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ATI PEDIATRICS PROCTORED EXAM (LATEST and VERIFIED)

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HESI AND ATI PEDS STUDY GUIDE 1: Family centered nursing care 1. Parenting styles -Dictatorial or authoritarian: -Parents try to control the child’s behaviors and attitudes through unquestioned rules and expectations -Ex: The child is never allowed to watch television on school nights -Permissive: -Parents exert little or no control over the child’s behaviors, and consult the child when making decisions -Ex: The child assists with deciding whether he will watch television -Democratic or authoritative: -Parents direct the child’s behavior by setting rules and explaining the reason for each rule setting -Ex: The child can watch television for 1 hr on school nights after completing all of his homework and chores -Parents negatively reinforce deviations from the rules -Ex: The privilege is taken away but later reinstated based on new guidelines 2: Physical assessment findings 1. Vital signs -Usually vital signs are all high except for BP -Temperature: -3 – 6 months 99.5 -1 year 99.9 -3 year 99.0 -5 years 98.6 -7 years 98.2 -9 – 11 years 98.1 -13 years 97.9 -Pulse: -Newborn 80 – 180/min -1 weeks – 3 months 80 – 220/min -3 months – 2 years 70 – 150/min -2 – 10 years 60 – 110/min -10 years and older 50 – 90/min -Respirations: -Newborn – 1year 30 – 35/min -1 – 2 years 25 – 30/min -2 – 6 years 21 – 25/min -6 – 12 years 19 – 21/min -12 years and older 16 – 19/min -Blood pressure: -Low as a baby but increases the older they get -Infants: -Systolic: 65-78 -Diastolic: 41-52 2. Head -Fontanels should be flat -Posterior fontanel: -Closes by 6-8 weeks -Anterior fontanel: -Closes by 12-18 months 3. Teeth -Infants should have 6-8 teeth by 1 year old -Children and adolescents should have teeth that are white and smooth, and begin replacing the 20 deciduous teeth with 32 permanent teeth 4. Infant Reflexes Stepping Birth to 4 weeks Palmar Grasp Birth to 3 months Tonic Neck Reflex (Fencer Position) Birth to 3 – 4 months Sucking and Rooting Reflex Birth to 4 months Moro Reflex (Fall backward) Birth to 4 months Startle Reflex (Loud Noise) Birth to 4 months Plantar Reflex Birth to 8 months Babinski Reflex Birth to 1 year 3: Health promotion of infants (2 days to 1 year) 1. Physical Development -Weight: -Doubled by 5 months -Tripled by 12 months -Quartered by 30 months -Height: -2.5 cm (1 in) per month for the first 6 months -Length: -Increases by 50% by 12 months -Dentition: -First teeth erupt between 6-10 months 2. Motor skill development  1 Month o Head lag o Strong grasp reflex  2 Months o Lifts head when prone o Holds hand in open position | Grasp reflex fades  3 Months o Raises head and shoulders when prone | Slight head lag o No grasp reflex | Keeps hands loosely open  4 Months o Rolls from back to side o Grasp objects with both hands  5 Months o Rolls from front to back o Palmar grasp dominantly  6 Months o Rolls from back to front o Holds bottle  7 Months o Bears full weight on feet | Sits, leaning forward on both hands o Moves objects from hand to hand  8 Months o Sits unsupported o Pincer grasp  9 Months o Pulls to a standing position | Creeps on hands and knees instead of crawling o Crude pincer grasp | Dominant hand is evident  10 Months o Prone to sitting position o Grasps rattle by its handle  11 Months o Walks while holding onto something | Walks with one hand held o Places objects into a container | Neat pincer grasp  12 Months Stands without support briefly | Sits from standing position without assistance o Tries to build a two-block tower w/o success | Can turn pages in a book 3. Cognitive development -Piaget: sensorimotor (birth to 24 months) -Object Permanence: objects still exists when it is out of view -Occurs at 9-10 months 4. Language development -3-5 words by the age of 1 year 5. Psychosocial development -Erikson: Trust vs. Mistrust: - Learn delayed gratification -Trust is developed by meeting comfort, feeding, simulation, and caring needs -Mistrust develops if needs are inadequately or inconsistently met or if needs are continuously met before being vocalized by the infant 6. Social developme

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HESI AND ATI PEDS STUDY GUIDE


1: Family centered nursing care

1. Parenting styles
-Dictatorial or authoritarian:
-Parents try to control the child’s behaviors and attitudes through
unquestioned rules and expectations
-Ex: The child is never allowed to watch television on school nights
-Permissive:
-Parents exert little or no control over the child’s behaviors, and consult the
child when making decisions
-Ex: The child assists with deciding whether he will watch television
-Democratic or authoritative:
-Parents direct the child’s behavior by setting rules and explaining the
reason for each rule setting
-Ex: The child can watch television for 1 hr on school nights after
completing all of his homework and chores
-Parents negatively reinforce deviations from the rules
-Ex: The privilege is taken away but later reinstated based on new
guidelines

2: Physical assessment findings

1. Vital signs
-Usually vital signs are all high except for BP
-Temperature:
-3 – 6 months 99.5
-1 year 99.9
-3 year 99.0
-5 years 98.6
-7 years 98.2
-9 – 11 years 98.1
-13 years 97.9
-Pulse:
-Newborn 80 – 180/min
-1 weeks – 3 months 80 – 220/min
-3 months – 2 years 70 – 150/min
-2 – 10 years 60 – 110/min
-10 years and older 50 – 90/min
-Respirations:

, -Newborn – 1year 30 – 35/min
-1 – 2 years 25 – 30/min
-2 – 6 years 21 – 25/min
-6 – 12 years 19 – 21/min
-12 years and older 16 – 19/min
-Blood pressure:
-Low as a baby but increases the older they get
-Infants:
-Systolic: 65-78
-Diastolic: 41-52
2. Head
-Fontanels should be flat
-Posterior fontanel:
-Closes by 6-8 weeks
-Anterior fontanel:
-Closes by 12-18 months
3. Teeth
-Infants should have 6-8 teeth by 1 year old
-Children and adolescents should have teeth that are white and smooth,
and begin replacing the 20 deciduous teeth with 32 permanent teeth
4. Infant Reflexes
Stepping Birth to 4 weeks
Palmar Grasp Birth to 3 months
Tonic Neck Reflex (Fencer Position) Birth to 3 – 4 months
Sucking and Rooting Reflex Birth to 4 months
Moro Reflex (Fall backward) Birth to 4 months
Startle Reflex (Loud Noise) Birth to 4 months
Plantar Reflex Birth to 8 months
Babinski Reflex Birth to 1 year




3: Health promotion of infants (2 days to 1 year)

1. Physical Development
-Weight:
-Doubled by 5 months
-Tripled by 12 months
-Quartered by 30 months
-Height:
-2.5 cm (1 in) per month for the first 6 months
-Length:
-Increases by 50% by 12 months
-Dentition:

,-First teeth erupt between 6-10 months
2. Motor skill development
 1 Month
o Head lag
o Strong grasp reflex
 2 Months
o Lifts head when prone
o Holds hand in open position | Grasp reflex fades
 3 Months
o Raises head and shoulders when prone | Slight head lag
o No grasp reflex | Keeps hands loosely open
 4 Months
o Rolls from back to side
o Grasp objects with both hands
 5 Months
o Rolls from front to back
o Palmar grasp dominantly
 6 Months
o Rolls from back to front
o Holds bottle
 7 Months
o Bears full weight on feet | Sits, leaning forward on both hands
o Moves objects from hand to hand
 8 Months
o Sits unsupported
o Pincer grasp
 9 Months
o Pulls to a standing position | Creeps on hands and knees instead of
crawling
o Crude pincer grasp | Dominant hand is evident
 10 Months
o Prone to sitting position
o Grasps rattle by its handle
 11 Months
o Walks while holding onto something | Walks with one hand
held o Places objects into a container | Neat pincer grasp
 12 Months
Stands without support briefly | Sits from standing position without
assistance o Tries to build a two-block tower w/o success | Can turn
pages in a book
3. Cognitive development
-Piaget: sensorimotor (birth to 24 months)
-Object Permanence: objects still exists when it is out of view
-Occurs at 9-10 months
4. Language development

, -3-5 words by the age of 1 year
5. Psychosocial development
-Erikson: Trust vs. Mistrust:
- Learn delayed gratification
-Trust is developed by meeting comfort, feeding, simulation, and
caring needs
-Mistrust develops if needs are inadequately or inconsistently met or if
needs are continuously met before being vocalized by the infant
6. Social development
-Separation Anxiety: protest when separated from parents
-Begins around 4-8 months
-Stranger Fear: ability to discriminate between familiar and unfamiliar
people -Begins 6-8 months
7. Age appropriate activities
-Rattles
-Playing pat-a cake
-Brightly colored toys
-Playing with blocks
8. Nutrition
-Breastfeeding provides a complete diet for infants during the first 6
months
-Solids are introduced around 4-6 months
-Iron-fortified cereal is the first to be introduced
-New foods should be introduced one at a time, over a 5–7-day period
to observe for allergy reactions
-Juice and water usually not needed for 1 year
st


-Appropriate finger foods:
-Ripe bananas
-Toast strips
-Graham crackers
-Cheese cubes
-Noodles
-Firmly cooked vegetables
-Raw pieces of fruit (except grapes)
9. Injury prevention
-Avoid small objects (grapes, coins, and candy)
-Handles of pots and pans should be kept turned to the back of the
stove
-Sunscreen should be used when infants are exposed to the sun
-Infants and toddlers remain in a rear-facing car seat until age 2
-Crib slats should be no farther apart than 6 months
-Pillows should be kept out of the crib
-Infants should be placed on their backs for sleep

4: Health Promotion of Toddlers (1 to 3 years)

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