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Peds/OB > Peds exam 1 > Flashcards

Peds exam 1 Flashcards

1
Q

the nurse is assessing a 6 mo old infant. Which gross motor skill should be expected at this age?
-Sits unsupported
- can feed self with spoon
- creeps on hands and knees
- rolls from back to front

A

Rolls from back to front

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2
Q

A toddler’s mom asks when it is safe to place the car seat in a forward-facing position. The nurse’s best response is:
- after the toddler turns 2 and exceeds manufacturer’s height recommendations
-never, due to risk of the child unbuckling
-not unless there are safety locks in the car
- when weight of child is > 40 pounds

A

After toddler turns 2 and exceeds manufacturer height recommendations

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3
Q

Which of the following activity is most age-appropriate for a 4 year old in traction following a femur fracture?
- large picture book
- crayons and coloring book
- listening to music
-model airplanes

A

Crayons and coloring book

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4
Q

The nurse is assessing a 4-month-old infant. The nurse would anticipate finding which of the following? Pick 2
- positive babinski reflex
-presence of a crude pincer grasp
-open posterior fontanelle
- able to hold head erect

A

Able to hold head erect and positive babinski reflex.

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5
Q

A mom of a 3 yr old tells the nurse that the child constantly has temper tantrums. What is the nurse’s best response?
- punish child every time they say “no” to change the behavior
- set limits regarding expected behaviors
-allow the behavior because this is normal at this age
- ignore the child when this behavior occurs

A

Set limits regarding expected behaviors

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6
Q

The nurse is planning care for a 18 month old child. Which of the following should be included in the child’s care?
- hold and cuddle often
- allow the child to walk independently on the nursing unit
- encourage/allow child to feed self
- engage child in games with other children

A

Encourage/allow child to feed self

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7
Q

A nurse assesses the language development of a 6 mo old infant. Which demonstrates normal developmental achievement?
- uses simple words with meaning like “mama”
- coos when comforted
- babbles using simple vowel sounds
- links syllables together

A

Babbles using simple vowel sounds

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8
Q

A nurse is observing children playing in the hospital playroom. They would expect to see 4 year old children playing?
- sharing toys but doing their own thing
- with their own toys alongside other children
-competitive board games with other children
- alone with hand held computer games

A

Sharing toys but doing their own thing

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9
Q

While examining a 2 yr old, the nurse assesses that the anterior fontanelle is open. The nurse should?
- look for other signs of abuse
- ask about family Hx of craniosynastosis
-notify the provider
- document this as a normal finding

A

Notify the provider

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10
Q

A nurse is teaching parents about ear infections. Which anatomical feature predisposes children to this disorder?
- tympanic membrane
-external ear canal
-eustachian tubes
- nasopharynx

A

Eustachian tubes

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11
Q

Which of the following is the best method for performing a physical exam on a toddler?
- from abd to toes, then to head
- dismally to proximally
-from head to toe
-from least to most invasive

A

From least to most invasive

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12
Q

Which stressor is common in hospitalized toddlers?
Pick 3
- interrupted routine
- self-concept disturbance
- fear of being hurt
- social isolation
- sleep disturbance

A

Fear of being hurt, sleep disturbances, and interrupted routine

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13
Q

A preschooler is in what Ericsson’s stage of development?
- autonomy vs. shame and doubt
- industry vs inferiority
-initiative vs. guilt
- trust vs. mistrust

A

Initiative vs guilt

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14
Q

Animism is when preschoolers believe their thoughts are all powerful?

A

False(animism is like Toy Story- items come to life/have feelings)

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15
Q

“Baby teeth” are usually completely in by age 3?

A

True

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16
Q

Normal growth parameter for infant (Ht, Wt, HC)

A

Ht=19-21 in (inc 50% by 12 mo)
Wt=6-9lbs(doubles by 5 mo, triples by 12 mo)
HC=33-35 cm(inc 10 cm by 12 mo)

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17
Q

Anterior fontanelle closes

A

12-18 mo

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18
Q

posterior fontanel closes

A

6-8 weeks

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19
Q

What are the primitive reflexes?

A

Sucking/rooting, palmar grasp, plantar grasp, tonic neck or “fencing”, Moro, stepping, babinski

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20
Q

How many teeth by 12 mo

A

6-8

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21
Q

Language development 3 mo

A

Coos
Turns head to rattle sound
Seems to recognize caregiver voice

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22
Q

language development 6 mo

A

Babbles with vowels
Pleasure/displeasure
Responds to name
Distinguishes emotion based on voice

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23
Q

Language development by 12 mo

A

3-5 words
Understands simple commands
Recognizes words for common items

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24
Q

Nutrition for an infant

A

Vitamin D supplementation for first few days of life
Water/juices not needed for first 4 months
Breastfeeding=complete diet for 6 months
Iron supplementation for infants being exclusively breastfed for 4 months

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25
Q

When can an infant progress to solid foods?

A

4-6 mo

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26
Q

What must happen before an infant can progress to solid foods?

A

4-6 mo, extrusion reflex must be extinguished

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27
Q

food intro for infants

A

Infant cereals first(rice, barley, oatmeal.. usually rice cereal first), fruits, then veggies
One new food every 3-5 days to allow to determine allergies

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28
Q

If not breastfeeding, then formula must be…..

A

Iron fortified

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29
Q

Fruit juice for infants…

A

Limited to 2-4oz/day at 6 mo

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30
Q

Foods to avoid-infant

A

Honey, unpasteurized drinks/food, cow’s milk, food/drinks with added sugar, caffeinated drinks

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31
Q

Sensory development for infant

A

Sight-nearsighted, prefers contrasts, full color vision by 7 mo
Hearing- acute as an adult at birth
Smell and taste-prefer sweet, can differentiate smell and taste of mothers breast milk by day 7
Touch- prefers soft sensations, soothing strokes, can tell caregiver’s mood by touch

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32
Q

Psychosocial development is what theory?

A

Erickson’s

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33
Q

Erickson’s theory is…

A

Psychosocial development

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34
Q

What stage of Erickson’s are infants?

A

trust vs. mistrust
Quality of caregiver and needs being met

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35
Q

Gross and fine motor skills 4 mo

A

Rolls from back to side
Head control
Grasps objects with both hands

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36
Q

Gross and fine motor skills 6 mo

A

Rolls from back to front
Holds bottle

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37
Q

Gross and fine motor skills 9 mo

A

Sits unsupported, creeps on hands/knees, has crude pincer grasp

38
Q

Gross and fine motor skills 12 mo

A

Sits down from standing, walks with one hand/on own, attempts 2 block tower, can turn pages in book (multiple), feeds self with cup and spoon

39
Q

Piaget major tasks for infant

A

Separation (separate themselves from objects in environment), object permanence (object leaves visual field but still exists), mental representation ( visualize things not physically present)

40
Q

When does separation anxiety present in infants and why?

A

8 mo and because of object permanence

41
Q

When does object permanence develop in infants?

A

8 mo

42
Q

Piaget discusses…

A

Cognitive development

43
Q

Piaget stage for infants

A

Sensorimotor; learn about themselves and world through developing sensory and motor capabilities

44
Q

Age-appropriate play activities for infants

A

Rattles, soft stuffed toys, mirrors, teething toys, being read to, brightly colored toys, soothing music

45
Q

what are infants susceptible to?

A

URI, heat loss, dehydration

46
Q

Type of play for toddlers

A

Parallel

47
Q

language development- toddlers

A

50-300 words by 2 yo
Echolalia and telegraphic speech

48
Q

Age-appropriate toys for toddlers

A

Push-pull toys, messy play, books, blocks/balls, filling/emptying containers. Thick crayons, large piece puzzle

49
Q

Erikson’s theory for toddlers

A

Autonomy vs. shame and doubt

50
Q

Erikson’s components for toddlers

A

Egocentrism
Ritualism
Independence
Negativism
Temper tantrums
Regression

51
Q

Egocentrism

A

Unable to see things from other’s perspectives

52
Q

Ritualism

A

Like consistency and routine

53
Q

Cognitive development for toddlers (Piaget)

A

Sensorimotor into preoperational
-Symbolic thought (pretend object represents something else-broomstick=horse)
Domestic mimicry
Limited attention span

54
Q

Speech patterns for toddlers

A

Echolalia and telegraphic speech

55
Q

Safety/ anticipatory guidance/education for parents for toddlers

A

Car seat rear facing until age 2 in backseat
Childproof environment
Establishing independence and following boundaries

56
Q

Nutrition/eating habits for toddlers

A

Weaning from bottle 12-15 mo
Food jags
Picky eaters
Finger foods
Iron deficiency
Physiologic anorexia
Ritualism

57
Q

Negativism

A

Toddlers- “No” and “Mine”- expresses independence

58
Q

Regression

A

Reverting backwards in behaviors or stages in times of high stress

59
Q

Transitional objects-toddlers

A

Teddy bears, blankets, etc for comfort and soothing-familiarity. Use in care

60
Q

car seat safety/education-toddler

A

Rear facing until the age of two in back seat

61
Q

Preschool fears (what and why)

A

Dark, pain, unknown, “monsters”, losing parts of their body/mutilation, hospitalization, nightmares common- super active imagination

62
Q

Piaget’s theory for preschoolers

A

Preconceptual into intuitive

63
Q

Piaget’s major tasks for preschoolers

A

Magical thinking
Imaginary friends
Animism
Time (in relation to daily events)

64
Q

Language development-preschooler

A

2,000 word vocabulary 5 word sentences

65
Q

Magical thinking-preschoolers

A

thoughts are all powerful; certain actions they take will include the world around them (step on a crack…pink blanket keeps monsters away)

66
Q

Animism

A

Giving life-like qualities to inanimate objects (ToyStory)

67
Q

Types of play- preschooler

A

Associative- begin to share,acknowledge, copy, and work with one another yet do not share same focus- not cohesive

68
Q

Age-appropriate toys-preschoolers

A

Play pretend, dress-up, reading books, messy play, arts and crafts, puzzles, riding tricycles

69
Q

Appropriate atraumatic care- preschooler

A

Story telling, puppets, simple terms, allow choices, imaginative play, speak honestly

70
Q

Health promotion- sleep and rest, dental health for preschoolers

A

Need 12 hr/day
Bedtime rituals, resist bedtime- nightmares significant due to magical thinking
Dental health Q 6 mo baby teeth completely in by 3
Lose teeth 5-6
Trauma to teeth common

71
Q

Cognitive development (Piaget’s major tasks)- school-age

A

concrete operations

72
Q

Piaget’s major tasks for school-age children

A

principle of conservation, classify and sort objects, reversibility, can tell time

73
Q

Erickson’s theory for school-age

A

industry vs. inferiority

74
Q

reversibility-school age children

A

numbers or objects can be changed or returned to their original state

75
Q

classify and sort objects-school age children

A

common for them to start a “collection””

76
Q

Developmental concern topics-school age

A

bullying, tobacco and alcohol use, school refusal, TV/video games, internet

77
Q

Relationships/peers groups school age

A

awareness of themselves in relation to others, feeling accepted/not different is very important, peer pressure and conformity begins/BFFs
very interested in how other view their body

78
Q

Nutrition promotion/obesity for school age

A

risk factors: HEAVY
(high caloric diet, exercise lacking, accessibility to healthy foods limited, view food as a way to deal with stress, and your genetics/family dynamics)
caloric needs decrease

79
Q

Bullying awareness/signs of bullying school age

A

unexplained injuries/missing items, fakes illness (to avoid school), poor grades, behavioral changes(depressed, angry, SI)

80
Q

Assessment of systems (how they change) school age

A

-girls usually taller than boys
-sex characteristics appear in middle school age.
-brain growth complete by 10. -frontal sinuses by 7.
-abdominal breathing to diaphragmatic breathing
-20 baby teeth replaced by 28-32 permanent teeth
-screened for scoliosis
growth plates begin to close

81
Q

Play types for school age

A

cooperative

82
Q

Age-appropriate toys for school age

A

arts and crafts, build simple models, collect rocks and cards, board games, video games

83
Q

hospitalization and illness/care of hospitalized adolescent

A

increased ability to understand cause and effect
-perceptions of illness severity based on degree of body image changes
-provide factual information
-include in planning of care
-encourage contact with peer group

84
Q

Erikson’s theory-adolescents

A

identity vs role confusion

85
Q

piaget’s theory-adolescents

A

formal operations
-abstract thinking (possibilities and hypothetical situations, less egocentric)
-can view selves as invincible->risk taking behaviors

86
Q

Assessment of systems (how do they change, boys vs girls)-adolescents

A

girls: puberty=9-10, grow 2-8 in and gain 15-55lb, rapid before period and ceases 2-2.5 years after first period, fat deposit inc
boys: puberty=10-11, grow 4-12 in and gain 15-65 lbs stops growing 18-20 yrs, muscle mass inc

87
Q

Assessment/puberty order of maturation

A

Girls:breast development–>pubic hair–>axillary hair–> menstruation
boys: testicular enlargement->pubic hair growth-> penile enlargement->axillary hair growth->facial hair–>vocal changes

88
Q

Hormones of puberty

A

GnRH, FSH,LH, Estrogen, testosterone , progesterone

89
Q

Safety and developmental concerns (leading causes of death/risk factors, Suicide)- adolescents

A

unintentional injuries=leading cause of death
MVA=leading cause of injury death
poisoning-due to opioid overdose-2nd leading cause of injury death
deaths from firearms 15-19 y/o rising
suicide=2nd leading cause of death-monitor for changes in mood and self harm:
-poor school performance
-lack of interest in things that were of interest in the past
-social isolation
-disturbances in sleep/appetite
=expression of SI

90
Q

Nutrition requirements (important vitamins/minerals)- adolescents

A

average 2,000 calories
calcium1300mg/daily
males 11mg daily iron
females 15mg daily iron
bulimia and anorexia common (self image/body image and peer approval)

91
Q

Health promotion-sexual health- adolescents

A

contraception and safe sex practices- risk for STIs and pregnancy

Peds/OB (11 decks)

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