Care of the School-Age Child Overview
The nurse is teaching a group of school-aged children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching?
"Girls typically experience a rapid growth spurt before boys."
When are frontal sinuses fully developed?
7 years old
When can school-aged children discontinue the use of a booster seat?
They reach 4 ft. 9 in. and reach between 8-12 years of age the lap belt should be worn low and snug across the thighs, not the stomach
True or false: keeping dialogue with the child and encouraging exploration of feelings is beneficial; helping the child identify reasons for the parents' action can help
True
The nurse is conducting a support group for parents of 9- and 10-year-olds. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide?
a sense of security as children gain independence
In order to develop self-confidence, the school-aged child needs...
consistent rules, positive attention, and clear expectations
While observing a group of 9-year-old children at school, the nurse is concerned that one of the children is not cognitively developing according to Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned?
does not understand the phrase "slow as molasses" when used by the teacher
Children should be encouraged to try new things, but the pressure can...
feel as thought they are disappointing their parents
What is the age range for school-age kids?
6-12 years old
How much sleep do school-aged children require?
9-12 hours of sleep per night
The nurse is creating a care plan for a school-aged child with a nursing diagnosis of Ineffective health maintenance related to lack of exercise and poor food choices. Which nursing interventions should the nurse include? Select all that apply.
Educate the parents and the child on the need to decrease TV/computer/device time. Educate the parents and child on the need to increase the amount of daily exercise. Interview the parents about their eating and exercising habits. Plot out the child's height, weight, and BMI to detect weight loss or gain.
The school nurse is meeting with a 10-year-boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestion should the nurse prioritize to help him maintain a healthy weight?
Encourage activities that will increase his physical activity.
A school-aged child goes to the school nurse with a headache and stomachache. The child has normal physical exam findings. The nurse questions the child further, and the child confides experiences of being bullied by another child in the class. What is the best action made by the nurse?
Encourage the child to seek help from the teacher.
What are nutritional needs for school-aged children?
Family needs to be involved in meal planning/prepping Exercise 60 minutes/day, discourage skipping meals caloric needs decrease because of increased stomach capacity which permits retention of food
Fears and anxieties are normal (to a degree), parents should...
Give positive self-talk Utilize relaxation techniques Should acknowledge fears and anxieties but avoid catering to them
Which of Erikson's developmental theories do school-age kids fall under?
Industry v. Inferiority
What is vaginal discharge a sign of in school-age children?
Infection Any secretions that cause vulvar irritation should be evalutated by a HCP
A father brings his 6-year-old son in to the doctor's office. He says his son just began first grade a week ago and, after attending the first day of classes, has refused to go to school each day since, complaining of stomach cramps and nausea. He says he has spoken to the boy's teacher, who says she did not notice anything unusual with her interaction with the boy, other than perhaps a bit of homesickness. After the nurse examines the boy and finds nothing wrong, the father asks how he should handle the problem. What action should the nurse recommend?
Insist that the child return to school.
How do school-aged children think?
Literally Struggle with terms such as "half past" and "quarter to"
What are some concerns with tonsillar hypertrophy?
May lead to partial airway obstruction/sleep apnea Is normal unless snoring/choking/gagging/difficulty swallowing
What are key gross motor milestones in school-aged children?
Muscle coordination, ride bike, play sports
The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child?
Needs 10 to 12 hours of sleep per night
If a child is under 5, can they get a sinus infection?
No
What is the treatment for ringworm?
Oral antifungals can influence liver enzymes Administer with a fatty meal to increase absorption
A nurse is caring for a hospitalized 10-year-old child. What would be an appropriate activity for this child to meet the developmental tasks of this age group?
Participating in a craft project
The nurse is preparing a presentation for a community health fair on the topic of helping school-aged children develop the self-confidence they will need to mature into responsible adults. Which suggestion should the nurse prioritize to caregivers to enable them to help their children in this area?
Caregivers should maintain consistent rules and expectations.
The school nurse is developing a school wellness program to promote healthy eating habits and regular physical activity. What is the most important element to emphasize to maximize compliance, healthy habits, and long-term change?
Include both parents and children in the wellness program.
When providing anticipatory guidance to a group of parents with school-aged children, what would the nurse describe as the most important aspect of social interaction?
Peer relationships
What re key fine motor milestones in school-aged children?
Play an instrument, braiding, building models
What are the risk factors for tinea infections (ringworm)?
Poor diet and hygiene, highly contagious
The mother of a 6-year-old girl tells the nurse that she is very concerned that her daughter develops good self-esteem. Which nursing instruction is best?
"You need to provide guidance and celebrate successes."
The nurse is teaching the parents of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which information would the nurse include in her teaching plan?
Continuous peer relationships provide the most important social interaction for school-age children.
The nurse is teaching the student nurse how to perform a physical assessment based on the child's developmental stage. Which statement accurately describes a recommended guideline for setting the tone of the examination for a school-age child?
Include the child in all parts of the examination; speak to the caregiver before and after the examination.
During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be?
"Play is important for your daughter's overall growth and development."
In a health assessment for school-age, who do you direct questions toward?
Direct questions to child
How much weight to kids gain during the school-age period?
Gain 6.5 to 7.5 pounds per year (weight varies)
An 8-year-old male child is being seen for a well-child visit. His weight at his visit last year was 50 lb (22.7 kg) and his height was 47 in (119 cm). If he is developing normally, which finding will the nurse expect to note this year?
Height 49.5 in (124 cm)
What are the s/s of streptococcal pharyngitis?
Sandpaper-like rash
What is precocious puberty?
early puberty Female: 6 and under Male: 7 and under
What is the FACES pain scale?
faces of pain Child chooses (subjective)
What is conservation?
the ability to appreciate that a change in shape does not necessarily mean a change in size
A child awaiting a blood draw procedure states, "I am so nervous and really do not want to have this done." Which response by the nurse is best?
"Imagine that you are swimming in a cool, shady pool where nothing can harm you."
The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents?
"Is there a family history of hypertension, heart disease, or diabetes?"
Why is media not always beneficial to school-aged children?
Affect sleep *promotes violence and risky behaviors*
What are the treatments for streptococcal pharyngitis and tonsillitis?
Antibiotics
What does school refusal look like in school-aged children?
Anxiety behavior "my tummy hurts" Unwillingness to attend school Frequent absences, skipping class, chronic lateness, severe misbehavior, attending school with great fear
Why should school-aged children avoid electronics 2 hours before bedtime?
Blue light wavelengths inhibit natural melatonin production
The nurse is about to see a 9-year-old girl for a well-child checkup. Knowing that the child is in Piaget's period of concrete operational thought, which characteristic should the child display?
Consider an action and its consequences.
Where are school-age kids in moral development?
Conventional stage: "good boy" "good girl" Changing toward "you're tough" to give them more confidence
What is the first sign of puberty in males?
Enlarged scrotum
How tall do kids grow during the school-age period?
Grow 2.5 to 3 inches per year
Satisfaction in achieving success in new skills equals...
Increased self-worth
The nurse at a hospice care facility is caring for a 13-year-old adolescent. Which intervention best meets the needs of this adolescent?
Urging the client to invite friends to visit
What is the OUCHER pain scale?
Uses pictures of kids in pain The nurse chooses (objective)
Help the children understand that if they discontinue an activity they dislike, does not make the child a...
a quitter
What is decentering?
ability to project one's self into other people's situations and see the world from their viewpoint rather than focus only on their own
A nurse is discussing ways parents can foster the development of self-confidence in their school-aged child. Which action if stated by the parents would lead the nurse to continue the discussion?
comparing the child to an older sibling regarding academic achievements
A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to:
make her child attend school every day.
The nurse is educating the parents of a 10-year-old girl in ways to help their child avoid tobacco. Which suggestion should be part of the nurse's advice?
"As parents, you need to be good role models."
The nurse is assessing the gross motor skills of an 8-year-old boy. Which interview question would facilitate this assessment?
"Do you participate in any sports?"
What is accomodation?
the ability to adapt through processes to fit what is perceived; such as understanding there can be more than one reason for other people's actions
What is class inclusion?
the ability to understand that objects can belong to more than one classification
What type of peer relationships do children form?
Tend to be same-sex Peers of like mind activities Can exclude specific peers (secret password, etc.) These groups *don't* encourage sexism and bullying
What is the first sign of puberty in females?
Thelarche (breast development)
