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NURS 6541 Peds Midterm Study Guide, Primary Care Adolescnt & Child
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NURS 6541 Peds Midterm Study GuideSection 1 Emily Turner
1. Children are able to sit without extra support at what age?
6-8 montholds should be able to sit briefly without extra support,
7-9 months old sit well independently.
2. Types of car seats (see also #60):
Appropriate ages and weights for forward and rear facing seats.
When can kids ride in the front seat of the car? 13 years old. When
should they use booster seat? 4-8 years old
The AAP recommends:
Infants and toddlers should ride in a rear-facing car safety
seat as long as possible, until they reach the highest weight or
height allowed by their seat. Most convertible seats have
limits that will allow children to ride rear-facing for 2 years
or more.
Once they are facing forward, children should use a forward-
facing car safety seat with a harness for as long as possible,
until they reach the height and weight limits for their seats.
Many seats can accommodate children up to 65 pounds or
more.
When children exceed these limits, they should use a belt-
positioning booster seat until the vehicle’s lap and shoulder
seat belt fits properly. This is often when they have reached
at least 4 feet 9 inches in height and are 8 to 12 years old.
When children are old enough and large enough to use the
vehicle seat belt alone, they should always use lap and
shoulder seat belts for optimal protection.
All children younger than 13 years should be restrained in the
rear seats of vehicles for optimal protection.
,3. Recommended vaccine schedule (many questions):
https://www.cdc.gov/vaccines/schedules/hcp/imz/child-
adolescent.html
(Items 3, 6, 46, and 85 in this study guide address vaccines)
4. Child abuse questions:
What age is it appropriate to have certain types of fractures?
Metaphyseal fractures, multiple differently aged posterior rib
fractures, complex or multiple skull fractures, spinous
process or scapular fractures are suspicious in children.
When should you be concerned about a young infant with
tons of bruises (eg - if they are not walking yet would be
unusual)? Long bone fx are unusual in young infants.
When is it necessary for you to report? Anytime you suspect
any sort of abuse.
Who do you report to? CPS.
Do you face any repercussions? Should not.
Any fracture in a non-ambulatory infant without clear
accidental and consistent mechanism should raise a red flag.
(items 4, 5 and 29 in this guide address child abuse)
5. Toddler abuse: There will be a list of injuries. Which would be
caused by abuse?
Bruises TEN4 by AAP
1. T- torso; E- ear; N- neck; 4- in children less than or
equal to 4 years and ANY bruise in children less than 4
months
Injuries tend to occur away from bony prominences (neck,
head, buttocks, trunk, hands, and upper arms)
6. Contraindications of vaccinating children. Who should not
receive a live vaccine?
, Immunocompromised, allergic reaction to a previous dose or
component of vaccine, history of intussusception for Rotavirus
See CDC sheet “vaccines by medical indication”
https://www.cdc.gov/vaccines/schedules/hcp/imz/child-
indications.html
Immunocompromised should not receive: Rotavirus, MMR,
influenza (LAIV) or varicella
HIV infection should not receive: Influenza (LAIV), MMR or
varicella
Kidney disease should only cautiously receive influenza (LAIV)
Asthma: No influenza (LAIV)
CSF leaks: No influenza (LAIV)
(Items 3, 6, 46, and 85 in this study guide address vaccines)
7. Young boy with mental retardation. He was a premie. They give a
scenario. What caused his mental retardation? eg - understand
congenital abnormalities, infections, preemie complications,
chromosomal aberrations, brain tumor, serum blood levels
Important risk factors for intellectual disability (ID) include
low level of maternal education, advanced maternal age, and
poverty.
The causes of ID are extensive and include conditions that
interfere with brain development and functioning. Among the
known causes of ID, the majority are genetic abnormalities.
1. A genetic cause can be identified in >50 percent of
cases of ID in populations referred for specialty
evaluation. Down syndrome is the single most common
genetic cause of ID. X-linked disorders (including
fragile X syndrome) account for approximately 5 to 10
percent of ID in males. De novo dominant mutations
are an important cause of severe ID.
Metabolic disorders can cause ID or may be comorbid. ID
can present alone or with neurologic abnormalities such as
, epilepsy or structural brain defects, or with other congenital
anomalies.
Nongenetic prenatal causes of ID include congenital
infections, and teratogens such as alcohol, lead, and
valproate. Perinatal abnormalities account for up to 5 percent
of ID and include preterm birth, hypoxia, infection, trauma,
and intracranial hemorrhage. Postnatal and acquired causes
of ID include accidental or nonaccidental trauma, central
nervous system (CNS) hemorrhage, congenital
hypothyroidism, hypoxia (eg, near-drowning), environmental
toxins, psychosocial deprivation, malnutrition, intracranial
infection, and CNS malignancy.
1. Blood lead testing should be performed if the child has
not had prior lead screening and/or risk factors for
exposure are present (eg, persistent mouthing behavior,
pica, living in a house or child care facility built before
1950, recent immigration or home renovation, ethnic
remedies, and some parental occupations [smelting,
soldering, and auto body repair]).
Section 2 Melissa Burris
8. Newborns: What type of vitamin deficienc\ies cause problems? eg
- vitamin A, B1, C, D and K
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