Spring 2018 Final Exam Blueprint
Chapter 4- Communication, Physical, and Developmental Assessment
1. Perform a complete age-specific head-to-toe assessment
FIRST SUPINE POSITION: to examine heart, lungs, abdomen, & hips
NEXT PRONE POSITION: to examine spine, back, and sacrum
Auscultate, percuss, and palpate while quiet
Minimal physical contact first to establish that you’re not scary. Distract with play
In older children/adolescents: assess genitalia last
2. Identify birthmarks (e.g., café au lait, Mongolian spot) and implications.
Mongolian spot: bluish- bruise like spot on the back
Café au lait: note size and number. 5+ could mean neurofibromatosis
Chapter 5- Pain Assessment and Management in Children
1. Review responses and effects of pain (e.g., see slide harmful effects of pain in Pediatric client).
Harmful Effects of Unrelieved Pain
• Physiologic stress responses
– Increased ICP, HR, RR, BP
– Decreased SaO2
• Behavioral changes (particularly neonates)
– Muscle rigidity, facial expression, crying,
withdrawal, and sleeplessness
• Chronic pain syndromes
2. Understand how to appropriately assess pain in children
HOW? Use OLDCARTS! (onset, location, duration, characteristics, aggravating &
relieving factors, timing, severity). Assess of treatment is effective
WHEN? 15-30 minutes after intervention
Chapter 22- Family Centered Care of the Child During Illness and Hospitalization
1. Understand the effects of hospitalization on the child and the family
ON INFANT/CHILD: goes through separation anxiety consisting of the following
stages:
Stage of protest: crying and screaming for parent
State of despair: depression, crying stops, withdrawals, less active
Detachment/denial: NOT COPING MECHANISM, but child accepts that parents are
gone & gets used to new environment
ADOLESCENTS
, Loneliness & isolation
Fear of treatment, losing self-determination, and choices
Anger, sad, stress, regression
Special needs: more emotional consequences possible
FAMILIES
Parents feel loss of control and helplessness
Fam-centered care must also include siblings too
Siblings may feel hospitalization is their fault (siblings need support too and
parents may forget that)
Jealousy & anger may result
2. Identify ways to minimize loss of control in the pediatric client during hospitalization
Minimizing Loss of Control
• Importance of consulting Child Life
• Promote freedom of movement
• Preserve parent-child contact
• Truth and Reassurance
• Maintaining routine and independence
– Provide information
– Provide resources
Chapter 10- Health Promotion of the Infant and Family
1. Major physical and developmental milestones expected in the first year as discussed in class
(e.g., head control, sitting, walking, pincer grasp, etc.)
Fine/motor skills (before age 1)
o 2-3 mo: grasps object
o 7 mo: transfers object btwn hands
o 10 mo: pincer grasp
o 11 mo: removes object from container
o 12 mo: builds tower of 2 blocks
Gross motor skills
o 4-6 mo: head control improves
o 5-6 mo: rolls over
o 7 mo: sits alone
Locomotion:
, o 6-7 mo: crawling
o 9 mo: creeping
o 11 mo: walk w/ assist
o 12 mo: walk alone
2. Review feeding in the first year of life (i.e., what can they eat/drink and when).
Chapter 11- Health Promotion of the Infant
1. Identify the management of serious food allergy
Common allergies: eggs, cow’s milk, peanuts. ATOPY = allergy w/ heredity
Management:
Epipen
Benadryl (diphenhydramine)
Medicalert bracelet
Emergency plan (giving epipen vs. calling 911?)
Caution of biphasic response (when allergy feels better but suddenly gets
worse)
2. Review the topic of Apnea in Infancy including definition and management
Definition: respiratory pause lasting 15-20 sec +, or less than 15-20 sec w/ pallor,
cyanosis, bradycardia, hypotension
Management: use apnes monitor, stimulation, parent education, medications
Chapter 12- Health Promotion of the Toddler and Family
1. Identify the Erikson stage of psychosocial development and how is one achieved versus the
result of not achieving this stage
Autonomy: developing independence (negativism: “I’ll do it”, no)
Shame: parents shame child for trying to do things themselves.
Chapter 13- Health Promotion of the Preschooler and Family
1. Identify expected play in preschoolers.
Chapter 14- Health Problems of Early Childhood
1. Identify the different types of neglect and abuse including presentation and symptoms.
Physical neglect: deprivation of food, clothing, shelter, supervision, medcal care,
education. Most common form of maltreatment
Emotional neglect: lack of affection, attention, emotional nurturance
Chapter 4- Communication, Physical, and Developmental Assessment
1. Perform a complete age-specific head-to-toe assessment
FIRST SUPINE POSITION: to examine heart, lungs, abdomen, & hips
NEXT PRONE POSITION: to examine spine, back, and sacrum
Auscultate, percuss, and palpate while quiet
Minimal physical contact first to establish that you’re not scary. Distract with play
In older children/adolescents: assess genitalia last
2. Identify birthmarks (e.g., café au lait, Mongolian spot) and implications.
Mongolian spot: bluish- bruise like spot on the back
Café au lait: note size and number. 5+ could mean neurofibromatosis
Chapter 5- Pain Assessment and Management in Children
1. Review responses and effects of pain (e.g., see slide harmful effects of pain in Pediatric client).
Harmful Effects of Unrelieved Pain
• Physiologic stress responses
– Increased ICP, HR, RR, BP
– Decreased SaO2
• Behavioral changes (particularly neonates)
– Muscle rigidity, facial expression, crying,
withdrawal, and sleeplessness
• Chronic pain syndromes
2. Understand how to appropriately assess pain in children
HOW? Use OLDCARTS! (onset, location, duration, characteristics, aggravating &
relieving factors, timing, severity). Assess of treatment is effective
WHEN? 15-30 minutes after intervention
Chapter 22- Family Centered Care of the Child During Illness and Hospitalization
1. Understand the effects of hospitalization on the child and the family
ON INFANT/CHILD: goes through separation anxiety consisting of the following
stages:
Stage of protest: crying and screaming for parent
State of despair: depression, crying stops, withdrawals, less active
Detachment/denial: NOT COPING MECHANISM, but child accepts that parents are
gone & gets used to new environment
ADOLESCENTS
, Loneliness & isolation
Fear of treatment, losing self-determination, and choices
Anger, sad, stress, regression
Special needs: more emotional consequences possible
FAMILIES
Parents feel loss of control and helplessness
Fam-centered care must also include siblings too
Siblings may feel hospitalization is their fault (siblings need support too and
parents may forget that)
Jealousy & anger may result
2. Identify ways to minimize loss of control in the pediatric client during hospitalization
Minimizing Loss of Control
• Importance of consulting Child Life
• Promote freedom of movement
• Preserve parent-child contact
• Truth and Reassurance
• Maintaining routine and independence
– Provide information
– Provide resources
Chapter 10- Health Promotion of the Infant and Family
1. Major physical and developmental milestones expected in the first year as discussed in class
(e.g., head control, sitting, walking, pincer grasp, etc.)
Fine/motor skills (before age 1)
o 2-3 mo: grasps object
o 7 mo: transfers object btwn hands
o 10 mo: pincer grasp
o 11 mo: removes object from container
o 12 mo: builds tower of 2 blocks
Gross motor skills
o 4-6 mo: head control improves
o 5-6 mo: rolls over
o 7 mo: sits alone
Locomotion:
, o 6-7 mo: crawling
o 9 mo: creeping
o 11 mo: walk w/ assist
o 12 mo: walk alone
2. Review feeding in the first year of life (i.e., what can they eat/drink and when).
Chapter 11- Health Promotion of the Infant
1. Identify the management of serious food allergy
Common allergies: eggs, cow’s milk, peanuts. ATOPY = allergy w/ heredity
Management:
Epipen
Benadryl (diphenhydramine)
Medicalert bracelet
Emergency plan (giving epipen vs. calling 911?)
Caution of biphasic response (when allergy feels better but suddenly gets
worse)
2. Review the topic of Apnea in Infancy including definition and management
Definition: respiratory pause lasting 15-20 sec +, or less than 15-20 sec w/ pallor,
cyanosis, bradycardia, hypotension
Management: use apnes monitor, stimulation, parent education, medications
Chapter 12- Health Promotion of the Toddler and Family
1. Identify the Erikson stage of psychosocial development and how is one achieved versus the
result of not achieving this stage
Autonomy: developing independence (negativism: “I’ll do it”, no)
Shame: parents shame child for trying to do things themselves.
Chapter 13- Health Promotion of the Preschooler and Family
1. Identify expected play in preschoolers.
Chapter 14- Health Problems of Early Childhood
1. Identify the different types of neglect and abuse including presentation and symptoms.
Physical neglect: deprivation of food, clothing, shelter, supervision, medcal care,
education. Most common form of maltreatment
Emotional neglect: lack of affection, attention, emotional nurturance
