HESI PN Pediatric Nursing
Developmental milestones (birth to 1 year) -
☑️birth weight doubles by 6 months and triples by 12 months
birth length increases by 50% at 12 months
posterior fontanel closes by 8 weeks
social smile at 2 months
turns head to locate sounds at 3 months
moro reflex disappears around 4 months
achieves steady head control at 4 months
turns completely over at 5 to 6 months
plays peek-a-boo after 6 months
transfers objects hand to hand at 7 months
develops stranger anxiety at 7 months
sits unsupported at 8 months
crawls at 10 months
fine pincer grasp appears at 10 to 12 months
waves bye-bye at 10 months
walks with assistance at 10 to 12 months
says a few words in addition to "mama" and "dada" at 12 months
explores environment by motor and oral means
erikson's theory: developing a sense of trust (trust vs mistrust)
nursing implications (birth to 1 year) -
☑️during hospitalization, the infant's emerging skills may disappear
if the parents are not able to be with the infant, the baby may experience separation anxiety, usually
beginning around 6 months
the PN should encourage and plan to have the parents be part of the infants care
the infant's usual schedule at home should be respected
preparation and/or reinforcement of teaching should be directed to the family. however, the PN
should always speak to the infant and console the infant, especially while performing painful or
stressful procedures
toys for hospitalized infants include mobiles, rattles, squeaking toys, picture books, bals, colored
blocks, and activity boxes.
HESI HINT #! -
☑️the stages of separation anxiety consist of protest, despair, denial, and detachment.
HESI HINT #2 -
☑️when does birth length double? by 4 years
when does the child sit unsupported? 8 months
when does a child achieve 50% of adult height? 2 years
1
,when does a child throw a ball overhand? 18 months
when does a child speak two-to-three word sentences? 2 years
when does a child use scissors? 4 years
when does a child tie his/her shoes? 5 years
be aware that a girl's growth spurt during adolescence begins earlier than boys (as early as 10 yaars)
temper tantrums are common in the toddler and are considered "normal" behavior
be aware that adolescence is a time when the child forms his or her identity and that rebellion
against family values is common for this age group
developmental milestones (toddler 1-3 years) -
☑️birth weight quadruples by 30 months
achieves 50% of adult height by 2 years
growth velocity slows
appears to be bowlegged and potbellied
all primary teeth (20) are present by age 3
anterior fontanel closes by 12 to 18 months
throws a ball overhand at 18 months
kicks a ball at 24 months
feeds self with spoon and cup at 2 years
daytime toilet training can usually be started around 2 years
two-to-three word sentences at 2 years
three-to-four word sentences at 3 years
states first and last name by 2.5 to 3 years
temper tantrums are common.
erikson's theory: developing a sense of autonomy (autonomy vs doubt and shame)
Nursing Implications (toddler 1-3 years) -
☑️simple brief explanations should be given immediately before procedures because
toddlers have limited concept of time
during hospitalization, enforced separation from parents is the greatest threat to the toddler's
psychological and emotional integrity
security objects or favorite toys from home should be provided for toddler
encourage parents to explain their plans to child
respect child's routine
expect regression
toys for the hospitalized toddler include board and mallet, push/pull toys, toy telephone, stuffed
animals, storybooks with pictures.
toddlers benefit from being taken to the playroom when possible because mobility is important to
their development;.
toddlers engage in parallel pla.
toddlers are learning to name body parts and are concerned about their bodies
2
,support autonomy by giving choices
developmental milestones (preschool 3-5 years) -
☑️each year child gains about 5 pounds and grows 2.5 to 3 inches
stands erect with more slender posture
learns to run, jump, skip and hop
3 year olds ride a tricycle
handedness is established
uses scissors at 4 years
ties shoelaces at 5 years
learns colors and shapes
visual acuity approaches 20/20
thinking is egocentric and concrete
uses sentences of 5 to 8 words
learns sexual identity
imaginary playmates and fears are common
aggressiveness at 4 years is replaced by more independence at 5 years
eriksons theory: developing a sense of initiative (initiative vs guilt)
nursing implications (preschool 3-5 years) -
☑️nursing care for hospitalized preschoolers needs to emphasize understanding of the
child's egocentricity.
explain that he or she did not cause the illness and that painful procedures are not a punishment for
misdeeds
the child's questions need to be answered at his or her level. use simple words that will be
understood by the child
therapeutic play or medical play to allow the child to act out his or her experiences is helpful
fear of mutilation from procedures is common.
a band-aid may be helpful in restoring body integrity; children fear loss of blood because they are
beginning to associate it with life.
3
, toys and play for the hospitalized preschooler include coloring books, puzzles, cutting and painting,
dolls, building blocks, clay and toys that allow the preschooler to work out hospitalization
experiences.
preschoolers engage in associative play where they engage in similar activities and play together but
there is no organization leadership or group goals
the preschooler needs preparation for procedures. he or she needs to understand what is and what is
not going to be fixed.
simple explanations and basic pictures are helpful.
let the child handle equipment or models of the equipment.
HESI HINT #3 -
☑️use facts and principles related to growth and development when reinforcing teaching
interventions.
"what task could a 5-year-old boy with diabetes be expected to accomplish by himself?"
one correct answer would be to pick the injection sites. this is possible for a preschooler to do so
and gives the child some sense of control.
developmental milestones (school-age 6-12 years) -
☑️each year, child gains 4 to 6 pounds and about 2 inches in height
girls may experience menarche
loss of primary teeth and eruption of most permanent teeth occur
fine and gross motor skills mature
able to write script at 8 years
dresses self completely
egocenric thinking is replaced by social awareness of others
learns to tell time and understands past, present and future
learns cause-and-effect relationships
socialization with peers becomes important
molars (6-year) erupt
erikson's theory: developing a sense of industry (industry vs inferiority)
Nursing implications (school age 6-12 years) -
☑️the hospitalized school-age child may need more support from the parents than the
child wishes to admit
maintaining contact with peers and school activities is important during hospitalization
explanation of all procedures is important.
children can learn from verbal explanations, pictures, books or handling equipment.
privacy and modesty are important and should be respected during hospitalization
participation in care and planning with staff fosters a sense of involvement and accomplishment.
toys of the school-age child include board games, card games, and hobbies such as stamp collecting,
puzzles and video games.
school age children engage in cooperative play where the play is organized and they play with other
children.
4
Developmental milestones (birth to 1 year) -
☑️birth weight doubles by 6 months and triples by 12 months
birth length increases by 50% at 12 months
posterior fontanel closes by 8 weeks
social smile at 2 months
turns head to locate sounds at 3 months
moro reflex disappears around 4 months
achieves steady head control at 4 months
turns completely over at 5 to 6 months
plays peek-a-boo after 6 months
transfers objects hand to hand at 7 months
develops stranger anxiety at 7 months
sits unsupported at 8 months
crawls at 10 months
fine pincer grasp appears at 10 to 12 months
waves bye-bye at 10 months
walks with assistance at 10 to 12 months
says a few words in addition to "mama" and "dada" at 12 months
explores environment by motor and oral means
erikson's theory: developing a sense of trust (trust vs mistrust)
nursing implications (birth to 1 year) -
☑️during hospitalization, the infant's emerging skills may disappear
if the parents are not able to be with the infant, the baby may experience separation anxiety, usually
beginning around 6 months
the PN should encourage and plan to have the parents be part of the infants care
the infant's usual schedule at home should be respected
preparation and/or reinforcement of teaching should be directed to the family. however, the PN
should always speak to the infant and console the infant, especially while performing painful or
stressful procedures
toys for hospitalized infants include mobiles, rattles, squeaking toys, picture books, bals, colored
blocks, and activity boxes.
HESI HINT #! -
☑️the stages of separation anxiety consist of protest, despair, denial, and detachment.
HESI HINT #2 -
☑️when does birth length double? by 4 years
when does the child sit unsupported? 8 months
when does a child achieve 50% of adult height? 2 years
1
,when does a child throw a ball overhand? 18 months
when does a child speak two-to-three word sentences? 2 years
when does a child use scissors? 4 years
when does a child tie his/her shoes? 5 years
be aware that a girl's growth spurt during adolescence begins earlier than boys (as early as 10 yaars)
temper tantrums are common in the toddler and are considered "normal" behavior
be aware that adolescence is a time when the child forms his or her identity and that rebellion
against family values is common for this age group
developmental milestones (toddler 1-3 years) -
☑️birth weight quadruples by 30 months
achieves 50% of adult height by 2 years
growth velocity slows
appears to be bowlegged and potbellied
all primary teeth (20) are present by age 3
anterior fontanel closes by 12 to 18 months
throws a ball overhand at 18 months
kicks a ball at 24 months
feeds self with spoon and cup at 2 years
daytime toilet training can usually be started around 2 years
two-to-three word sentences at 2 years
three-to-four word sentences at 3 years
states first and last name by 2.5 to 3 years
temper tantrums are common.
erikson's theory: developing a sense of autonomy (autonomy vs doubt and shame)
Nursing Implications (toddler 1-3 years) -
☑️simple brief explanations should be given immediately before procedures because
toddlers have limited concept of time
during hospitalization, enforced separation from parents is the greatest threat to the toddler's
psychological and emotional integrity
security objects or favorite toys from home should be provided for toddler
encourage parents to explain their plans to child
respect child's routine
expect regression
toys for the hospitalized toddler include board and mallet, push/pull toys, toy telephone, stuffed
animals, storybooks with pictures.
toddlers benefit from being taken to the playroom when possible because mobility is important to
their development;.
toddlers engage in parallel pla.
toddlers are learning to name body parts and are concerned about their bodies
2
,support autonomy by giving choices
developmental milestones (preschool 3-5 years) -
☑️each year child gains about 5 pounds and grows 2.5 to 3 inches
stands erect with more slender posture
learns to run, jump, skip and hop
3 year olds ride a tricycle
handedness is established
uses scissors at 4 years
ties shoelaces at 5 years
learns colors and shapes
visual acuity approaches 20/20
thinking is egocentric and concrete
uses sentences of 5 to 8 words
learns sexual identity
imaginary playmates and fears are common
aggressiveness at 4 years is replaced by more independence at 5 years
eriksons theory: developing a sense of initiative (initiative vs guilt)
nursing implications (preschool 3-5 years) -
☑️nursing care for hospitalized preschoolers needs to emphasize understanding of the
child's egocentricity.
explain that he or she did not cause the illness and that painful procedures are not a punishment for
misdeeds
the child's questions need to be answered at his or her level. use simple words that will be
understood by the child
therapeutic play or medical play to allow the child to act out his or her experiences is helpful
fear of mutilation from procedures is common.
a band-aid may be helpful in restoring body integrity; children fear loss of blood because they are
beginning to associate it with life.
3
, toys and play for the hospitalized preschooler include coloring books, puzzles, cutting and painting,
dolls, building blocks, clay and toys that allow the preschooler to work out hospitalization
experiences.
preschoolers engage in associative play where they engage in similar activities and play together but
there is no organization leadership or group goals
the preschooler needs preparation for procedures. he or she needs to understand what is and what is
not going to be fixed.
simple explanations and basic pictures are helpful.
let the child handle equipment or models of the equipment.
HESI HINT #3 -
☑️use facts and principles related to growth and development when reinforcing teaching
interventions.
"what task could a 5-year-old boy with diabetes be expected to accomplish by himself?"
one correct answer would be to pick the injection sites. this is possible for a preschooler to do so
and gives the child some sense of control.
developmental milestones (school-age 6-12 years) -
☑️each year, child gains 4 to 6 pounds and about 2 inches in height
girls may experience menarche
loss of primary teeth and eruption of most permanent teeth occur
fine and gross motor skills mature
able to write script at 8 years
dresses self completely
egocenric thinking is replaced by social awareness of others
learns to tell time and understands past, present and future
learns cause-and-effect relationships
socialization with peers becomes important
molars (6-year) erupt
erikson's theory: developing a sense of industry (industry vs inferiority)
Nursing implications (school age 6-12 years) -
☑️the hospitalized school-age child may need more support from the parents than the
child wishes to admit
maintaining contact with peers and school activities is important during hospitalization
explanation of all procedures is important.
children can learn from verbal explanations, pictures, books or handling equipment.
privacy and modesty are important and should be respected during hospitalization
participation in care and planning with staff fosters a sense of involvement and accomplishment.
toys of the school-age child include board games, card games, and hobbies such as stamp collecting,
puzzles and video games.
school age children engage in cooperative play where the play is organized and they play with other
children.
4
