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NSG412 OB/Peds > Exam 3 - Peds > Flashcards

Exam 3 - Peds Flashcards

1
Q

Place in order the sequence of maturational changes for girls. Begin with the first change seen, sequencing to the last change.

a. Growth of pubic hair
b. Rapid increase in height and weight
c. Breast changes
d. Menstruation
e. Appearance of axillary hair

A

C, B, A, E, D

breast changes > rapid increase in weight + height > pubic hair > axillary hair > menstruation

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2
Q

Which describes the cognitive abilities of school-age children? (Select all that apply.)

A. Have developed the ability to reason abstractly
B. Are capable of scientific reasoning and formal logic
C. Developed the ability to understand relational term and concepts
D. Have a mastery of the concept of conservation
E. Have a steady reduction in egocentricity

A

C, D, E

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3
Q

When teaching injury prevention during the school-age years, which would the nurse include?

A. Promote the fear of strangers.
B. Basic rules of water safety.
C. Avoidance of microwave cooking.
D. Emphasize the negative aspects of competitive sports.

A

B

fuccckkkkk, sorry if you looked at these earlier. it said C but it’s most definitely not.

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4
Q

Which would the nurse expect of a healthy 3-year-old child?

A. Jump rope
B. Ride a two-wheel bicycle
C. Skip on alternate feet
D. Balance on one foot for a few seconds

A

D

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5
Q

According to Piaget, which describes magical thinking common in preschool age children?

A. Events have cause and effect.
B. God is like an imaginary friend.
C. Thoughts are all-powerful.
D. If the skin is broken, the child’s insides will come out.

A

C

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6
Q

Which play is most typical of the preschool period?

A. Solitary
B. Parallel
C. Associative
D. Team

A

C

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7
Q

Which is descriptive of a toddler’s cognitive development at age 20 months?

A. Searches for an object only if he or she sees it being hidden
B. Realizes that “out of sight” is not out of reach
C. Puts objects into a container but cannot take them out
D. Understands the passage of time, such as “just a minute” and “in an hour”

A

B

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8
Q

Which characteristic best describes the gross motor skills of a 24-month-old child?

A. Skips and can hop in place on one foot
B. Rides tricycle and broad jumps
C. Jumps with both feet and stands on one foot momentarily
D. Walks up and down stairs and runs with a wide stance

A

D

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9
Q

Which is the leading cause of death during the toddler period?

A. Unintentional injuries
B. Infectious diseases
C. Congenital disorders
D. Childhood diseases

A

A

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10
Q

A nurse is assessing a 12-month-old infant. Which statement best describes the infant’s physical development a nurse would expect to find?

A. Anterior fontanel closes by age 6 to 10 months.
B. Binocularity is well established by age 8 months.
C. Birth weight triples by age 1 year.
D. Maternal iron stores persist during the first 12 months of life.

A

C

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11
Q

At which age can most infants sit steadily unsupported?

A. 4 months
B. 6 months
C. 8 months
D. 10 months

A

C

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12
Q

In terms of gross motor development, which would the nurse expect a 5-month-old infant to do? (Select all that apply.)

A. Roll from abdomen to back. 
B. Put feet in mouth when supine. 
C. Roll from back to abdomen. 
D. Sit erect without support. 
E. Move from prone to sitting position. 
F. Adjust posture to reach an object.
A

A, B

back to abdomen: 6 mo
sit erect w/o support: 8 mo
prone to sitting: 10 mo
adjust posture to reach: 8 mo

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13
Q

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy. Which action should the nurse include in the child’s postoperative care plan? (Select all that apply.)

A. Notify the surgeon if the child swallows frequently.
B. Apply a heat collar to the child for pain relief.
C. Place the child on the abdomen until fully awake.
D. Prepare for oral liquids immediately following procedure.
E. Encourage the child to cough frequently.

A

A, C

swallowing frequently could indicate hemorrhage
(abdomen until fully awake for drainage)

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14
Q

Parents have understood teaching about prevention of childhood otitis media if they make which statement? (Select all that apply.)

A. “We will avoid second hand smoke.”
B. “Breastfeeding will be discontinued after 4 months of age.”
C. “We will place the child flat right after feedings.”
D. “A conjugate vaccine may be administered.”
E. “We will adminster medications as prescribed.”

A

A, D, E

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15
Q

G+D. what age can:

track objects with eyes

A

1 month

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16
Q

G+D. what age:

smile
lift head off mattress when prone

A

2 months

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17
Q

G+D. what age:

turn head to sounds ​
make cooing & babbling sounds ​

A

3 months

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18
Q

G+D. what age:

roll abdomen to back
puts feet in mouth when lying supine

A

5 months

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19
Q

G+D. what age:

Rolls from back to front
Sit WITH support

A

6 months

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20
Q

when do 1st teeth usually come in?

A

around 6-9 months

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21
Q

G+D. what age:

sits WITHOUT support

A

8 months

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22
Q

G+D. what age:

Pincer grasp
Creeps on hands and knees

A

9 months

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23
Q

G+D. what age:

Go from prone to sitting ​
Stand while holding on to furniture ​
Lift one foot while standing ​

A

10 months

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24
Q

G+D. what age:

Turn pages in a book
Walks with one hand held

A

12 months

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25
Q

G+D. what age:

walk w/o help
2 block tower
Use cup

A

15 months

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26
Q

G+D. what age:

Throw ball overhand
3 block tower

A

18 months

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27
Q

G+D. what age:

6-7 block tower
Turn doorknob
2-3 word phrases (“all done!”)
Turn book pages

A

2 yrs

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28
Q

G+D. what age:

Jump w/both feet
Draw circles

A

2.5 yrs

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29
Q

at what age do children usually have all of their baby teeth in?

A

2.5 yrs

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30
Q

G+D. what age:

rides a tricycle

A

3 yrs (3 wheels = 3 yrs)

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31
Q

G+D. what age:

skip + hop

A

4 yrs

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32
Q

G+D. what age:

jump rope
walk backwards

A

5 yrs

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33
Q

what is 1st leading cause of death in ages 1-4?

A

unintentional injuries

congenital abnormalities are 2nd

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34
Q

child should be in rear facing car seat until what age?

A

2

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35
Q

erikson infant

A

trust vs mistrust

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36
Q

erikson toddler

A

autonomy vs shame + doubt

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37
Q

erikson preschool

A

initiative vs guilt

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38
Q

erikson school-age

A

industry vs inferiority

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39
Q

erikson adolescent

A

identity vs role confusion

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40
Q

what erikson stage does this represent?

developing a sense of trust when caregivers give reliable care
“Is my world safe?”

A

trust vs mistrust (infant)

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41
Q

what erikson stage does this represent?

Develop sense of personal control of skills; INDEPENDENCE
“Can i do things by myself or will I always have to rely on others?”

A

autonomy vs shame + doubt

toddler

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42
Q

what erikson stage does this represent?

Assert power over the environment
“Am I good or am I bad?”

A

initiative vs guilt

preschool

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43
Q

what erikson stage does this represent?

School activities become important; learning to cope with new social + academic demands

A

industry vs inferiority

school age

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44
Q

what is a way we can help school age children not feel inferior? (re: erikson)

A

positive reinforcement

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45
Q

what erikson stage does this represent?

Sense of self + personal identity developed
Social relationships are paramount
“Who am I and where am I going?”
Peers very important + body image becomes very important

A

identity vs role confusion

adolsecent

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46
Q

piaget stage: birth through 2 years

A

sensorimotor (learning about world through senses)

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47
Q

piaget stage: toddler through early childhood (7)

A

preoperational

“PREschool = PREoperational”

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48
Q

piaget stage: 7-11 yrs

A

concrete operational

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49
Q

piaget stage: adolescent through adulthood

A

formal operational

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50
Q

psychosocial stages created by who?

A

erikson

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51
Q

cognitive stages created by who?

A

piaget

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52
Q

what is main accomplishment of sensorimotor stage

A

object permanence

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53
Q

when does object permanence develop?

A

9 months

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54
Q

piaget stage:

represents things with words + images 
Intuitive rather than logical
Pretend play 
Egocentric 
Magical thinking
A

preoperational

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55
Q

re: piaget, what is magical thinking? what’s an example?

A

thoughts are powerful + can cause events to occur (can be positive or negative)

ex: if they said something bad about sibling and they ended up in hospital, they would think it was their fault)

56
Q

piaget stage:

give life-like qualities to inanimate objects: “the tricycle is bad because I fell off of it”

A

preoperational

example is a form of magical thinking

57
Q

piaget stage:

thinking logically + conceptually
Can do math + solve problems

A

concrete operational

58
Q

which piaget stage does understanding of “conservation” happen in?

A

concrete operational

school age

59
Q

re: piaget, what is conservation?

A

ex: same amount of water in different size + shape container

60
Q

piaget stage:

abstract thinking
thinking about their future

A

formal operational

61
Q

type of play for toddler

A

parallel

62
Q

type of play for preschool

A

associative

63
Q

type of play for school age

A

team

64
Q

when is pretend play very common? (play kitchen, play grocery store, etc)

A

preschool

65
Q

around what time should solid foods be introduced to infant? how should it be done?

A

~ 6 months

1 new food at a time to assess for allergies or intolerances

66
Q

what is limit for juice in infancy stage?

A

4-6 oz

67
Q

cows milk shouldn’t be given until what age?

A

12 months

68
Q

normal newborn pulse

A

110-160

69
Q

normal newborn RR

A

30-60

70
Q

normal newborn temp

A

97.7-98.9

71
Q

how do vital signs change as infant grows?

A

HR + RR decrease w/age

BP increases w/age

ex adolescent: HR 55-85, RR 12-20, BP 110-120/65-80

72
Q

how should exam/assessment be performed on kid?

A

do “scariest” thing last

ex: listen to heart and lung sounds/RR before messing with head/face/nose

73
Q

birth weight should be doubled by when?

A

6 months

74
Q

birth weight should be tripled by when?

A

12 months

75
Q

when does posterior fontanel close?

A

2-3 months

76
Q

when does anterior fontanel close?

A

12-18 months

77
Q

re: atraumatic care, where should painful procedures be performed?

A

procedure room.

NOT in patient room, bed or playroom let these spaces stay safe for them

78
Q

what pain assessment tool would be good for young children (infants to 7 yrs)?

A

FLACC

79
Q

what does FLACC encompass?

A 
Face
Legs
Activity
Cry
Consolability
80
Q

what pain scale is this?

Photographs that include cultural differences to help identify more

A

OUCHER scale

81
Q

what pain scale is this?

0-10 pain scale AND faces

A

visual analog scale

82
Q

asthma patho (simple)

A

hyperresponsiveness –> edema, mucus, narrowing of airway

83
Q

what testing is used to determine severity classification for asthma?

A

pulmonary fxn test

84
Q

asthma severity classification:

symptoms <2days/week, waking up with symptoms <2days/month, SABA use <2days/week, no limit on activity

A

intermittent

85
Q

asthma severity classification:

symptoms > 2days/week, waking up with symptoms <3-4 days/month, SABA use >2days/week, minor limitations on activity

A

mild persistent

86
Q

asthma severity classification:

symptoms daily, waking up with symptoms >1/week, SABA use daily, some activity limitations

A

moderate persistent

87
Q

asthma severity classification:

symptoms multiple times/day, waking up with symptoms almost nightly, SABA use multiple times/day, extremely limited activity

A

severe persistent

88
Q

how do you use a peak flow meter? (6)

A
  1. Ensure marker is zeroed
  2. Remove food or gum
  3. Stand up straight
  4. Close lips around mouth piece
  5. Blow out as hard + quickly as possible; 3x
  6. Record highest #
89
Q

SE of SABA meds

A

irritability, insomnia, tremors, nervousness

90
Q

what should a person do after using an inhaled glucocorticoid?

A

rinse (to prevent thrush in mouth)

91
Q

name some triggers for asthma (7)

A
  1. exercise
  2. smoke
  3. allergens
  4. pollutants
  5. extreme temperatures
  6. infections
  7. strong emotions/stress
92
Q

what is CF?

A

autosomal recessive lower airway disease that causes thick mucus; impacts gas exchange + many other systems of the body

93
Q

what transport is affected by CF?

A

NaCl and H2O –> makes very thick and sticky mucus

94
Q

what is meconium ileus and what could it indicate?

A

meconium ileus: no meconium stool in expected timeframe (first 72 hrs)

could mean: newborn has CF

95
Q

how does CF impact GI and pancreas?

A

mucus impacts pancreas ability to produce enzymes and breakdown fat/other foods –> steatorrhea

96
Q

what manifestations might you see in a patient with malnutrition r/t CF?

A

protuberant abdomen, thin extremities, anemia

97
Q

how does CF impact fertility?

A

mucus blocks vas deferens (AMAB) + prevents implantation (AFAB)

98
Q

what is one of the biggest concerns with CF?

A

infection risk!!! (b/c of all the stagnant mucus)

99
Q

what diagnostic tool can we use for CF?

A

Quantitative Sweat Chloride skin test

100
Q

what is positive result for CF with Quantitative Sweat Chloride skin test?

A

> 60 mEq/L

101
Q

what are nutritional interventions for CF? (3)

A
  1. small, high calorie, high protein meals
  2. pancreatic enzymes w/food
  3. infants: predigested formula
102
Q

interventions for CF r/t respiratory (4)

A
  1. Chest PT
  2. bronchodilators
  3. mucolytics
  4. ABX (if resp infection)
103
Q

what would be good exercise option for someone with CF?

A

swimming

104
Q

when should we give pancreatic enzymes to patient with CF?

A

right before or with meals/snacks

105
Q

group of disorders affecting larynx, trachea + bronchi

A

croup disorders

106
Q

s+s of croup (6)

A
  1. Barky, seal-like cough
  2. Inspiratory stridor (usually worse @ night)
  3. Wheezing
  4. retractions
  5. nasal flaring
  6. hypoxemia
107
Q

interventions for croup (4)

A
  1. humidified O2
  2. cool mist
  3. Monitor O2 sats
  4. Calm (environment) + comfort (prevent crying)
108
Q

epiglottitis is caused by what?

A

Hib (bacteria)

MEDICAL EMERGENCY

109
Q

What are the 4 D’s of epiglottitis?

A

Drooling
Dysphagia
Dysphonia
Dyspnea

110
Q

priority intervention for epiglottitis

A

protect AIRWAY!!! no tongue blades, cultures, anything that could obstruct airway, etc

111
Q

what precautions would someone be on for epiglottitis?

A

droplet

112
Q

priority assessment after tonsillectomy

A

assess gag reflex

ABC!

113
Q

what 3 manifestations could indicate hemorrhage after tonsillectomy?

A
  1. excessive swallowing
  2. excessive clearing of the throat
  3. visible bright red bleeding
114
Q

what can we use post op tonsillectomy for pain, inflammation + vasoconstriction?

A

ice collar around neck

115
Q

what food items should be avoided after tonsillectomy to prevent confusion and distinguish from bleeding complications ?

A

red or brown liquids/foods

116
Q

what is otitis media? what is otitis media with effusion?

A

OM: middle ear infection

OME: fluid in the middle ear

117
Q

when is OM common?

A

first 24 months of life + when kids enter school

118
Q

OM is less common in infants that _________

A

breastfeed

119
Q

these s+s could indicate what:

Fever, crying, tugging, rubbing, irritable, not eating well, nausea + other differences in temperaments

A

otitis media

120
Q

these s+s could indicate what:

Fullness in ear, popping when swallowing, hearing loss, balance issues, tinnitus

A

otitis media with effusion (fluid in middle ear)

121
Q

what is usual intervention / care for otitis media?

A

“watchful waiting” + comfort measures

most clear up on own in a few days. keep an eye on fever and kid and ride it out unless they get worse

122
Q

how can parents be educated to help children avoid otitis media?

A
  1. stay up to date with vaccines

2. don’t bottle prop or lay down when eating

123
Q

administering ear drops to kid that’s less than 3 years old (re: pinna)

A

pull pinna DOWN and back

124
Q

untreated streptococcal infection leading to a systemic inflammatory disease

A

rheumatic fever

125
Q

what organ does rheumatic fever greatly impact?

A

heart

126
Q

what assessment questions would you ask if you suspected rheumatic fever?

A

recent strep infection?
Sore throat recently?
Any family with recent strep?
assess Heart sounds, joint pain, rash

127
Q

what diagnostic tool would you use for rheumatic fever

A

ASO titer (would indicate recent strep infection)

128
Q

bacterial infection → vesicles w/honey colored crust

A

impetigo

129
Q

interventions for impetigo (5)

A
  1. topical ABX
  2. hand hygiene
  3. contact isolation
  4. avoid scratching of lesions
  5. proper washing of things coming in contact with lesions
130
Q

interventions for lice

A

OTC lice shampoo for live lice (doesn’t get nits) + nit comb to remove nits from hair

131
Q

small mite burrows into skin - intense itching (esp @ night)

A

scabies

132
Q

interventions for contact dermatitis (2)

A
  1. remove irritant

2. thoroughly wash area w/soap + water

133
Q

allergic + inflammatory response →patches of red, edema, itching

A

atopic dermatitis (eczema)

134
Q

interventions for eczema (4 - things to avoid and things to do)

A
  1. avoid bubble baths, soaps, perfumes, fabric softeners, wool or synthetic fabrics
  2. tepid water baths with mild soaps
  3. cotton clothing
  4. topical steroid ointments
135
Q

name some contraindications for a kid to receive a vaccine

A
  1. severe allergic rxn to vaccine in the past
  2. severe fever or illness (common cold and mild illness doesn’t count)
  3. no live vaccines for immunocompromised (varicella or MMR)

NSG412 OB/Peds (5 decks)

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