Exam 2 - NUR201

strabismus

Misalignment of the eyes (crossed eyes), is common in the newborn up to 6 months of age.

What are the major tasks of adolescence?

develop an identity, a moral compass, and abstract thinking, which help the adolescent transition to adulthood.

Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of:

diabetic ketoacidosis

S/S of a child with congenital hypothyroidism

difficult to keep the child awake, below weight and height, pale and mottled skin, lethargic, and irritable.

A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client?

enlarged clitoris

Clinical manifestations of atopic dermatitis include:

erythematous patches, extreme pruritus, and severely dry skin

Nursing care for syndrome of inappropriate antidiuretic hormone includes:

fluid monitoring and restriction to prevent decreased serum sodium levels.

tinea pedis

fungal infection of the foot; athlete's foot

A positive Chvostek sign may indicate:

hypoparathyroidism

Kussmaul respiration and drowsiness are signs

metabolic acidosis

s/s of Grave's disease in children

nervousness, tremors, fatigue, increased heart rate and blood pressure.

What medication will be prescribed to a child diagnosed with oral candidiasis (thrush)?

nystatin Application of nystatin to the oral lesions every 6 hours is an effective treatment for oral candidiasis (thrush). Treatment for diaper rash caused by Candida albicans is nystatin ointment or cream applied to the affected area.

dysmenorrhea

painful menstruation

The most common cause of hyperpituitarism is:

pituitary adenoma

An adolescent on fluoxetine should be monitored for what behavioral side effects?

restlessness, hyperactivity, agitation

Untreated or partially treated pharyngitis caused by group A Streptococcus (GAS) can lead to:

rheumatic fever

Adolescents with mononucleosis should avoid participation in contact sports for 2 to 3 weeks due to the risk of:

splenic

The first sign of puberty in females is a rapid growth spurt and the development of breast buds, also known as:

thelarche

Echolalia

toddlers repeat words and phrases without knowing what they are saying, can be a sign of autism if it persists beyond 3 years of age.

Two screening tools to evaluate an adolescent's substance use:

- CRAFT (Car, Relax, Alone, Forget, Friends, and Trouble) - SBIRT (Screening, Brief Intervention, and Referral to Treatment)

Routine schedule for newborn office visits for the first year:

1 week, and then at 1, 2, 4, 6, 9, and 12 months of age

What is the recommended age to start encouraging an infant to self-feed?

10-12 months of age

A child should have all 20 baby teeth by _______ years of age.

3

Blood pressure monitoring becomes part of the routine health assessment at what age and older?

3 years

Normal annual weight gain and height growth for toddlers should be approximately

5 to 10 pounds per year and about 3 inches in height

At what age does a fear of strangers usually develop in a child?

7 months

tinea capitis

A fungal infection of the scalp characterized by red papules, or spots, at the opening of the hair follicles.

The neonatal nurse assesses newborns for iron-deficiency anemia. Which newborn is at highest risk for this disorder?

A preterm newborn Maternal iron stores are transferred to the fetus throughout the last trimester of pregnancy. Newborns born prematurely miss all or at least a portion of this iron store transfer.

animism

A state in which children believe inanimate objects have a consciousness and other life-like properties and is a hallmark of the preconventional stage.

Fifth's Disease: S/S

Bright red cheeks and a lacey, erythematous rash on the trunk and extremities

Priority nursing assessment for a child with salt-losing form of congenital adrenogenital hyperplasia

Dehydration With this form of the disorder, children are unable to produce aldosterone. This leads to the inability to retain sodium and fluid.

Tanner stages

Five stages of sexual development in adolescence evaluating pubic hair, genitals and breast development

Observations that a newborn is experiencingp ain.

Frequently awakening within the hour or being constantly awake Grimacing or grimacing with a noncry vocalization grunt present, an increase from baseline heart rate or blood pressure, requiring oxygen, and crying in a high pitched whether easily consolable or inconsolable.

Most common cause of hyperthyroidism

Graves disease Hyperthyroidism occurs less often in children than hypothyroidism. Graves disease, the most common cause of hyperthyroidism in children, occurs in 1 in 5,000 children between 11 and 15 years of age. Hyperthyroidism occurs more often in females, and the peak incidence occurs during adolescence.

Normal heartrate and respirations for a toddler

HR between 90 and 140 beats per minute RR between 20 to 37 respirations per minute

6 vaccinations needed by 2 months

Hep B IPV (inactivated polio vaccine) PCV (pneumococcal) HiB (haemophilus influenzae Type B) RV (rotavirus) DTaP (Diptheria Tetanus acellular Pertussis)

How would a chronic illness affect a newborn's growth and development?

It is common for newborn with chronic illnesses to grow and develop at a slower pace.

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism?

Low T4 level and high TSH level

Medication that reduces glucose production from the liver?

Metformin

Priority nursing concern for a pediatric patient with diabetes insipidus.

Monitor & document urine output. Strict fluid precautions will not alter urine formation. This assessment is important because the infant will be at great risk for dehydration and electrolyte imbalance. It is part of a basic assessment to monitor heart rate, temperature, skin turgor, and mucous membranes. These are important but may not indicate the infant's overall health. On fluid restriction, oral intake will be specified.

s/s of a child with Cushing's syndrome

Obesity, a rounded face, prominent cheeks, and abdominal striae

How would you administer oral medication to a 4 month old child?

Position the infant upright, present a pleasant- or neutral-tasting substance to ensure that the child is awake and swallowing, give the medication slowly enough to allow the child to swallow and prevent any risk of aspirating, and give a pleasant-tasting "chaser."

Candida infections

Seen in occluded skin sites, body folds, genitals, and diaper areas

How do you calculate a preterm infant's adjusted age?

Subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age

Acrocyanosis

Temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands and fingernails, feet and toenails. May last for a few hours and disappear with warming. Due to vasomotor instability.

At what ages do the fontanelles close?

The diamond-shaped anterior fontanel (fontanelle) normally closes between ages 9 and 18 months. The triangular posterior fontanel (fontanelle) normally closes between ages 2 and 3 months.

How do you determine the respiratory rate for a child?

The primary muscle for breathing until 5 years of age is the diaphragm; therefore, the abdomen should be observed to determine the respiratory rate.

Treatment of Type 2 Diabetes in children

Treating type 2 diabetes in children may require insulin at the outset if the child is acidotic and acutely ill. More commonly, the child can be managed initially with oral agents, meal planning, and increasing activity.

Mongolian spot

a bluish discoloration on the sacral area and is more common in infants with darker skin

Chvostek sign

a facial muscle spasm that occurs when the facial nerve is tapped. This can indicate heightened neuromuscular activity, possibly caused by hypocalcemia. Hypoparathyroidism may be suspected

Tinea corporis (ringworm)

a fungal infection that occurs on the body, is treated with topical antifungal creams

Acanthosis nigricans

a shiny, velvet-like patch on the back of the neck, inner thighs, or axillae that can occur due to insulin resistance. (syptom of Diabetes Type II and gastric carcinoma)

Between what ages does colic in newborns peak?

between 6 weeks of age and stops at about 3 months In breastfed infants, colic sometimes is a reaction to something the mother has eaten. In other infants, colic may result from sensitivity to milk or milk products. Treatment is a restful, soothing environment. Changing an infant's formula or having a breastfeeding mom decrease her intake of gassy foods may alleviate the symptoms.

When should a nurse expect a child's posterior fontanelle to be closed up by?

by 2-3 months of age

At what age can an infant turn onto its back?

by 4 months

magical thinking

cognitive feature of preoperational children; ideas that one's thoughts or behaviors have control over specific situations (example: imaginary friends, possible to turn into a racecar)

What is the most accurate way to determine a 2 year old child's heart rate?

count the apical rate by auscultation

The goals of treatments for a child with diabetes insipidus are to:

dehydration and decrease urinary symptoms

associative play

when children play together and are engaged in a similar activity but without organization, rules, or a leader—and each child does what she or he wishes

When should a parent start potty training a child?

• Generally around age 18 months • Waking up dry in the morning • When the child can pull one's pants up and down • When the child has a wet diaper and takes it off

Describe the principles of atraumatic care.

• preventing or minimizing physical stressors • preventing or minimizing separation of the child from the family • promoting a sense of control