Flashcards in Exam 1 Deck (96):
When to prepare medication (injection, etc) for toddler
right before procedure
When to prepare medication (injection, etc) for school-aged child
a few days in advance
When to prepare medication (injection, etc) for preschool aged child
1 hour before procedure
When to prepare medication (injection, etc) for adolescent
up to 1 week prior to procedure
what position should newborn be in when giving oral meds
what position should toddler be in when giving oral meds?
absorption of rectal medications is directly related to what?
the time the medication is in the rectum
If need to cut rectal med in half,
cut it length-wise
What position should child be if giving a rectal medication?
left lateral position
knee to chest position
Adult - 10 cm (4 in)
Child - 7.6 cm (3 in)
Infant - 5 cm (2 in)
If child closes eye tightly when giving eye medication,
instill drops into nasal corner of the closed eye.
*If applying more than 1 type of eye drop, wait 5 min between drops to prevent one from washing other out.
Best time to give eye meds?
before nap (slide 24 review)
Most important thing to do when giving eye meds?
gently massage conjunctival sac (corner of eye) for 1 minute to make sure that it only goes into eye and doesn’t become systemic.
How should child be sitting for eye meds?
supine or sitting and looking up
How should child be sitting for otic meds?
upright or supine with head turned with affected ear up
How to give ear meds for child older than 3 years old?
pull pinna upward and back
How to give ear meds for child younger than 3 years old?
pull earlobe down and back
SubQ meds: what size syringe and needle
1 mL syringe with 26-30 gauge needle
SubQ meds: what angle to give shot?
90 degrees (or 45 degrees for very thin child)
Appropriate sites to give subQ meds:
- anterior thighs
- lateral upper arms
- area around belly button
What should volume be for subQ meds?
less than 0.5 mL
What size needle should be used for IM meds?
22-25 gauge, 1/2 - 1 in needle
What is muscle of choice when giving children IM injection?
Positions child should be in for IM in vastus lateralis?
How much can infants receive in this muscle?
supine, side-lying, or sitting
Infants can receive up to 0.5 mL
Children can receive up to 2 mL
How much IM med can be given to a child in the deltoid?
up to 1 mL
Nasal DROPS should be held where in relation to nose?
1/2 inch above nares
child should keep head tilted for how long after receiving nasal DROPS
What position should child be in for nasal SPRAY?
What should child do after receiving nasal spray?
hold breath for a few seconds then exhale through the mouth
What size catheters for IV fluids?
24 to 20 gauge
where would access be for long term IV fluids?
central venous access
How many hours of feeds (NG/GT/JT) should be at a time?
4 hrs of feeds at a time
How often should placement of NG/GT/JT and/or residual be checked?
every 4 hours
When do children see biggest growth spurt?
infancy and adolescence
how do children grow?
cephalocaudal (head to toe)
Infancy (birth - 12 months) is what stage?
trust vs mistrust
Infancy is a period of rapid growth, what happens during this time period?
Gain 5-7 ounces per week
By 6 months, double birthweight
By 12 months, triple birthweight and have 6-8 teeth
Height increases by 1 inch per month for 6 months.
Organ systems that are still maturing within first year?
when does head lag greatly improve in an infant?
when can infant begin to roll around and look at things?
When can infant usually tripod sit?
When can infant sit unsupported?
When does an infant typically begin to crawl?
What age does infant start pulling to stand?
At what age do infants start trying to walk independently?
What age can infant sit alone but still needs support from hands
Trigger: Loud noise (even baby’s own cry!), sudden movement, or sensation of falling
Response: Baby cries and extends legs, arms, and fingers, arches back, then retracts arms and legs
Trigger: A gentle stroke on the newborn’s cheek
Response: Baby turns toward the touch, with mouth open
Trigger: Something, such as a nipple (breast or bottle) or parent’s finger, touching roof of baby’s mouth
Response: Baby sucks on object
place finger palm or foot and they will try and grasp that
Plantar/Palmar Grasp Reflex
hold baby up and they pretend like they are going to stand and walk – should go away by 4 weeks
Trigger: A gentle stroke on the sole of the foot (from heel to toe)
Response: Foot turns in and toes flare up
--Doesn't leave until 8mos-1 year
Fine motor skills at 1 month
fists are mostly clenched and near face
Fine motor skills at 3 months
fists open up some but are still mainly by face
Fine motor skills at at 4 months
begin to bat at things
Fine motor skills at 5 months
begin to grasp things like a rattle (because they really want to)
Fine motor skills at 6-7 months
begin to transfer things from 1 hand to the other
Fine motor skills at 8 months
Gross Pincer Grasp (raking at cheerios)
Fine motor skills at 10 months
Fine Pincer Grasp (picking cheerios up 1 by 1); puts objects into container and takes them out
Fine motor skills at 12 months
Feeds self with cup and spoon
simple marks on paper
pokes with index finger
Language at 1-3 months:
Language at 4-5 months:
simple vowel sounds, laughs, raspberries
*responds to name
Language at 4-7 months:
squealing and yelling
Mama and Dada without meaning
Language at 9-12 months:
Mama and Dada with meaning
At what age do babies start to know who parents are?
At what age do babies begin to enjoy games like peek-a-boo?
When does stranger anxiety develop?
______ is referred to as the "how" of behavior -- can start to tell if baby will be laid back, etc.
What ages are considered to be toddlers?
12 -36 months (1-3 years)
Toddler Growth facts:
gains 4-6 lbs/year
birth weight is quadrupled by 2 1/2 years old
Height increases about 3 inches per year
When does anterior fontanel close?
When do sphincter controls for bladder or bowel develop? (important for anticipatory guidance for parents)
Toddlers stage of Erikson's development
Autonomy vs Shame and Doubt
(*This is when time out starts)
- punishment vs reward
At what age does gender identity begin?
3 years old
Toddler Gross Motor Skills: at 12-15 months
Toddler Gross Motor Skills at 18 months
pulls toys while walking
Toddler Gross Motor Skills at 24 months
carries toys while walking, stand on tip toe, kick ball, run
Toddler Gross Motor Skills at 36 months
climbs well, pedals tricycle, bends over easily without falling, climbs stairs with alternate feet.
At what age can a child ride a tricycle? (NCLEX question)
3 years old.
Toddler fine motor skills at 12-15 months
feeds self finger foods, uses a cup
Toddler fine motor skills at 18 months
masters reaching, grasping, releasing
removes shoes and socks
turns pages of book
Toddler fine motor skills at 24 months
builds tower of 6-7 cubes
right or left handed
Toddler fine motor skills at 36 months
copies circle, square, etc
holds pencil in writing position
When may separation anxiety reemerge?
between 18 - 24 months
Erikson's Stage for Preschoolers:
Initiative vs Guilt
At what age/stage do children begin to regress if they get sick?
Preschooler age (3-6 years)
At what age can a child draw a person with 2 to 4 parts?
4 years old
at 5 years old, children can draw a person with how many body parts?
at least 6
At what age is 75% of speech understood by others outside of family?
4 years old
At 5 years of age, child's language includes
- talking about past, future, and imaginary events
- count to 10
- say name and address
At what stage do chlildren believe that if they or family members/friends are sick, it is completely their fault?
Preschooler age (3-6 years)
School age children (6-12 year olds) height and weight increases by what?
height: 2 in/ year
Weight: 2-4 kg/year
School age children Erikson stage
Industry vs Inferiority
When does average teen girl go through puberty?
9-12 years old