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• Pediatric Nursing Exam Study Guide

Dosage Calculations

• Always calculate medication doses based on weight (kg) and safe dose range per drug.
• Confirm dosage is within the recommended range before administration.
• Double-check calculations and verify with another nurse when required.

Importance of Family-Centered Care

• Family is the primary source of support for the child.
• Encourage parental involvement in decision-making and care planning.
• Provide emotional, social, and developmental support.
• Respect cultural beliefs and practices.

Head Circumference

• Measure until 36 months or until anterior fontanel closes.

Most Important Consideration When Communicating with a Child

• Use age-appropriate language
• Engage at eye level.
• Consider developmental level and cognitive abilities.

FLACC Scale

• Used for children 2 months to 7 years or nonverbal patients.
• Assesses Face, Legs, Activity, Cry, consolability.

EMLA Cream Application

• Apply 60 minutes before procedure.
• Cover with an occlusive dressing.

8-Month-Old Adjusting to Hospitalization

• Encourage parental presence.
• Maintain routine and provide familiar objects.
• Offer comfort measures (rocking, soft voice).

Kwashiorkor

• It is a severe protein deficiency with an adequate supply of calories (carbs).
• Symptoms include edema, distended abdomen, irritability, and muscle wasting.

Cyanosis in Infants

• Indicates hypoxia, which requires immediate intervention.

Growth & Development Tracking

• Growth charts should be used, because standardized growth reference charts are used in infants, children, and adolescents.
• They compare head circumference, height, and weight with percentile distribution of others in the same age group.

Marasmus

• Severe malnutrition from calorie deficiency and protein, is common in underdeveloped countries.
• Symptoms include muscle wasting, no edema, and fragile appearance.

Bottle Propping Danger

• Risk of aspiration and ear infections.

Failure to Thrive (FTT) Possible Causes

• Inadequate growth results from an inability to obtain or use calories required for growth.
• Inadequate caloric intake, inadequate absorption, increased metabolism, and defective utilization, may be the cause.

Diaper Dermatitis Treatment

• Keep area dry, frequent diaper changes, and a barrier cream (zinc oxide).

Treatment of Excoriated Areas

• Clean gently, apply protective ointments, and expose to air.

SIDS Safety Teaching

• Infant should sleep on their back
• Use a firm mattress
• No pillows/stuffed animals in the crib
• Avoid overheating
• Breastfeeding reduces risk.
• No co-sleeping.
• Avoid maternal smoking

Home Safety for Toddlers

• Secure furniture, use safety gates, lock cabinets, avoid small objects, place all toxins in high cabinet, hide sharp objects

Toddlers Play

• Toddlers engage in parallel play (playing alongside, not with, peers).

Growth Milestone Measuring Tool

• Growth charts

Best Place to Count Heart Rate

• Use apical pulse for one full minute.

Preventing Jealous Tendencies in Toddlers

• Include them in caregiving activities for younger siblings.

Theorist Covering Autonomy

• Erikson: Autonomy, Shame, Doubt: Toddlers acquire a sense of autonomy while overcoming a sense of doubt and shame.
• Negativism involves giving a negative response to requests.
• Ego is reason or common sense during psychological development.
• ID works to tolerate frustration and learning socially acceptable ways of interacting with the environment.
• Superego is the conscience the incorporation of the morals of society and the process of acculturation.

Age-Appropriate Play Activities

• Gross motor: running, climbing stairs, jump using both feet, stand on one foot, throw a ball overhand.
• Limited fine motor: large puzzles, stacking blocks.
• Appropriate toys: Blocks, dolls, clay, push-pull toys, slides, balls of all sizes

Preventing Aspirations

• Avoid large round foods like; hot dogs, grapes, peas, carrots, popcorn, fruit gel snacks, nuts, and hard candy

Appropriate Snacks

• Soft fruits, yogurt (if tolerated), cheese, and crackers

Toileting Training Cues & Considerations

• 3 Signs a child is ready for toilet training: Being aware of the urge to void or stool, interest in or motivation to use the toilet, and being dry for at least 2 hours during the day.
• Consider selection of the child's clothing and the potty chair or use of the toilet.

How to Avoid Hearing "No"

• Offer choices instead of yes/no questions.

Toddler's Pain Expression

• includes crying, resisting, guarding area, and withdrawal.

Piaget's Stage for Toddlers

• Sensorimotor transitioning to Preoperational: The cognitive process develops rapidly but reasoning skills are still primitive.
• Children cannot think in terms of operations the ability to manipulate objects in relation to each other in a logical way.

Kohlberg's Moral Development in Toddlers

• Follow parental rules, avoid punishment.

Other Important Info

• Eye contact establishes trust and reduces intimidation.
• Avoid choking hazards (hard candy, nuts).
• Establish routine to provide security and reduce anxiety.
• Voluntary Control of Urinary Sphincter develops around 24- 30 months.

Side Rail Safety

• Keep rails up when unattended.

3-Year-Old Gross Motor Skills

• Ride a tricycle, walk on tiptoe, balance on one foot for a few seconds, and do broad jumps.

When to Limit Choices for Toddlers

• When safety is a concern.

Narcotic Safety

• Double-check doses, store securely.

Developing Initiative

• Encourage exploration and independence.

Preschoolers Imitate

• Copy adult behavior in play. Dress up clothes, dolls, housekeeping toys, dollhouses, play store toys

Erikson's Stage for Preschoolers

• Initiative vs. Guilt: They are in a stage of energetic learning play, work, live life to the fullest, and feel a sense of accomplishment.
• Conflict arises when children over step the limits of their ability and experience a sense of guilt for not behaving appropriately.

Using Correct Anatomical Words

• Helps prevent confusion and promotes body autonomy.

Animism

• Belief that inanimate objects have feelings.

Toddler and Egocentrism

• Difficulty seeing others' perspectives.

Preschoolers' Play

• Associative Play: group play in similar or identical activities like construction sets, large puzzles, dress up, dolls, farm animals, trucks, cars, and planes.

Piaget's Preoperational Stage

• The shift from total egocentric to thought to social awareness and the ability to consider other viewpoints.
• Preschoolers assume that everyone thinks as they do and engage in magical thinking; they believe thoughts are all-powerful.

Kohlberg's Moral Development

• Preconventional: Moral judgement is at the basic level.
• In punishment and obedience orientation children 2-4 years old judge whether an action is good or bad depending on whether it results in a reward or a punishment.
• Children 4-7 years old demonstrate a naïve instrumental orientation in which actions are directed towards satisfying their needs and less frequently the needs of others.

Appropriate Play for a 12-Month-Old

• Includes push toys, stacking rings, and soft books.

When to Assess Toddler's Ears

• Pull pinna down and back (under 3 years old).

Atraumatic Care for a 5-Year-Old

• Avoid restraint, use distraction techniques.

Nightmares vs. Night Terrors

• Nightmares which are a scary dream takes place during rapid eye movement followed by full waking. Sit with child offer comfort assurance and sense of protection.
• Sleep terrors are a partial arousal from very deep sleep. No memory of dream or yelling. Observe child for a few minutes without interfering until child becomes calm or wakes fully

Correcting Behavior

• Use calm, consistent correction.

Pain Assessment

• Use age-appropriate pain scales while observing facial expressions, body movement, and vital signs.