Peds Final exam

Question 1

Types of play for all ages

Answer 1

Infant - solitary

Toddler - parallel

Pre school - associative

School age - cooperative

Question 2

Infant nursing care

Answer 2

Play soothing music, Therapeutic hugging, speak in calming tone

Question 3

infant toys

Answer 3

Mobiles, Noise-making, Soft toys, Large blocks

Question 4

Toddler nursing care

Answer 4

Approach carefully, use toys/books to distract, parallel play with them

Question 5

Toddler toys

Answer 5

Push-pull toys, Lg-piece puzzles, Balls

Question 6

pre-school nursing care

Answer 6

imagination (bear gets a shot)

allow choices

Question 7

Pre-school games

Answer 7

Art & crafts, Playing pretend, Books

Question 8

school age nursing care

Answer 8

Encourage questions, Use diagrams, illustrations

Question 9

school age games

Answer 9

Board games, Action figures, Models, Video games

Question 10

Adolescent nursing care

Answer 10

Respect privacy, Do not force to talk, Use appropriate medical terms

Question 11

Adolescent toys

Answer 11

Reading, Listening to music, peer time

Question 12

newborn weight gain

Answer 12

Doubles by 5 months

Triples by 1 year

Question 13

Newborn height gain

Answer 13

1 inch per month the first 6 months

Birth length increases about 50% by 12 months of age

Question 14

Head circumference

Answer 14

Rapidly increases during first six months and about 10cm by 12 months of age

Question 15

infant respiratory

Answer 15

Lack of IgA in mucosal lining of upper respiratory tract
Narrow nasal passages
Trachea and chest wall more compliant
Bronchi and bronchioles are shorter and narrower
Larynx more funnel shaped
Tongue larger
Significantly fewer alveoli

Question 16

4 months

Answer 16

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

Question 17

6 months

Answer 17

Rolls from back to front
Holds bottle

Question 18

9 months

Answer 18

Sits unsupported
Creeps on hands/knees
Has crude pincer grasp

Question 19

12 months

Answer 19

Sits down from standing
Walks with one hand/on own
Builds 2 block tower
Makes simple marks on paper
Feeds self with cup & spoon

Question 20

Breastfeeding

Answer 20

Provides a complete diet for infants during the first 6 months

Iron supplementation for infants breastfed after age 4 months.

Question 21

Bottle Feeding

Answer 21

Formulas are designed to imitate breast milk and provide 20 kcal/oz

Iron-fortified formulas (10-12mg Fe+ per liter) should be used

Question 22

when can an infant drink cow milk?

Answer 22

after 1 year

Question 23

Progressing to Solids

Answer 23

Around 4-6 months of age, infants can be assessed for readiness for solid foods

Extrusion Reflex must be extinguished (4-6 months) so that the spoon can be accepted;

Enzymes to digest food are not in sufficient quantity until 4-6 months

Question 24

which solids to start with

Answer 24

Iron-fortified infant cereal are first foods
(rice-cereal, barley, oatmeal)

Question 25

how often do we introduce new food

Answer 25

One new food every 3-5 days; vegetables first then fruits

Question 26

toddler nutrition facts

Answer 26

Food should be room temp & soft, and cut into small, bite-size pieces; generally prefer finger foods due to increasing autonomy

Question 27

toddler Physiologic Anorexia

Answer 27

growth rate slows, decreasing the need for calories, protein, and fluid as compared to infancy

Question 28

toddler food jags

Answer 28

prefers certain foods for time periods, then not wanting for another time

Question 29

toddler Ritualism

Answer 29

same dish, cup or spoon, or will not eat

Question 30

Toddler LANGUAGE DEVELOPMENT

Answer 30

Ability to comprehend and understand speech (receptive language) is far greater than the number of words they can say (expressive language) 50-300 words by age 2

Question 31

toddler type speech

Answer 31

Echolalia is a typical speech pattern (repeating what others say) Telegraphic Speech: only few words to get point across; 2 words into simple sentence

Question 32

car safety

Answer 32

Rear facing with harness straps and clip in back seat After age 2, forward-facing seat in back seat of car If appropriate rear seat unavailable, airbag must be disabled

Question 33

pre school overview

Answer 33

imagination/magical thinking animism - life qualities to inanimate objects FEARS- loud noises dark places or hospitals

Question 34

School aged overview

Answer 34

lots of self conscious feelings peer pressure onset of puberty girls 9-10 & boys 10-11

Question 35

physical differences with school aged child

Answer 35

HR decreases, BP increases, RR decreases; Abdominal breathing disappears + replaced by diaphragmatic breathing Frontal sinuses developed by age 7 Tonsils decrease in size but remain large 20 baby teeth replaced by 28-32 permanent teeth (except wisdom teeth)

Question 36

Adolescent 411

Answer 36

obesity has tripled in past 30 years Anorexia and bulimia are common average calorie count is 2000 During times of rapid growth, additional calcium, iron, protein and zinc are needed

Question 37

Hypoxia/Hypoxemia (Respiratory Distress)

Answer 37

Tachypnea often 1st sign cyanosis, nasal flaring, accessory muscle use, grunting on expiration, stridor on inspiration

Question 38

Hypoxemia Management

Answer 38

O2 Less than 91% require nursing intervention; less than 86% is a life-threatening emergency Chest Physiotherapy: Promotes mucus clearance by mobilizing secretions Suctioning Removal of mucus plugs or secretions via bulb syringe, yankauer, or suction catheter

Question 39

Asthma Labs

Answer 39

CBC: ↑ WBC, ↑ Eosinophils ABG: ↑ CO2, ↓O2 Allergy/RAST Testing: Identify triggers SpO2: ↓ (normal if mild episode) CXR: Hyperinflation/infiltrates PFT: overall lung function - not for acute PIFR - used daily + for acute

Question 40

cystic fibrosis tx

Answer 40

Chest PT w/postural drainage Aerosol therapy + 02 fat-soluble vitamins A, D, E, and K Administer pancreatic enzymes within 30 minutes of eating a meal or snack For infants, open capsule and sprinkle on an acidic-type food (applesauce)

Question 41

cystic fibrosis Dx

Answer 41

Sweat Chloride Test: Chloride > 40 mEq/L in infants (<3 mo) >60 mEq/dL for all other ages. Sodium >90 mEq/L

Question 42

CROUP aka

Answer 42

Laryngotracheobronchitis

Question 43

Croup assesment findings

Answer 43

"barking cough”, inspiratory stridor, tachypnea, respiratory distress.