PEDS CMS
IV Trochlear Motor
Infant - looks at face and tracks with eyes Child/Adolescent - has the ability to look down and in with eyes
X Vagus
infants - has no difficulties swallowing Child/Adolescent - speech clear, no difficulties swallowing Ulva is midline
A nurse is reinforcing teaching regarding immunizations schedule with the parents of a newbornwho is 1 weeks old. Which of the following pieces of information should the nurse include in the teaching?
initial vaccines should be administered between birth and 2 weeks of age. First dose of the hep B vaccine should be administered within the first 2 weeks after birth. The dose should be given before discharge from the hospital if the mother is hep B surface antigen negative.
2 month infant
lifts head off mattress when prone holds hands in an open position grasp reflex fading
which asthma medication for an acute attack?
Levalbuterol - short actinb beta2 agonist, to the preschooler for acute asthma attacks
II Optic Sensory
Looks at face and tracks with eyes Child/Adolescent - has intact visual acuity, peripheral vision, and color vision
A nurse is reinforcing teaching regarding the immunization schedule with the parent of a 6 month old infant during a well baby visit. which of the followoing statements by the parent indicates an understanding of the teaching?
My baby will receive his first DTaP today. The nurse should reinforce with the parent that the infant receive his third diptheria, tetanus, and pertsussia (DTaP) immunization at 6 months of age.
A nurse is caring for a child with acute lympcytic leukemia . which of the following lab vallus should the nurse expect?
RBC 2.5 million it is below the expected range. A child who has an acute lympocytic leukemia has a low RBC. A child with lymphocytic leukemia has a low platelet.
Fasting blood glucose for school age child
105 mg/dL The nurse should identify that a fasting blood glucose of 105 mg/dL is within the expected reference range for a school-age child.
creatinine
0.5-1.2 critical >7.4, renal insufficiency if 1.5-3
Hgb level
10 to 15.5 g/dL
Bun
10-20
Tdap vaccine
11-12 years
The first dose of MMR vaccine should be administered at what age?
12 moths of age
hemoglobin female
12-16 g/dL
sodium range
134-150
Sodium level range
134-150 mEq/L
Na (Sodium)
135-145
hemoglobin male
14-18 g/dL
platelets
150,000-450,000 cu/mm
Rotavirus (RV)
2, 4, 6 months
Fasting blood glucose for school age child
74mg/dL
Calcium range
8.8 to 10.8
Calcium range
9.0-10.5
chloride level
90-110
WBC count for a school age child
9400 / mm3
children temperature
97.4 - 99.6 F 36.3 to 37.6 C
A nurse is caring for an 8 year old child in the acute care setting. Which of the following actions should nurse take?
Assign the child the task of checking her blood sugar before meals. Erikson's stage of industry versus inferiority. They are willing to accept and thrive when assigned the responsibility to perform simple tasks.
Tonic neck reflex (fencer position)
BIRTH TO 3 or 4 MONTHS Turn newborn head turned to the right: Right arm/leg EXTEND Left arm/leg flex Turn newborn head to the left: Left arm/leg EXTEND Right arm/leg flex
s/s hypernatremia: FRIED
F: fever R: restless I: increased BP E: edema D: decreased urinary output flushed skin Hypernatremia is a condition caused by excessive sodium intake, fever, or renal disease. The manifestations include increased thirst, hoarseness, nausea, vomiting, and flushed skin.
Hbg level in school age child
Hgb 13 g/dL The nurse should identify that a Hgb of 13 g/dL is within the expected reference range for a school-age child.
Cobb technique
Scoliosis - measure degree of curvature to diagnose curvature < 25 degrees: re assess every 6 months curvature > 25 degrees: refer for external bracing curvature > 40 degrees: surgery
within range sodium for school age child
The nurse should identify that a sodium level of 140 mEq/L is within the expected reference range for a school-age child.
Morro reflex (startle reflex)
The splaying out of limbs in response to a loud noise. birth to 4 months
Varicella vaccine
Varivax - 1 year of age
The nurse should identify that vomiting, especially unrelated to feedings, is a manifestation of digoxin toxicity and should be reported to the provider.
Vomiting - The nurse should identify that vomiting, especially unrelated to feedings, is a manifestation of digoxin toxicity and should be reported to the provider.
11 months
Walks holding onto something, places objects into containers
A nurse is reviewing recommended immunizations with the guardian of a 2 month old infant. Which of the following statements should the nurse make?
Your baby can start the pneumoccal vaccine now - first dose with two additional doses at 4 months, and 2 months of age.
Recognizing sour taste at the back of the tongue
adolescent when testing glossopharyngeal cranial nerve IX
A nurse is caring for an adolescent client who has sickle cell anemia and is experiencing a vaso-occusive crisis. Which of the following actions should the nurse take?
apply heat to the affect area to sooth the pain
Length of newborn full term
average head o heel length: 19-21 inche)
7 months
bears full weight on feet sits, leaning forward on both hands Moves objects from hand to hand
annual influenza vaccine
beginning six months of age
immunizations
birth: hep B 2 months: diphtheria and tetanus toxoids and pertusssis (DTaP), roavirus vaccine (RV), inactibated poliiovirus (IPV), haemophilus influenzae type B (Hib), pneumoccal vaccine (PCV) and Hep B 4 months: DTaP, RV, IPA, Hib, PCV 6 months: DTaP, IPV (6 to 18 months), PCV, and Hep B (6 to 18 months), RV; Hib 6 - 12 months seasonal influenza vaccination yearly (the inactivated influenza vacccine is aailable as an intramuscular injection)
A nurse is collecting data from an adolescent who takes insulin for the treatment of of type 1 diabetes mellitus. the nurse should identify that which of the following findings indicates effective management of the client's diabetes mellitus?
blood glucose value at bedtime of 140 mg 80 before meals means dose needs adjusting HbA1c of 9% OR GREATER IS elevated for adolescent. need to prevent hyperglycemia by adjusting dosage 24 hour urine glucose level of 400 mg is above the expected range for adolescent. Glycosuria might indicate a need for the provider to adjust the client's insulin dosage, frequency or type
recognizing smells through each nostril is an expected response
by an adolescent when checking the olfactory cranial nerve
looking down and in with the yes is an expected response
by an adolescent when checking the trochlear cranial nerve
V Trigeminal
infant - has rooting and sucking reflexes Child/Adolescent - is able to clench teeth together and detects touch on face with eyes closed
VII facial
infant - has symmetric facial movements Child/Adolescent - has the ability to differentiate between salty and sweet on tongue has symmetric facial movements
10 months
changes from prone to a sitting position. Grasps rattle by its handle.
A nurse is checking the trigeminal nerve of an adolescent client. Which of the following responses should the nurse expect?
clenching teeth together tightly detecting facial touches with eyes closed
Polio (IPV)
complete by 6 yo
XI spinal accessory
infant - moves shoulders symmetrically has equal strength of shoulder shrug against examiners hands
VIII Vestibulocochlear - acoustic
infant - tracks a sound and blinks in response to a loud noise Child/Adolescent - does not experience vertigo and has intact hearing
Respirations
infant 30 -60 Children: 20-30
1 month infant
demonstrates head lag has a strong grasp reflex
I Olfactory Nerve (sensory)
difficult to test in infant Child/Adolescent - identifies smells through each nostril individually
A nurse is preparing to administer routine immunizations to a 6 year old child. In addition, tetanus, and pertussis (DTaP) vaccine, the measles, mumps, and rubella (MMR) vaccine, and the varicella vaccine, which of the following immunizations should the nurse plan to administer?
inactivated poliovirus vaccine (IPV) The nurse should plan to administer the fourth dose of the inactivated poliovirus vaccine between 4 and 6 years of age. The first 3 doses are administered between 2 months and 18 months of age.
IX Glossopharyngeal
infant - has an intact gag reflex Child/Adolescent - has an intact gag reflex is able to taste sour sensations on back of tongue
XII hypoglossal
infant - has no difficulties swallowing opens mouth when nares are occluded Child/Adolescent - has a tongue that is midline is able to move tongue in all directions with equal strength against tongue blade resistance
albumin
3.5-5 g/dL
Potassium range in Ped
4.1 to 5.3 for an infant
RBC males
4.7-6.1
6 months
rolls from back to front holds bottle
4 months infant
rolls from back to side grasps objects with both hands
potassium range for school age child
3.7 to 5.2
Potassium level for school age child
4.2 mEq/L
lead
lower than 9
A nurse is reviewing the lab results for a school age child who has acute glomerulonephritis. Which of the following results should the nurse report to the provider?
Bun 25 mg/dL An elevated BUN level is an expected finding for a child who has acute glomerulonephritis. The nurse should identify that a BUN of 25 mg/dL is above the expected reference range for a school-age child. Therefore, the nurse should report this result to the provider.
III Oculomotor Nerve
Infants blinks in response to light and has pupils that are reactive to light Child/Adolescent - has no nystagmus and PERRLa is intake
A nurse is reviewing lab findings of an adolescent who has acute renal failure. Which of following findings should the nurse expect?
Metabolic acidosis for clients who have acute renal failure. Also hyperkalemia, hypocalcemia and elevated plasma creatinine level for acute renal failure
Predniosone
Sodium 150 mEq/L - Hypernatremia is an adverse effect of prednisone. This level is above the expected reference range for a school-age child. Therefore, the nurse should report this value to the provider.
the nurse is reviewing the medical records of a 2 month old infant who has rotavirus. The nurse notes a hemoglobin level of 12 and a hemocrit of 51%. Which of the following statements by the nurse indicates an understanding of the lab values?
The infant might be dehydrated. An increased hemocrit level indicates dehydration. Hemocrit levels rise whenever blood volume is decreased during dehydration. The infant might b anemic The hemoglobin value is within range. Clients with anemia have decreased hemoglobin level. The infant has received too much fluid overhydration would result in a decreased level of hemocrit - 51% is an increaesd value The infant might have leukemia Leukemia results in a high WBC and a low RBC. These hemogobin and hemocrit levels do not indicate impaired bone marrow production seen in leukemia.
Pulse
infant: 100-160 BPM Children: 70-120 BPM
Blood pressure
infant: 65/45 - 90/65 Children: 90/55 - 110/75
level of 8% or lower
means good glycemia control in school age child
A nurse is caring for a child who has tetrology of fallot. which of the follow lab values should the nurse expect?
RBC 6.8 million. Tetrology of fallot causes cyanosis, therefore the body responds by increasing RBC production (polythemia) in an attempt to supply oxygen to all body parts.
Average weight of newborn full term
2,700 to 4,000 g ( 6 to 9 lb)
Crown to rump length in full term newborn
31 to 35 cm (12.5 to 14 in), approx. equal to head circumference
head circumference of full term newborn
33 and 35 cm (13 and 14 in)
Infant temperature up to 1 y.o
36.5-37.2 (99.4-99.7)
stepping reflex disappears
4 weeks
RBC female
4.2-5.4 million/mm3
WBC
5,000 to 13,000
A nurse is caring for a child in an acute setting. The nurse should identify which of the following children is at risk for impaired elimination?
A child who has hyperglycemia A client who ha hyperglycemia exhibits manifestations of polyuria, lethargy, confusion, thirst, nausea, vomiting abdominal pain, signs of dehydration, rapid rspirations, and fruity breath. A child who has hyperglyemia is at risk for dehydration.
A nurse on a pediatric unit is caring for a group of clients. Which of the following findings should be the nurse/s priority?
A child who has sickle cell anemia and a urine specific gravity of 0.030 The nurse should apply the ABC priority setting framework. A child who has a sickle cell anemia must maintain adequate hydration because dehydration might cause sickle cell crisis that can occlude the child's circulation.
A nurse is caring for a 7 yea old child who has kawaski disease. Which of the following interventions should the nurse perform?
Monitor for signs of fluid retention children with kawaski disease are at a high risk for developing heart failure due to the disorder causing inflammation of the small and medium blood vessels throughout the body. This can lead to coronary aneurysms and myocarditits. The nurse should monitor daily weights intake and output, and the development of tachycardia and respiratory distress. cold soaks would be an appropriate intervention. Children with kawaski disease typically present pruritic rash over their trunk and extremities. This rash often results in peeling of the skin. They should be kept in a quiet environment with minimal stimulation for adequate rest. These children experience irritability throughout the acute and convalescent phase of the disease. The nurse should perform passive range of motion exercise for a child who develops arthritic joint pain due to the disorder. These exercises are best tolerated after the child's bath.
VI Abducens
infant - looks at face and tracks with eyes Child/Adolescent - is able to move eyes laterally toward temples
A nurse is reviewing the laboratory report of an adolescent who has respiratory alkalosis. Which of the following lab results should the nurse expect?
pH 7.49 The nurse should identify that a pH of 7.49 is above the expected reference range and indicates respiratory or metabolic alkalosis.
A nurse is collecting data from a 6 month old infant. Which of the following reflexes should the nurse expect the infant to exhibit?
plantar grasp
A nurse is reinforcing teaching with the parent of a school aged child who has muscular dystrophy. Which of the following instructions would the nurse reinforce?
provide your child with a decreased calorie diet low in calories and high in protein . this low calorie diet helps prevent excessive weight gain, which can aggravate mobility issues.
9 months
pulls to standing position creeps on hands and knees has a crude pincer grasp
3 month infant
raises head and shoulders off mattress when prone only slight head lag no longer has a grasp reflex keeps hands loosely open
5 months infant
rolls from front to back uses palmar grasp dominantly
Haemophilus influenza type b (HIB)
series administered by 18 months of age
12 months
sits down from a standing position iwthout assistance walks with one hand held tries to build a two block tower without success can turn pages in a book
8 months
sits unsupported begins using pincer grasps
A nurse is caring for a group of infants who have congenital heart defects. Which of the following defects should the nurse expect to observe cyanosis?
transposition of the great arteries - an infant ho has transposition of the great arteries will have severe cyanosis because reversal of the anatomic position of the aorta and pulmonary artery allows venous blood to enter the system circulation without oxygenation. ventricular septal defect is incorrect because a hole in the septal wall between the ventricles can have increased pulmonary vascular resistance but is unlikely to have cyanosis because oxygenation of the blood remains inadequate for the systemic circulation. coarctation of the aorta is incorrect because infants who has coarctation of the aorta, a constricted segment of the aorta that obstructs blood flow into the body, is unlikely to have cyanosis because even though the left ventricle ust generate higher than normal pressures for adequate stroke volume oxygenation of the blood remains adequate for the systemic circulation. An infant who has a patient ductus arteriosus will have a blood vessel connecting the pulmonary artery to the aorta. The infant can have increased pulmonary vascular resistance but oxygenation of the blood remains adequate for the systemic circulation.
Risser scale
xray to determine skeletal maturity
