Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
Pediatrics : Nursing care of children from birth through adolescence
★ Infant mortality is high in the U.S. compared to other countries
● Must assess developmental milestones
○ Age 4 months, babies should be making baby
sound→ if they are not could indicate hearing
problems
● Monitor growth and development:
● Physical:
○ Height vs Length:
■ Crown to heel
■ measured laying down (recumbent) for children under 3
years old.
■ Measured standing up for children more than 3 years old
○ Weight: weigh babies consistently on the SAME scale EVERYDAY
○ Head circumference (measure until age 3)
○ Immunizations
● Cognitive:
○ Erikson’s stages
○ Language development
○ Presence of learning and developmental disabilities
● Sequence of exam: altered to accommodate the child’s developmental
need
Family centered care: families are key to the well-being of the child.
➢ Let family be as involved as much as possible, if they are not this is a
RED flag!
Child life specialists
➢ Non-nursing professionals who promote effective coping and
normalization for families
➢ Used to relieve stress
➢ Have a 4-year degree in psychology and child psychology
Pain Scales:
➢ FLACC scale: used at 2 months-7 years → based on how
the child is acting
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
,Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
○ 0-2- points each for Face, Legs, Activity, Cry, inconsolably
➢ Faces scale: used from 3 years to early teens→ scale of 0-5
○ Six-line drawings of faces with expressions from happy to neutral to
crying
➢ Adolescent pediatric pain tool: used from 8-17 years old
○ Body outline (draw location of pain)
○ Word graphic scale (mark on a line closest to the intensity
descriptor)
○ Word list (circle the sensory, affective, and evaluative words that
apply)
Cultural sensitivity care
● Accommodate dietary restrictions
● Use of interpreters
● Accommodating time for prayers, etc..
● Tolerance of complementary and alternative (CAM) medicine when safe
Truth telling: Children generally prefer the truth!
Narcotics:
➢ It is safe to give narcotics to children
➢ Ex: morphine→ common S.E. itching, nausea,
constipation, and resp depression
➢ Give Benadryl for itchiness
Failure to Thrive:
➢ Failure to grow and develop at an expected rate
➢ Diagnosis is given to children who fall below the 5th percentile
ranges on height/weight charts
➢ Infant presents first with absence of weight gain or weight loss
➢ Drop in height is followed by drop in head circumference.
Barriers to effective communication
● Physical abnormalities Hearing or vision impairment
● Cognitive impairment
● Environmental noise
● Cultural differences
○ Asians are less likely to complain about pain
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
,Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
○ African americans are more likely to complain about pain
● Language barrier
Communicating with infants
➢ Communicate primarily with parent/caregiver
● Use gentle touch (security, comfort)
● Allow them to suck on pacifier (stress relief, relax)
● Talk to the infant in soft voice when providing care
● Use music and sound to sooth them→ sing song
approaches to communicate
● Provide continuity of care
● Speak slowly
● Cluster care→ less invasive to most invasive
Communicating with toddlers and preschoolers
➢ Have tantrums and are egocentric
➢ Sit in a chair at their eye level
➢ Label their emotions to validate feelings of fear and anxiety
➢ Prepare the child for procedures just before the procedure
● Use medical play, have toys available
● Give praise such as “good job”
● Use simple words
● Give them choices when appropriate
● Don’t use phrases such as “a small stick in the arm”
Communicating with school-age children (age 6-12)
➢ Direct communication
● Allow them to participate in care when safe
● Allow them to voice their concerns
● Encourage them to ask questions→ answer honestly and
with simple words
● Allow time for play
Communicating with adolescent children (age 13-18)
➢ Trust is extremely important
➢ Incorporate genuineness, trust, active listening, respect, and rapport
skills
➢ Do not confuse the adolescents’ mature body with emotional maturity
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
, Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
● Use open-ended questions
● Explain limits of confidentiality
● Provide privacy
● Encourage them to express feelings and concerns
Working with Interpreters:
● Avoid using “charades” to communicate
● Take caution when using family members
● Always speak directly to the patient/family and NOT the interpreters
● It is required by law that health care agencies provide these services at
no charge to the patient
Cephalocaudal – starts at the head and moves downward
➢ Ex: child can control his/her head and neck before it can control
his/her arms & legs
Proximal distal – starts in the center and moves outward
➢ Ex: movement and control of the trunk section of the body
occurs before movement & control of the arms
Differentiation – simple to complex progression
➢ Ex: the child learns to crawl before learning to walk
Psychosocial Development: ERIKSON
AGE STAGE COMMENTS
Infancy: Trust versus mistrust -The child learns to
Birth to age 1 trust as needs are met
year by the caregiver→ sees
world as a “safe place”
-play is considered a
psychosocial activity &
referred to as solitary
-explains personality
development...predictability of
environment.
Toddler: Autonomy versus shame and doubt -The child becomes more
Age 1-3 independent
years
-Frame of mind: “ I am a
big kid now.”
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
Pediatrics Nursing latest update 2022
Pediatrics : Nursing care of children from birth through adolescence
★ Infant mortality is high in the U.S. compared to other countries
● Must assess developmental milestones
○ Age 4 months, babies should be making baby
sound→ if they are not could indicate hearing
problems
● Monitor growth and development:
● Physical:
○ Height vs Length:
■ Crown to heel
■ measured laying down (recumbent) for children under 3
years old.
■ Measured standing up for children more than 3 years old
○ Weight: weigh babies consistently on the SAME scale EVERYDAY
○ Head circumference (measure until age 3)
○ Immunizations
● Cognitive:
○ Erikson’s stages
○ Language development
○ Presence of learning and developmental disabilities
● Sequence of exam: altered to accommodate the child’s developmental
need
Family centered care: families are key to the well-being of the child.
➢ Let family be as involved as much as possible, if they are not this is a
RED flag!
Child life specialists
➢ Non-nursing professionals who promote effective coping and
normalization for families
➢ Used to relieve stress
➢ Have a 4-year degree in psychology and child psychology
Pain Scales:
➢ FLACC scale: used at 2 months-7 years → based on how
the child is acting
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
,Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
○ 0-2- points each for Face, Legs, Activity, Cry, inconsolably
➢ Faces scale: used from 3 years to early teens→ scale of 0-5
○ Six-line drawings of faces with expressions from happy to neutral to
crying
➢ Adolescent pediatric pain tool: used from 8-17 years old
○ Body outline (draw location of pain)
○ Word graphic scale (mark on a line closest to the intensity
descriptor)
○ Word list (circle the sensory, affective, and evaluative words that
apply)
Cultural sensitivity care
● Accommodate dietary restrictions
● Use of interpreters
● Accommodating time for prayers, etc..
● Tolerance of complementary and alternative (CAM) medicine when safe
Truth telling: Children generally prefer the truth!
Narcotics:
➢ It is safe to give narcotics to children
➢ Ex: morphine→ common S.E. itching, nausea,
constipation, and resp depression
➢ Give Benadryl for itchiness
Failure to Thrive:
➢ Failure to grow and develop at an expected rate
➢ Diagnosis is given to children who fall below the 5th percentile
ranges on height/weight charts
➢ Infant presents first with absence of weight gain or weight loss
➢ Drop in height is followed by drop in head circumference.
Barriers to effective communication
● Physical abnormalities Hearing or vision impairment
● Cognitive impairment
● Environmental noise
● Cultural differences
○ Asians are less likely to complain about pain
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
,Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
○ African americans are more likely to complain about pain
● Language barrier
Communicating with infants
➢ Communicate primarily with parent/caregiver
● Use gentle touch (security, comfort)
● Allow them to suck on pacifier (stress relief, relax)
● Talk to the infant in soft voice when providing care
● Use music and sound to sooth them→ sing song
approaches to communicate
● Provide continuity of care
● Speak slowly
● Cluster care→ less invasive to most invasive
Communicating with toddlers and preschoolers
➢ Have tantrums and are egocentric
➢ Sit in a chair at their eye level
➢ Label their emotions to validate feelings of fear and anxiety
➢ Prepare the child for procedures just before the procedure
● Use medical play, have toys available
● Give praise such as “good job”
● Use simple words
● Give them choices when appropriate
● Don’t use phrases such as “a small stick in the arm”
Communicating with school-age children (age 6-12)
➢ Direct communication
● Allow them to participate in care when safe
● Allow them to voice their concerns
● Encourage them to ask questions→ answer honestly and
with simple words
● Allow time for play
Communicating with adolescent children (age 13-18)
➢ Trust is extremely important
➢ Incorporate genuineness, trust, active listening, respect, and rapport
skills
➢ Do not confuse the adolescents’ mature body with emotional maturity
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
, Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
● Use open-ended questions
● Explain limits of confidentiality
● Provide privacy
● Encourage them to express feelings and concerns
Working with Interpreters:
● Avoid using “charades” to communicate
● Take caution when using family members
● Always speak directly to the patient/family and NOT the interpreters
● It is required by law that health care agencies provide these services at
no charge to the patient
Cephalocaudal – starts at the head and moves downward
➢ Ex: child can control his/her head and neck before it can control
his/her arms & legs
Proximal distal – starts in the center and moves outward
➢ Ex: movement and control of the trunk section of the body
occurs before movement & control of the arms
Differentiation – simple to complex progression
➢ Ex: the child learns to crawl before learning to walk
Psychosocial Development: ERIKSON
AGE STAGE COMMENTS
Infancy: Trust versus mistrust -The child learns to
Birth to age 1 trust as needs are met
year by the caregiver→ sees
world as a “safe place”
-play is considered a
psychosocial activity &
referred to as solitary
-explains personality
development...predictability of
environment.
Toddler: Autonomy versus shame and doubt -The child becomes more
Age 1-3 independent
years
-Frame of mind: “ I am a
big kid now.”
Peds_OB Final Exam Study Guide-
Pediatrics Nursing latest update 2022
