Module 12 Maternal and Pediatric Health Promotion
falls from bicycles cause ______________
head injuries always wear a helmet!
Do preschoolers need naps?
infrequently
whats the best way to help a preschooler overcome their fears?
is by actively involving them in finding practical methods to deal with the frightening experience. Exposing them to the feared object in a safe situation can provide conditioning or desensitization.
when should kids get the HPV vaccine?
is recommended for the prevention of cervical pre-cancers and cancers for girls beginning at a minimum of 9 years of age and for boys 11-12 years of age.
what should we teach parents about convertible restraint car seats?
it is important not to add extra blankets, head cushions, or padding between the child and the restraint straps that did not come with the seat.
what is cradle cap? also known as seborrheic dermatitis
it's a chronic recurrent inflammation of the skin. Usually seen in scalp. Occasionally avoid eyelids or ears. Thick yellow sticky adherent scaly patches that are difficult to remove. can prevent by adequate scalp hygiene. gentle soap and leave it on scalp for a few minutes then use a soft comb to help loosen and remove the crusts.
What is the cycle of violence?
pattern of repeating violent or abusive behaviors from one generation to the next. Phase 1 = tension building Phase 2 = abusive incident Phase 3 = honeymoon period
what are long term effects of tanning?
premature aging of the skin, increased risk for skin cancer, and phototoxic reactions.
why do preschoolers experience fear of procedures compared to toddlers?
related to poorly defined body boundaries and improved cognitive abilities, young children develop concerns related to loss of body parts. They may see procedures as real threats to their existence.
how is colic diagnosed?
rule of 3 crying and fussing for more then 3 hrs/day, occurring 3 days/week, for more than 3 weeks
at what age can children distinguish between fact and fantasy?
school age
what is perimenopause?
stage immediately before menopause where physical changes begin to occur
what kind of sugar is especially harmful to toddlers teeth b/c it causes dental caries?
sucrose
what kind of sunscreen would we recommend to adolescents?
sun protective factor (SPF) of at least 15 and a non alcohol base WITHOUT lanolin, parabens, or fragrance is important. Broad spectrum sunscreens that protect against both UVA and UVB are the most effective.
at what age is thumb sucking and use of a pacifier normal?
throughout the infant stage. If infant is not thumb-sucking and use of pacifier, that's not normal. No need to restrict thumb sucking during infancy and early development.
what erikson stage of growth and development is an infant in?
trust vs mistrust separation and stranger fear is normal at this age
what are latchkey children?
used to describe schoolage children who are left to care for themselves before or after school without the supervision of an adult. Inadequate adult supervision after school leaves children at greater risk for injury and delinquent behavior. Latchkey children may feel more lonely, isolated, and fearful than children who have someone to care for them.
what are convertible restraint car seats used for?
used with infants and toddlers and are placed in the rearward facing positions.
___________ can lead to iron deficiency anemia
whole milk
do patients in perimenopause still need birth control?
yes
Intimate partner violence
•Can be inflicted by women •Physical or emotional abuse •Sexual assault •Isolation •Controlling all aspects of the woman's life (money, shelter, time, food) Intimate partner violence can happen for the first time during pregnancy. The risk to the fetus include miscarriage, preterm birth, and stillbirth.
Which recommendation would the nurse provide a parent who asks when it is safe to transition a toddler from a crib to a bed? 1. "Children can sleep in a bed safely when their height reaches 35 inches (89 cm)." 2. "Children are safe to sleep in a bed when they reach a weight of 25 pounds." 3. "Children can sleep in a bed safely around the time they begin toilet training." 4. "Children are safe to sleep in a bed when they are no longer waking up at night."
1. "Children can sleep in a bed safely when their height reaches 35 inches (89 cm)."
8-10 year olds spend at least ___ hours a day on media related activities
8
Which statement by the adolescent indicates a need for further teaching about the importance of sleep? 1. "I need 7 hours of sleep each night." 2 "Not getting enough sleep can affect my grades." 3 "Sleep deprivation can affect my physical health." 4 "I should leave my phone in the other room to improve my sleep."
1. "I need 7 hours of sleep each night." Adolescents need around 9 hours of sleep each night, although many teens get less than that. Not getting enough sleep can affect school performance and mental and physical health. Many factors cause a teen to not get the sleep he or she needs, including homework, extracurricular activities, time with friends, and use of electronic devices. Leaving the phone in the other room at bedtime can help improve quantity and quality of sleep.
Which parental statement would concern the nurse during a toddler's wellness visit? 1. "My child loves to eat popcorn." 2. "My child loves our family pets." 3. "My child likes to play with gardening toys." 4. "My child loves to play with a fork and spoon."
1. "My child loves to eat popcorn." Popcorn kernels pose a choking risk to a toddler
What is the MOST important strategy to use when teaching about smoking prevention in teenagers? 1. Emphasizing immediate effects of smoking 2. Emphasizing long-term effects of smoking 3. Promoting large-scale public information campaigns 4. Threatening the social norms of groups most likely to smoke
1. Emphasizing immediate effects of smoking This has proven to be the most effective strategy for preventing smoking. Information focuses on tobacco smell and other negative aesthetic issues. Because this age group is not future oriented, this strategy does not work as well as emphasizing immediate effects. Such campaigns can be effective only when focused on the immediate effects of smoking. If the social norms are threatened, the strategy will not work.
The nurse is preparing the playroom on a newly opened pediatric unit. The nurse should include which items to foster the development of the preschool child? (Select all that apply.) 1. Large blocks 2. Alphabet flash cards 3. 100-Piece puzzles 4. Dolls 5. Hand puppets
1. Large blocks 2. Alphabet flash cards 4. Dolls 5. Hand puppets
why are unintentional injuries so common among toddlers?
1. Repetitive use of gross motor skills 2. Curiosity 3. Explorative 4. Not fully developed 5. No understanding of cause and effect 6. Poor depth perception
Which topics will the nurse include when educating adolescents about injury prevention? Select all that apply. One, some, or all responses may be correct. 1. Suicide 2. Depression 3. Seat belt use 4. Contraception 5. Firearm safety
1. Suicide 3. Seat belt use 5. Firearm safety Education about injury prevention for adolescents will include suicide, seat belt use, and firearm safety. Depression should be addressed when assessing mental health. Contraception should be included in discussions about sexuality.
how can we prevent sunburns?
1. Sunscreen of 15 SPF to 50 SPF (should be more than 30) 2. protective cotton clothing and hats 3. avoid sunexposure
how should we explain sugar intake for a toddler to a parent?
1. The frequency with which the sugar is consumed is more important than the total amount eaten. 2. The form of sugar (sucrose) is important. The more cariogenic foods are those that are sticky or hard because they remain in the mouth longer.
Which is true regarding a toddler's sleep? 1. Total sleep averages 12 hours a day. 2. In the awake period, a toddler exhibits sleepwalking. 3. A toddler normally takes several naps during the day. 4. It is uncommon for toddlers to awaken during the nigh
1. Total sleep averages 12 hours a day. Toddlers sleep 12 hours a day on an average. In the awake period, preschoolers, rather than toddlers, exhibit brief crying, walking around, unintelligible speech, sleepwalking, or bedwetting. An infant normally takes several naps during the day but usually sleeps an average of 8 to 10 hours during the night. It is common for toddlers to awaken during the night.
The parents of a toddler state their child is having trouble sleeping. What is the nurse's BEST suggestion to improve sleep habits? 1. Using a transitional object. 2. Varying the bedtime ritual. 3. Restricting stimulating activities during the day. 4. Explaining away fears.
1. Using a transitional object. A transitional object may help the child ease anxiety and facilitate sleep. A consistent ritual will facilitate sleep. The child should have stimulating physical activity during the daytime. Verbal explanations are not understood by a child this age.
The nurse is teaching a community health promotion class to parents and school-age children related to bicycle safety. Issues to cover in the sessions include: 1. bicycles should be walked through busy intersections. 2. bicycles should be ridden against the traffic so that the rider can see the cars. 3. reflectors should be installed only on bicycles that are to be ridden at night. 4. bicycle helmets need to be worn only if the child is planning to ride in traffic.
1. bicycles should be walked through busy intersections. Bicycles should be walked through busy intersections to allow the child to have full view of the traffic and be able to react accordingly, with safety the number one priority. Bicycle helmets should be worn at all times to prevent head injuries. Reflectors should be installed on all bicycles, whether they are ridden during the daytime or at night only. Bicycles should always be ridden with the traffic, not against the traffic. This will assist in preventing accidents.
whats the caloric requirement for preschoolers?
1000-1800 calories
how can we try to decrease bedtime resistance and night waking by toddlers?
1. having a consistent night routine 2. providing transitional objects 3. keep TV out of bedroom 4. provide a light snack before bed 5. quiet time before bed 6. place child in their own bed 7. The bed should also be used only for sleeping, not for a play yard/playpen. 8. Do not hang things over the bed, so that the child associates the bed with sleep and not with activity.
what is the care management of colic?
1. introduce a change in diet (limiting cows milk can help) 2. supportive measures
when should kids get the TDAP vaccine?
11-18 years of age
how many hours of sleep should a 5 year old get?
11.5
how many hours of sleep per night should a preschooler achieve?
12
how can we prevent toddler drownings?
1. supervision is key!! most important 2. fencing around a pool
at what ages is the most critical period for speech development?
2-4 years of age
Which risky adolescent behavior has increased in occurrence in recent years? 1- Binge drinking alcohol 2- Having unprotected sex 3- Using electronic vapor products 4- Experimentation with hard drugs
3- Using electronic vapor products
by what age should colic naturally get better by?
3-4 mo of age
at what cm should child switch from crib to bed?
89 cm
how many hours of sleep should an adolescent get each night?
9 hours of sleep each night
Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake? 1. Using developmental stimulation by a specialist during feedings 2. Avoiding solids until after the bottle is well accepted 3. Being persistent through 10 to 15 minutes of food refusal 4. Varying schedule of routine activities on a daily basis
3. Being persistent through 10 to 15 minutes of food refusal
how should exercise needs be changed during pregnancy?
During pregnancy, exercise should be continued but it should is should be less intense and less often. Sedentary women should obtain medical clearance to initiate exercise during pregnancy and begin with low impact/intensity workouts.
An 8-year-old child admitted to the hospital 2 days ago tells the nurse, "I'm too sick to feed myself." The nurse recognizes that this statement most likely indicates which emotional state? 1. Rebellion 2. Loneliness 3. Regression 4. Immaturity
3. Regression
The nurse is interviewing the parents of a 4-month-old male infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. They say he was "just fine" when they put him in his crib already asleep. The nurse should suspect his death was caused by: 1. suffocation 2. child abuse 3. SIDS 4. infantile apnea
3. SIDS Although the child was found under the blanket, the bloody fluid is consistent with sudden infant death syndrome (SIDS), not suffocation. No other injuries are reported. No previous acute life-threatening events had been reported. The death is consistent with the characteristics of SIDS.
total fat over several days should be ____% of total caloric intake for children 2 years of age and older
30%
A nurse is caring for a 2-month-old exclusively breast-fed infant with an admitting diagnosis of colic. Based on the nurse's knowledge of breastfed infants, what type of stool is expected? 1. dark brown and small hard pebbles 2. loose with green mucus streaks 3. seedy yellow 4. formed with white mucus
3. seedy yellow
At what age do imaginary friends usually begin?
4
The nurse is educating adolescents on using sunscreen to reduce skin cancer risk. Which statement by an adolescent requires correction by the nurse? 1 "I'll use sunscreen without lanolin." 2 "Sunscreen will be applied every 2 hours." 3 "I can use sunscreen with an alcohol-free base." 4 "I will use sunscreen with a sun protective factor (SPF) of 10."
4 "I will use sunscreen with a sun protective factor (SPF) of 10." The nurse will recommend using sunscreen with an SPF of at least 15, not 10. Adolescents using sunscreen without lanolin, with an alcohol-free base, and applying it every 2 hours do not need correction by the nurse.
how does the behavior change between 4 and 5 years of age?
4 year olds are more aggressive and tend to act out against parental authority, but as they hit age 5, they become calmer.
how does lead cause issues within the body?
Lead competes with molecules of calcium interfering with the regulating action of calcium*. In the brain, this disrupts the biochemical processes and may have a direct effect on the release of neurotransmitters, can cause alterations in the blood brain barrier, and interfere with the regulation of synaptic activity
Which factor increases an adolescent's risk for injury in the community? 1. Employment 2. Eating disorders 3. Sleep deprivation 4. Distracted driving
4. Distracted driving
The school nurse knows that which attribute is characteristic of the psychosocial development of school-age children? 1. A developing sense of initiative is very important. 2. Peer approval is not yet a motivating power. 3. Motivation comes from extrinsic rather than intrinsic sources. 4. Feelings of inferiority or lack of worth can be derived from children themselves or from the environment.
4. Feelings of inferiority or lack of worth can be derived from children themselves or from the environment. Developing initiative is characteristic of preschoolers. Peer group formation is one of the major characteristics of this age-group. School-age children gain satisfaction from independent behaviors. This age child is eager to develop skills and participate in activities. All children are not able to do all tasks well, and the child must be prepared to accept some feeling of inferiority.
In planning sex education and contraceptive teaching for adolescents, the nurse should consider which information? 1. Most teenagers today are knowledgeable about reproductive anatomy and physiology. 2. Both sexual activity and contraception require planning. 3. Most teenagers who become pregnant do so as an act of hostility, especially toward their parents. 4. Teenagers need contraception education in both oral and written form.
4. Teenagers need contraception education in both oral and written form. Sex education and contraceptive teaching are independent of an adolescent's knowledge of reproductive anatomy and physiology. Contraception requires planning. Most adolescents are sexually active for 6 months to 1 year before seeking contraceptive information. This is not one of the major identified risks for teenage pregnancy. Sex education and contraceptive information need to be concrete and concise. Oral presentations with visual demonstrations and written information with diagrams should be provided.
The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. What is the nurse's BEST reply? 1. A pacifier should be substituted for the thumb. 2. Thumb-sucking should be discouraged by age 12 months. 3. Thumb-sucking should be discouraged when the teeth begin to erupt. 4. There is no need to restrain nonnutritive sucking during infancy.
4. There is no need to restrain nonnutritive sucking during infancy.
How many mcg of folic acid should be taken during pregnancy and lactation?
400 mcg
by what age do preschoolers tend to try new foods and become a little less picky?
5
at what age should an infant recognize their parents?
6 months of age
at what age should the child begin teething?
6 months of age
when would you recommend to a parent of a newborn to start cleaning their childs mouth?
Begins when primary teeth erupt (around 6 mo)
baby bottle tooth decay
Between 18 mos and 3 years of age the toddler can develop early childhood caries, otherwise known as nursing caries or baby bottle tooth decay.
what is Colic (Paroxysmal Abdominal Pain)?
Abdominal pain or cramping manifested by loud crying and drawing the legs up to the abdomen. typically worse in the evenings and is self limiting.
how can we protect kids from falling out of windows?
Accessible windows should have window guards, not screens, to prevent falls to the ground.
how should we handle body piercing and tattooing of adolescence?
Adolescents often seek body art as an expression of their personal identity and style. Tattoos may mark significant life events such as new relationships, births, and deaths. Piercing the ear, nose, nipple, eyebrow, labia, navel, penis, or tongue may sometimes create a health problem. It is a nursing responsibility to caution girls and boys against having piercing performed by friends, parents, or themselves. Using the same unsterilized needle to pierce body parts of multiple teenagers presents the same risk for HIV, Hepatitis C and Hepatitis B virus transmission that occurs with other needle sharing activities. A qualified operator using proper sterile technique should perform the procedure. tattoo risk is low
whats the recommended exercise regimen for adolescence?
Adolescents should engage in a minimum of 60 minutes of moderate to vigorous physical activity daily and muscle strengthening activity at least 3 days per week.
after a nightmare is over, what does the child do?
After the dream is over, the child wakes and cries or calls; not during the nightmare itself. The child awares up aware and can be reassured by the parents. After being reassured by parents, it can take some time for the child to fall back asleep.
how can we calculate the number of teeth a child is supposed to have?
Age of child in months and subtract 6 - this is the number of teeth the child should have. Example, child is 8 months old, subtract 6 = child should have 2 teeth.
whats the general rule about school age children and car seats?
All children in specially designed car restraints until 145 cms (4 feet 9 inches) and 8-12 years of age
at what age do children become aware of the anatomic difference between the sexes?
At about 3 years of age, children are aware of the anatomic difference between sexes and concerned with how the other works.
what kinds of drugs are cocaine and methamphetamine?
CNS stimulants
what can cocaine cause in the fetus?
Cocaine increases risk of miscarriage, small for gestational age, placental abruption, and stillbirth.
what are common causes of speech problems?
Common causes of speech problems include hearing loss, developmental delay, autism, lack of environmental stimulation, and physical conditions that impede normal speech production.
how long does it take for a child to die from drowning?
Death from drowning can also occur within minutes, diminishing the chance for rescue and survival.
what causes stuttering or stammering?
Failure to master sensorimotor integrations
where should gates be placed around the house?
Gates must be placed at both ends of stair cases.
what are interventions to help with sleep disturbances in preschoolers?
Ignoring attention seeking behavior, not taking the child into the parent's bed, keeping a light on in the room, providing transitional objects such as a favorite toy, or leaving a drink of water are all appropriate interventions. Helping children slow down before bed reduces the resistance. Establish limited rituals and consistently carry them out. And NO TV before bed.
between what ages should children using a belt positioning booster seat?
In general, school age children should ride in a belt positioning booster seat until approximately 7 to 8 years of age.
at what age what we introduce using toothpaste for oral hygiene in toddlers?
Introduce toothpaste around 2 years of age only using a smear or rice size amount. For the child 3-6 years of age, use a pea size amount of toothpaste. After brushing the teeth, floss them.
what temperature should we limit the household water temperatures to?
Limiting household water temps to less than 120 degree F is highly recommended
where does drowning most commonly occur in toddlers?
Most commonly in the bathtub and large buckets
what is a transitional object?
Providing transitional objects, such as a favorite stuffed animal or blanket, can ease the child's insecurity at bedtime.
how do the cycle of violence phases change the longer the relationship continues?
Over time, phase 1 and 2 get longer and phase 3 gets shorter until there's no more phase 3 at all.
are sleep termors normal?
Sleep terrors are a normal, common phenomenon in preschoolers/toddlers that require relatively little intervention.
what is a sleep terror? what stage of sleep does a sleep terror occur in?
Sleep terrors are a partial arousal from very deep sleep, occurs in the non REM sleep. During the terror itself, the child screams and thrashes and is calm afterward.
What is the SCOFF questionnaire?
SCOFF questionaries is easy to use and help nurse decide if eating disorder is apparent.
describe how nutrition requirements change for the infant in the first year of life
Second 6 months of first year, human breastmilk or formula should continue being the infants primary food source. We also start introducing solid foods during this time in addition to the breastmilk or formula since this is when the infants head control is better and they have started to develop teeth!
at what age is it important to begin limit setting and discipline with an infant?
Second half of first year is when we start limit setting and discipline since this is when the infant starts to move.
how should toddlers hold objects that are sharp?
Sharp objects should be pointed away from the face
what does the amount of sleep demand on in a school age child?
Sleep depends on the child's age, activity level, and state of health
what guidance is important about a 6 year old?
Strong food preferences and ravenous appetite Erratic mood changes Injury prevention and safety Privacy - separation bedroom
SAFE PAD
Suffocation Asphyxia/Aspiration/Animal bites Falls Electrical Poisoning Automobile safety Drowning
what are the most common causes of infant death?
Suffocation, motor vehicle injuries, drownings
what immunizations are recommended for adolescents?
Tdap vaccine Meningococcal vaccine HPV vaccine Hepatitis A and B vaccines Annual flu vaccine Varicella vaccine
how should we teach parents to apply barrier cream when their baby has diaper dermatitis?
Teach parents to avoid wiping off all the barrier cream in between diapers changes b/c that can increase irritation, only do it 1-2x per day with mineral oil or a bath.
how can we handle stress in the preschooler?
The best approach to dealing with stress is prevention and monitoring the amount of stress in children's lives so levels do not exceed their coping ability and informing them of anticipated changes on a short term basis.
does a child remember a sleep terror?
The child will have no memory of the dream, yelling, or thrashing
whats the first food typically introduced to infants?
The first food introduced is typically iron-fortified cereal. Then followed with soft foods like pureed veggies and fruits. Then meats as they get older.
what diseases do physicians have to look for if a child is on a vegetarian or macrobiotic diets?
The healthcare provider should evaluate for iron deficiency anemia and rickets in children on strict vegetarian and macrobiotic diets. Vegetarian and vegan diets are becoming more and more popular however the stricter vegan diets are inadequate protein for growth; inadequate calories for energy and growth; poor digestability of many of the bulky natural, unprocessed foods, especially for infants and deficiencies of vitamin B6, niacin, riboflavin, vitamin D, iron, calcium, and zinc.
what is the safest area in the car for a child to sit?
The safest area of the car for children is the back seat and children who must ride in the passenger side of the front seat with an airbag should be positioned as far back as possible or have the airbag disabled. Children should not ride in the open back of a truck.
what are the 5 types of car seats?
There are five types of restraints available in car seats: infant only devices, convertible models for both infants and toddlers, boosters, safety belts, and devices for children with disabilities.
how can we help with physiologic anorexia?
Toddlers like to have the same dish, cup, or spoon every time they eat. Food separate on the plate, not touching each other
at what age should a toddler start using a cup? at what age should the toddler be weaned by the bottle?
Toddlers should be offered a cup at the first birthday and weaned from a bottle by 14 mos of age.
what habits can lead to dental caries besides sugar intake?
This occurs when a child is routinely given a bottle of milk or juice at naptime or bedtime or uses the bottle as a pacifier while awake. Frequent nocturnal breastfeeding for prolonged periods also leads to extensive destruction of the teeth.
how many hours of sleep should a toddler recieve per night?
Total sleep 11 to 12 hours per day with one nap
what are the second types of teeth to appear in an infant?
Upper central incisors
how does the behavior change between 3 and 4 years old?
Warn parents that the equilibrium of a 3 year old will change to the aggressive, out of bounds behavior of a 4 year old
avoid sun exposure during what times of day?
avoiding sun exposure between 10 am and 2 pm
________ supplements should be introduced at 6 months for dental hygiene
fluoride
Why is prenatal counseling during first 12 weeks important?
b/c we can determine if mom if at risk for complications and can initiate measures to prevent problems or treat them if they arise
why is maternal dental health important before and during pregnancy?
bc if moms gums get infected due to poor dental hygiene, then it can lead to an infection and may harm the fetus
When is the eruption of the primary teeth complete?
beginning of preschool age
are birth defects r/t caffeine?
birth defects are not related. However, high intake of caffeine increases risk for high birth weight and increases risk of miscarriage.
____________ increases risk of high birth weight and miscarriage
caffeine
what additional supplements are recommended for adolescents?
calcium, iron, and zinc and vitamins during periods of rapid growth
Sudden infant death syndrome
death of infant under 1 years old that's unexplained. Most thing its because of suffocation in bed. Has decreased when parents started placing their babies on their backs to sleep.
what are physical signs of perimenopause?
-Decreased estrogen -Irregular bleeding -Vasomotor symptoms - hot flashes -Fertility is reduced at this period, but birth control is still recommended
whats the nursing role in caring for a patient with failure to thrive?
-Help to collect careful diet history -Assisting with testing to rule out other diagnoses -Hospitalized for initial workup and nutrition support if severe
A parent tells the nurse at the clinic, "Each morning I offer my 24-month-old juice, and all I hear is 'No.' What should I do? I know she needs fluid!" Which is the best response by the nurse? 1- Offer the child a choice of two juices. 2- Distract the child with a favorite food. 3- Offer the child the glass in a firm manner. 4- Allow the child to see the parent getting angry.
1- Offer the child a choice of two juices. Children who are expressing negativism need to have a feeling of control. One way of achieving this within reasonable limits is for the parent or caregiver to provide a choice of two items instead of forcing one on the child. Distracting the child with a favorite food will not achieve the goal of giving fluids. Offering the child the glass in a firm manner will probably not be successful with a toddler. Allowing the child to see the parent getting angry will complicate the situation and further inhibit the child's willingness to take fluids.
The nurse should teach volunteers in the after school program that which characteristic is MOSTdescriptive of the social development of school-age children? 1. Identification with peers is minimal. 2. Children frequently have "best friends." 3. Boys and girls play equally well with children of either gender. 4. Peer approval is not yet an influence toward conformity.
2. Children frequently have "best friends." identification with peer group is an important factor toward gaining independence from families. Same-sex peers form relationships that encourage sharing of secrets and jokes and coming to each other's aid. During the school-age years there are more gender-specific groups. Conforming to the rules is an essential part of group membership.
Which statement about early childhood caries (ECC) is correct? 1. The syndrome is distinguished by protruding upper front teeth, resulting from sucking on a hard nipple. 2. Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome. 3. The syndrome can be prevented by breastfeeding. 4. Giving the child juice in the bottle instead of milk at bedtime prevents this syndrome.
2. Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome. This may result from pacifier use or thumb-sucking. Sweet liquids pooling in the mouth during sleep cause dental caries. Frequent breastfeeding before sleep can also cause bottle-mouth caries. Juice in bottles before sleep contributes to bottle-mouth caries.
Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. When teaching the parents about the infant's care, what is the most important information the nurse should include in the discharge teaching plan? 1. CPR 2. administering IV fluids 3. Reassurance that the infant cannot be electrocuted during monitoring 4. Advice that the infant not be left with other caretakers such as baby-sitters
1. CPR Cardiopulmonary resuscitation (CPR) is essential for parent and caregivers to know. Most likely the child will not have venous access; thus home intravenous (IV) therapy is not necessary. The monitor is insulated and grounded. The parents should arrange for other caregivers to help out. All need to be taught how to use the monitoring equipment and how to perform CPR.
The school nurse is teaching a class on safety. Which activities require protective athletic gear? (Select all that apply.) 1. Lacrosse 2. Football 3. Swimming 4. Gymnastics 5. Skateboarding
1. Lacrosse 2. Football 5. Skateboarding Any sport that involves body contact such as lacrosse, football, and skateboarding requires a child to wear protective equipment. Swimming does not involve body contact and requires no protective equipment. Gymnastics does not require protective equipment.
When teaching about the effects of social media on the adolescent population, the nurse should include which negative impacts? (Select all that apply.) 1. Possibility of cyberbullying 2. Opportunity for adolescents without many friends to interact with others 3. Disruptive texting during school 4. Sharing of personal information with sexual predators 5. Time management
1. Possibility of cyberbullying 3. Disruptive texting during school 4. Sharing of personal information with sexual predators
The nurse preparing a nutritional teaching plan for the parents of a preschool child should include which information? 1. The quality of the food consumed is more important than the quantity. 2. Nutrition requirements for preschoolers are very different from requirements for toddlers. 3. Requirement for calories per unit of body weight increases slightly during the preschool period. 4. average daily intake of preschoolers should be about 3000 calories.
1. The quality of the food consumed is more important than the quantity. It is essential that the child eat a balanced diet with essential nutrients. Requirements are similar. Caloric requirement decreases slightly. Average intake is about 1800 calories each day.
The nurse is assessing a preschool age child who is stuttering when answering the nurse's questions. The nurse should offer alternate methods of responding to the stuttering when observing the parent: 1. completing the childs sentences 2. listening attentively 3. helping the child relax 4. encouraging the child to speak slowly
1. completing the childs sentences The National Institute on Deafness and Other Communication Disorders NIDCD encourages parents and caregivers of children who stutter to speak slowly and relaxed, refrain from criticizing the child's speech, resist completing the child's sentences, and take time to listen attentively
A nurse is presenting a class on injury prevention to parents of preschoolers. Which injuries should the nurse identify as occurring in this age-group? (Select all that apply.) 1. falls 2. drowning 3. Poisoning 4. Sports injuries 5. Tricycle and bicycle accidents
1. falls 2. drowning 3. Poisoning 5. Tricycle and bicycle accidents Falls occur frequently in preschoolers. Closely monitor playground activities such as climbing a jungle-gym. Closely supervise around any water and ensure swimming pools are securely fenced to prevent near drowning. Place all medications and poisons out of reach and in locked cabinets. Administer medications as a drug, not "candy." Keep poison control phone number by telephone. When riding tricycles and bicycles, children often forget not to ride in the streets. Sports injuries occur in older children.
teenagers spend at least ___ hours a day on media related activities
11
by how many months should we expect a baby to use a spoon?
18 months (a year and half) at 12 mo, they eat with their hands. by 18 mo, they can use a spoon.
how many meals and snacks should a toddler eat per day?
3 meals and 2 snacks daily of a balanced diet of veggies, fruits, and whole grains
A 4-month-old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention? 1. "Never shake baby powder directly on your infant because it can be aspirated into his lungs." 2. "Do not permit your child to chew paint from window ledges because he might absorb too much lead." 3. "When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall." 4. "Keep doors of appliances closed at all times."
3. "When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall." This is appropriate guidance for a first-month appointment. This information should be included at the 9-month visit when the infant is beginning to crawl and pull to a stand. Rolling over from abdomen to back occurs between 4 and 7 months. This is the appropriate anticipatory guidance for this age. This information should be included at the 9-month visit when the infant is beginning to crawl and pull to a stand.
The nurse is teaching the parent of a 2-year-old child how to care for the child's teeth. Which of the following should be included? 1. Flossing is not recommended at this age. 2. The child is old enough to brush teeth effectively. 3. Brush teeth with plain water if child does not like toothpaste. 4. Toothbrush should be small and have hard, rounded, nylon bristles.
3. Brush teeth with plain water if child does not like toothpaste. Flossing should be done after brushing. Two year olds cannot effectively brush their own teeth; parental assistance is necessary. Some children do not like the flavor of toothpaste or the foam; water alone can be used. Soft, multitufted, bristled toothbrushes are recommended.
what is the care management for positional plagiocephaly?
Placing infant prone from time to time - tummy time during day alternating head position when infant cant turn their own head helmet
what are some preventable habits that can be done to reduce the risk of dental caries in toddlers?
Prevention includes eliminating the bedtime bottle completely, feeding the last bottle before bedtime, substituting a bottle of water for milk or juice, not using the bottle as a pacifier, and never coating pacifiers in sweet substances. Juice in bottles is discouraged and should always be offered in a cup to avoid prolonging the bottle feeding habit.
how should sex education be presented to adolescents?
Sexuality education should consist of instruction concerning normal body functions and should be presented in a straightforward manner using correct terminology. When discussing sex and sexual activities, nurses should use simple but correct language, not street language, not scientific terminology, or evasive jargon. Need to also discuss sexual predators, technological exposure to sex (ex = sending nudes), and safe sex practices.
how should we explain sex education to a curious preschooler?
The first is to find out what children know and think. After investigating the theories children have produced as a reasonable explanation, parents can give correct information and help them understand why their explanation is inaccurate. You also would not want to provide information that the child did not necessarily ask for. The second rule for giving information is to be honest. The correct anatomic words should be used as they become foundational content for explaining the concepts. This also allows for the correct information to be repeated when the child forgets.
The school nurse is discussing dental health with some children in first grade. What should the nurse include in the discussion? 1. Teaching how to floss teeth properly. 2. Recommending a toothbrush with hard nylon bristles. 3. Emphasizing the importance of brushing before bedtime. 4. Recommending nonfluoridated toothpaste approved by the American Dental Association.
3. Emphasizing the importance of brushing before bedtime. Parents should help with flossing until children develop the dexterity required, which occurs at about the time of third grade. A toothbrush with soft nylon bristles is recommended. Children should be taught to brush their teeth after meals, after snacks, and before bedtime. The American Dental Association recommends fluoridated toothpaste for this age-group.
An important consideration for the school nurse planning a class on injury prevention for adolescents is that: 1. adolescents generally are not risk takers. 2. adolescents can anticipate the long-term consequences of serious injuries. 3. during adolescence a need exists for discharging energy, often at the expense of logical thinking. 4. during adolescence participation in sports should be limited to prevent permanent injuries.
3. during adolescence a need exists for discharging energy, often at the expense of logical thinking. Adolescents are risk takers because of their feelings of indestructibility. The feelings of indestructibility that are common in adolescence interfere with understanding the consequences. The physical, sensory, and psychomotor development of adolescents provides a sense of strength and confidence. There is also an increase in energy coupled with risk taking that puts them at risk. Sports can be a useful way for adolescents to discharge energy. Care must be taken to avoid overuse injuries.
Nursing interventions to promote health during middle childhood include: 1. stressing the need for increased calorie intake to meet increased demands. 2. instructing parents to defer questions about sex until the child reaches adolescence. 3. educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt. 4. advising parents that the child will need decreasing amounts of rest toward the end of this period.
3. educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt. Caloric needs are diminished; however, a balanced diet is important to prepare for the adolescent growth spurt. Parents should approach sex education with a lifespan approach and respond to a child's questions with an answer appropriate to the child's age. Because the permanent teeth are present, it is important for the child to learn how to care for these teeth. School-age children often need to be reminded to go to sleep.
Which treatment would the nurse anticipate administering to a toddler who has acetaminophen poisoning? 1- Oxygen 2- Naloxone 3- Amyl nitrate 4- N-acetylcysteine
4- N-acetylcysteine N-acetylcysteine is used to treat an acetaminophen poisoning. Oxygen is used to treat carbon monoxide poisoning. Naloxone is used to treat opioid overdoses. Amyl nitrate is used to treat cyanide poisoning.
The school nurse is teaching a class on injury prevention. What should be included when discussing firearms? 1. Adolescents are too young to use a gun properly for hunting. 2. Gun carrying among adolescents is on the rise, primarily among inner-city youth. 3.Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns. 4. Adolescence is the peak age for being a victim and/or offender in the case of injury involving a firearm.
4. Adolescence is the peak age for being a victim and/or offender in the case of injury involving a firearm. Adolescents can be taught to safely use guns for hunting, but they must be stored properly and used only with supervision. Gun carrying is on the rise among adolescents and is not limited to just the stereotypic inner-city youth population. These types of nonpowder guns cause almost as many injuries as powder guns. Gun carrying among adolescents is on the rise. The increase in gun availability is linked to increased gun deaths among children.
A 4-year-old female child is afraid of dogs. What should the nurse recommend to her parents to help her with this fear? 1. Keep her away from dogs 2. Buy her a stuffed dog toy 3. Force her to touch a dog briefly 4. Let her watch other children play with a dog
4. Let her watch other children play with a dog These actions avoid the object of fear rather than approaching it and finding solutions. These actions avoid the object of fear rather than approaching it and finding solutions. Forcing the child to interact with the dog may increase the level of fear. The parents should actively seek ways to deal with fear. By observing other children at play with dogs, the child can learn to adapt.
When explaining the proper restraint of toddlers in motor vehicles to a group of parents, the nurse should include: 1. wearing safety belts snugly over the toddler's abdomen 2. placing the car seat in the front passenger seat if there is an airbag 3. using lap and shoulder belts when the child is over 3 years of age 4. placing the car seat in the back seat of the car facing forward
4. placing the car seat in the back seat of the car facing forward Car seats are required for toddlers to prevent injury in case of a motor vehicle accident. The car seat should be placed in the back seat, forward facing. Safety belts can cause injuries if they are placed over a toddler's abdomen. Car seats should be in the rear of the car because airbags can injure the toddler. Three year olds should be restrained in car seats. remember: after age 2, they can move from rear facing to forward facing
at what age do first permanent teeth erupt?
6 years old
how many minutes of physical activity should a preschooler achieve per day?
60
at what age would we prepare parents for prepubescent changes in girls?
7-10
how many hours of sleep should a 12 year old get?
9
how should parents handle sexual curiosity in preschoolers?
A positive approach is to neither condone or condemn it but to express that if children have questions, they should ask the parents. Then parents can answer their questions and encourage them to engage in some other activity.
how does the idea of ritualism r/t toddler nutrition?
A regular mealtime schedule also contributes to their desire and need for predictability to eat and ritualism.
how should we help parents choose a preschool for their child?
Areas for parents to evaluate include the facility's daily program, teacher qualifications, staff to student ratio, discipline policy, environmental safety precautions, provision of meals, sanitary conditions, adequate indoor and outdoor space per child, safety and injury prevention, and fee schedule. Evaluation of the facility's health practices is extremely important. Nurses play an important role in infection control.
what is physiologic anorexia?
At approximately 18 mos of age, most toddler manifest this decreased nutritional need with a decreased appetite, physiologic anorexia. They become picky, fussy eaters with strong taste preferences. This is normal!
what guidance is important for a child 11-12 years of age?
Body changes Sex Education Increase in dangerous activities
do breastfed infants or bottle fed infants awake more often in the night to feed?
Breastfed infants awaken more often for feeding compared to bottle fed
how can we prevent diaper dermatitis?
Change diaper as soon as its wet or dirty, expose healthy skin to air to facilitate drying, powders are ok if they have cornstarch (no powders with talc), ointment with zinc or petroleum to protect skin.
what are the risk factors for developing lead poisioning?
Children who live in poverty, younger than 6 years of age, living in urban areas, and living in older rental homes are all at increased risk for lead poisoning
why is discipline important?
Discipline helps the child interrupt or inhibit the forbidden action, points out a more acceptable form of behavior, provides reason, and explains why one action is inappropriate and one is more desirable
A hospitalized toddler clings to a worn, tattered blanket. She screams when anyone tries to take it away. What is the nurse's BEST explanation to the parents for the child's attachment to the blanket? 1. The blanket encourages immature behavior. 2. The blanket is an important transitional object. 3. She has not mastered the developmental task of individuation-separation. 4. She has not bonded adequately with her mother.
2. The blanket is an important transitional object. Transitional objects are important to help toddlers separate. The blanket is an important transitional object that provides security when the child is separated from parents. Transitional objects are helpful when the child is experiencing an increased stress situation such as hospitalization. This does not reflect bonding behavior.
During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. His birthday is close to the cutoff date, and he has not attended preschool. The nurse's BEST recommendation is to: 1. start kindergarten 2. perform developmental screening 3. observe a kindergarten class. 4. postpone kindergarten and go to preschool.
2. perform developmental screening A developmental screening will provide the necessary information to help the family determine readiness. Observing will provide information about kindergarten but not whether the child is ready. If the child is ready for kindergarten, preschool may lead to boredom.
apparent life-threatening event (ALTE)
Infant found not breathing, cyanotic and unresponsive but resumes breathing with stimulation. ◦Aborted or near-miss SIDS ◦May or may not include apnea ◦Infant not arousable, infant apnea, choking
how many times a year should an adolescent go to the dentist?
It is recommended that an evaluation for cavities takes place at a minimum of every year and optimally at 6 month intervals.
what kinds of toys are most safe for toddlers?
Large, sturdy toys without sharp edges or removable parts are safest. We need to avoid small things that they can swallow.
why is swallowing difficult in toddlers?
No gum chewing- Gum chewing takes practice to learn how to chew it without swallowing it.
how is the childs reaction after a sleep terror different than a nightmare?
after the sleep terror, The child may sit up, thrash, or run in a bizarre manner with the eyes bulging, heart racing, and profuse perspiring; may cry, scream, talk or moan. They are NOT aware and cannot be comforted. The child may fall back asleep fairly quickly.
when is sexual curiosity and masturbation common in the preschool years?
age 4 - Parents should emphasize that masturbation is a private act, thus teaching children socially acceptable behavior.
by what age should real and imagined fear of preschoolers go away?
age 5-6
________ consumption is the most important and preventable cause of cognitive impairment in children.
alcohol - In addition to fetal alcohol syndrome other risks include miscarriage, stillbirth, and preterm birth.
what are nightmares? during what sleep stage does it occur in?
as a scary dream taking place during REM sleep and followed by full waking.
What are the 5 A of smoking cessation?
ask, advise, assess, assist, and arrange follow up
scalds
burns caused by hot liquids. ex: children pulling pots with hot liquids on top of themselves are a major source of burns. Pot handles should be turned toward the back of the stove, and electric pots including cords should be placed out of reach
what is the most common way that children get lead poisioning?
by ingesting or inhaling particles of nonintact lead based paint in an older home or lead contaminated bare soil in the yard
The parent of a 2 week old asks the nurse if the infant needs fluoride supplements because they plan to exclusively breastfed. What is the nurse's best response? a. "Your infant needs to begin taking them now." b. "They are not needed if you drink fluoridated water." c. "Your infant may need to begin taking them at age 6 months." d. "Your infant can have infant cereal mixed with fluoridated water instead of supplements."
c. "Your infant may need to begin taking them at age 6 months." Fluoride supplementation is recommended by the American Academy of Pediatrics beginning at age 6 months if the child is not drinking adequate amounts of fluoridated water. The recommendation is to begin supplementation at 6 months, not at 2 weeks. The amount of water that is ingested and the amount of fluoride in the water are evaluated when supplementation is being considered.
what can CNS stimulants to do the pregnant patient?
can cause tachycardia + HTN --> heart attack, stroke, liver disease and seizures
What is the most common cause of death in the adolescent age-group? a. Drownings b. Firearms c. Drug overdoses d. Motor vehicles
d. Motor vehicles
what can substance abuse cause?
delayed fetal growth and maturation
sleep disorders during pregnancy are associated with
depression, pain, and fibromyalgia.
how does emotional well being change between early and late adolescence?
early = immediate and emotional late = calm and rational early adolescents react immediately and emotionally, older adolescents can control their emotions until socially acceptable times and places for expression present themselves.
at what age do kids typically get braces?
early adolescence
what are automobile safety measures to reduce severity of injury?
effective car restraint systems, door lock mechanisms, and appropriate passenger seating locations in the motor vehicle.
by what age should every child have an oral health exam?
every child have an oral health examination by a practitioner by 6 mos or within 6 mos of the eruption of the first tooth or if a high risk category for caries. Every child should have an established dental home by 12 months of age.
what are some ways to prevent SIDS?
exclusively breastfeeding, pacifier use when infant is falling asleep, baby sleeping on back
infibulation/surgical closure of the labia majora and circumsion is another way to refer to what?
female genital mutilation
substance use is the most teratogenic in what trimester?
first trimester
what is the common reason for poisoning?
improper storage
___________ kill more adolescents in the US than any other single cause.
injuries, specifically motor vehicle accidents as first and homicide is second Distracted driving and Firearm safety are both issues that can cause adolescent death
Dyslalia
is articulation problems that develop from children producing sounds ahead of their developmental level or reverting to infantile speech.
what are the first teeth to appear in an infant?
lower central incisors at about 6- 10 months of age
what causes more accidental deaths in all pediatric age groups after 1 year of age?
motor vehicle injury
how many ounces at a time should fruit juice be offered to an infant?
only 4-6 oz at a time
emotional upheaval
overwhelmed, feelings of lost control over emotions thats common in adolescence
how do toddlers die by being in the open trunk?
play behind a parked car and are not seen soon enough to avoid being hit. Crawling into an open trunk has become more commonplace. Asphyxia can occur. To avoid this, car trunks should not be left open when children are not being supervised.
Diaper dermatitis occurs b/c?
r/t sensitive skin and exposure to irritation materials in that diaper area (urine and feces most common, perfumed soaps or harsh detergents).
what is the most common type of thermal injury in children?
scalds, just is most oftne due to high temperature tap water.
what health screening is common in adolescents?
scoliosis
when should kids get the meningococcal vaccine?
should be given to adolescents 11-12 years of age with a booster dose at 16 years of age.
how average, how many hours does a newborn sleep per day if the newborn is ages 3-4 mo old?
sleep lasts 9 to 11 hours with naps
are school age children capable of identifying their own stress?
yes! Children from 7-12 years of age are capable of identifying their own physiologic responses to stress and should be taught to recognize these signs as indicators of stress and to use techniques to manage their stress. Encouraging children to use physical activity to reduce tension and anxiety can be encouraged to observe effective coping strategies in others and adopt them for their own use.
should school age children still sit in the back seat?
yes! up until 13 years of age
how does nutrition change for a school age child?
●Caloric needs are diminished in relation to body size ●The quality of the child's diet depends on the family's pattern of eating obesity is increasing concern of this age group that predisposes children to diseases
for 24-36 months, how should we guide parents about topics?
●Imitation and mimicry ●Toilet training ●Uniqueness of thought processes ●Discipline ●Preschools
for the toddler 12-18 months of age, how should we guide parents about topics?
●Negativism and ritualism ●Assess feeding habits, wean from the bottle, increase solid foods ●Picky eaters ●Sleep patterns, no bedtime bottles ●Safety ●Discipline Play
what are some motor vehicle related injuries seen in toddlers?
●Pedestrian traffic injuries ●Open trunks ●Overheating ●Left in car
why are lead levels completed in children at 9 mo and 18 mo at the same time as hemoglobin screening?
There is a direct relationship between anemia and lead poisoning as children that are anemic absorb lead more readily. This allows the child with a low hemoglobin to be accurately assessed to see if it is lead instead.
why is cheating common in young children?
They find it difficult to lose at a game or contest, so they may cheat to win. This behavior usually disappears as they mature. When parents set examples of honesty, children are more likely to conform to these standards.
do preschoolers brush their own teeth?
The preschooler still requires assistance and supervision with brushing, and flossing should be performed by parents. Trauma to teeth during this period is common, and prompt evaluation by a dentist is warranted if oral trauma occurs.
at what age do the second permanent molars appear?
The second permanent molar appears at 12 years of age and indicates most permanent teeth are present
Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats? a. Social isolation b. Level of stress c. Degree of depression d. Desire to punish others
a. Social isolation Social isolation is a significant factor in distinguishing adolescents who will kill themselves from those who will not. It is also more characteristic of those who complete suicide than of those who make attempts or threats. Level of stress, degree of depression, and desire to punish others are contributing factors in suicide, but they are not the most significant factor in distinguishing those who complete suicide from those who attempt suicide.
how does stress impact the preschooler?
Minimal amounts of stress are beneficial during the early years to help children develop effective coping skills. However, excessive stress is harmful. Young children are especially vulnerable because of their limited capacity to cope. Expression of frustration, fear, and anxiety is hampered by inadequate expressive language.
modeling aggression
Modeling, or imitating the behavior of significant others, is a powerful influencing force in preschoolers. Children who see their parents as physically abusive are observing behavior that they come to know as acceptable and therefore may exhibit this behavior with others. Another aspect of modeling is the double standard for acceptable conduct.
why is smoking bad during pregnancy?
Mom can have thromboembolic complications, premature rupture of membranes, placenta previa, and a risk of miscarriage, IUGR, and preterm birth.
how many hours does it take after the ingestion of a battery to cause harm in the child?
2 hours, it needs to be removed immediately
the traffic seat administration recommends that children up to ____ years of age ride in the backseat and are rear facing?
2 years of age.once they hit 2,they can turn forward facing
A toddler presents in the emergency department (ED) with an infected wound. The child's mother states, "I don't have time to take care of this." A review of the child's medical record indicates that each appointment related to the wound was cancelled. Which would the nurse suspect based on the current data? 1- Physical abuse 2- Physical neglect 3- Emotional neglect 4- Psychologic abuse
2- Physical neglect
stuttering and stammering often occurs in what age?
2-5 - Stuttering affects boys more frequently than girls, has a genetic link, and usually resolves during childhood.
One of the major tasks of toddlerhood is toilet training. In teaching the parents about a child's readiness for toilet training, it is important for the nurse to emphasize that: 1. nighttime bladder control develops first, so parents should focus on that in the initial teaching with their toddler. 2. bowel control is accomplished before bladder control, so the parent should focus on bowel training first. 3. the toddler must have the gross motor skill to climb up to the adult toilet before training is begun. 4. the universal age for toilet training to begin is 2 years, and the universal age for completion is 4 years.
3. the toddler must have the gross motor skill to climb up to the adult toilet before training is begun. Bowel training is usually accomplished before bladder training because of its greater regularity and predictability. The sensation to defecate is stronger than that of urination. The completion of bowel training will give the toddler a sense of accomplishment that can be carried onto bladder training. Nighttime bladder control normally takes several months to years after daytime training; therefore, this should not be the initial focus of toilet training with a toddler. There is no universal right age to begin toilet training or an absolute deadline to complete training. One of the nurse's most important responsibilities is to help parents identify the readiness signs in their child.
A low grade point average in adolescence is associated with what?
Low grade point average associated with emotional distress; cigarette, alcohol, and marijuana use; and earlier onset of sexual activity
describe how posture impacts adolescence
Many adolescents demonstrate altered posture. Rapid skeletal growth is often associated with slower muscular growth, and some teenagers may appear awkward or slump and fail to stand or sit upright. Scoliosis is a defect of the spine that occurs frequently in adolescence and is more common in girls than in boys. The majority of cases are idiopathic, and the defect manifests as a painless curvature of the spine. Fortunately most of these spinal curvatures will not require treatment. All curvatures of the spine should be referred for further evaluation.
whats the most important thing to teach parents about injury prevention?
◦Ensuring safety in the home ◦Teaching infant CPR
what practices can be avoided to prevent dental caries?
◦No bottle propping ◦No milk in bed ◦No fruit juices
the second 6 months of the first year of life should include implemented what aspects of nutrition?
◦Selection and preparation of solid foods ◦Introduction of solid foods ◦Weaning from breast or bottle
What should the nurse recommend to help a toddler cope with the birth of a new sibling? 1. Give the toddler a doll on which he or she can imitate parenting. 2. Discourage the toddler from helping with care of new sibling 3. Prepare the toddler for upcoming changes about 1 to 2 weeks before birth of the sibling 4. Explain to the toddler that a new playmate will soon come home
1. Give the toddler a doll on which he or she can imitate parenting. The toddler can participate in the activity of caring for a new family member. The child should be encouraged to participate in accordance with his or her abilities. Preparation should begin as soon as changes in the mother's physical appearance and the home setting occur. This will establish unrealistic expectations.
The primary goals in the nutritional management of children with failure to thrive (FTT) are: (Select all that apply.) 1. allow for growth catch up 2. correct nutritional deficiencies 3. achieve ideal weight for height 4. restore optimum body composition 5. educate the parents or primary caregivers on child's nutritional requirements 6. educate the parents or primary caregivers that the child will need tube feedings first
1. allow for growth catch up 2. correct nutritional deficiencies 3. achieve ideal weight for height 4. restore optimum body composition 5. educate the parents or primary caregivers on child's nutritional requirements
A nurse is providing teaching about expected changes during puberty to a group of guardians of early adolescent girls. Which of the following statements by one of the guardians indicates an understanding of teachings? 1. girls usually stop growing about 2 years after menarche 2. girls are expected to gaine about 65 pounds during puberty 3. girls experience menstruation prior to breast development 4. girls typically grow more than 10 inches during puberty
1. girls usually stop growing about 2 years after menarche
how would you recommend parents clean their childs teeth during the first year of life?
1. the first few teeth we are just wiping that with a damp cloth, no need for toothpaste in the first year of life 2. Once they get a few more teeth, you can start to use a soft bristle brush toothbrush. Encourage family to pick a dentist and have that first visit by a year of age or so.
Which ages are the most critical for speech development during the preschool years? Select all that apply. One, some, or all responses may be correct. 1. 2 years 2. 3 years 3. 4 years 4. 5 years 5. 6 years
2. 3 years 3. 4 years The most critical ages for speech development for the preschool-aged client are 3 and 4 years of age. Although critical speech development occurs at the age of 2, this is the toddler, not preschool, stage of development. The ages of 5 and 6 years are not considered critical ages for speech development for the preschool-aged client.
Which age group is most appropriate for a hygiene class to prepare young girls for their first period? 1. 6- to 7-year-olds 2. 8- to 9-year-olds 3. 12- to 13-year-olds 4. 14- to 15-year-olds
2. 8- to 9-year-olds The average age of onset of menarche is between the ages of 12 and 13, although most girls experience their first period between 10.5 and 15.5 years of age. Having the class for 8- to 9-year-old girls is most appropriate because they are right before the age where the girls will start to get their first period
Which clinical condition is associated with lead poisoning? 1. Asthma 2. Anemia 3. Metabolic acidosis 4. Systemic infection
2. Anemia
The nurse is preparing a health teaching session for school-age children. The nurse should include which information about injury prevention in the plan? 1. Peer pressure is not strong enough to affect risk-taking behavior. 2. Most injuries occur in or near school or home 3. Injuries from burns are the highest at this age because of fascination with fire. 4. Lack of muscular coordination and control results in an increased incidence of injuries.
2. Most injuries occur in or near school or home Peer pressure is significant in this age-group. This is where most injuries occur. Automobile accidents account for the majority of severe accidents, either as a pedestrian or passenger. School-age children have more refined muscle development, which results in an overall decrease in the number of accidents.
The parents of a toddler ask the nurse how to handle their child's increasing number of temper tantrums. The nurse should include which positive reinforcement methods of reducing the number of tantrums? (Select all that apply.) 1. Suggest that parents provide the child an "all or none" position. 2. Suggest that parents ignore the behavior as long as child is not harming self. 3. Encourage the parents to provide comfort once the child has calmed down. 4. Ask parents to praise the child for positive behavior when not having a tantrum. 5. Tell parents not to give in to the original request that started the temper tantrum.
2. Suggest that parents ignore the behavior as long as child is not harming self. 3. Encourage the parents to provide comfort once the child has calmed down. 4. Ask parents to praise the child for positive behavior when not having a tantrum. 5. Tell parents not to give in to the original request that started the temper tantrum.
how many mg of caffeine should be limited for pregnant patients per day?
200 mg
The parents of a 4-year-old girl are worried because she has an imaginary playmate. The nurse's BEST response is to tell the parents: 1. a psychosocial evaluation is indicated. 2. an evaluation of possible parent-child conflict is indicated. 3. having imaginary playmates is normal and useful at this age. 4. having imaginary playmates is abnormal after about age 2 years.
3. having imaginary playmates is normal and useful at this age. Since an imaginary playmate is part of normal development, an evaluation is not necessary. Since an imaginary playmate is part of normal development, an evaluation is not necessary. Imaginary playmates are a part of normal development at this age. The peak incidence of imaginary playmates occurs at 2.5 to 3 years of age. These "playmates" usually are not present once school starts.
thromboembolic complications, premature rupture of membranes, placenta previa, and a risk of miscarriage, IUGR, and preterm birth is caused by pregnant patients: 1. cocaine 2. alcohol 3. smoking 4. caffeine
3. smoking
at what age should a child stop thumb sucking and using a pacifier by?
4 years of age.
Which recommendation would the nurse make to a parent to address bedtime resistance in a 4-year-old child? 1- "You should sleep with your child." 2- "You should listen to your child's concerns." 3- "You should implement consequences for your child." 4- "You should limit screen time in the hour before bedtime."
4- "You should limit screen time in the hour before bedtime." The nurse should suggest that the parent limit screen time before bedtime because screens are alerting and disrupt the sleep-wake cycle. The nurse should not suggest that the mother sleep with the child because it may cause further bedtime delays and establish difficult-to-break cosleeping. Scolding the child will induce a sense of fear and exacerbate bedtime problems. A parent should listen to the child's concerns, but this action should not be done at bedtime because the child may further delay sleeping.
Which consideration would the nurse make when preparing to give a preschooler an intramuscular injection in the vastus lateralis site? 1- The anterior third of the vastus lateralis is used to give an injection. 2- The vastus lateralis site is used to inject volumes greater than 10 mL. 3- The child should keep the knee straight to receive an injection at the vastus lateralis site. 4- The maximum recommended length of the needle insertion at the vastus lateralis site is 1 inch for preschoolers.
4- The maximum recommended length of the needle insertion at the vastus lateralis site is 1 inch for preschoolers.
at what age should solid foods be introduced?
4-6 months
what is positional plagiocephaly?
Cranial molding during infancy r/t supine position
what is the primary cause of fatal ingestions in children younger than 5 years?
Disk or button battery ingestion
what guidance is important for a child 7-10 years old?
Fewer illnesses Increase in minor injuries Encourage independence
what are common needle borne diseases in cocaine users?
Needle-borne diseases like hepatitis B and acquired immunodeficiency syndrome are common in cocaine users.
how do suffocation deaths usually occur in toddlers?
Suffocation deaths usually occur in this age group by wedging between a wall and mattress or crib side or collapse of a play yard wall. They also have issues. They also have difficulty with large pieces of food swallowing it.
what kinds of supplements would you expect to see in an infant for who exclusively breastfeeding?
Supplement with vitamin D in first few weeks of life and continue if exclusively breastfeed. At 4 mo, iron supplementation until infant starts eating iron fortified cereals.
how does nutrition change in adolescence?
The rapid and extensive increase in height, weight, muscle mass, and sexual maturity of adolescence is accompanied by increased nutritional requirements. Pressure for time and commitments to activities adversely affect teenager's eating habits and as such omitting breakfast or eating a breakfast that is nutritionally poor in quality is frequently a problem. Snacks chosen based on accessibility and not on the nutritional aspect including an excess intake of calories, sugar, fat, cholesterol, and sodium are common problems for adolescents.
The nurse is caring for an adolescent diagnosed with acute cocaine toxicity. Initial data collection should include what focus? a. Mode of administration. b. Actual content of the drug. c. Function the drug plays in the adolescent's life. d. Adolescent's level of interest in rehabilitation
a. Mode of administration. When the drug is questionable or unknown, every effort must be made to determine the type, amount of drug taken, the mode and time of administration, and factors relating to the onset of presenting symptoms. Because the actual content of most street drugs is highly questionable, this information would be difficult to obtain.
what are some menstrual problems that can occur in women?
amenorrhea, dysmenorrhea, premenstrual syndrome, endometriosis, and heavy menstrual bleeding or intermenstrual bleeding. Questions should never be considered inconsequential, and age-specific reading materials are recommended
flame burns
are one of the most fatal types of burns and commonly occur when children play with matches and accidentally set themselves and the home on fire.
should toddlers brush and floss their teeth?
brushing and flossing should be implemented to remove plaque but the most effective cleaning is done by the parents.
Which statement by the nurse is most appropriate to a 15 year old whose friend has mentioned suicide? a. "Tell your friend to come to the clinic immediately." b. "You need to gather details about your friend's suicide plan." c. "Your friend's threat needs to be taken seriously and immediate help for your friend is important." d. "If your friend mentions suicide a second time, you will want to get your friend some help."
c. "Your friend's threat needs to be taken seriously and immediate help for your friend is important."
Young people diagnosed with anorexia nervosa are often described as possessing what personal characteristic? a. Independent b. Disruptive c. Conforming d. Low achieving
c. Conforming Individuals with anorexia nervosa are described as perfectionist, academically high achievers, conforming, and conscientious. Independent, disruptive, and low achieving are not part of the behavioral characteristics of anorexia nervosa.
by late adolescence, what should be checked at dental appointments?
careful cleaning of dental appliances and if wisdom teeth are in
hyperaggression in preschoolers
characterized by unprovoked physical attacks on other children and adults, destruction of others' property, frequent intense temper tantrums, extreme impulsivity, disrespect, and noncompliance.
The parents of a 12-month-old child ask the nurse if the child can eat hot dogs. The nurse's reply should be based on what understanding? a. The child is too young to digest hot dogs. b. The child is too young to eat hot dogs safely. c. Hot dogs must be sliced into sections to prevent aspiration. d. Hot dogs must be cut into small, irregular pieces to prevent aspiration.
d. Hot dogs must be cut into small, irregular pieces to prevent aspiration. Hot dogs are of a consistency, diameter, and round shape that may cause complete obstruction of the child's airway. If given to young children, the hot dog should be cut into small irregular pieces rather than served whole or in slices. The child's digestive system is mature enough to digest hot dogs. To eat the hot dog safely, the child should be sitting down, and the hot dog should be appropriately cut into irregularly shaped pieces.
what are the leading causes of death in women?
heart disease, cancer, respiratory illness, stroke, and Alzheimers disease
what screenings for nutrition are important in adolescence?
height, weight, and BMI obesity and being underweight both pose as problems in adolescence
for the 18-24 mo toddler, how should we guide parents about topics?
●Peer companionship ●Discipline methods ●Negativism ●Toilet training ●Fears ●Regression during stress ●Separation
how can we teach children about respecting the property of others?
●Teach children about respecting others by respecting them first Most children can be taught to respect the property rights of others with little difficulty despite numerous temptations and opportunities. If the right of the child is respected, they are likely to respect the rights of others.
what is failure to thrive?
Inadequate growth due to inability to obtain or use amount of calories to promote growth and weight gain at an appropriate weight. Abnormal pattern of weight gain defined by the lack of usable, sufficiency nutrition, and documented by inadequate weight gain over time.
which type of aggression applies to children who are well behaved at home but have discipline problems at school or are bullies? 1. hyperaggression 2. frustration 3. modeling 4. reinforcement
2. frustration
The nurse is giving anticipatory guidance to the parent of a 5 year old. In this guidance, it is MOST important to: 1. prepare the parent for increased aggression 2. encourage the parent to offer the child choices. 3. inform the parent to expect a more tranquil period at this age. 4. advise parents that this is the age when stuttering may develop.
3. inform the parent to expect a more tranquil period at this age. The end of preschool/beginning of school age is a more tranquil period.
Which education would the nurse provide the parents of an exclusively breast-fed infant about vitamin D supplementation? Select all that apply. One, some, or all responses may be correct. 1- "Do not administer more than 400 IU per day." 2- "Add the vitamin D into supplemental formula." 3 - "Read the syringe before administering the vitamin D." 4- "Supplement your breast-feeding with formula fortified with vitamin D." 5- "Do not administer vitamin D supplementation if your baby is solely taking in formula."
1- "Do not administer more than 400 IU per day." 3 - "Read the syringe before administering the vitamin D." To avoid vitamin D toxicity, the infant should receive no more than 400 IU of vitamin D daily. It is important for the parents to read the markings on the syringe to administer the proper dosage. Vitamin D should not be added into supplemental formula. There is no need to give the infant supplemental formula with vitamin D because the infant is already prescribed liquid vitamin D. Vitamin D supplementation is recommended if the infant is consuming less than 1 liter per day of vitamin D-supplemented formula.
The parents of a toddler tell the nurse the family has been living in a very old building. The nurse would carefully assess the child for the irreversible effects of possible lead poisoning by focusing on which organ system? 1- Urinary system 2- Skeletal system 3- Hematologic system 4- Central nervous system
4- Central nervous system Nerve cells do not regenerate; once neurological damage has occurred, changes are irreversible. Changes in the urinary, skeletal, and hematologic systems are reversible with treatment.
Which education would the nurse provide the parent of a child diagnosed with sleep terrors? Select all that apply. One, some, or all responses may be correct. 1- Sleep terrors are followed by full waking. 2- Sleep terrors usually occur 1 to 4 hours after falling asleep. 3- It takes place during rapid eye movement (REM) sleep. 4- The child rapidly returns to sleep after an episode of sleep terrors. 5- The child is aware of and reassured by another's presence after an episode of sleep terrors.
2- Sleep terrors usually occur 1 to 4 hours after falling asleep. 4- The child rapidly returns to sleep after an episode of sleep terrors. Sleep terrors usually occur 1 to 4 hours after falling asleep, when non-REM sleep is deepest. After an episode, the child rapidly returns to sleep; it is often difficult to keep the child awake after this. Nightmares are followed by full waking; sleep terrors are followed by partial arousal. Nightmares take place during REM sleep; sleep terrors take place during stage IV, non-REM sleep. After a nightmare, the child is aware of and reassured by another's presence. After an episode of sleep terrors, however, the child is not very aware of another's presence, is not comforted, and may push the person away and scream and thrash more if held or restrained.
Which additional information reported by the parents of a 4-year-old who often wakes up crying at night would cause the nurse to suspect that the child is experiencing nightmares, not sleep terrors? Select all that apply. One, some, or all responses may be correct. 1- Perspiring 2- Thrashing 3- Heart racing 4- Crying after a dream 5- Appearing frightened
4- Crying after a dream 5- Appearing frightened
At the beginning of the school year, the school nurse identifies several new children at the school. The nurse knows that which factors place the children at high risk adjustment problems? (Select all that apply.) 1. The child is from a middle class family. 2. The child has not attended a preschool program. 3. The child exhibits signs of emotional immaturity. 4. The parents of a child demonstrate warm, loving behaviors. 5. The child appears physically immature.
2. The child has not attended a preschool program. 3. The child exhibits signs of emotional immaturity. 5. The child appears physically immature.
A child is brought to the emergency department after falling down the basement stairs. On assessment, what findings may cause the nurse to suspect child maltreatment? (Select all that apply.) 1. The child's bruises are located only on the right arm and leg. 2. The child is brought to the emergency department by an unrelated adult. 3. The child has a history of a broken arm last year from falling off a swing. 4. The child's caregiver is anxious that the child get immediate medical attention. 5. The child has red, green, and yellow bruises on more than one plane of the body.
2. The child is brought to the emergency department by an unrelated adult. 5. The child has red, green, and yellow bruises on more than one plane of the body. A child brought to a health care provider for a trauma or suspicious injury by an unrelated adult or if the primary care provider is totally unavailable is a warning sign of abuse. Varying degrees of healing of bruises in more than one plane of the body is a warning of abuse. Falling down stairs can be an unintentional injury. A child with an isolated documented injury is not a warning sign of abuse. Multiple fractures of differing ages are a warning sign of abuse. An anxious caregiver is a normal response for an injured child. A delay in seeking care is a warning sign of abuse.
The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem? 1. putting her in parents bed to cuddle 2. beginning to put her to bed while still awake 3. Letting her cry herself back to sleep. 4. Giving her a bottle of formula instead of breastfeeding her so often at night.
2. beginning to put her to bed while still awake The nurse needs to discuss the issue of co-sleeping with parents. Having the infant in bed with them may still interfere with their sleep. Parents need to develop bedtime rituals that involve putting the child in bed when awake. If the child is put in bed awake, she will be able to return to sleep more easily if she awakens at night. Providing formula at night contributes to bottle-mouth caries.
When caring for a youngster with anorexia nervosa, the MOST important nursing intervention is to: 1. encourage weight gain. 2. correct malnutrition. 3. limit fluid intake. 4. prevent depression.
2. correct malnutrition. The individual with anorexia nervosa would probably not be receptive to encouragement because of the complex etiology of the disorder. This is the priority goal of treatment. Fluids are often restricted by the individual with anorexia. It is important to correct fluid and electrolyte imbalances if present. Depression may be a component of the process.
A mother tells the nurse that her daughter's favorite toy is a large, empty box that contained a stove. She plays "house" in it with her toddler brother. Based on the nurse's knowledge of growth and development, the nurse recognizes that this is: 1. unsafe play that should be discouraged. 2. creative play that should be encouraged. 3. suggestive of limited family resources. 4. suggestive of limited adult supervision.
2. creative play that should be encouraged. This type of play should be encouraged. After children create something new, they can then transfer it to other situations. There should be some supervision to prevent injury or accidents. As long as the play is supervised, it should be encouraged. This is not considered unsafe play. There is no indication of limited resources. There is no indication of limited adult supervision.
A parent phones the nurse and says that her child just knocked out a permanent tooth. The nurse's instructions to the parent should include: 1. rinsing the tooth in hot water. 2. holding tooth by the crown and not by the root area. 3. taking the child and tooth to a dentist within 48 hours. 4. taking the child to the hospital emergency room if mouth is bleeding.
2. holding tooth by the crown and not by the root area. Only if dirty should the tooth be rinsed with running water. The root area should not be touched. Reimplantation should occur as soon as possible. The child needs to be seen by a competent dentist as soon as possible.
The parents of 9-year-old twin children tell the nurse, "They have filled their bedroom with collections of rocks, shells, stamps, and cars." The nurse should recognize that this behavior is: 1. is characteristic of psychosocial development at this age. 2. is characteristic of cognitive development at this age. 3. indicates typical "twin" behavior. 4. indicates giftedness.
2. is characteristic of cognitive development at this age. This is characteristic of the age-group, not giftedness. This is characteristic of the age-group, not their twin status. Classification skills are developed during the school-age years. This age-group enjoys sorting objects according to shared characteristics. Psychosocial development at this age is focused on accomplishment.
A parent tells the nurse, "I am worried about my 13-year-old son. He has not started puberty, and my daughter did when she was 11 years of age." The nurse should explain to this parent that this is: 1. unusual and requires further evaluation of the son. 2. unusual because the onset of pubescence is usually the same in siblings. 3. normal because the onset of pubescence is usually earlier in girls than it is in boys. 4. abnormal because the onset of pubescence is usually earlier in boys than it is in girls.
3. normal because the onset of pubescence is usually earlier in girls than it is in boys.
When preparing parents to teach their preschool child about human sexuality, the nurse should emphasize that: 1. a parent's words may have a greater influence on the child's understanding than the parent's actions. 2. parents should determine exactly what the child wants to know before answering a question about sex. 3. parents should avoid using correct anatomic terms because they are confusing to the preschooler. 4. parents should allow children to satisfy their sexual curiosity by playing "doctor."
2. parents should determine exactly what the child wants to know before answering a question about sex. The actions may have a greater influence because language is not fully developed. It is important that the parent answer the question that the child is asking. Using correct terminology lays the foundation for later discussion. Parents should encourage the asking of questions to resolve curiosity without undue investigation on the child's part.
The nurse's BEST approach for effective communication with a preschool-age child is through: 1. speech. 2. play 3. drawing 4. actions
2. play
A 4-year-old boy has been having increasingly more frequent angry outbursts in preschool. He is very aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. The MOST appropriate intervention is to: 1. explain that this is normal in preschoolers, especially boys. 2. refer the child for professional help. 3. talk to the preschool teacher to obtain validation for the behavior the parent reports. 4. encourage the parent to try more consistent and firm discipline.
2. refer the child for professional help. This is not normal behavior. This is not expected behavior; the child should be referred to a competent professional to deal with his aggression. The validation will be helpful for the referral, but the referral is the priority action. This may be recommended by the professional.
A 4-year-old female child sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened. Yet she is not aware of her parents' presence when they check on her. She lies down and sleeps without any parental intervention. This is MOST likely described as: 1. a nightmare. 2. sleep terror. 3. seizure activity. 4. sleep apnea.
2. sleep terror. A nightmare is a frightening dream followed by full awakening. In sleep terrors, the child is only partially aroused; therefore she does not remember her parents' presence. This does not resemble seizure activity. Sleep apnea is a cessation of breathing during sleep.
Poisoning in toddlers can best be prevented by: 1. consistently using safety caps 2. storing poisonous substances in a locked cabinet. 3. keeping ipecac syrup in the home. 4. storing poisonous substances out of reach.
2. storing poisonous substances in a locked cabinet. Not all poisonous substances have safety caps. This is an appropriate action. Ipecac does not prevent poisoning and is not recommended. Toddlers can climb; therefore little is out of reach.
The exhausted parents of a 2-month-old infant with colic ask the nurse what is the best method to promote comfort and sleep for the infant. The nurse's initial action is to: 1. advise mom to follow a milk free diet for 3-5 days 2. take a detailed history of usual daily events 3. administer simethicone drops 4. explain that the parents need to stay calm so the infant will remain calm
2. take a detailed history of usual daily events The initial step in managing colic is to take a thorough, detailed history of the usual daily events including: diet, time of day when child cries, presence of family members, type of cry, etc. Before suggesting formula changes or medications to relieve symptoms, a detailed history is needed. It is important that the nurse convey an empathetic and compassionate attitude and reassure the parents that they are not doing anything wrong.
A parent of an 8-month-old infant tells the nurse that the baby cries and screams whenever he or she is left with the grandparents. The nurse's reply should be based on knowledge that: 1. the infant is most likely spoiled 2. this is a normal reaction for this age 3. this is an abnormal reaction for this age 4. grandparents are not responsive to the infant
2. this is a normal reaction for this age
A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant? 1. vitamin B 2. vitamin D 3. vitamin K 4. vitamin A
2. vitamin D The American Academy of Pediatrics recommends that infants who are exclusively breast-fed receive 400 international units (IU) of vitamin D daily in the first few days of life and continued daily supplementation to decrease vitamin D deficiency. Vitamin B is not needed. Vitamin C is not needed. Vitamin K is not needed.
Infants most at risk for sudden infant death syndrome (SIDS) are those: (Select all that apply.) 1. who sleep supine 2. who sleep prone 3. who were premature 4. prenatal drug exposure 5. with a cousin who died of SIDS
2. who sleep prone 3. who were premature 4. prenatal drug exposure
When caring for a preschool-age child, the nurse should incorporate knowledge that body image has developed to include: 1. a well-defined body boundary 2. knowledge about his or her internal anatomy 3. fear of intrusive procedures 4. anxiety and fear of separation
3. fear of intrusive procedures Preschoolers have poorly defined body images. Preschoolers have little or no knowledge of their internal anatomy. Preschoolers fear that their insides will come out with intrusive procedures. Preschoolers are able to separate.
The MOST appropriate recommendation for relief of teething pain is to instruct the parents to: 1. rub gums with aspirin to relieve inflammation. 2. apply hydrogen peroxide to gums to relieve irritation. 3. give child a frozen teething ring to relieve inflammation. 4. have child chew on a warm teething ring to encourage tooth eruption.
3. give child a frozen teething ring to relieve inflammation.
Nursing responsibilities in the management of adolescent obesity include: 1. planning a low-calorie, low-protein diet. 2. encouraging diversional activities during mealtimes. 3. incorporating favorite foods into the child's diet. 4. using nutritious foods as a method of reward.
3. incorporating favorite foods into the child's diet. A food plan high in nutrients, with calories and fats kept at a healthy level, is recommended. Incorporating small amounts of the adolescent's favorite foods will increase adherence to the nutritional plan. Diversional activities such as television watching may contribute to overeating. Foods should not be used as a reward.
Which response to hospitalization would the nurse expect in a 4-year-old child? 1- Anger, resentment over depersonalization, and loss of peer support 2- Boredom, depression over separation from family, and fear of death 3- Out-of-control behavior, regression to overdependency, and fear of bodily mutilation 4- Intense panic, loss of security over separation from parents, and low frustration tolerance
3- Out-of-control behavior, regression to overdependency, and fear of bodily mutilation
The school nurse is asked to speak with the parents of a 10-year-old boy who has been bullying other children. The nurse's response should be based on knowledge that: 1. bullying at this age is considered normal. 2. children who bully others usually join gangs. 3. children who bully others usually have low self-esteem. 4. bullies often have difficulties developing and maintaining relationships.
4. bullies often have difficulties developing and maintaining relationships. Bullying is a maladaptive response to poor relationships with peers and lack of group identification. Bullying is a maladaptive response to poor relationships with peers and lack of group identification. These individuals usually have strong self-esteem and little anxiety. Children who bully are defiant toward adults, antisocial, and likely to break school rules. They have little anxiety, strong self-esteem, and may come from homes where physical punishment is used and there is a lack of parental involvement and warmth. Long term this negativity continues into adulthood, causing difficulties developing and maintaining relationships.
children 2 years or older can switch to what kind of car seat?
Children 2 years of age or older (or those younger than 2 years of age) who have outgrown the rear facing height or weight limit for their car safety seat should use a forward facing car safety seat with a harness up to the maximum height or weight recommended by the manufacturer.
why is stealing common in young children?
Between 5 and 8 years of age, children's sense of property rights is limited and they tend to take things simply because they are attracted to them or to take money for what it will buy. They are equally likely to give away something valuable that belongs to them.
what are complications of female genital mutilation?
Complications include bleeding, pain, localized scarring, keloid or cyst formation, and infection. Impaired drainage of blood from menstrual flow and urine may lead to pelvic infections, pelvic and back pain, and chronic UTI.
how should we position the crib for a toddler to prevent falls?
Crib rails should be fully raised with the mattress at the lowest position, and toys or bumper pads that could be used to climb on and use to climb out of the crib should be removed. Ideally the floor under the crib should be carpeted or have a throw rug.
how can we discipline toddlers?
Discuss the need for firm but gentle discipline and ways to deal with negativism and temper tantrums; stress the positive benefits of appropriate discipline. Emphasize importance for both child and parents of brief, periodic separations
Do early-maturing adolescents experience more or less stress than late maturing children?
Early maturing girls and late maturing children are especially sensitive to the stresses of being different from their peers. Both early and late maturing children feel out of place among their classmates, but slow maturing children appear to experience the most pronounced inner turmoil and be hesitant to voice their concerns. Slow maturing adolescents need support and reassurance that they are not abnormal and need only be patient until the time comes when they, too, will mature physically.
how does frustration relate to aggression?
Frustration, or the continual thwarting of self satisfaction by disapproval, humiliation, punishment or insults, can lead children to act out against others as a means of release. Especially if they fear their parents, children displace their anger on others, particularly peers and other authority figures. This type of aggression often applies to children who are well behaved at home but have a discipline problems at school or are bullies.
how does guidance for injury prevention differ between toddlers and preschoolers?
Less prone to falls than toddlers, tend to be less reckless, listen more to rules, and are aware of potential dangers. Poisioning and motor vehicle accidents still pose a threat. Emphasis shifts to educating the parent AND child safety and potential hazards in addition to appropriate protection. Safety equipment such as bike helmets should be stressed. It is essential that parents set the example by practicing what they preach as kids will want to imitate them. Children are quick to pick up discrepancies and creating good behaviors can create long term safety behaviors.
do school age kids know that lying, stealing, or cheating is wrong?
Most children know that lying and cheating are wrong, and they are concerned when it is observed in their friends. They are quick to tell on others when they detect cheating.
what are examples of sucrose that should be eliminated from a childs diet?
Refined table sugar, honey, molasses, corn syrup, and dried fruits such as raisins are highly cariogenic and should be eliminated from the diet.
reinforcement aggression
Reinforcement can also shape aggressive behavior. Sometimes the reward for aggression is negative yet reinforcing because it brings attention. When children exhibit extreme behavior such as aggression, parents may be concerned about the need for professional help.
role modeling for nutrition is important... how can we educate parents about their childs nutrition?
The importance of role modeling by parents cannot be overemphasized in regard to food intake and dietary habits; if parents will not eat a particular food or if their dietary habits are poor, children are likely to develop the same habits.
whats the difference between aggression and anger?
The term aggression refers to behavior that attempts to hurt a person or destroy property. Aggression differs from anger, which is a temporary emotional state, but anger may be expressed through aggression.
electrical burns
Young toddlers may explore outlets by putting their tongue into them. As water is an excellent conductor, the chance for a severe circumoral electrical burn is great. Protective guards should be placed on all outlets and children should not be allowed to play with electrical cords, appliances, or batteries.
Which clinical manifestations should cause the nurse to suspect that a child, diagnosed with a digestive disorder, may be demonstrating signs of failure to thrive? a. Avoidance of eye contact. b. An associated malabsorption defect. c. Weight that falls below the 15th percentile. d. Normal achievement of developmental landmarks
a. Avoidance of eye contact. One of the clinical manifestations of nonorganic failure to thrive is the child's avoidance of eye contact with the health professional. A malabsorption defect would result in a physiologic problem, not behavioral. Weight (but not height) below the 5th percentile is indicative of failure to thrive. Developmental delays, including social, motor, adaptive, and language, exist.
In teaching parents about appropriate pacifier selection, the nurse should explain that a pacifier should have which characteristics? (Select all that apply.) a. Easily grasped handle b. One-piece construction c. Ribbon or string to secure to clothing d. Soft, pliable material e. Sturdy, flexible material
a. Easily grasped handle b. One-piece construction e. Sturdy, flexible material A good pacifier should be easily grasped by the infant. One-piece construction is necessary to avoid having the nipple and guard separate. The material should be sturdy and flexible. An attached ribbon or string and soft, pliable material are not characteristics of a good pacifier.
A parent asks the nurse "At what age do most babies begin to fear strangers?" The nurse responds that most infants begin to fear strangers at what age? a. 2 months b. 4 months c. 6 months d. 12 months
c. 6 months Between ages 6 and 8 months, fear of strangers and stranger anxiety become prominent and are related to the infant's ability to discriminate between familiar and nonfamiliar people. At age 2 months, the infant is just beginning to respond differentially to the mother. At age 4 months, the infant is beginning the process of separation individuation when the infant begins to recognize self and mother as separate beings. Twelve months is too late and requires referral for evaluation if the infant does not fear strangers at this age.
