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Nur 160 Peds > Growth and Development > Flashcards

Growth and Development Flashcards

1
Q

Describe Growth

A

physical development that is sequential(linear) and directional,, continuous and predictable but NOT the SAME RATE

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2
Q

Cephalocaudal

A

head to toe

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3
Q

Example of Cephalocaudal normal growth

A

Child gains control of the head and neck before the trunk and limbs

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4
Q

Example of Proximodistal normal growth

A

Child controls arm movements before hand movement

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5
Q

Describe Developement

A

Qualitative increase in capabilities or functions

Sequence is predictable and specific; each child must pass through every stage

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6
Q

Examples of development

A

Children crawl > creep > stand > they walk.

Child babbles > forms words > speaks in sentences;

Personality is built on the early foundation of trust.

Writing emerges from scribbling.

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7
Q

Growth Rate

A

uneven and individual with rapid growth during infancy and puberty beginning of adolescence)

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8
Q

Infant Age

A

birth to 1 year

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9
Q

Infant Erikson Stage

A

Trust vs Mistrust (0-1yr)

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10
Q

Trust vs. Mistrust

A

Child needs consistency- primary caregiver must meet infant’s needs

Nutrition, warmth, stimulation, sleep, comfort

Trust: When child is crying, and the mother responds quickly it will build a sense of trust

Mistrust: When Child is crying and no one comes to sooth the child, the child will develop a sense of mistrust because no one is tending to the needs of the child.

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11
Q

Resolution/ Characterization for Trust vs Mistrust

A

Hope

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12
Q

Infant: Piaget Stage

A

Sensorimotor (birth - 2yrs)

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13
Q

Sensorimotor (birth - 2yrs)

A

Motor activity without the use of symbols. All things learned are based on experiences, or trial and error

Key Features:
Object permanence, symbolic thought, separation anxiety

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14
Q

Infant Weight rate

A

Weekly gain: 140 to 200 g (5 to 7 oz)
Weight gain of 1.49 lb (0.68 kg) per month fisrt 6 months
After 6 months weight gain slows to .99 lb (0.45 kg) per month

Birth weight doubles by end of first 4 to 7 months
Triples in 1 year

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15
Q

Infant Height rate

A

Measure lying down until age two years
Monthly gain: 2.5 cm (1 inch) for 1st 6 months
After 6 months Length gain of .5 in (1.27 cm) per month is seen

Double the ht in 1 year

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16
Q

Posterior fontanel closure

A

2-3 months

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17
Q

Anterior fontanel closure

A

12 to 18 months

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18
Q

Shape of posterior fontanel

A

triangle shaped

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19
Q

Shape of anterior fontanel

A

diamond shaped

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20
Q

Head circumference growth rate

A

1.5 cm per month for the first six months

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21
Q

During a well-baby visit, the mother of an 18-month-old appears concerned. Which assessment
findings might lead the nurse to suspect developmental delay? SELECT ALL THAT APPLY

A

Not walking, Not speaking 15 words, Not pulling up from a sitting position

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22
Q

A parent is upset that her 34-month-old girl has begun to wet the bed and suck her thumb after being
admitted to the hospital. The parent asks the nurse to explain why this is happening. The nurse’s best
response is which of the following?

A

“This behavior is a defense mechanism when normal routines are changed.”

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23
Q

The nurse is teaching a parent of a 2-year-old how to handle negativism. Which of the following question/statement to the child by the partent should indicate understanding of the nurse’s teaching?

A

“Do you want peanut butter or ham sandwhich for lunch?”

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24
Q

Which of the following is an early sign of heart failure that the nurse should recognize?

A

Tachypnea

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25
Q

Nursing interventions for the child after a cardiac catheterization would include which of the following?

A
  • Assess the affected extremity for temperature and color.
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26
Q

Nursing care of the infant and child with heart failure would include which of the following?

A
  • Organize activities to allow for uninterrupted sleep.
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27
Q

Which of the following heart defects causes hypoxemia and cyanosis because desaturated venous blood is entering the systemic circulation?

A
  • Tetralogy of Fallot
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28
Q

Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress which of the following?

A
  • Administer analgesics before procedure.
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29
Q

Therapeutic management of the child with rheumatic fever includes

A
  • administration of penicillin.
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30
Q

Which of the following is an important nursing responsibility when a dysrhythmia is suspected?

A
  • Count the apical rate for 1 full minute and compare with radial rate.
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31
Q

Assessment findings of heart failure

A
  • Sweating
  • Weak, thready pulses
  • Dependent edema
  • Fatigue
  • Tachycardia
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32
Q

The nurse is explaining blood components to an 8-year-old child. The nurse’s best description of platelets is that they do which of the following?

A

Help your body stop bleeding by forming a clot (scab) over the hurt area

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33
Q

When hemoglobin falls sufficiently, the signs and symptoms are caused by

A
  • tissue hypoxia
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34
Q

The nurse suspects a child is having an adverse reaction to a blood transfusion. The first action by the nurse should be which of the following?

A
  • Stop transfusion and maintain a patent intravenous line with normal saline and new tubing.
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35
Q

Which of the following urine tests of renal function is used to estimate glomerular filtration?

A

Creatinine

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36
Q

Which of the following factors predisposes the urinary tract to infection?

A
  • Short urethra in girls
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37
Q

A young child is diagnosed with vesicoureteral reflux. The nurse should know that this usually results in

A
  • recurrent urinary tract infections.
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38
Q

Which of the following best describes the cause of most cases of acute glomerulonephritis?

A
  • Antecedent streptococcal infection
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39
Q

In acute glomerulonephritis, the nurse is aware that an early warning sign of encephalopathy is which of the following?

A
  • Dizziness
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40
Q

The clinical manifestations of nephrotic syndrome include which of the following?

A
  • Proteinuria,
  • hypoalbuminemia, and
  • edema
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41
Q

Therapeutic management of nephrotic syndrome includes which of the following?

A
  • Corticosteroids
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42
Q

Which of the following is the primary clinical manifestation of acute renal failure?

A

Oliguria

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43
Q

Dialysis or transplantation becomes necessary for chronic renal failure when

A
  • glomerular filtration rate falls below 10% to 15% of normal.
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44
Q

What is the most appropriate assessment needed to monitor renal function?

A
  • Strict intake and output records
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45
Q

Classic symptoms of UTI in children include __________________, ________________________ and __________________________.

A
  • increased frequency,
  • foul smelling urine, and
  • fever
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46
Q

What name is given to inflammation of the bladder?

A
  • Cystitis
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47
Q

______________________ is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia and edema.

A

Nephrotic syndrome

48
Q

In _____________________ blood filtrate is circulated outside the body across a semipermeable membrane and replaced by electrolyte solution.

A
  • Hemofiltration
49
Q

What condition is the most common cause of acute renal failure in children?

A
  • Severe dehydration
50
Q

The parents of a 2-year-old boy who had a repair of extrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

A

Additional surgery may be necessary to achieve continence.

51
Q

What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)

A
  • Excessive thirst
  • Frequent urination
  • Pallor
  • Poor feeding
52
Q

What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)

A

Swelling and tenderness of graft area

  • Diminished urinary output
  • Feve
53
Q

What month is birth weight usually tripled?

A

12 months

54
Q

At what age is sexual curiosity most common?

A

preschoolers

55
Q

What time period covers infancy?

A

1 month to 1 year

56
Q

What is Erikson’s developmental theory for school aged children?

A

industry vs inferiority

57
Q

What is the age span of a toddler?

A

1 to 3 years

58
Q

At what age is it normal to have imaginary friends?

A

3 to 4 years

59
Q

What is Erikson’s developmental theory for infants?

A

trust vs mistrust

60
Q

What time period covers newborn/ neonatal stage?

A

birth to 1 month

61
Q

At what month should an infant be able to sit without support?

A

8 months

62
Q

At what age should an infant be able to bring things to his or her mouth?

A

4 months

63
Q

What is Erikson’s developmental theory for adolescents?

A

identity vs role confusion

64
Q

What is the age span of a school aged child?

A

5 to 10 years

65
Q

Which is Erikson’s developmental theory for toddlers?

A

autonomy vs shame/doubt

66
Q

What is the age span for a preschooler?

A

3 to 5 years

67
Q

When should an infant be able to pick up an object with his fingers?

A

4 months

68
Q

At what age should an infant’s birth weight double?

A

6 months

69
Q

What is Erikson’s developmental theory for preschoolers?

A

initiative vs guilt

70
Q

What is the age span for adolescence?

A

10 to 18 years

71
Q

A nurse is assessing a 3 month old. Which of the following findings should be reported to the provider?

A

Unable to raise head when in prone position

72
Q

A nurse is providing home safety information to the parents of an 11 month old infant. Which should be included?

A

avoid grapes and popcorn

73
Q

RN assesses the psychological development of a toddler. RN is aware this stage is characterized by which of the following?

A

Negative behaviors characterized by the need for autonomy

74
Q

RN is admitting a 1 year old with respiratory precautions. Which toy is appropriate?

A

large building blocks

75
Q

A RN is doing a well baby check at 6 months. Which should he expect to find?

A

Posterior fontanel is closed

76
Q

A mother arranges a playdate for her 2 1/2 year old and her friend’s 3 yo. The mom should expect what kind of play?

A

parallel

77
Q

Aortic stenosis is what kind of heart defect?

A

Acyanotic Obstruction of flow from ventricles

78
Q

Cystic fibrosis affects which systems?

A

Pulmonary, GI, Endocrine

79
Q

What is the primary goal when treating heart failure?

A

Improve Cardiac Function

80
Q

Following a cardiac catheterization the nurses primary concern

A

Monitoring for bleeding

81
Q

The risk for SIDS can be reduced by

A

Placing infants to sleep on their back

82
Q

Children admitted with CHF usually Absence of fistulas or strictures

A

Should be fluid restricted

83
Q

Rheumatic fever sometimes occurs following

A

Strep throat or URI

84
Q

Differences in upper extremity and lower extremity blood pressure result from

A

Coarctation of the aorta

85
Q

The primary concern following kawasaki disease is?

A

coronary aneurysm

86
Q

If you have a patient who is shunting blood from left to right what should you expect?

A

Pulmonary hypertension

87
Q

The ductus arteriousus usually closes

A

In the first 1-2 days of life

88
Q

When a Ductus Arteriosus does not close this increases

A

Flow to the lungs

89
Q

Clubbing refers to

A

Rounding of fingertips due to chronic hypoxia

90
Q

The most common congenital heart defect

A

VSD

91
Q

Kids with Tetrology of Fallot assume what position to improve flow to the lungs?

A

Squat/knee to chest

92
Q

Systemic vasculits involving fever, rash, oral lesions peeling hands and feet, lymphadenopathy?

A

Kawasaki

93
Q

What is a croup syndrome that is considered a true pediatric emergency?

A

Epiglottitis

94
Q

The best diet for a child with CF is

A

High protein

95
Q

Before eating any food, all children with CF must

A

Take pancreatic enzymes

96
Q

A newborn has bounding radial pulses, and thready pedal pulses. What condition would you suspect based on this?

A

coarctation of the aorta

97
Q

A 4 mo w/a VSD has new s/s of sweating with feeds, fatigue, edema, and cool extremities. Which would the nurse suspect?

A

heart failure

98
Q

Which finding is expected in a child with a hx of hypo plastic left heart syndrome (HLHS)?

A

murmur

99
Q

Pt has a hx of strep, and now has joint pain, painless SC nodules, and random jerky movement. What do you suspect?

A

rheumatic fever

100
Q

A 2 year old has a fever, groin rash, reddened eyes, strawberry tongue, and irritability. What do you suspect?

A

Kawasaki

101
Q

What are some causes of a murmer? Select all that apply.

A

high fever
congenital heart defect
growth spurt

102
Q

You receive an order for prostaglandin infusion for a newborn. Which statement would best help educate the parent?

A

This will temporarily keep open a connection in the heart between two vessels.

103
Q

Which defect has increased pulmonary blood flow (aka acyanotic)?

A

ventricular septal defect

104
Q

Patent ductus ateriosus Tx

A

Indomethacin - can be used in premature infants (0.2 mg/kg)
Ibuprofen mg\kg
PDA requires surgical or catheter closure.
Closure is required treatment heart failure & to prevent pulmonary vascular disease.

105
Q

Which medication directly reduces afterload?

A

Enalapril

106
Q

Sound of ventricular septal defect

A

Pansystolic/holosystolic murmur - loud, harsh, blowing heard best over the LLSB, frequently is accompanied by thrill

107
Q

Sound of patent ductus ateriosus

A

Classic continuous machine-like murmur

108
Q

Ventricular Septal Defect

Treatment

A

Small VSD - no surgical intervention, no physical restrictions;
Bacterial endocarditis prophylatic abx is indicated.
• Symptomatic/Large VSD - Medical treatment initially with afterload reducers (ACEI: captopril, enalapril) & diuretics (furosemide) DIgoxin to improve cardiac output

Open heart surgery with cardiopulmonary bypass, will suture or patch hole closed. àIf child is not stable for open heart surgery. Pulmonary artery banding: narrowing of pulmonary artery to reduce blood flow to lungs.

109
Q

Severe dehydration in infants

A

Tachycardia, parched mucous membranes, and sunken eyes and fontanels

110
Q

Tx for persistent diarrhea

A

rehydration with oral rehydrates

111
Q

Which vitamin decreases the chance of spina bifida?

A

B9 or folic acid

112
Q

Indication of tracheoesophageal fistula

A

excessive amount of frothy saliva in the mouth.

113
Q

Method for feeding infant with cleft palate

A

Pigeon bottle feeding

114
Q

HIrschsprung’s disease

A

megacolon; obstruction caused by lack of motility or peristalsis in the segment of intestine causing inability to pass meconium or feces .

115
Q

Manifestation of CHF

A

Tachynea, Tachycardia, weigth gain, sweating

116
Q

Four characteristics of teratology of fallot

A

Pulmonary stenosis
Right ventriculer hyoertrophy
Overriding aorta
Ventricular septal defect

117
Q

Signs of digoxin toxicity in children

A 
Vomiting
Bradycardia
Anorexia
Nausea
Dysrhythmia

Nur 160 Peds (1 decks)

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