Pedi Hesi Review

1 Home 2 School 3 Hospital 4 Daycare cente Pediatric developmental assessments are performed in many settings, including the home, school, hospital, and daycare center environments. It is unlikely that a pediatric developmental assessment would be performed in an assisted living center.

1 Sensorimotor period There are four periods of Piaget's theory of cognitive development. The first period is the sensorimotor period; this period describes object permanence. During the ages of birth to 2 years old, the child understands that objects continue to exist even when they are not visible. The second period is the preoperational period, which is observed in children between the ages of 2 and 7 years. During this time, children learn to think about the use of symbols and have mental images. The third period is the concrete operations period, which is observed between the ages of 7 and 11 years. During this period, the child thinks about an action before performing it. The formal operations period is the fourth period, which is observed in children from the ages of 11 years old throughout adulthood. During this period, there is a prevalence of egocentric thought. Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer.

3 Early childhood According to Piaget, the early childhood (toddler) and preschool-age child are both egocentric [1] [2]. Infancy, adolescence, and middle childhood are not characterized as being egocentric, according to Piaget.

1 Expressing feelings openly Health professionals have long been aware that boys and girls are socialized differently by parents and teachers. Girls are encouraged to express their emotions openly. Girls are also expected to be sensitive and responsive to others. Girls are often ostracized if they want to play a sport that is historically associated with the male gender, such as football. Taking the most challenging classes in school is an expectation for males, not females.

1 A life-long enjoyment of fitness. A goal for organized athletics for school-age children is a life-long enjoyment of fitness. A physical examination every two years, the use of appropriate safety equipment, and participating in warm-up exercises prior to physical activity are all safe guards for athletic programs.

4 20 weeks An infant develops a color preference for yellow and red between 20 to 28 weeks of age. At 4 weeks, the infant can follow a range of 90 degrees. Between 6 to 12 weeks of age, the infant develops peripheral vision to 180 degrees. Between 12 to 20 weeks of age, the infant is able to accommodate to near objects.

4 The slow to warm-up child The child will be categorized as a slow to warm-up child. These children are uneasy or cautious in new situations or with unfamiliar people. They react negatively with mild intensity to new stimuli. An easy child is open and adaptable to change and displays a mild-to-moderately intense mood that is typically positive. A difficult child adapts slowly to new routines, people, or situations. This type of child has intense mood expressions with negative behavior. A hyperactive child usually has problems concentrating and paying attention.

2 By identifying with the parent of the same sex

3 "When I lied to my parents, I was punished for a week and my brother never gets punished." A critical component of any child's development is discipline. Applying appropriate discipline to the child who is chronically ill or disabled can also limit the resentment and hostility that can develop among siblings if parents apply different standards to each child. The nurse's responsibility is to help parents learn successful methods of guiding the child. The statements regarding wishing that the brother wasn't sick, fears of having caused the illness, and missing play dates may require further assessment and family teaching, but the teaching would not be related to discipline.

4 Determine whether there is anyone who can help with chores and the infant's care Recruiting someone to help with chores and infant care will allow the parent time to rest and will provide the infant with care and attention. Making the parent feel guilty is not therapeutic and will increase anxiety. The disabled sibling requires attention, and this responsibility may cause jealousy, rivalry, and resentment. Toys need not be employed for sensory stimulation; household objects and quality human contact can serve as well. Test-Taking Tip: Have confidence in your initial response to an item, because it more than likely is the correct answer.

2 Concrete thinking child of nine years of age will exhibit concrete thinking. Logical reasoning is observed in individuals starting from the age of 11. Object permanence is observed in children between birth and two years old. The idea of being constantly observed by an imaginary audience is observed in individuals starting from the age of 11.

3 School-age During the school-age stage of development, boys and girl differ very little in terms of size. During the toddler, preschool, and adolescence stages of development boys are often larger than girls.

2 During this stage, sexual urges are repressed and channeled into productive activities. During the latency stage, Freud believed that sexual urges from the earlier Oedipal stage are repressed and channeled into productive activities that are socially acceptable. During the phallic stage, the genital organs are the focus of pleasure. During the oral stage, infants begin to think that the parent is something separate from the self. During the genital stage, sexual urges reawaken and are directed to an individual outside the family circle.

1 A 9-month-old infant The nurse would conduct a developmental screening for the 9-month-old infant during a scheduled health maintenance visit. The 2-week-old newborn, the 15-month-old toddler, and the 4-year-old preschooler would all require developmental surveillance during a health maintenance visit.

2 Specific reasoning 3 Increased curiosity 4 Magical thinking Preschoolers begin to engage in specific reasoning and become curious. Preschoolers' thinking is often described as magical thinking. Between the ages of 12 and 36 months, toddlers start thinking of the self as separate from the mother. School-age children around the age of 12 years start concentrating on more than one aspect of a situation. They also start understanding different points of view.

4 Any adult with authority over the child When a school-age child and an adult differ in judging an act, the adult is right. The school-age child, the child's peers, and a higher power that the child believes in are not authorities to moral development of the school-age client.

1 An individual recognizes that there is more than one correct point of view. During the instrumental relativist orientation stage, an individual finds that there is more than one correct point of view. During the postconventional reasoning stage, a person finds a balance between societal rules and basic human rights and obligations. During the punishment and obedience orientation stage, a child's response to a moral dilemma is in terms of absolute obedience to authority and rules. During the conventional reasoning stage, the person sees moral reasoning based on his or her own personal internalization of societal and other's expectations

4 Stage 4 Level II, conventional reasoning, stage 4 is when the nurse anticipates a client will expand focus from the relationship with others to societal concerns. In level I, preconventional reasoning, stage 1, the nurse anticipates absolute obedience to authority and rules. In level I, preconventional reasoning stage 2, the nurse anticipates that the client will realize there is more than one right view. In level II, preconventional reasoning stage 3, the client wants to win approval and maintain expectations of his or her immediate group.

2 "Hold the baby while continuing to feed a regular formula slowly and burp frequently." If there are no complications, the infant resumes regular feedings soon after surgery. The infant does not need special dietary modifications. Also, holding the infant should be encouraged because it is an important part of the parent-child relationship.

1 Local or systemic and usually mild Mild reactions consist of redness and induration at the injection site, slight fever, and irritability. Serious reactions are not common. Induration at the injection site may occur, but not ulceration. Permanent brain damage is not likely after an immunization.

4 Weight compared with prior weight Loss of weight is the most accurate measurement of the magnitude of fluid loss; 1 L of fluid weighs 2.2 lb. Tissue turgor is subjective measure of dehydration and not as accurate as a comparison with the pre-illness weight. Although an increased hematocrit and dry mucous membranes each indicate dehydration, neither is an effective tool for assessing the amount of fluid loss.

1 Notifying the healthcare provider immediately Bradycardia (pulse rate slower than 90 to 110 beats/min in infants) is an early sign of toxicity. Additional doses of digoxin will worsen the toxicity. The medication should be stopped; when bradycardia is no longer present, the practitioner may modify the dose. The mother is not a reliable source; the nurse should rely on pulse readings taken before the digoxin was prescribed.

3 Cognitive impairment Children who are exposed to lead are at risk for lead poisoning, which causes multisystem damage with the worst effects in the central nervous system. Lead poisoning can result in seizures, cognitive impairment, and death. Although abdominal cramps and headache may be symptoms of chronic lead poisoning, they are not the primary problems as lead poisoning progresses and central nervous system symptoms appear. The development of dental caries is not related to lead exposure and poisoning. The child may not be malnourished; plumbism can occur if the child eats paint or plaster chips (pica) containing lead in addition to the diet or if there are lead particles in the atmosphere that the child inhales.

respiratory rate mechanics of breathing breath sounds skin color chest rise and fall

true Austin's weight and height (length) will be plotted on a clinical growth chart (Birth to 36 months: Boys) that uses recumbent length. Recumbent length is obtained by measuring from the infant's heels to the top of his head as he lies supine. The clinical growth chart for older boys (2 to 20 years: Boys) uses stature (standing height). When measuring Austin's recumbent length, you place gentle pressure on his knees to make sure his legs are fully extended.

Pulmonary congestion Cough Wheezing CF is characterized by thick mucous secretions from exocrine glands. Thick secretions cause mechanical obstructions in the respiratory and gastrointestinal systems. In the airways, thick mucous is susceptible to colonization and infection with various bacteria, fungi, and mycobacterium, often resulting in pneumonias throughout the course of the disease

Salty-tasting skin Meconium ileus Because of water and sodium transport problems and thick mucous secretions, infants and children with CF have intestinal contents that lack moisture and may be thick with mucous. Inability to pass stool may occur. In the newborn, meconium ileus (small intestine obstruction) may be an early sign of CF. In some newborns with CF, the meconium is so thick that it obstructs the ileum. Meconium ileus is very serious and must be cleared immediately (either with radiologic contrast enemas or surgically) to prevent bowel rupture. In older children with CF, distal intestinal obstructive syndrome can result in intestinal obstruction

Easier breathing Austin's breathing should require less effort if Ventolin (albuterol) therapy is effective.

Strict adherence to hand hygiene guidelines For all patient care, not just CF patients with respiratory infections, strict adherence to hand hygiene guidelines, as dictated by CDC (Centers for Disease Control) and OSHA, is most important in preventing nosocomial infection. Hand washing with soap and water, or hand decontamination using an alcohol-based hand rub, should be implemented as appropriate to the situation

It would not be wise to have him share a room with another CF patient Among CF patients, patient-to-patient spread of Burkholderia cepacia must be prevented. Burkholderia cepacia is especially virulent, and can rapidly lead to fatal bacteremia. Having a CF patient with Burkholderia cepacia share a room with another CF patient would not be wise

nasopharyngeal/respiratory Haemophilus influenzae type b (Hib) causing epiglottitis can be transmitted to others through direct contact with nasopharyngeal/respiratory secretions.