Peds workbook 1

An 8-year old who is the size of an 11-year old will think and act like a(n) _ year old.

8

Inconsolable crying, known as _ _ _ _ _ , lasts longer than 3 hours.

Colic

The thin, yellowish fluid called _ _ _ _ _ _ _ _ is produced by the breasts for the first 2 to 4 days after birth.

Colostrum

Communication in preschool children is ________ in nature, as they are not yet capable of abstract thought.

Concrete

Piaget in school-age child

Concrete operational

Lymph system in school-age child

Continues to grow until the child is 9 years old

Kohlberg in school-age child

Conventional: "good child, bad child"

Calcium

Dairy products, broccoli, tofu, legumes

Malocclusion

Improper teeth alignment

What would concern you in a 6-month-old?

Inability to sit with assistance, does not turn to locate sound, crosses eyes most of the time, does not laugh or squeal, does not smile or seem to enjoy people

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptoms would the nurse identify?

Increased biting and sucking

Ways to develop self-worth is termed ________.

Industry

Erikson in school-age child

Industry versus inferiority

The nurse is teaching a first-time mother with a 14-month-old boy about child safety. Which is the most effective overall safety information to provide guidance for the mother?

"Never let him out of your sight when outdoors."

The parents of an overweight 2-year-old boy admit that their child is a bit "chubby," but argue that he is a picky eater who will eat only junk food. Which response by the nurse is best to facilitate a healthier diet?

"Give him more healthy choices with less junk food available."

The nurse is discussing sensory development with the mother of a 2-year-old boy. Which parental comment suggests the child may have a sensory problem?

"He doesn't respond if I wave to him."

The education of parents about what to expect in the next phase of development is referred to as _ _ _ _ _ _ _ _ _ _ _ _ guidance.

Anticipatory

The mother of an 18-month-old girl voices concerns about her child's social skills. She reports that the child does not play well with others and seems to ignore other children who are playing at the same time. What response by the nurse is indicated?

"It is normal for children to engage in play alongside other children at this age."

The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement indicates a need for further teaching?

"She can ride on the street if I am riding with her."

Dietary fiber

Applesauce, carrots, corn, green beans

The nurse is providing teaching about proper dental care for the parents of a 5-year-old girl. Which response indicates a need for further teaching?

"She needs to floss her teeth before brushing."

The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares?

"She screams and thrashes when we try to touch her."

The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best?

"Talk to your son's new teacher and schedule a tour with him."

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention?

"The school is quite structured and advocates corporal punishment."

The nurse is providing teaching about child safety to the parents of a 4-year-old girl. Which statement by the parents indicates a need for further teaching?

"We need to tell her that her vitamins are candy."

A nurse is providing a routine wellness examination for a 5-year-old boy. Which response by the parents indicates a need for an additional referral or follow-up?

"We often have to translate his speech to others."

The mother of 1-week-old boy voices concerns about her baby's weight loss since birth. At birth the baby weighed 7 lb (3.2 kg); the baby currently weighs 6 lb 1 oz (2.8 kg). Which response by the nurse is most appropriate?

"Your baby has lost a bit more than the normal account."

How do you prevent temper tantrums in toddlers?

- Adhering to reasonable food and sleep schedules - Friendly warnings, distractions, refocusing, or removal from the situation may prevent the tantrum

What is the adjusted age and how is it calculated?

- Assessing the growth and development of a premature infant - Subtract the number of weeks that the infant was premature from the infant's chronological age

Care for the toddler's teeth and gums

- At the age of 1, every child should have an initial dental visit - To prevent the development of dental caries children should be weaned by 15 months of age - Use of sippy cups should be limited

Motor skills in order for preschooler

1. Copies circles and traces squares 2. Throws ball overhand 3. Swings and climbs well

Developmental milestones in the proper sequence for school-age child

1. Gross motor skills develop 2. Frontal sinuses development is complete 3. Lymphatic tissue growth is complete 4. Brain growth is complete 5. Fine motor skills develop

Brain growth is complete by the time the ____ birthday is celebrated.

10th

The bladder capacity for a 10-year old would be __ ounces.

12

The anterior fontanel normally remains open until _ _ _ _ _ _ months of life.

12 to 18

The Academy of Pediatrics recommends _ hours or less of television viewing per day.

2

The nurse is conducting a well-child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination?

2.5 to 3 in (6.35 to 7.62 cm)

Difference between nightmares and night terrors

A nightmare is a scary or bad dream. After a nightmare, the child is aroused and interactive. Night terrors are different. A short time after falling asleep, the child seems to awaken and is screaming. The child usually does not respond much to the parent's soothing, eventually stops screaming, and goes back to sleep.

Piaget-Intuitive

Able to classify and relate objects

Jose's father states that Jose's favorite word is "No." He asks if this is normal at this age. How would you respond?

Always saying "no," referred to as negativism, is a normal part of healthy development. If there is no option of avoiding an action, do not ask toddlers if they want to do something. If the child continues with negative answers, then the parent should remain calm and make the decision for the child.

What Erickson stage is a toddler in?

Autonomy versus shame and doubt

The nurse is assessing a 2-year-old boy during a well-child visit. The nurse correctly identifies the child's current stage of Erikson's growth and development as:

Autonomy vs. shame and doubt

Folate

Avocados, broccoli, green peas, dark greens

Vitamin C

Broccoli, oranges, strawberries, tomatoes

Secondary sexual characteristics

Changes in breast development and genitalia during late school age or early adolescence

The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which recommendations should be the most helpful to the parents?

Describing proper behaviors when she misbehaves

Kohlberg-Punishment-obedience orientation

Determines good and bad dependent upon associated punishment

What is the primary social task of the preschool-aged child?

Developing a sense of initiative

The sequential process by which infants and children gain various skills and function is referred to as _ _ _ _ _ _ _ _ _ _ _ .

Development

Piaget-Preconceptual

Displays animism

The leading cause of unintentional injury and death in children in this country is due to ________.

Drowning

Inferiority

Feelings of inability or not measuring up to the abilities of others

Asymmetric tonic neck

Fencing position

The parents of a 2-year-old girl are concerned with her behavior. For which behavior would the nurse share their concern?

Frequently babbles to herself when playing

The nurse is teaching a mother of a 1-year-old girl about weaning her from the bottle and breast. Which recommendation should be part of the nurse's plan?

Give the child an iron-fortified cereal

Proper motor skills of a 5-month old

Grasps rattle or toy

Bruxism

Gritting or grinding of teeth

Moro

Hands form "C"

Proper motor skills of a 3-month old

Hold open hand to face

Breastfeeding is contraindicated in

Infants with galactosemia, maternal use of illicit drugs and a few prescription medications, maternal untreated active tuberculosis, and maternal human immunodeficiency virus (HIV)

Motor vehicle accidents are a common cause of ______ in the school-aged child.

Injury

Individuation

Internalizing a sense of self and one's environment

The over-consumption of cow's milk may result in a deficiency of ____ due to the calcium blocking its absorption.

Iron

Freud in school-age child

Latency

Proper motor skills of a 1-month old

Lifts head while prone

Erikson-Initiative versus guilt

Likes to please parents

Compared with the earlier years, caloric needs of the school-aged child are _____.

Lower

The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively?

Maintain a feed-on-demand approach

Principle of conversation

Matter does not change when forms change

Bones in school-age child

Mineralization not complete until maturity

When _____________ of the spinal cord is achieved around age 2 years, the toddler is capable of exercising voluntary control over the sphincters.

Myelinization

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?

No teeth

The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying:

Object permanence

The best way to encourage development in an infant?

PLAY!

During school children are influenced by _____ and teachers.

Peers

During the ______________ stage of development, according to Piaget, children begin to become more sophisticated with symbolic thought.

Preoperational

Parachute

Prepare to "catch themselves"

The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation?

Presence of 10 deciduous teeth

Milk production is stimulated by _ _ _ _ _ _ _ _ _ , a hormone secreted by the anterior pituitary.

Prolactin

The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look?

Puts down a little ball to pick up a stuffed toy

The nurse is teaching the parents of a 6-month-old boy about proper child dental care. Which action will the nurse indicate as the most likely to cause dental caries?

Putting the baby to bed with a bottle of milk or juice

Proper motor skills of a 2-month old

Raises head and chest

The ability to understand what is being said or asked is called _________ language.

Receptive

Regression

Returning to a prior developmental stage

Proper motor skills of a 4-month old

Rolls from prone to supine

Root

Searches with the mouth

Egocentrism

Self-interest due to an inability to focus on another's perspective

Stranger anxiety is an indicator that the infant is recognizing himself as _ _ _ _ _ _ _ _ from others.

Separate

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice?

Serve new food several times

Heart in school-age child

Smaller in size, in relation to the rest of the body, than any other developmental stage

The nurse is assessing the language development of a 3-year-old girl. Which finding would suggest a problem?

Speaks in 2- to 3-word sentences

Telegraphic speech

Speech that uses essential words only

How does the care change after the child reaches the age of 2 years?

Start brushing with a very small pea-sized amount of fluoridated toothpaste

Most young children are not capable of handling ______ or making decisions on their own before 11 or 12 years of age.

Stress

Freud-Phallic stage

Super-ego is developing and the conscience is emerging

During a night ______ a child will scream and thrash but not awaken.

Terror

What is the underlying cause of a swayback appearance in toddlers?

The abdominal musculature is weak in the young toddler. This causes a pot-bellied appearance. In addition the child appears sway-backed. As the muscles mature, this resolves.

Changes in the genoitourinary system in the toddler that allow for readiness for toilet training

The kidney functions reach adult levels between 16 and 24 months of age. The bladder is able to hold urine for increased periods of time.

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother:

The newborn's stomach can hold between one-half to one ounce

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated?

The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

What strategies should be used by the parents of a preschool-aged child who has lied?

The parent should ascertain the reason for the lie before punishing the child. If the child has broken a rule and fears punishment, then the parent must determine the truth. The child needs to learn that lying is usually far worse than the misbehavior itself. The punishment for the misbehavior should be lessened if the child admits the truth. The parent should remain calm and serve as a role model of an even temper.

What do you need to consider when assessing language development in a bilingual 2-year-old?

They may blend two languages, that is, parts of the word in both langauges are blended into one word or may language mix within a sentence; he will combine languages or grammar within a sentence

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep

Caries

Tooth decay

Proper motor skills of a 6-month old

Tripod sits

The nurse is discussing the activities of a 20-month-old child with his mother. The mother reports the children of her friends seems to have more advanced speech abilities than her child. After assessing the child, which finding is cause for follow-up?

Understands approximately 200 words

The nurse is observing a 36-month-old boy during a well-visit. Which motor skill has he most recently acquired?

Undress himself

Preschool-aged children are more susceptible to bladder infections than are adults due to the length of the _______.

Urethra

The _______ remains short in both the male and female toddler, making them more susceptible to urinary tract infections compared to adults.

Urethra

Nila's parents express concerns about the transition to Kindergarten. What guidance can you give them regarding this?

When talking about starting kindergarten with Nila, do so using an enthusiastic approach. Keep the conversation light and positive. Incorporate and practice the new daily routine prior to school starting.

The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated?

"At this age it is helpful to remind children to go to the bathroom."

A nurse is caring for a 4-year-old girl. The parents indicate that their daughter often reports that objects in the house are her friends. They are concerned because the girl says that the grandfather clock in the hallway smiles and sings to her. Which response by the nurse is best?

"Attributing life-like qualities to inanimate objects is quite normal at this age."

The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 cm (6.35 cm) in the past year. Which response by the nurse is most appropriate?

"Both your son's height and rate of growth are within normal limits for his age."

Discuss specific developmental warning signs you are assessing for a preschooler

- Cannot jump in place or ride a tricycle - Cannot stack four blocks - Cannot throw ball overhand - Does not grasp crayon with thumb and fingers - Difficulty with scribbling - Cannot copy a circle - Does not use sentences with three or more words - Cannot use the words "me" and "you" appropriately - Ignores other children or does not show interest in interactive games - Will not respond to people outside the family, still clings or cries if parents leave

What stages are a 6-month-old in?

Erickson: Trust versus mistrust Piaget: Sensorimotor

Ritualism

Familiar routine that provides structure and security for the toddler

A nutrient _____ diet along with physical activity is the foundation for obesity prevention in the preschool child.

Dense

The mother of a 3-year-old child reports her son is afraid of the dark. She asks the nurse for help. Which advice is best for the nurse to offer?

Encourage the parent to allow a small night light.

The mother of a 4-year-old boy reports her son has voiced curiosity about her breasts. She asks the nurse what she should do. Which information is best for the nurse to give the parent?

Encourage the parent to determine what the child's specific questions are and answer them briefly.

Between the ages of 10 and 12 (the pubescent years for girls), ______ levels remain high, but are more controlled and focused than previously.

Energy

Babinski

Fanning and hyperextension

The parents of a 3-year-old boy have asked the nurse for advice about a preschool for their child. Which suggestion is most important for the nurse to make?

"The staff should be trained in early childhood development."

Cognitive abilities of a child in the intuitive phase

- Can count 10 or more objects - Correctly names at least 4 colors - Understands the concept of time - Knows about things that are used in everyday life such as appliances, money, and food

Nursing interventions to increase the proportion of mothers who breastfeed

- Encourage breastfeeding beginning with the prenatal visit - Provide accurate education - Be available for questions or problems - Consult lactation consultant - Encourage pumping of breast milk when mother returns to work - Refer to local breastfeeding support groups (e.g., La Leche League)

Appropriate discipline for a toddler

- Focus on clear limit setting, consistency, negotiation, and techniques to assist the toddler to learn problem solving - Positive reinforement should be used as much as possible

The changes infants undergo during the first year of life

- Heart doubles in size - The average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1-year old - BP steadily increases from an average of 60/40 in the newborn to 100/50 in the 12-month-old - More susceptible to heat loss d/t peripheral capillaries being closer to the surface of the skin - Thermoregulation becomes more effective by constricting to cold and dilating to heat

Promoting healthy teeth and gums in preschoolers

- Should have teeth brushed and flossed daily with a pea-sized amout of toothpaste - Cariogenic foods should continue to be avoided - If sugary foods are consumed, the mouth should be rinsed with water if it is not possible to brush the teeth directly after their consumption - Should visit the dentist every 6 months

How would you encourage language development in a toddler?

- Talking and singing during routine activities encourages conversation - Frequent, repetitive naming - Listen to and answer questions - Help choose the appropriate words to label feelings and emotions - Encourage both languages in the home - Reading

Motor skills of infant in order of occurrence

1. Transfers object from one hand to the other 2. Sits unsupported 3. Crawls on hands and knees 4. Puts objects in container 5. Pokes with index finger

Expressive language of a toddler in the order displayed

1. Uses a finger to point to things 2. Babbles in what sounds like sentences 3. Uses primarily descriptive words (hungry, hot) 4. Talks about something that happened in the past

The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern?

Head size has increased 5 in (12 cm) since birth

Vitamin A

Apricots, cantaloupe, carrots, sweet potatoes

The nurse is observing a 3-year-old boy in a daycare center. Which behavior might suggest an emotional problem?

Has persistent separation anxiety

Nila's mother states that "Nila loves to play make-believe. She is constantly playing in a fantasy world. I am not sure if this is healthy behavior." How would you address Mrs. Patel's concerns?

Magical thinking and playing make believe are a normal part of preschool development.

Early cues of hunger in infants

Making sucking motions, sucking on hands, or putting the fist to the chin

Four primitive reflexes present at birth

Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski *Except for Babinski, which disappears around 1 year of age, these primitive reflexes diminish over the first few months of life

Echolalia

Repetition of words and phrases without understanding

The nurse is assessing an infant at his 4-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3.6 kg) and was 20 in (50.8 cm) in length. Which finding is most consistent with the normal infant growth and development?

The baby weighs 16 lb (7.3 kg) and is 26 in (66.0 cm) in length

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?

The respirations of a 1-month-old infant are normally irregular and periodically pause.

The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term?

Urging the baby's mother to take time for herself away from the child