PEDIATRIC EXIT
HESI
1 yr old child with neuroblastoma crying continuously and curled into a fetal position. Most
important
Give a prescribed analgesic
Mother brings her newborn to the well clinic for the 1 month check-up. Nurse reviews infant
record and identifies that received first dose of HBV immunization on discharge. When should
next be
During this visit, one month of age
When obtaining a throat culture from a 6 yr old with possible strep, which action
Swab the child’s erythematous oropharyngeal surfaces or tonsillar pustules
Infant is treated for intussusceptions with hydrostatic reduction. What instructions in parents
teaching plan
Signs and symptoms of recurrence
Mother of 5 yr old boy calls the ER and reports pot of hot soup pulled off stove onto her child’s
right arm and leg. Do first
Place him in a cool bath and remove clothing
Child swallowed corrosive substance. What should mom do immediately
Call poison control
Teen demanding mom to stay in hospital room
Patient is insecure
Question refers to baby soft spot and sutures
Document
Newborn baby with flea-like rash
normal and will disappear
Toddler needing genitals checked, what should nurse do
examine genitals last
Baby acting jittery
check glucose level
Gullain Barre syndrome
Patient with severe cold week ago
Celiac Disease
,Patient with fever of 101-best nursing Dx
r/t temperature elevation
Where to administer shot for 4 year old
RSV needs contact precautions
Cystic Fibrosis
Skin tastes salty
Gullain Barre syndrome
Weakness progresses from legs upward –respiratory arrest
Post strep URI diseases and conditions
Acute
glumerulonephritis
Rheumatic fever
Scarlet fever
Patient in traction
Provide age-appropriate toys
Sweat test used in
Cycstic fibrosis
Current jelly stool with blood and mucus, sausage-shaped mass in RUQ
intussusception
Patient with pyloric stenosis
Olive-shaped mass in epigastric area with projectile vomiting
Milestones to know (several Qs)
Birth weight doubles at 6 months and triples at 12 months
Birth length increases by 50% at 12 months and doubles at 4
years Post fontanel closes by 8 weeks
Anterior fontanel closes by 12-18 months
Moro reflex disappears at 4 months
Steady head control achieved at 4
months Turns over at 5-6 months
Head to hand transfers at 7
months Sits unsupported at 8
months Crawls at 10 months
Walks 10-12
months Cooing at 2
months
Monosyllabic babbling at 3-6 months, linking syllables at 6-9
months Mama/dada and other single words at 9-12 months
Throws ball overhand at 18 months
, Daytime toilet training at 18 months-2
years 2-3 word sentences at 2 years
50% of adult height at 2
years Uses scissors at 4 years
Ties shoes at 5 years
Autosomal Recessive Diseases
CF, PKU, Sickle Cell, Tay-Sachs, Albinism
Autosomal Dominant Diseases
Huntington’s, Marfans, Polydactyl, Achondroplasia, Polycystic
kidney 50% if one parent has the disease
X-linked recessive Diseases
MD, Hemophilia A
Females are carries and never have the
disease Males have the disease
Down syndrome (Trisomy 21)
Simian creases on palms, hypotonia, protruding tongue, upward and outward slant of the
eyes, low ears
PKU
Avoid phenylalanine (aspartame/NutraSweet)
Testing for PKU
Guthrie test
Care of patient with myelomeningocele
Cover with moist sterile water soaked gauze and keep from pressure
Indicators of IICP in infants
Bulging fontanels, high pitched cry, increased head circumference, wide suture lines, lethargy
Avoid in patients with IICP
Suctioning, coughing, straining and bending
Water retention, fluid overload, dilutional hyponatremia
SIADH (too much ADH)
CF kids need enzymes sprinkled on their foods
NO MMR immunization for kids with Hx of allergic rxn to eggs or neomycin
HESI
1 yr old child with neuroblastoma crying continuously and curled into a fetal position. Most
important
Give a prescribed analgesic
Mother brings her newborn to the well clinic for the 1 month check-up. Nurse reviews infant
record and identifies that received first dose of HBV immunization on discharge. When should
next be
During this visit, one month of age
When obtaining a throat culture from a 6 yr old with possible strep, which action
Swab the child’s erythematous oropharyngeal surfaces or tonsillar pustules
Infant is treated for intussusceptions with hydrostatic reduction. What instructions in parents
teaching plan
Signs and symptoms of recurrence
Mother of 5 yr old boy calls the ER and reports pot of hot soup pulled off stove onto her child’s
right arm and leg. Do first
Place him in a cool bath and remove clothing
Child swallowed corrosive substance. What should mom do immediately
Call poison control
Teen demanding mom to stay in hospital room
Patient is insecure
Question refers to baby soft spot and sutures
Document
Newborn baby with flea-like rash
normal and will disappear
Toddler needing genitals checked, what should nurse do
examine genitals last
Baby acting jittery
check glucose level
Gullain Barre syndrome
Patient with severe cold week ago
Celiac Disease
,Patient with fever of 101-best nursing Dx
r/t temperature elevation
Where to administer shot for 4 year old
RSV needs contact precautions
Cystic Fibrosis
Skin tastes salty
Gullain Barre syndrome
Weakness progresses from legs upward –respiratory arrest
Post strep URI diseases and conditions
Acute
glumerulonephritis
Rheumatic fever
Scarlet fever
Patient in traction
Provide age-appropriate toys
Sweat test used in
Cycstic fibrosis
Current jelly stool with blood and mucus, sausage-shaped mass in RUQ
intussusception
Patient with pyloric stenosis
Olive-shaped mass in epigastric area with projectile vomiting
Milestones to know (several Qs)
Birth weight doubles at 6 months and triples at 12 months
Birth length increases by 50% at 12 months and doubles at 4
years Post fontanel closes by 8 weeks
Anterior fontanel closes by 12-18 months
Moro reflex disappears at 4 months
Steady head control achieved at 4
months Turns over at 5-6 months
Head to hand transfers at 7
months Sits unsupported at 8
months Crawls at 10 months
Walks 10-12
months Cooing at 2
months
Monosyllabic babbling at 3-6 months, linking syllables at 6-9
months Mama/dada and other single words at 9-12 months
Throws ball overhand at 18 months
, Daytime toilet training at 18 months-2
years 2-3 word sentences at 2 years
50% of adult height at 2
years Uses scissors at 4 years
Ties shoes at 5 years
Autosomal Recessive Diseases
CF, PKU, Sickle Cell, Tay-Sachs, Albinism
Autosomal Dominant Diseases
Huntington’s, Marfans, Polydactyl, Achondroplasia, Polycystic
kidney 50% if one parent has the disease
X-linked recessive Diseases
MD, Hemophilia A
Females are carries and never have the
disease Males have the disease
Down syndrome (Trisomy 21)
Simian creases on palms, hypotonia, protruding tongue, upward and outward slant of the
eyes, low ears
PKU
Avoid phenylalanine (aspartame/NutraSweet)
Testing for PKU
Guthrie test
Care of patient with myelomeningocele
Cover with moist sterile water soaked gauze and keep from pressure
Indicators of IICP in infants
Bulging fontanels, high pitched cry, increased head circumference, wide suture lines, lethargy
Avoid in patients with IICP
Suctioning, coughing, straining and bending
Water retention, fluid overload, dilutional hyponatremia
SIADH (too much ADH)
CF kids need enzymes sprinkled on their foods
NO MMR immunization for kids with Hx of allergic rxn to eggs or neomycin
