PEDS Exam 1 2024 Study Guide | Pediatric Nursing Practice Questions & Exam Review Notes

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PEDS Exam 1 2024 Study
Guide | Pediatric Nursing
Practice Questions & Exam
Review Notes




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Fall 2019 Pediatric Exam 1, Chapter 26-43
50 Questions, all multiple choice, 2 math questions
Your goal is to UNDERSTAND not just know.
This is intended as a GUIDE and is not considered ALL inclusive!!!
 Family centered care and atraumatic care
o Art of Pediatric Nursing
 Family-centered care: two BASIC concepts are enabling and
empowerment
 Atraumatic care: cause least harm from all perspectives
 Family advocacy
o Family: “Whoever the client considers it to be”
o Family Systems Theory
 The family is greater than any one individual in the family
 The family continually interacts with its members and the
environment
 Emphasis on “interaction”
 Difficulties: do not lie in any one member but in the type of
interactions used by the family
o Atraumatic care can be provided with EMLA and LMX
 prevent or minimize the child's separation from the family
 promote a sense of control
 prevent or minimize bodily injury and pain
o Examples of providing atraumatic care: fostering parent-child
relationship, preparing child before unfamiliar procedure, controlling
pain, allowing privacy, providing play activities for expression of fear
and aggression, providing choices, and respecting cultural differences
 Erickson stages
o Infancy: (Hope) Trust vs Mistrust (birth to 1)
o Toddlerhood: (Will) Autonomy vs Shame and Doubt (1 to 3)
o Preschool Years: (Purpose) Initiative vs Guilt (3-6)
o Early School Years: (Competence) Industry vs Inferiority (6-12)
o Adolescence: (Fidelity) Identity vs Role Confusion (12-18)
o Young Adulthood: (Love) Intimacy vs Isolation (20-40)
o Middle Adulthood: (Care) Generativity vs Stagnation – Midlife crisis
o Late Adulthood: (Wisdom) Integrity vs Despair – tell stories
 Therapeutic communication with families
o Guidelines for communication and interviewing
 Establishing a setting of privacy and confidentiality
o Communicating from families
 Encouraging parent to talk
 Directing the focus
 Listening and cultural awareness
 Using silence
 Being empathetic
 Providing anticipatory guidance
 Avoiding blocks to communication




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o Communicating with families
 Communication techniques
 Conventional interview methods
 Open-ended questions
 Word games
 Nonverbal techniques
 Draw a picture
 Play
 Therapeutic communication and education techniques for patients (based on
development)
o Communicating with children should be adapted to developmental
level
 Infants: cry or bear down
 Toddler: NO NO NO play play play
 Preschooler: “Whats THAT” show and play with equipment
 School age: “Wait Wait I’m not ready” education
 Adolescence: direct questions to them instead of parent
 Types of play
o Play influences
 Onlooker (Watch): looking at sibling bounce ball
 Solitary Play (Alone): play with dollhouse
 Parallel Play (Beside): working on individual projects
 Associative Play (Together)
 Cooperative Play (Organized): purpose
 Egocentricity, Animism, Object permeance, delayed gratification
o Egocentrism: Inability to envision situations from perspectives other
than one's own
o Animism: Attributing lifelike qualities to inanimate objects
o Object permanence: a critical component of parent-child attachment
and is seen in the development of separation anxiety at 6 to 8 months
of age; realization that objects that leave the visual field still exist
o Delayed gratification: subject resists the temptation of an immediate
reward in preference for a later reward
 BMI/Height/Weight percentages and interpretations; failure to thrive/risk
for/obesity
o BMI: a measure of an adult's weight in relation to his or her height,
specifically the adult's weight in kilograms divided by the square of his
or her height in meters
 BMI 18.5 or less—Underweight
 BMI 18.5 to 24.9—Normal weight
 BMI 25.0 to 29.9—Overweight
 BMI 30.0 to 34.5—Obese BMI
 35.0 to 40—Very obese
o Height measured based on the consistency of the percentile that they
stay on. Height and weight are measured on a growth chart, find age
then both height and weight plotted on graph and fall onto the line
present on the chart, watch over time where the child lands




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 If fall below 5th percentile  too low
 If fall above 95th percentile  too high
 If fall 85th percentile for weight  risk for being overweight
 Above 95th percentile for weight  obesity
 If fall below 15th percentile for weight start to look at failure to
thrive
 Does not mean failure to thrive if child is consistent, the
child is growing just at the low percentile then considered
normal for them.
o Failure to thrive (FTT), or growth failure, is a sign of inadequate growth
resulting from an inability to obtain or use calories required for growth
 Clinical manifestations
 Growth failure
 Developmental delays—social, motor, adaptive, language
 Undernutrition
 Apathy
 Withdrawn behavior
 Feeding or eating disorders, such as vomiting, feeding
resistance, anorexia, pica, rumination
 No fear of strangers (at age when stranger anxiety is
normal)
 Avoidance of eye contact
 Wide-eyed gaze and continual scan of the environment
(“radar gaze”)
 Stiff and unyielding or flaccid and unresponsive
 Minimal smiling
 Head and chest circumference; growth trends
o Head circumference: taken right above browline and top of the pin of
the ear, wrap around the occipital prominence. Use a paper tape and
note the length in CM
o Chest circumference measured at nipple line
o Head and chest circumferences are equal at about 1 to 2 years of age
o During childhood, chest circumference exceeds head size by 5 to 7 cm
(2 to 2.75 inches)
o Growth Trends: Sequential development (sequence in which we grow
but grow at different rates)
 Infant
 By 6 months, double birth weight
 By one, weight triples (average is 9.75 kg or 21.5 lbs)
 Toddler
 Weight gain slows to 4 to 6 Ibs per yr
 Height increases 3 inch per yr
 Growth is step like
 Preschooler
 Growth slows and stabilizes
 Average weight gain 5 Ibs per yr




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