NUR 254 EXAM 3 WITH QUESTIONS AND ANSWERS, LATEST 2025/2026-GALEN COLLEGE OF NURSING

NUR 254 EXAM 3 WITH QUESTIONS AND ANSWERS, LATEST 2025/2026-GALEN COLLEGE OF NURSING Creative Communication - ANSWER -Nurse will have to be creative when communicating with children Pain Scales - ANSWER -NIP 2months FLACC 2 months to 7 years old Wong Baker- Faces- 3 to 4 years old Numeric Scales (0 to 10)- 8 years old to older Red Flags call HCP - ANSWER -Posterior fontanelle open after 2 months Anterior fontanelle open after 18 months Weight Gain 2x @ 6 months Weight gain 4x @ 12 months Should babble @ 9 months Fontanelle bulging or sunken in Pediatric Assessment - ANSWER -Interact with parents Child sits on parents lap Equipment out of sight Invasive last (BP, temp, ear exam) Ear Assessment - ANSWER -3- pinna down and back 3- pinna up & back Infant Milestones - ANSWER -1 month: grasp reflex 2 months: posterior fontanelle closes 3 months- hold objects 4 months: roll front to back, smiles, Moro gone 6 months: roll back to front, first sounds, teeth erupt, solid foods introduced 8 months: sits unsupported 9-12 months: starting to walk Toddler Milestones - ANSWER -15 months- creeps upstairs 18 months- anterior fontanelle closes 24 months- parallel play, egocentric, runs well 30 months- jumps both feet, starts potty training Screening for Lead Poisoning - ANSWER -Universal screening done at 1 & 2 years old Preschooler Developmental Milestones - ANSWER -3 years- rides tricycle, walks upstairs with alternate feet, parallel & associative play 4 years- hops on 1 foot, uses scissors 5 years- associative play Immunizations - ANSWER -Minor illnesses (cold)- not contraindicated in vaccines For administration- consent signed & vaccine sheet provided to parent Immunocompromised- no live vaccines Active Immunity - ANSWER -Give vaccine Passive Immunity - ANSWER -Breastmilk Pediatric Indicators of Cardiac Dysfunction - ANSWER -POOR FEEDING tachypnea, tachycardia, hypoxia, failure to thrive, developmental delays positive prenatal & family history After Care Cardiac Cath - ANSWER -Cover site with bandage & change daily for 2 days Keep clean & dry Observe for redness, swelling, drainage, bleeding, or fever Encourage rest & quiet Diet not restricted Avoid tub baths & swimming Infants have increased HR to: - ANSWER -Keep up with metabolic demand Maintain cardiac output Infants have little cardiac reserve because muscle fibers can't stretch enough to increase stroke volume so they increase heart rate and Cardiac output Blood pressure begins low then increases with age Acyanotic - ANSWER -left to right shunt Pink Increase pulmonary blood flow (PDA, ASD, VSD) Obstruction to blood flow from ventricles (CoArc, Aortic Stenosis, Pulmonic Stenosis) Cyanotic - ANSWER -right to left shunt- blue Decrease pulmonary blood flow (TOF, Tricuspid Atresia) Mixed blood Flow (TGA/TGV, HLHS) patent ductus arteriosus (PDA) - ANSWER -*ACYANOTIC - left to right shunting - increased pulmonary bloodflow* Ductus arteriosus fails to close normally in an infant soon after birth Machine like Murmur May be asymptomatic Administer Indomethacin Transposition of Great Vessels - ANSWER -Cyanotic Septal defects or PDA Life threatening require surgery in the 1st week of life Treatment- PGE Vital Signs with pulses & BP on all 4 extremities Monitor for CHF Heart Failure - ANSWER -Early signs- increase respiratory rate, poor feeding Digoxin (Apical pulse, monitor K & NA) Lasix Increase HR & RR @ rest Increase weight Right sided heart failure - ANSWER -1. Jungular Vein Distention 2. Ascending Dependent Edema 3. Weight Gain 4. Hepatomegaly (Liver Enlargement) 5. Ascites Heart Failure Goals - ANSWER -apical pulse 90 beats per minute Getting better Weight decrease Acute Epiglottis - ANSWER -Emergency Drooling, Irritable No visualizing/ inspection