HESI PEDS Flashcards
When does birth leng double?
By four years
When does the child sit unsupported?
8 months
When does a child achieve 50% of adult height?
2 years
when does a child throw a ball overhand
18 months
when does a child speak 2-3 word sentences
2 years
when does a child use scissors
4 years
when does a child tie his or her shoes
5 years
be aware that a girl’s growth spurt during adolescence begins ? than a boys. what age?
earilier than a boys, 10 years of age
temper tantrums are common in?
toddler, they are normal behaviors
Be aware that adolescene is at ime when the forms?
his or her identity and that rebellion against family values is common for this age group
What behavior would indicate that thyroid hormone therapy for a 4 month-old is effective?
You must know which milestones are accomplished by a 4 month old. One correct answer would be: has steady head control, which is an expected milestone for a 4-month old an indicates that replacement therapy is adequate for growth
what task could a 5-year-old diabetic boy be expected to accomplish by himself?
One correct answer would be to let him choose the injection sites. This is possible for a preschooler to do and gives the child some sense of control
School-age children are in Erikson’s stage of ?
industry: meaning they like to do and accomplish things. Peers are also becoming important for children of this age
After 6 months, cognitive development allows them to remember?
pain
Toddlers will fear _____ proceedures
intrusive
preschoolers fear body___?
body mutilation
school age childrem fear loss of?
loss of control of their bodies
major concern for adolescents is?
change in body image
_____________ are a major cause of death in children and adolescents?
Accidents: teach parents and children developmentally appropriate safety and accident-prevention techniques
What invalidates the Mantoux test?
Subcutaneous injection rather than intradermal injection
Is the common cold a contraindication for immunization?
no
German measles pose a serious threat to a child’s?
unborn siblings. The nurse should counsel all expectant mothers, especially those with young children, to be aware of the serious consequences of exposure to German measles during pregnancy.
Add potassium to IV fluids only with?
adequate urine output
• Urinary output for infants and children should be?
1 to 2 ml/ kg/ hr.
Use of syrup of ipecac is?
no longer recommended by the American Academy of Pediatrics. Teach parents that it is not recommended to induce vomiting in any way because it may cause more damage.
List three classic signs and symptoms of measles.
Photophobia, confluent rash that begins on the face and spreads downward, and Koplik spots on the buccal mucosa
Liver, sweet potatoes, carrots, spinach, peaches, and apricots
food sources of vitamin A.
What measurements reflect present nutritional status?
Weight, skinfold thickness, and arm circumference
List the signs and symptoms of dehydration in an infant.
Poor skin turgor, absence of tears, dry mucous membranes, weight loss, depressed fontanel, and decreased urinary output
List the laboratory findings that can be expected in a dehydrated child.
Loss of bicarbonate/ decreased serum pH, loss of sodium (hyponatremia), loss of potassium (hypokalemia), elevated Hct, and elevated BUN
What interventions should the nurse perform first in caring for a child who has ingested a poison?
Assessment of the child’s respiratory, cardiac, and neurologic status
What early signs should the nurse assess for if lead poisoning is suspected?
Anemia, acute cramping, abdominal pain, vomiting, constipation, anorexia, headache, lethargy, hyperactivity, aggression, impulsiveness, decreased interest in play, irritability, short attention span
Should you examine the throat of a child with epiglotitis with an object such as a tongue blade?
do not put a tongue blade or any object into the throat)because of the risk of obstructing the airway completely.
What are the physical assessment findings for a child with asthma?
Expiratory wheezing, rales, tight cough, and signs of altered blood gases
What nutritional support should be provided for a child with cystic fibrosis?
Pancreatic enzyme replacement, fat-soluble vitamins, and a moderate- to low-carbohydrate, high-protein, moderate- to high-fat diet
List seven signs of respiratory distress in a pediatric client.
Restlessness, tachycardia, tachypnea, diaphoresis, flaring nostrils, retractions, and grunting
Why are IV fluids important for a child with an increased respiratory rate?
The child is at risk for dehydration and acid-base imbalance.
Children with chronic otitis media are at risk for developing what problem?
Hearing loss
What is the most common postoperative complication following a tonsillectomy? Describe the signs and symptoms of this complication.
Hemorrhage; frequent swallowing, vomiting fresh blood, and clearing throat.
Polycythemia is common in children with?
cyanotic defects
difference between cyanotic and acyanotic
- Acyanotic: Has abnormal circulation; however, all blood entering the systemic circulation is oxygenated. Also associated with CHF
- Cyanotic: Has abnormal circulation with unoxygenated blood entering the systemic circulation.
The two objectives in treating CHF are?
reduce the workload of the heart and increase cardiac output.
List the four defects associated with tetralogy of Fallot.
VSD, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy
List the common signs of cardiac problems in an infant.
Poor feeding, poor weight gain, respiratory distress and infections, edema, and cyanosis
Describe nursing interventions to reduce the workload of the heart.
Give small, frequent feedings or gavage feedings. Plan frequent rest periods. Maintain a neutral thermal environment. Organize activities to disturb child only as indicated.
What position would best relieve the child experiencing a tet spell?
Knee-chest position or squatting
What cardiac complications are associated with rheumatic fever?
Aortic valve stenosis and mitral valve stenosis
What medications are used to treat rheumatic fever?
Penicillin, erythromycin, and aspirin
The nursing goal in caring for a child with Down syndrome is
reach his or her optimal level of functioning.
most common cause of increased seizure activity?
medication non-compliance
Headache on awakening is the most common presenting symptom of?
brain tumors
describe scissoring
A common characteristic of spastic cerebral palsy in infants; legs are extended and crossed over each other, feet are plantarflexed
What are two nursing priorities for a newborn with myelomeningocele?
Prevention of infection of the sac and monitoring for hydrocephalus (measure head circumference; check fontanel; assess neurologic functioning).
What are the side effects of Dilantin?
Gingival hyperplasia, dermatitis, ataxia, GI distress
Describe the signs and symptoms of a child with meningitis.
Fever, irritability, vomiting, neck stiffness, opisthotonos, positive Kernig sign, positive Brudzinski sign; infant may not show all classic signs even though very ill
What antibiotics are usually prescribed for bacterial meningitis?
Ampicillin, penicillin, or chloramphenicol
Describe the function of an osmotic diuretic.
Osmotic diuretics remove water from the CNS to reduce cerebral edema.
Describe the mechanism of inheritance of Duchenne muscular dystrophy.
Duchenne muscular dystrophy is inherited as an X-linked recessive trait.
Gowers sign?
Gowers sign is an indicator of muscular dystrophy; to stand, the child has to “walk” hands up legs.
first sign of renal failure.
decreased urinary output
Compare the signs and symptoms of acute glomerulonephritis (AGN) with those of nephrosis.
- AGN: gross hematuria, recent strep infection, hypertension, and mild edema;
- nephrosis: severe edema, massive proteinuria, frothy-appearing urine, anorexia
Compare the dietary interventions for AGN and nephrosis.
AGN: low-sodium diet with no added salt; nephrosis: high-protein, low-salt diet
What antecedent event occurs with AGN?
Beta-hemolytic streptococcal infection
Describe safe monitoring of prednisone administration and withdrawal.
Long-term prednisone should be given every other day. Signs of edema, mood changes, and GI distress should be noted and reported. The drug should be tapered, not discontinued suddenly.
what are the priorities for a client with WILMS tumor
Protect the child from injury to the encapsulated tumor. Prepare the family and child for surgery.
Describe the preoperative nursing care for a child with Hirschsprung disease.
Check vital signs and take axillary temperatures. Provide bowel cleansing program, and teach about colostomy. Observe for bowel perforation; measure abdominal girth.
What are the priorities for a child undergoing abdominal surgery?
Maintain fluid balance (I& O, nasogastric suction, monitor electrolytes); monitor vital signs; care for drains, if present; assess bowel function; prevent infection of incisional area and other postoperative complications; and support child and family with appropriate teaching.
• Remember the Hgb norms:
newborn, infant, child
- Newborn: 14 to 24 g/ dl •
- Infant: 10 to 17 g/ dl •
- Child: 9.5 to 15.5 g/ dl
transmission pattern of sickle cell anemia, cystic fibrosis, and phenylketonuria (PKU).
Autosomal recessive:
hemophilia
X-linked recessive trait:
What is a supplement given to sickle cell patients
Folic acid is given orally to stimulate RBC synthesis.
Have ____& ____readily available to treat anaphylaxis when administering L-asparaginase.
epinephrine and oxygen
frequently used in combination with antineoplastic drugs to reduce the mitosis of lymphocytes?
Prednisone
_____a xanthine oxidase inhibitor, is also administered to prevent renal damage caused by uric acid buildup and cellular lysis.
. allopurinol
Describe the sequence of events in a vaso-occlusive crisis in sickle cell anemia.
A vaso-occlusive crisis is caused by the clumping of red blood cells, which blocks small blood vessels; therefore, the cells cannot get through the capillaries, causing pain and tissue and organ ischemia. Lowered oxygen tension affects HgbS, which causes sickling of cells
An infant with hypothyroidism is often described as
a good quiet baby by parents
Early detection of hypothyroidism and phenylketonuria is essential in preventing?
mental retardation in infants. Knowledge of normal growth and development patterns is important because a lack of attainment can be used to detect the presence of a disease and to evaluate the treatment’s effects.
When a child is in ketoacidosis administer?
regular insulin IV in normal saline as prescribed.
Describe developmental factors that would impact the school-age child with diabetes.
Need to be like peers; assuming responsibility for own care; modification of diet; snacks and exercise in school
What is compartment syndrome?
Damage to nerves and vasculature of an extremity due to compression
What instructions should a child with scoliosis receive about the Milwaukee brace?
The child should be instructed to wear the brace 23 hours per day; wear a T-shirt under brace; check skin for irritation; perform back and abdominal exercises; and modify clothing. The child should be encouraged to maintain normal activities as able
