Pediatrics Proctored ATI Review

what vaccine do kids need to get before entering into a college dormitory? Correct answer- meningococcal polysaccharide vaccination because of the high risk creep on hands and knees Correct answer- 9 months begin to stand while holding onto furniture Correct answer- 10 months begin vocalizing vowel sounds Correct answer- 7 months say at least one word Correct answer- 10 months crude pincer grasp Correct answer- 9 months use of dominant hand is evident Correct answer- 9 months preschool age views of death Correct answer- -thinks of death as sleep -thinks thoughts can cause death -thinks death is a punishment toddler physical assessment Correct answer- -minimize physical contact with child initially 4 years old distractions during assessment Correct answer- -use plastic stethescope -puzzles are too hard -cannot read by themselves yet -mobile is too young for a 4 y/o 3 years old distractions during assessment Correct answer- -cutting figures out of paper 2 years old distractions during assessment Correct answer- -building blocks if the child has increased blood lead levels, the parents should make sure of... Correct answer- parents should make sure the child has adequate calcium and iron intake because they promote excretion of the lead and decreased absorption of the lead MMR and Varicella administration Correct answer- - should be administered either at the same time or 1 month apart 12 month old infant nutrition requirements Correct answer- -SHOULD be introduced to same food the family is eating -SHOULD be having dry cereal and chilled banana slices for snacks -SHOULD have 4 ounces of juice per day -should NOT have 2 quarts of skim milk each day -SHOULD have 24-30 ounces per day of WHOLE milk. Skim milk should be introduced AFTER 2 years old. Femoral venipuncture position for child? Correct answer- supine most common food allergy in children? Correct answer- Cow's Milk Vaccines at 2 months? Correct answer- Hib and IPV Home safety Correct answer- - water temperature should be at 49 C or 120 F Adult tetanus booster can be given to children at a minimum of what age? Correct answer- 7 years old and up peek a boo game shows... Correct answer- object permanence posterior fontanel closes at Correct answer- around 2 months anterior fontanel closes at Correct answer- at 18 months crossed and extended legs when supine can indicate what condition? Correct answer- Cerebral Palsy does not refer to him/herself with pronouns until what age Correct answer- 30 months should be DAYTIME potty trained by Correct answer- 30 months -do not attempt to accomplish this task until 24 months scribble with crayons by Correct answer- 15 months interest in looking at pictures at Correct answer- 15 months stepping reflex disappears by Correct answer- 4 weeks babinski reflex is present until Correct answer- 1 year old Moro reflex disappears by Correct answer- 3-4 months Extrusion reflex disappears by Correct answer- 4 months crawl reflex disappears by Correct answer- 6 weeks startle reflex disappears by Correct answer- 4 months Birth weight is quadrupled by Correct answer- 30 months Birth weight is tripled by Correct answer- 12 months Intussusception Correct answer- Diagnosed by: abdominal ultrasound will confirm the pocket in the intestine possibly will need barium enema to resume normal configuration of intestines leukopenia care Correct answer- monitor for increased temperature because it places the child at risk for infection hypoglycemia in school age child Correct answer- drink 240 mL or 8 ounces of milk as soon as possible what nutritional needs should you delay until after 12 months? Correct answer- -whole milk -eggs -strawberries associative play Correct answer- children playing together without organization denver developmental screening test Correct answer- language, cognition, fine motor development and gross motor development -NOT IQ sickle cell crisis Correct answer- -maintain bedrest cleft lip repair Correct answer- -suction infant gently with bulb syringe PRN boston brace for scoliosis Correct answer- -wear brace for 23 hr/day -only remove for showering or physical therapy -wear over a tshirt to prevent plastic pads from causing excoriation to skin -avoid loosening straps of brace insulin injections on school age child Correct answer- -demonstrate injection on orange THEN, have the child teach the injection technique to the parents tosillectomy post op report Correct answer- freq swallowing (could be blood) ventricular septal defect in infant Correct answer- -report 4 pound weight gain because it indicates increased fluid and worsening of child's HF -should expect murmur at the left sternal border atrial septal defect Correct answer- diastolic murmur is expected patent ductus arteriosus Correct answer- widened pulse pressure tracheomalacia clinical manifestation Correct answer- barking cough, stridor, wheezing cyanosis and apnea d/t weakened trachea which leads to collapse infant dehydration S/S Correct answer- flat or sunken fontanel tachycardia (slightly) tachypnea decreased urinary output dry mucous membranes fiberglass arm cast teaching Correct answer- -plastic bag cover when showering -exercise fingers every 4 hours for first 24 hours -do not use magic markers to draw or sign cast peak expiratory flow meter Correct answer- -record highest reading of three attempts -teach adolescent to take a deep breath, place lips around mouthpiece, and then blow into the mouthpiece as hard and as fast as possible measles s/s Correct answer- koplik spots = small, irregular lesions with bluish white center mumps s/s Correct answer- parotitis aka swollen parotid galnds pertussis s/s Correct answer- paroxysmal cough scarlet fever s/s Correct answer- strawberry tongue expected finding in child w/ glomerulonephritis Correct answer- periorbital edema and HTN Toddlers nutrition Correct answer- -consume 1000 calories daily -2 oz protein daily -no more than 24 oz or 3 cups of milk per day -8 oz or 1 cup of veggies daily wilms' tumor nursing care Correct answer- NO ABDOMINAL PALPATATION - could aid in metastasis nephrotic syndrome Correct answer- keep child away from those with infection(s) dehydration specific gravity Correct answer- higher than 0.025 Antistreptolysin O (ASO) titer Correct answer- tests for a recent strep infection epiglottitis Correct answer- drooling pyloromyotomy postop Correct answer- small, frequent feedings by bottle of electrolyte solution or sterile water beginning 4-6 hours post op cleft palate - postop nutrition Correct answer- should be fed clear liquids using a CUP for 7-10 days following cleft lip repair to prevent trauma and injury to suture line administration of eardrops for infant Correct answer- -pull pinna DOWN and back until 3 years old then it is up and back -massage anterior area of ear following administration -do not hyperextend the neck -otic solutions should be warmed before instillation GERD in infants Correct answer- add rice cereal to feedings to thicken in order to decrease # of vomiting episodes diabetic ketoacidosis priority intervention Correct answer- -admin 5% dextrose in 0.9% sodium chloride by continuous IV infusion tetralogy of fallot Correct answer- -will not have decreased platelet count -will not have neutropenia (decreased WBC) -WILL have increased RBC or polycythemia d/t cyanosis. body produces more in an attempt to supply o2 to all body parts acute lymphocytic leukemia Correct answer- low RBC high WBC low platelets low hct insulin for T1D Correct answer- - do not stop taking insulin if you are vomiting. you may need increased dosage -use an opened vial of insulin for 28 to 30 days stored in refrigerator -if you take too much insulin, have a class of milk or juice and eat a complex carb -insulin requirements will increase as you go through puberty anaphylaxis s/s from bee sting Correct answer- nausea, stridor and urticaria burns - nutritional needs Correct answer- -high protein diet to promote healing -supplement the child's feedings with enteral feedings rheumatic fever teaching Correct answer- -child may take ASA for joint pain -standard isolation precautions tylenol overdose/poisoning antidote Correct answer- acetylcysteine reason that toddlers bellies stick out Correct answer- because they do not have well- developed abdominal muscles. common to see potbellied appearance in toddlers DTaP Correct answer- boosters of DTap should be given between the ages of 4 and 6. Pneumococcal (PCV) Correct answer- receive PCV at 2, 4 and 6 months and the fourth dose between 12-18 months haemophilus influenza type B (Hib) Correct answer- receive Hib at 2, 4 and 6 months and the fourth dose between 12-18 months Hep B Correct answer- within 12 hours of birth, 2nd dose at 1-2 months and the 3rd dose at 6-18 months low platelet count Correct answer- would mean that the child is at high risk for bleeding so you want to encourage quiet play so there is a reduced risk for injury that could lead to hemorrhage increased hematocrit level indicates... Correct answer- dehydration. the hemoatocrit levels rise when blood volume is decreased during dehydration overhydration would result in decreased hematocrit level. bone marrow aspiration Correct answer- -no headache post procedure (usually in lumbar punctures only) -prone position during procedure -no antibiotic prior to procedure -apply pressure dressing over the area following procedure to prevent bleeding from site