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?

<p>Communicating at eye level (B)</p> Signup and view all the answers

What is the maximum dosage frequency of Ibuprofen for children?

<p>Every 6 hours (B)</p> Signup and view all the answers

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

<p>Child's gender (B)</p> Signup and view all the answers

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

<p>To meet the needs of growing children (B)</p> Signup and view all the answers

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

<p>5 days (D)</p> Signup and view all the answers

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

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

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

<p>Oral intubation (C)</p> 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?

<p>2 ml or more (C)</p> Signup and view all the answers

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

<p>Isotonic solution (A)</p> Signup and view all the answers

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

<p>Cephalocaudal development (D)</p> Signup and view all the answers

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

<p>4-6 hours (A)</p> Signup and view all the answers

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

<p>Slower metabolic rate (B)</p> Signup and view all the answers

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

<p>Perform abdominal thrusts and back blows (C)</p> Signup and view all the answers

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

<p>Influenza vaccine (B)</p> Signup and view all the answers

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

<p>History of severe headache (C)</p> Signup and view all the answers

What is the most common sexually transmitted infection in adolescents?

<p>Human Papillomavirus (HPV) (B)</p> Signup and view all the answers

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

<p>AZT (ZDV) (B)</p> Signup and view all the answers

Which symptom is commonly associated with pediatric HIV/AIDS?

<p>Failure to thrive (B)</p> Signup and view all the answers

What does the Denver 2 Test primarily assess?

<p>Social and motor skills (C)</p> Signup and view all the answers

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

<p>Economic status (D)</p> Signup and view all the answers

At what age is the first dental appointment recommended?

<p>Between 1-3 years (C)</p> Signup and view all the answers

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

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

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

<p>1 tbsp per year of age (A)</p> Signup and view all the answers

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

<p>Use an oral syringe to place medication on the side of the mouth. (D)</p> 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?

<p>Down and back (D)</p> Signup and view all the answers

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

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

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

<p>Every 2 hours (C)</p> Signup and view all the answers

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

<p>Use of a “hat&quot; in the toilet (C)</p> Signup and view all the answers

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

<p>Both B and C (B)</p> Signup and view all the answers

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

<p>20-30 breaths per minute (D)</p> Signup and view all the answers

Which medication administration route is used for applying ointments?

<p>Topical (C)</p> Signup and view all the answers

What is the main focus of a clinical pathway?

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

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

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

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

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

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

<p>Toddlers (B)</p> Signup and view all the answers

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

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

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

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

What is the primary purpose of mummy restraints?

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

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

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

Flashcards

Consciousness Sedation

IV drugs used to impair consciousness while retaining protective reflexes and airway management.

Cultural Concerns in Healthcare

Variations in diet, illness reactions, staff interaction, and patient expectations influenced by culture.

Clinical Pathways

Interdisciplinary care plans that show the overall treatment progress beyond just nursing care.

Toddler Reaction to Hospitalization

Separation anxiety peaks with regression, intense emotions, and clinginess after discharge.

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Preschooler Reaction to Hospitalization

Egocentric thinking leads to fear of punishment and bodily harm; explanations must be honest and concise.

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School-Aged Child Reaction

May feel depressed or frustrated due to loss of control; need choices and emotional outlets.

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Adolescent Reaction to Hospitalization

Early fears of body image; middle focus on peers; late fears about future plans and career impacts.

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Emancipated Minor

An adolescent under 18 who is independent from parental authority, can receive care without consent.

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Vaccine Allergies

Do not give vaccines if the patient is allergic to certain substances like eggs or neomycin.

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Vaccine Contraindications

Conditions under which vaccines should not be administered, such as compromised immune systems or pregnancy.

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STI Transmission

Sexually transmitted infections can spread through sexual activity, from mother to fetus, or contaminated needles.

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HPV Overview

Human Papillomavirus is the most common STI in adolescents, linked to warts, preventable by vaccination.

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Pediatric HIV Symptoms

Symptoms of HIV/AIDS in children include failure to thrive, enlarged lymph glands, and persistent infections.

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IM Injection Sites

Vastus Lateralis for infants & toddlers; Ventrogluteal for older children and adults.

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Needle Size for IM

Use 22-25 gauge, ½-1 inch needle for IM injections based on age.

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Subcutaneous Injection

Administered with a 23-35 gauge, 5/8 inch needle.

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NG Tube Medication

Check placement, flush with water before and after administration.

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Oxygen Therapy Regulator

Typically regulated by Respiratory Therapy; nurse monitors for distress signs.

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Airway Obstruction for Infants

Back blows & chest thrusts if conscious; compressions, look and remove if unconscious.

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Growth Patterns

Growth rate varies; spurts followed by plateaus.

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Cephalocaudal Development

Development proceeds from the head to the toe.

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Factors Influencing Growth

Elements that affect an individual's growth and development, including hereditary traits, environment, and health.

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Denver 2 Test

A screening test assessing social, fine motor, language, and gross motor skills in children under 6 years; not an intelligence test.

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Family Structures

Different configurations of families such as nuclear, single-parent, or blended families.

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Childhood Obesity

A condition affecting 1 in 3 children, linked to greater risk of adult obesity and health issues.

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Tooth Development

The process of dental growth in children, starting with the first tooth around 6-7 months, and requiring dental checkups by age 1-3 years.

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Stages of Growth

Developmental stages from fetus to adolescence, encompassing various age ranges.

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Neonate

A newborn from birth to 4 weeks old.

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Toddler

Child aged 1 to 3 years, known for increased mobility and speaking.

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Separation Anxiety

Distress experienced by infants and toddlers when separated from caregivers.

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Three Stages of Separation Anxiety

Protest, Despair, Denial/Detachment are the three reactions to separation.

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Pain Management Techniques

Methods to relieve children's pain, including distraction and guided imagery.

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Pain Medications

Medications like NSAIDs and opioids for managing severe pain in children, dosed by weight.

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Patient-Controlled Analgesia (PCA)

A method that allows patients aged 7 and up to manage their own pain relief.

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Skin Assessment Timing

Restraints must be removed every 2 hours for skin and circulatory assessment.

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Normal Respiratory Rates

Respiratory rates vary by age: Newborn (40-60), Infant (25-55), Toddler (20-30), Preschool (20-25), School Age (14-22), Adolescent (12-18).

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Normal Heart Rates

Heart rates, Newborn (110-160), Infant (80-150), Toddler (70-110), Preschooler (65-100), School Age (60-95), Adolescent (55-85).

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Temperature Range

Normal temperature for children is 97.5-100.4°F.

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Specimen Collection for Urine

Collect urine from diapers in young children or a 'hat' in the toilet for older children.

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Oral Medication Administration

Do NOT mix medications with food; use syrup or jelly and administer via oral syringe on the side of the mouth.

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Ear Medication Administration

For children under 3, pull ear back and down; for adults, pull back and up.

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Medications Calculations

Always calculate dosages to ensure safety when administering medications to children.

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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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