NR222 - FINAL EXAM REVIEW
1. PREGNANCY AND WEIGHT GAIN
For women who are at normal weight for height, the recommended weight gain during
pregnancy is 11 to 15 kg (25–35 lb) over three trimesters
2. TRISOMY 21 – DOWNS SYNDROME
Extra copy of chromosome 21
Distinct features: size, shape, symmetry, landmarks, position, and color of the auricle
The position of the auricle is almost vertical. Ears that are low set or at an unusual angle are a
sign of chromosomal abnormality, ie, downs syndrome
Deep transverse palmar creases
Protruding tongue
Short neck
Fissured tongue, mouth breathing, hypodontia, Macroglossia
3. NEWBORN ASSESSMENT
essential to ensure that the transition from intrauterine to extrauterine life is proceeding as
expected
Physical assessment
o Apgar score - Heart rate, respiratory effort, muscle tone, reflex irritability, and color –
conducted at 1 and 5 mins after birth and continues until stabilized (if necessary)
o maintaining an open airway, stabilizing and maintaining body temperature, and
protecting the newborn from infection.
o Neurological - level of activity, alertness, irritability, and responsiveness to stimuli and
the presence and strength of reflexes
o Normal physical characteristics - continued presence of lanugo (fine downy hair) on the
skin of the back; cyanosis of the hands and feet for the first 24 hours; and a soft,
protuberant abdomen
o measure height, weight, head and chest circumference, temperature, pulse, and
respirations and observe general appearance, body functions, sensory capabilities,
reflexes, and responsiveness
o head circumference of 33 to 35 cm (13–14 inches).
o Neonates lose up to 10% of birth weight in the first few days of life, primarily through
fluid losses by respiration, urination, defecation, and low fluid intake They usually regain
birth weight by the second week of life, and a gradual pattern of increase in weight,
height, and head circumference is evident
o sutures and fontanels are usually palpable at birth
4. THERAPEUTIC COMMUNICATION WITH NEWBORN EDUCATION
Carseat education – rear facing in back seat
Sleep on back on firm mattress; co-sleeping is NOT recommended
Safeguards to reduce the risk for SIDS include proper positioning; removing stuffed animals, soft
bedding, crib bumper pads, and pillows; and avoiding overheating the infant
Crib slats are no more than 6 cm (2.4 inches) apart
Screening – follow up testing if needed
1
, 5. CARING FOR NEWBORN
Encourage parent-child attachment: skin to skin contact, breastfeeding
Behavior is greatly influenced by interaction among the newborn, the environment, and
parents/caregivers
newborn may cry, which is generally a reflexive response to an unmet need such as hunger,
fatigue, or discomfort: counsel the parents to feed the infant on demand rather than on a rigid
schedule
6. TODDLER STAGE OF DEVELOPMENT
1-3 years of age
Walks independently; climbs stairs; stand on tiptoes
Vocab @ 3 yrs old: 150-300 words
Erikson: Autonomy vs. shame & doubt – learn to be self sufficient (toileting, feeding, walking,
exploring, and talking or they doubt their own abilities.
Piaget: Preoperational – Self-centered; asks questions; explores environment; language
development is rapid; associates words with objects (symbols); egocentrism; pretend play
Freud: Anal stage
Kohlberg: No moral development
7. TODDLER NUTRITION
meet nutritional needs by eating solid foods. The healthy toddler requires a balanced daily intake
of bread and grains, vegetables, fruit, dairy products, and proteins
advise parents to limit milk intake to 2 to 3 cups per day; should not be offered low-fat or skim
milk until age 2
offer a variety of nutritious foods at meals and to provide only nutritious snacks between meals.
Serving finger foods to toddlers allows them to eat by themselves and to satisfy their need for
independence and control. Small, reasonable servings allow toddlers to eat all of their meals.
8. PRE-SCHOOLER FEARS
greatest fear of this age-group appears to be that of bodily harm. This is evident in children’s fear
of the dark, animals, thunderstorms, and medical personnel
9. COGNITIVE CHANGES IN PRE-SCHOOLER
Piaget: Egocentric thinking diminishes; includes other in environment; enjoys repeating words;
may count to 10; words express thoughts
Imaginative play, play with others
Remain egocentric in their communication and believe others think as they do
Aware of cause & effect relationships
Preschoolers’ knowledge of the world remains closely linked to concrete (perceived by the
senses) experiences.
Preschoolers believe that if a rule is broken, punishment results immediately. During these years
they believe that a punishment is automatically connected to an act and do not yet realize that it
is socially mediated
10. PRE-SCHOOLER DEVELOPMENTAL TASKS
Erikson: Psychosocial – Initiative vs. guilt – children want to undertake many adult-like
activities, sometimes overstepping the limits set by parents and feeling guilty
2
1. PREGNANCY AND WEIGHT GAIN
For women who are at normal weight for height, the recommended weight gain during
pregnancy is 11 to 15 kg (25–35 lb) over three trimesters
2. TRISOMY 21 – DOWNS SYNDROME
Extra copy of chromosome 21
Distinct features: size, shape, symmetry, landmarks, position, and color of the auricle
The position of the auricle is almost vertical. Ears that are low set or at an unusual angle are a
sign of chromosomal abnormality, ie, downs syndrome
Deep transverse palmar creases
Protruding tongue
Short neck
Fissured tongue, mouth breathing, hypodontia, Macroglossia
3. NEWBORN ASSESSMENT
essential to ensure that the transition from intrauterine to extrauterine life is proceeding as
expected
Physical assessment
o Apgar score - Heart rate, respiratory effort, muscle tone, reflex irritability, and color –
conducted at 1 and 5 mins after birth and continues until stabilized (if necessary)
o maintaining an open airway, stabilizing and maintaining body temperature, and
protecting the newborn from infection.
o Neurological - level of activity, alertness, irritability, and responsiveness to stimuli and
the presence and strength of reflexes
o Normal physical characteristics - continued presence of lanugo (fine downy hair) on the
skin of the back; cyanosis of the hands and feet for the first 24 hours; and a soft,
protuberant abdomen
o measure height, weight, head and chest circumference, temperature, pulse, and
respirations and observe general appearance, body functions, sensory capabilities,
reflexes, and responsiveness
o head circumference of 33 to 35 cm (13–14 inches).
o Neonates lose up to 10% of birth weight in the first few days of life, primarily through
fluid losses by respiration, urination, defecation, and low fluid intake They usually regain
birth weight by the second week of life, and a gradual pattern of increase in weight,
height, and head circumference is evident
o sutures and fontanels are usually palpable at birth
4. THERAPEUTIC COMMUNICATION WITH NEWBORN EDUCATION
Carseat education – rear facing in back seat
Sleep on back on firm mattress; co-sleeping is NOT recommended
Safeguards to reduce the risk for SIDS include proper positioning; removing stuffed animals, soft
bedding, crib bumper pads, and pillows; and avoiding overheating the infant
Crib slats are no more than 6 cm (2.4 inches) apart
Screening – follow up testing if needed
1
, 5. CARING FOR NEWBORN
Encourage parent-child attachment: skin to skin contact, breastfeeding
Behavior is greatly influenced by interaction among the newborn, the environment, and
parents/caregivers
newborn may cry, which is generally a reflexive response to an unmet need such as hunger,
fatigue, or discomfort: counsel the parents to feed the infant on demand rather than on a rigid
schedule
6. TODDLER STAGE OF DEVELOPMENT
1-3 years of age
Walks independently; climbs stairs; stand on tiptoes
Vocab @ 3 yrs old: 150-300 words
Erikson: Autonomy vs. shame & doubt – learn to be self sufficient (toileting, feeding, walking,
exploring, and talking or they doubt their own abilities.
Piaget: Preoperational – Self-centered; asks questions; explores environment; language
development is rapid; associates words with objects (symbols); egocentrism; pretend play
Freud: Anal stage
Kohlberg: No moral development
7. TODDLER NUTRITION
meet nutritional needs by eating solid foods. The healthy toddler requires a balanced daily intake
of bread and grains, vegetables, fruit, dairy products, and proteins
advise parents to limit milk intake to 2 to 3 cups per day; should not be offered low-fat or skim
milk until age 2
offer a variety of nutritious foods at meals and to provide only nutritious snacks between meals.
Serving finger foods to toddlers allows them to eat by themselves and to satisfy their need for
independence and control. Small, reasonable servings allow toddlers to eat all of their meals.
8. PRE-SCHOOLER FEARS
greatest fear of this age-group appears to be that of bodily harm. This is evident in children’s fear
of the dark, animals, thunderstorms, and medical personnel
9. COGNITIVE CHANGES IN PRE-SCHOOLER
Piaget: Egocentric thinking diminishes; includes other in environment; enjoys repeating words;
may count to 10; words express thoughts
Imaginative play, play with others
Remain egocentric in their communication and believe others think as they do
Aware of cause & effect relationships
Preschoolers’ knowledge of the world remains closely linked to concrete (perceived by the
senses) experiences.
Preschoolers believe that if a rule is broken, punishment results immediately. During these years
they believe that a punishment is automatically connected to an act and do not yet realize that it
is socially mediated
10. PRE-SCHOOLER DEVELOPMENTAL TASKS
Erikson: Psychosocial – Initiative vs. guilt – children want to undertake many adult-like
activities, sometimes overstepping the limits set by parents and feeling guilty
2
