Peds Ch 21,22,23
Which of the following factors are associated with the development of childhood obesity? Select all
-Genetics -A sedentary lifestyle -A high-fat diet
Puberty for boys
9-14
mature minor rule
Some states recognize minor children maybe of sufficient capacity and maturity to comprehend their illness and maybe allowed to provide consent for treatment.
IM site for children
Vastus Lateralis, Ventrolateral, and Deltoid
A mother informs the nurse that her child is being bullied at school. What is the nurse's best response?
"Bullying is a very real and devastating experience."
A nurse is reinforcing teaching with a group of parents about expected changes during puberty. Which of the following parent statements indicates an understanding of the teaching?
"Females usually stop growing about 2 years after menarche."
The nurse is teaching the parents of a 6-year-old child what to expect in terms of normal growth and development. Which parental statement indicates the need for further education?
"Finger feeding is abnormal and indicates the need for intervention."
A nurse is teaching a parent about the home administration of prescribed antibiotics for a child being discharged from the hospital. Which comment by the parent would indicate a need for additional teaching?
"I can use a household teaspoon to give two teaspoons of antibiotic."
The LPN/LVN is reinforcing teaching provided by the RN to a school-aged child on appropriate dog handling. Which statement made by the child would indicate appropriate understanding of preventing dog-bite injuries?
"I should always ask a dog's owner if it is okay to approach and pet the dog first."
The LPN/LVN assists the RN in presenting community education to parents and children about safety related to strangers. Which comment by an attending child would indicate that teaching is effective?
"I won't help or give directions to someone I don't know."
The nurse is educating a young adolescent with gender dysphoria. What should the nurse tell the patient about treatment?
"Treatment in young adolescence consists of suppressing the release of gonadotropin releasing hormone."
Evan, an 11- year- old, has been hospitalized for a fractured femur caused by an all-terrain vehicle accident while the family was on vacation. The injury requires 2 weeks of traction and the nurse notes that Evan appears bored and restless. Applying developmental theory which of the following does the nurse select to distract Evan? Select all
-A board game requiring multiple players -A video game for two on the large screen in the play room
Health screen for an adolescent 12-18:
-Child abuse and neglect -Substance use disorder -Risk for unprotected sex -Risk for pregnancy -Depression, suicide risk, and other mental health -Alcohol, drug, and tobacco use
Tips for sleep success 1
-Consistent lights out and bedtime while hospitalized -Minimal nighttime disruptions for vitals or assessments when possible -Bedtime rituals maintain while hospitalized(bath, reading) -Personal comfort items kept at bedside and offered to child at bedtime -Lighting minimized but adequate for safety(bathroom light only) -Noise reduced to allow child to fall asleep and stay asleep -Fears assessed and addressed such as strangers, monsters, and the dark -Presence of a parent or an extended family member so that someone familiar to the child is with them over the night
preparing for surgery
-Explain the surgery -Comfort the child -Talk in a quiet soft voice with direct eye contact -Keep the child with the parents until sedation
Health screening for school age children:
-Immunizations -Hearing screening -Visual screening -Scoliosis -Child abuse screening -Lice screening -Dental screening -BP screening -BMI -Well child visit
Tips for talking with teens 1:
-Listen nonjudgmentally and show a greater interest in their topic than in stating or discussing your own. -Pose open-ended questions that inquire into the teen's interests and lifestyle -Do not ask "why" questions; they can make teens defensive and stop talking. -Do not "attack" and put the teen on the defensive or make them feel accused or something. -Try to match the teen's emotional state while talking, such as enthusiasm or sadness -Be emotional authentic; do not communicate anger, hurt, or disappointment when you are not experiencing these emotions. Similarly do not communicate happiness and approval when you do not feel that way. Teens can read parents emotions well, so express your true emotions.
Tips for sleeping success 2
-Medication administered before bedtime and as infrequently as possible at night as well as grouped together for minimal sleep disruption -Aromatherapy such as a small lavender pillow -Essential oils -Music therapy such as soothing jazz, light Disney tunes, or classical music before bedtime -Massage therapy before bed, such as a soft foot rub or back rub with lotion -Water intake minimized at bedtime, as hydration orders allow, to prevent the need to use the bathroom during the night -Warmth provided before bedtime, such as a soft blanket from the blanket warmer
Which of the following contribute to the development of acne? select all
-Poor hygiene -Hormones
Long term pain response
-Poor motor performance -Poor adaptive behavior, learning disorder, and cognitive issues -Temperament changes and psychosocial problems
Tips for bedtime for adolescents.
-Regular bedtime schedule -Avoid stimulants after 4pm -keep lights out or on low -Refrain from napping or no longer then 30min -Exercise regularly but not right before bed -Unwind the mind before bed
Pre-surgery checklist
-Remove jewelry -Tie hair back -Wash skin -remove mail polish -REPORT loose teeth -Ensure readable ID band is on
A nurse is providing education on sleep needs for the school-aged child. What interventions should the nurse include in the teaching? (Select all that apply.)
-Sleep involves a predictable routine. -Get 10 to 12 hours of sleep per night. - Lack of sleep can cause poor academic performance -Set a reasonable bedtime each night.
Tips for talking with teens 2:
-Talk about the news; discuss social or ethical dilemmas and interesting global issues of importance. -Role-model decision-making during conversation, such as explaining how you got to your position or how you arrived at a decision. -Keep it short and simple by keeping the conversation to a reasonable length -Be yourself; do not try to act or talk like the teen or one of their friends -Seize the moment; be ready to identify a relaxing, good moment for conversation or discussion; be around enough to grab a good moment to connect -Show genuine deep respect for what your teen has to say and what they want to discuss with you
Immediate pain response
-Vitals change -Glucose metabolism -Mistrust in environment and healthcare team -impaired sleep and physical function
Which topics are appropriate for the nurse to include in a teaching session for an adolescent patient who is experiencing acne? (Select all that apply.)
-Washing the face twice per day -Using a mild soap on the face -Apply topical products that contain benzoyl peroxide or salicylic acid.
Specimen collection
-Wear gloves -Place in appropriate container -Label with collector's initials, date, medical record number, and time of collection
Adolescence girls physical growth chart:
-Weight gain: 6.8kg-24.9kg(15lb to 55lb) -Height: 2.54cm to 7.62cm (1-3inches) -Growth spurt begins at 10years old and ends at 16years
Safety considerations for school age
-sports -protective gear -skateboarding -Rollerblading and roller skating -Avoid trampoline -Automobiles -water safety -Stanger safety -touching -Firearm safety -Fireworks safety
Adolescence boys physical growth chart:
-weight gain: 6.8kg-29.5kg(15lb to 65lb) -Height: 5.08cm to 10.16cm(2-4) -Growth spurt begins at 13years old and ends late teen
The 10 medication rights are?
1.Right patient 2.Right drug 3.Right dose 4.Right route 5.Right time 6.Right method of administration for the Childs developmental stage and medical needs 7.Right pre-administration assessment (HR, BP, pain score) 8.Right family education 9.Right post-administration assessment 10.Right documentation
School age children need how much sleep?
10-12 hours
Adolescence is the period of onset of puberty, typically from?
13-18years old
When educating a teenage girl on her expected weight gain during adolescence, the nurse would be correct in stating that the average weight gain between 12 and 18 years of age is?
15-55 pounds
Average weight gain for a school age girls and boys?
4.0-6.6 lbs per year
Adolescence need how much sleep?
8-10 hours
Puberty for girls
8-12
The LPN in the emergency department is assisting with the admission of a young school-age child to the pediatric unit. The child has suffered physical trauma, which will likely require surgery. The child's parents are at the bedside. Which factor would the LPN/LVN identify as the greatest source of distress for the child at this time?
Frightening surroundings
Average height increase for school age girls and boys?
2in per year
How to gain the Childs trust?
Gain the parents trust first, child senses the parents ease with you.
Which of the following growth and development expectations should a girl and her parents have after she experiences the first menses?
Accelerated weight gain
Who tend to enter puberty earlier, African Americans or Caucasians?
African American girls
A pediatric patient who is 16 months of age is hospitalized in an acute care facility. The parents live several hours away and have two young children at home. One parent has a full-time job with only weekends off. Which action would the nurse perform to help the patient experience less anxiety?
Ask that the same nurses be assigned to the patient each shift.
Milestone for school age child?
Bike riding, skating, skiing, and climbing
child obesity
Body mass index is above the 95th percentile. In 2019 more than one third of U.S. children/adolescents were overweight or obese. Risks associated with obesity include: diabetes, cardiovascular problems, increased cancer risk, bullying, isolation, screen time and obesity in adulthood.
How does the nurse determine how many calories a child needs on a daily basis?
By using a child's age to estimate his or her daily calorie need per kilogram of weight
Peds pain scale CRIES
C-Crying R-Requires O2 I-Increased vitals (HR, RR, BP) E-Expressions S-Sleeplessness Used for infants who are preverbal and neonatal postop pain, a score of 4 or higher needs pain management, Best used with infants 32-40 weeks gestation which is why not used often in peds but could depending on work location.
Which one of the following pain assessment tools is used for a newborn?
CRIES pain scale
Protest (separation anxiety)
Cries, demands loudly, rejects being consoled, watches for parents, feels abandonment
Erikson: Industry vs. Inferiority in school age kids
Developing a sense of worth. Engage school age children in task to complete.
The LPN/LVN on a pediatrics unit is assisting with the care of a child admitted with an acute illness. The LPN/LVN is aware that the parents are unable to spend extended periods of time at the hospital because of employment and home responsibilities. Which action would the LPN/LVN implement with the child to ease anxiety and stress?
Encourage the child to draw pictures of family, home, and pets.
Peds Pain scale FLACC
F-Face L-Legs A-Activity C-Cry C-Consolability Can be used in children between 2months and 7 years old or Nonverbal pediatric patients
Safety in the hospital setting
Follow hospital policy to instigate safety measures such as identification/name bands, security devices, and bed selection that keeps unattended children close to the nursing station.
Self harm in adolescence
Harming of self in any way possible. Cutting is the most common.
The abbreviation LGBTQIA is widely used and stands for?
L-Lesbian G-Gay B-Bisexual T-Transgender Q-Queer/Questioning I-Intersex A-Asexual/Allied
The nurse is preparing a young school age child to go to surgery. As the nurse is completing the preoperative checklist, special attention should be given to which of the following?
Loose Teeth
According to Erickson the greatest influence on a school-aged child's readiness to master this stage of development is?
Mastery of the first three stages of psychosocial development
Peds pain scale Numeric
Only use this scale when the child is old enough and developmentally able to conceptualize numerical values and distance between numbers
emancipated minor
Person younger than 18 years of age who lives independently, is totally self-supporting, is married or divorced, is a parent even if not married, or is in the military and possesses decision-making rights.
While providing care at a summer camp for children the nurse is approached by a counselor who asks what prepubescence is. Which explanation by the nurse is correct?
The time period just before sexual maturity
Pubescence
The two-year span preceding puberty during which the changes leading to physical and sexual maturity take place.
The tanner scale
This is used to assess and describe the external changes that take place during sexual development.
Which is often the reason why an adolescent engages in self-harm activities such as cutting?
To release anger
Acne teaching
Wash face twice daily with warm water and mild soap, over the counter topical products, topical and oral medication.
Oral morphine sulfate has just been administered to a 6 year old in severe pain after a surgical appendectomy. According to the child's age and developmental level which pain tool would the nurse use to assess this child's level of pain relief?
Wong-Baker FACES pain rating scale
Peds pain scale FACE
Wong-Baker- Used for children as young as 3 through 7. This used cartoon faces to represent their pain
Which type of toy would be best for the LPN/LVN to provide to a toddler who cannot go to the unit's playroom but can be out of bed?
Wooden train set and blocks
precocious puberty
a condition in which puberty begins before the age of 8 in girls and 9 in boys
Bullying
aggressive behavior among children that is unwanted and demonstrates a feeling of perceived or real power imbalance.
Detachment/Denial (separation anxiety)
becomes interested in the environment, play, seems to form relationship with caregiver, child may ignore parents. Appears to be adjusted but in reality using a coping mechanism to detach themselves and decrease emotional pain
First signs of puberty in girls.
breast buds and pubic hair
seperation anxiety
can occur at any age, but most profoundly effects ages 6 months - 3 years old
Transgenders in adolescence
discomfort or lack of identification with one's sex assignment at birth
Erickson adolescent stage
identity vs role confusion: Figuring out who they are.
family centered care
is acting in ways that offer the patient and family consistence, collaboration, and empowerment. (Key elements of family centered care include recognizing that the Childs family is the constant in the Childs life)
Regression
is when the child displays behaviors with a younger development level
Despair (separation anxiety)
may appear apathetic, quiet, withdrawn, sad, depresses. May not eat or sleep well, doesn't want to play.
puberty
normally begins in girls between the age of 8 and 12 and in boys between the ages of 9 and 14.
What are the 3 stages of separation anxiety?
protest, despair, detachment/denial
Medical play
structured play that allows a child to learn about their diagnosis, procedures, surgery, and diagnostic or medical equipment.
A school nurse is preparing a class about male puberty. Which of the following manifestations should the nurse identify as occurring first when sexual maturation begins?
testicular enlargement
First signs of puberty in boys.
testicular growth and red-lined scrotum with pubic hair at the base of the penis
stranger anxiety
the fear of strangers that infants commonly display, beginning by about 8 months of age and lasts from 8-18months