Pediatric Study Guide

Intervention in the plan of care for an 18 mon old with cerebral palsy

Use manual jaw control when feeding toddler Rationale: children diagnosed with cerebral palsy can lose jaw control

A child with ADHD is taking methylphenidate sustained-release tablets. Following statement by parent indicates understanding of teaching

"I should give this medication to my child half an hour before breakfast." Rationale: administer on an empty stomach

Child has type 1 diabetes mellitus and an upper respiratory tract infection. Which statement made by the parent indicates an understanding of the instructions?

"I will check my child's blood glucose every 3 hours." Rationale: a child with type 1 diabetes is at an increased risk of diabetic ketoacidosis during an illness.

Erikson's Psychosocial Stages (Peds)

1. Trust vs. Mistrust (infancy: birth-1 year) 2. Autonomy vs. Shame and Doubt (toddler: 2-3 years) 3. Initiative vs. Guilt (pre-school: 3-6 years) 4. Industry vs. Inferiority (school-age: 6-11 years) 5. Identity vs. Role Confusion (adolescence: 12-18 years) 6. Intimacy vs. Isolation (early adulthood: 19-mid 20s)

Hib immunization

2 mon, 4 mon, 6 mon; fourth dose given between 12-18 mon

PCV immunization

2 mon, 4 mon, 6 mon; fourth dose given between 12-18 mon

Child had a ventriculoperitoneal shunt replacement. This finding indicates a complication of the procedure

Abdominal distention Rationale: VP shunt allows excess CSF from the ventricles to drain into the peritoneal cavity to be reabsorbed

Nurse should take this action when assisting with the care of a child who has paralytic poliomyelitis

Administer oral analgesics prior to exercise Rationale: ROM exercises prevent contractures Paralytic poliomyelitis presents with pain/stiffness in the back, neck, and legs followed by signs of CNS paralysis

4 yr old child stutters. Patient teaching with parent includes

Ignore the stuttering and do not interrupt the child Rationale: expected part of speech development in preschool years. Should cease by age 5

Toddler has AIDS. Which finding is an indication of an opportunistic infection?

Candidiasis Rationale: candidiasis (oral thrush) is the overgrowth of Candida albicans that affects the oral cavity. Opportunistic infection: infections that occur more often in people that have a weakened immune system

Appropriate diversional activity for a 7 year old (school-age) in skeletal traction following a femur fracture

Chapter books

Fine motor development of a 4 year old. Child should be able to do what activity?

Copy a square

A nurse is contributing to a plan of care for a 6 mon old who has respiratory syncytial virus (RSV). Which intervention is appropriate?

Implement droplet & contact precautions

Infant has cleft palate and nurse recommends to wait no longer than 6-12 mon to do corrective surgery to avoid what?

Difficulty with language acquisition Rationale: palate is used for vocalizing sounds. Infant could develop poor speech habits

Type of restraint to use on a 3 mon old infant following a cleft lip and palate repair to protect the surgical site

Elbow restraints

Child with nephrotic syndrome and receiving corticosteroid. Home-care instructions should include

Keep child away from those with/might have an infection Restrict sodium intake Weigh daily, same time, and wearing the same clothing Rationale: corticosteroids impair the immune system

Indications of severe dehydration in an infant

Skin cool to the touch Acrocyanosis Mottled skin Delayed capillary refill >4 sec

Play activity for a 4-month old infant

Splash in the tub Rationale: provides tactile stimulation

Nursing care for a 3 year old toddler with haemophilus influenzae type b meningitis

Avoid using a pillow in supine position Head of the bed should be slightly elevated

Findings of an infant at risk for increased intracranial pressure

High-pitched cry Firm, bulging fontanelle Bradycardia Increased sleep time

1 week old infant has manifestations of neonatal abstinence syndrome. Following action to take:

Keep infant in a small isolation nursery Rationale: this decreases the infant's exposure to extraneous lights and noise

Nursing action to take for an infant with pertussis

Maintain a cardio-respiratory monitor Rationale: infants with pertussis typically present apnea in response to coughing spasms/mucus plugs. Humidified oxygen and suction equipment should be used as needed

Adverse effects of Baclofen

Muscle weakness Dizziness Drowsiness Nausea

Dietary teaching with a parent for a toddler with cystic fibrosis. Instructions to include

Provide a high-fat diet Rationale: cystic fibrosis causes impaired intestinal absorption of fat

Child has scarlet fever. What piece of information should the nurse reinforce?

Provide a soft or liquid diet until the pain in their throat improves Rationale: scarlet fever causes inflamed/enlarged tonsils, creating pain in the throat and causes difficulty swallowing

Hep B immunization

birth, 1-2 mon, 6-18 mon