Peds ch. 5-6
B,D,E
A 13-month-old toddler is being discharged from the hospital. Which potential health risks should the nurse address with the parents? (select all that apply) A. Elevated cholesterol levels B. Poisoning C. Peer pressure D. Burns E. Falls
animism
A hospitalized 5 year old thinks that the IV pole is a tall, skinny monster that is going to tie him or her up. This is an example of a. animism b. centration c. egocentrism d. magical thinking
BCE (sunscreen should be every 2 hrs; avoid sun between 12-4)
A mother of an 8-month-old boy states that the family is vacationing at a beach house for the next 2 weeks. Which information should the nurse educate the mother about in relation to sun exposure? (Select all that apply) A. Reapply sun lotions to all exposed skin every 4 to 6 hours. B. Use sun lotions that protect against both UVA and UVB rays. C. Have the baby wear child-sized sunglasses whenever he is in the sun. D. Avoid exposing the child to the sun between the hours of 12 and 2 PM. E. Dress the child in light-weight clothing that covers the majority of his skin
Our baby loved to play with his crib gym, but we took it away from him.
A nurse is cautioning the parents of an 4-month-old about safety? Which statement indicates an understanding of safety by the parents? A."Our baby loved to play with his crib gym, but we took it away from him." B."We just bought a soft mattress so our baby will sleep better." C."Our baby really likes sleeping on a fluffy pillow we just got for him." D.We just bought a child-safety gate that folds like an accordion."
C,D E
A nurse is planning diversionary activities for children on an inpatient unit. Which play activities should be used? (Select all that apply) A.Building simple models. B.Working with clay. C.Filling and emptying containers. D.Playing with blocks. E. Looking at picture books.
A,B,D
A nurse is talking to the parents of a 6-month-old about gross motor development. Which skills are expected findings in the next 3 months? (SATA) A.Rolls from back to front. B.Bears weight on legs. C.Walks holding on to furniture. D.Sits unopposed. E.Sits down from standing position.
An infant screaming when left with grandparents is an abnormal reaction for this age.
A parent of an 8-month-old infant tells the nurse that the baby cries and screams whenever he is left with his grandparents. The nurse's response is based on which observation? a. The infant is most likely spoiled. b. An infant screaming when left with grandparents is a normal reaction for this age. c. An infant screaming when left with grandparents is an abnormal reaction for this age. d. The grandparents are not responsive to the infant.
initiative
According to Erikson, preschoolers who are encouraged to try new things and be creative will develop a sense of a. autonomy b. initiative c. industry d. integrity
27 months
Age of success for toilet training is ___ __
3
All 20 deciduous teeth should be present by ______ years of age.
Pincer grasp
An 11-month-old infant enjoys picking up Cheerios one by one with the thumb and index finger and throwing them on the floor. This is an example of: A.Egocentrism. B.Pincer grasp C.Oral gratification D.Reflexive activity
crackers
An appropriate "finger food" for an 11-month-old infant is: A.Crackers. B.Raisins. C.Lollipops. D.Popcorn.
10 months
An infant is expected to be able to say "mama" and "dada" with meaning by age: a. 4 months. b. 6 months. c. 10 months. d. 14 months.
Let Ashley watch other children play with a dog.
Ashley, age 4 years, is afraid of dogs. The nurse should recommend which to her parents to help Ashley cope with this fear? a. Keep Ashley away from dogs. b. Buy Ashley a stuffed dog toy. c. Force Ashley to touch a dog briefly. d. Let Ashley watch other children play with a dog.
6-7 months
Birth weight should double by
2-3
Children should reach half their adult height by ___________ years of age.
rolls from back to side grasps a rattle turns eyes and head towards sound stuff starts going into mouth separation anxiety starts between 4 to 8 months palmar reflex disappears
Clinical Milestones: 4 months
rolls over in both directions plamar grasp in dominant hand holds bottle begins to sit up Stranger anxiety starts from 6 to 9 months
Clinical Milestones: 6 months
smiles spontaneously open hands lifts head off mattress
Clinical milestones: 2 months
holds cup with both hands builds a tower of 3 to 4 blocks turns pages of books places block in cup says 150 to 200 single words walks well and creeps up stairs
Critical milestones 15-18 months
removes one article of clothing uses fork or spoon 400 word vocabulary with 2-3 word sentences Runs, walks up/down steps Throws/kicks ball tower of 6 to 7 blocks
Critical milestones 2 years:
brushes teeth with help puts on clothes jumps good hand/eye coordination gender identity
Critical milestones 3 years:
Skip, hop, jump rope and balance on one foot Walk backwards Know 2 adjective Balances in each foot for 1 second
Critical milestones 4 to 5 years
Places objects in containers picks up 2 cubes but cant stack mama and dada specific 2-3 words specific sits from standing about 29 inches in length and 43-45 head circumference
Critical milestones: 12 months
Crude pincer grasp feeds self (finger foods) dominant hand preference sits up without support pulls to standing responds to own name object permanence
Critical milestones: 9 months
don't mix cereal in bottles don't give mixed foods to start avoid salt and sugar avoid honey
Don'ts related to infant feeding
5
During early childhood, the average weight gain is ______ pounds per year.
10-12 months
Fine motor skills such as the pincer grasp develop by
6 to 10 months
First teeth by
using a transitional object
For a toddler with sleep problems, the nurse should suggest: a. restricting stimulating activities. b. using a transitional object. c. varying the bedtime ritual. d. explaining away fears.
restricting stimulating activities
For a toddler with sleep problems, the nurse should suggest: a. restricting stimulating activities. b. using a transitional object. c. varying the bedtime ritual. d. explaining away fears.
expect 6 wet diapers per day introduce cup at 6 months limit juice to 6 oz per day only milk in bottle
Guidelines for fluid intake
hearing
If a toddler has delayed speech, check
General Measurements (percentile rank) Physical activity (gross or fine motor delays) Oral Health (Calcium intake and tooth development) ] Developmental milestone immunizations
Major health concerns of infancy:
When Michael learns to roll over you must supervise him whenever he is on a surface from which he might fall.
Michael, age 4 months, is brought to the clinic by his parents for a well-baby checkup. Which recommendation about injury prevention should the nurse include at this time? a. Keep doors of appliances closed at all times. b. Never use baby powder on Michael because it can be aspirated into his lungs. c. Do not permit Michael to chew paint from window ledges because he might absorb too much lead. d. When Michael learns to roll over you must supervise him whenever he is on a surface from which he might fall.
Tylenol
Most common drug for ingestion poisoning is
Diced peaches, mashed potatoes, spaghetti.
Ms. Coleon gave a 24-hour recall for her 18-month-old son, Racy. As the nurse is alert to common causes of choking, she would consider which groups of foods as safest for toddlers like Racy. A.Apple quarters, green beans, chicken noodle casserole. B.Grapes, carrot strips, macaroni and cheese. C.Diced peaches, mashed potatoes, spaghetti. D.Watermelon chunks, cheese-stuffed celery, sliced hotdogs
Control of anal and urethral sphincters
Myelination of the spinal cord is almost complete by 2 years of age. As a result of this, what can gradually be achieved by the toddler? a. Visual acuity of 20/20 b. Throwing a ball without falling c. Slowing of gastrointestinal transit time d. Control of anal and urethral sphincters
Food Warmth and comfort oral gratification environmental stimulation Self- discovery
Needs in the first year of life:
storing all poisonous substances in a locked cabinet
Poison prevention in toddlers can best be done by: a. consistently using safety caps. b. keeping ipecac syrup in the home. c. storing poisonous substances out of reach. d. storing all poisonous substances in a locked cabinet..
Light switches and dry cleaner bags
Potential dangers for toddlers:
fluids in addition to breast milk are not needed.
The mother of a 3-month-old breastfed infant asks about giving her baby water because it is summer and very warm. The most appropriate recommendation by the nurse is that: a. fluids in addition to breast milk are not needed. b. water should be given if the infant seems to nurse longer than usual. c. water once or twice a day will make up for losses resulting from environmental temperature. d. clear juices would be better than water to promote adequate fluid intake.
Iron-fortified cereals
The nurse is caring for an infant who will soon eat solid foods. The RN should inform the parent to introduce which foods first into the infant's diet? A. Stained yellow vegetables B. Iron-fortified cereals C. Pureed fruits D. Whole milk
5 years
The nurse would expect that most children would be using sentences of 6 to 8 words by age: a. 18 months. b. 24 months. c. 3 years. d. 5 years.
3 years
The nurse would expect that most children would be using sentences of 6 to 8 words by age: a. 18 months. b. 24 months. c. 3 years. d. 5 years.
He is old enough to feed himself. Let's think of ways to make the mess more tolerable.
The parent of 12-month-old Chris says to the nurse, "He pushes the teaspoon right out of my hand when I feed him. I can't let him feed himself; he makes too much of a mess." The most appropriate response by the nurse is: a. "It's important not to give in to this kind of temper tantrum at this age." b. "Maybe you need to try a different type of spoon, one designed for children." c. "It's important to let him make a mess. Just don't worry about it so much." d. "He is old enough to feed himself. Let's think of ways to make the mess more tolerable."
characteristic of cognitive development at this age (Classification skills are developed during the school-age years. This age group enjoys sorting objects according to shared characteristics.)
The parents of 9-year-old twin children tell the nurse, "The twins have filled up their bedroom with collections of rocks, shells, stamps, and cars." The nurse should recognize that this is: a. indicative of giftedness. b. indicative of typical "twin" behavior. c. characteristic of cognitive development at this age. d. characteristic of psychosocial development at this age.
imaginary playmates are normal and useful at this age
The parents of a 4-year-old girl are worried because she has an imaginary playmate. The nurse's response is based on the knowledge that: a. a psychosocial evaluation is indicated. b. imaginary playmates are normal and useful at this age. c. imaginary playmates are abnormal after about age 2 years. d. an evaluation of possible parent-child conflict is indicated
Start putting her to bed while still awake.
The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem? a. Put her in her parents' bed to cuddle. b. Let her cry herself back to sleep. c. Start putting her to bed while still awake. d. Give her a bottle of formula instead of breastfeeding her so often at night.
there is no need to restrain nonnutritive sucking during infancy.
The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. The nurse's response is based on: a. a pacifier should be substituted for the thumb. b. thumb-sucking should be discouraged by age 12 months. c. thumb-sucking should be discouraged when the teeth begin to erupt. d. there is no need to restrain nonnutritive sucking during infancy.
weak abdominal muscles
The toddler's pot belly appearance is caused by
1
Time out should be ___ min for year of life
have limited language ability
Toddlers have temper tantrums because they a. have limited language ability b. are not getting enough attention c. are unable to distinguish right from wrong d. have poor parent-child attachments
offer simple choices encourage new skills simple and minimal rules reduce opportunities for "no" answers
Ways to support autonomy:
parents should determine exactly what the child wants to know before answering a question about sex.
When preparing parents to teach their children about human sexuality, the nurse should emphasize: a. a parent's words may have a greater influence on the child's understanding than the parent's actions. b. parents should determine exactly what the child wants to know before answering a question about sex. c. parents should avoid using correct anatomic terms because they are confusing to the preschooler. d. parents should allow children to satisfy their sexual curiosity by playing "doctor."
b,d,e
Which are language and cognitive milestones for a 15-18 month old? a. understands cause and effect b. understands simple directions c. points to 6 body parts d. ponts to familiar objects e. uses holographic speech f. uses egocentric language
It is paroxysmal abdominal pain or cramping manifested by episodes of loud crying.
Which best describes colic? a. It is usually the result of poor or inadequate mothering. b. The infant experiences periods of abdominal pain that result in weight loss. c. Infants older than 6 months of age experience periods of abdominal pain and crying. d. It is paroxysmal abdominal pain or cramping manifested by episodes of loud crying.
Able to grasp object voluntarily
Which characteristic best describes the fine motor skills of a 5-month-old infant? a. Neat pincer grasp b. Strong grasp reflex c. Able to grasp object voluntarily d. Able to build a tower of two cubes
a,b,c
Which indication(s) suggest that a 27 month old is ready to begin toilet training? a. The child is able to sit and squat. b. The child notices when the diaper is wet. c. The child can remove own clothing d. The child has a difficult time staying dry during the night. e. The child relapses often for long periods of time
Putting the infant to sleep in the supine position
Which intervention lowers the risk of sudden infant death syndrome (SIDS)? a. Smoking near the infant b. Putting the infant to sleep in the supine position c. Making sure the infant is kept very warm while sleeping d. Having the infant sleep with parents instead of alone in a crib
Give the child a frozen teething ring to relieve inflammation.
Which is the most appropriate recommendation for relief of teething pain? a. Rub gums with aspirin to relieve inflammation. b. Apply hydrogen peroxide to gums to relieve irritation. c. Give the child a frozen teething ring to relieve inflammation. d. Have the child chew on a warm teething ring to encourage tooth eruption.
Pots are placed on the front burners of the stove
Which of the following represents a burn hazard in a toddler's home? a. Pots are placed on the front burners of the stove b. The fireplace is covered with a screen that attaches to the wall. c. Electrical outlets are covered with plastic socket protectors. d. The hot water temperature is set at 110F.
We always put our cleaning supplies on the shelves above the sink.
Which statement indicates the parents of a toddler need more information about toddler safety? A."We always put her in her car seat, even if we only drive down the street." B."We never let her play outside alone." C."We always put our cleaning supplies on the shelves above the sink." D."One of us stays with her the entire time she is in the bathtub."
ritualism
Which type of conceptual thinking provides a toddler with a sense of security? a. animism b. egocentrism c. negativism d. ritualism
Explain to the child why he is in the hospital.
While a 5-year-old is hospitalized for an appendectomy, he tells the nurse that he is in the hospital because he was bad. The nurse should: A.Suspect child abuse and report it to the authorities. B.Question the parents about their discipline methods. C.Ignore the comment. D.Explain to the child why he is in the hospital.
Musculoskeletal support of head is insufficient.
Why are infants particularly vulnerable to acceleration-deceleration head injuries? a. Musculoskeletal support of head is insufficient. b. Anterior fontanel is not yet closed. c. Nervous tissue is not well developed. d. Scalp has extensive vascularity.
Consistency rather than severity
____ rather than ____ helps the child learn
asphyxiation
common cause if infant death
myelination
control of elimination cannot occur until ___________________ has taken place
physiologic anorexia
decreased appetite relative to decreased caloric need
once a day nutritious
guidelines for infant snacks
removing own clothes able to sit, squat, and walk well walking for one year notices soiled diaper
signs of readiness for toilet training
food jag
when a toddler or preschooler will only eat one food item meal after meal.