UNIT 6 Growth and Development

Question 1

Does family have an influence on the Child’s growth and development? Would they’re influence fall under primary or secondary social groups?

A. No
B. Yes

Answer 1

B. Yes

Primary

Question 2

What is the objective of Family-centered care in Pediatric Nursing?

Answer 2

• enabling – families are given opportunity to display their caring abilities and gain new ones
• empowerment – families are given the ability to maintain or acquire sense of control and make positive
  changes.

Question 3

What is the objective of providing Atraumatic care to a pediatric patient?

Answer 3

 Prevent separation from parents
 Promote sense of control
 Minimize bodily injury

Question 4

What is the role of Pediatric Nurse

Answer 4

Role of Pediatric Nurse
 Therapeutic relationship
 Family advocacy
 Health promotion and teaching
 Injury prevention
 Family support

Question 5

Which of the following has an influence on child health? SELECT ALL THAT APPLY

A. Social Roles (PRIMARY & SECONDARY)
B. Self esteem & Culture (Cultural background)
C. Communities (Environment)
D. Peer Groups(friends
E.Cultural & Religious Health Beliefs & Practices

Answer 5

All

Question 6

Social Roles

Primary vs Secondary

Question 7

Self Esteem and Culture

Question 8

Communities

Question 9

Peer Groups

Question 10

Cultural and Religious beliefs

Question 11

What is the definition of Growth?

Answer 11

 Increase in number and size of cells as they divide and synthesize new proteins

 Physiological size (height, weight, bone length, etc.

Question 12

What is DEVELOPMENT

Answer 12

 DEVELOPMENT

 Advancement from lower to more advanced stage of complexity; increased
capacity through growth, maturation, and learning

 Acquisition of skills and functioning

Question 13

What is the importance of sequential trends

Answer 13

sequence:
a particular order in which related events, movements, or things follow each other.

example “ first the baby must know how to crawl before they walk”

 Based on the concept that each child will normally pass through each stage of
growth and development in a predictable sequence

 Universal and basic to all human beings, but each person accomplishes these
individually

Question 14

What are the two directional patterns of growth?

Answer 14

Cephalocaudal
 Head to toe direction

Proximodistal
 Near to far
 Midline to peripheral concept

Question 15

Which of the following can effect the rate and time growth and development in children?

A. Single mother
B. Malnutrition
C. Single father
D. Non-existence grandparents

Answer 15

B. Malnutrition

Severe illness or malnutrition will affect the rate of both growth and
development

Question 16

Does growth only occur externally in children?

A. Yes
B. No

Answer 16

B. No

Growth occurs both internally and externally

Question 17

When does Dramatic growth take place? SELECT ALL THAT APPLY

A. birth to 4 years old
B. birth to 3 years old
C. year 12 during puberty
D. year 10 to year 18
E. birth to 18 years of age

Answer 17

A. birth to 4 years old
C. year 12 during

Question 18

When does most of Neurological maturation take place?

A. before birth
B. after birth
C. from birth to year 20
D. year 20 to year 40

Answer 18

A. before birth

most occurs before birth

Periods of rapid neurological growth between 15-29 weeks gestation

 Rapid growth from birth to 1 year; continues through early childhood

 More gradual rate through childhood into adolescence

Question 19

What is referred to as the work of children?

Answer 19

PLAY

Through the universal medium of play, children learn what no one can teach them.
They learn about their world and how to deal with this environment of objects, time, space, structure, and people.

They learn about themselves operating within that environment—what they can do, how to relate to things and situations, and how to adapt themselves to the demands society makes on them.

Play is the work of children. In play, children continually practice the complicated, stressful processes of living, communicating, and achieving satisfactory relationships with other people.

Question 20

What is the function of Sensorimotor development (PLAY) PG 702

Answer 20

Active play is essential for muscle development and serves a useful purpose as a release for sur- plus energy.

SENSES PLAY

Through sensorimotor play, children explore the nature of the physical world. Infants gain impressions of themselves and their world through tactile, auditory, visual, and kinesthetic stimulation.

Question 21

What is the function of Intellectual development (PLAY)

Answer 21

Through exploration and manipulation, children learn colors, shapes, sizes, textures, and the significance of objects. They learn the signifi- cance of numbers and how to use them; they learn to associate words with objects; and they develop an understanding of abstract concepts and spatial relationships, such as up, down, under, and over.

EXAMPLES

Activities such as puzzles and games help them develop problem-solving skills. Books, stories, films, and collections expand knowledge and provide enjoyment as well.

Question 22

What is the function of Creativity (PLAY)

Answer 22

Children can experiment and try out their ideas in play through every medium at their disposal, including raw materials, fantasy, and exploration.

Creativity is stifled by pressure toward conformity; therefore striving for peer approval may inhibit creative endeavors in school-age or adolescent children.

Question 23

What is the function of Self-awareness (PLAY)

Answer 23

*Children learn who they are and their place in the world. They become increasingly able to regu- late their own behavior, to learn what their abilities are, and to compare their abilities with those of others.

*Through play, children can test their abilities, assume and try out various roles, and learn the effects that their behavior has on others.

*They learn the sex role that society expects them to fulfill, as well as approved patterns of behavior and deportment.

Question 24

What is the function of Therapeutic value (PLAY)

Answer 24

Play is therapeutic at any age (Fig. 28.10). In play, children can express emotions and release unacceptable impulses in a socially acceptable fashion.

Children reveal much about themselves in play. Through play, children can communicate to the alert observer the needs, fears, and desires that they are unable to ex- press with their limited language skills.

Question 25

What is the function of Moral value (PLAY)

Question 26

Unoccupied play (INFANT)

Answer 26

child is not mobile and has random movements with
no purpose.

Question 27

Solitary Play (INFANT/TODDLER)

Answer 27

play alone with their interest centered on their
own activity

PLAYING BY ONESELF

Question 28

Onlooker play (infant/toddler)

Answer 28

Looking to play observing (with others)

Onlooker play (infant/toddler) -watch what other children are doing but do not
make any attempt to enter the play activity

Question 29

Parallel play (toddler)

Answer 29

children play independently but with other children

playing with toy indecent sitting by people (helps with social interaction)

Question 30

Associative Play (preschooler)

Answer 30

(preschooler)-children play together with no group goal (NOT GOAL ORIENTED)

starts making friends

Question 31

Cooperative play (school-age)

Answer 31

play is organized and children play in a group with other children working to complete a goal (GOAL ORIUENTED)

*TEAM WORK
*ORGANIZED SPORTS
*HELPS WILL WORK TOGETHER

Question 32

How do you communicate with an infant? 1-3 YEARS OLD

Answer 32

by acknowledging and responding to their non-verbal cues

such as cooing and crying

respond to non-verbal cues - cannot understand verbal ones yet. Cooing and
crying are their main forms of communication

Question 33

How you you communicate with a toddler/ Early Childhood (Preschool) 1-3 OR 3-6 YEARS OLD

Answer 33

By highlighting how they will be affected if this(something) is not done

ex- You will not be able to play with your friends or mom if you don’t take this shot

Early Childhood: egocentric, respond best when you discuss how THEY will be
effected. Experience of others has no interest to them.

Question 34

How do you communicate with a school age patient? 6-12 YEARS OLD

Answer 34

School-Age: want explanations and reasons for everything. Need to know why

Question 35

How do you communicate with an Adolescent (12-18 years old)?

Answer 35

Adolescence: confidentiality is important

example “as a nurse you ask them if they are sexually active and they respond truthfully , and they ask you to not tell they’re parents”

Question 36

How is a Physical Assessment normally done in what sequence?

A. toes to eyes
B. Toe to head
C. fingers to head
D. head to toe

Answer 36

D. head to toe

Question 37

How you successfully assess the ears of the 12 year old child?

A. pull pinna up and back
B. pull pinna down & back
C. straighten the ear canal
D. use a penlight for clarity of ear canal

Answer 37

A. pull pinna up and back

Question 38

What are the 4 common pain scales used from birth to adulthood?

Answer 38

*NIPS
*FLACC
*Wond Baker faces
*Numeric Scale (0-10)

Question 39

You suspect that your 2 day old newborn patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?

A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)

Answer 39

A.NIPS

(facial expression, cry, breathing pattern, arms, legs, state of arousal)- neonates
<2mo

Question 40

You suspect that your 4 month old patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?

A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)

Answer 40

B.FLACC

(Face, legs, activity, cry, consolability)- infants >2mo

Question 41

You suspect that your 3 year old patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?

A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)

Answer 41

C.Wond Baker faces

Question 42

You suspect that your 5 year old patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?

A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)

Answer 42

D.Numeric Scale (0-10)

Numeric Scale (0-10)- 8 years and older. May be used as early as 5 (as long as they
can count and understand values of the numbers

Question 43

Non-pharm management of of pain for Pediatrics

Answer 43

Containment
 Ex: Blanket rolls to provide a “nest”

 Positioning
 Ex: Swaddling
 Sucking
 Ex: Providing pacifier

 Kangaroo care
 Ex: Skin to skin contact with a parent

 Distraction
 Relaxation
 Music/pet/art therapy

Question 44

Pharm management for pain for pediatrics

Answer 44

For mild to moderate:
 Acetaminophen
 NSAIDS (Ex: Ibuprofen)

 For moderate to severe:
 Opioids (morphine, dilaudid, fentanyl)

 Adjuvant:
 Antianxiety: Diazepam (valium) & midazolam (versed)
 Tricyclic antidepressants (amitriptyline)
 Antiepileptics (gabapentin, clonazepam)
 Stool softeners/Laxatives
 Antiemetics
 Diphenhydramine
 Steroids

Question 45

benefits of adjuvant pain management

Answer 45

enhance the effects of pain medications, treat concurrent symptoms, and provide analgesia for other types of pain

Question 46

What is a common adverse effect of Morphine

Answer 46

Respiratory depression
Severe Hypotension

Question 47

What’s a common side effect of Morphine?

Answer 47

Constipation
Drowsiness

Question 48

Reaction to hospitalization - INFANT

Answer 48

*Reliant on parent
 Assign primary nurse, stick to routine

Question 49

Reaction to hospitalization- TODDLER

Answer 49

*Hospitalization disrupts autonomy; may cause regression
 Follow daily routin

Question 50

Reaction to hospitalization- PRESCHOOL

Answer 50

*Egocentric; may view hospitalization as punishment. Fear body mutilation
 Need reassuranc

Question 51

Reaction to hospitalization- SCHOOL AGE

Answer 51

*Strive for independence, fear abandonment, injury and death
 Need reassurance

Question 52

Reaction to hospitalization-ADOLESCENT

Answer 52

*Struggle for independence; hospitalization may cause anger
 Benefit from contact with peers

Question 53

Complications of Obesity in Pediatrics

Answer 53

consequences/Complications:
elevated blood cholesterol,
high blood pressure,
respiratory disorders,
orthopedic conditions,
cholelithiasis,
fatty later disease,
cancer,
Type II diabetes,
poor body image,
low self-esteem,
social isolation,
depression,
and rejection.

Question 54

What is the difference between being overweight and obese?

Answer 54

Obese

Increase in body weight resulting from an excessive accumulation of body fat relative
to lean body mass.

 Overweight=BMI between 85th-95th percentile
 Obesity= BMI greater than or equal to 95th percentile

Question 55

Risk factors of Obesity

Answer 55

Influencing factors:
1. Environmental Conditions
 Abundance of food, limited access to low-fat foods, reduced or minimal activity,
snacking, family/cultural views, socioeconomic status
2. Community Factors
 Unsafe neighborhoods, increased availability of fast food restaurants, overzealous
food advertising
3. Institutional factors
 School lunches, vending machines, allowing students to leave for lunch
4. Physical Inactivity
 Video games, TV
5. Psychologic factors
 Positive reinforcement and comfort

Question 56

Failure to thrive

Answer 56

 Weight (and sometimes height) below the 5th percentile for age

 Risk Factors & Causes:
 Organic: Preemie, IUGR, CHD
 Nonorganic: Poverty, neglect, knowledge deficit

 Clinical manifestations
 Growth/developmental delays
 Withdrawn, apathetic
 Minimal smiling, avoidance of eye contact

 Treatment: reverse the cause

Question 57

 Immunization reactions

Answer 57

 Immunization reactions
 Immunizations among the safest and most reliable drugs available

 Serious reactions rare; mild side effects more common
 Side effects usually occur within a few hours or days
 Local tenderness, erythema, swelling at injection site
 Low-grade fever
 Drowsiness, eating less, prolonged crying

 Treatment of side effects- cold compress to area, comfort measures

Question 58

Should you get consent before administering a vaccine?

Yes

No

Answer 58

Yes

 Administration
 Must have consent signed
 VIS provided to parent

Question 59

Contraaindications of vaccine

Answer 59

Contraindications for vaccines
 Severe febrile illness
 Known allergy to vaccine

 ** minor illness such as a cold is not a contraindication**

 Severely immunocompromised children should not receive live viruses

 Children receiving immunoglobulin therapy should not get MMR and varicella vaccines for minimum of 3 months