Child Health -Growth and development and visual/auditory

Toilet training, child's readiness include the ability to:

-ambulate to and sit on the toilet -remain dry for several hours or through a nap - pull clothes up and down - understand a 2 step command - express the need to use the toilet (urge to defecate or urinate) -imitate the toilet habits of adults or older siblings -express an interest in toilet training

Acute otitis media (AOM) clinical manifestations:

-high fever -ear pain -irritability/restlessness -loss of appetite -pulling on the affected ear

Teaching for sleep routines when caring for a school-aged child should include the following:

-provide a darkened, cool, quiet room for sleep -avoid large amounts of food or drinks in the evening before bedtime to decrease nighttime awakenings -establish a bedtime schedule at approx. the same time every evening, including weekends, that is reasonable for the family's lifestyle to promote adherence -encourage 9-12 hours of sleep per nigh -reduce the number of naps in the afternoon and evenings.

Coping mechanism used by hospitalized toddlers include:

following home rituals and routines, having parents stay with the childe (including overnight), and using the playroom for relief of anxiety and fear

Preschool-age children (3-6 years) are in Piaget's preoperational stage of cognitive development. They become .... feelings about adoption?

increasingly verbal but are unable to understand cause and effect, often ascribing inappropriate causes to phenomena; therefore adopted child may feel responsible for being adopted

Place the components of assessment in order for a toddler:

interact with the parent in a friendly manner play with the child using a finger puppet measure the child's height and weight auscultate the child's heart an d lung sounds take the child's vital signs

Hearing impairment in infants delays development of intelligible speech. What are signs of this:

may appear shy, timid, or withdrawn, often avoiding social interaction speech is usually monotone, difficult to understand, and loud increased use of gestures and facial expressions is also common may seem attentive when given directions and appear "dreamy" -but not nodding smiling when given directions

What is myopia?

nearsightedness, reduced visual acuity when viewing objects at a distance. often need to hold objects near their face or sit near objects to see clearly often report headaches, dizziness, and the need to squint the eyes to see clearly.

When assessing an infant, the nurse should perform these in what order:

observe, auscultate, palpate, and then perform traumatic procedure (eg, examine eyes, ears, mouth). Elicitation of the Moro reflex should be performed last

When assessing a toddler's ear, the nurse should wait until the end of the assessment to use what? what should follow after ?

otoscope pull down and back on the pinna, insert the speculum no further than the outer external auditory canal, and inspect the tympanic membrane for signs of infection (eg, redness, bulging, perforation). nurse should also recommend the influenza and pneumococcal conjugate vaccinations to prevent acute otitis media.

Infants should be transitioned to what type of milk at age 12 months to keep up with rapid growth?

whole milk

developmental milestones during the first year of life

2 months: -gross motor: holds up head when prone -fine motor: opens and closes hands -language: startles at loud noises -social/cognitive: smiles in response to smiling and talking 4 months: -gross motor: gains head control when held -fine motor: holds objects placed in hand -language: makes cooing sounds and turns head to caregiver's voice -social/cognitive: tracks caregiver with eyes 6 months: -gross motor: rolls from prone to supine position, later progresses to rolling from supine to prone position, and sits with support -fine motor: puts objects in mouth -language: begins to laugh and makes some consonant sounds -social/cognitive: becomes calmed by caregiver's voice 9 months: -gross motor: moves to sitting position -fine motor: moves objects between hands -language: "babbles" and imitates sounds -social/cognitive: may have stranger anxiety 12 months: -gross motor: moves to standing position and may walk with help or take independent steps -fine motor: uses 2 finger pincer grasp -language: identifies caregivers by name (eg, dada) -social/cognitive: searches for hidden objects and uses nonverbal gestures (eg, waving goodbye)

By age 30 months, current weight should be approx. ..... than birth weight?

4 x greater

Visual acuity testing in children ages ..... is generally assessed by use of the Snellen letter chart.

6 and older

What is retinoblastoma?

a unilateral or bilateral retinal tumor, is the most common childhood intraocular malignancy it is typically diagnosed in children under age 2 and is usually first recognized when parents report a white "glow" of the pupil. The child will not have the normal red eye reflex. Treatment may include radiation therapy or enucleation (removal of the eye)

Assessment findings of a 12 month old child should include

a weight that is approx. triple the birth weight. expected motor skills include the ability to sit from a standing position without assistance and to use a fully developed pincer grasp

Separation anxiety in toddlers and preschool-age children key nursing interventions to alleviate symptoms include:

encouraging the parents to leave favorite toys, books, and pictures from home -establishing a daily schedule that is similar to the child's home routine -maintaining a close, calming presence when the child is visibly upset -facilitating phone or video calls when parents are available -providing opportunities for the child to play and participate in activities

separation or stranger anxiety occurs when the primary caregivers leave the child in the care of others. This behavior starts around:

age 6 months, peaks at age 10-18 months, and can last until age 3 years.

Growth hormone replacement should begin when?

as soon as delays are noted and continue until bone growth begins to cease despite replacement therapy. replacement is administered vis subcutaneous injections

Failure to thrive is defined as: What is the priority for the nurse to perform in order to identify potential factors contributing to insufficient intake?

as weight less than 80% of ideal for age and/or depressed weight for length, correcting for gestational age, sex, and special medical conditions observing the child feeding or when hungry will provide the nurse the opportunity to identify potential factors contributing to insufficient intake

What is Marfan syndrome and what do be avoided?

autosomal dominant disorder affecting the connective tissues of the body competitive or contact sports are discouraged due to the risk of cardiac injury and sudden death

Key interventions for prevention of otitis media include:

avoiding exposure to tobacco smoke, obtaining routine immunizations, and discontinuing use of a pacifier after age 6 months.

Piaget's theory of cognitive development

birth - 2 years: -sensorimotor: learning by sense and movement, exploration, and early verbal skills 2-7 years: -preoperational: improved language, poor causality (eg, magical thinking), egocentrism 7-11 years: -concrete operational: able to reason if concrete objects are used to teach 11+ years: -formal operational: abstract thinking and reasoning

What is strabismus ?

crossed eyes disorder involving misalignment of the eyes caused by congenital defect or acquired weakness of an eye muscle patch over the stronger eye is a common treatment to strengthen the muscles of the weaker eye

Infant growth is fast paced during the first year of life, with birth weight ..... by age ... and tripling by age ...

doubling by age 6 months and tripling by age 12 months

Preschoolers enjoy plat that

enables them to imitate others and be dramatic. They have rich imaginations and enjoy make-believe. Their play often centers in imitating adult behaviors by playing dress up and using housekeeping toys, telephones, medical kits, dolls, and puppets quiet play appropriate for the preschooler includes finger paints, crayons, illustrated books, puzzles with large pieces, and clay

What is second-line treatment for nocturnal enuresis in children age > 5 years?

pharmacological interventions this is done when there has been little or no response to behavioral approaches and/or when short-term improvement of enuresis is desired for attending sleepovers or overnight camp. medications used to treat nocturnal enuresis include the following: 1. desmopressin reduces urine production during sleep. 2. tricyclic antidepressants such as imipramine, amitriptyline, and desipramine improve functional bladder capacity

formula should NEVER be

sweetened due to risk of infection and their immature gut system

What is the first manifestation of puberty in boys?

testicular enlargement and the first manifestation in sexual maturation as well followed by changes in the scrotum, appearance of pubic, axillary, facial and body hair, and voice changes

As a rule, if thumb sucking stops before..... begin to erupt, .... of the teeth and .... can be avoided

the permanent teeth misalignment malocclusion