Growth and Development
Drawing, coloring, pretend play, writing, etc are examples of?
Therapeutic play
Which Dx test is done to test CSF?
Lumbar puncture
Which Congenital Heart Defect is made up of four abnormalities, what are they?
TOF
1. VSD
2. Pulmonic Stenosis
3. Dextroposition of the Aorta
4. Hypertrophy of the R. Ventricle
_____________: Process of moving air in and out
Ventilation
Red meat, organ meats, lentils, cooked spinach, firm tofu
Give an example of Regression post hospitalization or illness:
Bedwetting or having accidents after gaining full bladder control in a child
Thumb sucking or wanting a pacifier after training off of it
What is Separation Anxiety?
Children display behaviors of protest, despair, and detachment.
Prevention of this is a priority of Strabismus:
Eye straining
________ is presented with Pulmonary congestion, SOB, wheezing, crackles, fatigue, restlessness, confusion
L. Sided HF
________ is the leading cause of Bronchiolitis and Viral Pneumonia in infants and young children
RSV
What are triggers of a Vaso-occlusive crisis in Sickle cell?
Dehydration, cold temps, high altitudes, infection, anything that stresses your body out
What are the stages of Grief
Denial, Anger, Bargaining, Depression, Acceptance
In which stage of Piaget's Developmental stage do children exhibit Egocentric thinking?
Preoperational Stage
Brain hyperactivity when body temperature rises too high too fast:
Febrile Seizure
Which CHD would present with bounding pulses and a wide pulse pressure?
PDA
A newly hired pediatric nurse is assessing a 4-year-old brought to the emergency department by the parent. The child is sitting upright in a tripod position, appears anxious with wide eyes, is drooling, and has inspiratory stridor.
The nurse reaches for a tongue depressor because she is unable to visualize the child's airway and wants to ensure the child is not choking on a foreign body.
What should the charge nurse do first?
Immediately stop the nurse from examining the child's throat with a tongue depressor, keep the child calm and in an upright position, and notify the provider/anesthesia team for suspected epiglottitis
Neutropenic precautions include which interventions?
Private room (often with HEPA filtration)
No fresh flowers or plants (due to risk of mold and bacteria)
No fresh fruits or vegetables unless washed and prepared safely
Strict hand hygiene for everyone entering the room (staff, visitors, patient)
Limit visitors — screen for illness, sometimes require masks
Mask for the patient when leaving the room (if they must leave)
Which Erikson's Developmental stage views hospitalization as punishment?
Preschool age
In which Erikson's Developmental stage do Children understand the concept of cause and effect?
The School Age
The amount of time conjunctivitis stays contagious after starting abx
24hrs
P-R interval: 1st degree heart block, indication of Carditis
ESR elevated: Increased inflammation
Arthralgia: joint pain
CRP elevated: Abnormal increase in proteins
Elevated Temperature: indicative for carditis
Minor s/sx of the Jones Criteria
What is pancrealipase?
Provided to patients with CF to assist with digestion of food.
This must be administered each time the child eats, meals and snacks.
Prolonged bleeding, hemarthrosis, excessive bruising, hematomas, hematuria, bleeding with tooth eruption, and anemia.
Which age groups can you see Trashing, Stretching of Limbs, Crying, Protesting, Irritability, Tantrums with hospitalizations
The Infant, Toddler, and Preschool age
Define competitive play and tell me in which age group do you see it?
Play in which children compete against one another while following rules, encouraging healthy competition, teamwork, and skill development. i.e. Team sports, competitive board games, relay races, etc
You observe this in the Adolescent age
__________ is made up of LOC, pupil and eye movement, VS, and Motor function.
Neuro assessment
Why is Delaying live vaccines for 11 months important when receiving treatment for Kawasaki's?
Children with Kawasaki disease typically receive high-dose IVIG. IVIG contains ready-made antibodies from donated blood.
If a child receives a live vaccine (such as MMR or varicella) too soon after IVIG:
What are the signs of respiratory distress in an infant/child?
Nasal flaring, Grunting, Wheezing, Retractions
What are nursing interventions for a sickle cell vaso-occlusive crisis?
Decrease oxygen consumption.
Rehydrate.
Control pain: Use Morphine; do not use Demerol.
Apply warm compresses and elevate joints.
Administer blood transfusions, folic acid, and Hydroxyurea as ordered.
What is the perception of death in each of the Age stages?
Infant- No perception, anxiety is reactive to parents
Toddler- Perceives death as separation or abandonment
Preschooler- Perceives death as a reversible sleep state
School- Concept of death is now realistic, understands the permanence of death
Adolescent- Anger, Resentment, feelings of invisibility
Which pain scale is used for toddlers and young children?
The Wong Baker Faces Scale
___________: Indicative of disability d/t brain injury before development is complete
Cerebral Palsy
Nursing interventions before administering digoxin to an infant:
Checking the apical pulse for one full minute at the 4th intercostal space, mid-clavicular line and holding for a BPM of less than 100
What are nursing interventions for Acute Laryngotracheobronchitis (Croup?)
Nursing care interventions: HOB elevated, Cool mist humidifier, IV fluids, Steroids, Neb- epinephrine, Maintain O2 sats to at least 90%
Use of Opiates and Sedatives contraindicated.
Thrombocytopenia, Leukemic cells crowd out platelet production in the bone marrow.
A 12-year-old has been declared dead, and the parents ask whether organ donation is possible. Before determining whether the child may be a candidate for organ donation, what clinical factor is most important to assess?
Whether organ perfusion has been maintained (e.g., brain death with continued circulation versus prolonged cessation of circulation resulting in tissue hypoxia).
A 3 year old toddler is brought to the pediatric clinic for a well-child visit.
The nurse observes the following:
Which finding requires further intervention?
Has a vocab of 10 words. By three years old, a child should have about 200 words in their vocabulary and be able to make 3 word sentences.
A 7-year-old is brought to the emergency department because of persistent vomiting, increasing lethargy, irritability, and confusion. The parents state the child was not feeling well a few days ago, just a bug that's been going around. The mother recalls giving a medicine for the fever, however, does not remember which one exactly. During assessment, the nurse notes the child is difficult to arouse and has periods of combativeness.What condition does the nurse suspect?
Reye's Syndrome
A Postpartum RN is doing 24hr tests on a Newborn. CCHD shows an O2 Sat of 98% in the R. Hand and 82% in the L. Foot. What interventions/orders should the RN expect from the provider when she reports this?
- Obtain a four-point blood pressure
- Assess and compare Brachial-Radial-Femoral pulses for strength and symmetry, use a doppler if needed
- Order for ECHO
1. 8 month old with a positive RSV PCR. SPO2 92%, RR 58, smiling
2. 3 yr old with Croup, Barking cough, Stridor audible when crying
3. 4 yr old presenting with Epiglottitis, drooling, tripod position, wide eyed
4. 9yr old with CF. Chronic cough, awaiting CPT
C. Airway obstruction is imminent
Cold or hot compresses should not be used to relieve pain in a child with sickle cell anemia because?
Cold promotes sickling and ischemia
Ischemic tissues have reduced sensations, burns can occur with Hot compresses
You SHOULD use a warm compress
A child dies in the PICU. Before the parents leave, the nurse quietly removes the child's identification band because "it isn't needed anymore."
The identification band should remain on the body until postmortem identification procedures are complete, according to institutional policy. Removing it prematurely can lead to identification errors and interfere with legal documentation.