Peds Exam 1 Objectives PDF

Peds Exam Objectives 1. Recognize important signs of alteration in health conditions that require nursing interventions a. Respiratory distress: nasal flaring, grunting, retractions, cyanosis, tachypnea i. Interventions: oxygen therapy, suctioning, positioning, and...

Peds Exam Objectives 1. Recognize important signs of alteration in health conditions that require nursing interventions a. Respiratory distress: nasal flaring, grunting, retractions, cyanosis, tachypnea i. Interventions: oxygen therapy, suctioning, positioning, and monitoring O2 sats b. Dehydration: sunken fontanelles, poor skin tugor, dry mucus membranes, tachycardia ii. Interventions: fluid replacement and strict I&Os c. Neuro changes iii. Interventions: neuro checks, seizure precautions, and med administration d. Skin abnormalities : rashes, petechiae, ecchymosis iv. Interventions: identify cause and administer appropriate treatments 2. Modify physical assessment techniques according to the age and development stage of the child e. Infants: use soothing voice, assess in caregiver's lap, assess reflexes, listen to heart/lungs first f. Toddlers: allow play with equipment, assess non-threatening areas first, and perform quick efficient assessments g. Preschoolers: Use simple explanations, allow choices when possible, and involve them in care h. School-age: explain procedures in concrete terms, encourage questions, and respect modesty i. Adolescents: provide privacy, explain findings, and allow for independence in care discussions 3. Discuss typical stressors and reactions to illness or hospitalization for children in each developmental stage and strategies to minimize effects j. Infants: separation anxiety; encourage parental presence and provide comfort measures k. Toddlers: fear of loss of autonomy; offer choices when possible and use distraction techniques l. Preschoolers: fear of body mutilation; use simple explanations and allow medical play m. School-age: loss of control and fear of pain; provide privacy and involvement in decision-making n. Adolescents: loss of privacy and independence; provide privacy and involve in decision-making 4. Discuss children's concepts of illness and pain using Piaget's framework o. Sensorimotor (0-2 years): no understanding of illness; reacts to pain with crying or withdrawal p. Preoperational (2-7 years): illness is magical or a punishment and fear of bodily harm with an exaggerated pain perception q. Concrete operational (7-10 years): begins to understand cause and effect; fears pain but understands treatment helps r. Formal operational (13+ years): understands illness logically, fears long-term effects, and has concerns about body image 5. Describe the psychosocial milestones contributing to illness adjustment s. Trust vs mistrust (infant): parental presence is essential t. Autonomy vs shame and doubt (toddler): needs choices to feel control u. Initiative vs guilt (preschooler): may blame self for illness v. Industry vs inferiority (school-age): may worry about school or peers w. Identity vs role confusion (adolescent) : concerned with independence and social acceptance 6. Impact of moral development on illness perception x. Preconventional (2-7 years): sees illness as punishment y. Conventional (7-12 years): concerned about following rules z. Postconventional (12+ years): understands ethical reasoning behind health care decisions 7. Nursing management of children with malabsorption from celiac disease a. Nutritional education: strict gluten-free diet b. Monitoring growth: ensure proper weight gain c. Managing symptoms: address diarrhea, bloating, and fatigue 8. Signs and symptoms of diabetes mellitus d. Hyperglycemia: polyuria, polydipsia, polyphagia, weight loss, and fatigue e. Hypoglycemia: sweating, irritability, tremors, and confusion 9. Nonpharmacologic DM management f. Nutrition: carb counting and balanced meals g. Exercise: regular physical activity h. Hypoglycemia prevention: snacks before exercise 10. DKA and hypoglycemia emergency treatment i. DKA: IV fluids, insulin drip, electrolyte monitoring j. Mild hypoglycemia: juice or glucose tabs k. Severe hypoglycemia: glucagon injection 11. Teaching children and family about DM home management l. Insulin administration: proper technique and rotate sites m. Blood sugar monitoring: routine checks and recognizing symptoms n. Sick day management: check for ketones and stay hydrated 12. Renal disorders o. Assessment: edema, HTN, and hematuria p. Management: fluid restrictions, antihypertensives, and infection prevention 13. Parental and sibling reactions to hospitalization q. Parents: guilt, stress, and financial concerns r. Siblings: jealousy, fear, and regression 14. Celiac disease management s. Gluten free education: avoid wheat, rye, barely, and some oats t. Family compliance: alternative meal planning 15. Patho of leukemia, Hodgkin's and non-Hodgkin's lymphoma u. Leukemia: Uncontrolled WBC proliferation v. Hodgkin's: Reed-Sternberg cells present and localized to lymph nodes w. Non-Hodgkin's: widespread lymph node involvement 16. Abnormal findings in cancer assessment x. Pallor, fatigue (anemia), brushing, frequent infection (bone marrow suppression), swollen lymph nodes, and weight loss 17. Nursing care for diagnostics and leukemia management y. Bone marrow biopsy or lumbar puncture: pain management and sedation z. Chemotherapy: managing side effects 18. Chemotherapy side effects and interventions a. Nausea: anti-emetics before chemo b. Alopecia: support with wigs or hats c. Mucositis: oral care and pain relief 19. Bone marrow transplant care d. Donor selection: HLA matching and sibling donors e. Post-transplant care: infection prevention and engraftment monitoring 20. Physosocial needs and oncologic emergencies f. Emotional support: family involvement and child life specialists g. Emergencies: Sepsis, tumor lysis syndrome: rapid response