Milestone/Erikson
The loss of this reflex signals readiness for walking, which aligns with the Erikson stage where toddlers strive for independence in toilet training and self-care.
What is the Babinski reflex and Autonomy vs. Shame and Doubt?
18 months to 3 years.
Babinski disappears around 12 months; walking begins. Erikson’s toddler stage emphasizes autonomy through independence in daily skills.
A 6-month-old infant presents with vomiting and diarrhea. Compared to adults, this patient is more vulnerable to rapid fluid loss due to a higher proportion of this in their body composition.
What is water?
Infants have approximately 70% of their body weight as water, making them more susceptible to dehydration. Their higher metabolic rate and greater insensible fluid losses further increase vulnerability.
A patient reports burning mid-gastric pain at night that improves with meals.
What is duodenal ulcer?
Duodenal ulcer pain often improves after eating, unlike gastric ulcer pain.
This type of toy helps toddlers develop gross motor skills and coordination, often involving riding, pushing, or pulling safely around the home.
What are push-pull or ride-on toys?
Toddlers are developing gross motor skills and coordination. Push-pull and ride-on toys encourage walking, balance, and spatial awareness. Safety precautions (supervision, non-slip surfaces, and age-appropriate toy size) are essential to prevent falls or injury.
A nurse is teaching parents how to reduce the risk of urinary tract infections in their preschool-aged daughter. Which habit should they prioritize?
What is encouraging frequent urination and adequate fluid intake?
Regular voiding and hydration help flush bacteria from the urinary tract, reducing UTI risk.
A 6-month-old begins to roll over and shows stranger anxiety. This milestone occurs during Erikson’s stage where consistent caregiving leads to this positive outcome.
What is trust vs. mistrust?
Infants (birth–1 year) need consistent care to build trust. Stranger anxiety (6–8 months) is normal as attachment develops.
A parent reports that their 8-month-old seems unusually fussy and has a faster heartbeat after a mild fever. Which vital sign should the nurse recognize as a possible early indicator of dehydration?
What is tachycardia?
An increased heart rate can indicate fluid loss in infants and toddlers, and is an early compensatory mechanism.
A patient presents with sudden severe abdominal pain, hypotension, and a rigid abdomen.
What is perforated ulcer?
Board-like rigidity and hypotension indicate a perforation, which requires emergency intervention.
Priority intervention: Call the surgical team immediately for emergency laparotomy
Supporting nursing actions:Monitor vital signs and hemodynamic status Start IV fluids to manage hypotension
Keep the patient NPO
Prepare for possible blood transfusion Provide pain management as ordered
Preschoolers enhance imaginative play and learn about daily routines using these safe household-inspired toys.
What are play kitchens, dress-up clothes, or pretend household sets?
Imaginative play helps preschoolers develop cognitive, social, and language skills. Pretend household sets teach problem-solving, cooperation, and understanding daily routines. Safety includes avoiding small parts, sharp edges, or toxic materials.
A child with acute glomerulonephritis reports a headache. Which assessment should the nurse perform immediately?
What is check the child’s blood pressure?
In AGN, headaches can signal hypertension and potential cerebral complications; monitoring BP is the first priority.
A 4-year-old pretends to be a doctor during play. This behavior demonstrates Erikson’s psychosocial task for this stage. Failure to support it may cause this negative feeling.
What is Initiative vs. Guilt?
Preschoolers explore through imagination and role play. Encouragement builds initiative; harsh punishment fosters guilt.
A hospitalized school-age child recovering from gastroenteritis needs careful fluid balance monitoring. What daily measurement is most reliable for assessing their hydration status?
What is weight?
Daily weight changes accurately reflect fluid gains or losses in children.
A patient with a peptic ulcer asks when to take their Sucralfate prescription for it to work best.
What is on an empty stomach, 1 hour before meals or 2 hours after meals?
Sucralfate forms a protective coating over ulcers. Taking it with food or other medications can reduce effectiveness.
School-age children can strengthen social skills and teamwork by creating these with friends, while learning about rules and cooperation.
What are secret clubs or organized group games?
School-age children are developing social skills, peer relationships, and teamwork. Forming clubs or playing organized games fosters cooperation, rule-following, and leadership. Supervision ensures that activities remain safe and conflicts are managed.
A child hospitalized with acute glomerulonephritis shows periorbital swelling and mild dyspnea. To evaluate changes in fluid status, which method gives the most precise daily information?
What is taking the child’s weight at the same time each day on a standing scale?
Daily weights provide a sensitive measure of fluid retention in AGN, detecting subtle increases in edema that intake/output may not reveal.
An adolescent refuses to follow family traditions and instead explores different friend groups. According to Erikson, this behavior reflects the search for this developmental task.
Identity vs. Role Confusion?
Adolescents (12–18) experiment with roles, values, and beliefs. Successful resolution leads to identity; failure leads to confusion.
An infant has fever and tachypnea, increasing insensible fluid losses. Through which two routes does most of this fluid loss occur?
What are the skin and respiratory tract?
Infants have large surface area and higher respiratory rates, so they lose more water through these routes compared with older children or adults.
A 45-year-old patient with chronic GERD reports worsening heartburn and regurgitation after meals, especially when lying down. The patient asks why this happens and what non-medication strategies could help.
Part A: Which physiological factor contributes most to the reflux when the patient is supine?
Part B: What nursing intervention can reduce symptoms without medication?
Part A: What is increased gastric pressure on a relaxed lower esophageal sphincter?
Part B: What is elevating the head of the bed 30–45° (semi-Fowler’s position)?
When lying flat, gastric contents more easily reflux into the esophagus due to pressure on the lower esophageal sphincter, causing heartburn.
Elevating the head of the bed reduces reflux by using gravity to keep gastric contents in the stomach.
Infants develop fine motor and sensory skills safely by handling these items, which are soft, textured, and designed to avoid choking hazards.
What are cloth books, rattles, and soft stacking toys? Infants explore the world through sensory and fine motor development. Soft, textured toys promote tactile exploration and hand-eye coordination. Safety involves avoiding choking hazards, small detachable parts, and ensuring toys are washable and non-toxic.
A toddler with nephrotic syndrome develops generalized edema and a temperature of 101.5°F. Which finding should the nurse identify as the most urgent concern?
What is infection?
Children with nephrotic syndrome are immunocompromised due to protein loss in urine and corticosteroid therapy. Fever may indicate a serious infection, which is the highest priority over edema or minor lab abnormalities.
Hospitalization during this Erikson stage may cause decreased self-esteem if the child cannot keep up with peers, since mastery of skills is central to development.
What is Industry vs. Inferiority?
School-age children (6–12) focus on competence and approval from peers. Illness or failure can lead to inferiority.
A 17-month-old child weighing 11 kg has been vomiting and experiencing diarrhea for 48 hours. The child appears lethargic, has a weak pulse, and a sunken anterior fontanel.
Part A: Which clinical finding in this child is most indicative of significant fluid loss?
Part B: What is the priority nursing intervention to stabilize this child before administering other treatments?
Part A: What is sunken anterior fontanel?
Part B: What is administer a rapid IV fluid bolus?
The sunken anterior fontanel, combined with lethargy, hypotension, and tachycardia, is a key physical indicator of severe dehydration in a young child.
Rapid IV fluid bolus is the first priority to restore circulating volume and prevent shock; other interventions follow after stabilization.
A 62-year-old patient who had a total gastrectomy reports dizziness, palpitations, and diarrhea 20 minutes after meals. They ask why drinking fluids with meals worsens these symptoms.
Part A: Which postoperative complication is most likely, and why does it occur?
Part B: What dietary strategy should the nurse recommend to minimize symptoms?
Part A: What is dumping syndrome due to rapid gastric emptying?
Part B: What is six small, low-carb meals per day with fluids between meals?
Rapid emptying draws fluid into the small intestine, causing dizziness, palpitations, and diarrhea. Small, frequent meals without fluids during meals slow gastric transit and reduce symptoms.
Adolescents often express peer connections and social identity through these modern communication tools, which require awareness of online safety.
What is engaging in social networking?
Adolescents are influenced by peers and developing identity. Social networking allows communication and peer bonding but requires education on online safety, privacy, and cyberbullying to prevent emotional or physical harm.
Parents of a boy with hypospadias ask why surgery is necessary. The nurse explains that the procedure’s main functional goal is to:
What is allow the child to urinate standing with a properly directed stream?
Surgical correction of hypospadias improves urinary function, genital appearance, and future sexual function. Functional outcome is the primary goal, while cosmetic improvement is secondary.