NU435 FINAL EXAM WITH 100% CORRECT
SOLUTIONS
Wong-Baker FACES scale - ANSWER - For ages 3 years and older, most commonly used
with children.
- Point to the face that best describes the pain.
FLACC - ANSWER - Face, legs, activity, crying, consolability
- for infants to 2 years of age
CRIES - ANSWER - Crying, Requires oxygen to maintain saturation, Increased vital
signs, Expression, and Sleeplessness
NIPS - ANSWER - Neonatal infant pain scale
- Facial expression, cry, breathing, arms, legs, alertness
Nonpharmacologic Pain Management - ANSWER - kangaroo care
- swaddling
- heat/cold application
- message
- distraction (age appropriate toys)
- guided imagery (adolescents)
Isotonic Dehydration - ANSWER - water loss = sodium loss (equal losses of sodium and
water)
- cause: vomiting & diarrhea
- treatment: NS, lactated ringers, D5W, D5 0.225% NS
Hypotonic Dehydration - ANSWER - water loss is LESS than sodium loss
- more sodium INSIDE than outside = fluid is pushed INTO cells
- cause: severe, prolonged vomiting & diarrhea, burns, or diluted formula
- treatment: NaCL, D5LR, D10W, D5NS, D5 0.45% NS
Hypertonic Dehydration - ANSWER - water loss is GREATER than sodium loss
,- more sodium outside than inside of cells = fluid pULLED OUT of cells
- SEVER -> can trigger shock quickly
- cause: DI, concentrated formula
- treatment: 0.45% NS
Mild Dehydration Symptoms - ANSWER LOC: alert, restless
Skin Turgor: immediate rebound, <2secs
Mucous membranes: moist
Thirst: slight increased
fontanels: usual
Extremities: warm, normal refill
Eyes: moist, usual
Urine output: usual
Moderate Dehydration Symptoms - ANSWER LOC: (young children) irritable, lethargic;
(older children) alert, more restless
Skin Turgor: poor rebound, 2-4secs
Mucous membranes: dry
Thirst: moderate
fontanels: sunken
Extremities: delayed refill
Eyes: slightly sunken, decreased tears
Urine output: decreased, dark color, increased S.G.
Severe Dehydration Symptoms - ANSWER LOC: (young children) lethargic, comatose;
(older children) conscious, apprehensive
Skin Turgor: very poor rebound, >4secs
Mucous membranes: parched
Thirst: intense
fontanels: sunken
Extremities: cool, more delayed refill
, Eyes: deeply sunken, absent tears
Urine output: very decreased or absent
Immunizations at 2 months - ANSWER Hep B, HiB, DTAP, Polio, PCV, RV
Immunizations at 4 months - ANSWER Hib, DTAP, Polio, PCV, RV
Immunizations at 6 months - ANSWER Hep B, HiB, DTAP, Polio, PCV, RV, Influenza
(annual)
Immunizations at 12-18 months - ANSWER HiB, DTAP, PCV, Hep A, MMR, Varicella
Signs & Symptoms of Rubeola (Measles) - ANSWER - prodromal: coryza (acute rhinitis),
cough, conjunctivitis, koplik spots
- days 3-4: red maculopapular rash (face then body)- turns brown and desquamation on
days 6-8
Failure to Thrive (FTT) - ANSWER - inadequate growth (under the 5th percentile)
- causes: inadequate caloric intake, inadequate absorption, increased metabolism,
defective utilization
- treatment: treat underlying cause
Diaper Dermatitis Treatment - ANSWER - keep skin dry/change diapers as soon as wet
- leave open to air
- use barrier cream (zinc oxide, petrolatum)- clean and dry skin first
- avoid over washing
Impact of Illness and Hospitalization for Toddlers - ANSWER - separation anxiety
- regression (revert back to infant skills)
Impact of Illness and Hospitalization for Preschoolers - ANSWER - may think their illness
is a punishment (reassure them)
- loss of control (can't do the things they normally did)
Parent Education for Temper Tantrums in Toddlers - ANSWER - normal part of childhood
development
- ignore the behavior
- don't give in to the child
- try to reason with the child
SOLUTIONS
Wong-Baker FACES scale - ANSWER - For ages 3 years and older, most commonly used
with children.
- Point to the face that best describes the pain.
FLACC - ANSWER - Face, legs, activity, crying, consolability
- for infants to 2 years of age
CRIES - ANSWER - Crying, Requires oxygen to maintain saturation, Increased vital
signs, Expression, and Sleeplessness
NIPS - ANSWER - Neonatal infant pain scale
- Facial expression, cry, breathing, arms, legs, alertness
Nonpharmacologic Pain Management - ANSWER - kangaroo care
- swaddling
- heat/cold application
- message
- distraction (age appropriate toys)
- guided imagery (adolescents)
Isotonic Dehydration - ANSWER - water loss = sodium loss (equal losses of sodium and
water)
- cause: vomiting & diarrhea
- treatment: NS, lactated ringers, D5W, D5 0.225% NS
Hypotonic Dehydration - ANSWER - water loss is LESS than sodium loss
- more sodium INSIDE than outside = fluid is pushed INTO cells
- cause: severe, prolonged vomiting & diarrhea, burns, or diluted formula
- treatment: NaCL, D5LR, D10W, D5NS, D5 0.45% NS
Hypertonic Dehydration - ANSWER - water loss is GREATER than sodium loss
,- more sodium outside than inside of cells = fluid pULLED OUT of cells
- SEVER -> can trigger shock quickly
- cause: DI, concentrated formula
- treatment: 0.45% NS
Mild Dehydration Symptoms - ANSWER LOC: alert, restless
Skin Turgor: immediate rebound, <2secs
Mucous membranes: moist
Thirst: slight increased
fontanels: usual
Extremities: warm, normal refill
Eyes: moist, usual
Urine output: usual
Moderate Dehydration Symptoms - ANSWER LOC: (young children) irritable, lethargic;
(older children) alert, more restless
Skin Turgor: poor rebound, 2-4secs
Mucous membranes: dry
Thirst: moderate
fontanels: sunken
Extremities: delayed refill
Eyes: slightly sunken, decreased tears
Urine output: decreased, dark color, increased S.G.
Severe Dehydration Symptoms - ANSWER LOC: (young children) lethargic, comatose;
(older children) conscious, apprehensive
Skin Turgor: very poor rebound, >4secs
Mucous membranes: parched
Thirst: intense
fontanels: sunken
Extremities: cool, more delayed refill
, Eyes: deeply sunken, absent tears
Urine output: very decreased or absent
Immunizations at 2 months - ANSWER Hep B, HiB, DTAP, Polio, PCV, RV
Immunizations at 4 months - ANSWER Hib, DTAP, Polio, PCV, RV
Immunizations at 6 months - ANSWER Hep B, HiB, DTAP, Polio, PCV, RV, Influenza
(annual)
Immunizations at 12-18 months - ANSWER HiB, DTAP, PCV, Hep A, MMR, Varicella
Signs & Symptoms of Rubeola (Measles) - ANSWER - prodromal: coryza (acute rhinitis),
cough, conjunctivitis, koplik spots
- days 3-4: red maculopapular rash (face then body)- turns brown and desquamation on
days 6-8
Failure to Thrive (FTT) - ANSWER - inadequate growth (under the 5th percentile)
- causes: inadequate caloric intake, inadequate absorption, increased metabolism,
defective utilization
- treatment: treat underlying cause
Diaper Dermatitis Treatment - ANSWER - keep skin dry/change diapers as soon as wet
- leave open to air
- use barrier cream (zinc oxide, petrolatum)- clean and dry skin first
- avoid over washing
Impact of Illness and Hospitalization for Toddlers - ANSWER - separation anxiety
- regression (revert back to infant skills)
Impact of Illness and Hospitalization for Preschoolers - ANSWER - may think their illness
is a punishment (reassure them)
- loss of control (can't do the things they normally did)
Parent Education for Temper Tantrums in Toddlers - ANSWER - normal part of childhood
development
- ignore the behavior
- don't give in to the child
- try to reason with the child
