NURS 373 - PEDIATRIC QUESTIONS WITH VERIFIED
ACCURATE ANSWERS
What is family centered care? - Answers -Recognizing the family as the unit of care
Supporting not only the child, but including the family and other loved ones in care
Age range - Neonate - Answers -birth to 28 days
Age range - infant - Answers -28 days to 12 months
Age range - toddler - Answers -1-3 years
Age range - preschool - Answers -3-6 years
Age range - school age/childhood - Answers -6-11 years
Age range - Adolescence - Answers -11-18 years
Normal development - infancy - Answers -Nurturance - meeting basic needs
Sense of trust - dependability, security
Oral phase - importance of sucking
Environment - strangers, safety are big concerns
Major stressors - separation
Normal growth - infancy - Answers -Length increase by 50%
Weight doubles by 6 months and triples by 1 year
Anterior and posterior fontanelles
Eruption of teeth around 8 months
Important interventions for infants - Answers -Have parents present
Familiar objects
Cuddling/rocking
Music
Sucking
Soft, slow voice
Normal development - toddler - Answers -Motor skills develop faster than intellectual
Sense of autonomy
Separation from mother
Anal stage: seeking control, ritualistic, tantrums
Major stressors: separation, fear of bodily harm, and alteration in routine
,Normal growth - toddler - Answers -Growth rate slows in 2nd year of life (mostly in legs)
Limited food intake
Growth spurts - steplike on growth curve
By age 2: half of adult height
Head circumference = chest circumference
Birth weight quadrupled (avg weight 27lbs)
By 33 months: all deciduous teeth erupted and child has about 20 teeth in total
Important interventions for toddlers - Answers -Familiar objects
Parents present
Allow for appropriate choices
Use simple terms - child's language
Try to keep the same routine as they have at home
Normal development - preschool - Answers -Increasing independence - imaginative,
curious, energetic learning
Sense of initiative - developing self-image (male/female)
Learning through imitation
Socializes with peers
Major stressors: fear of bodily harm, loss of control, heightened imagination leads to
fear and anxiety
Normal growth - preschool - Answers -Slow and steady (long bones of arms and legs)
Gain 3-5lbs per year
Grow about 2.5-3in per year
Deciduous teeth development complete
6 yrs - start to get deciduous teeth and get secondary teeth
Important interventions for preschoolers - Answers -Simple explanations
Allow for appropriate choices
Familiar objects
Parental presence
Be patient
Focus on the present
Normal development - childhood - Answers -Development of logical thinking
Interest outside of family
Sense of industry - challenges, achievement
Major stressors - loss of control, bodily injury, pain, separation
Normal growth - childhood - Answers -Slow and smooth (girls faster)
2in per year in height
6lbs per year in weight
By 7yrs nearly completed its growth
Development of small muscle and eye-hand coordination increases
Pubertal growth
,Loss of teeth
Important interventions for school age children - Answers -Explain procedures
Honesty
Privacy
Include in decision making
Parental presence
Normal development - adolescents - Answers -Independence
Physical and sexual maturity
Major stressors - loss of control, threats to independence
Tanner stages for sexual development
Normal growth - adolescents - Answers -Weight doubles and height increases 15-20%
Major organs double in size (except lymphoid tissue, which decreases)
Boys gain strength and muscle mass
Pituitary gland stimulated at puberty to produce androgen steroids responsible for
secondary sex characteristics
Important interventions for adolescents - Answers -Explain procedures
Involve in decision-making
Privacy
Avoid authoritarian approach when possible
Great time for health teaching
Promote positive attitudes
Need feedback that they are normal and healthy
Pediatric Differences - Neuro System - Answers -90% brain growth by age 6
CNS immature, poorly developed nerve fibres
Numerous reflexes present at birth
Myelination in 1st year of life
BBB not mature until 2 years
What are fontanelles? - Answers -'Soft spots' between suture lines in the skull
When does the anterior fontanelle close? - Answers -Around 18 months
When does the posterior fontanelle close? - Answers -2-3 months
Pediatric Neuro Assessment - Answers -General LOC
Behaviour and development - age appropriate?
Alertness
Orientation (if old enough to assess)
Cry (lusty normal, weak/high-pitched abnormal)
fontanelles (should be soft and flat)
Pupils (same as adult assmt)
, limb movement/ambulation
strength of suck
tone
Pediatric Differences - Upper Resp System - Answers -Shorter neck = structures closer
together
trachea shorter and narrower - risk for obstruction
newborns are nose breathers
larynx and glottis high in neck - risk for aspiration
tongue large in proportion to mouth
Pediatric Differences - Lower Resp System - Answers -Alveoli not fully developed
# of alveoli increases from 25 mil - 300 mil by age 8
smaller alveoli - risk of collapse
less lung volume
diaphragm breathing
CO2 not effectively expired when distressed - risk for acidosis
Airway resistance in kids - Answers -Greater in children > adults (narrower airway)
can be further narrowed with inflammation
increased work of breathing
Pediatric Resp Assessment - Answers -Rate - one full minute
rhythm
depth
cough with description
secretions if present
O2 sat
auscultation
What are transmitted lung sounds? - Answers -May seem to originate in the lungs but
actually referred from the upper airway (i.e. mucous in the throat or nose)
Most common sound to hear in kids
Resp assessment - work of breathing - Answers -Retractions/in-drawing - can see ribs
when inhaling
accessory muscles
grunting
head bobbing
nasal flaring
tracheal tug - abN down movement of trachea when inhaling
Pediatric Differences - CVS - Answers -HR is labile
tachycardic when stressed, fever, resp distress
lower BP - immature left ventricle
BP higher in lower limb vs upper
ACCURATE ANSWERS
What is family centered care? - Answers -Recognizing the family as the unit of care
Supporting not only the child, but including the family and other loved ones in care
Age range - Neonate - Answers -birth to 28 days
Age range - infant - Answers -28 days to 12 months
Age range - toddler - Answers -1-3 years
Age range - preschool - Answers -3-6 years
Age range - school age/childhood - Answers -6-11 years
Age range - Adolescence - Answers -11-18 years
Normal development - infancy - Answers -Nurturance - meeting basic needs
Sense of trust - dependability, security
Oral phase - importance of sucking
Environment - strangers, safety are big concerns
Major stressors - separation
Normal growth - infancy - Answers -Length increase by 50%
Weight doubles by 6 months and triples by 1 year
Anterior and posterior fontanelles
Eruption of teeth around 8 months
Important interventions for infants - Answers -Have parents present
Familiar objects
Cuddling/rocking
Music
Sucking
Soft, slow voice
Normal development - toddler - Answers -Motor skills develop faster than intellectual
Sense of autonomy
Separation from mother
Anal stage: seeking control, ritualistic, tantrums
Major stressors: separation, fear of bodily harm, and alteration in routine
,Normal growth - toddler - Answers -Growth rate slows in 2nd year of life (mostly in legs)
Limited food intake
Growth spurts - steplike on growth curve
By age 2: half of adult height
Head circumference = chest circumference
Birth weight quadrupled (avg weight 27lbs)
By 33 months: all deciduous teeth erupted and child has about 20 teeth in total
Important interventions for toddlers - Answers -Familiar objects
Parents present
Allow for appropriate choices
Use simple terms - child's language
Try to keep the same routine as they have at home
Normal development - preschool - Answers -Increasing independence - imaginative,
curious, energetic learning
Sense of initiative - developing self-image (male/female)
Learning through imitation
Socializes with peers
Major stressors: fear of bodily harm, loss of control, heightened imagination leads to
fear and anxiety
Normal growth - preschool - Answers -Slow and steady (long bones of arms and legs)
Gain 3-5lbs per year
Grow about 2.5-3in per year
Deciduous teeth development complete
6 yrs - start to get deciduous teeth and get secondary teeth
Important interventions for preschoolers - Answers -Simple explanations
Allow for appropriate choices
Familiar objects
Parental presence
Be patient
Focus on the present
Normal development - childhood - Answers -Development of logical thinking
Interest outside of family
Sense of industry - challenges, achievement
Major stressors - loss of control, bodily injury, pain, separation
Normal growth - childhood - Answers -Slow and smooth (girls faster)
2in per year in height
6lbs per year in weight
By 7yrs nearly completed its growth
Development of small muscle and eye-hand coordination increases
Pubertal growth
,Loss of teeth
Important interventions for school age children - Answers -Explain procedures
Honesty
Privacy
Include in decision making
Parental presence
Normal development - adolescents - Answers -Independence
Physical and sexual maturity
Major stressors - loss of control, threats to independence
Tanner stages for sexual development
Normal growth - adolescents - Answers -Weight doubles and height increases 15-20%
Major organs double in size (except lymphoid tissue, which decreases)
Boys gain strength and muscle mass
Pituitary gland stimulated at puberty to produce androgen steroids responsible for
secondary sex characteristics
Important interventions for adolescents - Answers -Explain procedures
Involve in decision-making
Privacy
Avoid authoritarian approach when possible
Great time for health teaching
Promote positive attitudes
Need feedback that they are normal and healthy
Pediatric Differences - Neuro System - Answers -90% brain growth by age 6
CNS immature, poorly developed nerve fibres
Numerous reflexes present at birth
Myelination in 1st year of life
BBB not mature until 2 years
What are fontanelles? - Answers -'Soft spots' between suture lines in the skull
When does the anterior fontanelle close? - Answers -Around 18 months
When does the posterior fontanelle close? - Answers -2-3 months
Pediatric Neuro Assessment - Answers -General LOC
Behaviour and development - age appropriate?
Alertness
Orientation (if old enough to assess)
Cry (lusty normal, weak/high-pitched abnormal)
fontanelles (should be soft and flat)
Pupils (same as adult assmt)
, limb movement/ambulation
strength of suck
tone
Pediatric Differences - Upper Resp System - Answers -Shorter neck = structures closer
together
trachea shorter and narrower - risk for obstruction
newborns are nose breathers
larynx and glottis high in neck - risk for aspiration
tongue large in proportion to mouth
Pediatric Differences - Lower Resp System - Answers -Alveoli not fully developed
# of alveoli increases from 25 mil - 300 mil by age 8
smaller alveoli - risk of collapse
less lung volume
diaphragm breathing
CO2 not effectively expired when distressed - risk for acidosis
Airway resistance in kids - Answers -Greater in children > adults (narrower airway)
can be further narrowed with inflammation
increased work of breathing
Pediatric Resp Assessment - Answers -Rate - one full minute
rhythm
depth
cough with description
secretions if present
O2 sat
auscultation
What are transmitted lung sounds? - Answers -May seem to originate in the lungs but
actually referred from the upper airway (i.e. mucous in the throat or nose)
Most common sound to hear in kids
Resp assessment - work of breathing - Answers -Retractions/in-drawing - can see ribs
when inhaling
accessory muscles
grunting
head bobbing
nasal flaring
tracheal tug - abN down movement of trachea when inhaling
Pediatric Differences - CVS - Answers -HR is labile
tachycardic when stressed, fever, resp distress
lower BP - immature left ventricle
BP higher in lower limb vs upper
