Chamberlain College x
Of Nursing Nr322
x x x
x Ese Study Guide
x x
Medication xcalculations x(IM, xmg x& xml; xIV-gtt/min)
Growth x& xDevelopment xTables xH x182-184
❖ Infant x(birth xto xone xyear)
• Developmental xmilestones
o Birth xweight xdoubles xby x6 xmonths
▪ Triples xby x12 xmonths
o Birth xlength xincreases xby x50% xat x12 xmonths
o Posterior xfontanel xcloses xby x8 xweeks
o Social xsmile xoccurs xat x2 xmonths
o Head xturns xto xlocate xsounds xat x3 xmonths
o Moro xreflex xdisappears xaround x4 xmonths
o Steady xhead xcontrol xis xachieved xat x4 xmonths
o Rolls xfrom xabdomen xto xback xand xback xto xabdomen xat x5-6 xmonths
o Plays xpeek-a- xboo xafter x6 xmonths
o Transfers xobjects xfrom xhand xto xhand xat x7 xmonths
o Develops xstranger xanxiety xat x7-9 xmonths
o Sits xunsupported xat x8 xmonths
o Crawls xat x10 xmonths
o Fine xpincer xgrasp xappears xat x10 x-12 xmonths
o Waves xbye xbye xat x10 xmonths
o Walks xwith xassistance xat x10-12 xmonths
o Says xa xfew xwords xin xaddition xto x“mama” xor x“dada” xat x12 xmonths
o Explores xenvironment xby xmotor xand xoral xmeans
• Erickson’s xtheory: xdeveloping xa xsense xof xtrust x( xtrust xvs xmistrust)
• Nursing ximplications
o During xhospitalization xthe xinfants xemerging xskills xmay xdisappear
1
,HESI xRN xPeds xHesi
x(1)
o If xthe xparents xare xnot xbale xto xbe xwith xthe xinfant xthe xbaby
may xbe xinconsolable xdue xto xseparation xanxiety
x
o The xnurse xshould xplan xto xhave xthe xparents xbe xpart xof xthe xinfant’s xcare
and xshould xencourage xthem xto xdo xso
x
o Respect xthe xinfant’s xschedule xat xhome xby xassessing xand
implementing xcomponents xas xpossible
x
o Preparation xand xteaching xshould xbe xdirected xto xthe xfamily xhowever
the xnurse xshould xalways xspeak xto xthe xinfant xespecially xwhile
x
x performing xpainful xor xstressful xprocedures
o Toys xfor xhospitalized xinfants xinclude:
▪ Mobiles
▪ Rattles
▪ Squeaking xtoys
▪ Picture xbooks
▪ Balls
▪ Colored xblocks
▪ Activity xboxes
❖ Toddler x(1-3 xyears)
• Developmental xmilestones
o Birth xweight xquadruples xby x30 xmonths
o Achieves x50% xof xadult xheight xby x2 xyears
o Growth xvelocity xslows
o Appears xto xbe xbowlegged xand xpotbellied
o All xprimary xteeth x(20) xare xpresent
o Anterior xfontanel xcloses xby x12-18 xmonths
o Throws xa xball xoverhand xat x18 xmonths
o Kicks xa xball xat x24 xmonths
o Feeds xself xwith xspoon xand xcup xat x2 xyears
o Daytime xtoilet xtraining xcan xusually xbe xstarted xaround x2 xyears
o Two xto xthree xword xsentences xare xspoken xby x2 xyears
2
,HESI xRN xPeds xHesi
x(1)
o Three xto xfour xword xsentence xspoken xby x3 xyears
o Own xfirst xand xlast xname xcan xbe xstated xby x2 x½ xto x3 xyears
o Temper xtantrums xare xcommon
• Erikson’s xtheory: xdeveloping xa xsense xof xautonomy x( xautonomy xvs xdoubt
xand xshame)
• Nursing ximplications
o Give xsimple xbrief xexplanations xbefore xprocedures xkeeping xin xmind xthat
a x1 xyear xold xdoes xnot xbenefit xfrom xthe xsame xexplanation xas xthat
x
x given xto xa x3 xyear xold
o During xhospitalization xenforced xseparation xfrom xparents xis xthe
greatest xthreat xto xthe xtoddler’s xpsychological xand xemotional
x
x integrity
o Security xobjects xor xfavorite xtoys xfrom xhome xshould xbe xprovided
for xa xtoddler
x
o Teach xparents xto xexplain xtheir xplans xto xthe xchild
o Respect xthe xchild’s xroutine xand ximplement xwhen xpossible
o Expect xregression xlike xbed xwetting
o Toys xfor xhospitalized xtoddlers xinclude xboard xand xmallet, xpush xpull xtoys,
toy xtelephones, xstuffed xanimals, xstory xbooks xwith xpictures, xdepending
x
x on xthe xreason xfor xhospitalization. xToddlers xbenefit xform xbeing xtaken
x to xthe xhospital xplayroom xwhen xable xbecause xmobility xis xvery
x important xto xtheir xdevelopment
o Toddlers xare xlearning xto xname xbody xparts xand xare xconcerned xabout
their xbodies
x
o Very xbasic xexplanations xshould xbe xgiven xto xtoddlers xabout xprocedures
o Autonomy xshould xbe xsupported xby xproviding xguided xchoices
when xappropriate
x
❖ Preschool xchild x(3-6 xyears)
• Developmental xmilestones
o Each xyear xa xchild xgains xabout x5 xlbs xand xgrows x2 x½ xto x3 xinches
o A xchild xstands xerect xwith xmore xslender xposture
3
, HESI xRN xPeds xHesi
x(1)
o A xchild xlearns xto xrun xjump xskip xand xhop
o A x3 xyear xold xcan xride xa xtricycle
o Handedness xis xestablished
o A xchild xuses xscissors xat x4 xyrs
o A xchild xties xshoelaces xat x5 xyrs
o A xchild xlearns xcolors xand xshapes
o Visual xacuity xapproaches x20/20
o Thinking xis xegocentric xand xconcrete
o A xchild xuses xsentences xof xfive xto xeight xwords
o A xchild xlearns xsexual xidentity x(curiosity xand xmasturbation xare xcommon)
o Imaginary xplaymates xand xfears xare xcommon
o Aggressiveness xat x4 xyrs xis xreplaced xby xmore xindependence xat x5 xyears
• Erikson’s xtheory: xdeveloping xa xsense xof xinitiative x(initiative xvs xguilt)
• Nursing ximplications
o Nursing xcare xfor xhospitalized xpreschoolers xshould xemphasize
x understanding xof xthe xchild’s xegocentricity. xExplain xthat xhe xor xshe xdid
not xcause xthe xillness xand xthat xpainful xprocedures xare xnot xa
x
x punishment xfor xmisdeeds
o The xchild’s xquestions xshould xbe xanswered xat xthe xchild’s xlevel xuse
simple xwords xthat xwill xbe xunderstood xby xthe xchild
x
o Therapeutic xplay xor xmedical xplay xthat xallows xthe xchild xto xact xout xhis
or xher xexperiences xis xhelpful
x
o Fear xof xmutilation xby xprocedures xis xcommon xa xband x– xaid xmay xbe
quite xhelpful xin xrestoring xbody xintegrity
x
o Toys xand xplay xfor xthe xhospitalized xpreschooler xinclude xcoloring
x books, xpuzzles, xcutting xand xpasting, xdolls, xbuilding xblocks, xclay xand
x toys xthat xallow xthe xpreschooler xto xwork xout xhospitalization
experiences xdepending xon xthe xreason xfor xhospitalization
x
o The xpreschooler xneeds xpreparation xfor xprocedures xhe xor xshe xshould
x understand xwhat xis xand xwhat xis xnot xgoing xto xbe x“fixed” xsimple
explanations
x
4