Exam 4

Question 1

Appropriate stage for teaching children names and functions of sexual organs

Answer 1

age 6-12

Question 2

Common time for infant to roll over

Answer 2

4mths rolls from back to side
5mths rolls from front to back
6mths rolls from back to front

Can turn over by 8-9 months of age.

Question 3

Typical height for adolescent is?

Answer 3

Final 20-30% of height is achieved during puberty, girls grow up 2-8 inches, and boys 4-8

Question 4

Implanon a contraceptive method when does it need replaced

Answer 4

It must be removed and replaced every 3 yrs if continued contraception is desired

Question 5

Which contraceptive would be appropriate for a lactating woman?

Answer 5

Appropriate candidates for intrauterine contraception (IUD) include nulliparas, women with previous ectopic pregnancies , women receiving treatment for PID, LACTATING WOMEN, women testing positive for HIV, and women immediately postpartum or postabortion

Question 6

How many regular menstrual cycles should one have before initiation of birth control pills?

Answer 6

Waiting until 2 years of menstrual cycles reduces the chance of suppression of the pituitary regulating centers

Question 7

Signs and symptoms of toxic shock syndrome

Answer 7

Common signs of TSS include fever of sudden onset greater than 101.1F, rash, hypotension with a systolic BP less than 90mm Hg.

Question 8

Difference between nature and nurture

Answer 8

Nature describes the traits inherent in the infant: biologically imposed idiosyncratic factors that create what and how each person “is”.

Nurture refers to the influence of external events such as parenting received , culture, or the time in which a child lives

Question 9

What is definition of growth ? Definition of development

Answer 9

Growth refers to physical change and increase in size

Development is an increase in the complexity of function and skill progression

Question 10

Which developmental domain is assessed for language development?

Answer 10

Social theory: Lev Vygotsky–emphasized that culture and certain factors within the child’s environment have a dramatic impact on language development.

Question 11

Latent stage of development according to Freud

Answer 11

LATENCY (6 years to puberty) - Freud believes child “takes a break”. Allows child to focus more intently on other aspects of growth and learning. Sexual impulses are repressed, relationships between peers of same sex develop, time for sports, and video games.

Question 12

The basic task for Erickson’s Industry vs Inferiority stage is?

Answer 12

Industry versus Inferiority - 6 to 12 years - Child develops sense of confidence through mastery of tasks. This is counterbalanced by sense of inadequacy or inferiority that comes from not succeeding. Realizing competency is important building blocks in development of self-esteem. If child cannot accomplish realistic expected tasks, the feeling of inferiority may result.

Question 13

Appropriate toys and activities for toddler

Answer 13

Filling and emptying containers, playing with blocks, looking at books, toys that can be pushed or pulled, tossing balls.

Question 14

Cyanosis of skin is indicative of ?

Answer 14

Poor oxygenation, circulation, cold

Question 15

OLD CAT

Answer 15

Used to clarify childs health history.
Onset, Location, Duration, Character, Aggravating/ Alleviating

Question 16

PRIORITY MEASURE FOR CHILD SAFETY IN HOSPITAL SETTING:

Answer 16

keeping toxic materials out of reach, identifying children with name bands, and knowing the whereabouts of children on the unit. Nurse must also provide a safe environment inside the room and in the transport of children from their room to other parts of the hospital.

Question 17

DENVER II SCREENING TEST IS USED TO ASSESS WHAT?

Answer 17

Assesses personal-social, fine motor-adaptive, gross motor, and language skills. Nurse also documents behaviors during administration of the test.

Question 18

AMBULATORY SURGERY-DESCRIBE SERVICES:

Answer 18

a place where children receive minimal treatment, recover from the procedure, and then are discharged home soon after the surgery. Minimizes separation between child and family. Some recovery takes place in the surgery center, but longer process continues at home. Assess knowledge in order to determine their ability to care for child independently at home or if additional support is needed.

Question 19

Separation anxiety.

Answer 19

May exhibit an intense reaction to any type of procedure due to the intrusion of boundaries. The three reactions are protest (screaming), despair (developmental regression), and detachment (lack of interaction with unfamiliar people)

Question 20

DESCRIBE DESPAIR:

Answer 20

Developmental regression, withdrawn, quiet.

Question 21

SERVICES PROVIDED BY PEDIATRIC COMMUNITY NURSE?

Answer 21

Nurse provides health screening and education, emphasizing health promotion and disease prevention. Focus is on early identification, assessment, and referral

Question 22

WHICH AGE GROUP BENEFITS FROM READING AS PART OF THERAPEUTIC PLAY?

Answer 22

Adolescent

Question 23

KUBLER-ROSS’S STAGES OF GRIEF:

Answer 23

Denial and Isolation, Anger, Bargaining, Depression, Acceptance

Question 24

DESCRIBE DEPRESSION:

Answer 24

When illness can no longer be denied or bargained away, the family and child may begin to feel a profound sadness. (insomnia or excessive sleeping, nightmares, weight gain or weight loss, loss of concentration that interferes with ability to function normally, overwhelming anger, constant fear or worry about the physical wellness of other family members.

Question 25

ZOLOFT 50 MG, WHAT SHOULD THE CLIENT BE TAUGHT ABOUT THE MEDICATION?

Answer 25

...SSRI, contraindicated in breastfeeding, MAOIs, hepatic or renal dysfunc, alchol, hx of suicide attempts

Question 26

PAXIL TO PREVENT DRUG/FOOD INTERACTIONS WHAT WOULD YOU TEACH CLIENT TO AVOID:

Answer 26

Alcohol

Question 27

CLOMID FOR INFERTILITY, WHAT DO YOU NEED TO TEACH CLIENT?

Answer 27

May increase the risk of multiple births, may need daily ultrasounds or ck serum estrogen levels if combined with other medications, can have "ovarian hyperstimulation" which pt may need to have a rest period and postponement of treatment until following cycle.

Question 28

WHAT SHOULD CLIENT AVOID WHILE TAKING ORAL CONTRACEPTIVES?

Answer 28

Smoking

Question 29

AT WHAT AGE WOULD THERE BE CONCERN IF GIRL HAS NOT STARTED MENSTRUAL CYCLE? ~

Answer 29

15

Question 30

WHAT STRATEGY USES REWARD TOINCREASE POSITIVE BEHAVIOR?

Answer 30

Positive reinforcement

Question 31

WHICH CULTURE WOULD BE MOST LIKELY TO USE FOLK MEDICINE?

Answer 31

...indian and hispanics

Question 32

What does the CDC recommend concerning physical activity for school children, how long and how many times a week?

Answer 32

1 hour or more of physical activity a day

Question 33

Describe who makes up the extended family?

Answer 33

Extended family is grandparents, aunts, uncles, cousins, who are outside of the nuclear family.

Question 34

Which assessment would you perform first on an infant?

Answer 34

APGAR if a newborn If this is an infant coming in for a checkup make sure that the reflexes(rooting,sucking,moro, grasping,babinksi) are present, and the child is neurologically intact. Measure the head circumference, length, weight, and BMI. As always AIRWAY is most important.

Question 35

Effective way to encourage good nutritional habits for preschoolers?

Answer 35

One way is to set a good example by eating healthy yourself. You can bring healthy snacks for your child, with you when you leave the house and teach them about the healthy choices that they can make outside of the home. Also, you can cut foods into shapes or present them in different ways, so the food looks more appealing to the child. Include your child in preparation and purchasing of foods. Have one family meal at the table to introduce your child to new foods and if they don't like them don't force them to eat it.

Question 36

How do you modify a toddler's behavior?

Answer 36

Parents and caregivers should know that tantrums for children of this age are normal. It may be possible to avoid such tantrums if the parent recognizes certain things that may "set the child off" like being too tired, or hungry. There are a few things that he nurse can teach the parents on how to help with discipline. 1. If the child is thrashing and crying and is not hurting themselves or anyone else...you can just leave them alone. 2. Distraction: Give the child a toy to divert their attention 3. Time-out: So the child can calm down 4. Removal of privileges: Withhold a favorite toy until the child's behavior is appropriate. 5. Verbal reprimands: Give spoken warning or disapprovals without judging the child as "bad" 6. Corporal punishment: Like spanking, swatting, grabbing....are NOT recommended (p.657) It is important for the parents to remember to never use name calling or yelling, to be clear, and firm. Also, they need to speak to the child as they would want to be spoken to if someone were reprimanding them.

Question 37

What site would you use to administer immunizations in an infant?

Answer 37

Anterolateral thigh muscle

Question 38

age group would you observe for pain rather than trying to use verbal report?

Answer 38

I would think it would be between the ages of 0-3 years.

Question 39

What activities to adolescents participate in?

Answer 39

This is the cooperative play stage. They like to play video games, computer games, board games, sports, card games, charades, etc.

Question 40

What play is appropriate for a 6-9 month old?

Answer 40

Solitary play phase: They like to play patty cake, pee a boo, itsy-bitsy spider, finger painting, ball rolling, songs, high chair fishing.

Question 41

Hospitalized adolescent what stressors would you anticipate?

Answer 41

They may have concerns about their body image, separation from their peers, loss of independence, and decrease in socialization.

Question 42

What are the stages and signs of grief?

Answer 42

S/S: tightness in the chest and throat, weakness, SOB, inability to focus, feelings of guilt, feeling responsible for the loved ones death, hostile reactions, inability to complete daily tasks, preoccupation with the image of the deceased, searching for what they could have done differently. Grief theories: * Elisabeth Kubler-Ross- Denial, anger, bargaining, depression, acceptance. * Miles and Perry's Stages of Grief- Phase 1: state of numbness and shock Phase 2: period of intense grief Phase 3: period of reorganization (p.1149) * Epperson's Theory of Grieving- High anxiety, Denial, anger, Remorse, Grief, Reconciliation. * Pathological Grief- When the person deviates from a healthy way of dealing with grief to a not so healthy way (violence, addictions, poor decision making)