ATI Nursing care of child – compete study guide
Chapter 1 – family-centered nursing care
Family
o Defined as what an individual considers it to be
Family-centered nursing care
o Agreed – upon partnerships between families of children, nurses, and children benefit
o Respecting culture diversity and incorporating cultural views in the plan of care
o Understanding growth and developmental needs of children and their families
o Treating children and their families as client
o Working with all type of families
o Collaborating with families regarding hospitalization, home, and community resources
o Allowing families to serve as experts regarding their children’s health conditions, usual behaviors
in different situations, and routine needs
o Nurse should include that the developmental theory defines consistencies in how families change
Nursing consideration of promoting family-centered care
o Nurses should pay close attention when family members state that a child “isn’t acting right” or
has other concerns
o Children’s opinions should be considered when providing care
Identifying community resources for a single mother
o One parent responsible for care of children
o May result from death, divorce, desertion, birth outside marriage or adoption
o Likely to encounter several challenges because of economic, social, and personal restraints; one
person as homemaker, caregiver and financial provider
Parenting styles
o Dictatorial or Authoritarian
Parents try to control the child’s behaviors and attitudes through unquestioned ruled and
expectations
o Permissive
Parents exert little or no control over the child’s behaviors, and consult the child when
making decisions
o Democratic or Authorities
Parents direct the child’s behavior by setting rules and explaining the reason for each
rule setting
o Passive
Parents are uninvolved, indifferent and emotionally removed
Chapter 2 – physical assessment findings
Assessment of the head and neck of an infants
o Posterior fontanel closes by 6 to 8 weeks
o Anterior fontanel closes by 12 to 18 months
o Head circumference
Increase 2 cm each month for first 2 months
Then 2 cm for 4 to 6 months
0.5 cm for next 6 months
Assessment findings of abdomen
o Without tenderness, no guarding. Peristaltic waves may be visible in thinner children
o Shape symmetric and without protrusions around the umbilicus
o Infants and toddlers have rounded abdomens
o Children and adolescents should have flat abdomen
o Bowel sounds should be heard q5-30 seconds
o Descending colon: cylindric mass that is possibly palpable in the lower left quadrant due to the
presence of stool
Reportable vital sign
o Temperature: 36.6 – 37.5 C
o Pulse
Newborn: 80 – 180
1 week to 3 months: 80– 220
3 months to 2 years: 70 - 150
2 ears to 10 years: 60 – 110
10+ years: 50 – 90
o Respiration
, NB to 1 year: 30 – 35
1 year to 2 year: 25 – 30
2year to 6 year: 21-25
6 year to 12 year: 19 – 21
12+ years: 16 – 19
o BP
65-78 to 41-52
Chapter 3 – Health promotion of toddlers (1 to 3 years)
Negativism with food
o Toddlers often use negativism, or negative responses, as they begin to express their
independence
o Avoid asking yes or no questions, as the toddler’s usual response will be “no” whether he means it
or not
o Offering child, a simpler choice will give the toddler a sense of control
o The parent should not ask the toddler if he “want” to do something, if there is aurally no choice
o “do you want to use the red cup or blue cup?” is more appropriate then “do you want your milk
now?”
o Generally picky eaters who repeatedly request their favorite foods
o Physiological anorexia occurs, resulting in toddlers becoming fussy eaters because of a decreased
appetite
o Toddlers should consume 24 to 28 oz of milk/day and may switch form drinking whole mile to
drinking low-fat milk after 2 years of age
o Juice consumption should be limited to 4 to 6 oz/day
o Toddlers generally prefer finger foods because of increasing autonomy
Injury prevention
o Aspiration of foreign objects
Hold infant for feedings; do not prop bottles
Small objects that can become lodged in the throat should be avoided – grapes, coins,
candy
Age-appropriate toys should be provided
Clothing should be checked for safety hazards (loose buttons)
o Bodily harm
Infant should not be left unattended with any animals present
o Burns
Avoid arming formula in the microwave
Hot water temperature (thermostats) should be set at or below 49 (120)
Handles of pots and pans should be kept turned to the back of strove
Sunscreen should be used when infants are exposed to the sun
Electrical outlet should be covered
o Drowning
Infant should not be left alone (unattended) in bathtub or around the water sources such
as toilet, cleaning buckets or drainage area
o Falls
Crib mattress should be kept in the lowest position possible with the rails all the way up
Restraints should be used in infant seats
Infant seats should be placed on the ground or floor if used outside of the car
Place safety gates at the top and bottom of stairs
o Poisoning
Safety locks should be kept on cabinets that contain cleaners and other household
chemicals
The phone number for poison control center should be kept near the phone
Medications should be kept in childproof containers, always form the reach of child
A working carbon monoxide detector should be kept in the home
o Motor-vehicle injuries
Infants and toddlers remain in the rare-facing car seat until age of 2 years of the height
recommended by the manufacture
o Suffocation
Plastic bags should be avoided
Crib mattress should fit snugly
Crib slates should be no farther apart then 6 cm (2.375 in)
Crib mobile and crib gyms should be removed by 4 to 5 months of age
Pillow should be kept out of the crib
Infant should be placed on their back for sleep
, Drawstrings should be removed from jacket and other clothing
Chapter 4
Chapter 5 – health promotion of preschoolers (3 to 6)
Physical development
o Weight – gain about 2 to 3 kg (4.5 to 6.5 lb) per year
o Hight – 6.5 to 9 cm (2.5 to 3.5 in) per year
Motor skills
o 3 years
Ride tricycle, jump off bottom step, stands on one foot for few seconds
o 4 years
Skip & hold on one foot, throw ball over head, catch ball reliably
o 5 years
Jumping rope, walks backward w/head to toe. Throws and catches a ball with
ease
Cognitive development
o Piaget – preoperational phase
Social awareness and ability to consider viewpoints of others
Magical thinking – thoughts are all powerful and can cause events occur
Animism – ascribing lifelike qualities to inanimate objects
Time – preschoolers begin to understand the sequence of daily events. Time is
best explained to them in relation to an event.
Psychosocial development
o Erickson
Intuitive vs Guilt
Guilt can occur when preschoolers believe they have misbehaved or when they
are unable to accomplish a task
o Kohlberg
Early preschoolers continue in the good-bad orientation of the toddler years,
and actions are taken based on whether or not it will result in a reward or
punishment
Beginning to understand the concepts of justice and fairness
Self-concept development -During stress, insecurity or illness
o preschooler can regress to previous immature behaviors or develop habits (nose
picking, bed-wetting, thumb sucking)
pretend play is healthy and allows preschoolers to determine the difference between reality
and fantasy
Age-appropriate activities
o Associative play
o Play ball, putting puzzles together, riding tricycles
o Playing pretend and dress-up activities, role playing
Nutrition
o 1,800 Kcal
Protein – 13 to 19 g/day
Saturated fat – 10 %
Total fat – 20 to 30 % of total caloric intake
Sleep and rest
o 12 hours sleep/day
o Night terrors
Keep a consistent bedtime routine
Use a night-light in the room
Provide the child with a favorite toy
Leave a drink of water by the bed
Reassure preschooler who are frightened, but avoid allowing preschoolers to
sleep with their parents
Dental health
Chapter 1 – family-centered nursing care
Family
o Defined as what an individual considers it to be
Family-centered nursing care
o Agreed – upon partnerships between families of children, nurses, and children benefit
o Respecting culture diversity and incorporating cultural views in the plan of care
o Understanding growth and developmental needs of children and their families
o Treating children and their families as client
o Working with all type of families
o Collaborating with families regarding hospitalization, home, and community resources
o Allowing families to serve as experts regarding their children’s health conditions, usual behaviors
in different situations, and routine needs
o Nurse should include that the developmental theory defines consistencies in how families change
Nursing consideration of promoting family-centered care
o Nurses should pay close attention when family members state that a child “isn’t acting right” or
has other concerns
o Children’s opinions should be considered when providing care
Identifying community resources for a single mother
o One parent responsible for care of children
o May result from death, divorce, desertion, birth outside marriage or adoption
o Likely to encounter several challenges because of economic, social, and personal restraints; one
person as homemaker, caregiver and financial provider
Parenting styles
o Dictatorial or Authoritarian
Parents try to control the child’s behaviors and attitudes through unquestioned ruled and
expectations
o Permissive
Parents exert little or no control over the child’s behaviors, and consult the child when
making decisions
o Democratic or Authorities
Parents direct the child’s behavior by setting rules and explaining the reason for each
rule setting
o Passive
Parents are uninvolved, indifferent and emotionally removed
Chapter 2 – physical assessment findings
Assessment of the head and neck of an infants
o Posterior fontanel closes by 6 to 8 weeks
o Anterior fontanel closes by 12 to 18 months
o Head circumference
Increase 2 cm each month for first 2 months
Then 2 cm for 4 to 6 months
0.5 cm for next 6 months
Assessment findings of abdomen
o Without tenderness, no guarding. Peristaltic waves may be visible in thinner children
o Shape symmetric and without protrusions around the umbilicus
o Infants and toddlers have rounded abdomens
o Children and adolescents should have flat abdomen
o Bowel sounds should be heard q5-30 seconds
o Descending colon: cylindric mass that is possibly palpable in the lower left quadrant due to the
presence of stool
Reportable vital sign
o Temperature: 36.6 – 37.5 C
o Pulse
Newborn: 80 – 180
1 week to 3 months: 80– 220
3 months to 2 years: 70 - 150
2 ears to 10 years: 60 – 110
10+ years: 50 – 90
o Respiration
, NB to 1 year: 30 – 35
1 year to 2 year: 25 – 30
2year to 6 year: 21-25
6 year to 12 year: 19 – 21
12+ years: 16 – 19
o BP
65-78 to 41-52
Chapter 3 – Health promotion of toddlers (1 to 3 years)
Negativism with food
o Toddlers often use negativism, or negative responses, as they begin to express their
independence
o Avoid asking yes or no questions, as the toddler’s usual response will be “no” whether he means it
or not
o Offering child, a simpler choice will give the toddler a sense of control
o The parent should not ask the toddler if he “want” to do something, if there is aurally no choice
o “do you want to use the red cup or blue cup?” is more appropriate then “do you want your milk
now?”
o Generally picky eaters who repeatedly request their favorite foods
o Physiological anorexia occurs, resulting in toddlers becoming fussy eaters because of a decreased
appetite
o Toddlers should consume 24 to 28 oz of milk/day and may switch form drinking whole mile to
drinking low-fat milk after 2 years of age
o Juice consumption should be limited to 4 to 6 oz/day
o Toddlers generally prefer finger foods because of increasing autonomy
Injury prevention
o Aspiration of foreign objects
Hold infant for feedings; do not prop bottles
Small objects that can become lodged in the throat should be avoided – grapes, coins,
candy
Age-appropriate toys should be provided
Clothing should be checked for safety hazards (loose buttons)
o Bodily harm
Infant should not be left unattended with any animals present
o Burns
Avoid arming formula in the microwave
Hot water temperature (thermostats) should be set at or below 49 (120)
Handles of pots and pans should be kept turned to the back of strove
Sunscreen should be used when infants are exposed to the sun
Electrical outlet should be covered
o Drowning
Infant should not be left alone (unattended) in bathtub or around the water sources such
as toilet, cleaning buckets or drainage area
o Falls
Crib mattress should be kept in the lowest position possible with the rails all the way up
Restraints should be used in infant seats
Infant seats should be placed on the ground or floor if used outside of the car
Place safety gates at the top and bottom of stairs
o Poisoning
Safety locks should be kept on cabinets that contain cleaners and other household
chemicals
The phone number for poison control center should be kept near the phone
Medications should be kept in childproof containers, always form the reach of child
A working carbon monoxide detector should be kept in the home
o Motor-vehicle injuries
Infants and toddlers remain in the rare-facing car seat until age of 2 years of the height
recommended by the manufacture
o Suffocation
Plastic bags should be avoided
Crib mattress should fit snugly
Crib slates should be no farther apart then 6 cm (2.375 in)
Crib mobile and crib gyms should be removed by 4 to 5 months of age
Pillow should be kept out of the crib
Infant should be placed on their back for sleep
, Drawstrings should be removed from jacket and other clothing
Chapter 4
Chapter 5 – health promotion of preschoolers (3 to 6)
Physical development
o Weight – gain about 2 to 3 kg (4.5 to 6.5 lb) per year
o Hight – 6.5 to 9 cm (2.5 to 3.5 in) per year
Motor skills
o 3 years
Ride tricycle, jump off bottom step, stands on one foot for few seconds
o 4 years
Skip & hold on one foot, throw ball over head, catch ball reliably
o 5 years
Jumping rope, walks backward w/head to toe. Throws and catches a ball with
ease
Cognitive development
o Piaget – preoperational phase
Social awareness and ability to consider viewpoints of others
Magical thinking – thoughts are all powerful and can cause events occur
Animism – ascribing lifelike qualities to inanimate objects
Time – preschoolers begin to understand the sequence of daily events. Time is
best explained to them in relation to an event.
Psychosocial development
o Erickson
Intuitive vs Guilt
Guilt can occur when preschoolers believe they have misbehaved or when they
are unable to accomplish a task
o Kohlberg
Early preschoolers continue in the good-bad orientation of the toddler years,
and actions are taken based on whether or not it will result in a reward or
punishment
Beginning to understand the concepts of justice and fairness
Self-concept development -During stress, insecurity or illness
o preschooler can regress to previous immature behaviors or develop habits (nose
picking, bed-wetting, thumb sucking)
pretend play is healthy and allows preschoolers to determine the difference between reality
and fantasy
Age-appropriate activities
o Associative play
o Play ball, putting puzzles together, riding tricycles
o Playing pretend and dress-up activities, role playing
Nutrition
o 1,800 Kcal
Protein – 13 to 19 g/day
Saturated fat – 10 %
Total fat – 20 to 30 % of total caloric intake
Sleep and rest
o 12 hours sleep/day
o Night terrors
Keep a consistent bedtime routine
Use a night-light in the room
Provide the child with a favorite toy
Leave a drink of water by the bed
Reassure preschooler who are frightened, but avoid allowing preschoolers to
sleep with their parents
Dental health
