Peds and Maternity HESI hints Questions Answered 100% correct

Peds and Maternity HESI hints Questions Answered 100% correct Health promotion The best place to check cap refill is on the childs sternum Know normal growth and development for evaluations of interventions and therapy. Steady head control would show thyroid hormone therapy for a 4 month old is effective because head control is an expected milestone for a 4 mo old and It indicates therapy is adequate for growth Infant Milestones (birth to a year) -birth weight doubles by 6 months; triples by 12 - birth weight increases by 50% at 12 months - explores environment by motor and oral means -toys: squeaking, picture books, balls, colored blocks, activity boxes Toldder milestones (1-3 years) - birth weight quadruples by 30 months - 50% of adult height by 2 years - growth velocity slows - give brief simple explanations - let kid have security object - toys: board and mallet, push-pull, toy telephones, stuffed animals, storybooks, hospital playroom Preschool milestones (3-6 years) 3 year old can ride a tricycle 4 year old can use scissors child learns colors and shapes Visual acuity approaches 22/20 imaginary playmates and fears egocentricity therapeutic play toys: coloring books, puzzles, cutting and pasting, dolls, building blocks, clay School aged child milestones (6-12 years) - Maintain contact with peers and school in hospital - explain all procedures: verbally, pictures, books, equipment - privacy - participation in care - toys: board games, card games., hobbies (collections), video games - eriksons industry development which means they like to accomplish skills and peers are important Tanner stages of development - Girls: breast, rapid increase of height and weight, pubic and axillary hair, menstruation, abrupt deceleration of linear growth -Boys: enlargement of testicles, pubic and axillary hair, facial hair, rapid increase in height, changes in voice, nocturnal emissions, abrupt deceleration of linear growth Adolescent Milestones (12-19 years) - adult-like thinking at 15 (abstract and problem solving) -Eriskons identity phase - maintain contact with peers and school - share room with another teen -hospitalization can effect teens body image - direct talking to teen, teach without parents - help maintain identity with own clothes, posters) - focus on here and now "how will It effect me today" - accident prevention is major to prevent death Review of age groups - Birth doubles in length by 4 years - head control at 4 months - Child can sit unsupported by 8 months - child achieves 50% adult height by 2 years - Child can throw a ball overhand by 18 months - Child can speak two-three word sentences by 2 years - Child can tie shoes at 5 years - Girls growth spurt happens before boys (10 years) - Temper tantrums are common in toddlers/ normal -adolescent gets rebellion towards parents and family values Age concepts of injury - Infant: after 6 months they can remember pain - Toddlers: fear intrusive procedures - Preschoolers: fear body mutilation - School age: fear loss of control of bodies - Adolescent: body image concerns Diseases -German measles should be screened for to prevent harm to child in pregnancy - DTaP be aware of history of seizures, neuro symptoms after vaccine, allergic reactions - MMR: (measles, mumps, and rubella) history of anaphylactic reactions to eggs or neomycin - Common cold is not a contraindication for vaccines - temp 102/ 38.8; irritable, redness, soreness at injection site for 2-3 days are all normal for DTaP and IPV (polio) - Call provider if seizures, high fever or high pitched cry - Warm washcloth on thigh injection site and "bicycling" the legs with each diaper change decreases soreness - Acetaminophen is administered orally every 4-6 hours - Pertussis fatalities are high in non immunized kids Diarrhea Make sure child does not have otitis media when taking temp in the ear Add potassium to IV fluids only when client has adequate urine output IV isotonic fluids are used (lactated ringers or normal saline fluid bolus of 20 mL/kg Urinary output for kids should be 1-2mL/kg/hr specific gravity should be less than 1.025 Poisonings Syrup of ipeac is not used; do not induce vomiting if kid is poisoned because It can cause more damage common house poisonings: perfume, alc, sunburn products, cigs, mouthwash Chelating agents (for lead poisoning) should not be used in kids with allergy to peanuts; when giving monitor CBC and renal functioning More lead is absorbed on empty stomach; only use cold water because hot water contains more lead Name two contraindications to live virus vaccines immunocompromised child and child who lives with someone who is immunocompromised list three classic signs and symptoms of measles photophobia confluent rash that begins on the face and spreads downward Koplik spots on the buccal mucosa List the signs and symptoms of iron deficiency anemia; pale conjunctive; pale skin; atrophy of papillae on tongue; brittle, ridged, or spoon-shaped nails; and thyroid edema identify food sources of vitamin A liver, sweet potatoes, carrots, spinach, peaches, apricots what disease occurs with vitamin C deficiency? Scurvy What measurements reflect present nutritional status? Weight, skinfold thickness, arm circumference List the signs and symptoms of dehydration in an infant Poor skin turgor, absence of tears, dry mucous membranes, weight loss, depressed fontanel, decreased urine list the laboratory findings that can be expected in a dehydrated child low bicarbinate, decreased pH, loss of sodium (hyponatremia), hypokalemia, elevated hct and BUN How should burns in children be assessed? By using the Lund-Browder chart, which takes into account the changing proportions of the child's body How can the nurse best evaluate the adequacy of fluid replacement in children? Monitoring urine output How should a parent be instructed to childproof a house? Lock all cabinets with toxic household items in them, examine the house from childs POV What interventions should the nurse perform first in caring for a child who has ingested a poison? Assess respiratory, cardiac and neuro status What early signs should the nurse assess for if lead poisoning is suspected? anemia, cramping, abd pain, vomiting, constipation, aggression, anorexia, headache, lethargy, hyperactivity, impulsiveness, decreased interest to play, short attention span symptoms of hypoxia - Early: Restlessness, anxiety, tachycardia/ tachypnea - Late: bradycardia, extreme restlessness, severe dyspnea - babies: difficulty feeding, inspiratory stridor, nares, grunting on expiration, sternal retractions Normal pulse and respiratory rates Newborn - Pulse: 100-160 -RR: 30-60 1-11 months: - Pulse: 100-150 -RR: 25-35 1-3 (toddler) -Pulse: 80-130 -RR: 20-30 3-5 (preschooler) - Pulse: 80-120 -RR: 20-25 6-10 (school age) - Pulse: 70-110 -RR: 18-22 10-16 (adolescent) - Pulse: 60-90 -RR: 16-20 Respiratory disorders - in cystic fibrosis a kid needs 150% of calorie intake for growth and development; It is tested after birth and is usually diagnosed within the first month before signs appear -signs of respiratory distress: restless, increased RR, increased pulse, diaphoresis; flaring nostrils, retractions, grunting, accessory muscles, breath sounds or absent breath sounds, head bobbing, cyanosis, pallor, alternations in mental status - in tonsilitis It is important to administer pain meds because they also have a cough suppressant effect because if kid coughs It will loosen clots and cause bleeding Describe the purpose of bronchodilators To help open the airways by relaxing the bronchial muscles What are the physical assessment findings for a child with asthma? Expiratory wheezing, rales, tight cough, signs of altered blood gases What nutritional support should be provided for a child with cystic fibrosis? Pancreatic enzyme replacement, fat soluble vitamins, moderate to low carbs, high protein, mod to high fats Genetic counseling is important because It is autosomal recessive