Peds and Maternity HESI hints
Health promotion - -The best place to check cap refill is on the childs
sternum
Know normal growth and development for evaluations of interventions and
therapy. Steady head control would show thyroid hormone therapy for a 4
month old is effective because head control is an expected milestone for a 4
mo old and It indicates therapy is adequate for growth
-Infant Milestones - -(birth to a year)
-birth weight doubles by 6 months; triples by 12
- birth weight increases by 50% at 12 months
- explores environment by motor and oral means
-toys: squeaking, picture books, balls, colored blocks, activity boxes
-Toldder milestones - -(1-3 years)
- birth weight quadruples by 30 months
- 50% of adult height by 2 years
- growth velocity slows
- give brief simple explanations
- let kid have security object
- toys: board and mallet, push-pull, toy telephones, stuffed animals,
storybooks, hospital playroom
-Preschool milestones - -(3-6 years)
3 year old can ride a tricycle
4 year old can use scissors
child learns colors and shapes
Visual acuity approaches 22/20
imaginary playmates and fears
egocentricity
therapeutic play
toys: coloring books, puzzles, cutting and pasting, dolls, building blocks, clay
-School aged child milestones - -(6-12 years)
- Maintain contact with peers and school in hospital
- explain all procedures: verbally, pictures, books, equipment
- privacy
- participation in care
- toys: board games, card games., hobbies (collections), video games
- eriksons industry development which means they like to accomplish skills
and peers are important
, -Tanner stages of development - -- Girls: breast, rapid increase of height
and weight, pubic and axillary hair, menstruation, abrupt deceleration of
linear growth
-Boys: enlargement of testicles, pubic and axillary hair, facial hair, rapid
increase in height, changes in voice, nocturnal emissions, abrupt
deceleration of linear growth
-Adolescent Milestones - -(12-19 years)
- adult-like thinking at 15 (abstract and problem solving)
-Eriskons identity phase
- maintain contact with peers and school
- share room with another teen
-hospitalization can effect teens body image
- direct talking to teen, teach without parents
- help maintain identity with own clothes, posters)
- focus on here and now "how will It effect me today"
- accident prevention is major to prevent death
-Review of age groups - -- Birth doubles in length by 4 years
- head control at 4 months
- Child can sit unsupported by 8 months
- child achieves 50% adult height by 2 years
- Child can throw a ball overhand by 18 months
- Child can speak two-three word sentences by 2 years
- Child can tie shoes at 5 years
- Girls growth spurt happens before boys (10 years)
- Temper tantrums are common in toddlers/ normal
-adolescent gets rebellion towards parents and family values
-Age concepts of injury - -- Infant: after 6 months they can remember pain
- Toddlers: fear intrusive procedures
- Preschoolers: fear body mutilation
- School age: fear loss of control of bodies
- Adolescent: body image concerns
-Diseases - --German measles should be screened for to prevent harm to
child in pregnancy
- DTaP be aware of history of seizures, neuro symptoms after vaccine,
allergic reactions
- MMR: (measles, mumps, and rubella) history of anaphylactic reactions to
eggs or neomycin
- Common cold is not a contraindication for vaccines
- temp 102/ 38.8; irritable, redness, soreness at injection site for 2-3 days
are all normal for DTaP and IPV (polio)
- Call provider if seizures, high fever or high pitched cry