Chapter 29: Health Promotion for the Infant, Child, and Adolescent (Due Date: 4/28/14 * see 1c)
1. Obtain a separate 2 ½ -3 or 4 inch Notebook and label it: Pediatric Nursing ( include your name)
a. Include tabs (labeled & durable) for each of the 5 chapters/ sections to be reviewed & include a sheet
protector at the end of each unit for listed drug cards. All areas are expected to be completed thoroughly,
especially when asked to discuss info in “details.” Notebooks not meeting these standards will receive a Failing
test grade & returned for corrections.
b. Students are to bring this notebook, as well as any other pertinent resources daily to scheduled clinical days.
c. Note: because the Pediatric rotation is at the end of May, your ATI Secured Peds Test Score (5/30/2014), will be
your Pediatric Exam Test grade Exam (it will be a double grades for diseases & meds), you will also be given 15
pediatric calculation questions ( see pediatric med calculation info on last),that will be averaged into your ATI
Peds Test score ( this score will be included in your Peds Meds Test grade).
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8.
Define Ch. 29 key terms as listed (list the terms separately at the beginning of each Unit).
Briefly describe the 10 leading health indicators cited in Healthy People 2010.
Describe three (3) benefits of regular physical activity in children.
According to the body mass index (BMI), when are children considered overweight? Obese?
What dietary guidelines are recommended for children aged 2 and older?
Name the two target areas cited by Healthy People that relate to adolescents and mental health.
State the American Academy of Pediatrics recommendations for immunization administration in healthy
infants and children.
9. What are the barriers to proper immunization?
10. In detail, describe at least 5 strategies to promote dental health.
11. List the statistics associated with morbidity and mortality because of the ingestion of harmful substances
in the pediatric patient.
12. Identify the legislation responsible for mandatory childproof packaging.
13. Identify the types of injuries most often associated with (& rationale): infants, toddlers, preschoolers,
school-age children and adolescents.
14. State the causes and prevention of accidental poisonings.
15. Explain the use of syrup of ipecac as a home treatment for poisoning.
16. Describe four strategies to prevent aspiration of a foreign body.
17. In detail, describe the proper use of infant safety seats in motor vehicles.
18. Identify six health benefits associated with exercise, activity, and sports.
19. List 16 safety precautions important in educating parents to prevent environmental injuries to children.
20. Review the Safety Consideration Chart-- at the end of the chapter
a. Select at least 7 safety considerations from each of the 3 age groups listed & briefly discuss why you
thought the 7 you chose were MOST important. You are to list the safety considerations & have a
brief response for each consideration. Do not write a paragraph discussing the 7 choices all
together. This information is to be your own info NOT a mere image of your classmates.
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NOTES & STUDY GUIDE FOR PEDS: Chapter 30: Basic Pediatric Nursing Care
1.
2.
3.
4.
5.
Define Ch. 30 key terms as (list the terms separately at the beginning of each Unit).
Describe the work of Dr. Abraham Jacobi and the significance of “milk stations.”
Describe the work of Lillian Wald and the significance of the Henry Street Settlement.
Why were children with contagious diseases isolated from adults?
What effects did Spite and Robertson discover?
6. Give examples of how the Depression caused poor conditions for children.
7. In a brief synopsis ( paragraph for each) discuss: when ( year) WIC & Head Start was initiated, what legislation
introduced them, why these programs were started & what is the significance of WIC and Head Start to children &
their families today (use additional resources for answer-cite source(s)).
8. Describe the purposes and outcomes of the White House Conference on Children from 1901 to the 1980s. Include in
your discussion care for the child with a communicable disease and the child labor law.
9. Explain how the purpose of pediatric nursing promotes the highest possible state of health in each child and how is
pediatric nursing different from adult nursing?
10. Discuss the personal characteristics and professional skills of a pediatric nurse.
11. Identify all of Erik Erikson’s stage of development &be familiar with the conflict & tasks for each life stage (prior
knowledge—may need to obtain info from another chapter or source).
12. Identify the diseases/disorders associated with child of special needs & discuss the impact technology (if any) has
had on their care.
13. Identify the philosophy, key components, basic concepts and key elements of family-centered care.
14. Describe areas in which growth and development principles are used by the pediatric nurse.
15. In detail, discuss the physical assessment of a child using the head-to-toe method (include all body systems).
Be sure to include the information listed below in your responses (or you may answer the questions individually).
a. Identify abnormal findings on a newborn that requires further evaluation.
b. Discuss techniques for assessing the child’s mouth & nose and list the changes to be concerned with
teeth eruption at age: birth, 3 y/o, 6 y/o and 12 years of age.
c. Discuss techniques used to comfort fussy babies who are teething.
d. How does the back of a newborn vary as growth occurs?
e. Give an example of skinfold measurements and sites.
f. Give examples of pallor and erythema.
g. What are the three flexion creases of the palm?
h. Why is it important to wipe only the outer portion of the ear canal with a swab?
i. How should the tongue and the mucous membranes appear in the mouth?
j. Why is it important to assess the oral cavity and the teeth?
k. Give an example of how the infant’s chest changes as the child grows.
l. What underlying problems might occur if the nurse notes asymmetry of the child’s chest?
m. What is the meaning of “arch development”?
n. Why are toddlers typically bowlegged?
o. Why should the nurse obtain a bowel history?
p. How might a child obtain pinworms?
q. Although all structural components are present in the renal system of a newborn, what
complications exist?
r. Why is it important to assess the child’s anal sphincter ( discuss anatomy & disorders)
s. The examination of the female genitalia is limited to what?
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NOTES & STUDY GUIDE FOR PEDS: Chapter 30: Basic Pediatric Nursing Care cont’d
16. How are VS taken on a child, what are the traditional sites for temperature reading, when would a
temperature be taken and what site is now used for temperature measurement?
t. Why are blood pressure readings not a concern in children less than 3 years old?
u. Why is it important to obtain a blood pressure reading prior to an anxiety-producing procedure?
17. How are respiration patterns different among children under age 6 to 7 years and children who are older?
a. Give an example of obligated nose breathers and explain why the rate vary?
18. Describe metabolism and relationship with nutrition in the child.
a. Give examples of positions for burping and explain why it is important to burp the infant?
b. Give examples of nutritious snacks to offer toddlers.
19. Under what circumstances would a child’s growth rate be a concern? Define the term “growth spurt.”
20. On which form would you expect the child’s growth measurements to be found in the chart?
a. Identify how to obtain a head circumference measurement & the length on children under 2 y/o.
21. Why does weight adequately measure fluid loss and calories in children?
22. List general strategies to consider when talking with children (2 y/o, 5-8 y/o and adolescents).
23. The developmental approach to caring for a child (see table 30-7) takes into consideration the child’s
developmental level, their understanding & response to hospitalization, the child’s strengths and
individuality. Write a brief synopsis of why you agree or don’t agree with this approach.
24. Give an example of a developmental vs. a chronological assessment of development for a pediatric pt.
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26.
27.
28.
Why should the nurse be knowledgeable about typical speech patterns?
Give some examples of nonverbal communication that a toddler would understand.
Give an example of change in pitch that would indicate anxiety or fear.
Give examples of how to use the Wong-Baker Faces Pain Rating Scale.
29. Why is it important to have age-appropriate toys and activities for the pediatric population?
30. Discuss pain management in infants and children and discuss the rationale for giving opioids to children.
31. Explain the needs of parents during their child’s hospitalization.
32. Why do parents of children with special needs become experts regarding their child’s disease process?
33. Describe the age-related concerns and needs of preschool children who are hospitalized.
34. When should a toddler be told he is going to be admitted in the hospital? What is the rationale for this time period?
35. List and briefly explain the six common stress points identified for children undergoing surgery.
36. Why is it important to explain procedures, tests, and medications to parents?
37. In detail, discuss common pediatric procedures: bathing (when should a child be bathe), feedings, (breast,
formula & solids), gavage, and TPN. Be sure to include the information listed below in your responses ( or
you may answer the questions individually).
a. Why should the water temperature be assessed?
b. Why is a tub bath contraindicated for the infant with an umbilical cord?
c. Why should infants and toddlers be allowed to play during their bath?
d. Why is the school-age child reluctant to bathe?
e. How can the nurse entice the school-age child to bathe?
38. Define gavage feedings and explain why the mouth is the preferred route for tube insertions in infants and discuss
how the procedure is performed. Be sure to include the information listed below in your responses ( or you may
answer the questions individually).
a. How can you check tube placement and why should the tube be flushed with sterile water?
b. Why should the child be placed on the right side or in the Fowler’s position?
c. Give examples of children who might require this type of feeding.
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NOTES & STUDY GUIDE FOR PEDS: Chapter 30: Basic Pediatric Nursing Care cont’d
39.When advising parents on ear cleansing, what techniques are recommended?
40. What is a safety reminder device (SRD), what is the rationale for its use and how often should it be
removed? Be sure to include the information listed below in your responses (or you may answer the
questions individually).
a. Why must circulation to the extremity be assessed?
b. Give examples of when and how a child could be restrained.
41. Describe the nurse’s responsibility R/T the use of a mist tent (discuss rationale, s/s that may warrant
usage).
42. Describe the nurse’s responsibility R/T the use of a nasal cannula (discuss rationale, placement of nasal
cannula and s/s that may warrant usage).
43. Describe the nurse’s responsibility R/T urine specimen collection (discuss rationale, s/s that may warrant
usage). Be sure to include the information listed below in your responses (or you may answer the
questions individually).
a. Which method should be utilized first?
b. Which methods pose an increased risk for infection?
44. Describe the nurse’s responsibility R/T venipuncture (discuss rationale, s/s that may warrant usage).
Be sure to include the information listed below in your responses (or you may answer the questions
individually).
a. Why would the jugular or femoral vein be utilized?
b. How would the nurse prepare the child for this procedure?
45. Describe the nurse’s responsibility R/T LP (discuss pt. positioning and pre/post instructions to parents).
Be sure to include the information listed below in your responses (or you may answer the questions
individually).
a. Describe how to restrain the child for this procedure.
b. Why is it important to restrain the child for this procedure?
46. Describe the nurse’s responsibility R/T suctioning (discuss rationale, s/s that may warrant suctioning,
devices used and describe the procedure (depth, timing and frequency).
47. Describe the nurse’s responsibility R/T the use of a mist tent (discuss rationale, s/s that may warrant
usage).
48. Discuss the nurse’s responsibility R/T I&O (rationale, acceptable fluids, parent education & I&O for the
child unable to consume fluids). Be sure to include the information listed below in your responses (or you
may answer the questions individually).
a. Why is I & O measured for this population?
b. Why would the nurse weigh the diaper?
49. In detail, discuss administration of pediatric medications & nsg considerations for the following routes:
oral, intradermal, subq, IM, IV, Optic, Otic and Nasal.
50. In detail, describe the factors that are considered when selecting a site for IM injection on an infant or a child?
51. In detail, identify each category of age/behavior; accident/hazard, and prevention in the pediatric child
(discuss all 8 areas).
a. Give examples of how the parents can be role models for their child
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NOTES & STUDY GUIDE FOR PEDS: Chapter 31: Care of the Child with a Physical Disorder
1. Define Ch. 31 key terms as listed (list the terms separately at the beginning of each Unit).
2. Name the four latest CHD categories related to physiologic characteristics.
3. Describe in detail the etiology/pathophysiology, types of defects, clinical manifestations, diagnostic tests, medical
management medical & nsg mgmt./ patient & family teaching and prognosis ( & med cards) for the following
diseases/disorders.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Tetralogy of Fallot
Patent ductus arteriosus
Atrial septal defect
Ventricular septal defect
Coarctation of the Aorta
 Give examples of environmental and genetic factors that cause congenital heart defects.
 What is mixed blood flow?
 What is cardiomegaly?
 Describe the pathophysiology that causes a pulse deficit between apical and radial pulse rates.
Iron deficiency anemia, sickle cell anemia, and aplastic anemia.
 Why would anorexia and tachycardia be a manifestation of anemia?
 Why do infants who are overweight because of excessive milk ingestion sometimes become anemic?
 Why should iron supplements be given between meals?
 Why would the patient with sickle cell anemia experience joint pain?
 What is sickle cell crisis?
 What type of analgesics would this patient receive?
 How does supplemental oxygen help these patients?
 Wha How does cold assist with coagulation?
 Give examples of signs and symptoms of increased intracranial pressure.
 What is the meaning of the term “aplastic”?
Hemophilia and idiopathic thrombocytopenia purpura.
 What are the activity restrictions for children who have idiopathic thrombocytopenia purpura (ITP)?
 Why is this condition considered idiopathic?
 Why should salicylates be avoided?
 How does the removal of the spleen assist these patients?
Children with leukemia.
 Why do these patients experience bone pain?
Children with acquired immunodeficiency syndrome (AIDS).
 Give an example of a child diagnosed with failure to thrive.
 Give an example of antiviral drugs.
 Describe a macular rash.
 Why are NSAIDs useful in this condition?
Children with juvenile rheumatoid arthritis.
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NOTES & STUDY GUIDE FOR PEDS: Chapter 31: Care of the Child with a Physical Disorder cont’d
k. Respiratory distress syndrome, bronchopulmonary dysplasia, pneumonia, sudden infant death
syndrome, upper respiratory tract infections, tonsillitis, croup, bronchitis, respiratory syncytial virus
(RSV), pulmonary tuberculosis, cystic fibrosis, and bronchial asthma.
a. What is expiratory grunting?
b. How do intercostal, subcostal and substernal retractions help the infant who is experiencing
respiratory distress?
 With this condition (bronchopulmonary dysplasia), what structural changes occur in the lungs?
 Give examples of how the nurse can get parents involved in their child’s care.
 Why should these parents learn CPR?
c. Is this condition more likely to affect males or females (SIDS)?
d. Describe how saline gargles and warm compresses help the patient with pharyngitis.
e. What is the difference between pharyngitis and tonsillitis?
f. Where are the cervical lymph glands?
 How should the child be prepared for a tonsillectomy?
 Why would the nurse assess for loose teeth?
 Why should red and chocolate drinks be avoided?
g. Why is epiglottitis considered an emergency situation?
 What are the pros and cons of this age group receiving annual influenza vaccinations?
h. Describe coryza ( Bronchitis).
 Why would the nurse encourage fluids?
 Why would this patient have difficulty eating?
i. What is streatorrhea ( Cystic Fibrosis)?
 Why do these patients have protruding abdomens?
j. Bronchial Asthma:
 Give an example of long-term control medications.
 Give an example of quick-relief medications.
 Give examples of breathing exercises for the patient.
k. What new protocol has been initiated to prevent RSV infection in premature neonates?
l. Disorders of the GI System:
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Cleft lip and cleft palate, dehydration, diarrhea, gastroenteritis, constipation, gastroesophageal reflux,
hypertrophic pyloric stenosis, intussusception, and Hirschsprung’s disease
Why do these patients have recurrent otitis media (Cleft Lip/palate)?
 How can the nurse avoid aspiration when feeding this patient?
 Give an example of feeding devices.
 Why is burping necessary?
Describe how to assess an infant’s fontanels (Dehydration).
Give examples of underlying causes ( Diarrhea/Gastroenteritis).
 How may electrolye imbalances be restored?
 What complications should the nurse avoid?
What is a Nissen fundoplication ( GERD)?
How does a hypertrophied pyloric muscle cause these symptoms?
 What is projectile vomiting?
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NOTES & STUDY GUIDE FOR PEDS: Chapter 31: Care of the Child with a Physical Disorder cont’d
m. What is the pathophysiology related to red currant jelly stools (Intussusception)?
 Describe hydrostatic reduction.
 What is the Fredet-Ramstedt procedure?
b. How does the fluid intake of the infant differ from that of an older child or adult?
c. BRAT diet
n. Disorders of the GU System:
i. Nephrotic syndrome, acute glomerulonephritis, and Wilm’s tumor
ii. Detail the parent teaching necessary to prevent UTIs in infants and children.
 What is the rationale for the administration of adrenocortical steroids (Nephrotic syndrome)?
 Why should abdominal girth be assessed?
 Why should this patient increase the protein intake?
 What are some side effects of steroids (address each body system affected)?
o. Why is bed rest encouraged ( Acute glomerulonephritis)?
a. Why should fluids be restricted?
p. What postoperative care should this patient receive (Wilm’s Tumor)?
 Give an example of discharge information parents require.
q. Disorders of the Endocrine System:
 Hypothyroidism, hyperthyroidism, and diabetes mellitus.
a. What type of periodic monitoring would this patient require ( Hypothyroidism)?
b. What is thyroid storm (Hyperthyroidism)?
 Why would iodine administration assist this patient?
 Why would the nurse promote a resting environment?
 Why should this patient’s caloric intake be increased?
r. Disorders of the Musculoskeletal System:
 Hip dysplasia, Legg-Calvé-Perthes disease, osteomyelitis, talipes, Duchenne’s muscular dystrophy,
and septic arthritis
 Scoliosis
a. Give an example of braces that can be applied to this patient.
b. Describe the surgery to correct scoliosis.
s. Give examples of activities this child might participate in while in a spica cast that would be
developmentally stimulating (Hip dysplasia).
 What complications should be prevented?
t. Describe epiphyseal necrosis and degeneration ( Legg-Calve- Perthes).
u. Why is clumsiness a manifestation ( Duchenne’s muscular dystrophy)?
a. Describe Gower’s sign.
b. Why are these children prone to contractures?
c. What type of coping strategies might help this family?
d. Why should these patients exercise?
v. Give an example of a complete and incomplete fracture (Fractures).
a. Why is this population prone to fractures of these sites?
b. Give examples of how to calm the child and parents.
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NOTES & STUDY GUIDE FOR PEDS: Chapter 31: Care of the Child with a Physical Disorder cont’d
w. Disorders of the Nervous System:

x.
y.
z.
aa.
bb.
cc.
Meningitis, encephalitis, hydrocephalus, cerebral palsy, seizures, spina bifida, neonatal abstinence
syndrome, and neuroblastoma
 What is the pathophysiology for these clinical manifestations (Meningitis)?
a. Describe Kernig’s and Brudzinski’s signs.
b. What is nuchal rigidity?
c. Why should these patients be placed in isolation for 24 hours?
d. Give an example of a neurological assessment.
How could this patient receive nutrition and hydration ( Encephalitis)?
Describe how shunting alleviates this condition (Hydrocephalus).
a. What education should the family receive regarding this patient?
Summarize the five broad aims of therapy for the patient with cerebral palsy.
i. How could the nurse promote independence for this patient?
Myelomeningocele
Lead poisoning
Muscular Dystrophy
dd. Disorders of the Integumentary System:

Contact dermatitis, diaper dermatitis, eczema, seborrheic dermatitis, acne vulgaris, herpes simplex virus
type I, tinea infections, candidiasis, and parasitic infections.
 Oral thrush
 Why should nystatin be administered after meals?
 Why should the child’s items be sterilized?
 Chicken Pox
i. What are papules and vesicles?
ii. How do antihistamines help with pruritus?
iii. What is the rationale regarding washing after contact with an antigen?
iv. How does cornstarch assist this condition ( Diaper Dermatitis)?
v. How can the nurse promote hydration of the skin ( Atopic Dermatitis)?
 How can the patient obtain a secondary infection ( Atopic Dermatitis)?
vi. How could the treatment of a dog bite differ from that of a cat?
vii. How can the nurse distinguish the signs and symptoms of impetigo, folliculitis and cellulitis?
 Give descriptions of the lesions associated with these infections.
viii. Where are these fungal infections located on the body?
 tinea capitis
 tinea corporis
 tinea cruris
 tinea pedis
ee. How can the nurse approach the patient and family who might be infected with a parasite?
i. What do the nits look like on the hair shaft?
ff. Disorders of the Sensory System:
 Otitis media, refractive errors (myopia, hyperopia), strabismus, periorbital cellulitis, and allergic
rhinitis.
a. Detail the nursing responsibility regarding Myringotomy.
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NOTES & STUDY GUIDE FOR PEDS: Ch. 32 Care of the Child with a Mental or Cognitive Disorder
1. Define Ch. 32 key terms separately and place at the beginning of each Unit).
2. Name the most common developmental disability and describe its four classifications.
Identify six possible causes of cognitive impairment (Be sure to include the information listed below in your
responses (or you may answer the questions individually).
a. How does a prenatal infection cause cognitive impairment?
b. What is perinatal anoxia?
c. How does lead poisoning cause cognitive impairment?
d. What metabolic screenings could be ordered during a neurologic examination?
e. Describe the Denver II test.
3. Describe the clinical manifestations of cognitive impairment and pertinent nursing interventions and
patient/family teaching.
4. Discuss the etiology/pathophysiology of Down syndrome.
5. Describe the clinical manifestations of Down syndrome, diagnostic tests used to dx/confirm diagnosis and
pertinent nursing intervention/ pt. teaching and education.
6. In addition to routine medical care, what other medical management procedures are recommended for a
Down syndrome patient?
7. Identify appropriate nursing interventions required for caring for a child with autism.
8. Summarize the two categories of neglect.
9. State five physical and behavioral indicators that should arouse suspicion of child abuse.
10. Describe the medical management and nursing interventions for the child with a learning disability.
11. Describe four nursing interventions for the child with attention deficit hyperactivity disorder.
12. Name the two most widely used medications used to improve the behavior of children with ADHD and
describe the common side effects ( identify classification, MOA , SEs, adverse reactions ( if any) and
pertinent nursing/teaching information).
13. Identify and briefly describe six clinical manifestations of depression in children.
14. What are the warning signs of suicide?
15. Identify three nursing interventions for the child who is suicidal.
16. What are the physiologic symptoms of children with anxiety?
17. Describe the clinical manifestations of a child with recurrent abdominal pain (RAP), as well as:
etiology/pathophysiology, dx tests used to confirm diagnosis, medical & nursing interventions of the
disorder?
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NOTES & STUDY GUIDE FOR PEDS: Medications: Pediatric Oral and Parenteral Medications
After reading the pediatric oral & parenteral medication handout (pages 279-294). Submit the work requested
below. Place the objectives and math calculations at the end of this notes & study guide assignment.
1. Complete Objectives 1-2 on page 279.
2. Complete Objectives (math calculations) 3 &4 on page 279. For objectives 3&4 students will answers the
following questions under the Summary Self-Test ( set-up your problems & round your final answer as
outlined in handout):
a. Part 1: Questions (1-4)
b. Part 2: Questions ( 13-16)
3. Complete Objectives 1-3 on page 286.
4. Complete Objectives (math calculations) 3, 4 &5 on page 286. For objectives 3-5, answer the following
questions under the Summary Self-Test only*, remember to (set-up your problems & round your final
answer as outlined in handout):
a. Part 1: Questions (1-2); (5-8); (11-13); (21-26); (32-39)
b. *A few questions are include in the packet (& answers provided) for practice. Do not include this work,
should you decide to answer these questions.
c. Place the pediatric oral & parenteral medication handout in the notebook (should be the last item in the
notebook).
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