NCLEX Review - Pediatrics
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| Piaget's Period for Infancy | show 🗑
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| show | Trust vs. Mistrust (0-18 months): Development of a sense that the self is good and the world is good when consistent, predictable, reliable care is received; characterized by hope.
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| Piaget's Period fo Toddlers & Preschoolers | show 🗑
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| Erikson's Stage for Toddlers | show 🗑
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| show | Initiative vs. Guilt (3-5 yr): Development of a can-do attitude about the self; behavior becomes goal-directed, competitive, and imaginative; initiation into gender role; characterized by purpose.
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| Piaget's Period for School Age | show 🗑
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| show | Industry vs. Inferiority (6-11 yr): Mastering of useful skills and tools of the culture; learning how to play and work with peers; characterized by competence.
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| show | Formal Operations: New ideas can be created; situations can be analyzed; use of abstract and futuristic thinking; understands logical consequences of behavior.
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| show | Identitity vs. Role Confusion (12-18 yr): Begins to develop a sense of “I”; this process is lifelong; peers become of paramount importance; child gains independence from parents; characterized by faith in self.
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| show | Intimacy vs. Isolation (19-40 yr): Development of the ability to lose the self in genuine mutuality with another; characterized by love.
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| Erikson's Stage for Middle Adulthood | show 🗑
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| show | Ego Integrity vs. Despair (> 65 yr): Realization that there is order and purpose to life; characterized by wisdom.
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| show | by 4 years.
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| When does the child sit unsupported? | show 🗑
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| show | 2 years.
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| show | 18 months.
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| When does a child speak two- to three-word sentences? | show 🗑
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| show | 4 years.
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| show | 5 years.
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| Start of Girl's growth spurt vs. Boy's growth spurt | show 🗑
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| Tanner Stage 1 | show 🗑
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| Tanner Stage 2 | show 🗑
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| Tanner Stage 3 | show 🗑
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| show | Boys: Increased size of penis w/ growth in breadth & development of glans; testes & scrotum larger, scrotum darker; Girls: Areola and papilla form a secondary mound above level of breast; Both: adult hair, but covering smaller area; no spread to thighs
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| show | Boys: Adult genitalia; Girls: Mature stage: projection of papilla only, related to recession of areola; Both: Pubic hair adult in type and quantity, with horizontal distribution ("feminine")
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| show | After 6 months, their cognitive development allows them to remember pain.
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| show | They fear intrusive procedures.
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| Concept of bodily injury in Preschoolers | show 🗑
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| Concept of bodily injury in School-age children | show 🗑
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| Concept of bodily injury in Adolescents | show 🗑
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| show | History of reactions, seizures, neurologic symptoms after previous vaccine, or systematic allergic reactions
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| show | History of anaphylactic reaction to eggs or neomycin
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| Varicella (chickenpox) symptoms | show 🗑
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| show | Discrete red maculopapular rash that starts on face and rapidly spreads to entire body and disappears within 3 days;
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| show | German measles
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| show | Fever, headache, malaise, parotid gland swelling and tenderness; manifestations include submaxillary and sublingual infection, orchitis, and meningoencephalitis
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| show | an infestation of lice on humans.
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| List two contraindications to live virus immunization. | show 🗑
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| List three classic signs and symptoms of measles. | show 🗑
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| show | Anemia; pale conjunctiva; pale skin color; atrophy of papillae on tongue; brittle, ridged, or spoon-shaped nails; and thyroid edema
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| Identify food sources of vitamin A. | show 🗑
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| show | Scurvy
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| show | Weight, skin-fold thickness, and arm circumference
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| List the signs and symptoms of dehydration in an infant. | show 🗑
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| show | Loss of bicarbonate/decreased serum pH, loss of sodium (hyponatremia), loss of potassium (hypokalemia), elevated Hct, and elevated BUN
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| show | By using the Lund-Browder chart, which takes into account the changing proportions of the child’s body
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| show | By monitoring urine output
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| How should a parent be instructed to child-proof a house? | show 🗑
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| What interventions should the nurse perform first in caring for a child who has ingested a poison? | show 🗑
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| show | Anemia, acute cramping, abdominal pain, vomiting, constipation, anorexia, headache, lethargy, hyperactivity, aggression, impulsiveness, decreased interest in play, irritability, short attention span
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| Normal Urinary output for infants and children | show 🗑
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| show | 30-60
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| show | 25-35
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| Normal respirations in 1-3 year olds (toddler) | show 🗑
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| Normal respirations in 3-5 year olds (preschooler) | show 🗑
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| Normal respirations in 6-10 year olds (school age) | show 🗑
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| Normal respirations in 10-16 year olds (adolescent) | show 🗑
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| show | Do not examine the throat of a child with epiglottitis (i.e., do not put a tongue blade or any object into the throat) because of the risk of obstructing the airway completely.
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| show | To reverse bronchospasm
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| What are the physical assessment findings for a child with asthma? | show 🗑
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| show | Pancreatic enzyme replacement, fat-soluble vitamins, and a moderate- to low-carbohydrate, high-protein, moderate- to high-fat diet
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| Why is genetic counseling important for the family of a child with cystic fibrosis? | show 🗑
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| List seven signs of respiratory distress in a pediatric client. | show 🗑
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| show | Monitor child’s temperature, keep tent edges tucked in, keep clothing dry, assess respiratory status, look at child inside tent.
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| show | Upright sitting, with chin out and tongue protruding (“tripod position”)
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| Why are IV fluids important for a child with an increased respiratory rate? | show 🗑
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| show | Hearing loss
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| What is the most common postoperative complication following a tonsillectomy? Describe the signs and symptoms of this complication. | show 🗑
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| show | 100-160
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| Normal pulse in 1-11 month old infants | show 🗑
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| Normal pulse in 1-3 year olds (toddler) | show 🗑
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| show | 80-120
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| show | 70-110
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| show | 60-90
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| show | Acyanotic: Has abnormal circulation; however, all blood entering the systemic circulation is oxygenated. Cyanotic: Has abnormal circulation with unoxygenated blood entering the systemic circulation.
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| Two objectives in treating CHF | show 🗑
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| show | hold if bradycardic; therapeutic levels should be 0.8-2; admin regularly and do NOT skip doses; do not mix with formula/food; monitor for s/s of toxicity (vomiting, anorexia, diarrhea, abdominal pain, fatigue, muscle weakness, and drowsiness)
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| show | A right-to-left shunt bypasses the lungs and delivers unoxygenated blood to the systemic circulation, causing cyanosis. A left-to-right shunt moves oxygenated blood back through the pulmonary circulation.
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| show | VSD, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy
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| show | Poor feeding, poor weight gain, respiratory distress and infections, edema, and cyanosis
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| What are the two objectives in treating congestive heart failure? | show 🗑
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| Describe nursing interventions to reduce the workload of the heart. | show 🗑
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| What position would best relieve the child experiencing a tet spell? | show 🗑
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| What are common signs of digoxin toxicity? | show 🗑
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| List five risks in cardiac catheterization. | show 🗑
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| show | Aortic valve stenosis and mitral valve stenosis
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| What medications are used to treat rheumatic fever? | show 🗑
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| show | The signs of increased intracranial pressure (ICP) are the opposite of those of shock. Shock: increased pulse, decreased blood pressure; Increased ICP: decreased pulse, increased blood pressure
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| show | Headache on awakening is the most common presenting symptom of brain tumors.
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| show | Feed infant or child with cerebral palsy using nursing interventions aimed at preventing aspiration. Position child upright, and support the lower jaw.
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| What are the physical features of a child with Down syndrome? | show 🗑
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| show | A common characteristic of spastic cerebral palsy in infants; legs are extended and crossed over each other, feet are plantar flexed
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| show | Prevention of infection of the sac and monitoring for hydrocephalus (measure head circumference, check fontanel, assess neurologic functioning)
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| show | Irritability, change in LOC, motor dysfunction, headache, vomiting, unequal pupil response, and seizures
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| show | Information about signs of infection and increased ICP; understanding that shunt should not be pumped and that child will need revisions with growth; guidance concerning growth and development
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| show | Maintain patent airway, protect from injury, and observe carefully.
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| show | Gingival hyperplasia, dermatitis, ataxia, GI distress
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| show | Fever, irritability, vomiting, neck stiffness, opisthotonos, positive Kernig sign, positive Brudzinski sign; infant may not show all classic signs even though very ill
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| show | Ampicillin, ceftriaxone, or chloramphenicol
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| show | Flat or on either side
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| Describe the function of an osmotic diuretic. | show 🗑
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| show | Suctioning and positioning, turning
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| show | Duchenne muscular dystrophy is inherited as an X-linked recessive trait.
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| show | Gowers sign is an indicator of muscular dystrophy; to stand, the child has to “walk” hands up legs.
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| First sign of renal failure | show 🗑
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| Compare the signs and symptoms of acute glomerulonephritis (AGN) with those of nephrosis. | show 🗑
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| What antecedent event occurs with acute glomerulonephritis (AGN)? | show 🗑
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| Compare the dietary interventions for acute glomerulonephritis (AGN) and nephrosis. | show 🗑
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| show | Hypoproteinemia occurs because the glomeruli are permeable to serum proteins.
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| Describe safe monitoring of prednisone administration and withdrawal. | show 🗑
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| What interventions can be taught to prevent urinary tract infections in children? | show 🗑
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| show | A malfunction of the valves at the end of the ureters, allowing urine to reflux out of the bladder into the ureters and possibly into the kidneys
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| show | Protect the child from injury to the encapsulated tumor. Prepare the family and child for surgery.
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| show | Preschoolers fear castration, achieving sexual identity, and acquiring independent toileting skills.
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| Describe feeding techniques for a child with cleft lip or palate. | show 🗑
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| show | Choking, coughing, cyanosis, and excess salivation
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| What nursing actions are initiated for the newborn with suspected esophageal atresia with TEF? | show 🗑
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| show | Maintain IV hydration, and provide small, frequent oral feedings of glucose or electrolyte solutions or both within 4 to 6 hours. Gradually increase to full-strength formula. Position infant on right side in semi-Fowler position after feeding.
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| show | A barium enema reduces the telescoping of the intestine through hydrostatic pressure without surgical intervention.
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| show | Check vital signs and take axillary temperatures. Provide bowel cleansing program, and teach about colostomy. Observe for bowel perforation; measure abdominal girth.
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| show | Family needs education about skin care and appliances. Referral to an enterostomal therapist is appropriate.
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| show | A newborn who does not pass meconium within 24 hours; meconium appearing through a fistula or in the urine; an unusual-appearing anal dimple
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| What are the priorities for a child undergoing abdominal surgery? | show 🗑
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| show | Newborn: 14 to 24 g/dL; Infant: 10 to 17 g/dL; Child: 9.5 to 15.5 g/dL
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| Describe the information families should be given when a child is receiving oral iron preparations. | show 🗑
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| List dietary sources of iron. | show 🗑
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| show | It is an X-linked recessive chromosomal disorder transmitted by the mother and expressed in male children.
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| Describe the sequence of events in a vaso-occlusive crisis in sickle cell anemia. | show 🗑
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| show | Hydration promotes hemodilution and circulation of the red cells through the blood vessels.
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| show | Keep child well hydrated. Avoid known sources of infections. Avoid high altitudes. Avoid strenuous exercise.
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| show | Anemia (decreased erythrocytes); infection (neutropenia); bleeding thrombocytopenia (decreased platelets)
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| How is congenital hypothyroidism diagnosed? | show 🗑
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| What are the symptoms of congenital hypothyroidism in early infancy? | show 🗑
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| show | Mental retardation and growth failure
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| show | CNS damage, mental retardation, and decreased melanin
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| What two formulas are prescribed for infants with PKU? | show 🗑
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| show | Meat, milk, dairy products, and eggs
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| show | Polydipsia, polyphagia, and polyuria
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| show | Hypoglycemia: tremors, sweating, headache, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around mouth, nightmares. Hyperglycemia: polydipsia, polyuria, polyphagia, blurred vision, weakness, weight loss, and syncope
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| show | Provide care for an unconscious child, administer regular insulin IV in normal saline, monitor blood gas values, and maintain strict I&O.
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| Describe developmental factors that would impact the school-age child with diabetes. | show 🗑
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| show | During exercise, insulin uptake is increased and the risk for hypoglycemia occurs.
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| List normal findings in a neurovascular assessment. | show 🗑
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| What is compartment syndrome? | show 🗑
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| show | Abnormal neurovascular assessment: cold extremity, severe pain, inability to move the extremity, and poor capillary refill
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| show | Fractures of the epiphyseal plate (growth plate) may affect the growth of the limb.
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| How is skeletal traction applied? | show 🗑
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| What discharge instructions should be included concerning a child with a spica cast? | show 🗑
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| show | Unequal skin folds of the buttocks, Ortolani sign, limited abduction of the affected hip, and unequal leg lengths
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| show | Ask the child to bend forward from the hips, with arms hanging free. Examine the child for a curve in the spine, a rib hump, and hip asymmetry.
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| show | The child should be instructed to wear the brace 23 hours per day; wear a T-shirt under brace; check skin for irritation; perform back and abdominal exercises; and modify clothing. The child should be encouraged to maintain normal activities as able.
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| What care is indicated for a child with juvenile rheumatoid arthritis? | show 🗑
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