School Age/Adolescentt
When do we typically screen for scoliosis
Before their growth spurt
What are the late signs of ICP?
Name 4 for each
Early-- mood swings, high pitched cry, bulging fontanelles, irritable, headache with N/V in the AM, poor feeding , slurred speech, change in pupil response, sunsetting eyes,
Late-- decrease in LOC and motor response, Cushings (BP, low HR, varied RR), posturing
Give 3-5 things that are included in post op care for cardiac catheterization?
VS every 5-15 minutes
Assess pulses frequently
Monitor insertion site
Keep leg straight
Limit HOB up
What is an important education point for a infant who was just diagnosed with hypospadias?
No circumcision-- foreskin is used for repair
A nurse is educating the parents of a child with type 1 diabetes on how to manage their child's diabetes during illness. Which statements by the parents indicate correct understanding? (Select all that apply.)
A. "I will continue giving my child insulin, even if they have a decreased appetite."
B. "I should check my child’s blood glucose more frequently than usual when they are sick."
C. "If my child is unable to eat solid food, I will offer liquids with carbohydrates to prevent hypoglycemia."
D. "I should avoid checking for ketones unless my child’s blood sugar is extremely high."
E. "If my child has vomiting that does not stop, I will contact the healthcare provider immediately."
F. "I will encourage my child to drink plenty of fluids, even if they don’t feel thirsty, to prevent dehydration."
G. "If my child’s blood sugar is normal, I can stop giving insulin until they feel better."
Here are the correct answers and explanations for the SATA question on diabetic sick day rules for pediatrics:
Correct Answers: A, B, C, E, and F
✅ A. "I will continue giving my child insulin, even if they have a decreased appetite."
✅ B. "I should check my child’s blood glucose more frequently than usual when they are sick."
✅ C. "If my child is unable to eat solid food, I will offer liquids with carbohydrates to prevent hypoglycemia."
❌ D. "I should avoid checking for ketones unless my child’s blood sugar is extremely high."
✅ E. "If my child has vomiting that does not stop, I will contact the healthcare provider immediately."
✅ F. "I will encourage my child to drink plenty of fluids, even if they don’t feel thirsty, to prevent dehydration."
❌ G. "If my child’s blood sugar is normal, I can stop giving insulin until they feel better."
Final Answer: ✅ A, B, C, E, F
W
What is abstract reasoning in adolescents
thinking about what is unobserved
Seeing things from different perspectives
Name the classic signs of meningitis? (the signs that when you see these words, you know it is meningitis)
photophobia
nuchal rigidity
opisthotonic position
positive Kernig or Brudzinski sign
What are 3 education points to teach a family about regarding digoxin?
Dont skip a dose
Rinse mouth after administering-- can cause tooth decay
S/S of dig toxicity-- blurry vision, nausea and vomiting,
Hold for HR >90 infants and >70 in children
A nurse is assessing a child with suspected Meckel’s diverticulum. Which symptom is most characteristic of this condition?
A. Projectile vomiting and poor weight gain
B. Severe abdominal pain that improves after vomiting
C. Painless rectal bleeding with dark red or "currant jelly" stools
D. Frequent small, foul-smelling stools with mucus
(C) Painless rectal bleeding with currant jelly stools is the most characteristic symptom of Meckel’s diverticulum due to gastric tissue in the diverticulum causing irritation and bleeding.
The nurse is educating parents about possible long-term complications for a child with cleft palate. Which statement by the parents indicates they understand the teaching?
A. "My child may have speech difficulties and frequent ear infections."
B. "Once the cleft is repaired, my child won’t need speech therapy."
C. "My child will not have any dental problems since the palate was repaired early."
D. "Frequent sinus infections are the biggest concern for children with cleft palates."
Correct Answer: A. "My child may have speech difficulties and frequent ear infections."
🔹 Rationale: Children with cleft palates are at risk for speech delays due to muscle involvement and frequent otitis media (ear infections) due to Eustachian tube dysfunction. Speech therapy and dental care may be needed long-term.
What is the expected height and weight per year for school age children?
4.5-7lbs /yr
2-2.5 in/yr
Your patient is coming back from surgery with a VP shunt placed. What would be included in your nursing care/management?
Supine position-- allow fluid
Measure HC
Assess vitals-- monitor temp to assess for s/s infx
Pain management
Assess feeding behaviors
S/S of infective endocarditis?
Treatment and Nursing management for it
S/S: fever, splinter hemorrhages under nails, fatigue, loss of appetite, s/s of HF
Tx/NM:
-long term abx therapy in PICC line
- good oral hygiene
-carry card AHA
-notify PCP for flu like symptoms
The nurse is caring for a child with newly diagnosed celiac disease who is experiencing severe abdominal pain, vomiting, and lethargy. Which complication should the nurse suspect first?
A. Acute appendicitis
B. Small bowel obstruction
C. Lactose intolerance
D. Intussusception
(B) Small bowel obstruction is a serious complication of untreated celiac disease due to chronic inflammation and malabsorption. Severe abdominal pain, vomiting, and lethargy suggest an obstruction.
A pediatric nurse is caring for a child with a peptic ulcer. The physician prescribes a proton pump inhibitor (PPI). Which of the following is an appropriate intervention for the nurse to implement while the child is on this medication?
A. Encourage the child to eat foods that are high in fat.
B. Advise the child to take the PPI with meals to increase its effectiveness.
C. Monitor for signs of gastrointestinal bleeding or discomfort.
D. Instruct the family to administer the PPI with antacids for quicker relief.
Correct Answer: C. Monitor for signs of gastrointestinal bleeding or discomfort.
🔹 Rationale: PPIs reduce gastric acid secretion and help heal ulcers. Gastrointestinal bleeding is a potential side effect, so it’s important to monitor for symptoms like vomiting blood, black stools, or abdominal pain.
A nurse is providing anticipatory guidance to the parents of a 16-year-old. According to Erikson, which developmental task is the adolescent working to achieve?
A. Industry vs. Inferiority
B. Initiative vs. Guilt
C. Identity vs. Role Confusion
D. Intimacy vs. Isolation
C-- adolescents are focused on finding themselves. If unsuccessful, they may experience role confusion
The nurse is assessing an infant with spina bifida. The nurse knows the infant is at the highest risk for developing which associated condition?
A. Hydrocephalus
B. Cleft palate
C. Clubfoot
D. Tetralogy of Fallot
Correct Answer: A. Hydrocephalus
🔹 Rationale: Hydrocephalus (excess cerebrospinal fluid in the brain) is common in infants with myelomeningocele due to Arnold-Chiari malformation, requiring ventriculoperitoneal (VP) shunting.
A nurse is caring for an infant with Tetralogy of Fallot who suddenly develops cyanosis and difficulty breathing. What is the nurse’s priority action?
A. Administer oxygen at 2L via nasal cannula
B. Place the infant in a knee-chest position
C. Start IV fluids to prevent dehydration
D. Prepare for immediate intubation and ventilation
Correct Answer: B. Place the infant in a knee-chest position
🔹 Rationale: A "Tet spell" (hypercyanotic spell) occurs due to sudden increased right-to-left shunting. The knee-chest position increases systemic vascular resistance, which helps push more blood into the lungs for oxygenation. Oxygen may help, but positioning is the priority.
A nurse is providing discharge teaching for the parents of an infant who had surgical repair of hypospadias. Which statement by the parent indicates understanding?
A. “We should avoid giving our baby a bath until the catheter is removed.”
B. “We should expect some blood in the diaper for up to 2 weeks.”
C. “We will need to circumcise our baby in a few months.”
D. “We should limit our baby’s fluids to reduce urine output.”
Correct! (A) "We should avoid giving our baby a bath until the catheter is removed."
A 4-year-old child presents with signs of mild dehydration, including dry mucous membranes and decreased urine output. The nurse should anticipate the following intervention:
A. Administering oral rehydration solution (ORS) in small, frequent amounts
B. Starting intravenous fluids immediately
C. Administering diuretics to enhance fluid loss
D. Restricting fluids completely to prevent further loss
ct Answer: A. Administering oral rehydration solution (ORS) in small, frequent amounts
🔹 Rationale: For mild dehydration, oral rehydration solution (ORS) is the first-line treatment. ORS helps to replace both water and electrolytes and should be administered in small, frequent sips to prevent further fluid loss.
A adolescent male asks the nurse about expected physical changes during puberty. Which response by the nurse is most appropriate?
A. "Your voice may deepen, and you will grow facial hair."
B. "You won’t notice any major changes for a few more years."
C. "Girls and boys go through puberty at the exact same time."
D. "You will stop growing as soon as puberty starts."
A--puberty in males include voice deepening, growth spurts, facial hair, and increased muscle mass
A nurse is caring for a child diagnosed with a supratentorial brain tumor. Which clinical manifestation would the nurse expect?
A. Ataxia and poor coordination
B. Personality changes and seizures
C. Nystagmus and difficulty swallowing
D. Positive Babinski reflex and hypertonia
Correct Answer: B. Personality changes and seizures
🔹 Rationale: Supratentorial tumors occur in the cerebrum and can cause personality changes, seizures, and visual disturbances. Infratentorial tumors (in the cerebellum or brainstem) more commonly cause ataxia, coordination issues, and cranial nerve dysfunction.
A nurse is assessing a child with coarctation of the aorta (CoA). Which finding is characteristic of this condition?
A. Bounding pulses in the lower extremities
B. Systolic murmur heard at the left lower sternal border
C. Higher blood pressure in the arms than in the legs
D. Cyanosis that worsens with crying
Correct Answer: C. Higher blood pressure in the arms than in the legs
🔹 Rationale: Coarctation of the aorta causes narrowing of the aortic arch, leading to higher BP in the upper extremities and lower BP in the legs. Pulses in the lower extremities are often weak or absent.
A 2-year-old with severe nephrotic syndrome is hospitalized. The nurse notes the child has severe edema and ascites. What is the priority nursing intervention?
A. Encourage oral fluid intake to flush out excess fluid
B. Maintain strict infection control precautions
C. Apply compression stockings to reduce edema
D. Administer diuretics to relieve swelling
Correct! (D) Administer diuretics to relieve swelling
What would we do for a pt with mild FVD vs a patient with mod-severe
Mild-- giving PO, popsicles
Moderate to Severe-- giving IV fluids specifically isotonic first then hypotonic when hemodynamically stable