Peds exam 1: Chapters 22-25
preoperational stage
A child demonstrates increasing language skills and an understanding of symbols. Creative play and the use of imagination is an important activity in the child's life. Based upon these characteristics, what stage of cognitive development according to Jean Piaget's theory is the child demonstrating? a. concrete operational stage b. formal operational stage c. sensorimotor stage d. preoperational stage
"We will position our infant on his side for sleeping."
A home visit nurse is providing health promotion on safety to a family of a 1-week-old infant. Which of the following statements by the parents indicates the need for further teaching? a. "We will place our infant in a rear-facing car seat in the back seat of the car." b. "We will position our infant on his side for sleeping." c. "We will swaddle our son to keep him quiet and warm to sleep." d. "We will give our son a pacifier before placing him in his crib."
Focus on positive factors in the caregiver's relationship with the child.
A homeless parent brings a child with a severe earache to the clinic. What can the nurse do to establish a therapeutic relationship so that the parent feels respected? a. tell the patient that he or she needs to bring the child in sooner next time illness strikes b. Focus on positive factors in the caregiver's relationship with the child c. tell the parent he or she must go to social services to see if the family qualifies for benefits d. begin washing the child's face and hands
anal stage
A hospitalized 2-year-old is toilet training and excited to show the nurse the product created in the toilet. What stage does the nurse recognize this child is in according to Freud? a. oral stage b. anal stage c. oedipal stage d. phallic stage
teething rings acetaminophen
A mother calls the clinic nurse asking for recommendations on comfort measures for her infant who is teething. What recommendation should the nurse make? Select all that apply. a. teething rings b. small chunks of ice c. acetaminophen d. hand cream e. hard candy
"You'll probably notice that your daughter is uncomfortable in wet diapers."
A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate? a. "Most children are ready for toilet training by the time they are 18 months old." b. "You'll probably notice that your daughter is uncomfortable in wet diapers." c. "Don't worry, your daughter will probably give you very definite signals." d. "Your daughter can understand holding urine and stool by about 1 year of age."
this is a primitive reflex known as the palmer grasp
A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information? a. this is a primitive reflex known as the palmer grasp b. this is a primitive reflex known as the planter grasp c. this is a protective reflex known as rooting d. this is a protective reflex known as the moro reflex
I keep trying until I get something done I like to learn about new things
A nurse is assessing a 10-year-old at a well-child visit. Which statement by the child would indicate to the nurse that the child is developing a sense of industry? Select all that apply. a. I keep trying until I get something done b. I feel like I'm not liked by my friends c. I like to learn about new things d. I feel like I can't do the things that my friends can
The nurse should have clear information about who the custodial parent is and adhere to his or her wishes
A nurse is caring for a hospitalized child with divorced parents. What intervention is important for the nurse to provide when caring for this child? a. the nurse should ask the child which parent is responsible for the child b. The nurse should have clear information about who the custodial parent is and adhere to his or her wishes c. the nurse should be sure to allow the same access to both parents d. it is not the nurse's responsibility to worry about the guidelines of custody agreements
the weight is too little for age
A nurse is collecting a weight on a 6-month-old infant. The weight was 14 lbs 3 oz. The mother states that the infant's birth weight was 8 lbs 8 oz. What is the nurse's assessment of this data? a. The weight is appropriate for age b. The weight is too much for age c. The weight is too little for age d. It cannot be determined
The infant says "da-da" when looking at her father
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child? a. The infant says "da-da" when looking at her father b. The infant squeals with pleasure c. The infant coos, babbles, and gurgles d. The infant imitates her father's cough
demonstrate the procedure on a teddy bear
A nurse is teaching a 7-year old diabetic child who is in Piaget's concrete operational stage about insulin injections. Based on Piaget's theory, what would be the nurse's best method of preparation for this child? a. give the child a pamphlet on diabetes to read b. show the child a video about diabetes and insulin c. demonstrate the procedure on a teddy bear d. explain the procedure to the child in detail
Delivery of low birth weight infants Lack of prenatal care Poor nourishment
A nurse recognizes that a pregnant homeless woman has challenges that other pregnant women may not. What problems should the nurse anticipate that the homeless pregnant patient will have? Select all that apply. a. delivery of low birth weight infants b. lack of prenatal care c. poor nourishment d. delivery of large for gestational age babies
developmental
A nursing instructor informs the class that for the child to be successful at achieving maturation, he or she must first master milestones. The instructor determines that the students understand when they correctly identify these milestones as what tasks? a. developmental b. cephalocaudal c. maturation d. proximodistal
At age 2 to 3 years, the child determines right or wrong by the physical consequence of a particular act
A nursing student realizes that which of the following is true about Kohlberg's theory of moral development? a. At age 2 to 3 years, the child determines right or wrong by the physical consequence of a particular act. b. during the first 2 years, the child realizes how behavior affects others c. In stage 1, the child obeys's a person and understands the principle for this d. during the first 2 years, children already have moral sensitivity
height and weight
A nursing student will correctly identify that growth is measured by which of the following patterns? a. developmental tasks b. milestones c. height and weight d. changes in maturation
The child's position on a growth chart does not necessarily indicate a health problem
A parent is distressed because the infant is on the 26th percentile for height and the 17th percentile for weight. What should the nurse teach the client? a. the infant's pediatrician will be made aware of these findings promptly b. the child's position on a growth chart does not necessarily indicate a health problem c. the infant is still heavier and longer than most other infants of the same age d. the child is healthy, provided the percentile for height exceeds that of weight
no evidence supports that children will have these behaviors if they are recognized for their dependability
A parent tells the nurse that a 9-year-old has to go home alone for 2 hours until the parents get off work, and they are afraid the child will begin smoking and drinking. What can the nurse inform them about "latchkey" children? a. it is too dangerous in this day and time for your child to be home alone at any time b. can't you hire a babysitter to meet the child at the house after getting off the bus? c. I left my child at home from the age of 8 years old and nothing ever happened d. no evidence supports that children will have these behaviors if they are recognized for their dependability
Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy.
A parent with a 2-year-old invites a friend with a toddler over for a play date when they notice their children are not really interacting while playing. The children are playing side-by-side when one toddler gets up and grabs a toy car out of the hands of the other toddler, which results in both toddlers crying. To prevent this from occuring again, which intervention should the parents make? a. Sit the toddlers down and give a lecture about "sharing." b. Parents should decide that they need to wait about a year when the children are more ready to share toys. c. Parent of the toddler who started the fight should put this child in "time out." d. Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy.
play
A pediatric nurse caring for children of all ages knows that children learn about themselves, the environment, and relationships best through: a. reading b. parents c. play d. school
3-year-old preschool-aged child who goes up stairs on hands and knees
A pediatric nurse is providing care to several children. The nurse is reviewing the assessment findings for each of the children. Which finding requires the nurse to intervene? a. 9-month-old infant who can pull self up to a standing position b. 14-month-old toddler who walks with a parent's assistance c. 24-month-old toddler who engages in parallel play d. 3-year-old preschool-aged child who goes up stairs on hands and knees
proximodistal
A pediatric nurse observes an infant holding a rattle. Upon dropping the rattle, the baby cannot pick it up with his fingers on his own. The nurse correctly identifies this to be an example of which type of growth? a. proximodistal b. abnormal development c. cephalocaudal d. abnormal growth
Parental anxiety related to lack of understanding of childhood development
A preschool-age child tells the nurse about an imaginary friend. The parents are concerned because the child refuses to do anything without the friend's help. Which nursing diagnosis is most applicable for the family? a. Compromised family coping related to abnormal behavior of child b. Disturbed thought processes related to deep-set psychological need c. Parental anxiety related to lack of understanding of childhood development d. Social isolation related to unwillingness to relate except through imaginary friend
"When my 3-year-old asks 'Why?' all the time, this is completely normal."
After teaching a group of parents about language development in toddlers, which statement by a member of the group indicates successful teaching? a. "When my 3-year-old asks 'Why?' all the time, this is completely normal." b. "A 15-month-old should be able to point to his eyes when asked to do so." c. "At age 2 years, my son should be able to understand things like under or on." d. "An 18-month-old would most likely use words and gestures to communicate."
The next visit would be at 6 months
An infant who is 4 months old continues to be seen at doctor visits for illness prevention. What would be the next scheduled appointment that this infant should attend to be evaluated? a. the next visit would be at 9 months b. the next visit would be at 6 months c. the next visit would be 1 month d. the next visit would be in 3 months
120 degrees F
Bathing is still a fun time for most preschoolers. Many exciting times can be had splashing in the tub with favorite toys. What temperature should water heaters maintain in order to prevent accidental burns? a. 110 ° F b. 115 ° F c. 120 ° F d. 125 ° F
Be aware (The Nurse's Role Related to Growth and Development)
Be aware that the client's age and stage of growth and development can affect the way the client copes with the situation or response to treatment
communicating with infants
Be careful how you handle the infant • Spend time at beginning of interaction to calm down and connect • Establish relationships with the caregiver- Praise for what is done right • Playing
communicating with school aged children
Begin by calming down or connecting with the child • Be sensitive to the child's concern about body integrity • Play, reenactment, or artwork can give insight into how well a child understands a procedure or experience • Briefly acknowledge adult but focus on the child • They want to know what and why • Allow them to voice concerns
4 years
By what age does birth length usually double? a. 1 year b. 2 years c. 4 years d. 6 years
Most 3-month-olds still have a Moro reflex
During an assessment, the nurse determines that a 3-month-old baby has a Moro reflex. What does this finding indicate to the nurse? a. It usually lasts until 9 months. b. It will persist until the age of 1 year. c. Most 3-month-olds still have a Moro reflex. d. If present at 3 months of age, a neurologic exam is needed
"You may be right, since infants can sense their mother's smell as early as 7 days old."
During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse? a. "Babies can't tell the difference between people at that age." b. "Maybe she just knows your voice better than your mother's." c. "You may be right, since infants can sense their mother's smell as early as 7 days old." d. "I'm not sure a 4-week-old has developed a sense of smell yet."
routine physical checkups of child
During the first year of life, at least six visits to the health care facility are recommended
physical development ages 1-3 years
Gains 5 to 10 Ib, about 3 in each year learns to chew food learns to stand alone and walk between 1 and 2 years (gross motor) most say their first words, refining language skills by end of this period, may have learned toilet training able to stand (gross motor) at 36 months holds cup by handle
principles of growth and development
Growth of the child follows a ORDERLY pattern. • Starting at the head and moving downward this pattern is called cephalocaudal. Ex. Child is able to control the head and neck before being able to control the arms and legs. The other pattern of growth is called proximodistal-growth starts in the center and progresses toward the outside or periphery ex. Child can control the arms before be able to control hand movements
10-12 hours at night and take 2-3 naps during the day (28 days to 1 yr )
How long do infants sleep?
3 months
In working with infants, the nurse would expect the posterior fontanel to be closed in an infant who is which age? a. 3 weeks b. 1 month c. 3 months d. 6 weeks
Move objects out of the way or move the toddler to prevent injury
Once a temper tantrum has started, which intervention is appropriate? a. Move objects out of the way or move the toddler to prevent injury b. Speak to the toddler during the tantrum. c. Engage the toddler's behavior. d. Have a long talk with the toddler regarding the tantrum
Uses two-word sentences or phrases
Parents and their nearly 3-year-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? a. Uses two-word sentences or phrases b. Talks about a past event c. Half of speech understood by outsider d. Asks "why" often
orange slices cheese slices yogurt
Parents share that their toddler often needs a snack in between meals. Which snack choice is nutritious enough to give the toddler energy but also may help prevent dental caries? Select all that apply. a. orange slices b. raisin oatmeal cookies c. cheese slices d. yogurt e. sugar-free candy bars
accident prevention (1-3 yrs old)
Poisoning is most common MEDICAL emergency higher between 1 and 4 yrs of age LEADING cause of death in toddlers is accidents involving motor vehicles, drowning, burn and poison
Preschool Child: 3-6 years
Preschoolers should have annual check ups • Set belt safety, bicycle safety helmets safety • Need supervision with bathing, brushing teeth • Continued reminders to wash hands after using the bathroom • Need to opportunity to pick out clothes and dress
Stages of development of moral reasoning in children (Lawrence Kohlberg)
Stage 1- (2-3) years child determines right or wrong by consequences Obeys without understanding of moral principle • Stage 2 (4-& years) children follow rules to benefit themselves
Post conventional stage (Lawrence Kohlberg)
Stage 5 (13-18)laws are for mutual good • Stage 6 - Not reached very commonly. Does whatever is right without regard to laws, $. Deep respect for life would never want to cause harm
Recommend the parents provide the infant a cold teething ring to chew
The clinic nurse is assessing a 9-month-old client. The parents state, "Our baby is having a really hard time teething." Which nursing action is appropriate? a. Encourage the parents feed the infant warmer foods while teething b. Have the parent's apply a topical numbing cream to the infant's gums hourly c. Tell the parents to give the infant acetaminophen every 4 hours d. Recommend the parents provide the infant a cold teething ring to chew
cephalocaudal
The head-to-toe direction of growth is referred to as: a. cephalocaudal b. proximodistal c. mass to specific d. sequential
The family's medications are located in a kitchen drawer
The home health nurse is visiting a 2-year-old client's home. Which finding will cause the nurse to intervene? a. All of the windows in the home are locked b. The toddler goes to the bathroom alone to urinate c. The family's medications are located in a kitchen drawer d. The toddler in not allowed in the kitchen while food is being prepared
12 weeks (28 days to 1 yr)
The infant pushes up from the prone position
4 weeks (28 days to 1 yr)
The infant turns their heads when lying in the prone position
19 lb 8 oz (8825 g)
The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months? a. 10 lb 8 oz (4760 g) b. 13 lb (5900 g) c. 15 lb 4 oz (6920 g) d. 19 lb 8 oz (8825 g)
amniotic
The intrauterine environment can have a profound and permanent effect on the developing fetus with or without chromosomes or genetic abnormalities. Most adverse intrauterine effects are the result of teratogens. The nurse is cognizant that this group of agents dose not include: a. accutane b. rubella c. amniotic d. alcohol
most babies do not sit steadily until 8 months
The mother of a 3-month-old baby is concerned because the child is not able to sit independently. How should the nurse respond to this mother's concern? a. most babies sit steadily at 3 monts b. sitting ability and the age of first tooth eruption are correlated c. most babies sit steadily at 4 months d. most babies do not sit steadily until 8 months
Give the child secondary, not primary, choices
The mother of a toddler is frustrated because no matter what she asks of the child, the response is "no." What can the nurse suggest to the mother to assist with this problem? a. Pretend she does not hear the child b. Ask no further questions to the child. c. Tell the child to never to say "no" again. d. Give the child secondary, not primary, choices.
Helping with teeth brushing encourages autonomy
The mother of a toddler is frustrated because the toddler insists on brushing his own teeth and being left alone in the bathtub. What advice should the nurse provide to the mother about these expectations? a. Helping with teeth brushing encourages autonomy. b. It is unusual for a 2-year-old to have such strong opinions. c. The mother should continue to give full care in all aspects. d. Leaving the child alone in the bathtub is a good way to encourage autonomy.
stands alone
The nurse is assessing the development of a 15-month-old girl during a well-child visit. Which skill would the nurse expect to see? a. Feeds herself with a spoon b. Points to her nose and mouth c. Stands alone d. runs to mother
ability to perform a skill
The nurse is planning to evaluate the development of a preschool-age child. On what should the nurse focus when performing this evaluation? a. ability to perform a skill b. change in height c. current weight d. appetite
object permanence
The nurse is playing with the 8-month-old infant. The nurse hides the toy to assess cognitive function of the infant. The infant tries to find the toy. The nurse is assessing which characteristic of Piaget's stages of cognitive development? a. concept of causality b. object permanence c. primary circular reactions d. preconceptual stage
Advising them to use praise, not scolding
The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching? a.Telling them either one may demonstrate toilet use b. Assuring them that bladder control occurs first c. Telling them that curiosity is a sure sign of readiness d. Advising them to use praise, not scolding
Bath time provides an opportunity for play
The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent? a. infants need a bath daily b. Soap lubricates and oils an infant's skin c. Bath time provides an opportunity for play d. Never use soap on an infant's hair
A regular routine and rituals will provide stability and security
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? a. A regular routine and rituals will provide stability and security b. Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. c. A sense of control can be provided through offering limited choices. d. Aggressive behaviors such as hitting and biting are common in toddlers.
The child uses his fingers and refuses to use a fork
The nurse is supervising lunch time for children on a pediatric ward. Which observation is considered abnormal for this age group? a. The child has a full set of primary teeth. b. The child has no difficulty chewing and swallowing meat. c. The child uses his fingers and refuses to use a fork. d. The child is a picky eater
The child should be able to turn over onto the back at age 4 months
The nurse is visiting a mother who has a 3-month-old infant. Which anticipatory guidance information should the nurse provide to the mother at this time? a. The child will have a fear of strangers. b. The child will experience many moody periods. c. The child will expect things to be done a certain way. d. The child should be able to turn over onto the back at age 4 months.
cooperative play
The nurse is watching a 4-year-old child play with another preschool child. The children are playing a game with rules. The nurse notes that the child is demonstrating what type of play? a. Cooperative play b. associate play c. parallel play d. dramatic play
the baby is moving the arms and hand and smiling
The nurse observes a new mother bathing her 9 month old baby. Which observation indicates that the experience is positive for both mother and infant? a. the baby is moving the arms and hand and smiling b. the baby is trying to keep the legs from touching the water c. the baby is reaching for the mother
the need for separation and control
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior? a. The need for separation and control b. The need for love and belonging c. The need for safety and security d. The need for peer approval
Deficient parental knowledge related to inappropriate method for toilet training
The parent of a 2-year-old toddler tells the nurse she needs to constantly scold the toddler for having wet pants. The parent says the toddler was potty trained at 12 months, but since starting to walk, the toddler wets the pants all the time. Which nursing diagnosis would be mostapplicable? a. Deficient parental knowledge related to inappropriate method for toilet training b. Excess fluid volume related to inability to control urination c. Ineffective coping related to lack of self-control of 2-year-old toddler d. Total urinary incontinence related to delayed toilet training
Most infants do not sit steadily until 8 months; this infant is normal
The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability? a. Most infants sit steadily at 3 months; this infant is slightly delayed. b. Most infants do not sit steadily until 8 months; this infant is normal. c. Sitting ability and the age of first tooth eruption are correlated. d. Most infants sit steadily at 4 months; this infant is normal
this is a screening to assess overall development
The parents of a 2-year-old ask the nurse the purpose of administering the Denver II Developmental Screening Test and the Revised Prescreening Development Questionnaire (R-PDQ). Which response should the nurse give the parents? a. the testing detects early language developmental delays b. this is a screening to assess overall development c. the testing will include difficulties with intellectual abilities d. this is developmental surveillance for suspected
Let the child choose what clothing he or she will wear the next day
The parents of a 2-year-old child born with short-gut syndrome feed their toddler via a feeding tube. Knowing this is a developmental time when children usually feed themselves, the parents are asking the nurses what they can do to help foster the child's independence. Which suggestion would be most appropriate at this time? a. Play catch with the child while others are eating so they do not have to feel left out. b. Let the child choose what clothing he or she will wear the next day. c. Try to focus the child's energy on learning to read simple books that are age appropriate. d. Imitate placing food in the child's mouth as long as the food is large enough so it cannot be swallowed
Wake the child up nightly 30 to 45 minutes after going to sleep.
The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. What is the most appropriate intervention? a. Wake the child up nightly 30 to 45 minutes after going to sleep. b. Explain that this is a developmental phase that will not last. c. Tell the parents to be sure to wake the child up during the next episode. d. Encourage the parents to let the child fall asleep in a safe place such as their bed.
Cephalocaudal
The pattern of growth in which the child is able to control the head and neck before the arms and legs is known as which of the following? a. proximodistal b. cephalocaudal c. development d. maturation
counting an apical rate
The preferred method to determine the pulse in an infant or a young child place the stethoscope between the child's left nipple and sternum count the pulse for one full minute
birth control pills
Toddlers are curious, and often what is in their hands goes into their mouths. What is one of the most common substance involved in the poisoning of a toddler? a. shaving lotion b. birth control pills c. toxic paints d. multivitamins
assertion of individuality
Toddlers are infamous for their use of the word "no". What is this negativism indicative of? a. intention to disobey b. rebellion against parental boundaries c. assertion of individuality d. assertion of age-appropriate maturity
understanding (The Nurse's Role Related to Growth and Development)
Understands-factors and influences and normal or expected patterns related to growth and development of the infant, child, and adolescent
4 to 5 years
What are group delights in using swear words? a. 3 to 4 years b. 4 to 5 years c. 5 to 6 years d. 6 to 7 years
develop sense of trust
What is Erickson's psychosocial development task for infants? This stage of development creates the foundation for the developmental tasks of the next stages If the infants' needs are not met; food, love, attention, and comfort they learn to mistrust the world and the caregiver
listening
What is one of the most important aspects of communication?
nutrition
What is probably the single most important influence on growth at all stages of development? a. nutrition b. heredity c. culture d. environment
thinking logical
What is the characteristic of the preoperational stage of cognitive development? a. thinking logical b. thinking is concrete c. reasoning is inductive d. generatlization can be made
nutrition
What is the major affect on the overall growth and development of a child?
localized tenderness and low grade fever within 1st 24-48 hrs, possibly local reaction, tenderness, redness, swelling at the injection site
What is the most common side effects from immunizations?
accident proofing, safety measures and firm but gentle discipline
What is the primary task of the caregiver during the growth and development of the toddler aged 1-3 years of age?
The toddler should speak in two-word sentences ("Me go")
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler? a. The toddler should say two words plus "ma-ma" and "da-da." b. The toddler should speak in two-word sentences ("Me go"). c. The toddler should be able to count out loud to 20. d. The toddler should say 20 nouns and 4 pronouns.
the developmental stage is based on developmental tasks achieved
When caring for a child with a cognitive impairment, what is a primary factor for the nurse to consider regarding the approach for interaction with the child? a. the developmental stage is based on the parent's report of level of functioning b. the developmental stage is based on the chronological age. c. the developmental stage is based on developmental tasks achieved d. the developmental stage is based on the gestational age
anticipatory guidance (related to normal growth and development, nurturing practices for childcare, safety and injury prevention)
When communicating with care givers the nurses understanding growth and development what is vital to provide proper care?
at 15 months
When does the practitioner see the child for routine check ups?
genetics
When planning care for children, the nurse knows that which factor has the largest impact but is not able to be altered to influence the growth and development of children? a. genetics b. environment c. family d. socialization
Let the toddler select an outfit each day and get dressed independently
Which activity will the nurse include when caring for a toddler to assist in achieving Erikson's developmental task of the toddler period? a. Allow the toddler to pick the time of day to take a prescribed antibiotic b. Let the toddler select an outfit each day and get dressed independently c. Provide the toddler with the needed equipment to perform a simple dressing change d. Ask the toddler which cartoon the toddler prefers to watch after lunch
The child can hop on one foot
Which gross motor skill would the 4-year-old child have most recently attained? a. The child can hop on one foot. b. The child can tie his/her shoelaces. c. The child can cut his/her food. d. The child can button his/her clothes.
sitting without support
Which milestone would the nurse expect an infant to accomplish by 8 months of age? a. Sitting without support b. Creeping on all fours c. Pulling self to a standing position d. Being able to sit from a standing position
a nurse who provides care in a large junior high school
Which nurse is most likely to care for patients who are trying to resolve identity versus role confusion? a. a nurse who works in long term care facility b. a pediatric nurse c. a nurse who provides care in a large junior high school d. an occupational health nurse based at a lumber mill
Preoperational - The child will want to play with the equipment
While preforming a preoperative assessment on a 3-year-old client, a nurse should be aware of what type of cognitive thought process by the child? a. formal operations- the child requires no formal introduction to the equipment b. Preoperational - The child will want to play with the equipment c. concrete operations- the child will understand the order of the assessment d. sensorimotor- responses to the assessment are based off of reflex activity
standards of growth
a growth chart with predictable patterns is used to plot and monitor a child's growth
Autonomy vs doubt and shame
ages 1 to 3- want to control and need to learn tasks independently even if it takes a while or causes a mess
industry vs inferiority
ages 6-12 learn to interact with others and like competition with others
24 months (1-3 yrs old)
appetite fair to moderate clearly defined likes and dislikes accepts no help
The anal stage
at 2-3 years - the beginning of the desire to mold and control the environmentthis is known as the "mud pie period'' in a child life
Trust vs mistrust
at age 0-1 year Infants are not in control of the world they cry for help hoping for rescue. They learn very early whether the world can be trusted to give love and care for them or frustration, fear and despair depending on their needs being met.
respirations
average 30 breaths per minute with a wider range (20 to 50 breaths per minute)
85/60 mmHg (circulatory system)
average blood pressure during the first year of life apical pulse first year of life: average apical rate ranges from 70(asleep) to 150 (awake) * as high as 180 beats per minute while infant is crying
health promotion and maintenance family teaching (1-3 yrs old)
bathing: enjoys having tub toys to play with use bubble bath with caution. Can contribute to UTI in (females) Dressing: 18 months: Remove shoes and socks 2 to 3 yrs: starts putting on own clothes avoid criticism roomy clothing with easy buttons. velcro and large zippers easiest
Dramatic play (3-6 yrs olds)
can act out troubling situations
stuttering
can develop during this period but usually disappears within 3-6 months
15 months (1-3 yrs old)
can sit through meals wants to self-feed; prefers finger feeding
cradle cap
caused by a collection of seborrhea yellow crusty patches of lesions on the scalp
anterior fontanel
closes between 12 to 18 month
posterior fontanel
closes by the second or third month
an infant in a tub should always be held securely
daily bath is unnecessary but is desirable and soothing in very hot weather
standards of development
developmental screenings by using standardized developmental screening
birth rate weight
doubles 1st 6 months ht increases 6 inches 1 year birth weight has triples, grows 10-12 inches
Sigmund Freud's theories of development
focus on the libido-(sexual drive or development)
Erikson theories of development
focuses on psychological development as a series of tasks and crises
body temperature
follows average normal range after initial adjustment to postnatal to postnatal living
Associative play (3-6yrs)
happens when children are doing a similar activity but no rules or organization
circulatory system: during fetal life
high levels of hemoglobin & red blood cells necessary for adequate oxygenation
12- 15 months old
holds spoon and drinks from cup (fine motor)
12-15 months
holds spoon and drinks from cup (fine motor) able to stage (gross motor)
During the first year of life, at least six visits to the health care facility are recommended
how many routine check ups should the child have during the first years of life?( health promotion and maintenance) (28 days to 1 yr)
nutrition quality
impacts growth and development-need adequate amounts, nutritional value
18 months (1-3 yr olds)
improved spoon control returns spilled food to spoon messiness is to be expected prepare for it
principles of communication
includes spoken and written words, body language, facial expressions, voice and emotion behind words
at birth
infants head circumference is slightly larger than the chest circumference. By 5 to 7 months of age the chest bypasses the head
genetics, nutrition, environment
influences on growth and development
latchkey child
is the child who comes home to an empty house after school. The term derived as a result of children wearing a key around their neck. Often the older sibling takes on the role of the parent • This is becoming more common in families with working parents.
prevent diaper rash (28 to days to 1 yr)
should be checked frequently, at least every 2-4 hours while awake for soiled diaper
caring for the diaper area
soiled diapers should be changed frequently: check every 2 to 4 hrs cloth vs commercial diapers
nutrition of children 28 days to 1 yr
the extrusion reflex causes infants to thrust food forward pushing it out of the mouth first, 4-6 months is breast milk or commercial formula when introducing new foods only one should be offered at a time, over 4-5 days allowing the infant to get used to it and they have a reaction is easier to figure which one generally can wean to a cup by 1 yr of age BOTTLE CARRIERS CAN OCCUR WHEN THE INFANT IS GIVEN A BOTTLE IN THE BED WITH FORMULA. It's BETTER TO USE WATER OR A PACIFIER FOR SUCKING AT BEDTIME
dentation
the first deciduous teeth, usually the lower central incisors between 6-8 months of age a cold teething ring is recommended to soothe teething symptoms teething is normal process, it does not cause high fever or upper respiratory conditions after several teeth have erupted, brush with a small, soft brush toothpaste not recommended
fetal life
the skeletal system is completely formed of cartilage at the end of three months gestation The pattern of maturation is so regular the bone growth can be determined by x-ray the bone age should match the chronological the remainder of this life cycle and childhood bone ossification occurs
Play ( growth and development of the toddler: 1-3 yrs)
this group moves from solitary play of the infant to parallel pay toddlers play alongside of other children but not with them • Discipline means to train or instruct in order to produce a particular behavior pattern, moral or mental, and self control. • Punishment means penalizing someone for doing wrong • Time out is a useful method for a child out of control. The duration of isolation is 1 MINUTE PER YEAR OF AGE
parallel play ( toddler 1-3 yr olds)
toddlers play alongside other children but not with them. playtime is imitation of role models doesn't share toys until later toddler years
ritualism (behavioral characteristics: toddler 1-3 yr olds)
used to help develop security
deciduous teeth
usually the lower central incisors between 6-8 months of age; • A cold teething ring is recommended to soothe teething symptoms Teething is a normal process, it dos not cause high fever or upper respiratory conditions
genetics
we have 46 chromosomes consisting of 23 essentially identical pars
false
when assessing the infant head you would expect the anterior fontanel to be closed by 3 months of age? True or False?
When using the upper arm for blood pressure the cuff should be?
wide enough to cover about two thirds of the upper arm long enough to encircle the extremity long enough to encircle the extremity without overlapping
• Sensorimotor phase (0 to 2 years) (Jean Piaget: theories of development)
‒ Infant uses the senses for physical satisfaction- feels, hears, sees, tastes, smells, "nursing "cause and effect-noises and verbal cues
Concrete operations phase -organize information, can consider another's point of view (Jean Piaget)
• (7 to 11 years) Child learns to problem solve in a systematic way • Formal operations phase (12 to 15 years)-abstract, double meanings, can draw logical conclusion Adolescent has own ideas and can think in abstract ways
communicating with young children
• Get to know them, ask them about their toy • Ignore defensive behaviors • Allow children to handle equipment • Get on eye level • Use simple words • Do not use this may be a bee sting- They will think it is literal
ages 3-6
• Magical thinking and immigration are common and can contribute to fears and anxiety due to not being able to to separate fantasy from reality • Preschoolers have sexual curiosity and exploration of their genitals and this is NORMAL • The caregiver should teach about stranger danger and good touch bad touch
nutrition and growth/development of the toddler: 1- 3 years)
• Meals should be planned with an understanding of the toddlers developing feeding skills. • Small portions- 1-2 teaspoons full is and adequate serving for the toddler • Try to plan regular meals with small nutritious snacks between meals • With slower growth and a drive for independence nutritional concerns and eating problems can occur-food jags and a variation in appetite
communicating with adolescents
• Might be challenging • Adolescents respond positively to individuals who show a genuine interest in them • Adolescents might need privacy to relate information they do not wish others to know • Let adolescents know that you will listen in an open-minded, nonjudgmental way • Focus interview on them and not the problem • Confidentiality • Inform them you will listen and be non judgmental • Avoid asking prying or embarrassing questions • Make contracts with adolescents so that communication can remain open and honest
Principals of Growth and Development
• Nurses are responsible for providing anticipatory guidance related to normal growth and development, nurturing childcare practices, and safety and injury prevention • An understanding of growth and development helps the nurse provide appropriate anticipatory guidance to caregivers
The Nurse's Role Related to Growth and Development
• Nurses are responsible for providing anticipatory guidance related to normal growth and development, nurturing childcare practices, and safety and injury prevention • An understanding of growth and development helps the nurse provide appropriate anticipatory guidance to caregivers
Preoperational phase (2 to 7 years) (Jean Piaget: theories of development)
• Young child sees the world from an egocentric point of view-cannot see things from another point of view
cognitive development (Jean Piaget: theories of development )
•intellectual development
imagination
A nurse is describing growth and development during the preschool period. What would the nurse identify as a predominant and heightened characteristic for this age group? a. imagination b. vocabulary c. gross motor skills d. fine motor skills
circulatory system: after birth
oxygen is supplied through the respiratory system hemoglobin decreases in volume red blood cells gradually decrease in number until third month of life RBC count gradually increases until adult levels are reached
Cooperative play
play in organized groups
• Solitary play (3-6 yr olds)
playing apart from others
cephalocaudal pattern
proceeds from head to toe The child is able to control the head and neck before being able to control the arms and legs
proximodistal pattern growth
proceeds from the center outward (midline periphery the child can control movement of the arms before being able to control movement of the hands
development
progressive change towards maturation
30 months (1-3 yrs old)
refusals and preferences less evident may hold utensils like an adult pursues last drop from cup
dawdling (behavioral characteristics: toddler 1-3 yr olds)
serves the purpose of asserting independence
kohlberg
The nursing student is reviewing growth and development of children. The student is interested in how children develop the knowledge of what is right and what is wrong in their younger years of development. Which theorist would the nursing student want to review? a. Erikson b. Kohlberg c. Pigeat
time management
There are several principles of communication that effect communication with children. What is one of them? a. Time management b. Use gestures when talking c. Talk to them on a professional level d. Listen in a judgmental way
4-5 yrs old
like using "naughty language-bathroom words
growth
measurable increase in the body's size caused by increasing numbers of new cells
developmental tasks
milestones/basic achievements associated with each stage of development
Conventional (Lawrence Kohlberg)
moral reasoning, become aware of feelings of others, living up to expectations • Stage 3 (7-10 yrs) Good boy nice and pleasing others • Stage 4 (10-12) showing respect and maintaining social order right and wrong - causes broken relationships
negativism: (behavioral characteristics : toddler 1-3 yr olds)
more an assertion of individuality
immunizations (28 days to 1 yr)
most common side effect is a low grade fever, possibly local reaction such as tenderness, redness and swelling at the injection sit
the process of growth
moves from simple to complex
Delayed growth and development related to frequent illness
A nurse is developing a plan of care for a 4-year-old client with cystic fibrosis who has frequent hospitalizations related to his illness. Which would be the most appropriate nursing diagnosis for this client? a. Health-seeking behaviors b. Risk for imbalance nutrition, more than body requirements c. Parental anxiety related to lack of understanding d. Delayed growth and development related to frequent illness
neuromuscular development (28 days to 1 yr)
nerve cells mature and fine muscles begin to coordinate in an orderly pattern of development
3 yr olds
old often talk to themselves
family teaching in dental (1-3 yrs old)
2 years brush after each meal of snack needs adult supervision no toothpaste until child learns to spit it out first visit to dentist to get acquainted subsequent first examination
seizures are not provoked; temper tantrums are
A 2-year-old toddler holds his breath until passing out when he wants something the parent does not want him to have. The nurse would decide whether these temper tantrums are a form of seizure based on the fact that: a. seizures are not provoked; temper tantrums are. b. seizures rarely occur in toddlers. c. seizures typically occur with fever; temper tantrums do not. d. with seizures, cyanosis rarely develops
Most 3-month-old infants still have a Moro reflex
A 3-month-old infant has a Moro reflex. Which statement is most true of this reflex? a. A Moro reflex normally lasts until 9 months b. It is not important how long the reflex persists, only that it is present at birth c. A Moro reflex present at 3 months of age requires referral for a neurologic exam d. Most 3-month-old infants still have a Moro reflex
"Your child is experiencing regression as a result of stress."
A 3-year-old child is hospitalized. The parents are concerned because the child is now refusing to use the potty and is wetting the bed, even though the child has achieved toilet training. Which response by the nurse is most appropriate? a. "Do not worry. This is a normal response to being in the hospital." b. "Your child is experiencing regression as a result of stress." c. "Once discharged, your child will quickly learn to use the toilet again." d. "Why do you believe your child is refusing to use the potty?"
speak in short sentences stand at eye level with the child when speaking to him or her speak in a slow, clear, positive voice
A 4-year-old is being seen in the emergency department after a fall down the steps. How can the nurse communicate with the child to develop rapport? Select all that apply. a. speak in short sentences b. speak to the parent and have him or her relay the information to the child c. stand at eye level with the child when speaking to him or her d. speak in a slow, clear, positive voice
teach the child to keep the house key hidden plan a telephone contact on the child's arrival home let the child know if you are going to be delayed
A community health nurse is giving a lecture to parents of children home alone in the afternoons ("latchkey" children). What advice should the nurse include? Select all that apply. a. teach the child to keep the house key hidden b. teach the child to show friends where the key is hidden in case its location is forgotten c. tell the child to open the door only to friends d. say the child can do whatever he or she wants as long as it is safe d. plan a telephone contact on the child's arrival home e. let the child know if you are going to be delayed
Opening drawers in the room, pulling out supplies, and examining them
A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which activity that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson? a. Opening drawers in the room, pulling out supplies, and examining them b. Singing a song he learned at preschool c. Rough-housing with his father d. Reading a book
third and fourth graders
A nurse is asked when to teach children about oral health. Based on Piaget's theory, at what age would the nurse suggest? a. junior high school b. preschoolers c. high school age d. third and fourth graders
growth progresses from gross motor movements to fine motor movements
A trend with growth and development of the infant is that development is proximodistal. This means: a. as nerve pathways develop, they become more specialized b. growth progresses from gross motor movements to fine motor movements c. all humans experience the same growth patterns d. both sides of the body grow equally
he is separate from his parents
According to Piaget, one basic concept that a child will learn during the first year is that: a. he cannot be fooled by changing shapes b. he is separate from his parents c. most procedures can be reserved d. his parents are not perfect
21 Ibs
An infant who weighs 7Ibs at birth would be expected to weigh how many pounds at age 1 year? a. 14 Ibs b. 16 Ibs c. 18 Ibs d. 21 Ibs
6 months
At which age would the nurse expect to find the beginning of object permanence? a. 1 month b. 6 months c. 9 months d. 12 months
32 weeks (28 days to 1 yr)
Develop pincer grasp to pick up small things and crawling around on the go
creep, crawl, stand, walk
Match the sequence of cephalopodscaudal development that the nurse expects to find in the normal infant with the appropriate step numbers. Begin with the first development excepted, sequencing to the final. a. crawl, b. creep, c. stand, d. walk Step 1______________________ Step 2______________________ Step 3______________________ Step 4______________________
10 to 12 weeks (28 days to 1 yr)
More aware of new environment, less crying, smiles at significant others
burns: accident prevention (1-3 yrs old)
Most common scalds from immersions and spills exposure to uninsulated electrical wires or live extension cord plugs playing with matches left unattended in home when fire breaks out
true
Nursing assessments that are made at well-child visits include the caregiver -child relationship and parenting skills. True or false?
around 4 yrs
Preschoolers can hop on one control movements of hands around
Monitoring the infant's weight and height
The nurse in a community clinic is caring for a 6-month-old infant and parent. Which intervention is the priority to promote adequate growth? a. Monitoring the infant's weight and height b. Encouraging a more frequent feeding schedule c. Obtaining the infant's current feeding pattern d. Recommending higher-calorie solid foods
Julie can hold her head erect and steady.
The nurse is assessing Julie, a 3-month-old infant. Which developmental milestone would the nurse expect? a. Julie can hold her head erect and steady b. Julie can grasp a toy at will c. Julie can sit by herself. d. Julie loves to play "pat-a-cake"
Provide whole-grain cereal for one feeding
The nurse is concerned that a 9-month-old baby is gaining too much weight. What should the nurse instruct the parents to help control the baby's weight gain? a. Use skim milk for feedings. b. Provide whole-grain cereal for one feeding c. Provide one bottle a day of diluted gelatin mix. d. Feed the baby a serving of pudding once a day.
The infant displays an asymmetric tonic neck reflex (fencing reflex).
The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development? a. The infant displays an asymmetric tonic neck reflex (fencing reflex). b. The infant grasps a finger when it is placed in his palm. c. His toes hyperextend when the bottom of the foot is stroked. d. The anterior fontanel (fontanelle) is open and easily palpated
43 inches
The nurse is conducting a well-child examination of a 5-year-old girl, who was 40 inches tall at her last examination at age 4. Which height measurement would be within the normal range of growth expected for a preschooler? a. 41 inches b. 43 inches c. 45 inches d. 47 inches
An extrusion reflux at 9 months of age
The nurse is conducting an educational session at a local community health fair illustrating the various reflexes which are normal in a newborn and how it changes as the infant grows and matures. The nurse determines more education is necessary after a member of the audience points out which finding as an expected occurance? a. An extrusion reflux at 9 months of age b. A Moro reflex at 3 months of age c. A positive Babinski reflex at 2 months of age d. A plantar grasp reflex at 7 months of age
Monitoring the toddler for developmental delays
The nurse is designing a nursing care plan for a toddler with lymphoma who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan? a. Limiting visitors to scheduled visiting hours b. Planning physical therapy for the child c. Introducing the toddler to other toddlers in the unit d. Monitoring the toddler for developmental delays
Speaks in two-word sentences using a noun and a verb
The nurse is determining a toddler's language development. What is an expected finding for language development in a 2-year-old? a. Able to count out loud to 20 b. Speaks 20 nouns and 4 pronouns c. Speaks two words plus "ma-ma" and "da-da" d. Speaks in two-word sentences using a noun and a verb
Uses only the left hand to grasp
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? a. Uses only the left hand to grasp b. Picks up small objects using entire hand c. Crawls with stomach down d. Cannot pull self to standing
Reward the child for initiative in order to build self-esteem
The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative? a. Reward the child for initiative in order to build self-esteem. b. Change the routine of the preschooler often to stimulate initiative. c. Do not set limits on the preschooler's behavior as this results in low self-esteem. d. As a parent, decide how and with whom the child will play.
The parents will not call attention to the child's broken fluency
The nurse is identifying outcomes for a family with a preschool-age who has broken fluency. Which initial outcome would be the most appropriate? a. The parents will not call attention to the child's broken fluency. b. The mother will encourage the child to repeat words after her. c. Other children will help the child by finishing words and sentences. d. The parents will correct the child each time there is a break in fluency.
The child is able to enunciate several sounds and has difficutly enunciating the "q" sound in words
The nurse is interacting with a 5-year-old child who lives in a home with bilingual parents. Which observation would alert the nurse to further assess the child's language development? a. The parents report the child interchanges words from both languages for communication at home. b. The child says "um" frequently when describing things to the nurse, such as the family pet. c. The child occasionally stutters when telling the nurse a story about planting vegetable seeds in the garden. d. The child is able to enunciate several sounds and has difficutly enunciating the "q" sound in words.
The child is unable to push a toy lawnmower
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? a. The child has trouble undressing himself. b. The child is unable to push a toy lawnmower. c. The child is unable to unscrew a jar lid. d. The child falls when he bends over
she looks for the toy the parents hide under the blanket
The nurse is observing parents with their 10-month old daughter. What should the nurse recognize as evidence that the child's is developing object permanence? a. she looks for the toy the parents hide under the blanket b. she returns the blocks to the same spot on the table c. she recognizes that a ball of clay is the same when flattened out d. she bangs two cubes held in her hand
28 days to 1 year
This is a time of transition- want to assert independence one moment they want to do it and the revert back to the caregiver
36 months
holds cup by handle
maintaining routine ( 1-3 yr olds- toddler in health care facility)
social assessment includes: nursing care plan should provide opportunities for independence separation anxiety include caregiver in care but don't neglect caring for toddler yourself
extinction (toddlers 1-3 yr olds)
spanking or physical punishment
Growth and Development of the Preschool Child: 3-6 years
• Preschoolers are like sponges-they soak up everything and favorite words are "why" and "How" • Ericksons developmental task is initiative vs guilt. Preschoolers want to do things toi help, but can feel guilty if scolded because of inexperience • Growth is slow during preschool period gain 3 to 5 lbs per year, and about 2.5 inches Deciduous teeth have completely emerged by the preschool period. The central incisiors are usually the first to go just as they are the first erupt in infancy
When the preschool age child in in a healthcare facility it is important to remember:
• Preschoolers are scared about intrusive procedures-NO RECTAL TEMP • May revert to bedwetting but should not be scolded, THIS IS NORMAL • Orient them to the bathroom and lights to use at night • Play is an effective way for the preschooler to express anxieties and learn what to expect in hospital situations
Health Promotion and Maintenance (Growth and Development of the toddler: 1- 3 years)
• Routine checkup: see the health care provider at 15 months for immunizations • And boosters • At least annually thereafter • At about 2 years of age the toddler should learn how to brush the teeth or at least rinse their mouth after meals and snacks • One good method for brushing teeth is to stand behind the child in front of a mirror and brush teeth. • A sign of bladder readiness training is when there is a puddle in the floor and the child makes a connection to it being something they did. • When the child stays dry for 2 hours at a time during the day indicates significant maturity for training. • Dressing the child in pull up type diapers and pants increase potty training success observing older children or a parent is also a positive role model
sleep (Growth and Development of the toddler: 1- 3 years)
• Sleep needs change, by the 3rd year of toddlerhood 10-12 hours of sleep • Give up morning nap, keep afternoon : 1 to 2 years: Total need 12 tp 14 hours daily 3: years: Total need 10 to 12 hrs daily naps bedtime rituals regular with consistent bedtimes
development (The Nurse's Role Related to Growth and Development)
• Talk client on their developmental level
Teaching (The Nurse's Role Related to Growth and Development)
• Teaching and working with caregiver
amblyopia- lazy eye
• The preschool child should be checked to screen Usually by age 6, the child achieves 20/20 vision, but mature depth perception may not develop in some children until 8 to 10 years of age
Communicating with caregivers
• View the caregiver as an expert • Include caregivers in providing information, problem-solving, and planning care • Pay attention to the verbal and non-verbal clues • Your are the consultant • Parent conveys concerns, worries, and anxieties about the child client • Avoid asking embarrassing question about family relations • Provide positive reinforcement. Do not ask judgmental questions • Compare what is actually happening to what the parents' expectations • Provide anticipatory guidance
