Pediatric Nursing Exam Study Guide PDF

**Pediatric Nursing Exam Study Guide (Based on Wong's Essentials of Pediatric Nursing)** **Dosage Calculations** - **Safe Range & Weight-Based Dosing** - Always calculate medication doses based on weight (kg) and safe dose range per drug. - Confirm dosage is within the reco...

**Pediatric Nursing Exam Study Guide (Based on Wong's Essentials of Pediatric Nursing)** **Dosage Calculations** - **Safe Range & Weight-Based Dosing** - 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. **Chapter 1: Family-Centered Care** - **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. **Chapter 4: Growth and Communication** - **Head Circumference** - Measured 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. **Chapter 5: Pain Management & Anesthesia** - **FLACC Scale (x2)** - 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. **Chapter 10: Infant Health and Hospitalization** - **8-Month-Old Adjusting to Hospitalization** - Encourage parental presence. - Maintain routine and provide familiar objects. - Offer comfort measures (rocking, soft voice). - **Kwashiorkor (x2)** - Severe protein deficiency with an adequate supply of calories (carbs) - Symptoms: edema, distended abdomen, irritability, muscle wasting. - **Cyanosis in Infants** - Indicates hypoxia; requires immediate intervention. - **Growth & Development Tracking** - Use **growth charts. Standardized growth reference charts are used in infants, children, and adolescents. Compares head circumference, height, weight with percentile distribution of others in the same age group** - **Marasmus (x2)** - Severe malnutrition from calorie deficiency and protein. Common in underdeveloped countries. - Symptoms: muscle wasting, no edema, fragile appearance. - **Bottle Propping Danger** - Risk of aspiration and ear infections. - **Failure to Thrive (FTT) Possible Causes** - Inadequate growth resulting from an inability to obtain or use calories required for growth. Inadequate caloric intake, inadequate absorption, increased metabolism, defective utilization. - **Diaper Dermatitis Treatment** - Keep area dry, frequent diaper changes, barrier cream (zinc oxide). - **Treatment of Excoriated Areas** - Clean gently, apply protective ointments, expose to air. - **SIDS Safety Teaching (x5)** - Sleep on **back**. - Firm mattress, no pillows/stuffed animals. - Avoid overheating. - Breastfeeding reduces risk. - No co-sleeping. - Maternal smoking **Chapter 11: Toddler Safety & Development** - **Home Safety for Toddlers** - Secure furniture, use safety gates, lock cabinets, avoid small objects, place all toxins in high cabinet, hide sharp objects - **Toddlers Engage in \_\_\_\_\_ Play (x2)** - **Parallel Play** (play alongside, not with, peers). - **Growth Milestone Measuring Tool** - **Growth charts**. - **Best Place to Count Heart Rate** - **Apical pulse** for one full minute. - **Preventing Jealous Tendencies in Toddlers** - Include them in caregiving activities for younger siblings. - **Theorist Covering Autonomy (x4)** - **Erikson** Autonomy, Shame, Doubt: Toddler acquire a sense of autonomy while overcoming a sense of doubt and shame. Negativism: giving a negative response to requests. Ego: Reason or common sense during psychological development. ID: tolerate frustration and learning socially acceptable ways of interacting with the environment. Superego: 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. - Blocks, dolls, clay, push-pull toys, slides, balls of all sizes - **Preventing Aspirations** - Avoid large round foods hot dogs, grapes, peas, carrots, popcorn, fruit gel snacks, nuts, hard candy - **Appropriate Snacks** - Soft fruits, yogurt (if tolerated), cheese, crackers. - **Toileting Training Cues & Considerations** - 3 Signs child is ready for toilet train: 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. Consideration: 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** - Crying, resisting, guarding area, withdrawal. - **Piaget\'s Stage for Toddlers** - **Sensorimotor transitioning to Preoperational**: During this time the cognitive processes and 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. - **Eye Level Importance** - Establishes trust, reduces intimidation. - **Snack Safety** - Avoid choking hazards (hard candy, nuts). - **Routine Importance** - Provides security and reduces anxiety. - **Voluntary Control of Urinary Sphincter** - Develops around **24- 30 months**. **Chapter 12: Preschool Development** - **Side Rail Safety (x2)** - 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**: Acquiring a sense of initiative they are in a stage of energetic learning play, work, and 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 (x2)** - 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. Construction sets, large puzzles, dress up, dolls, farm animals, trucks, cars, 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. 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. 4-7 years old 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** - Push toys, stacking rings, soft books. **Chapter 13: Toddler Ear Assessment** - **When to Assess Toddler's Ears** - Pull **pinna down and back** (under 3 years old). **Chapter 14: Preschool Hospital Care** - **Atraumatic Care for a 5-Year-Old** - Avoid restraint, use distraction techniques. - **Nightmares vs. Night Terrors** - Nightmares 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: 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. **Chapter 16: Pain Assessment** - **Pain Assessment (x2)** - Use age-appropriate pain scales. - Observe facial expressions, body movement, vital signs.