Pediatric Growth & Development Stages

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Questions and Answers

Based on the information provided, what is the age range for a toddler?

4 weeks to 1 year

1 to 3 years (correct)

6 to 12 years

3 to 6 years

A child exhibiting withdrawal and sadness, becoming uncommunicative, and regressing to earlier behaviors is in what stage of separation anxiety?

Protest

Despair (correct)

Denial or Detachment

None of the above

Which of the following medication types is suitable for short surgical procedures and has a rapid onset with short duration of action according to the text?

Local anesthetics

NSAIDS

PCA

Opioids (correct)

When dealing with a child experiencing separation anxiety, what is the most effective communication strategy?

Communicating at eye level (B) Signup and view all the answers

What is the maximum dosage frequency of Ibuprofen for children?

Every 6 hours (B) Signup and view all the answers

Which of the following is NOT a factor that affects a child's reaction to hospitalization?

Child's gender (B) Signup and view all the answers

What is the primary reason for incorporating familiar rituals and routines into a pediatric unit?

To meet the needs of growing children (B) Signup and view all the answers

What is the maximum duration of Ketorolac administration, as mentioned in the text?

5 days (D) Signup and view all the answers

What is the recommended needle size and gauge for administering intramuscular injections to a toddler?

22-25 Guage, 1/2-1 inch needle (A) Signup and view all the answers

Which of the following is NOT a recommended method for administering oxygen therapy to an infant?

Oral intubation (C) Signup and view all the answers

What is the maximum volume of medication that can be administered intramuscularly in the vastus lateralis muscle of a school-aged child?

2 ml or more (C) Signup and view all the answers

What is the recommended solution for enemas and gastrostomy tube feedings in children?

Isotonic solution (A) Signup and view all the answers

According to the content, what is the primary principle of developmental growth in infants and toddlers?

Cephalocaudal development (D) Signup and view all the answers

What is the recommended maximum duration of NPO (nothing by mouth) for infants before surgery?

4-6 hours (A) Signup and view all the answers

Which of the following physiological factors is NOT characteristic of pediatric patients?

Slower metabolic rate (B) Signup and view all the answers

What is the appropriate action for an older child who is conscious and experiencing an airway obstruction?

Perform abdominal thrusts and back blows (C) Signup and view all the answers

Which vaccine should not be administered if a patient is allergic to eggs?

Influenza vaccine (B) Signup and view all the answers

Which of the following is NOT a contraindication for vaccine administration?

History of severe headache (C) Signup and view all the answers

What is the most common sexually transmitted infection in adolescents?

Human Papillomavirus (HPV) (B) Signup and view all the answers

What medication significantly reduces the transmission of HIV from mother to baby during pregnancy?

AZT (ZDV) (B) Signup and view all the answers

Which symptom is commonly associated with pediatric HIV/AIDS?

Failure to thrive (B) Signup and view all the answers

What does the Denver 2 Test primarily assess?

Social and motor skills (C) Signup and view all the answers

Which of the following factors does NOT influence growth and development?

Economic status (D) Signup and view all the answers

At what age is the first dental appointment recommended?

Between 1-3 years (C) Signup and view all the answers

How does body surface area (BSA) affect fluid loss in infants compared to adults?

Infants have a greater BSA resulting in higher fluid loss (A) Signup and view all the answers

How much food should a child consume based on their age in years?

1 tbsp per year of age (A) Signup and view all the answers

What is the recommended method of administering oral medications to infants?

Use an oral syringe to place medication on the side of the mouth. (D) Signup and view all the answers

When administering ear drops to a child under the age of 3, what direction should the ear be pulled?

Down and back (D) Signup and view all the answers

Which of the following is a consideration for medication administration in children?

Children's metabolism is slower than adults. (B) Signup and view all the answers

What is the recommended frequency for removing restraints used for a child?

Every 2 hours (C) Signup and view all the answers

When obtaining a urine specimen from a child, which method is appropriate for older children?

Use of a “hat" in the toilet (C) Signup and view all the answers

When collecting blood from a child, which method is appropriate for a capillary sample?

Both B and C (B) Signup and view all the answers

What is the normal respiratory rate for a toddler (1 year to 3 years)?

20-30 breaths per minute (D) Signup and view all the answers

Which medication administration route is used for applying ointments?

Topical (C) Signup and view all the answers

What is the main focus of a clinical pathway?

To provide a comprehensive overview of a patient's care, incorporating multiple disciplines. (A) Signup and view all the answers

What is a common misconception about conscious sedation that needs to be addressed?

It guarantees a smooth and comfortable experience for patients. (D) Signup and view all the answers

Which of these is NOT a common concern regarding cultural differences in healthcare?

Patients' financial resources to afford treatment. (D) Signup and view all the answers

Which age group is most likely to display negativism and temper tantrums during hospitalization?

Toddlers (B) Signup and view all the answers

What is a key characteristic of a preschooler's thinking that impacts their response to hospitalization?

They may associate hospitalization with punishment for wrongdoing. (A) Signup and view all the answers

What makes the adolescent stage unique in terms of their reaction to hospitalization?

Focus on the importance of peer relationships and social acceptance. (A) Signup and view all the answers

What is the primary purpose of mummy restraints?

To immobilize patients during surgery or invasive procedures. (D) Signup and view all the answers

Which of these is NOT a typical characteristic of an emancipated minor?

They are usually adolescents with a strong sense of autonomy and independence. (B) Signup and view all the answers

Study Notes

Chapter 21: Stages of Growth & Development

Fetus: 9th gestational week to birth
Neonate: Birth to 4 weeks
Infant: 4 weeks to 1 year
Toddler: 1 to 3 years
Preschool: 3 to 6 years
School-age: 6 to 12 years
Adolescence: 12 to 18 years

Daily Routine of Pediatric Unit

Parents encouraged to room in
Caregivers consistent
Children wear own clothes/bring toys
Flexible schedules
Addresses growing child needs
Familiar routines incorporated into care plan
Communication at child's level

Factors Affecting Child's Reaction to Hospitalization

Child's age
Amount of preparation given
Previous hospital experiences
Family and medical staff support
Child's emotional health
Security of home life

Separation Anxiety

Occurs in infants 6 months or older, most pronounced in toddlers (ages 1-3)
3 Stages:
- Protest (1st stage): Infants cry, scream, look for parents; toddlers verbally or physically attack strangers.
- Despair (2nd stage): Infants withdraw, are sad, uninterested, and uncommunicative.
- Denial or Detachment (3rd stage): Infants show increased interest in surroundings, interact with caregivers and strangers, and appear happy.
Behaviors are a superficial adjustment to loss, not necessarily permanent.

Pain Management

Untreated pain can affect healing time and compromise wound healing
Methods to relieve pain include drawing, distraction, guided imagery, relaxation, thought-stopping, music therapy, and medications.

Interdisciplinary/Multidisciplinary Care

Care plans encompass entire treatment plan, beyond nursing care plan.

Reaction to Hospitalization: Toddlers

Separation anxiety is greatest
Intense emotional displays
Need simple language
Require structure and familiar items
May show regression, negativism, or temper tantrums
Prolonged illness worsens reactions
May be clingy after discharge.

Reaction to Hospitalization: Preschoolers

Egocentric and concrete thinkers
Concerned about permanence of relationships
May react with anger and noncompliance
Staff may characterize reactions as difficult

Reaction to Hospitalization: School-Aged Children

May feel depressed, hostile, or frustrated
Experience loss of control
Need consistency, education, and outlets for feelings

Reaction to Hospitalization: Adolescents

Early: Threat to body image
Middle: Peer group important, trying to emancipate from family
Late: Concerned about future plans and responsibilities
Can manifest as withdrawal, anger, and noncompliance.

Confidentiality and Legality – HIPAA Regulations

Emancipated minors (under 18) can receive medical care without parental consent, for example STIs or contraceptives

Chapter 22: Restraints

Mummy restraints: Short-term for procedures like IV placement or venipunctures
Elbow restraints: For placing scalp IVs or post-op cleft lip surgery
Removal every 2 hours for skin and circulation assessment

Physical Assessment

Vital signs (apical pulse for young children under 5)
Weight
Height
Head circumference (infants).

Specimen Collection

Urine: External collection devices, catheterization, clean catch, 24-hour urine collection
Stool: Gather from diapers (young children), children use toilet.
Blood: Venipucture, capillary sample
Lumbar puncture: Explain what to expect and restrain appropriately.

Medications

Calculate dose to ensure safety.
Document appropriately
Follow parent teaching guidelines for appropriate administration.
Oral meds: Use syrup/jelly, avoid mixing with formula/food/water.
Non-oral meds: Include injection sites, correct needle gauge and length for different age groups.

Chapter 32: Review of Terms

Communicable disease: Transmitted from one person to another
Incubation period: Time between exposure and symptom onset
Prodromal period: Time between first symptom and rash/fever
Vector: Insect/animal that carries disease
Pandemic: High incidence of disease globally
Epidemic: High incidence in specific area
Endemic: Expected incidence in specific area

Chapter 32: Rashes of the Skin

Erythema: Redness

Chapter 32: Pediatric Immunizations

Comprehensive immunization schedule summarized.

Chapter 15: Growth & Development

Growth varies based on individual child
Growth spurts are common
Understanding normal growth is key to recognizing deviations
Development follows cephalocaudal (head-to-toe) and proximodistal (midline-to-periphery) patterns.
Maturation refers to overall growth and development influenced by inheritance.
Understand developmental stages to adjust care accordingly.

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Description

Explore the critical stages of growth and development from fetal life through adolescence. Understand the implications of daily routines in pediatric units and factors affecting children's reactions to hospitalization. This quiz also covers insights on separation anxiety in young children.