Noelle Peds exam 2
play of 9-11 year olds
- bike - competitive play - sophisticated puzzles and games - drawing - reading - listening to the radio - watching tv - competitive play
intellectual characteristics of fragile x syndrome
- boys exhibit intellectual deficits in the moderate to severe range - girls manifest only mild intellectual deficits
although a childs thinking is still concrete, children begin to use abstract concepts to describe ________
god
siblings often have feelings of _____________ regarding their perceived role in the ill child's condition
guilt
prevention of acute nasopharyngitis
hand washing no touching eyes no touching nose
middle childhood is one of the ____________ periods of life
healthiest
in middle childhood (school aged), the _________ is smaller in relation to rest of the body
heart
what is the decrease in head circumfrence related to in middle childhood (school aged)?
height increase
acute viral nasopharyngitis is managed at
home
for advance prep for preschoolres, how long shsould you prepare them for minor events?
hours
care management of acute nasopharyngitis
hydration nasal suctioning
two types of GI obstructive disorders
hypertonic pyloric stenosis and intussusception
can you use the word "tummy" instead of stomach?
if that language best fits the child's understanding, yes
muscle changes in middle childhood (school aged)
increased muscle tissue
why is feeding difficult in a child with bronchiolitis caused by RSV?
increased respiratory effort that interferes with sucking and swallowing
a childs appetite usually ____________ during the school age years
increases
in middle childhood (school aged), bladder capacity
increases
what does goal setting do for a child with chronic illness?
increases abilities and self esteem
should children be encouraged to ride their bike at dusk or in the dark?
no
should the child listen to music while riding their bike?
no
should you take an oral temp for a child with cleft lip/ palate?
no
is isolation required for children with TB?
no because they are not usually contagious
should you do a childs homework for them?
no because this will make them think they are not trusted to do a good job; instead, provide assistance and suggestions when asked and praised their best efforts
life expectancy for FXs
normal life expectancy
Regression during times of stress will ________ affect long-term development.
not
in middle childhood (school aged) do boys and girls differ in size?
not by much
diagnostic evaluation for cleft lip/ palate
observation at birth ultrasound in utero
regression is mostly seen in what age group?
older infants and young schooler agers
_______________________ are able to classify objects according to characteristics they sgare
older school age children
_______________________ are able to place things in logical order
older school age children
____________________ are able to recall similarities and differences
older school aged children
what side should the child lay on with otitis media?
on effected side to promote drainage
central auditory impairment includes
organic or functional hearing loss
play of the school age child becomes ____________ with more direction
organized
what is influenza caused by?
orthomyxovirus types A and B
in middle childhood (school aged), bones continue to ______________
ossify
what med is given prophylactically in the hospital to decrease RSV transmission in children?
palivizumab
by 9-11 years, opinions become more important than ____________ opinions, and clubs with secret codes and rituals are at a peak
parents
hiatal hernia
part of stomach going through diaphragm
at the school age, the approval and esteem of those outside the family, especially ____________, become important
peers
major sign of bronchitis in the child
persistant cough
what other vaccines should the child get to prevent pneumonia?
pneumocaccal Tdap Hib
what is the most common complication of whooping cough?
pneumonia
children who have a good sense of humor may use it as a ____________ coping mechanism for stress associated with painful procedures and other situational life events
positive
how to decrease drainage following a tonsilectomy
postural seating ; no suctioning
helmets work only if they fit ____________
properly
social milestones of the 9-11 year old
- boys tease girls and girls may be interested in boys - may become angry learning to control it - critical of own work - may be rebellious - ready for away home experiences such as camp
what is the initial phase of separation?
protest the child cries and shows distress
umbilical hernia
protrusion of abdominal contents through the area of the umbilicus
children who are overweight tend to have earlier onset of _______________ and menarche
puberty
if the school aged child is not tired, advise the parent to allow
quiet reading time in bed
what is a risk with racemic epinephrine?
rebound stridor
what is the most common cause of cardiopulmonary arrest in children?
respiratory failure
school aged children will not stop an activity to _________.
rest
examples of regression
reverting back to a bottle or thumb sucking changes in toileting bed wetting baby talk
TB meds
rifampid iozinad ethambutol
a bike should be ridden on the __________ side of the road, in the direction of traffic
right
body piercing is a _________ taking behavior
risk
infants less than 8 months of age diagnosed with intussusception should not recieve the ____________ vaccine
rotavirus
to avoid obesity, parents should provide adequate space for children to _________ and ___________ as well as allow enough free time for exercise and play
run; jump
children with CI have the __________ developmental needs as any other child
same
by which age do children view death as a permanent state?
school age
______________________ move away from magical thinking as they discover that there are logical, physical explanations for most phenomena
school age children
when is the concept of conservation mastered?
school aged
school age children may need dental ______________ as permanent molars erupt
sealants
when a child has an intellectual disability, what are they more at risk for when the child matures?
seizures
how do children feel who mature early or late?
self conscious or inferior
example of a self stimulating behavior used in a downs patient while in the hospital?
self picking their arms (coping strategy)
if a child has intussusception, any signs of infection should be reported immediately as this can lead to
sepsis
if untreated, pneumonia can lead to ____________
sepsis
following the convalescent stage of pertussis, the cough may persist for how long?
several months
skeletal changes in in middle childhood (school aged)
skeletal lengthening
how does physical growth compare to the cognitive and social growth that occurs in the school aged child?
slow steady physical growth and rapid cognitive and social development
feedings of the infant with pertussis
small frequent feedings
children living in a house with ___________ are more likely to develop otitis media
smokers
what type of shoes should a child wear when riding a bike?
sneakers or closed toes shoes
ASD is a group of developmental disabilities characterized by persistent deficits in what?
social communication and social interaction that causes significant challenges
diagnostic test for infectious monolucleosis
spot test
what thought stage is the 8 year old in?
stage of concrete operations
how do you diagnose cognitive impairments?
standardized testing
4 characteristics of celiacs disease
steorrhea general malnutrition abdominal distension secondary vitamin defecits
example of positive reinforcement for the child with CI
sticker chart, can be used in and outside the hospital
episodes of sleep terrors increase when the child is under ___________
stress
parents should be reminded that regression is a normal response to __________________!
stress
when is influenza most common?
winter months
one of the differences between intellectual disability and autism
with intellectual disability, they usually imitate others, but with autism, they do not imitate others
the school aged child replaces fantasy play with "__________" at school, chores and hobbies
work
how is hirschsprung disease diagnosed?
xray barium enema studies
is it difficult to soothe the infant with FASD?
yes
is regression seen in children of all ages?
yes
acute bronchitis is most common in who? why?
young boys because their airway is already more narrow
some tips for caring for the gastrostomy tube
- clean site daily with soap and water - antimicrobial ointment if indicated - gently rotate tube in each direction everyday - skin barriers - report any signs of infection - use hydrogen peroxide for crust
medical management for sensorineural hearing loss
- cochlear implant - multichannel implant
what tasks can the school aged child perform that shows off their motor skills?
- ride a two wheeled bicycle - dance - skip - jump rope - participate in various sports
concerns of children with chronic illnesses
- self esteem - self reliance - autonomy
behaviors associated with mild intellectual disability
- self esteem issues due to their appearance - social isolation and loneliness - depression
behaviors associated with severe intellectual disability
- self harm - fecal smearing - destroying personal items - severe temper tantrums - disrobing
what are the abnormal facial features of a child with FASD?
- short palpebral fissures - smooth philtrum - thin upper lip - low set ears
in middle childhood (school aged) height increases by _________ inches a year
2
manifestations of down syndrome
- bradycephaly - flat profile - inner epicanthal folds - wide flat nasal bridge - narrow high arched palate - protruding tongue - small short ears - short stature - broad hands - broad neck - transverse crease across the palm and sole of the foot - wide gap between the second and first toes
relaxation techniques for the child in the hospital
- breathing (blowing bubbles, party blowers, balloons) - singing - distraction (water wheels, games, books, music, art - imagery
when can the dtap vaccine be given/
2 months of age 5 doses total
The parents of a child newly diagnosed with a chronic illness ask the nurse how long the illness will last. How should the nurse respond?
"A chronic illness may have residual aspects that can last a lifetime." "A chronic illness lasts at least three months and up to a lifetime, depending on the illness."
A parent asks the nurse how her child contracted autism spectrum disorder (ASD). Which is the nurse's best response? "Your child might have contracted ASD from chemical exposure as an infant." "ASD has many different proposed causes, so pinpointing the exact cause is likely impossible." "ASD is linked to genetics, so your child contracted ASD because it must run in your family." "ASD is not an illness, so it was not contracted from anyone. It develops over time for a variety of reasons."
"ASD has many different proposed causes, so pinpointing the exact cause is likely impossible."
what should the nurse assess in the pt with pneumonia?
- breaths sounds - RR - color -VS - degree of restlessness
clinical manifestations of pneumonia in children
- chest pain - productive cough - sob - confusion - fever - n+v
examples of therapeutic play
- child inspects the blood pressure cuff before the nurse places it on the child - demonstrating procedures on a stuffed animal before the child
The nurse is providing discharge teaching to the parents of a child with pyloric stenosis. Which statements, made by the parents, indicate that teaching was effective? "After surgery, I will be allowed to change my child's diapers." "This condition will affect the way my child absorbs my breast milk." "I can't talk with my friends about my child's condition because they don't understand." "We will have to get a second job to afford the medication that will cure him." "I have the number for the support group the social worker gave me this morning, and I will call today."
"After surgery, I will be allowed to change my child's diapers." child absorbs my breast milk." "I have the number for the support group the social worker gave me this morning, and I will call today."
The parent of a child with autism spectrum disorder (ASD) states, "I knew that I should not have allowed her to get her vaccinations. If I had listened to my sister, this never would have happened." How can the nurse appropriately respond to this statement? "Although many people think that vaccinations are linked to ASD, the research has not shown that there is a correlation between the development of ASD and receiving vaccines." "The link between the development of ASD and receiving vaccinations has been shown to be very weak and does not outweigh the risks of not receiving recommended immunizations. "Some children do develop ASD from receiving vaccinations, but very few kids are sensitive to the thimerosal in the vaccine. It is unfortunate that your child developed ASD from the vaccine." "There is no link between vaccinations and the development of ASD. If you read the research, you will find that there is not a correlation between vaccinations and ASD and that your sister was incorrect."
"Although many people think that vaccinations are linked to ASD, the research has not shown that there is a correlation between the development of ASD and receiving vaccines."
The nurse is discussing appropriate safety for school-aged children with the parents of a six-year-old and a 10-year-old. Which safety recommendations can the nurse make that are appropriate for both children? "Always use sunscreen while outdoors." "Discuss not allowing unfamiliar adults into the home." "Ensure guns are in a locked vault, in a separate location from the ammunition." "Both children can be restrained with only the three-point harness while in the motor vehicle." "Children should protect their eardrums by listening to only moderate-volume music and television."
"Always use sunscreen while outdoors." "Discuss not allowing unfamiliar adults into the home." "Ensure guns are in a locked vault, in a separate location from the ammunition." "Children should protect their eardrums by listening to only moderate-volume music and television."
girls enter the prepubesence stage
2 years earlier than males
The student nurse states, "My sister was so worried that her baby might be born with an intellectual disability. She was born healthy. I am so excited that intellectual disability is not even possible anymore." How should the nurse respond to this statement? "Childhood conditions and environmental problems can cause intellectual disability. Let's talk about ways to prevent these from causing intellectual disability." "The risk of developing intellectual disability after birth is very rare. Unless the family lives below the poverty level, development should no longer be a problem." "It is a relief when a child is born healthy and is no longer at risk for the development of intellectual disability. This is important information to share with families." "Several childhood illnesses can cause intellectual disability, but as long as a child receives immunizations, there is no risk of developing intellectual disability after birth."
"Childhood conditions and environmental problems can cause intellectual disability. Let's talk about ways to prevent these from causing intellectual disability."
The nurse is providing education to the parents of a child at risk for tuberculosis. The parents wish to forego testing because they report the child is healthy. Which response by the nurse is appropriate? "Children in urban areas are more at risk." "All children should be screened for tuberculosis." "Children with tuberculosis may not have symptoms." "A chest radiograph will show if the child has been exposed."
"Children with tuberculosis may not have symptoms."
The healthy sister of a 9-year-old male with cystic fibrosis approaches the nurse and states, "I feel so guilty my brother is sick and I'm not." Which response by the nurse is appropriate?
"Could you tell me a little more about how you are feeling?"
The parents of an infant suspected to have fragile X syndrome ask the nurse which testing confirms the suspicions. Which response by the nurse is appropriate? "DNA testing is the definitive method for diagnosing fragile X syndrome." "Karyotyping identifies the defective chromosome needed to diagnose fragile X syndrome." "An abnormal triple maternal serum screen value confirms the suspicion of fragile X syndrome." "A genogram confirms the presence of the genetic disorder and is the definitive method for diagnosing fragile X syndrome."
"DNA testing is the definitive method for diagnosing fragile X syndrome."
A mother is concerned about her infant getting tuberculosis. Which response by the nurse is appropriate? "Are the infant's vaccinations up-to-date?" "Taking rifampin will prevent tuberculosis." "Does a family member have symptoms of tuberculosis?" "The infant should have a Mantoux skin test every year."
"Does a family member have symptoms of tuberculosis?"
The nurse is assessing a 3-year-old child for an intellectual disability. What questions should the nurse ask the parent(s)? "Is your child physically healthy?" "Does your child have a seizure disorder?" "Can your child understand simple directions?" "Is your child developing as you would expect?" "Is your child able to verbally communicate needs?"
"Does your child have a seizure disorder?" "Can your child understand simple directions?" "Is your child developing as you would expect?" "Is your child able to verbally communicate needs?"
The nurse is caring for a newborn with Down syndrome. The parents state, "The health care provider just informed us that our daughter has Down syndrome. How long will my child be sick?" How should the nurse respond?
"Down syndrome is a chronic condition, so the child will always have this condition."
A pregnant woman asks the nurse why Down syndrome occurs. Which response by the nurse is appropriate? "Down Syndrome occurs because there is a chromosome missing on chromosome 21." "Down syndrome usually occurs because of a structural relocation of chromosome 21." "Down syndrome occurs because there is a fragile chromosome on the 21st chromosome." "Down syndrome occurs because there is an additional chromosome present on the 21st chromosome."
"Down syndrome occurs because there is an additional chromosome present on the 21st chromosome."
The parents of a newborn diagnosed with fragile X syndrome ask the nurse about the cause of the syndrome. Which response by the nurse is appropriate? "Fragile X syndrome is caused by a missing part of the X chromosome." "Fragile X syndrome is caused by one defective gene on the X chromosome." "Fragile X syndrome is caused by an additional entire set of chromosomes in each cell." "Fragile X syndrome is caused by an additional chromosome on the X chromosome".
"Fragile X syndrome is caused by one defective gene on the X chromosome."
Which statement made by a child suggests that bullying may be occurring? "He told me he has a crush on me." "I think they just want to be my friends." "He made fun of me at school because of my weight." "He told people that I failed my test when really I didn't." "He sent me unwanted email messages that made me feel nervous."
"He made fun of me at school because of my weight." "He told people that I failed my test when really I didn't." "He sent me unwanted email messages that made me feel nervous."
A preschool-aged child with cancer has begun crying for her pacifier, which she stopped using 6 months ago. The parents voice concerns to the nurse. How should the nurse respond to the parents?
"How do you feel about allowing her to use the pacifier while in the hospital?"
The nurse is teaching a parent how to care for a child's gastrostomy tube. Which statement, made by the parent, indicates successful patient teaching? "I will clean the area with alcohol." "I will apply antimicrobial ointment if indicated." "It is not necessary to clean new gastrostomy-tube." "I will make sure the tube remains closed after surgery." "If crusty drainage appears, I will use half-strength hydrogen peroxide."
"I will apply antimicrobial ointment if indicated." "If crusty drainage appears, I will use half-strength hydrogen peroxide."
IQ for profound intellectual disability
<20 to 25
A parent of two children, including a girl with an intellectual disability states, "I have a hard time working with my daughter. She just doesn't seem to understand what I'm saying like my son does." What information can the nurse provide to help the parent? "Your daughter needs more attention than your son, so make sure you spend more time with her." "Let's talk about how to use simple, concrete explanations and incorporate play while you are teaching her something new." "It is understandable that you are struggling because children with intellectual disability are often harder to work with than other children." "Are you expecting your daughter to be able to do everything that your son can do because that is not a reasonable expectation."
"Let's talk about how to use simple, concrete explanations and incorporate play while you are teaching her something new."
The nurse is caring for child diagnosed with croup, who is now being discharged. The parents are concerned and question the nurse about what to do when they get home. Which response by the nurse is most appropriate? "Observe for signs of respiratory distress." "Give racemic epinephrine if stridor persists." "Provide a sedative to help with sleep at night." "Call back for antibiotics if the child has a fever."
"Observe for signs of respiratory distress."
A 2-year-old child has just been diagnosed with autism spectrum disorder (ASD). The parents want to know whether their child has a serious case because it was diagnosed so early. How should the nurse respond? "The early diagnosis of ASD means that your child will have a milder form of ASD." "Recognizing that your child has ASD at an early age means that the child will need more interventions to ensure normal development." "Recognizing and treating ASD early does not determine the severity of the disorder, but it increases the chance that your child will maximize his or her potential." "The early recognition of ASD means that your child does have a severe case and will likely have a poorer prognosis than if the disorder were recognized at a later age."
"Recognizing and treating ASD early does not determine the severity of the disorder, but it increases the chance that your child will maximize his or her potential."
The parents of a child with cystic fibrosis tell the nurse they are considering having more children and want to know the likelihood of having another child with cystic fibrosis. Which response by the nurse is appropriate? "Since only one parent needs to be a carrier, your child has a 1 in 4 chance of having cystic fibrosis." "Since cystic fibrosis is an autosomal dominant trait, every child will be affected with cystic fibrosis." "Since cystic fibrosis is an autosomal dominant trait, your child has a 1 in 4 chance of having cystic fibrosis." "Since cystic fibrosis is an autosomal recessive trait, your child has a 1 in 4 chance of having cystic fibrosis."
"Since cystic fibrosis is an autosomal recessive trait, your child has a 1 in 4 chance of having cystic fibrosis."
A nurse is providing patient teaching to a couple whose infant has just had surgery for cleft lip. What information does the nurse provide regarding feeding to ensure the child receives adequate nutrition? "Feed the infant with a straw." "Stop feeding frequently to burp." "Feed the infant in an upright position." "Use a syringe with a rubber tip for feedings." Withhold feeding for 12 hours after the surgery.
"Stop feeding frequently to burp." "Feed the infant in an upright position." "Use a syringe with a rubber tip for feedings."
A pregnant patient whose fetus has trisomy 21 asks the nurse which medical conditions are associated with trisomy 21. Which responses by the nurse are appropriate? "There could be a failure of the upper lip to completely form." "There could be a hole between the right and left side of the baby's heart." "There could be a problem with the baby's esophagus, in which it is not completely formed." "There could problems with the hands and feet where the fingers and toes are fused together." "There could be a lack of nerves going to the large intestine that would cause it not to work correctly."
"There could be a hole between the right and left side of the baby's heart." "There could be a problem with the baby's esophagus, in which it is not completely formed." "There could be a lack of nerves going to the large intestine that would cause it not to work correctly."
The caregivers of a child with cleft lip ask the nurse how to decrease feeding difficulties associated with the condition. Which is the best response from the nurse regarding optimizing feeding of the child? "Stop breastfeeding." "Use a nipple with small hole." "Use a long nipple for feeding your child." "Make sure your child is lying flat during feedings."
"Use a long nipple for feeding your child."
A 9-month-old male infant is diagnosed with pneumonia. The parents are confused about the diagnosis because the infant had RSV a few weeks ago. Which response by the nurse is appropriate to help the parents understand the etiology of pneumonia? "Viruses can cause pneumonia in children." "Bacterial pneumonia is common in infants." "He probably had pneumonia a few weeks ago." "Antibiotics are not given for viral pneumonia."
"Viruses can cause pneumonia in children."
A 14-year-old female patient tells the nurse she is concerned about being taller than her peers and is worried she will continue to grow in height. Which question by the nurse is most useful for giving guidance regarding expected changes in height related to puberty?
"When did you start menstruation?"
The mother of a newborn with fetal alcohol spectrum disorder (FASD) appears withdrawn and depressed. The mother does not often hold or look at the infant. When she does hold the newborn, she becomes tearful. Which would be appropriate comments for the nurse to make? "You appear upset when you hold your baby. How are you feeling?" "You seem sad. Are you feeling guilty about causing your newborn to have FASD?" "How are you doing with your child's diagnosis? You seem to be upset all of the time." "Having a child with a disorder is very hard, but obstacles will be greater if you do not learn to care for your baby."
"You appear upset when you hold your baby. How are you feeling?"
nursing interventions for catarrhal stage of pertussis
- antibiotics - the abx should also be given to anyobdy in close contact with the child older than 13 - reportable health condition
how do you prevent misunderstandings when communicating with a child with a chronic illness?
- ask children what they know and understand - you want to strive to understand what the child is really asking - clarify any questions - try not to provide too much information; this might cause fear and inhibit them from asking questions in the future
prevention of hearing impairments in the child
- avoid ototoxic drugs - recurrent otitis media should be treated - avoid very loud sounds and environments - genetic testing
A nurse is caring for a child with a chronic illness who was recently hospitalized due to complications of the illness. After leaving the patient's room, the nurse notices a sibling standing outside the room looking very angry. The sibling says, "Today is my birthday and nobody even cares." Which response from the nurse is best?
"You sound upset. Tell me more about how you are feeling."
The nurse is caring for a patient with cystic fibrosis (CF) and observes a distended abdomen, fever, and weight loss. The parents ask the nurse what is wrong with their infant. Which statement does the nurse use to address the question? "Your baby is constipated and needs to have a bowel movement." "Your baby's body is not receiving enough calories to allow for weight gain." "Your baby's body may make mucus that is too thick so the intestines become blocked." "Your baby demonstrates signs of a bowel infection and requires intravenous fluids and medicines."
"Your baby's body may make mucus that is too thick so the intestines become blocked."
A child is being seen with dental malocclusion. The child's caregiver asks the nurse how the child's oral health routine will have to change with braces. What is the nurse's best response? "No change is necessary with braces." "Your child will not be able to eat most snacks." "Sticky snacks should be limited to the morning and not consumed at bedtime." "Your child should clean the teeth and use a water flosser several times per day."
"Your child should clean the teeth and use a water flosser several times per day."
A mother of two is adopting an infant with fetal alcohol spectrum disorder (FASD). She asks the nurse. "What can I expect my baby to be like?" What education is important for the nurse to share? "Your new infant may be more irritable than the average infant." "The new baby is more likely to have a smaller head than the average infant." "The baby will likely sleep more than your other children did at the same age." "The infant may be smaller and grow at a slower rate than your other children did." "Children with FASD are usually physically healthy, so the baby will be similar to your other children until toddlerhood."
"Your new infant may be more irritable than the average infant. "The new baby is more likely to have a smaller head than the average infant." "The infant may be smaller and grow at a slower rate than your other children did."
what is a hernia?
- abnormal protrusion of part of an organ or tissue
treatment for a child with epiglottitis
- achieve a patent airway - oxygenation - throat and blood specimens once the child is intubated - antipyretics - IV antibiotics
importance of active play in the school aged child
- active play refines motor skills - activities are exciting for the child - physical activity can provide a release of emotional tension and enhance the development of leader and follower skills
water safety for the school age child
- adult supervision is still needed - the school age child often overestimate their swimming capabilities and their endurance - children should be taught to stay away from pools, canals, and fast moving bodys of water - jump feet first into water to prevent neck injury
factors that affect a childs perception of hospitalization
- age - level of cognitive development - preparation - previous experiences - coping skills
how to prevent fear of loss of control and autonomy in the hospitalized child
- allow child to make decisions regarding their health - encourage patient to ask questions
if the child is answering questions several minutes after asked, what should the nurse do?
- allow extra time
how to prevent fear of separation from parents in children in the hospital
- allow the parents to remain with the child - 3 phases of separation
helping children with chronic conditions
- communicate health related information in a way that is appropriate for their developmental level, not just their age - introduce change slowly - provide an outlet for stress and frustration - decrease wait times - develop individualized health plans
physical problems associated with downs
- congenital heart disease - hypothyroidism - leukemia
barriers for children with chronic conditions
- control and autonomy may be decreased because of increased hospitalizations - they may feel they have no decision making control - age appropriate socialization may be compromised - the child might miss out on events their peers are taking place in due to their illness
symptoms of TEF
- coughing - choking (food entering the lungs) - severe abdominal distension (large amounts of air entering the stomach)
social and emotional characteristics of FXs
- difficulty looking at people directly - difficulty with peer social relationships
what should you not do when speaking for a child with a hearing impairment?
- dont talk louder - dont talk higher - talk in normal voice - dont stand far away
play of 6-8 year olds
- drawing - construction - dolls - pets - guessing games - complicated puzzles - board games - riddles - physical games - competitive play - reading - bike - hobbies - sewing - listening to the radio - watching tv - cooking
consequences of sibling involvement in the chronically ill child's life
- emotional consequences - sibling may require additional interventions - referral to support groups
what is the benefit of providing social activities both in and out of the hospital and encouraging peer interactions, completion of school work, and peer visits for a chronically ill child?
- encourages maintenance and acquisition of developmental skills
interventions for adolescents with chronic disease
- expect them to be a big part of decision making regarding their care - give information sensitively because they react to the information and also how you deliver it - allow as many choices as possible - be honest - stress adherence to care - contact with peer groups
how to prevent the child from fearing bodily injury and pain in the hospital
- explain all procedures - administer meds for painful procedures - use topical analgesics before insertion of IV
how to prevent fear of the unknown in children in the hospital
- explain all procedures - demonstrating
lip reading rules for the nurse
- face child - eye contact - eye level - good lighting - facial expression - sentences short and rephrase if child does not understand
fire drills and the school age child
- families should hold routine fire drills - there should be a plan to meet when everyone gets out of the house during a fire drill - they should understand why they should not play with flammable substances because they understand cause and effect relationships
symptoms of infectious mononucleosis
- fever - exudative pharyngitis - lymphadenopathy - hepatosplenomegaly
how does honesty create an emotional response in the child with a chronic illness?
- for children with a chronic illness, honesty may increase their emotional pain but comfort them at the same time
etiology of cognitive impairment
- genetic - biochemical (fetal alcohol syndrome) - infectious (rubella syphilis) - familial - social - environmental - trauma
how to promote self esteem in the school age child
- give children household responsibilities according to their developmental and capabilities; set reasonable rules - allow children to solve problems and make responsible choices - give praise for what is praiseworthy. do not e afraid to encourage a child to do better - allow children to make mistakes and encourage them to take responsibility for the consequences of their mistakes
interventions for school aged children with chronic disease
- give choices whenever possible - contact with peer group - diagrams and pictures - emphasize "normal" things the child can do. and that they have done nothing wrong - encourage the child to be involved in their own care
some nursing interventions for parents with a child with a chronic illness?
- grief education - grief support - consider their cultural beliefs - religious beliefs - referrals
manifestations of FASD
- growth deficiency - microcephaly - joint anomalies - mild to moderate intellectual disabilities present in early childhood - seizures in neonatal period - irritibility - abnormal facial features
what are some anticipatory guidance and safety topics for children ages 6-11?
- gun safety - bikes, skating, scooter safety - playground and sports safety - fire safety - automobile safety - water safety - sun protection - good vs. bad touch - stranger awareness - avoid listening to loud music through headphones - how to contact emergency services - discuss exposure to contact allergens
medical management for conductive haring loss
- hearing aid - antibiotics - surgery - tympanostomy tubes
types of sensory impairments in children
- hearing impairment
how does the use of honesty affect the response by family members of a child who has a chronic illness?
- honest answers are not always handled well by family members - the nurse strives to help family understand the importance of maintaining the child's trust - the family may ask the nurse to answer deceitfully
conflicts within the family that arise due to honesty when communicating with a chronically ill child
- in many situations a compromise is reached in that the nurse will not initiate conversations that may lead to questions about whether or not the child is expected to die - however if the child asks specifically if they are going to die, the nurse will respond honestly in terms approved by the family - some families still may not want this
what are some ways health care professionals can support parents with a chronic illness child?
- increase their confidence - acknowledge each parent as a person - acknowledge them as the experts on the child - ease their worries by providing information and easy access to the HCP when questions/ problems arise - acknowldge the child as valuable and unique - help the parents see the childs potential and abilities help them understand the childs normal growth and developmental needs - encourage them to set goals
cognitive milestones of the 6-8 year old
- increases vocabulary - understands properties of language - adapts well to changing physical properties of objects - improved long term memory
how does a child get fragile x syndrome?
- inherited through a sex linked pattern - inherited from carrier mothers
what does collaborating with the child and school do for a child with chronic illness?
- involving the child will support achievement - maintains the normalcy of attending school and meeting social and developmental tasks of childhood
in an infant with FASD, what is one more the most common issues parents find?
- issue with feeding (try different ways of feeding)
what are the effects of dishonest communication with chronically ill children?
- lack of trust - the child may not be cooperative - if a chronic condition becomes terminal, the child's trust can be very important to achieving comfort and peace
physical characteristics of FXs
- larger prominent ears - long narrow face
what is dexamethasone given for?
- laryngeotrachobronchitis - decreases airway inflammation
what are some things a helmet should have?
- lightweight - ventilated - reflective - chin strap
signs of dehydration in the ped patient
- look at urine- ologuria - skin turgor - sunken fontanelles - weighing diapers
social milestones of a 6-8 years old
- loves new ideas and places - good sense of humor - may be argumentative - likes to make things but may not finish projects - strong sense of fairness
symptoms of TB
- malaise - fever - night sweats - silent cough - weight loss
Malrotation and Volvulus
- malrotation is rotation of the bowel around the mesenteric artery in utero - volvulus is the bowel rotating around itself compromising blood supply to intestines
possible of autism
- maternal rubella - untreated PKU - tuberous sclerosis - anoxia during birth - seizures - fragile x syndrome
relationship between the sibling and the ill child
- may be altered because of normal feelings of resentment, jealousy, and competition - guilt and shame about their feelings - guilt over being well
interventions for toddlers with chronic diseases
- minimize separation from significant others - keep security objects close - provide simple explanations - oppurtunities for play - maintain bed or crib as a safe space
what is the first intervention for a child with cleft lip/palate?
- modifying feeding by using different nipples
TB exposure
- no signs and symptoms - neg skin test
TB infection
- no signs and symptoms - pos skin test
manifestations of laryngomalacia
- noisy inspiratory respirations (stridor) - retractions - acyanotic - increase in symptoms when the infant is supine or crying
what is croup
- occurs as a result of an upper airway infection - swelling of the larynx, trachea, bronchi
care safety for the school age child
- one a child reaches a height or 4'9 and is between 8-12 years old, they can use the cars seat belt.
early signs suggestive of cognitive impairment
- organ system issues - dysmorphic syndrome - irritability - fine motor skills delayed - behavior - language difficulties
unstructured play
- play that is controlled by the child - the nurse can play along with the child - the nurse directs the child to the playroom and tells them it is a safe place to play and no procedures occur in the play room
why has the prevalence of pneumonia decreased in chidlren?
- pneumocaccal vaccine
manifestations of asd in infants
- poor eye contact - absence of babbling - little interest in verbal interaction - lack of smiling - not seeking comfort or cuddling
TB disease
- pos for signs and symptoms - pos skin test
what is the benefit of offering the chronically ill child choices to make age appropriate treatment decisions?
- promotes autonomy - promotes normalization
interventions for infants with chronic diseases
- provide consistent caregivers - minimize separation from parents and caregivers - decrease parental anxiety - maintain the crib and nursery as a safe space
nursing care for patients will tonsilitis involves
- providing comfort - minimizing activities that cause bleeding
environment for the child with pneuonia
- quiet - diversional activities
meds given for laryngotracheobronchitis
- racemic epinephrine - dexamethasone - antibiotics
cognitive milestones of the 9-11 year old
- reads more and enjoys comics and newspapers - understands fractions, conservation of volume, and weight - likes to talk on the telephone - interested in how things work
therapeutic management of bronchitis
- rest - humidification - increased fluid intake - frequent assessments - meds - education
what is the concept of reversibility?
- retracing their steps - subtraction - taking a toy apart and putting it back together
attention for the sibling of the chronically ill child
- sibling may associate illness with extra attention and gifts - may experience real or imagined illness as a bid for familiar attention - the nurse should encourage family and friends to give attention and gifts to the siblings as well as to the ill child - encourage parent to spend some time everyday with each sibling is essential for the family
developmental and emotional changes in siblings of the chronically ill child
- siblings may regress in developmental stage and activities - siblings may act out - anger and jealousy
what should the nurse educate the sibling on in regards to the chronically ill child?
- siblings should be kept up to date regarding changes in the ill child's condition, both positive and negative
if the child with asd has lack of verbal skills, how should the nurse continue the assessment?
- sign language - pictures
interventions for preschoolers with chronic illness
- simple, concrete explanations - advance prep is important - use pictures, models, actual equipment, medical play - maintaining their bed/ crib as their safe space
risks with self care children
- smoking, alcohol use - inappropriate eating - quality of child and parent relationship dampered
sports safety for the school aged child
- sports should be well supervised - protective gear should be mandatory
language, speech, and sensory characteristics of FXs
- temper tantrums - self injury - agitation
sibling involvement in the chronically ill childs life
- the nurse and the family should try to include siblings as much as possible in the life and activities of the ill child - there are pros and cons to sibling involvement
risks for the infant with cleft lip/ palate
- they cannot suck when feeding - liquid may enter the nose - risk for aspiration - risk for respiratory distress
why is dehydration and overheating a concern for the school aged child?
- they do not recognize fatigue - they will not stop an activity to rest - they have a high metabolic rate - decreased sweat ability
what is the child life specialists role in education?
- they typically incorporate medical play and art and therapeutic play and art - they help the child express their feelings and develop additional coping mechanisms
fine motor skills of the school aged child
- tying shoelaces - button and zip clothes - dress and undress without help - print - color - draw well - model clay - cut with scissors
what may be used to help the infant with TEF prevent aspiration?
- use of a chalasia board - suctioning - abx admin to prevent pneumonia
What is racemic epinephrine? what is it for?
- used to treat laryngotreachobronchitis - usually nebulized with oxygen - decreased laryngeal edema and bronchospasm
how to answer a child's questions with a chronic illness
- usually the most difficult questions are whether the child is going to die or why they became sick and is dying - conflict might arise between the nurse and the parents because the parents might have different ways they want their child's questions to be answered - nurses are responsible for encouraging the parents to be as honest as possible with their answers
positioning for the child with pneumonia
-hob elevated - turn q2hr - put them on the side of the unaffected lung - infant seats avoided due to pressure on diaphragm
environment for child with pertussis an why
-quiet - calmness - reassure parents - this is because fear or anxiety can bring on the cough
puberty begins in girls about ________ yr before it begins in boys
1
in middle childhood (school aged) total height gained is _____ to _______ feet
1-2
convalescent stage of pertussis
1-2 weeks everything decreases in severity
catarrhal stage of pertussis
1-2 weeks rhinorhea mild cough low grade fever
3 stages of pertussis
1. catarrhal 2. paroxysmal 3. convalescent
6 stages of pubic hair development in females
1. no hair 2. scarcely pigmented straight hair 3. sparse, dark, curly pubic on labia 4. hair course and curly 5. lateral spreading 6. further extension
6 stages of pubic hair development in males
1. no pubic hair 2. slightly pigmented, longer, straight hair, usually at the base of the penis, sometimes on the scrotum 3. dark, pigmented, curly pubic hair around base of penis 4. pubic hair is adult type but not in extent 5. hair is spread to medial surface of thighs, but not upward 6. hair spread along linea alba
5 stages of the female breast development
1. only the nipple is raised above the level of the breast 2. budding stage 3. breast and areola enlarged, no contour separation 4. increasing fat deposits 5. adult stage. nipple projects
five stages of penis and testes/ scrotum development in males
1. testes, scrotum, and penis are the same size and shape as in the young child 2. enlargement of scrotum and testes. the skin of the scrotum becomes redder, thinner, and wrinkled 3. enlargement of the penis, further enlargement of the testes, descent of the scrotum 4. continues enlargement of the penis and sculpturing of the glans , increased pigmentation of the scrotum 5. adult stage- scrotum ample, penis reaching nearly to the bottom of scrotum
puberty begins about ________ to ________ years later in boys
1.5-2
what percent of the population with cognitive impairment is moderately impaired? educable or trainable?
10%; trainable
when does peak height velocity occur in girls?
10-11 years
when does peak height velocity occur in boys?
13.5 years
A female patient who experienced her first period on her 13th birthday can expect her peak height to be achieved by age __.
15
what percent of children in the US meet the criteria to be considered a child with special healthcare needs?
15.1%
some diagnoses of intellectual disability can either be made at birth or younger than ___________ years of age
18
symptoms of laryngomalacia typically resolve by ______-________ months without treatment
18-24 mo
at around age 10 or 11 years, girls begin to catch up in size, and by 12, girls are ______ in taller than boys and about ______ lb heavier
1;2
during the early school age period, boys are approx _____ inch taller and ______ lb heavier than girls
1;2
girls achieve peak height velocity approx ________ yrs before boys
2
in middle childhood (school aged) weight increases by _______ to ________ kg/year
2-3
paroxysmal stage of pertussis
2-4 weeks or longer increased severity of cough cyanosis salivation distension of neck veins coughing may induce vomiting
Females are expected to reach reproductive maturity ______-______ years after menarche.
2-5
Most young women achieve reproductive maturity ______-______ years after the start of menstruation.
2-5
gynecomastia occurs in approx ____/____ of young males
2/3
average height gain in growth spurt is _________%-________% of adult height over a 2-3 year period
20-25
IQ for severe intellectual disability
20-25 to 35-40
children between the ages ___-____ are normally asymptomatic for TB
3-15
croup usually lasts about _______-_________ days
3-4
how should a hospitalized infant with bronchiolitis be positioned?
30-40 degree angle with the head slightly extended to take pressure off of the diaphragm and maintain an open airway
IQ for moderate intellectual disability
35-40 to 50-55
there are _________ distinct stages (tanner) in sexual maturity
5
average weight gain during growth spurt is ___________% of adult weight
50
IQ for mild intellectual disability
50-55 or anywhere up until 70
A 7-year-old child who is 48 inches is expected to be approximately __________ inches at age 9.
52 inches (they grow about 2 inches a year)
the meds for TB re given for _______ months
6
healing time for piercings can take anywhere from _________ weeks up to a year
6 weeks
middle childhood ages
6-11 or 12 years
at what age does a child tie shoelaces, button and zip clothes, and dress and undress without help?
6-8 years
what age group is effected by hospitalization the most?
6mo- 5yrs
a "god boy" or "good girl" orientation characterizes the ages from _______-______ years, in which the child conforms to rules to please others and avoid dissaproval
7-12
intellectual disability IQ
70-75 or less
IQ for borderline intellectual disability
71-84
at what age can childern laugh at incongruities and love silly jokes, riddles, and puns?
8
at what age can the child use and understand the clock?
8
at wha age do children have fully developed eye hand coordination and fine motor control similar to adults?
8-11 years
what percent of the population with cognitive impairment is mildly impaired? educable or trainable?
85%; educable
normal intelligence IQ
85-115
when is formal screening for asd reccomended?
9 mo
age of prepubescence varies from
9-12
school aged children usually go to bed by _________PM and are up by ___________PM
9;7
The nurse is screening a child for tuberculosis . Which child is at risk for developing tuberculosis? A 9-year-old child whose father is incarcerated. A 3-year-old male child who lives in a rural area. A 6-year-old Caucasian child with varicella-zoster virus (VZV). A 13-year-old malnourished Latino female who lives in an urban area.
A 13-year-old malnourished Latino female who lives in an urban area.
Why is it important to identify the special needs for children with chronic and terminal illness?
A clear definition can help families and caregivers obtain the support necessary to adequately care for children with special health care needs.
Which statement below describes one of the ways that male physical development differs from females? Males develop increased muscle mass. Males develop increased adipose tissue. Males experience height increase of 3.15 in (8 cm)/year. Males experience an increase in body mass index.
Males develop increased muscle mass.
chronic conditions often have a large impact on the patients _____________
ADLs
Which physical changes are experienced by girls during the adolescent years? Menarche Pubic hair growth Breast development Formation of ovaries Decrease in adipose tissue
Menarche Pubic hair growth Breast development
which physical sign would the nurse recognize as indicative of approaching death in a child? Loss of bowel control Cheyne- Strokes respirations Progressive loss of sensation Increase in appetite and thirst Increase in BP
Loss of bowel control Cheyne-Strokes respirations Progressive loss of sensation
Which physical changes are experienced by boys during the adolescent years? Thelarche Increased height Growth of sexual organs Increased fat deposits Growth of pubic hair
Increased height Growth of sexual organs Growth of pubic hair
otitis media can either be
bacterial or viral
hallmark sign of croup
barking cough
African-American and Hispanic girls begin puberty __________ Caucasian girls.
before
infectious mononucleosis effects ages
below 25
what is body art?
body piercing and tattooing
what is tdap
booster for pertussis tetanus diptheria
what is pertussis caused by?
bordatella pertussis, gram neg bacteria
bronchitis is inflammation of the
bronchi
bronchiolitis is inflammation of the
bronchioles
what is the first sign of physical sexual maturation in girls?
budding of breasts
Which body system changes are expected in the school-age child? SATA Skeletal muscles fully develop. Enlarged tonsils and adenoids. Lungs and alveoli fully develop. Development of frontal sinuses. Eustachian tubes angle upward.
Enlarged tonsils and adenoids. Lungs and alveoli fully develop. Development of frontal sinuses.
when are symptoms of asd normally noticeable?
by 3 years of age
when do the lungs and alveoli develop fully?
by the school age; less respiratory infections
dysacusis
cannot distinguish sounds or process details
agnosia
cannot hear sound correctly
if the child with asd has reluctance to initiate or sustain eye contact, how should the nurse continue the assessment?
carry on and assume the child is listening
2 types of malabsorption syndrome
celiacs disease and short bowel syndrome
asd patients can get very upset when there is a minor ______________ in their daily life
change
third phase of separation
child becomes interested in the environment and begins to play
what group of children experience the highest rates of disabilities
children living in poverty
what are self care children?
children who are home alone after school
The nurse is caring for a 7-year-old child due to strident cough and irritability. Upon exam, the nurse finds the child's epiglottis to be edematous and cherry red, with vital signs readings of T = 100.9 oF, HR 100, RR 24, BP 100/70, O2 sat 95% on room air. Which action should the nurse take? Assess lung sounds. Administer amoxicillin. Review arterial blood gas. Apply oxygen via facemask.
Administer amoxicillin.
The nurse is caring for a child with intussusception who presented with vomiting and diarrhea. Laboratory values reveal elevated serum sodium and elevated hematocrit. Which priority action should the nurse take to achieve the expected outcomes for this patient? Asses the child's A1c Increase dietary iron Notify the provider immediately Encourage the child to sit up in a chair Administer intravenous (IV) normal saline
Administer intravenous (IV) normal saline
A 4-year-old child with cystic fibrosis presents to the emergency department with a 1-day history of a productive cough, wheezing, fever, and poor appetite. The child's oxygen saturation level is 85% on room air, respiratory rate of 22 and shallow, and heart rate of 120. Which action is priority for the nurse to take? Start bronchodilator nebulization. Administer oxygen via nasal cannula. Obtain a temperature to assess for fever. Perform chest physiotherapy twice a day
Administer oxygen via nasal cannula.
Which problem behaviors can occur when leaving a child home alone after school? Alcohol use Binge eating Creating messy art Drug experimentation Preparing snacks and meals
Alcohol use Binge eating Drug experimentation
The parents of a 3-year-old child with Down syndrome tell the nurse that their child's lips and fingertips turn dusky purple when the child runs around the house for more than a few minutes. They also report a persistent cough over the past 4 months. The parents state that their child's last physical exam was 2 years ago. Which action is most appropriate for the nurse to take?
Alert the health care provider to the symptoms described by the parents.
The nurse is caring for a 2-month-old infant who presents with fever, breathing difficulties, wheezing, persistent cough, and difficulty feeding. Which health instructions by the nurse are appropriate to provide the parents? Allow rest periods during the day. Administer an antihistamine daily. Offer the child's liquids frequently. Use a humidifier in the child's room. Give a cough suppressant every four hours
Allow rest periods during the day. Offer the child's liquids frequently. Use a humidifier in the child's room.
The nurse senses sadness in a parent with a child who has terminal cancer. Which action is the most appropriate for the nurse take in this situation?
Allow the parent to talk and express emotions.
The nurse is caring for a child with a left lower lobe infiltrate. Labs are obtained and the nurse receives the following results: WBC 16,000, Hgb 12.5, Platelet count 180,000, urine specific gravity 1.035, BUN 22. Which provider's prescription would the nurse anticipate in this patient? NPO status Antibiotics Acetaminophen Intravenous fluids Pneumococcal conjugate vaccine
Antibiotics Acetaminophen Intravenous fluids
Which newly acquired cognitive/language milestones are achieved by the adolescent? Understanding conservation Arguing a hypothesis Reversing a math problem Expressing abstract concepts Planning for college
Arguing a hypothesis Expressing abstract concepts Planning for college
hypertrophic pyloric stenosis
circular area of muscle surrounding the pylorus constricts and obstructs gastric emptying
The nurse is conducting an assessment of a school-aged child who has autism spectrum disorder (ASD). What should the nurse do to best assess the child's functional abilities? Ask the child "Can you tell me about your morning routine?" Ask the child, "To whom could you go at home and school if you need help?" Change the child's usual routine to determine how the child can cope with minor changes. Observe the child while the child is performing activities of daily living (ADLs) to see what assistance is needed. Make an effort to interact with the child on a regular basis and talk with the child about his or her interests.
Ask the child "Can you tell me about your morning routine?" Observe the child while the child is performing activities of daily living (ADLs) to see what assistance is needed.
The nurse is caring for a school-aged child with a chronic illness that requires the child to wear a mask when leaving the hospital room. The child does not want to attend social activities on the unit. Which action by the nurse can help encourage the child to participate?
Ask the child why the hesitation to wear the mask when leaving the hospital room
A nurse is caring for a four-year-old child who must have surgery. The child will require an IV and an indwelling urinary catheter. How can the nurse best prepare the child for this experience?
Assure the child that a nurse or parent will be caring for him or her at all times. Show the child a doll that has an IV and a urinary catheter in place while explaining what each is for. Give simple explanations about the surgery and what the child should expect a few days before the surgery.
A 15-year-old patient is a member of the school's swim team. When educating on water safety, which water safety recommendation takes priority? Avoid drugs and alcohol Wear appropriate attire Attend practice regularly Refrain from playing around the pool
Avoid drugs and alcohol
Which is an example of a negative influence affecting a school-aged child's food choices? Eating snacks after school Involvement in food preparation Exposure to fast food commercials Eating a wide variety of food choices at home
Exposure to fast food commercials
what is the most common craniofacial deformity?
cleft lip and palate
When assessing a child treated for intussusception, which behavioral finding would indicate the expected outcomes had been met for that child? Guarding Flexing the legs Crying while standing Knocking over blocks
Knocking over blocks
sign of pain in the legs of the infant
flexed legs
treatment for intussusception
Barium or air enema
The parent of an eight-year-old child is frustrated because the child constantly makes up reasons not to attend school. The child's health care provider ruled out any serious health issues. The nurse should suggest that the parent take which actions to address this behavioral problem? Be firm in enforcing school attendance Encourage group activities with peers Discipline the child for wanting to leave school Rationally discuss the reasons the child wants to stay home Remove child from school any time they feel stressed or frightened
Be firm in enforcing school attendance Encourage group activities with peers Rationally discuss the reasons the child wants to stay home
school aged children should brush their teeth with _____________ toothpaste twice daily and flossing daily
flouride
The parents of a preschooler with intellectual disability are in the health care provider's office. The parents seem anxious, disheveled, and tired. What can the nurse do to be most effective when working with this family? Bring up the aspects of caring for the preschooler that the parents are doing well. Provide information about local support groups for parents of children with disabilities. Ask the parents about their ability to maintain other roles, such as that of an employee or a significant other. Explain to the parents the need to put the child in a residential care facility that will provide the necessary care for the child. Discuss with the parents the need to set an example for the child by caring for their own needs, getting enough sleep, and remaining calm.
Bring up the aspects of caring for the preschooler that the parents are doing well. Provide information about local support groups for parents of children with disabilities. Ask the parents about their ability to maintain other roles, such as that of an employee or a significant other.
influenza is also known as the
flu
oral ____________ supplementation may be necessary for school aged children if there is no access to fluoridated water
fluoride
The parents of a 10-year-old child with Down syndrome tell the nurse that their child currently participates in soccer and basketball. They state that the child will start football in the next month. Which does the nurse consider before advising this patient?
Children with Down syndrome have issues on the cervical area, making them prone to injury.
3 C's of TEF
Coughing Choking Cyanosis
A 3-year-old male presents with persistent coughing and a temperature of 101.8 oF. The parents report the child became sick over the past few days. The child is now resting. Which action by the nurse is a priority? Count respirations. Obtain blood culture. Apply humidified oxygen. Administer acetaminophen
Count respirations.
cardinal signs of epiglottitis (4D'S)
DROOLING DYSPHAGIA DYSPHONIA DISTRESSED INSPIRATORY EFFORTS
what is reccomended for children to prevent pertussis?
DTaP vaccine (diptheria, tetanus, pertussis)
The nurse is assessing a patient with cystic fibrosis (CF). To determine if enzyme replacements are adequate, which assessment detail should the nurse look for? Urine output Color of stool Dietary intake Regularity of stool Constancy of stool
Dietary intake Regularity of stool Constancy of stool
Which water safety guideline is a priority for children playing in a neighborhood pool? Jump head first Use a flotation device Do not dive into water Only run while wearing shoes
Do not dive into water
what is the most common chromosomal abnormality?
Down syndrome
Which milestones associated with fine/gross motor control are achieved by the adolescent? Driving a car Jumping in place Playing an agility sport Texting on a smart phone Playing a complex musical instrument
Driving a car Playing an agility sport Texting on a smart phone Playing a complex musical instrument
ages 7-8 years thought process... what is it? attention span?
ENTERS STAGE OG CONCRETE OPERATIONS - learn that their pov is not the only one - attention span increases
The nurse receives the following results of a first trimester prenatal screening: Triple maternal serum screen value—low alpha fetoprotein, low unconjugated estriol, and increased human gonadotropin levels. Which action is most important for the nurse to take? Teach patient about Down syndrome. Prepare patient for a level II ultrasound. Refer patient and her partner for genetic counseling. Educate the patient about amniocentesis or chorionic villi sampling (CVS).
Educate the patient about amniocentesis or chorionic villi sampling (CVS).
The nurse is providing education to the parents of a 6-month-old infant diagnosed with bacterial pneumonia, who is now being discharged home from the emergency department. Which education by the nurse is appropriate? Education on offering the infant a bottle frequently Education on administering acetaminophen for a fever Giving guidance and education on how to use a car seat to promote drainage Advising the parents on allowing the child to cry to increase circulation and oxygenation Providing instruction and emphasizing the importance of finishing the antibiotics prescribed
Education on offering the infant a bottle frequently Education on administering acetaminophen for a fever Providing instruction and emphasizing the importance of finishing the antibiotics prescribed
During feeding, an infant with pyloric stenosis begins to cough and wheeze. Which is the priority nursing action? Elevate the infant's head Provide supplemental oxygen Obtain a STAT chest radiograph Place the infant in the supine position
Elevate the infant's head
The infant with congestive heart failure needs to have an IV inserted. To increase the comfort of the baby, what should the nurse do?
Encourage the parents to stay with the child as long as they are comfortable.
what is cued speech for?
for words that sound alike ex: bat and mat. if talking about a bat, you want to do a swinging motion like you are using a bat.
While assessing an infant with fetal alcohol spectrum disorder (FASD), the nurse does not see many of the characteristics that she expected to see. What is the explanation for this finding? FASD is a spectrum of disorders, so a variety of signs and symptoms is possible. The child is misdiagnosed because the lack of specific characteristics means that the child does not have FASD. Children with FASD have very specific facial characteristics, so the nurse may not be recognizing the signs of the disorder. The nurse will need to spend more time with the child to determine whether the characteristics she expected to see are present.
FASD is a spectrum of disorders, so a variety of signs and symptoms is possible.
A 13-month-old female is brought to the hospital because the parents suspect spasmodic croup. What information would help the nurse determine appropriate interventions for this child? Family history Onset of symptoms Presence of mucus Exposure to bacteria When coughing occurs
Family history Onset of symptoms Presence of mucus When coughing occurs
Which parental practice encourages motor vehicle safety for a school-aged child? Checking brake lights Speak quietly while conversing with the driver Fastening seat belt for every ride Leaving extra time to reach destination
Fastening seat belt for every ride
During pediatric care rounds, the nursing staff discusses a toddler with sragile X Syndrome who is nonverbal, unable to hold a crayon, and crawls instead of walks. Which cause and effect relationship does the nurse consider before starting a care plan for this patient? Fragile X syndrome causes intellectual decline that affects the child's ability to speak, write, and move. Fragile X syndrome causes prefrontal lobe dysfunction that affects the child's ability to speak, write, and move. Fragile X syndrome causes physical feature abnormalities that affect the child's ability to speak, write, and move. Fragile X syndrome causes speech and motor dysfunction that affects the child's ability to speak, write, and move
Fragile X syndrome causes speech and motor dysfunction that affects the child's ability to speak, write, and move.
Which person is most important to the identity development of an adolescent? Friend Sibling Mentor Parent
Friend
after surgical intervention of TEF, children are at high risk for
GERD
When assessing an infant with a tracheoesophageal fistula, which findings would be expected? Crying when not being held Gagging during bottle feeding Blue discoloration around the mouth Coughing after latching onto breast for feeding Abnormally high platelet count and thrombin level
Gagging during bottle feeding Blue discoloration around the mouth Coughing after latching onto breast for feeding
Which activity could help foster a sense of industry in the school-age child? Discourage the child from competing on a team. Give the child an allowance for completing chores. Allow the child to watch a favorite television show. Tell the child he must make an A on the test tomorrow.
Give the child an allowance for completing chores.
Puberty is considered delayed in males if which physical changes do not occur by age 14? Growth of testes Gynecomastia Penis enlargement Axillary hair growth Scrotum color darkening
Growth of testes
most frequent cause of acute epiglottitis
Haemophilus influenzae type b
An 8-year-old patient is having problems adjusting to daily radiation treatments. Which is the most appropriate action for the nurse to take to help with the adjustment?
Have a discussion with the child life specialist.
adolescent cognitive development stage
formal operations (abstract thinking)
A patient is learning to cope with a newly diagnosed chronic illness. To help the patient adjust, which actions should the nurse take?
Help the child with incorporating the illness into each stage of life Provide support as the child accepts the illness as a part of each stage of life Educate the child in a way that there is an understanding that illness will be present long-term
ribbon like stools
Hirshsprung disease
ages 6-7 years thought process..... what is it? what can they and cannot understand?
INTUITIVE THOUGHT FROM PRESCHOOL - based on the childs own viewpoint - thinking is still egocentrism, animism, and centration - the child cannot understand anothers viewpoint, form hypotheses, or deal with abstract concepts.
The nurse is caring for a child who presents with abdominal distention and currant jelly stools. Since admission, the patient's blood pressure has decreased and the patient has become lethargic. Which is the priority nursing action for this patient? Notify the health care provider Administer intravenous (IV) pain medication Prepare the patient for abdominal ultrasonography Prepare the patient for magnetic resonance imaging (MRI) of the chest and abdomen
Notify the health care provider
The parents of a young child who is hospitalized appear nervous and state that they have had terrible past experiences in the hospital. What is the most appropriate nursing action to help promote comfort to this patient and family? Ask the child about previous hospitalization. Allow the child to draw a picture of previous hospital experience. Tell the family that this hospitalization will be different from previous hospitalization. Offer clear information on the patient's hospitalization and allow the family opportunities to ask questions.
Offer clear information on the patient's hospitalization and allow the family opportunities to ask questions.
Which cognitive developmental changes are expected in the school-age child? Organizing toys by size Starting a new leaf collection Telling jokes to make others laugh Understanding the idea of volume and mass Believing their magic wand makes the sun set
Organizing toys by size Starting a new leaf collection Telling jokes to make others laugh Understanding the idea of volume and mass
The nurse is evaluating how a couple is coping with their young child's diagnosis of cleft lip. For which signs does the nurse look to determine whether effective coping is taking place? Parents do not voice fears. Parents will not hold the child. Parents plan and organize all special care appointments. Parents sit quietly in the room without looking at the child.
Parents plan and organize all special care appointments.
first sign of cleft palate
formula coming from the nose
what is the most common known genetic cause of autism?
fragile x syndrome
Why might a patient who tests positive for Bordetella Pertussis also present with an unusually low blood pressure? Pertussis releases endotoxins. Pertussis causes a high fever. Pertussis can bind to the mitral value affect cardiac output. Pertussis has a thick cell wall which can affect the cardiovascular system.
Pertussis releases endotoxins.
Bordatella pertussusis have pili that surround their thin cell wall. Why is this significant for understanding the pathophysiology of the disease? Pili make phagocytosis of the bacteria by the host cells more difficult. Pili propel the bacteria through the host's body by excreting exotoxins. Pili help the bacteria survive and adhere to the mucosa of the respiratory tract. Pili hide the bacteria's presence in the host so the immune system cannot respond.
Pili help the bacteria survive and adhere to the mucosa of the respiratory tract.
The nurse is caring for a child with pyloric stenosis. The nurse notes that the abdomen is distended, skin turgor is poor, and fontanels are sunken. Which action would the nurse take? Administer acetaminophen Give IV potassium supplements Administer narcotic pain medication Provide an intravenous (IV) normal saline bolus
Provide an intravenous (IV) normal saline bolus
Which intervention should the nurse use to reduce anxiety in parents of a child with congenital diaphragmatic hernia? Provide discharge teaching. Refer parents to a support group. Inform the parents about the procedure. Teach the parents standardized feeding techniques. Allow the parents to yell in order to express emotions.
Provide discharge teaching. Refer parents to a support group. Inform the parents about the procedure. Teach the parents standardized feeding techniques.
Which intervention would the nurse implement when caring for a child who is dying? Provide the child and family with time to share memories Refer the family to a self-help group to manage their grief emphasize that acute grieving is a process that lasts for years encourage the use of alcohol and drugs as a way to escape grief
Provide the child and family with time to share memories
Parents of a child with asthma are feeling overwhelmed and worried about how to access care to meet their child's health care needs. What should the nurse do to help the parents in this situation?
Provide the parent with the clinic hours of operation. Provide the parent with information about after-hour clinic provider coverage. Utilize nursing resources to provide information on asthma and when to seek medical attention. Provide the parent with the address and telephone number of the closest emergency department.
common cause of bronchiolitis
RSV
A parent confides in the nurse and states, "I believe it's my fault that my child is sick." The parent is crying and also admits to not sleeping well at night. Which actions by the nurse are most appropriate?
Recommend a referral to a psychologist specializing in grief therapy. Talk with the child's health care provider regarding the parent's statements. Provide the parent with the date and time of the next grief support meeting in the area.
Which task demonstrates the school-age child has progressed from intuitive thought to concrete operational stage? Retracing steps without getting lost Guessing the answer after a few tries Stating the sidewalk caused the accident Chooses favorite toy as a gift for another child
Retracing steps without getting lost
A 10-year-old with braces recently joined the soccer team. The nurse recommends use of a mouth guard for which reasons? Comfort Safeguards the braces Provides barrier for teeth Enhanced functionality of braces Protection from soft tissue damage
Safeguards the braces Provides barrier for teeth Protection from soft tissue damage
The parents of a child with fragile X syndrome tell the nurse that they have researched the disease online and are concerned about their child's future. They ask the nurse how they will know what services their child will need and where to obtain the services. Which action is appropriate for the nurse to take? Ask the case manager to talk with the parents. Schedule a multidisciplinary team meeting with the parents. Ask the provider to review the plan of care with the parents. Review the support groups available in the community with the parents.
Schedule a multidisciplinary team meeting with the parents.
A child who insists on staying home from school because they fear that something will happen to make him/her look bad in front of the other children is exhibiting which common school-age behavioral problem? Bullying Family stress School refusal Social isolation
School refusal
While taking a history from an adolescent with behavioral problems, the nurse learns that the adolescent has a fondness for violent activities and physical punishment is used at home. Which safety recommendation takes priority when addressing the adolescent's violence risk? Teach alternatives to physical punishment. Restrict movies and shows with adult content. Minimize time allowed playing shooting sports. Eliminate computerized games featuring fighting.
Teach alternatives to physical punishment.
Parents of a two-year-old child with type 1 diabetes are concerned about their child's diabetes and its impact over time. How should the nurse respond to their concerns?
Teach and help the parents adjust and cope with the child having type 1 diabetes. Inform the parents how treatment for type 1 diabetes will be incorporated into their daily lives. Inform the parents that care needs and approaches will likely change as the child grows and develops. Help prepare the parents to care for the child by letting them know what future school accommodations to expect with type 1 diabetes.
what med for FXs behavioral control
Tegretol/ prozac
A 3-year-old child with Down syndrome is hospitalized with pneumonia. The child becomes agitated when the parents leave the room and often picks at his arms. He doesn't respond to the nurse's questions and stumbles often when walking in his room and the hallway. What does this behavior suggest to the nurse? The behavior suggests that the child may have sensory deficits. The behavior suggests that the child may have inadequate social skills. The behavior suggests that the child is trying to cope with his hospitalization. The behavior suggests that the child has a diminished emotional response. The behavior suggests that the child may have problems with balance and coordination.
The behavior suggests that the child may have sensory deficits. The behavior suggests that the child is trying to cope with his hospitalization. The behavior suggests that the child may have problems with balance and coordination.
A child with fragile X syndrome is unable to walk without stumbling, has uncoordinated limb movement, fails to respond to his name, and does not track eye and hand movement together. Which therapeutic intervention is most appropriate for the patient? The child requires special education services to improve sensory functioning. The child requires occupational therapy sessions to improve limb movement. The child requires sensorimotor integration therapy to decrease the symptoms. The child requires safety assessment to address issues related to safety and mobility.
The child requires sensorimotor integration therapy to decrease the symptoms.
The nurse auscultates the lungs of a child with cystic fibrosis and notes coarse crackles and rhonchi. The patient also has a productive cough with thick yellow mucus. Which considerations does the nurse undertake in planning before implementing care for the child? The child's pulse oximetry needs to be measured frequently. A barrel chest and digital clubbing indicate long-standing respiratory difficulty. The child may have pneumonia or bronchitis, and gas exchange may be impaired. The child may demonstrate orthopnea and activity intolerance related to the respiratory symptoms. The child may have a prolonged inspiratory phase of respiration due to long standing respiratory difficulties.
The child's pulse oximetry needs to be measured frequently. A barrel chest and digital clubbing indicate long-standing respiratory difficulty. The child may have pneumonia or bronchitis, and gas exchange may be impaired. The child may demonstrate orthopnea and activity intolerance related to the respiratory symptoms.
What is one way adolescents receive inappropriate or incorrect information regarding sex and sexuality? The internet Outdated books Health teacher Talking to parents
The internet
A term newborn female is brought to the newborn nursery for evaluation. The nurse suspects that the newborn has Down syndrome. Which clinical manifestations support the nurse's suspicion? The newborn has a protruding tongue. The newborn has fused fingers and toes. The newborn has inner epicanthal folds. The newborn presents with a flat nasal bridge. The newborn has a single transverse crease across the palmar surface.
The newborn has a protruding tongue. The newborn has inner epicanthal folds. The newborn presents with a flat nasal bridge. The newborn has a single transverse crease across the palmar surface.
The nurse is trying to feed a newborn with fetal alcohol spectrum disorder (FASD). The nurse is holding the baby in different positions to promote feeding, but the newborn is still spitting up the formula. What should be the nurse's next action? The nurse should try only feeding the infant small quantities at a time. Weigh the infant daily to determine whether he or she is gaining or losing weight. The nurse should decrease the frequency of feedings to allow the baby to digest each feeding. The nurse should document the intake to determine whether enough nutrition is being given.
The nurse should try only feeding the infant small quantities at a time.
what is a sign there is bleeding during tinsilitis in the child?
frequent swallowing
A 4-year-old patient is diagnosed with congenital diaphragmatic hernia. What are appropriate nursing outcomes for this patient? The patient's mucosa will appear pink. The patient will play outside for 3 hours. The patient will have minimal wheezing. The patient will have regular breath sounds. The patient will sit quietly while tests are run.
The patient's mucosa will appear pink. The patient will have regular breath sounds.
A teenaged patient with leukemia is frustrated by the amount of time spent in the hospital and expresses anger to the nurse. Which nursing intervention is most appropriate?
The teen should be allowed to express anger and frustration through talking.
which conclusion would the nurse make upon learning the parent grieving the death of their child is experiencing disturbed sleep, can hear their child talk, perfers to be left alone, and does not speak to any of the family members?
This is a normal part of grief and will subside over time
Which are common reasons that adolescents pierce or tattoo their bodies? To avoid being bullied Because parents have body art To express individualism To represent a deep belief To identify with a specific peer group
To express individualism To identify with a specific peer group
Which safety recommendation is a priority for the adolescent who reports previously drinking alcohol at a party? Use a ride-home agreement Drive slowly on secondary roads Do not use the phone while driving Call parents on arrival to the destination
Use a ride-home agreement
Which action can exacerbate respiratory distress in a patient with congenital diaphragmatic hernia? Using a nasogastric (NG) tube Elevating the head of the bed Using a facemask or bag valve mask for ventilatory support Using a high-frequency ventilation system for ventilatory support
Using a facemask or bag valve mask for ventilatory support
what should you not do for a child with epilottitis?
further examination and visualization of the epiglottis; this can cause further distress and laryngospasms
after a child has their TEF or EA surgically corrected, they will have a _____________ tube
gastrostomy
The nurse is caring for a child with esophageal atresia who has been diagnosed with failure to thrive. Which assessment findings indicate the expected outcomes have been met for this patient? Weight gain Normal sleep patterns Increased head circumference Normal urine specific gravity Normal cognitive milestones met
Weight gain Increased head circumference Normal urine specific gravity
A mother questions the nurse about motor skills she should expect to see in her 9-year-old child. Which response by the nurse is appropriate? There are no new motor skills you should expect. It is normal for your child to need help zipping a jacket. Your child has fine motor control similar to an adult. School-age children have trouble with hand-eye coordination.
Your child has fine motor control similar to an adult.
how do most children get TB
a family member
what type of nipple is best to use for feeding a child with cleft lip/ palate?
a long nipple; but not too long that they are gagging
What is moratorium?
a period of delay granted to someone not yet ready to make more than a tentative commitment
older children with pertusis may not show signs of
a whooping cough
Congenital Diaphragmatic Hernia (CDH)
abdominal contents protrude into thoracic cavity
the classic signs of intussusception
abdominal pain currant jelly stools diarrhea sausage shaped abdominal mass
Hirschsprung disease
absence of neurons in the bowel wall, typically in the sigmoid colon
medical condition associated with downs in the childhood period
acute leukemias
what is infectious momonucleosis
acute self limiting infectious disease
the child who lacks a sense of industry has a poor foundation for mastering the tasks of _______________
adolesence
what is a ride-home agreement
an agreement between an adolescent and a parent that ensures the adolescent can count of the parent to provide a safe ride home with no questions asked if the adolescent uses alcohol or drugs
prevention of influenza
annual vaccine
when does the child enter the stage of formal operation thought stage?
around 12 years
the infant with TEF is at at constant risk for
aspiration
eustachian tube of the school aged child
assumes a more downward and inward position, resulting in fewer ear infections
bronchitis in a child can be confused with
asthma
what are some examples of chronic diseases in children?
asthma epilepsy diabetes sickle cell disease
medical condition associated with downs in the neonatal period
atrial septal defect
when does menarche occur?
average age 12
when a child has braces, sticky snacks should be ____________, not limited.
avoided
many respiratory conditions in children are caused by
bacteria or virus
what is epiglottitis?
bacterial form of croup
where should the infant with bronchiolitis be placed in relation to the nurses station?
close to the nurses station for supervision
some families try to maintain the existing degree of ______________ between the ill child by having the siblings closely involved
closeness
nursing care for pertussis should be -______________-
clustered
where should an avulsed tooth be placed when in route to the dentist?
cold milk
acute viral nasopharyngitis
common cold
children in the _________ operations stage grasp the concept of reversibility
concrete
children in the ____________ operations stage have a delightful sense of humor
concrete
if a child believes that success is unattainable the child will lose ______________ and not take pleasure in attempting new experiences
confidence
hirschsprung disease is also called
congenital aganglionic megacolon
Tracheoesophageal fistula (TEF)
congenital defect in which the trachea and esophagus are together
laryngomalacia is also known as
congenital laryngeal stridor
functional hearing loss examples
conversion hysteria unconcious withdrawal to block out traumatic sounds
for advance prep for preschoolers, how long should you prepare them for major events?
days
severity of hearing loss is measured in
decibels (dB)
what is the unit of loudness?
decibels (dB)
head circumfrence in middle childhood (school aged)
decreased
second phase of separation
despair quiet and withdrawn
when caring for a child with CI in the hospital, consider the childs __________ age when caring for them
developmental
how is influenza spread
direct contact
transmission of bordatella pertussis
direct contact or droplet from coughing
what information is ultimately shared with the siblings of a chronically ill child is at the parents _______________
discretion
in middle childhood (school aged) weight almost _____________
doubles
what type of precautions for pertussis
droplet
clinical manifestations of influenza
dry cough hoarseness fever chills
parents may not want the ill child to know that they are _________.
dying; this is a parental right
what is the key of nursing care of children with impaired cognitive function?
early intervention is key
physical assessment finding for acute nasopharyngitis
edema vasodilation of the mucosa
splint the ___________ lung
effected
what intervention is used to keep the child with cleft lip/ palates hands out of the mouth?
elbow restraints
epiglottitis is an _____________
emergency
intussusception is a pediatric ___________
emergency
what type of hospital admission is the most stressful?
emergency admission
infectious monolocleosis etiology
epstein barr virus
what consult may be appropriate to make communication decisions about the child dying easier?
ethics consultation
hypertrophic pyloric stenosis is a vicious cycle that causes
even more constriction of the pylorus and further obstuction
how often should the school age child go to the dentist?
every 6 months
how often should parents allow their child to practice sucking when their child has TEF?
everyday
what type of masks should you not use for a child on ventilator support and why?
facemasks or bag valve masks because it causes air to enter the stomach and inhibit breathing
hyperopia
farsighted
fat changes in middle childhood (school aged)
fat diminution
although school aged children are very full of energy, they do not recognize ____________
fatigue
epiglottitis is accompanied by a high ____________
fever
clinical manifestations of acute nasopharyngitis
fever irritibility restlessness no appeitie sneezing vomiting diarrhea
instruct the parent of a child with cleft lip/ palate to keep what out of the mouth for 7-10 days?
fingers, spoons, pacifiers
most common birth defect of the larynx
flaccidity
in middle childhood (school aged), the immune system is ________________ effective
increasingly
the central task of the school age years is the development of a sense of _______________
industry
at the school age, children learn their parents are not _______________
infalliable
who is most susceptible for pertussis?
infants due to their immature immune system
the negative component of the developmental stage is a sense of __________________
inferiority
_____________ claim more lives during adolescence than all other causes of death combined
injuries
sensorineural hearing loss is damage to the ___________ ear or auditory nerve
inner
medial condition with downs in the adolescent period
intellectual disability
medical condition associated with downs in the infancy period
intestinal obstruction
intussusception
invagination of a section of the intestine into the distal bowel
organic hearing loss
involves reception of auditory stimuli aphasia agnosia dysacusis
why should antihistamines be avoided for pediatric bronchitis patients?
it dries out secretions
how does the school aged childs metabolic rate compare to that of an adult?
it is higher.
what is a chalasia board?
keeps the child at a 30 degree angle
at ages 5-6, children become more outgoing and "______________", but become more reflective and quiet by 8 years.
know it all
in the adolescent, most drowning occurs in what body of water?
lakes, rivers, and ponds
what is cued speech?
lip reading and hand movements together
pneumonia is inflammation of the
lung parynchyma and alveoli
short bowel syndrome
malabsorptive disorder from decreased mucosal surface area
what gender is effected by hospitalization the most?
male
who is more often effected by fragile x syndrome?
males
premature loss of deciduous teeth can complicate the eruption of permanent teeth and lead to ______________
malocclusion
for a child with CI, limit setting measures must be simple, consistent, appropriate, for a child's __________ age
mental
intellectual disability is the new word for
mental retardation
conductive hearing loss is in the _________ ear
middle
the school aged child is considered ___________ aged childhood
middle
what type of intellectual impairment do downs patients have?
mild to moderate
many families choose to ______________ siblings time and involvement at the hospital as a means of keeping the siblings lives as normal and uninteruppted as possible
minimize
if an infant is born with EA, they spend the first ________ of their life in the hospital recieving TPN feeds and G tubes
month
communication with the child is the ________________________ factor in establishing a good relationship with the child and they family
most important
Hirschsprung disease is a disorder of ___________________
motility
in middle childhood (school aged) how is movement compared to that of a preschooler?
movement is more graceful
during adolescent growth, ____________ mass increases in boys, and __________ deposits increase in girls
muscle; fat
school aged children have increased __________________ of the central nervous system, which is shown by refinement of fine motor skills
myelinization
what is the otitis media surgery called
myringotomy
myopia
nearsighted
with croup, symptoms are worse at _____________
night
are there safe fireworks?
no
do chronic conditions spontaneously resolve?
no
in middle childhood (school aged), is physical maturity correlated with emotional and social maturity?
no
is it safe for a child to ride a bike with another child?
no
supplementation of vitamin d for the school aged child- when should they?
supplement 400 IU vitamin D if consuming less than 1L/day of milk
therapeutic management of hirschsprungs disease
surgery
acute otitis externa is also known as
swimmers ear
how to prevent uncertainty about limits and expected behaviors of the hospitalized child
talk to the child and allow them to express emotions
in middle childhood (school aged), it is the age of "losing ___________"
teeth
2 stages of surgery for hirschsprungs disease
temporary ostomy pull through procedure
what is the first sign of physical sexual maturation in males?
testicular enlargement
puberty male changes in order
testicular enlargement pubic hair penile enlagargement deeper voice axillary hair facial hair
how do you know if a bike is the right size for a school age child?
the child should be able to place the balls of both feet on the ground when sitting on the seat with the hands on the handle bars.
which concept of death would the preschooler have when diagnosed with a terminal condition?
the child would consider it to be a punishment for their own actions
a cough suppresant is contraindicated in pediatric patients with bronchiolitis unless
the cough interferes with the infants sleep
anticipatory grief happens when
the death is expected
what thought stage are the 6 and 7 year old in?
the intuitive thought process (of the preschooler)
why is a child with intussusception at risk for FVD?
the involution of the bowel prevents absorprtion of water and the child may also be vomiting
regression
the loss of recently acquired skills or reappearance of behaviors seen when the child was younger
thelarche
the onset of female breast development
what conclusion would the nurse have when caring for an 8 year old with a tracheostomy whose parent is providing nearly all the child's care during a hospitalization?
the parent is the expert in care of the child.
what age is the age of preadolescence?
the period of 2 years before age 13
mixed hearing loss interferes with
the transmission of sound
why is pneumonia most commonly caused by viruses in the child under 3?
their immune systems are immature and have a hard time fighting off viruses
why are downs patients at risk for falls?
they may be physically developmentally delayed
regression is experienced in ___________ when coping with a serious illness
toddlers
in the school aged child, behaviors such as cheating and lying are not _________________
uncommon
children with asd generally ______________ more language than they can ______________
understand; express
if goals are not met through therapeutic play, the nurse should initiate more time for _____________ play
unstructured
are chronic condtions curable?
usually incurable
spasmodic croup is usually related to a __________ infection
viral
most typical cause of croup
viral infection
acute bronchitis is usually cause by a
virus
what is the most common cause of pneumonia in children is
virus; particularly influenza and RSV
most common symptom of upper GI hernias in children
vomiting
pyloric stenosis usually also causes
vomiting
bikes should be __________ across busy intersections
walked
what is the illness trajectory?
when the care of children with special health care needs often requires consistent ongoing attention and adaptation
Esophageal atresia (EA)
when the esophagus ends in a pouch rather than being attached to the stomach
pertussis is also known as
whooping cough
when is acute bronchitis the most common?
winter
