HESI RN Peds Hesi (1)
Chamberlain College of Nursing
NR322 ESE Study Guide
Medication calculations (IM, mg & ml; IV-gtt/min)
Growth & Development Tables H 182-184
❖ Infant (birth to one year)
• Developmental milestones
o Birth weight doubles by 6 months
▪ Triples by 12 months
o Birth length increases by 50% at 12 months
o Posterior fontanel closes by 8 weeks
o Social smile occurs at 2 months
o Head turns to locate sounds at 3 months
o Moro reflex disappears around 4 months
o Steady head control is achieved at 4 months
o Rolls from abdomen to back and back to abdomen at 5-6 months
o Plays peek-a- boo after 6 months
o Transfers objects from hand to hand at 7 months
o Develops stranger anxiety at 7-9 months
o Sits unsupported at 8 months
o Crawls at 10 months
o Fine pincer grasp appears at 10 -12 months
o Waves bye bye at 10 months
o Walks with assistance at 10-12 months
o Says a few words in addition to “mama” or “dada” at 12 months
o Explores environment by motor and oral means
• Erickson’s theory: developing a sense of trust ( trust vs mistrust)
• Nursing implications
o During hospitalization the infants emerging skills may disappear
1
,HESI RN Peds Hesi (1)
o If the parents are not bale to be with the infant the baby may be
inconsolable due to separation anxiety
o The nurse should plan to have the parents be part of the infant’s care and
should encourage them to do so
o Respect the infant’s schedule at home by assessing and implementing
components as possible
o Preparation and teaching should be directed to the family however the
nurse should always speak to the infant especially while performing
painful or stressful procedures
o Toys for hospitalized infants include:
▪ Mobiles
▪ Rattles
▪ Squeaking toys
▪ Picture books
▪ Balls
▪ Colored blocks
▪ Activity boxes
❖ Toddler (1-3 years)
• Developmental milestones
o Birth weight quadruples by 30 months
o Achieves 50% of adult height by 2 years
o Growth velocity slows
o Appears to be bowlegged and potbellied
o All primary teeth (20) are present
o Anterior fontanel closes by 12-18 months
o Throws a ball overhand at 18 months
o Kicks a ball at 24 months
o Feeds self with spoon and cup at 2 years
o Daytime toilet training can usually be started around 2 years
o Two to three word sentences are spoken by 2 years
2
,HESI RN Peds Hesi (1)
o Three 2ato 2afour 2aword 2asentence 2aspoken 2aby 2a3 2ayears
o Own 2afirst 2aand 2alast 2aname 2acan 2abe 2astated 2aby 2a2 2a½ 2ato 2a3 2ayears
o Temper 2atantrums 2aare 2acommon
• Erikson’s 2atheory: 2adeveloping 2aa 2asense 2aof 2aautonomy 2a( 2aautonomy 2avs
2adoubt 2aand 2ashame)
• Nursing 2aimplications
o Give 2asimple 2abrief 2aexplanations 2abefore 2aprocedures 2akeeping 2ain 2amind
2athat 2aa 2a1 2ayear 2aold 2adoes 2anot 2abenefit 2afrom 2athe 2asame 2aexplanation
2aas 2athat 2agiven 2ato 2aa 2a3 2ayear 2aold
o During 2ahospitalization 2aenforced 2aseparation 2afrom 2aparents 2ais 2athe
2agreatest 2athreat 2ato 2athe 2atoddler’s 2apsychological 2aand 2aemotional
2aintegrity
o Security 2aobjects 2aor 2afavorite 2atoys 2afrom 2ahome 2ashould 2abe
2aprovided 2afor 2aa 2atoddler
o Teach 2aparents 2ato 2aexplain 2atheir 2aplans 2ato 2athe 2achild
o Respect 2athe 2achild’s 2aroutine 2aand 2aimplement 2awhen 2apossible
o Expect 2aregression 2alike 2abed 2awetting
o Toys 2afor 2ahospitalized 2atoddlers 2ainclude 2aboard 2aand 2amallet, 2apush 2apull
2atoys, 2atoy 2atelephones, 2astuffed 2aanimals, 2astory 2abooks 2awith 2apictures,
2adepending 2aon 2athe 2areason 2afor 2ahospitalization. 2aToddlers 2abenefit
2aform 2abeing 2ataken 2ato 2athe 2ahospital 2aplayroom 2awhen 2aable 2abecause
2amobility 2ais 2avery 2aimportant 2ato 2atheir 2adevelopment
o Toddlers 2aare 2alearning 2ato 2aname 2abody 2aparts 2aand 2aare 2aconcerned
2aabout 2atheir 2abodies
o Very 2abasic 2aexplanations 2ashould 2abe 2agiven 2ato 2atoddlers 2aabout 2aprocedures
o Autonomy 2ashould 2abe 2asupported 2aby 2aproviding 2aguided 2achoices
2awhen 2aappropriate
❖ Preschool 2achild 2a(3-6 2ayears)
• Developmental 2amilestones
o Each 2ayear 2aa 2achild 2agains 2aabout 2a5 2albs 2aand 2agrows 2a2 2a½ 2ato 2a3 2ainches
o A 2achild 2astands 2aerect 2awith 2amore 2aslender 2aposture
3
, HESI RN Peds Hesi (1)
o A 2achild 2alearns 2ato 2arun 2ajump 2askip 2aand 2ahop
o A 2a3 2ayear 2aold 2acan 2aride 2aa 2atricycle
o Handedness 2ais 2aestablished
o A 2achild 2auses 2ascissors 2aat 2a4 2ayrs
o A 2achild 2aties 2ashoelaces 2aat 2a5 2ayrs
o A 2achild 2alearns 2acolors 2aand 2ashapes
o Visual 2aacuity 2aapproaches 2a20/20
o Thinking 2ais 2aegocentric 2aand 2aconcrete
o A 2achild 2auses 2asentences 2aof 2afive 2ato 2aeight 2awords
o A 2achild 2alearns 2asexual 2aidentity 2a(curiosity 2aand 2amasturbation 2aare 2acommon)
o Imaginary 2aplaymates 2aand 2afears 2aare 2acommon
o Aggressiveness 2aat 2a4 2ayrs 2ais 2areplaced 2aby 2amore 2aindependence 2aat 2a5 2ayears
• Erikson’s 2atheory: 2adeveloping 2aa 2asense 2aof 2ainitiative 2a(initiative 2avs 2aguilt)
• Nursing 2aimplications
o Nursing 2acare 2afor 2ahospitalized 2apreschoolers 2ashould 2aemphasize
2aunderstanding 2aof 2athe 2achild’s 2aegocentricity. 2aExplain 2athat 2ahe 2aor
2ashe 2adid 2anot 2acause 2athe 2aillness 2aand 2athat 2apainful 2aprocedures 2aare
2anot 2aa 2apunishment 2afor 2amisdeeds
o The 2achild’s 2aquestions 2ashould 2abe 2aanswered 2aat 2athe 2achild’s 2alevel
2ause 2asimple 2awords 2athat 2awill 2abe 2aunderstood 2aby 2athe 2achild
o Therapeutic 2aplay 2aor 2amedical 2aplay 2athat 2aallows 2athe 2achild 2ato 2aact 2aout
2ahis 2aor 2aher 2aexperiences 2ais 2ahelpful
o Fear 2aof 2amutilation 2aby 2aprocedures 2ais 2acommon 2aa 2aband 2a– 2aaid
2amay 2abe 2aquite 2ahelpful 2ain 2arestoring 2abody 2aintegrity
o Toys 2aand 2aplay 2afor 2athe 2ahospitalized 2apreschooler 2ainclude 2acoloring
2abooks, 2apuzzles, 2acutting 2aand 2apasting, 2adolls, 2abuilding 2ablocks, 2aclay
2aand 2atoys 2athat 2aallow 2athe 2apreschooler 2ato 2awork 2aout 2ahospitalization
2aexperiences 2adepending 2aon 2athe 2areason 2afor 2ahospitalization
o The 2apreschooler 2aneeds 2apreparation 2afor 2aprocedures 2ahe 2aor 2ashe
2ashould 2aunderstand 2awhat 2ais 2aand 2awhat 2ais 2anot 2agoing 2ato 2abe 2a“fixed”
2asimple 2aexplanations
4
Chamberlain College of Nursing
NR322 ESE Study Guide
Medication calculations (IM, mg & ml; IV-gtt/min)
Growth & Development Tables H 182-184
❖ Infant (birth to one year)
• Developmental milestones
o Birth weight doubles by 6 months
▪ Triples by 12 months
o Birth length increases by 50% at 12 months
o Posterior fontanel closes by 8 weeks
o Social smile occurs at 2 months
o Head turns to locate sounds at 3 months
o Moro reflex disappears around 4 months
o Steady head control is achieved at 4 months
o Rolls from abdomen to back and back to abdomen at 5-6 months
o Plays peek-a- boo after 6 months
o Transfers objects from hand to hand at 7 months
o Develops stranger anxiety at 7-9 months
o Sits unsupported at 8 months
o Crawls at 10 months
o Fine pincer grasp appears at 10 -12 months
o Waves bye bye at 10 months
o Walks with assistance at 10-12 months
o Says a few words in addition to “mama” or “dada” at 12 months
o Explores environment by motor and oral means
• Erickson’s theory: developing a sense of trust ( trust vs mistrust)
• Nursing implications
o During hospitalization the infants emerging skills may disappear
1
,HESI RN Peds Hesi (1)
o If the parents are not bale to be with the infant the baby may be
inconsolable due to separation anxiety
o The nurse should plan to have the parents be part of the infant’s care and
should encourage them to do so
o Respect the infant’s schedule at home by assessing and implementing
components as possible
o Preparation and teaching should be directed to the family however the
nurse should always speak to the infant especially while performing
painful or stressful procedures
o Toys for hospitalized infants include:
▪ Mobiles
▪ Rattles
▪ Squeaking toys
▪ Picture books
▪ Balls
▪ Colored blocks
▪ Activity boxes
❖ Toddler (1-3 years)
• Developmental milestones
o Birth weight quadruples by 30 months
o Achieves 50% of adult height by 2 years
o Growth velocity slows
o Appears to be bowlegged and potbellied
o All primary teeth (20) are present
o Anterior fontanel closes by 12-18 months
o Throws a ball overhand at 18 months
o Kicks a ball at 24 months
o Feeds self with spoon and cup at 2 years
o Daytime toilet training can usually be started around 2 years
o Two to three word sentences are spoken by 2 years
2
,HESI RN Peds Hesi (1)
o Three 2ato 2afour 2aword 2asentence 2aspoken 2aby 2a3 2ayears
o Own 2afirst 2aand 2alast 2aname 2acan 2abe 2astated 2aby 2a2 2a½ 2ato 2a3 2ayears
o Temper 2atantrums 2aare 2acommon
• Erikson’s 2atheory: 2adeveloping 2aa 2asense 2aof 2aautonomy 2a( 2aautonomy 2avs
2adoubt 2aand 2ashame)
• Nursing 2aimplications
o Give 2asimple 2abrief 2aexplanations 2abefore 2aprocedures 2akeeping 2ain 2amind
2athat 2aa 2a1 2ayear 2aold 2adoes 2anot 2abenefit 2afrom 2athe 2asame 2aexplanation
2aas 2athat 2agiven 2ato 2aa 2a3 2ayear 2aold
o During 2ahospitalization 2aenforced 2aseparation 2afrom 2aparents 2ais 2athe
2agreatest 2athreat 2ato 2athe 2atoddler’s 2apsychological 2aand 2aemotional
2aintegrity
o Security 2aobjects 2aor 2afavorite 2atoys 2afrom 2ahome 2ashould 2abe
2aprovided 2afor 2aa 2atoddler
o Teach 2aparents 2ato 2aexplain 2atheir 2aplans 2ato 2athe 2achild
o Respect 2athe 2achild’s 2aroutine 2aand 2aimplement 2awhen 2apossible
o Expect 2aregression 2alike 2abed 2awetting
o Toys 2afor 2ahospitalized 2atoddlers 2ainclude 2aboard 2aand 2amallet, 2apush 2apull
2atoys, 2atoy 2atelephones, 2astuffed 2aanimals, 2astory 2abooks 2awith 2apictures,
2adepending 2aon 2athe 2areason 2afor 2ahospitalization. 2aToddlers 2abenefit
2aform 2abeing 2ataken 2ato 2athe 2ahospital 2aplayroom 2awhen 2aable 2abecause
2amobility 2ais 2avery 2aimportant 2ato 2atheir 2adevelopment
o Toddlers 2aare 2alearning 2ato 2aname 2abody 2aparts 2aand 2aare 2aconcerned
2aabout 2atheir 2abodies
o Very 2abasic 2aexplanations 2ashould 2abe 2agiven 2ato 2atoddlers 2aabout 2aprocedures
o Autonomy 2ashould 2abe 2asupported 2aby 2aproviding 2aguided 2achoices
2awhen 2aappropriate
❖ Preschool 2achild 2a(3-6 2ayears)
• Developmental 2amilestones
o Each 2ayear 2aa 2achild 2agains 2aabout 2a5 2albs 2aand 2agrows 2a2 2a½ 2ato 2a3 2ainches
o A 2achild 2astands 2aerect 2awith 2amore 2aslender 2aposture
3
, HESI RN Peds Hesi (1)
o A 2achild 2alearns 2ato 2arun 2ajump 2askip 2aand 2ahop
o A 2a3 2ayear 2aold 2acan 2aride 2aa 2atricycle
o Handedness 2ais 2aestablished
o A 2achild 2auses 2ascissors 2aat 2a4 2ayrs
o A 2achild 2aties 2ashoelaces 2aat 2a5 2ayrs
o A 2achild 2alearns 2acolors 2aand 2ashapes
o Visual 2aacuity 2aapproaches 2a20/20
o Thinking 2ais 2aegocentric 2aand 2aconcrete
o A 2achild 2auses 2asentences 2aof 2afive 2ato 2aeight 2awords
o A 2achild 2alearns 2asexual 2aidentity 2a(curiosity 2aand 2amasturbation 2aare 2acommon)
o Imaginary 2aplaymates 2aand 2afears 2aare 2acommon
o Aggressiveness 2aat 2a4 2ayrs 2ais 2areplaced 2aby 2amore 2aindependence 2aat 2a5 2ayears
• Erikson’s 2atheory: 2adeveloping 2aa 2asense 2aof 2ainitiative 2a(initiative 2avs 2aguilt)
• Nursing 2aimplications
o Nursing 2acare 2afor 2ahospitalized 2apreschoolers 2ashould 2aemphasize
2aunderstanding 2aof 2athe 2achild’s 2aegocentricity. 2aExplain 2athat 2ahe 2aor
2ashe 2adid 2anot 2acause 2athe 2aillness 2aand 2athat 2apainful 2aprocedures 2aare
2anot 2aa 2apunishment 2afor 2amisdeeds
o The 2achild’s 2aquestions 2ashould 2abe 2aanswered 2aat 2athe 2achild’s 2alevel
2ause 2asimple 2awords 2athat 2awill 2abe 2aunderstood 2aby 2athe 2achild
o Therapeutic 2aplay 2aor 2amedical 2aplay 2athat 2aallows 2athe 2achild 2ato 2aact 2aout
2ahis 2aor 2aher 2aexperiences 2ais 2ahelpful
o Fear 2aof 2amutilation 2aby 2aprocedures 2ais 2acommon 2aa 2aband 2a– 2aaid
2amay 2abe 2aquite 2ahelpful 2ain 2arestoring 2abody 2aintegrity
o Toys 2aand 2aplay 2afor 2athe 2ahospitalized 2apreschooler 2ainclude 2acoloring
2abooks, 2apuzzles, 2acutting 2aand 2apasting, 2adolls, 2abuilding 2ablocks, 2aclay
2aand 2atoys 2athat 2aallow 2athe 2apreschooler 2ato 2awork 2aout 2ahospitalization
2aexperiences 2adepending 2aon 2athe 2areason 2afor 2ahospitalization
o The 2apreschooler 2aneeds 2apreparation 2afor 2aprocedures 2ahe 2aor 2ashe
2ashould 2aunderstand 2awhat 2ais 2aand 2awhat 2ais 2anot 2agoing 2ato 2abe 2a“fixed”
2asimple 2aexplanations
4
