distended scalp veins
  • irritability
  • respiratory changes
  • bradycardia
140
Q

Increased ICP signs in children

A
  • increased irritability
  • N/V
  • headache
  • diplopia
  • seizures
  • bradycardia
  • respiratory changes

NUR 514: Pediatrics (4 decks)

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