ATI Peds Exam Slides and Study Guides 2024

Preferred IM site for newborns/ infants - vastus lateralis Toddlers G&D - Negativism / Ritualism" "no" Egocentricity: only their POV Transitional Objects: blankie Parallel Play: next to each other but not together Preschool G&D - Sex Typing Punishment vs Obedience Associative, Imaginative & Mutual Play Magical thinking Associative play - group play without rules Mutual Play - between parent & child Nursing interventions for preschoolers - Reinforce they are not bad if they are hospitalized or have to get a shot. Distraction during painful procedures Don't say "Stick in the arm" for shot as they will actually think they have a shot in the arm or Take your vital signs...what are you going to take away? give (3) choices when possible band aids and stickers School age G&D - Industry v Inferiority Erikson Concrete Operations: thinking to explain events Conservation: altering arrangements doesn't change the amount Team Play What is the play of the teen? - cliques Nursing considerations for toddlers - be firm Offer 2 choices Simple terms like "owie" Offer reward: tablet, ice cream routines Medical play - play with real medical equipment and often dolls, which allows children a non-threatening way to learn about and familiarize themselves with medical procedures, equipment, hospitals, doctors and nurses Should you mix medication with formula or breast milk? - no. Do not want an aversion to their nutrition What gauge of needle is used for the newborn? - 25g What direction to pull ear children 3 years - Pull Pinna down & back older is up and back Pediatric Maintenance Fluid Requirements 0-10 kg - 100ml/kg/24hr Pediatric Maintenance Fluid Requirements 10-20 kg - 1000ml + 50ml/kg/24hr for each kg between 11-20 ex: 15kg child= 1000ml+ (50mL x 5kg = 250) = 1250ml/day = 52ml/hr fluid rate Pediatric Maintenance Fluid Requirements 20-70 kg - 1500ml + 20ml/kg/24hr for each kg between 21-70 ex: 58kg child = 1500ml + (20ml x 38kg= 760) = 2260ml/day = 94ml/hr fluid rate Pediatric Maintenance Fluid Requirements over 70 kg - 2500 ml/24hr (adult) FLACC Scale = 5 categories with 1 - 2 points for pain / 0 for none - Facial Expression - relaxed, grimace Leg Movement - Relaxed or drawn up Activity- quiet, squirming, rigid Cry - no cry, whimper, vigorous Consolability - relaxed - consolable or difficult to console The nurse is listening to the heart rate of a young child and notes an irregular heart rate. She should: a: page the doctor b: administer a shock c: mark as a normal finding - c: mark as a normal finding where to do venipuncture on an infant below 1 - Plantar surface of the heel (outer surface) First drop is contaminated (Wipe with sterile guaze) Until what age will the head circumference be larger than the chest circumference - Until 1 year of age equal with HC. Then CC surpasses HC. cephalocaudal growth - head to tail ex: First lift head before crawling Proximodistal growth - near to far midline to peripheral concept ex: shoulders before hands, dexterity takes more time to develop trends in birth length/ height - Birth Length increases by 50% by end of 1st year trends in birth weight - Doubles by end of 1st 4 - 7 months (6mo) Triples by end of 1st year what age is the basal metabolic rate the highest? - infants because they have the fastest rate of growth - can easily overheat trends in sleep for children - 12 - 18 months most have outgrown 2 naps a day. After age 3 years most have given up daytime naps Freud oral stage - Birth to 1 year oral gratification - explore everything with their mouths Choking hazard Freud anal stage - 1 - 3 years anal region as learning to toilet train Freud Phallic Stage - 3-6 years Oedipus & Electra complexes - (Son marries Mother and Daughter marries Dad) Penis Envy & castration anxiety Children become interested in genitalia as acquire sensations. Ok to do in your bedroom, not in a public place. Latency Period - 6-12 years children elaborate on previously acquired traits team sports, &skills: sexual energy channeled into skills Freud genital stage - 12+ years sexual maturity Piaget Sensorimotor stage - birth to 2 years progress from a reflex activity to imitate behavior object permanence Piaget Pre-operational stage - 2 to 7 years Egocentrism (inability to put oneself in the place of another) Have concrete and tangible thinking Don't say a "stick in the arm" instead give your arm a hug for BP. preconceptual (2- 4) intuitive (4-7) Piaget Concrete Operations - 7 - 11 years conservation - the amount of water remains the same even if they are in different containers. Inductive Reasoning Kolberg preconventional level - Right / Wrong motivation with pleasure/consequence good behavior = reward Kolberg conventional Level - Confirmation & Loyalty. Obey the rules & do one's duty. Boy Scouts Kolerg Post-conventional or Principled Level - Changing laws based upon individual's belief such as abortion Associative play - play together, but no organization or mutual goal Cooperative Play - organized with a division of labor & role play ex: I'm the mom you're the dad Choking for infants - coins, hot dogs, grapes, candy frequency of APGAR scores - Performed after birth at 1, 5, and 10 minutes (if initial score is less than 7) Most common scores are 8 & 9 What bone is most frequently fractured during the birth process? - clavicle sx: Crepitus (like Rice Krispie's snap, crackle & pop) may be felt or heard.