School Age Children- 9

Question 1

School age range

Answer 1

6-12

Question 2

Vital signs

Answer 2

Explain the procedures to the child and allow him or her to choose, as appropriate, which side blood pressure will be taken, oral versus axillary temperature, and which finger to use for pulse oximetry.

Question 3

O2

Answer 3

same as adult values (93% to 100%).

Question 4

Fever

Answer 4

generally considered to be a temperature greater than 101.4°F or 38.5°C

Question 5

high Fever-infection

Answer 5

High fevers greater than 104°F or 40°C in children do not indicate that the infection is more serious, as they may in adults, because less-refined pediatric immune systems may produce higher fevers than needed

Question 6

Height/weight

Answer 6

Gain 3 kg/year in weight

Gain 5 cm/year in height

Question 7

growth spurt

Answer 7

10 to 12 years for girls and around age 12 years for boys

Question 8

FACES scale

Answer 8

used for younger school-age children.

Question 9

downside noted with the FACES scale

Answer 9

some children will choose the smile face because that is the most desirable. In addition, if a child is feeling pain, he or she may automatically be drawn to the crying face, number 10.

Question 10

visual analog scale or numeric of 1 to 10

Answer 10

Older school-age children

Question 11

Fluid Requirements by Weight

Answer 11

11-20kg: 1000+50mL per each kg over 10kg

> 20kg: 1500 + 20mL per each kg over 20kg

Question 12

Expected Urine Output 6-7y

Answer 12

1-2mL/kg/hr

Question 13

Expected Urine Output 8-12y

Answer 13

.5-1mL/kg/hr

Question 14

Annual assessments

Answer 14

check height, weight, body mass index (BMI), blood pressure, hearing, vision, and anemia. Immunizations should also be given as recommended by the schedule

Question 15

Somatic complaints without verified diagnostic clinical data

Answer 15

may be an indication of school or home avoidance/problems, anxiety and stress, or depression

Question 16

Skin

Answer 16

signs of abuse

Assess for dryness, rashes, eczema, abrasions, and contusions or scratches.

Question 17

Head

Answer 17

Lice
dry/brittle- nutrition
open lesions- signs of trauma

symptoms or recent history of head trauma, including headaches, difficulty concentrating, or loss of consciousness.

Question 18

Eyes

Answer 18

glasses
visual acuity
broken blood vessels, dryness, jaundice

Question 19

Ears

Answer 19

hearing aid
hearing acuity
buildup of earwax
excess fluid

Question 20

mouth/teeth

Answer 20

loss of baby teeth
Orthodontic treatment
Promotion of good dental hygiene
Dental checkups every 6 months
loose teeth

Question 21

loss of baby teeth

Answer 21

starts with 6y molars

Question 22

Tooth fairy

Answer 22

not everyone believes

Question 23

Throat

Answer 23

Ensure the trachea is midline.
Inspect and palpate for an enlarged thyroid (goiter).
Assess for difficulty swallowing.

Question 24

nose

Answer 24

blue/boggy- allergies
Assess for allergic rhinitis and treatments
Assess for frequent nosebleeds and mucosal dryness.
Assess for airflow, which may be restricted because of acute or chronic sinusitis.

Question 25

Cardiovascular

Answer 25

Assess for any congenital cardiac anomalies by history and auscultation. Innocent heart murmurs are very common in school-age children. Normal S1 and S2

Question 26

Innocent heart murmurs

Answer 26

Some cardiologists estimate that up to 90% of children aged 4 to 7 years have heart murmurs, often a result of turbulent blood flow at the aorta or pulmonary artery

Question 27

Respiratory

Answer 27

asthma lungs-clear S/S chronic respiratory issues such as barrel chest and clubbed fingers. skin color- pallor or cyanosis

Question 28

encopresis

Answer 28

deliberate withholding of stool

Question 29

Gastrointestinal/Genitourinary

Answer 29

Assess for enuresis, or urine incontinence encopresis Assess for constipation/diarrhea, acute or chronic, and any treatments the patient may be receiving.

Question 30

Reproductive

Answer 30

Girls may experience menarche, the start of menses, near the end of this stage The onset of puberty in boys will be accompanied by increased upper body mass, increased amount and thickness of hair on the body and genitalia, and nocturnal emissions, or the release of semen during sleep.

Question 31

precocious puberty

Answer 31

defined as experiencing puberty before age 7 years for girls and before age 9 years for boys

Question 32

Neurovascular/Musculoskeletal

Answer 32

Increased coordination Increased fine motor skills Increased balance The ability to do complex tasks, such as riding a bike Scoliosis checks beginning at age 12 years

Question 33

Cognitive

Answer 33

Piaget’s cognitive developmental theory Mastery of mathematics and reading skills Classification and serialization of numbers Understanding cause and effect The ability to decenter

Question 34

Psychological

Answer 34

Freud’s | Erikson

Question 35

Freud

Answer 35

psychosexual development theory—age 6–12 years: latency stage

Question 36

Erikson

Answer 36

psychosocial development-age 6 to 12 years: industry versus inferiority

Question 37

Kohlberg’s

Answer 37

moral development: preconventional level

Question 38

Social

Answer 38

Likes to forms clubs with rules and requirements Likes to do favorite activities with a best friend Usually socializes primarily with children of the same gender Follows rules and understands consequences Enjoys playing games Enjoys having a collection of items, such as video games

Question 39

Good Touch/Bad Touch

Answer 39

Use inspection of the genital area during the physical assessment as a springboard for discussing good/bad touches. Indicate which areas the child should report to a trusted adult if anyone touches them, including the breasts, buttocks, and genitals.

Question 40

Medication dosing

Answer 40

Basing medication dosage on weight gives an accurate and safe dose for each patient. Medication dosing should not be based on age because patient size may vary.

Question 41

Oral medication

Answer 41

- syringe or cup - food or drink as a reward if appropriate - chaser - numb tongue with popsicle - pinch nose - use caution with mixing meds with things that taste like candy

Question 42

Subcutaneous Medications

Answer 42

-local anesthetics medicated cream when appropriate

Question 43

IV Meds

Answer 43

- medical play helpful - child life specialist can help - non-dominant arm - let them pick which side - distractions

Question 44

Eutectic Mixture of Lidocaine and Prilocaine (EMLA) Cream

Answer 44

It should be in place at least 45 minutes. The longer it is in place, the deeper it will penetrate; 2 hours is best for intramuscular injection. After 4 hours, it begins to lose its effectiveness and should be removed.

Question 45

NURSING PROCEDURES

Answer 45

important to gain the trust of the child before beginning assessment or procedures. Explain procedures in an age-appropriate way. Do not lie if a procedure will be uncomfortable or painful; this will cause you to lose the child’s trust.

Question 46

nursing procedures step by step

Answer 46

``` assess talk with child about recent problems nonthreatening touch privacy appropriate rewards have instruments ready and inform immediately before least to most invasive ```

Question 47

Safety

Answer 47

``` Head injury prevention (symptoms may be minimal) bike/scooter safety pedestrian safety need for adult supervision ```

Question 48

independence

Answer 48

- may be able to do many activities with less direct supervision. - Children are able to play alone with adults nearby but should not be left unsupervised for any extended period. - By the end of this phase, children will engage in unsupervised activities, such as staying home - may start babysitting - more team activities

Question 49

babysit safety

Answer 49

Knowledge of fire safety Care for and observation of children in various stages of growth and development Basic first aid and possibly CPR Many of these skills are taught in babysitting classes offered by hospitals and other organizations, such as the YMCA

Question 50

nutrition

Answer 50

decreased caloric requirement compared with previous stages of development

Question 51

high BMI in children

Answer 51

linked with increased lipid levels, insulin levels, and blood pressure

Question 52

Exercise

Answer 52

Children should have at least 1 hour of physical activity a day

Question 53

school avoidance/refusal/phobia

Answer 53

Child displays somatic symptoms such as a “stomachache” without any clinical basis, but only on school days. Child refuses to attend school.

Question 54

Various factors are associated with being a bully, a victim, or both, including:

Answer 54

Age Lower socioeconomic status Parents and caregivers with a high school or lower educational level Poor health status, increased health needs, and mental health issues Physical appearance Poor academic achievement or social adjustment Sexual orientation

Question 55

The nurse caring for a school-age child should:

Answer 55

1. Assess for both physical and psychological signs of bullying. 2. Help caregivers find resources to assist with bullying. 3. For children with special needs, assess the resources available at the school.

Question 56

Sex ed the nurse should:

Answer 56

- Assess whether the caregivers have started to discuss sex with older school-age children. - Be aware that discussing this subject can be difficult for caregivers. - Help caregivers find resources to teach their children and creative ways to open the discussion.

Question 57

two leading causes of death for children 5 to 14 years old

Answer 57

Unintentional injuries and cancer

Question 58

ACUTE-CARE HOSPITALIZATION

Answer 58

- caregivers have active role - bring items from home - allow walks - encourage visitation of siblings if possible - siblings admitted together- near each other - separate room for care

Question 59

Pediatric Early Warning System (PEWS)

Answer 59

good tool to improve earlier identification of a deteriorating condition behavior, Cardiovascular, respiratory

Question 60

Child life specialists

Answer 60

offer a variety of services for children who are hospitalized and their families.

Question 61

Pediatric Care Preferences

Answer 61

- Older school-age children seek more autonomy and may want to assist with their own care. - All children in this age range will be curious about their care. - Nurses should answer questions honestly at an age-appropriate level.

Question 62

Role of the Primary Caregiver chronically ill child

Answer 62

- fatigue common - active role - knowledgeable about disease - divorce more common

Question 63

Home-Care Considerations chronically ill child

Answer 63

- need to have some control over their time and activities. - School work should be kept up to date - time for interaction with peers, either in person or over the phone or internet, should be allotted daily.