PEDS Test question from Highlights Exam 1

Miss Gray

Exam
o Relate the impact of culture on childbearing families.

o motor vehicle (MV)–related accidents continue as the most common cause of

death in children older than 1 year of age. As children grow older, the
percentage of deaths from injuries increases. The most common types of
unintentional injuries, in addition to MV accidents, include drowning, burns, and
firearm accidents. Many childhood injury fatalities could be avoided. For
example, the majority of bicycling deaths are from head injuries. Although
helmets reduce the risk of head injury by 85%, few children wear them

o The infant mortality rate is the number of deaths during

the first year of life per 1000 live births.

o Infant mortality is divided into neonatal mortality (less

than 28 days of life) and postneonatal mortality (28 days
to 11 months). In the United States infant mortality has
decreased dramatically.).

Incorporating into policy and practice the recognition that the family is the
constant in a child's life while the service systems and support personnel
within those systems fluctuate

Facilitating family-professional collaboration at all levels of hospital, home, and

community care:

o Care of an individual child

o Program development, implementation, and evaluation

o Policy formation

Exchanging complete and unbiased information between family members and

professionals in a supportive manner at all times

Incorporating into policy and practice the recognition and honoring of cultural
diversity, strengths, and individuality within and across all families, including
ethnic, racial, spiritual, social, economic, educational, and geographic diversity

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 Recognizing and respecting different methods of coping and
implementing comprehensive policies and programs that provide
developmental, educational, emotional, environmental, and financial support
to meet the diverse needs of families

Encouraging and facilitating family-to-family support and networking

Ensuring that home, hospital, and community service and support

systems for children needing specialized health and developmental care and
their families are flexible, accessible, and comprehensive in responding to
diverse family-identified needs

Appreciating families as families and children as children, recognizing

that they possess a wide range of strengths, concerns, emotions, and
aspirations beyond their need for specialized health and developmental
services and support

Chapter 32 social/cultural

o The manner and sequence of the growth and development

phenomenon are universal and fundamental features of all
children; however, the variations in behavioral responses
that children display to similar events are believed to be
determined by their culture.
Four categories of external assets that youth receive from the
community include (Search-Institute, 2008):
1. Support—Young people need to feel support, care, and love
from their families, neighbors, and others. They also need organizations
and institutions that offer positive, supportive environments.
2. Empowerment—Young people need to feel valued by their community
and be able to contribute to others. They need to feel safe and secure.
3. Boundaries and expectations—Young people need to know what is
expected of them and what actions and behaviors are within the
community boundaries and what are outside of them.
4.Constructive use of time—Young people need opportunities for growth
through constructive, enriching opportunities and quality time at home.
Internal assets must also be nurtured in the community's young
members. These internal qualities guide choices and create a sense
of centeredness, purpose, and focus.
The four categories of internal assets are:
1.Commitment to learning—Young people need to develop a
commitment to education and life-long learning.
2. Positive values—Youth need to have a strong sense of values that
direct their choices.
3. Social competencies—Young people need competencies that help
them make positive choices and build relationships.

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 4. Positive identity—Young people need a sense of their own power,
purpose, worth, and promise.
Day Care-clinical study:
Randomized controlled trials of day care for preschool children identified
using electronic databases, hand searches of relevant literature, and
contact with authors
In these eight studies, all conducted in the United States, a total of 2203
children were randomized to day care or a control group. All subjects were
less than 4 years old at enrollment. Day care ranged from 2 hours a week
for 8 months to 7 hours a day, 5 days a week for 7 years. All studies
examined cognitive development, six studies examined school
performance, four studies evaluated behavior, and one study assessed
children's health.
Apply the Evidence: Nursing Implications:
o Studies revealed out-of-home day care has beneficial effects for
children, enhancing cognitive development and preventing later
school failures.
o Observational studies have reported that day care can negatively
affect child development. The studies reviewed show that preschool
education has a beneficial effect on a child's behavior
o Center-based day care increases maternal employment and
education, which could lead to improved socioeconomic status.
o Mother-child interaction can be improved by day care, with studies
showing improved communication between mother and child when
compared with children who receive no day care.
o Evidence suggests that out-of-home day care can have a positive
effect on social outcomes for children and their families

Ch. 33 Development: Be sure to know these and give a definition and

example of them:

Growth—An increase in number and size of cells as they divide

and synthesize new proteins; results in increased size and weight of
the whole or any of its parts

Development—A gradual change and expansion; advancement from lower

to more advanced stages of complexity; the emerging and expanding of the
individual's capacities through growth, maturation, and learning

Maturation—An increase in competence and adaptability; aging; usually

used to describe a qualitative change; a change in the complexity of a
structure that makes it possible for that structure to begin functioning; to
function at a higher level

Differentiation—Processes by which early cells and structures are

systematically modified and altered to achieve specific and characteristic

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physical and chemical properties; sometimes used to describe the trend of
mass to specific; development from simple to more complex activities and
functions

Ch. 33 Stages of Development

o The age ranges of these stages are admittedly arbitrary

o These patterns, or trends, are universal and basic to all

human beings, but each human being accomplishes these in
a manner and time unique to that individual.

Developmental Age Periods-commit this to memory

Prenatal Period—Conception to Birth
Germinal—Conception to approximately 2 weeks
Embryonic—2 to 8 weeks
Fetal—8 to 40 weeks (birth)
o A rapid growth rate and total dependency make this one of the most
crucial periods in the developmental process.
o The relationship between maternal health and certain manifestations
in the newborn emphasizes the importance of adequate prenatal care
to the infant's health and well-being.
Infancy Period—Birth to 12 Months
Neonatal—Birth to 27 or 28 days
Infancy—1 to approximately 12 months
o The infancy period is one of rapid motor, cognitive, and social
development.
o Through mutuality with the caregiver (parent), the infant
establishes a basic trust in the world and the foundation for
future interpersonal relationships.
o The critical first month of life, although part of the infancy period,
is often differentiated from the remainder because of the infant's
major physical adjustments to extrauterine existence and the
parent's psychologic adjustment.
Early Childhood—1 to 6 Years
Toddler—1 to 3 years
Preschool—3 to 6 years
o This period, which extends from the time children attain
upright locomotion
until they enter school,
o is characterized by intense activity and discovery. It is a time of
marked physical and personality development.

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 o Motor development advances steadily
o . Children at this age acquire language and wider social
relationships, learn role standards, gain self-control and mastery,
develop increasing awareness of dependence and independence,
and begin to develop a self-concept.

Middle Childhood—6 to 11 or 12 Years

o Frequently referred to as the school age,
o this period of development is one in which the
child is directed away from the family group and centered
around the wider world of peer relationships.
o There is steady advancement in physical, mental, and
social development, with emphasis on developing skill
competencies.
o Social cooperation and early moral development take on
more importance with relevance for later life stages.
o This is a critical period in the development of a
self-concept.
Later Childhood—11 to 19 Years
Prepubertal—10 to 13 years
Adolescence—13 to approximately 18 years
o The tumultuous period of rapid maturation and change known as
adolescence is considered to be a transitional period that begins at the
onset of puberty and extends to the point of entry into the adult world
—usually high school graduation.
o Biologic and personality maturation are accompanied by physical and
emotional turmoil, and there is redefining of the self-concept
o In the late adolescent period the young person begins to internalize all
previously learned values and to focus on an individual, rather than a
group, identity.

Chapter 33 growth
o The sequence is predictable; the exact timing is not
o Rates of growth vary, and measurements are defined in terms of
ranges to allow for individual differences.
o ‘Nutrition is probably the single most important influence on
growth.

Go to companion website for the cranial nerve stuff

http://evolve.elsevier.com/Perry/maternal/
• NCLEX Review Questions
• Anatomy Reviews
• Animation—Abdominal Anatomy
• Animation—Cranial Nerves-look at this

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 Chapter 37 Toddler
One of the more prominent changes of the gastrointestinal
system is the voluntary control of elimination. With complete
myelination of the spinal cord, control of the anal and urethral
sphincters is gradually achieved. The physiologic ability to control the
sphincters probably occurs somewhere between ages 18 and 24
months. Bladder capacity also increases considerably, and by 14 to 18
months of age the child is able to retain urine for up to 2 hours or
longer.

According to Erikson, the developmental task of toddlerhood is

acquiring a sense of autonomy while overcoming a sense of
doubt and shame.

Traumatic injury is the leading cause of childhood

hospitalization, and infants and younger children are at higher
risk because of their small size and inability to protect
themselves
Most organ systems can adjust to moderate stress and change.
Moral Development
Preschoolers often misinterpret illness as a punishment for
real or imagined transgressions.
It is important that children view God as one who bestows
unconditional love, rather than as a judge of good or bad
behavior.
Toddler
She said this will be on at least one test-she went over this a
little bit in class
Attributes of Temperament
o Activity—Level of physical motion during activity such as sleep,
eating, play, dressing, and bathing
o Rhythmicity—Regularity in the timing of physiologic functions
such as hunger, sleep, and elimination
o Approach-withdrawal—Nature of initial responses to new
stimuli such as people,
situations, places, foods, toys, and procedures (Approach responses
are positive and are displayed by activity or expression; withdrawal
responses are negative expressions or behaviors.)
o Adaptability—Ease or difficulty with which the child adapts or adjusts
to new or altered situations

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o Threshold of responsiveness (sensory threshold)—Amount of
stimulation, such as sounds or light, required to evoke a response in
the child
o Intensity of reaction—Energy level of the child's reactions,
regardless of quality or direction
o Mood—Amount of pleasant, happy, friendly behavior compared with
unpleasant, unhappy, crying, unfriendly behavior exhibited by the
child in various situations
o Distractibility—Ease with which a child's attention or direction of
behavior can be diverted by external stimuli
o Attention span and persistence—Length of time a child pursues a
given activity (attention) and the continuation of an activity in spite
of obstacles (persistence)

Look at Table 37-1- Growth and Development During Toddler

Years and
38-21 Preschool years

Chapter 38 Preschooler
Play: Various types of play are typical of this period, but preschoolers
especially enjoy associative play—group play in similar or identical
activities but without rigid organization or rules
Probably the most characteristic and pervasive preschool
activity is imitative, imaginative, and dramatic play. Dress-up
clothes, dolls, housekeeping toys, dollhouses, play store toys,
telephones, farm animals and equipment, village sets, trains, trucks,
cars, planes, hand puppets, and medical kits provide hours of self-
expression

One of the issues that parents face is the child's readiness for
preschool or kindergarten. There are no absolute indicators for school
readiness, but the child's social maturity, especially attention span, is
as important as his or her academic readiness. Using a
developmental screening tool that addresses cognitive
(especially language), social, and physical milestones can
identify children who may benefit from diagnostic testing and
early intervention programs before starting school.

Young children are especially vulnerable because of their

limited capacity to cope. Expression of frustration, fear, or
anxiety is hampered by inadequate expressive language.
The use of varicella-zoster immune globulin (VariZIG) or immune
globulin intravenous (IGIV) is recommended for children who are
immunocompromised, who have no previous history of varicella, and
who are likely to contract the disease and have complications as a
result

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Note from Miss Gray: Varicella Immune globulin is different from the
typicaly varicella vaccine that is administered to healthy individuals.
The immune globulin is a way to provide already produced immunity to
children who are immunocompromised.