NUR 231
EXAM 3 STUDY GUIDE
Concepts Of Nursing:
The Childbearing/Child Caring Family
Galen College of Nursing
,Exam 3 Peds
Children lab values:
- Hgb
o 1-6 yrs 9.5-14
o 6-18 10-15.5
- Hct
o 1-6 years: 30-40%
o 6-18 years: 32-44%
- WBC
o Less than 2 years: 6.2-17
o Greater than 2 years: 5-10
- Platelet:
o Same as adults 150-400
- Glucose:
o Under 2: 60-100
o Older than 2: 70-110
- Sodium
o Same as adults 135-145
- Potassium:
o 3.4-7
- Creatinine:
o 0.3-0.7
- BUN
o 5-18
- RBC
o 1-6 years: 4.5-5
o 6-18 years: 4.5-5
- Calcium
o 8.8-10.8
- Chloride
o 90-110
- Specific gravity:
o Same as adults 1.005-1.030
Clinical Growth and Development paper:
Infant Birth to 1 year:
- Developmental milestones:
o Birthweight doubles by 6 months and triples by 12 months
o Birth length increases by 50% at 12 months
o Social smile occurs at 2 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 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 Walks with assistance at 10-12 months
o Says few words in addition to “mama” or “dada” at 12 months
o Explores environment by motor and oral means
- Erickson theory: Developing a sense of trust *Trust VS Mistrust
- Nursing implications:
o During hospitalization the infants emerging skills may disappear.
o If the parents are not able 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 infants care and should
encourage them to do so
o Respect the infants 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 and console the infant, especially while performing painful or
stressful procedures
o Toys for hospitalized infants include mobiles, rattles, squeaking toys, picture books, balls,
colored blocks, and activity boxes
Toddler 1 to 3 years
- Developmental milestones:
o Birth weight quadruples by 30 months
o Achieves 50% of adult height by 2 years
o Appears to be bowlegged and potbellied
o All primary teeth *20* are present
o Anterior fontanel closes by 12-18 months
o Throw ball overhead at 18 months
o Kicks ball at 24 months
o Feeds self with spoon and cup at 2 years
o Daytime toilet training started around 2 years
o 2 to 3-word sentences are spoken by 2 years
o 3 to 4-word sentences are spoken by 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 1 year old does
not benefit from the same explanation as the given to a 3-year-old
o During hospitalization, enforced separation from parents is the greatest threat to the
toddlers psychological and emotional integrity
, o Security objects or favorite toys from home should to provide for a toddler
o Teach parents to explain their plans to the child “I will be back after your nap”
o Respect the child’s routine and implement when possible
o Expect regression *Bed-wetting*
o Toys for the hospitalized toddler include board and mallet, push-pull toys, toy
telephones, stuffed animals, and storyboards with pictures, depending on the reason for
hospitalization. Toddlers benefit from 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 A child learns to run, jump, skip, and hop
o Handedness is established
o A child uses scissors at 4 years old
o A child learns colors, shapes
o Visual acuity approaches 20/20
o Thinking is egocentric and concrete
o A child uses sentences of 5 to 8 words
o A child learns sexual identity *curiosity and masturbation are common*
o Imaginary play mates and fears are common
- 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 to them they didn’t 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 the hospitalization.
School-Age Child *6 to 12 years*
- Developmental milestones:
o Girls may experience menarche
o Loss of primary teeth and eruption of most permanent teeth occurs
o Fine and gross motor skills mature
EXAM 3 STUDY GUIDE
Concepts Of Nursing:
The Childbearing/Child Caring Family
Galen College of Nursing
,Exam 3 Peds
Children lab values:
- Hgb
o 1-6 yrs 9.5-14
o 6-18 10-15.5
- Hct
o 1-6 years: 30-40%
o 6-18 years: 32-44%
- WBC
o Less than 2 years: 6.2-17
o Greater than 2 years: 5-10
- Platelet:
o Same as adults 150-400
- Glucose:
o Under 2: 60-100
o Older than 2: 70-110
- Sodium
o Same as adults 135-145
- Potassium:
o 3.4-7
- Creatinine:
o 0.3-0.7
- BUN
o 5-18
- RBC
o 1-6 years: 4.5-5
o 6-18 years: 4.5-5
- Calcium
o 8.8-10.8
- Chloride
o 90-110
- Specific gravity:
o Same as adults 1.005-1.030
Clinical Growth and Development paper:
Infant Birth to 1 year:
- Developmental milestones:
o Birthweight doubles by 6 months and triples by 12 months
o Birth length increases by 50% at 12 months
o Social smile occurs at 2 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 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 Walks with assistance at 10-12 months
o Says few words in addition to “mama” or “dada” at 12 months
o Explores environment by motor and oral means
- Erickson theory: Developing a sense of trust *Trust VS Mistrust
- Nursing implications:
o During hospitalization the infants emerging skills may disappear.
o If the parents are not able 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 infants care and should
encourage them to do so
o Respect the infants 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 and console the infant, especially while performing painful or
stressful procedures
o Toys for hospitalized infants include mobiles, rattles, squeaking toys, picture books, balls,
colored blocks, and activity boxes
Toddler 1 to 3 years
- Developmental milestones:
o Birth weight quadruples by 30 months
o Achieves 50% of adult height by 2 years
o Appears to be bowlegged and potbellied
o All primary teeth *20* are present
o Anterior fontanel closes by 12-18 months
o Throw ball overhead at 18 months
o Kicks ball at 24 months
o Feeds self with spoon and cup at 2 years
o Daytime toilet training started around 2 years
o 2 to 3-word sentences are spoken by 2 years
o 3 to 4-word sentences are spoken by 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 1 year old does
not benefit from the same explanation as the given to a 3-year-old
o During hospitalization, enforced separation from parents is the greatest threat to the
toddlers psychological and emotional integrity
, o Security objects or favorite toys from home should to provide for a toddler
o Teach parents to explain their plans to the child “I will be back after your nap”
o Respect the child’s routine and implement when possible
o Expect regression *Bed-wetting*
o Toys for the hospitalized toddler include board and mallet, push-pull toys, toy
telephones, stuffed animals, and storyboards with pictures, depending on the reason for
hospitalization. Toddlers benefit from 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 A child learns to run, jump, skip, and hop
o Handedness is established
o A child uses scissors at 4 years old
o A child learns colors, shapes
o Visual acuity approaches 20/20
o Thinking is egocentric and concrete
o A child uses sentences of 5 to 8 words
o A child learns sexual identity *curiosity and masturbation are common*
o Imaginary play mates and fears are common
- 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 to them they didn’t 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 the hospitalization.
School-Age Child *6 to 12 years*
- Developmental milestones:
o Girls may experience menarche
o Loss of primary teeth and eruption of most permanent teeth occurs
o Fine and gross motor skills mature
