NSG 3600 Exam 4 | Nursing Practice – Children’s Health | (2026) Study Guide PDF | Galen

NSG 3600
EXAM 4 STUDY GUIDE
Nursing Practice – Children’s Health

Galen College of Nursing

, UNIT 8
Neurological and Cognitive

Attention Deficit Hyperactivity Disorder:

 Attention Deficit Disorder (distractibility) with hyperactive component. Very common.
 Signs & Symptoms: Inattention along with behaviors displaying hyperactivity & impulsivity.
Characteristics of Attention Deficit Hyperactivity Disorder & behaviors.
 Diagnosis: Evaluation by multi-disciplinary team: medical & developmental histories,
physical exam, vision & hearing assessment, & detailed neurologic evaluation. Psychologic
testing identifies intelligence & achievement levels. Behavioral checklists & adaptive scales
measuring social adaptive functioning. Rule out psychiatric disorders, medical problems &
traumatic experiences.
 Prevention: Cause & prevention unknown.
 Collaborative Care:
o Medical: Treatment is 3-pronged:
 Pharmacologic therapy: psychostimulants Methylphenidate,
Dextroamphetamine and amphetamine, Lisdexamfetamine-- are
dose titrated; observe for development of tics & other side effects.
Non-stimulant meds added to achieve optimal therapy. Prescribed
dose based on resolution of symptoms & not child’s weight. Family
history important to identify patients who require ECG to detect
arrhythmia or structural heart disease. Requires regular monitoring
of health status, including growth & development parameters, BP,
sleep quality, appetite, nausea & vomiting, abdominal pain,
headache, irritability & nervous stimulation.
 Behavioral therapy: Focus on prevention of undesired behavior
through parent training on skills & tools. Includes
counselling/therapy for pts with anxiety or depression. Peer group
work focuses on social skill development. Family therapy.
 Environmental Manipulation: Environment modified to allow child
to be successful: organizational skills, distractions, structure &
routine schedules, including classroom & schoolwork
considerations. If identified learning disorder, special training
activities & educational strategies.
o Nursing: Educate & assist families long-term to understand treatment plan,
implement therapies, evaluate effectiveness & develop strategies; Liaison with
medical & educational teams, coordinate services, provide support & guidance
to child & family, promote safety for child at high risk for injury.
 Family Teaching Guidelines\

Down Syndrome:

 Most common chromosomal abnormality: 47 chromosomes present, usually as Trisomy of
21st pair: changes development of body & brain
 Signs & Symptoms: Poor muscle tone, slanting eyes with epicanthal folds, hyperflexibility of
the joints, flat bridge of nose, short neck with extra folds of skin, small head, short, low-set

, ears, simian crease, broad feet with increased space between 1 st & 2nd toe, small oral cavity &
protruding tongue. Also common in this group: heart defects, decreased immune function,
gastrointestinal anomalies, visual & hearing difficulties, hypothyroidism, speech difficulties &
sleep apnea. Wide variation in cognitive abilities, behavior, & developmental progress.
 Diagnosis: Chromosomal blood test
 Collaborative Care:
o Nursing Care: Assist new parents with information & resources. Early
intervention with speech therapy, social skills, self-help skills, & occupational &
physical therapies to improve gross & fine motor development.
 Family Teaching Guidelines:
o Feeding techniques for weak suck & resources.

Autism Spectrum Disorders:

 Continuum of disorders involving limitations in social relatedness, verbal & nonverbal
communication, & range of interest & behaviors.
 Signs & Symptoms: Impairment in social reciprocity, impaired communication, restrictive or
repetitive behaviors, interests or activities.
 Diagnosis: “First Signs” Program
 Collaborative Care:
o Nursing Care: Early intervention for language development, social competence
training & practice programs. Be aware of child’s physical boundaries &
reluctance to be touched by others.
 Family Teaching Guidelines: CDC ALARM acronym as a means of understanding autism & its
treatment.

Endocrine
Diabetes
 Type 1 Diabetes Mellitus
o Signs and symptoms (Triad)
 Polyuria
 Polydipsia
 Polyphagia
 Weight loss
o Diagnosis
 Blood Glucose
 Hemoglobin level (HbA1c)
 Prevention
o Not preventable
o Growth and development
 Collaborative Care
o Nursing Care
 Child and family monitoring, stabilization, & education
 Hypoglycemia
o Medical
 Blood Glucose Monitoring
 Ketone Monitoring
 Insulin (Types)

,  Education/Discharge
o Blood Glucose monitoring
o Insulin administration
o Nutritional choices
o Sick Day Rules
 Type 2 Diabetes Mellitus
o Signs and symptoms
 May have no signs
 Obesity
 Fatigue
o Diagnosis
 Obesity >85th percentile for age, sex and weight
 Plus two additional risk factors
 Family history
 Race/ethnicity
 Insulin resistance
 Maternal history
o Prevention
 Healthy lifestyle
 Diet
 Physical activity
 Healthy weight
o Collaborative Care
 Nursing Care
 Child and family monitoring, stabilization, & education
 Medical
 Blood Glucose Monitoring
 Hemoglobin HbA1c
 Insulin (Types)
 Oral hypoglycemic
o Education/Discharge
 Blood Glucose monitoring
 Insulin and other hypoglycemic administration
 Nutritional choices
 Exercise
 Diabetic Ketoacidosis
o Presenting complaint in newly diagnosed Type 1 DM
o Signs & Symptoms
 Acetone odor of breath
 Fatigue
 Malaise
 N&V
 Polydipsia
 Polyuria
 Polyphagia
 Weight loss
 Fever