HESI RN Peds Hesi (1)
Chamberlain College of Nursing
NR322 ESE Study Guide
Medication calculations (IM, mg & ml; IV-gtt/min)
Growth & Development Tables H 182-184
❖ Infant (birth to one year)
• Developmental milestones
o Birth weight doubles by 6 months
▪ Triples by 12 months
o Birth length increases by 50% at 12 months
o Posterior fontanel closes by 8 weeks
o Social smile occurs at 2 months
o Head turns to locate sounds at 3 months
o Moro reflex disappears around 4 months
o Steady head control is achieved at 4 months
o Rolls from abdomen to back and back to abdomen at 5-6 months
o Plays peek-a- boo after 6 months
o Transfers objects from hand to hand at 7 months
o Develops stranger anxiety at 7-9 months
o Sits unsupported at 8 months
o Crawls at 10 months
o Fine pincer grasp appears at 10 -12 months
o Waves bye bye at 10 months
o Walks with assistance at 10-12 months
o Says a few words in addition to “mama” or “dada” at 12 months
o Explores environment by motor and oral means
• Erickson’s theory: developing a sense of trust ( trust vs mistrust)
• Nursing implications
o During hospitalization the infants emerging skills may disappear
1
,HESI RN Peds Hesi (1)
o If the parents are not bale to be with the infant the baby may be
inconsolable due to separation anxiety
o The nurse should plan to have the parents be part of the infant’s care and
should encourage them to do so
o Respect the infant’s schedule at home by assessing and implementing
components as possible
o Preparation and teaching should be directed to the family however the
nurse should always speak to the infant especially while performing
painful or stressful procedures
o Toys for hospitalized infants include:
▪ Mobiles
▪ Rattles
▪ Squeaking toys
▪ Picture books
▪ Balls
▪ Colored blocks
▪ Activity boxes
❖ Toddler (1-3 years)
• Developmental milestones
o Birth weight quadruples by 30 months
o Achieves 50% of adult height by 2 years
o Growth velocity slows
o Appears to be bowlegged and potbellied
o All primary teeth (20) are present
o Anterior fontanel closes by 12-18 months
o Throws a ball overhand at 18 months
o Kicks a ball at 24 months
o Feeds self with spoon and cup at 2 years
o Daytime toilet training can usually be started around 2 years
o Two to three word sentences are spoken by 2 years
2
,HESI RN Peds Hesi (1)
o Three to four word sentence spoken by 3 years
o Own first and last name can be stated by 2 ½ to 3 years
o Temper tantrums are common
• Erikson’s theory: developing a sense of autonomy ( autonomy vs doubt and
shame)
• Nursing implications
o Give simple brief explanations before procedures keeping in mind that a 1
year old does not benefit from the same explanation as that given to a 3
year old
o During hospitalization enforced separation from parents is the greatest
threat to the toddler’s psychological and emotional integrity
o Security objects or favorite toys from home should be provided for a
toddler
o Teach parents to explain their plans to the child
o Respect the child’s routine and implement when possible
o Expect regression like bed wetting
o Toys for hospitalized toddlers include board and mallet, push pull toys, toy
telephones, stuffed animals, story books with pictures, depending on the
reason for hospitalization. Toddlers benefit form being taken to the
hospital playroom when able because mobility is very important to their
development
o Toddlers are learning to name body parts and are concerned about their
bodies
o Very basic explanations should be given to toddlers about procedures
o Autonomy should be supported by providing guided choices when
appropriate
❖ Preschool child (3-6 years)
• Developmental milestones
o Each year a child gains about 5 lbs and grows 2 ½ to 3 inches
o A child stands erect with more slender posture
3
, HESI RN Peds Hesi (1)
o A child learns to run jump skip and hop
o A 3 year old can ride a tricycle
o Handedness is established
o A child uses scissors at 4 yrs
o A child ties shoelaces at 5 yrs
o A child learns colors and shapes
o Visual acuity approaches 20/20
o Thinking is egocentric and concrete
o A child uses sentences of five to eight words
o A child learns sexual identity (curiosity and masturbation are common)
o Imaginary playmates and fears are common
o Aggressiveness at 4 yrs is replaced by more independence at 5 years
• Erikson’s theory: developing a sense of initiative (initiative vs guilt)
• Nursing implications
o Nursing care for hospitalized preschoolers should 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
o The child’s questions should be answered at the child’s level use simple
words that will be understood by the child
o Therapeutic play or medical play that allows the child to act out his or her
experiences is helpful
o Fear of mutilation by procedures is common a band – aid may be quite
helpful in restoring body integrity
o Toys and play for the hospitalized preschooler include coloring books,
puzzles, cutting and pasting, dolls, building blocks, clay and toys that
allow the preschooler to work out hospitalization experiences depending
on the reason for hospitalization
o The preschooler needs preparation for procedures he or she should
understand what is and what is not going to be “fixed” simple explanations
4
Chamberlain College of Nursing
NR322 ESE Study Guide
Medication calculations (IM, mg & ml; IV-gtt/min)
Growth & Development Tables H 182-184
❖ Infant (birth to one year)
• Developmental milestones
o Birth weight doubles by 6 months
▪ Triples by 12 months
o Birth length increases by 50% at 12 months
o Posterior fontanel closes by 8 weeks
o Social smile occurs at 2 months
o Head turns to locate sounds at 3 months
o Moro reflex disappears around 4 months
o Steady head control is achieved at 4 months
o Rolls from abdomen to back and back to abdomen at 5-6 months
o Plays peek-a- boo after 6 months
o Transfers objects from hand to hand at 7 months
o Develops stranger anxiety at 7-9 months
o Sits unsupported at 8 months
o Crawls at 10 months
o Fine pincer grasp appears at 10 -12 months
o Waves bye bye at 10 months
o Walks with assistance at 10-12 months
o Says a few words in addition to “mama” or “dada” at 12 months
o Explores environment by motor and oral means
• Erickson’s theory: developing a sense of trust ( trust vs mistrust)
• Nursing implications
o During hospitalization the infants emerging skills may disappear
1
,HESI RN Peds Hesi (1)
o If the parents are not bale to be with the infant the baby may be
inconsolable due to separation anxiety
o The nurse should plan to have the parents be part of the infant’s care and
should encourage them to do so
o Respect the infant’s schedule at home by assessing and implementing
components as possible
o Preparation and teaching should be directed to the family however the
nurse should always speak to the infant especially while performing
painful or stressful procedures
o Toys for hospitalized infants include:
▪ Mobiles
▪ Rattles
▪ Squeaking toys
▪ Picture books
▪ Balls
▪ Colored blocks
▪ Activity boxes
❖ Toddler (1-3 years)
• Developmental milestones
o Birth weight quadruples by 30 months
o Achieves 50% of adult height by 2 years
o Growth velocity slows
o Appears to be bowlegged and potbellied
o All primary teeth (20) are present
o Anterior fontanel closes by 12-18 months
o Throws a ball overhand at 18 months
o Kicks a ball at 24 months
o Feeds self with spoon and cup at 2 years
o Daytime toilet training can usually be started around 2 years
o Two to three word sentences are spoken by 2 years
2
,HESI RN Peds Hesi (1)
o Three to four word sentence spoken by 3 years
o Own first and last name can be stated by 2 ½ to 3 years
o Temper tantrums are common
• Erikson’s theory: developing a sense of autonomy ( autonomy vs doubt and
shame)
• Nursing implications
o Give simple brief explanations before procedures keeping in mind that a 1
year old does not benefit from the same explanation as that given to a 3
year old
o During hospitalization enforced separation from parents is the greatest
threat to the toddler’s psychological and emotional integrity
o Security objects or favorite toys from home should be provided for a
toddler
o Teach parents to explain their plans to the child
o Respect the child’s routine and implement when possible
o Expect regression like bed wetting
o Toys for hospitalized toddlers include board and mallet, push pull toys, toy
telephones, stuffed animals, story books with pictures, depending on the
reason for hospitalization. Toddlers benefit form being taken to the
hospital playroom when able because mobility is very important to their
development
o Toddlers are learning to name body parts and are concerned about their
bodies
o Very basic explanations should be given to toddlers about procedures
o Autonomy should be supported by providing guided choices when
appropriate
❖ Preschool child (3-6 years)
• Developmental milestones
o Each year a child gains about 5 lbs and grows 2 ½ to 3 inches
o A child stands erect with more slender posture
3
, HESI RN Peds Hesi (1)
o A child learns to run jump skip and hop
o A 3 year old can ride a tricycle
o Handedness is established
o A child uses scissors at 4 yrs
o A child ties shoelaces at 5 yrs
o A child learns colors and shapes
o Visual acuity approaches 20/20
o Thinking is egocentric and concrete
o A child uses sentences of five to eight words
o A child learns sexual identity (curiosity and masturbation are common)
o Imaginary playmates and fears are common
o Aggressiveness at 4 yrs is replaced by more independence at 5 years
• Erikson’s theory: developing a sense of initiative (initiative vs guilt)
• Nursing implications
o Nursing care for hospitalized preschoolers should 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
o The child’s questions should be answered at the child’s level use simple
words that will be understood by the child
o Therapeutic play or medical play that allows the child to act out his or her
experiences is helpful
o Fear of mutilation by procedures is common a band – aid may be quite
helpful in restoring body integrity
o Toys and play for the hospitalized preschooler include coloring books,
puzzles, cutting and pasting, dolls, building blocks, clay and toys that
allow the preschooler to work out hospitalization experiences depending
on the reason for hospitalization
o The preschooler needs preparation for procedures he or she should
understand what is and what is not going to be “fixed” simple explanations
4
