Growth and Development

Question 1

Describe Growth

Answer 1

physical development that is sequential(linear) and directional,, continuous and predictable but NOT the SAME RATE

Question 2

Cephalocaudal

Answer 2

head to toe

Question 3

Example of Cephalocaudal normal growth

Answer 3

Child gains control of the head and neck before the trunk and limbs

Question 4

Example of Proximodistal normal growth

Answer 4

Child controls arm movements before hand movement

Question 5

Describe Developement

Answer 5

Qualitative increase in capabilities or functions

Sequence is predictable and specific; each child must pass through every stage

Question 6

Examples of development

Answer 6

Children crawl > creep > stand > they walk.

Child babbles > forms words > speaks in sentences;

Personality is built on the early foundation of trust.

Writing emerges from scribbling.

Question 7

Growth Rate

Answer 7

uneven and individual with rapid growth during infancy and puberty beginning of adolescence)

Question 8

Infant Age

Answer 8

birth to 1 year

Question 9

Infant Erikson Stage

Answer 9

Trust vs Mistrust (0-1yr)

Question 10

Trust vs. Mistrust

Answer 10

Child needs consistency- primary caregiver must meet infant’s needs

Nutrition, warmth, stimulation, sleep, comfort

Trust: When child is crying, and the mother responds quickly it will build a sense of trust

Mistrust: When Child is crying and no one comes to sooth the child, the child will develop a sense of mistrust because no one is tending to the needs of the child.

Question 11

Resolution/ Characterization for Trust vs Mistrust

Answer 11

Hope

Question 12

Infant: Piaget Stage

Answer 12

Sensorimotor (birth - 2yrs)

Question 13

Sensorimotor (birth - 2yrs)

Answer 13

Motor activity without the use of symbols. All things learned are based on experiences, or trial and error

Key Features:
Object permanence, symbolic thought, separation anxiety

Question 14

Infant Weight rate

Answer 14

Weekly gain: 140 to 200 g (5 to 7 oz)
Weight gain of 1.49 lb (0.68 kg) per month fisrt 6 months
After 6 months weight gain slows to .99 lb (0.45 kg) per month

Birth weight doubles by end of first 4 to 7 months
Triples in 1 year

Question 15

Infant Height rate

Answer 15

Measure lying down until age two years
Monthly gain: 2.5 cm (1 inch) for 1st 6 months
After 6 months Length gain of .5 in (1.27 cm) per month is seen

Double the ht in 1 year

Question 16

Posterior fontanel closure

Answer 16

2-3 months

Question 17

Anterior fontanel closure

Answer 17

12 to 18 months

Question 18

Shape of posterior fontanel

Answer 18

triangle shaped

Question 19

Shape of anterior fontanel

Answer 19

diamond shaped

Question 20

Head circumference growth rate

Answer 20

1.5 cm per month for the first six months

Question 21

During a well-baby visit, the mother of an 18-month-old appears concerned. Which assessment
findings might lead the nurse to suspect developmental delay? SELECT ALL THAT APPLY

Answer 21

Not walking, Not speaking 15 words, Not pulling up from a sitting position

Question 22

A parent is upset that her 34-month-old girl has begun to wet the bed and suck her thumb after being
admitted to the hospital. The parent asks the nurse to explain why this is happening. The nurse’s best
response is which of the following?

Answer 22

“This behavior is a defense mechanism when normal routines are changed.”

Question 23

The nurse is teaching a parent of a 2-year-old how to handle negativism. Which of the following question/statement to the child by the partent should indicate understanding of the nurse’s teaching?

Answer 23

“Do you want peanut butter or ham sandwhich for lunch?”

Question 24

Which of the following is an early sign of heart failure that the nurse should recognize?

Answer 24

Tachypnea

Question 25

Nursing interventions for the child after a cardiac catheterization would include which of the following?

Answer 25

- Assess the affected extremity for temperature and color.

Question 26

Nursing care of the infant and child with heart failure would include which of the following?

Answer 26

- Organize activities to allow for uninterrupted sleep.

Question 27

Which of the following heart defects causes hypoxemia and cyanosis because desaturated venous blood is entering the systemic circulation?

Answer 27

- Tetralogy of Fallot

Question 28

Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress which of the following?

Answer 28

- Administer analgesics before procedure.

Question 29

Therapeutic management of the child with rheumatic fever includes

Answer 29

- administration of penicillin.

Question 30

Which of the following is an important nursing responsibility when a dysrhythmia is suspected?

Answer 30

- Count the apical rate for 1 full minute and compare with radial rate.

Question 31

Assessment findings of heart failure

Answer 31

- Sweating - Weak, thready pulses - Dependent edema - Fatigue - Tachycardia

Question 32

The nurse is explaining blood components to an 8-year-old child. The nurse's best description of platelets is that they do which of the following?

Answer 32

Help your body stop bleeding by forming a clot (scab) over the hurt area

Question 33

When hemoglobin falls sufficiently, the signs and symptoms are caused by

Answer 33

- tissue hypoxia

Question 34

The nurse suspects a child is having an adverse reaction to a blood transfusion. The first action by the nurse should be which of the following?

Answer 34

- Stop transfusion and maintain a patent intravenous line with normal saline and new tubing.

Question 35

Which of the following urine tests of renal function is used to estimate glomerular filtration?

Answer 35

Creatinine

Question 36

Which of the following factors predisposes the urinary tract to infection?

Answer 36

- Short urethra in girls

Question 37

A young child is diagnosed with vesicoureteral reflux. The nurse should know that this usually results in

Answer 37

- recurrent urinary tract infections.

Question 38

Which of the following best describes the cause of most cases of acute glomerulonephritis?

Answer 38

- Antecedent streptococcal infection

Question 39

In acute glomerulonephritis, the nurse is aware that an early warning sign of encephalopathy is which of the following?

Answer 39

- Dizziness

Question 40

The clinical manifestations of nephrotic syndrome include which of the following?

Answer 40

- Proteinuria, - hypoalbuminemia, and - edema

Question 41

Therapeutic management of nephrotic syndrome includes which of the following?

Answer 41

- Corticosteroids

Question 42

Which of the following is the primary clinical manifestation of acute renal failure?

Answer 42

Oliguria

Question 43

Dialysis or transplantation becomes necessary for chronic renal failure when

Answer 43

- glomerular filtration rate falls below 10% to 15% of normal.

Question 44

What is the most appropriate assessment needed to monitor renal function?

Answer 44

- Strict intake and output records

Question 45

Classic symptoms of UTI in children include __________________, ________________________ and __________________________.

Answer 45

- increased frequency, - foul smelling urine, and - fever

Question 46

What name is given to inflammation of the bladder?

Answer 46

- Cystitis

Question 47

______________________ is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia and edema.

Answer 47

Nephrotic syndrome

Question 48

In _____________________ blood filtrate is circulated outside the body across a semipermeable membrane and replaced by electrolyte solution.

Answer 48

- Hemofiltration

Question 49

What condition is the most common cause of acute renal failure in children?

Answer 49

- Severe dehydration

Question 50

The parents of a 2-year-old boy who had a repair of extrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

Answer 50

Additional surgery may be necessary to achieve continence.

Question 51

What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)

Answer 51

- Excessive thirst - Frequent urination - Pallor - Poor feeding

Question 52

What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)

Answer 52

Swelling and tenderness of graft area - Diminished urinary output - Feve

Question 53

What month is birth weight usually tripled?

Answer 53

12 months

Question 54

At what age is sexual curiosity most common?

Answer 54

preschoolers

Question 55

What time period covers infancy?

Answer 55

1 month to 1 year

Question 56

What is Erikson's developmental theory for school aged children?

Answer 56

industry vs inferiority

Question 57

What is the age span of a toddler?

Answer 57

1 to 3 years

Question 58

At what age is it normal to have imaginary friends?

Answer 58

3 to 4 years

Question 59

What is Erikson's developmental theory for infants?

Answer 59

trust vs mistrust

Question 60

What time period covers newborn/ neonatal stage?

Answer 60

birth to 1 month

Question 61

At what month should an infant be able to sit without support?

Answer 61

8 months

Question 62

At what age should an infant be able to bring things to his or her mouth?

Answer 62

4 months

Question 63

What is Erikson's developmental theory for adolescents?

Answer 63

identity vs role confusion

Question 64

What is the age span of a school aged child?

Answer 64

5 to 10 years

Question 65

Which is Erikson's developmental theory for toddlers?

Answer 65

autonomy vs shame/doubt

Question 66

What is the age span for a preschooler?

Answer 66

3 to 5 years

Question 67

When should an infant be able to pick up an object with his fingers?

Answer 67

4 months

Question 68

At what age should an infant's birth weight double?

Answer 68

6 months

Question 69

What is Erikson's developmental theory for preschoolers?

Answer 69

initiative vs guilt

Question 70

What is the age span for adolescence?

Answer 70

10 to 18 years

Question 71

A nurse is assessing a 3 month old. Which of the following findings should be reported to the provider?

Answer 71

Unable to raise head when in prone position

Question 72

A nurse is providing home safety information to the parents of an 11 month old infant. Which should be included?

Answer 72

avoid grapes and popcorn

Question 73

RN assesses the psychological development of a toddler. RN is aware this stage is characterized by which of the following?

Answer 73

Negative behaviors characterized by the need for autonomy

Question 74

RN is admitting a 1 year old with respiratory precautions. Which toy is appropriate?

Answer 74

large building blocks

Question 75

A RN is doing a well baby check at 6 months. Which should he expect to find?

Answer 75

Posterior fontanel is closed

Question 76

A mother arranges a playdate for her 2 1/2 year old and her friend's 3 yo. The mom should expect what kind of play?

Answer 76

parallel

Question 77

Aortic stenosis is what kind of heart defect?

Answer 77

Acyanotic Obstruction of flow from ventricles

Question 78

Cystic fibrosis affects which systems?

Answer 78

Pulmonary, GI, Endocrine

Question 79

What is the primary goal when treating heart failure?

Answer 79

Improve Cardiac Function

Question 80

Following a cardiac catheterization the nurses primary concern

Answer 80

Monitoring for bleeding

Question 81

The risk for SIDS can be reduced by

Answer 81

Placing infants to sleep on their back

Question 82

Children admitted with CHF usually Absence of fistulas or strictures

Answer 82

Should be fluid restricted

Question 83

Rheumatic fever sometimes occurs following

Answer 83

Strep throat or URI

Question 84

Differences in upper extremity and lower extremity blood pressure result from

Answer 84

Coarctation of the aorta

Question 85

The primary concern following kawasaki disease is?

Answer 85

coronary aneurysm

Question 86

If you have a patient who is shunting blood from left to right what should you expect?

Answer 86

Pulmonary hypertension

Question 87

The ductus arteriousus usually closes

Answer 87

In the first 1-2 days of life

Question 88

When a Ductus Arteriosus does not close this increases

Answer 88

Flow to the lungs

Question 89

Clubbing refers to

Answer 89

Rounding of fingertips due to chronic hypoxia

Question 90

The most common congenital heart defect

Answer 90

VSD

Question 91

Kids with Tetrology of Fallot assume what position to improve flow to the lungs?

Answer 91

Squat/knee to chest

Question 92

Systemic vasculits involving fever, rash, oral lesions peeling hands and feet, lymphadenopathy?

Answer 92

Kawasaki

Question 93

What is a croup syndrome that is considered a true pediatric emergency?

Answer 93

Epiglottitis

Question 94

The best diet for a child with CF is

Answer 94

High protein

Question 95

Before eating any food, all children with CF must

Answer 95

Take pancreatic enzymes

Question 96

A newborn has bounding radial pulses, and thready pedal pulses. What condition would you suspect based on this?

Answer 96

coarctation of the aorta

Question 97

A 4 mo w/a VSD has new s/s of sweating with feeds, fatigue, edema, and cool extremities. Which would the nurse suspect?

Answer 97

heart failure

Question 98

Which finding is expected in a child with a hx of hypo plastic left heart syndrome (HLHS)?

Answer 98

murmur

Question 99

Pt has a hx of strep, and now has joint pain, painless SC nodules, and random jerky movement. What do you suspect?

Answer 99

rheumatic fever

Question 100

A 2 year old has a fever, groin rash, reddened eyes, strawberry tongue, and irritability. What do you suspect?

Answer 100

Kawasaki

Question 101

What are some causes of a murmer? Select all that apply.

Answer 101

high fever congenital heart defect growth spurt

Question 102

You receive an order for prostaglandin infusion for a newborn. Which statement would best help educate the parent?

Answer 102

This will temporarily keep open a connection in the heart between two vessels.

Question 103

Which defect has increased pulmonary blood flow (aka acyanotic)?

Answer 103

ventricular septal defect

Question 104

Patent ductus ateriosus Tx

Answer 104

Indomethacin - can be used in premature infants (0.2 mg/kg) Ibuprofen mg\kg PDA requires surgical or catheter closure. Closure is required treatment heart failure & to prevent pulmonary vascular disease.

Question 105

Which medication directly reduces afterload?

Answer 105

Enalapril

Question 106

Sound of ventricular septal defect

Answer 106

Pansystolic/holosystolic murmur - loud, harsh, blowing heard best over the LLSB, frequently is accompanied by thrill

Question 107

Sound of patent ductus ateriosus

Answer 107

Classic continuous machine-like murmur

Question 108

Ventricular Septal Defect | Treatment

Answer 108

Small VSD - no surgical intervention, no physical restrictions; Bacterial endocarditis prophylatic abx is indicated. • Symptomatic/Large VSD - Medical treatment initially with afterload reducers (ACEI: captopril, enalapril) & diuretics (furosemide) DIgoxin to improve cardiac output Open heart surgery with cardiopulmonary bypass, will suture or patch hole closed. àIf child is not stable for open heart surgery. Pulmonary artery banding: narrowing of pulmonary artery to reduce blood flow to lungs.

Question 109

Severe dehydration in infants

Answer 109

Tachycardia, parched mucous membranes, and sunken eyes and fontanels

Question 110

Tx for persistent diarrhea

Answer 110

rehydration with oral rehydrates

Question 111

Which vitamin decreases the chance of spina bifida?

Answer 111

B9 or folic acid

Question 112

Indication of tracheoesophageal fistula

Answer 112

excessive amount of frothy saliva in the mouth.

Question 113

Method for feeding infant with cleft palate

Answer 113

Pigeon bottle feeding

Question 114

HIrschsprung's disease

Answer 114

megacolon; obstruction caused by lack of motility or peristalsis in the segment of intestine causing inability to pass meconium or feces .

Question 115

Manifestation of CHF

Answer 115

Tachynea, Tachycardia, weigth gain, sweating

Question 116

Four characteristics of teratology of fallot

Answer 116

Pulmonary stenosis Right ventriculer hyoertrophy Overriding aorta Ventricular septal defect

Question 117

Signs of digoxin toxicity in children

Answer 117

``` Vomiting Bradycardia Anorexia Nausea Dysrhythmia ```