pediatric ThIs one!

age range for toddler years

12-36mos

What is the required average daily intake of calories in preschoolers?

1800

What is the average weight of a three-year-old child?

32 lb (14.5 kg)

What does the nurse state the average weight of a preschooler at the age of 5 years old?

41 pounds (18.59 kg)

Which areas are sources of stress in four-year-old children?

Attention, insecurity, and activity level

What changes are observed in a preschool-aged child?

Balanced and coordinated body Decreased abdominal protrusion

Pulse oximetry is prescribed for an adolescent. What should the nurse do to ensure accuracy of the pulse oximeter reading?

Capillary beds are closest to the surface in a *finger or earlobe*; this proximity permits more accurate measurement of arterial oxygen saturation.

A nurse educates a group of parents about how to teach their children to safely cross roads and walk in parking lots. Which age group of the children is the nurse referring to?

Preschoolers

Which description provided by the parent of a preschool-age client would suggest to the nurse that the child is experiencing sleep terrors?

Sweating profusely

Which nursing actions are appropriate when assessing a client's growth?

assessing a client's growth include assessing weight, measuring height, and comparing data to norms for the age of the client

Which type of language development is seen in 4-year-olds?

knows simple songs

Which information related to school-age play should the nurse include in a teaching session for parents of children in this stage of development?

team play, card games, board games, and club membership

Which of these statements are true about an adolescent according to Lawrence Kohlberg's theory of moral development?

"An individual's thoughts are influenced by moral decisions and behaviors." "An individual expands his or her focus from a relationship with others to societal concerns."

The parent of a 2-year-old calls a nurse who is a neighbor and reports that the child just ate several multivitamins with iron. What should the nurse say to the parent?

"Call the Poison Control Center." The Poison Control Center will provide the best guidance for treatment of excess ingestion of a substance; enemas, lavage, or chelation therapy with deferoxamine (Desferal), a heavy metal antagonist, may be recommended, depending on the amount ingested and the child's age and response.

What is the priority nursing care in the immediate postoperative period for a toddler with a newly applied hip spica cast?

*Checking the toddler's peripheral circulation*. Priority nursing care for any cast application includes checking the color and temperature of the area surrounding the cast to ensure that the cast is not too tight. A tight cast compresses arteries and veins, thereby impairing circulation.

A 4-year-old child with nephrotic syndrome is admitted to the pediatric unit. What clinical finding does the nurse expect when assessing this child?

*Dark, frothy urine* is characteristic of a child with nephrotic syndrome; large amounts of protein in the urine cause it to take this appearance

A 4-year-old child is admitted to the pediatric unit with a diagnosis of Wilms tumor. Considering the unique needs of a child with this diagnosis, the nurse should place a sign on the child's bed that states what?

*Do not palpate the abdomen.* -- increases risk of tumor rupture

A 2-year-old toddler has hearing loss caused by recurrent otitis media. What treatment does the nurse anticipate that the practitioner will recommend?

*Myringotomy* is a surgical opening into the eardrum to permit drainage of accumulated fluid associated with otitis media. Ear drops are not used because they will obscure the view of the tympanic membrane. Removal of the mastoid will not relieve pressure within inflamed ears. Antibiotics, not steroids, are used for an infectious process.

A nurse in the daycare center is teaching several aides about the play behavior of 2-year-old toddlers. What is this type of play called?

*Parallel*: Toddlers play independently but beside other children; they are aware of the other children, often grabbing toys from them, but do not socially interact with them.

A nurse is obtaining a health history from the mother of a 15-month-old toddler with celiac disease. The nurse expects the mother to indicate what about her toddler?

*Steatorrhea (fatty, foul-smelling, frothy, bulky stools)* occurs with celiac disease because of an intolerance to gluten; toxic substances, which can damage the intestinal mucosal cells, accumulate and cause diarrhea.

During which health maintenance visit for a toddler-age client should the nurse assess the ability to throw a ball overhand without losing balance?

18mos

Which ages are the most critical for language development during the preschool stage of development?

3 & 4 years

What is the current minimum level of lead in the blood used to identify children associated with exposure to lead hazards, according to the Centers for Disease Control and Prevention, 2012?

5 mcg/dL

According to Erikson's theory, what behavior would the nurse explain a preschooler exhibits?

According to Erikson's theory, a preschooler develops superego or conscience during the initiative versus guilt stage.

The nurse is caring for a young child diagnosed with lead poisoning. Which finding indicates that the client has suffered from high-dose exposure to lead?

Blindness indicates that the client is suffering from encephalopathy as a result of high-dose exposure to lead.

A student nurse is assessing socialization skills in 3-year-old and 4-year-old children. Which similar characteristics may be seen in the children of the two different ages?

Both have fear.

The nurse is providing anticipatory guidance to the parents of a child who has a difficult temperament. Which statement should the nurse include in the teaching session with these parents regarding their child's temperament?

Children who are classified as having a difficult temperament will benefit from a bedtime routine, will likely adapt slowly to a new daycare setting, and will display intense emotions, including those associated with happiness.

After assessing a 4-day-old newborn, the nurse anticipates that the newborn has impaired vision. Which finding supports the nurse's conclusion?

Corneal reflex in infants is activated by a light touch. Therefore the nurse anticipates that the newborn has impaired vision when there is no corneal reflex after a light touch.

Which clinical manifestation would cause the nurse to suspect that a preschool-age client ingested a corrosive agent, such as bleach?

Drooling is often associated with the ingestion of a corrosive agent, such as bleach.

The nurse discusses discipline with parents of a 4-year-old child. Which parental statement regarding time-out reflects an appropriate application of this method of discipline?

Explaining the reason for the time-out before and after reinforces the child's association of the time-out with the undesirable behavior, allowing the child to work to control those behaviors.

A preschool-aged child visits the health clinic with his mother. The mother is concerned about the child's interaction with "imaginary friends." What is the best response by the nurse?

Imaginary friends and imaginary play are normal for children at the preschool developmental level. Their thinking is influenced by role fantasy. Children believe that their wishes are real and that dreams come to life. They believe that inanimate objects have feelings and thoughts. It is important for the mother to know that this form of thinking is normal for a child of this age and that there is no need for a psychiatrist, medication, or a developmental assessment.

What is true about a preschooler's imaginary playmates?

Imaginary playmates experience what a preschooler wants to remember.

What does the nurse state is the cause of frequent upper respiratory tract infections in toddlers?

Immature immune system

Which quantity of iron, ingested by a child, would be considered in the range of mildly to moderately toxic?

Ingestions of 20 to 60 mg/kg of iron are considered mildly to moderately toxic.

A nurse in the child life center encourages preschool children to engage in role play. Why does the nurse consider this an important part of socialization?

It encourages expression of concerns.

While in the playroom of a pediatric unit the nurse sees several toddlers seated at a table trying to copy the same picture from a book. They are not talking to each other or sharing their crayons. What does the nurse conclude about this behavioral interaction?

It is a typical expression of toddlers' social development. As part of the socialization process, toddlers enjoy playing beside other children (parallel play).

A nurse is obtaining a health history from the parents of a preschooler with celiac disease. What characteristic does the nurse expect when the parents describe their child's stools?

Large, pale, foul-smelling

When preparing a child with asthma for discharge, what instructions must the nurse emphasize to the family?

Parents should be taught to limit allergens in the home that can precipitate asthma attacks (e.g., no carpets, no down pillows, no scented products; wet-mopping floors, vacuuming when the child is not in the home). Medications to control inflammation, including inhaled corticosteroids and long-acting β2-agonists, must be continued to suppress exacerbations of asthma. Environmental moisture is necessary for these children; in addition, cold environments should be avoided. Consistent limits should be placed on the child's behavior, regardless of the illness; a chronic illness does not eliminate the need for limit setting. The child should return to school and continue to interact with schoolmates and friends.

Which reactions does a nurse expect of a 4-year-old child in response to illness and hospitalization?

Preschoolers experience loss of control caused by physical restriction, loss of routines, and enforced dependency, which may make them feel out of control. Preschoolers are also likely to experience feelings of regression or overdependency and fear of bodily mutilation.

What change is seen when a child enters from a stage of toddlerhood to the stage of preschooler?

Preschoolers get into the habit of extending bedtimes.

Which step should the nurse follow for the administration of ear drops in children of 4 to 5 years of age?

Pull the auricle up and out.

The nurse is providing education to the parents of a preschool-age client who is experiencing a severe fear of the dark. Which treatment option should the nurse share with the parents during the teaching session?

Repetition of brave statements

Which is a particular source of stress in 3-year-olds?

Speech

The preschool-age client is learning sociocultural norms. What should this imply to the nurse regarding this client?

The child is developing a conscience.

What body weight is a normal finding in a 1-year-old infant whose birth weight was 3.2 kg?

The infant's body weight generally triples by 1 year of age. Therefore the infant's normal body weight by 1 year of age should be 3.2 x 3 = 9.6 kg.

For which clients should the nurse measure head circumference during the growth and development assessment?

The nurse measures head circumference during the growth and development assessment until 36-months of age.

A mother complains that her three year old still performs thumb sucking. What should the nurse suggest to the mother?

The nurse should suggest that the mother engage the child in more play activities because playing can help the child release his or her frustration. In a preschooler, thumb sucking may be a sign of stress. Therefore, the mother should try to identify any sources of stress.

Elbow restraints are prescribed for an 18-month-old toddler who just had surgery for a cleft palate. The nurse explains to the parents that the restraints are used to keep the child from doing what?

The suture lines in the mouth must be protected. Because the toddler uses the mouth to explore the environment, elbow restraints are needed to keep the child from placing fingers or objects in the mouth.

Which teaching points regarding fine motor skills should the nurse include during the health maintenance visit for a 30-month-old toddler-age client? Select all that apply.

The toddler-age client at 30 months of age exhibits the fine motor skills of drawing a circle, having good hand-eye coordination, and building a tower using eight blocks.

A toddler on the pediatric unit is required to have temporary dietary restrictions after colorectal surgery. What is the best way for the nurse to promote adherence to the restrictions?

Toddlers are ritualistic and do not tolerate change well; *any change in diet should be done matter of factly.*

A nurse on the pediatric unit is planning recreational activities for a 4-year-old with an exacerbation of nephrotic syndrome. What are the most appropriate activities in light of the child's developmental level and physical status?

Watching cartoon videos and listening to stories Enjoyment of fantasy and listening to stories are quiet, pleasurable pastimes for a 4-year-old.

While obtaining the health history of a 15-month-old toddler, the child of a migrant worker, a nurse learns that the infant recently had a fever, runny nose, cough, and white spots in the mouth lasting 3 days. A rash started on the face and spread to the whole body. What communicable disease does the nurse suspect the infant suffered from?

White spots in the mouth (Koplik spots) and the rash, combined with increased mucus secretions (coryza), are indicative of measles *(rubeola)*.

Which is a particular source of stress in 4-year-olds?

attention