Pediatric Nursing Exam Objectives
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Questions and Answers

A child undergoing chemotherapy experiences mucositis. Which nursing intervention is most appropriate to implement?

  • Recommending the use of wigs or hats to address alopecia.
  • Providing meticulous oral care and pain relief. (correct)
  • Administering anti-emetics to prevent nausea.
  • Limiting fluid intake to reduce oral secretions.

    • What is a primary characteristic differentiating Hodgkin's lymphoma from non-Hodgkin's lymphoma?

  • Hodgkin's lymphoma is identified by the presence of Reed-Sternberg cells. (correct)
  • Non-Hodgkin's lymphoma is characterized by localized lymph node involvement.
  • Hodgkin's lymphoma involves widespread lymph node involvement.
  • Non-Hodgkin's lymphoma presents with uncontrolled white blood cell proliferation.

    • A child with leukemia is undergoing a bone marrow biopsy. What is the priority nursing intervention during this procedure?

  • Monitoring for signs of infection at the insertion site.
  • Providing pain management and sedation. (correct)
  • Encouraging deep breathing exercises to promote relaxation.
  • Administering anti-emetics to prevent nausea.

    • Which of the following assessment findings in a child could indicate bone marrow suppression secondary to cancer or its treatment?

    <p>Pallor, fatigue, and frequent infections. (D)</p> Signup and view all the answers

    A child undergoing a bone marrow transplant requires meticulous post-transplant care. Which of the following nursing interventions is of utmost importance during this phase?

    <p>Implementing strict infection prevention measures and monitoring for engraftment. (B)</p> Signup and view all the answers

    According to Piaget's stages of cognitive development, what is a typical understanding of illness for a child in the concrete operational stage (ages 7-10)?

    <p>Fearing pain but understanding that treatment can help. (C)</p> Signup and view all the answers

    During which psychosocial stage, according to Erikson, is parental presence most essential to a child's well-being?

    <p>Trust vs Mistrust (infant) (D)</p> Signup and view all the answers

    According to Kohlberg's stages of moral development, a child between the ages of 2 and 7 is most likely to view their illness as:

    <p>A punishment for bad behavior. (C)</p> Signup and view all the answers

    Which of the following is the most critical nutritional intervention for a child newly diagnosed with celiac disease?

    <p>Strict adherence to a gluten-free diet. (A)</p> Signup and view all the answers

    A child with diabetes mellitus is pale, sweating, and confused. Which of the following conditions is the MOST likely cause?

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

    What is an important consideration for a child with diabetes before participating in physical activity?

    <p>Having a snack to prevent hypoglycemia. (A)</p> Signup and view all the answers

    Which of the following assessment findings would be most concerning for a child with a suspected renal disorder?

    <p>Edema, hypertension, and hematuria (C)</p> Signup and view all the answers

    Which emotional response is most commonly observed in siblings of a child who is hospitalized?

    <p>Jealousy, fear, and regression (B)</p> Signup and view all the answers

    Which finding is the MOST indicative of respiratory distress in a pediatric patient?

    <p>Nasal flaring with grunting (B)</p> Signup and view all the answers

    A toddler is hospitalized. Which intervention would be MOST appropriate to minimize stress associated with fear of loss of autonomy?

    <p>Allowing the child to choose between a sticker or a toy after a procedure. (C)</p> Signup and view all the answers

    During a physical assessment of a school-age child, which approach demonstrates the BEST understanding of their developmental needs?

    <p>Explaining the procedures using concrete terms and encouraging questions. (B)</p> Signup and view all the answers

    An adolescent expresses concern about the lack of privacy during hospitalization. What is the MOST appropriate nursing intervention?

    <p>Provide privacy during examinations and allow for independence in care discussions. (D)</p> Signup and view all the answers

    According to Piaget's framework, how might a preschooler (ages 2-7) perceive illness?

    <p>As a magical occurrence or a form of punishment. (C)</p> Signup and view all the answers

    Which assessment finding would be MOST concerning for moderate dehydration in a 9 month old infant?

    <p>Sunken fontanelle and tachycardia (A)</p> Signup and view all the answers

    Which intervention is MOST appropriate when administering medication to a toddler?

    <p>Offering the child a choice between taking the medication with juice or water. (A)</p> Signup and view all the answers

    A nurse observes petechiae on a child's skin during an assessment. What is the MOST important initial nursing action?

    <p>Notify the healthcare provider for further evaluation. (A)</p> Signup and view all the answers

    Flashcards

    Gluten-free grains

    Grains that do not contain gluten, like rice and corn.

    Leukemia definition

    A cancer characterized by uncontrolled proliferation of white blood cells (WBC).

    Hodgkin's Lymphoma

    A type of lymphoma identified by Reed-Sternberg cells and localized lymph node involvement.

    Chemotherapy side effects

    Common effects include nausea, alopecia, and mucositis after treatment.

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    Bone marrow transplant care

    Involves HLA matching for donors and post-transplant infection prevention.

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    Respiratory distress signs

    Indicators like nasal flaring, grunting, retractions, cyanosis, and tachypnea that require nursing intervention.

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    Dehydration symptoms

    Signs including sunken fontanelles, poor skin turgor, dry mucous membranes, and tachycardia.

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    Infants assessment tips

    Use soothing voice, assess in caregiver's lap, evaluate reflexes, listen to heart/lung sounds first.

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    Toddler assessment techniques

    Allow play with equipment, assess less threatening areas first, and be quick with assessments.

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    Preschooler reactions to illness

    Fear of body mutilation; use simple explanations and encourage medical play for understanding.

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    School-age stressors

    Loss of control and fear of pain; provide privacy and engage them in decision-making.

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    Adolescent concerns during hospitalization

    Loss of privacy and independence; provide privacy and include them in care discussions.

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    Piaget's Sensorimotor stage

    Children (0-2 years) react to pain with crying or withdrawal, not understanding illness.

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    Concrete Operational Stage

    A stage (7-10 years) where children begin to understand cause and effect.

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    Trust vs Mistrust

    An infant psychosocial milestone where parental presence is essential.

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    Preconventional Morality

    A stage (2-7 years) where children see illness as punishment.

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    Celiac Disease Management

    Involves strict gluten-free diet and monitoring growth.

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    Signs of Hyperglycemia

    Symptoms include polyuria, polydipsia, polypagia, weight loss, and fatigue.

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    Mild Hypoglycemia Response

    Treatment involves juice or glucose tabs to raise blood sugar.

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    Renal Disorder Assessment

    Look for edema, hypertension, and hematuria symptoms.

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    Parental Reactions to Hospitalization

    Parents may experience guilt, stress, and financial concerns during a child's hospitalization.

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    Study Notes

    Pediatric Exam Objectives

    • Recognize signs of health conditions needing nursing interventions (respiratory distress, dehydration, neuro changes, skin abnormalities)

    • Respiratory distress signs: nasal flaring, grunting, retractions, cyanosis, tachypnea. Interventions include oxygen therapy, suctioning, positioning, and O2 monitoring.

    • Dehydration: sunken fontanelles, poor skin turgor, dry mucus membranes, tachycardia. Interventions include fluid replacement and strict I&Os.

    • Neuro changes: require neuro checks, seizure precautions, and medication administration.

    • Skin abnormalities (rashes, petechiae, ecchymosis): require identifying the cause and appropriate treatment.

    Modifying Physical Assessments

    • Adapt assessment techniques to the child's age and developmental stage.

    • Infants: use soothing voice, assess in caregiver's lap, assess reflexes.

    • Toddlers: allow play with equipment, assess non-threatening areas first, perform quick assessments.

    • Preschoolers: use simple explanations, allow choices, and involve them in care.

    • School-age: explain procedures in concrete terms, encourage questions, respect modesty.

    • Adolescents: provide privacy, explain findings, encourage independence in care discussions.

    Stressors and Reactions to Illness/Hospitalization

    • Discuss typical stressors and reactions to illness/hospitalization for children in each developmental stage, and strategies to minimize effects.

    • Infants: separation anxiety, comfort measures (parental presence).

    • Toddlers: fear of loss of autonomy, choices, distraction techniques.

    • Preschoolers: fear of body mutilation, simple explanations, medical play.

    • School-age: loss of control, fear of pain, privacy, involvement in decision-making.

    • Adolescents: loss of privacy, independence, involvement in decision-making.

    Children's Concepts of Illness and Pain

    • Discuss children's concepts of illness and pain using Piaget's framework.

    • Sensorimotor (0-2 years): no understanding of illness, reacts to pain with crying or withdrawal.

    • Preoperational (2-7 years): illness is magical or a punishment, fear of bodily harm with exaggerated pain perception.

    • Concrete operational (7-10 years): understands cause and effect, fears pain but understands treatment helps.

    • Formal operational (13+ years): understands illness logically, fears long-term effects, has concerns about body image.

    Illness Adjustment and Moral Development

    • Describe psychosocial milestones contributing to illness adjustment.

      • Trust vs mistrust (infants); parental presence essential.
      • Autonomy vs shame and doubt (toddlers); needs choices.
      • Initiative vs guilt (preschoolers); may blame self for illness.
      • Industry vs inferiority (school-age): may worry about school or peers.
      • Identity vs role confusion (adolescents): concerned with independence and social acceptance.

    • Impact of moral development on illness perception: Preconventional (2–7 years): illness as punishment (2–7 years) Conventional (7-12 years): follow rules; ethical reasoning Postconventional (12+ years): ethical reasoning behind health decisions

    Nursing Management of Children's Conditions

    • Celiac Disease: strict gluten-free diet; monitor growth, address diarrhea, bloating, and fatigue.

    • Diabetes Mellitus: Hyperglycemia (polyuria, polydipsia, polyphagia, weight loss, fatigue) and Hypoglycemia (sweating, irritability, tremors, confusion). Management includes nutrition (carb counting), exercise, and hypoglycemia prevention. Address DKA (IV fluids, insulin drip, electrolyte monitoring) and mild/severe hypoglycemia (juice/glucose tabs or glucagon injection).

    • Teach home management (insulin administration, blood sugar monitoring, sick day management).

    • Renal disorders: assessment (edema, HTN, hematuria); management (fluid restrictions, antihypertensives, infection prevention).

    Additional Pediatric Health Conditions

    • Discuss Parental and sibling reactions to hospitalization (parents’ guilt, stress, financial concerns; siblings’ jealousy, fear, regression).
    • Celiac disease management (gluten-free education, family compliance).
    • Patho of leukemia, Hodgkin's, and non-Hodgkin's lymphoma.
    • Abnormal findings in cancer assessment (pallor, fatigue, swollen lymph nodes, frequent infections).
    • Bone marrow transplant care (donor selection, HLA matching, post-transplant care, and engraftment monitoring).
    • Psychosocial needs and oncologic emergencies (emotional support, family involvement, child life specialists), emergencies (sepsis, tumor lysis syndrome, rapid response).
    • Chemotherapy side effects and interventions (nausea, alopecia, mucositis).

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    Peds Exam 1 Objectives PDF

    Description

    This quiz covers key objectives for nursing assessments in pediatrics, including the identification of health conditions that require intervention and modifications in assessment techniques based on developmental stages. Learn to recognize signs of respiratory distress, dehydration, neuro changes, and skin abnormalities while understanding the appropriate nursing interventions.

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