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Pediatric Ch 15
Growth, Development, and Nutrition
| Question | Answer |
|---|---|
| Which statement explains child growth and development? A. Proceeds at a predictable rate. B. Predictable sequence of developmental milestones. C. Growth rates are consistent among children. D. With rapid growth, there is accelerated development. | B. Predictable sequence of developmental milestones. |
| A nurse is discussing development with a parent. Which will foster the achievement of autonomy in a toddler? A. Help complete tasksB. Provide play with other childrenC. Help learn the difference of right and wrongD. Encourage to do things for self | A. Help the toddler complete tasks. |
| Which is the concrete operations stage of cognitive development? A. Progress from reflex to imitative behavior B. Can put oneself in another's place C. Logical and coherent thought increasesD. Think in abstract terms and draw logical conclusions | A. Progression from reflex to imitative behavior |
| According to Piaget, at what stage of development do children typically solve problems through trial and error? A. Sensorimotor B. Preoperational C. Formal operational D. Concrete operational | B. Preoperational |
| The nurse observes that adolescents are skeptical of their parents' religious practices. This is: A. Normal B. Abnormal C. Related to illness D. Related to the parent's inability to explain their practices | A. Normal in spiritual development. |
| Which is an important consideration related to childhood stress? A. Children should be protected from stress. B. Children have no coping strategiesC. Parents cannot prepare children for stress D. Some children are more vulnerable to stress | D. Some children are more vulnerable to stress than others. |
| What is the age of a fetus? | ninth gestational week to birth |
| What is the age of a neonate? | birth to 4 weeks |
| What is the age of an infant? | 4 weeks to 1 year |
| What is the age of a toddler? | 1 to 3 years |
| What is the age of a preschooler? | 3 to 6 years |
| What is the age of a school-ager? | 6 to 12 years |
| What is the age of an adolescent? | 12-18 years |
| What does the term "catch up" refer to? | the process by which a child who has been sick or malnourished and whose growth has slowed or stopped experiences a more rapid period of growth after recovery as the body attempts to compensate |
| Sense of Initiative versus Guilt age | Preschooler: Age 3 to 6 |
| Sense of Integrity vs. Despair age | Older Adult: Age 65 and older |
| Sense of Identity vs. Role Confusion age | Adolescent: Age 12 to 20 |
| Sense of Generativity vs. Stagnation age | Adult: Age 45 to 65 |
| Sense of intimacy vs. Isolation age | Young Adult : Age 20 to 45 |
| Sense of Industry vs. Inferiority age | School Aged : Age 6 to 12 |
| Sense of Trust vs Mistrust age | Infant : Birth to age 1 year |
| Sense of Autonomy vs. Shame and Doubt age | Toddler: Age 1 to 3 |
| Erickson's developmental stage for a 10 Year old boy proudly displays his principal's award certificate. | Industry vs. Inferiority |
| Erickson's developmental stage for an Infant believes that his parents will feed him. | Trust vs. Mistrust |
| Erickson's developmental stage for a 22 year old woman picks a circle of friends with whom she spends her free time. | Intimacy vs. Isolation |
| Erickson's developmental stage for a 13 y.o. girl fights with her mother about appropriate dress. | Identity vs. Role Confusion |
| Erickson's developmental stage for a nursing home resident reflects positiviely on her past life experiences. | Ego Integrity vs. Despair |
| Erickson's developmental stage for a 15 year old boy worries about how his classmates treat him. | Identity vs. Role Confusion |
| Erickson's developmental stage for a 45 year old man meets a goal of guiding his two children into rewarding careers. | Generativity vs. Stagnation |
| Erickson's developmental stage for a Kindergarten student learns the ABC's. | Initiative vs.Guilt |
| Erickson's developmental stage for a 2 year old boy expresses interest in dressing himself. | Autonomy vs. Shame and Doubt |
| Erickson's developmental stage for a 35 year old woman volunteers Sat. Mornings to work with the homeless. | Generativitiy vs. Stagnation |
| adolescent | (347) 12 to 18 years |
| cephalocaudal | (348) development proceeds from head to toe |
| cognition | (355) intellectual ability |
| community | (355) immediate geographical area in which the family lives and interacts |
| competitive play | (378) play with structured rules and highly interactive physical activity |
| cooperative play | (378) children play with each other, each taking specific roles |
| deciduous | (375) baby |
| dysfunctional family | (354) does not provide for optimal physical, psychological, and emotional health of the children |
| Erikson | (362) states various tasks must be mastered by a certain age to achieve optimum maturity |
| extended family | (353) grandparents, parents, children |
| fluorosis | (376) mottled teeth |
| growth | (347) increase in physical size – measured in inches and pounds |
| height | (348) standing measurement |
| infant | (347) 4 weeks to 1 year |
| Kohlberg | (355) childhood theorist who suggested that moral development in children is sequential |
| length | (348) measurement in recumbent position |
| Maslow | (355) Abraham – developed hierarchy of needs |
| maturation | (347) total way in which a person grows and develops, as dictated by inheritance |
| metabolic rate | (348) energy utilization and oxygen consumption |
| neonate | (347) birth to 4 weeks |
| nuclear family | (353) biological family |
| nursing caries | (376) bottle mouth caries |
| parallel play | (378) playing next to each other, but not with each other |
| personality | (355) unique characteristic organization determining the individual’s typical or recurrent pattern of behavior |
| Piaget | (355) proposed intellectual maturity is obtained through 4 distinct, orderly stages of development, all interrelated |
| proximodistal | (348) from midline to periphery |
| therapeutic play | (378) play that is a part of the therapeutic process |
| toddler | (347) 1 to 3 years |
| How is caring for a child different than caring for an adult | child is in a continuous process of growth and development |
| How can the growth and development of a child be best described | proceeds from simple to complex – orderly but not steadily paced - spurts followed by plateaus |
| When does the most notable growth spurt take place | at puberty |
| How is the growth of a child studied | By measuring and comparing height, weight, increases in vocabulary, physical skills, and other parameters |
| How are the acute care units of a hospital different for an adult and a pediatric patient | separate units are typically maintained for adults but all medical surgical specialties for children are housed on one unit for patients from newborn to adolescent |
| What impacts the child’s response to illness and the approach a nurse must take to develop a plan of care | Developmental needs |
| What is important to remember in communicating with a pediatric patient | choose the right words to explain what will happen to them based on their ability to understand and phase of development |
| Define development | Progressive increase in the function of the body |
| What might be different from adults for children due to the difference in anatomy and physiology | Illness, response to illness, manifestations, treatments |
| What is done in the data collection phase of applying the nursing process to pediatric care | obtain height and weight, plot standard growth chart, record developmental milestones achieved related to age, observe infant; interview parents |
| What is done in the analysis/nursing diagnosis phase of applying the nursing process to pediatric care | determine appropriate nursing diagnosis related to parenting, coping skills, and unmet developmental needs |
| What is done in the planning phase of applying the nursing process to pediatric care | offer guidance and teaching to family, school personnel, and child to meet child’s developmental needs |
| What is done in the implementation phase of applying the nursing process to pediatric care | interventions that foster G&D in the hospital setting |
| What interventions might foster growth and development in the hospital setting | age-appropriate self-care, anticipatory guidance may be given to parents so they understand changes in behavior/eating habits/play for the growing child |
| What is done in the evaluation phase of applying the nursing process to pediatric care | ongoing evaluation of G&D of the child and follow-up of teaching and guidance offered at prior clinic/home visits are essential |
| What is cephalocaudal development | Development that proceeds from head to toe – the head is raised before sitting, trunk is controlled before walking |
| What is proximodistal development | Development that proceeds bilaterally from midline to periphery |
| What is an example of development proceeding from general to specific | Infants grasp with their hands before pinching with their fingers |
| What is linear growth caused by | Skeletal growth |
| When does linear growth cease fluxuating | When maturity is reached |
| When measuring linear growth, what is the nurse measuring | Height |
| What determines how tall someone will be | Generally a family trait |
| What is the typical rate of increase for infant height/length | 1 inch/month for the first 6 month, 50% increase by age 1 year |
| How is length measured for infants from birth to 2 years of age | Recumbent position, mild pressure on knee to straighten, measured from crown to heel |
| How is height measured for children ages 2 to 18 | Standing – body in alignment with shoulders, buttocks, and heels touching wall, head at midline, looking straight, no shoes, should stand on paper |
| What is instrumental in promoting linear growth | Good nutrition and general good health |
| What are the two rapid growing periods | Infancy and puberty |
| How much does the average term newborn weigh | 6 to 9 pounds |
| How much weight is lost in the first 3 or 4 days | 5 to 10% |
| When does the infant regain initial lost weight | By 10 to 12 days |
| What should the infant’s weight be by 5 to 6 months of age | Double birth weight |
| What should the infant’s weight be by 1 year of age | Triple birth weight |
| Why does the infant initially loose between 5 and 10% of its birth weight in the first 3 or 4 days of life | Stool passage, limited fluid intake |
| After tripling the birth weight at 1 year, what is the normal increase in a child’s weight | 4 to 6 pounds per year until puberty |
| The body weight of a newborn is composed of a higher percentage of ____ than in the adult. | Water |
| What is the percentage of extracellular fluid in relation to body weight in a newborn | 40% |
| What is the percentage of extracellular fluid in relation to body weight in an adult | 20% |
| Every infant must be closely monitored for ________ because of the higher proportion of extracellular fluid in the body | Dehydration |
| What is the fastest growing part of the body during fetal life | The head |
| What is the fastest growing part of the body during infancy | The trunk |
| What is the fastest growing part of the body during childhood | The legs |
| How does growth occur during adolescence | Characteristic male and female proportions develop as childhood fat disappears |
| Other than height and weight, what measurements are routinely taken as an indicator of health | Head and chest circumference |
| Who has the higher metabolic rate, adults or children | Children |
| Higher metabolic rates in children are accompanied by an increased production of ___ and ____. | Heat and waste |
| The body surface area in relation to body weight is (less or greater) in children than adults. | Greater |
| The young child looses more fluid from the ____ and ____ systems. | Pulmonary and Integumentary |
| How are respirations different in infants | They are irregular and abdominal |
| What are the dangers of a small infant’s airways respirations | Small airways are easily blocked with mucus |
| What can the thin chest wall and immature muscles of an infant cause | Pressure on the chest that interferes with respiratory efforts |
| What is the physical composition of the neonate’s heart | The right and left ventricles are almost equal in muscle mass |
| The increased need for ___ ___ is often met by an increase in ___ ___. | Cardiac output – heart rate |
| What contributes to the need for a higher cardiac output in infants | Presence of fetal hemoglobin, high oxygen consumption |
| What can cause physiological anemia in infants after 3 to 4 months of age in regard to the cardiovascular system | Disappearance of fetal hemoglobin along with loss of maternal iron stores |
| What illnesses are newborns protected from during the first 3 months of life | Ones to which the mother was exposed |
| When are adult levels of immunoglobin produced | by puberty |
| What must the newborn be protected from due to the immature immunity while in the hospital | Nosocomial infection and exposure to pathogens |
| When is kidney function mature | End of the second year of life |
| What are the dangers of the immature kidney function of children under 2 | Inadequate drug excretion, dehydration |
| What happens to the primitive reflexes of infants as they mature | They are replaced by purposeful, controlled movements |
| Head circumferences increases at what rate for the first 6 months of life - second 6 months | 1.5 cm/month to a total of 43cm - 0.5 cm/month to a total of 46cm at 1 year of age |
| What determines if a toy is age appropriate for an infant/child | Nervous system maturation |
| How much does a neonate sleep per night | 8 to 9 hours |
| How much does a neonate sleep per day | 8 to 9 hours |
| How much does a 2 year old sleep per night | 10 hours |
| How much does a 2 year old sleep per day | One short nap |
| How much sleep does a 7 year old require | 8 to 8 ½ hours at night |
| What may alter sleep patterns | Culture |
| What culture has all family members take a nap after work or school, before dinner | Israeli kibbutzim |
| The best indicator for biological age is | Bone growth |
| How can bone age be determined | X-ray studies |
| What are a fetus’s bones first made of | Connective tissue |
| What is a fetus’s connective tissue converted to | Cartilage |
| The process of cartilage converting to bone is called | Ossification |
| When does growth of the long bone end | When epipehyseal fusion occurs |
| When is bone synthesized and reabsorbed | Constantly |
| Which is greater in children, bone synthesis or destruction | Synthesis |
| What mineral is stored in the ends of long bones | Calcium |
| What vitamins and nutrients are necessary for the growth and development of skeletal and soft tissue | Vitamin A, vitamin D, sunlight, fluorine |
| Why do children connect and perfect skills | In preparation for learning a more complex one |
| How is growth measured | in dimensions (height, weight, volume, tissue thickness) |
| Why have growth standards been developed | To compare the measurements of a child to one of the same age and sex – compare a child’s measurements to with the former rate of growth and patterns of progress |
| What is the main tool used to compare growth standards | Growth chart |
| Children in good health tend to follow what pattern of growth | Consistent |
| At what age are there wide individual differences in measured values | Any age |
| How many percentile levels are charts customarily divided into | 7 |
| If a growth chart contains a 97th percentile, what other percentiles are labeled | 95th, 90th, 75th, 50th, 25th, 10th, 3rd |
| If a growth chart does not contain a 97th percentile, what percentiles are labeled | 95th, 90th, 75th, 50th, 25th, 10th, 5th |
| Do boys and girls have the same growth chart | No, there are separate charts for boys and girls |
| Which percentile level is designated by a solid black line in all growth charts | Median/middle/50th |
| What do percentile levels show | The extent to which a child’s measurements deviate from the 50th percentile |
| How many percentile levels below the median is a child in the 25th percentile | One |
| How many percentile levels above the median is a child in the 75th percentile | One |
| What result on a growth chart might suggest an underweight or overweight condition | A difference of 2 or more percentile levels between height and weight |
| Besides the 2 percentile level difference between height and weight, what result on a growth chart needs further investigation | Deviations of 2 or more percentile levels from an established growth pattern |
| What is a widely used assessment tool for developmental screening | Denver II/Denver Developmental Screening Test |
| What does the Denver II Developmental Screening Test assess | developmental status of children during the first 6 years of life |
| What categories of development does the Denver II Developmental Screening Test assess | personal-social, fine motor-adaptive, language, gross motor |
| Is the Denver II Developmental Screening test an intelligence test | No – it only identifies children who are unable to perform at a level comparable to other children their age |
| What does a low score on the Denver II Developmental Screening test indicate | A need for further evaluation |
| What is catch-up growth | A more rapid period of growth in which the body attempts to compensate in children whose growth has been delayed or stopped due to illness, malnourishment, or other reasons |
| What influences the growth and development of a child | Heredity traits, nationality and race, ordinal position within the family, gender, environment, the family |
| When are ancestral physical characteristics determined and by what | At conception by genes within each chromosome |
| What is a gene made of | Deoxyribonucleic acid (DNA) |
| What are examples of inherited traits | eye color, hair color, physical resemblance with family |
| What areas do ethnic (nationality and race) differences extend into | speech, food preferences, family structure, religious orientation, code of conduct |
| How does ordinal position affect the youngest and middle children in the family | learn from older children, motor development can be delayed if child is babied |
| In what areas do older and only children tend to excel and why | in language development because they converse mainly with adults |
| What ordinal position in the family tends to make the child the object of greater parental expectations | First or only |
| What is the main difference in male and female chidren | males weigh more and are longer than females |
| What, other than physical size, influences the differences in the type of development in male and female children | girls and boys tend to be treated differently by family |
| What are the greatest influences of the physical condition of a newborn | Prenatal environment, mother’s preconception and uterine health, mother’s diet during pregnancy |
| What areas of a child’s heath can be influenced by the financial status and education of the family | food preparation and immunizations, children can be affected by family tension |
| Nuclear family = | Traditional – husband, wife, children |
| Extended family = | 3 generations, parents grandparents and children |
| Single parent = | Women or men establishing separate households |
| What is often a major problem for a single parent | Good, affordable childcare |
| Blended family = | single parent getting married, unites unrelated familiesFoster = |
| Alternative family = | communal family |
| Dual career = | both parents work outside the home because of desire or need |
| Polygamous = | more than one spouse |
| Homosexual = | two persons of the same sex who have adopted children or had children from a previous marriage |
| Cohabitation = | hetero or homo sexual couples who live together but remain unmarried |
| Dysfunctional family = | family that does not provide for the optimum physical, psychological, and emotional health of the children |
| In regards to the family unit, what is the most influential in growth and development of a child | The families interactions with each other |
| What is a family apgar | A tool used to assess family function |
| In family APGAR, what do the letters stand for | Adaptation, Partnership, Growth, Affection, Resolve |
| With the family apgar, what is the adaptation assessing | how the family helps and shares resources |
| With the family apgar, what is partnership assessing | lines of communication and partnership in the family |
| With the family apgar, what is growth assessing | how responsibilities for growth and development of child are shared |
| With the family apgar, what is affection assessing | overt and covert emotional interactions among family members |
| With the family apgar, what is resolve assessing | how time, money, and space are allocated to prevent and solve problems |
| What is the goal in family assessment | To enable to nurse to develop interventions that aid the family to achieve a healthier adaptation to the child’s health needs or problems |
| What is the immediate geographical area in which the family lives and interacts | Community |
| Why is community assessment an important factor to consider in creating discharge plans for families of various cultures | Their lives may be broadened or restricted depending on the facilities within the community |
| What are some examples of factors to consider when assessing the family’s community | housing, access to public transportation, city services, safety, health care delivery system |
| What characteristics of a homeless family have an impact on the child’s growth and development | lacking support system and financial resources, limited health care |
| What are essential referrals to make to a homeless family | community referrals for food housing education and financial assistance |
| What is personality | unique organizations of characteristics that determine the individual’s typical or recurrent pattern of behavior |
| What creates personality | Interaction between biological and environmental heritages |
| Which group of theories explains all human behavior | None – each makes a useful contribution to it |
| What do system theorists believe and focus on | everyone in the family or system is affected by each of its members – focuses on interrelatedness of various persons rather than individuals |
| What do nurses using system theories focus on | Caring for the child by caring for the whole family, see family as protector, educator, resource, and health provider, see child’s health as having impact on each member of the family as a whole |
| What is Maslow’s theory | Needs are tiered in a hierarchy – the most basic needs (on the bottom) must be met or the others do not matter |
| What is the goal, or top level, or Maslow’s hierarchy of basic needs | Self actualization |
| What is self actualization | State of becoming a complete person, filling one’s greatest potential |
| What is the order of person’s needs, according to Maslow | Physiological, activity, safety and protection, love and belonging, esteem, self actualization |
| Physiological needs, according to Maslow | Air, water, food, elimination, rest |
| Activity needs, according to Maslow | Need for stimulation, novelty, change |
| Safety and protection needs, according to Maslow | Safety and protection from harm |
| Love and belonging needs, according to Maslow | Love and feeling of belonging to someone or some group |
| Esteem needs, according to Maslow | Need to respect oneself and to be respected by others |
| What is cognition | Intellectual ability |
| According to Piaget, what does intelligence consist of | Interaction and coping with the environment |
| According to Piaget, how do infants begin their interaction | Reflex response |
| According to Piaget, what increases as children grow older | Use of symbolism, particularly language |
| According to Piaget, what is it called when children develop a here and now orientation | Concrete operations |
| According to Piaget, what is it called when children develop a fully abstract comprehension of the world | Formal operations |
| According to Piaget, what are the four orderly and distinct stages of development | Sensorimotor, preoperational, concrete operation, formal operation |
| According to Piaget, what is the age range for sensorimotor | Birth to 2 years |
| According to Piaget, what is the age range for preoperational | 2 to 7 years |
| According to Piaget, what is the age range for concrete operation | 7 to 11 years |
| According to Piaget, what is the age range for formal operation | 11 to 16 years |
| What is Lawrence Kohlberg’s theory of moral development | Development is sequential, three levels with two stages each and emphasis on the conscience and the importance of rules with changing them to meet the needs of a culture considered |
| What are the three levels of Kohlberg’s theory and the ages of each | Preconventional (4 – 7), Conventional (7 – 11), Postconventional (12 +) |
| What is Kohlberg’s stage of preconventional development | Punishment & obedience – children ages 4 to 7 try to be obedient to their parents for fear of punishment |
| What is Kohlberg’s stage of conventional development | Conformity & loyalty – children focus on obeying rules, rules are created for the benefit of all and adhering to them is the right thing to do |
| What is Kohlberg’s stage of postconventional development | Moral values/Principled morality – acceptance of right or wrong based on own perceptions of the world and personal conscience |
| What is Erikson’s theory of development based on | various tasks must be mastered at each age to achieve optimum maturity – stages build on each other – achievement does not occur in isolation – parents must interact appropriately to assist the child |
| According to Erikson, what should parents do instead of preventing a child’s frustration | help deal with success/failure, provide acceptable frustration outlet-parent task= provide child with skills and tools appropriate for each level to deal with current events |
| According to Erikson, what stage of development is an infant in, and what occurs in this stage | Trust/Mistrust = getting, tolerating frustration in small doses, recognizing mother as distinct from others and self |
| According to Erikson, what stage of development is a Toddler in, and what occurs in this stage | Autonomy/Shame and Doubt = trying own power of speech, begin accepting reality vs pleasure principle |
| According to Erikson, what stage of development is a preschooler in, and what occurs in this stage | Initiative/guilt = questioning, exploring body and environment, differentiation of sexes |
| According to Erikson, what stage of development is a school aged child in, and what occurs in this stage | Industry/inferiority = learning to recognition by producing things, exploring, collecting, learning to relate to own sex |
| According to Erikson, what stage of development is an adolescent in, and what occurs in this stage | Identity/role diffusion = moving towards heterosexuality, selecting vocation, beginning separation from family, integrating personality (e.g. altruism) |
| According to Erikson, what are a parent’s tasks during the first trimester of pregnancy | Develop attitude toward newborn: Happy about child |
| According to Erikson, what are the nursing interventions during the first trimester of pregnancy | Develop positive attitude in both parents concerning expected birth of child. Use referrals and agencies as needed |
| According to Erikson, what are the parent’s tasks during the 2nd trimester of pregnancy | Mother focuses on infant because of fetal movements felt. Parents picture what infant will look like, what future he or she will have, and other ideas. |
| According to Erikson, what are the nursing interventions during the 2nd trimester of pregnancy | Parents’ focus is on child care and needs and providing physical environment for expected infant. Therefore information concerning care of the newborn should be given at this time |
| According to Erikson, what are the parent’s tasks during the 3rd trimester of pregnancy | Mother feels large. Attention focuses on how fetus is going to get out |
| According to Erikson, what are the nursing interventions during the 3rd trimester of pregnancy | Detailed information should be presented at this time concerning the birth processes, preparation for birth, breastfeeding, and care of sibling at home |
| According to Erikson, what are the fetus’s tasks during the pregnancy | Growth |
| According to Erikson, what is the newborn’s task at birth | Adjust to external environment |
| According to Erikson, what is the parent’s task at birth | Get positive responses from child and meet child’s need for food and closeness. If parents receive only negative responses (e.g., sleepy infant, crying infant, difficult feeder, congenital anomaly), development of the parent will be inhibited |
| According to Erikson what are the nursing interventions at birth | Encourage early touch, feeding, and other practices. Explain behavior and appearance to allay fears. Help identify positive responses. (Use infant’s reflexe to identify a positive response by placing mother’s finger into infant’s hand.) |
| According to Erikson, what are the infant’s tasks | Trust vs. Mistrust stage – develop trust |
| According to Erikson, what are the parent’s tasks during infancy | Learn the cues presented by the infant determine needs |
| According to Erikson, what are the nursing interventions during infancy | Help parents assess and interpret needs of infant (avoid feelings of helplessness or incompetence). Do not let in-laws take over parental tasks. Help parents cope with problems such as colic |
| According to Erikson, what are a toddler’s tasks | Autonomy vs Shame and Doubt – develop autonomy |
| According to Erikson, what are the parent’s tasks during the toddler years | Try to accept the pattern of growth and development. Accept some loss of control but maintain limits for safety |
| According to Erikson, what are nursing interventions for the toddler years | Help parents cope with transient independence of child (e.g., allow child to go on tricycle but don’t yell “Don’t fall” or anxiety will be radiated). |
| According to Erikson, what is the preschool child’s task | Initiative vs. Guilt – develop initiative |
| According to Erikson, what are the parent’s tasks during the preschool years | Learn to separate from the child |
| According to Erikson, what is the school age child’s tasks | Industry vs. Inferiority – develop industry |
| According to Erikson, what are the parent’s tasks during the school age years | Accept importance of child’s peers. Parents must learn to accept rejection at times. Allow children to do for themselves, even if it takes longer. Do not do the school project for the child. Provide chores for child appropriate to his age level. |
| According to Erikson, what are the nursing interventions during the school age years | Help parents to understand that child is developing his or her own limits and self-discipline. Be there to guide child, but do not constantly intrude. Help child get results from his or her own efforts at performance |
| According to Erikson, what are the tasks of the adolescent | Identity vs. Role Confusion – develop identity - Accepting pubertal changes - Developing abstract reasoning - Deciding on career - Investigating lifestyles - Controlling feeling |
| According to Erikson, what are the tasks of an adolescent’s parents | Parents must learn to let child live his or her own life and not expect total control over the child. Expect, at times, to be discredited by teenager. Expect differences in opinion and respect them. Guide but do not push. |
| According to Erikson, what are the nursing interventions during the adolescent years | Help parents adjust to changing role and relationship with adolescent. Expose child to varied career fields and life experiences. Help child to understand emerging emotions and feelings brought about by puberty |
| How does Piaget’s sensorimotor stage (birth – 2) describe cognitive characteristics | Progression is from newborn with automatic reflexes to intentional interaction with the environment and the beginning use of symbols |
| What does Piaget’s sensorimotor stage (birth – 2) indicate for feeding and nutrition | Progression from sucking/rooting to self feeding – food used to satisfy hunger, explore environment, and practice fine motor skills |
| How does Piaget’s preoperational stage (2-7) describe cognitive characteristics | Thought processes become internalized, are unsystematic and intuitive, symbol use increases, reasoning based on appearance, world viewed egocentrically |
| What does Piaget’s preoperational stage (2 – 7) indicate for feeding and nutrition | Eating less important than social, language, and cognitive growth. Food described by color, shape, quantity. Limited ability to classify into groups. Tends to be classified as likes/dislikes, can identify as good for you but knows not why |
| How does Piaget’s concrete operations stage (7 to 11) describe cognitive characteristics | Can focus on situation aspects simultaneously, cause-effect reasoning becomes more rational and systematic, decrease egocentrism permits other’s view |
| What does Piaget’s concrete operations stage (7 to 11) indicate for feeding and nutrition | Realizes nutritious food has positive effects on G&D with limited understanding of how or why, mealtimes have social significance, peer influence on food choices rise |
| How does Piaget’s formal operations stage (11 to 16) describe cognitive characteristics | hypothetic and abstract thought expand, understanding of scientific and theoretic processes deepens |
| What does Piaget’s formal operations stage (11 to 16) indicate for feeding and nutrition | Concept of nutrients from food understood, conflicts in making choices realized |
| What is the purpose of purpose of dietary guidelines | To help Americans make informed decisions about what they eat |
| What kinds of foods do children with vegetarian diets often consume | High fiber that cause a increased losses of calcium, zinc, magnesium, and iron in the stool |
| What foods contain water soluble fiber | Oats, apples, citrus fruits |
| What action does water soluble fiber have on the body | It delays intestinal transit and decreases serum cholesterol levels |
| What foods contain water insoluble fiber | Whole grain breads, wheat bran, and some cereals |
| What action does water insoluble fiber have on the body | It accelerates intestinal transit and slows starch digestion |
| What does a well balanced diet supply | All essential nutrients in necessary amounts |
| What is food made of | Minerals, compounds, and water |
| Approximately how many nutrients does the body needs | 50 |
| Where in the body is bile produced | gallbladder |
| What role does the duodenum play in nutrition | Absorbs vitamin A, vitamin B, iron, calcium, glycerol, fatty acids, and monodisaccharides |
| What role does the ascending colon play in nutrition | Absorbs water, bile salts, and secondary absorption of some minerals and vitamins (K) |
| What role does the jejunum play in nutrition | Absorbs glucose, galactose, zinc, ascorbic acid, copper, glycerol, fatty acids, monoglycerides, biotin, potassium, vitamin D, vitamin D, folic acid, fat soluable vitamins |
| Why are children susceptible to nutritional deficiencies | They are growing and developing |
| The ____ and ____ of portions are important in maintaining a reasonable weight. | Amount – size |
| How much fiber is recommended by the American academy of pediatrics | O.5g/kg increasing gradually to adult levels of 20 to 35g/day by the end of adolescents |
| Where can a nutritional care plan be used | hospital, home, outpatient departments |
| What does a nutritional care plan do | provides information and stores it in one place |
| How long is the digestive system of the newborn immature and minimally fuctioning | 3 months |
| What is “wrong” with the newborn digestive system | Minimal saliva, deficient amylase and lipase = no effective complex carb or fat digestion, limited liver function, no teeth |
| What is the basis for food introduction | Physiology of the digestive tract |
| What is the food of choice for the first year of life | Breast milk or iron fortified formula |
| Foods containing essential minerals such as iron, zinc, and calcium should be combined with what to enhance absorption | Citrus, fish, poultry - vitamin d and lactose sugars |
| Where does most nutrient absorption occur in the body | Duodenum – Jejunum |
| Where does most of the water absorption occur in the body | Large intestine |
| What are ways to reduce cholesterol in school age children | Exercise, fresh fruits and vegetables instead of junk, low fat foods, vegetable oil sprays, bake & broil, visit nutritionist, check cholesterol if history of heart disease |
| How can atherosclerosis be prevented | Starting healthy dietary patterns in childhood |
| Why are fat and cholesterol needed in a child’s diet | For calories and development of the CNS |
| Why has the sodium content of baby food been reduced | Adequate sodium is in the average diet |
| What should be minimized in the child’s diet | Food additives that prolong the shelf life of food and food dyes that make food look more attractive |
| When should height and weight be plotted on a growth chart | At each clinic visit |
| Which weight or triceps skinfold thickness percentiles indicate a need for further evaluation | > 85%, < 3% |
| What is an oral rehydration solution (ORS) and what is it used for | Mixture of electrolytes, glucose, and water – acute diarrhea in 3rd world countries, for dehydration in any child |
| Why should a nursing mother avoid becoming fatigued | It affects milk production |
| Infants who can not tolerate milk may be given what | Soybean mixtures = ProSobee, Isomil |
| What is the first food introduced, and when | Rice cereal @ 6 months |
| What are the symptoms that indicate underfeeding | Restlessness, crying, failure to gain weight |
| What are the symptoms that indicate overfeeding | Regurgitation, mild diarrhea, too rapid weight gain |
| What effects do high fat diets have on the digestive system | Delayed gastric emptying, abdominal distention, constipation |
| What effects do high carb diets have on the digestive system | Distention, flatus, excessive weight gain |
| What type of diets may cause constipation | Too much fat or protein, not enough bulk |
| What should be done for the constipated child | Increased amounts of cereal, vegetables, and fruits |
| What foods should not be pureed for children in the home, and why | Spinach, broccoli, beets – nitrite content can cause methemoglobinemia in young infants |
| Why should overblending of home made infant food be avoided | It can cause over oxidation of nutrients |
| How long can home prepared foods be stored in the refrigerator | 48 hours |
| How long can home prepared foods be stored in the freezer | Several months |
| What are the benefits of home prepared foods | Less expensive, less salt, less sugar, familiarize the infant with family’s cultural tastes |
| When do infants usually adapt to a three meal a day schedule | By the first birthday |
| When should whole and non-fat milk be introduced to a child | Whole = 1 year, Non-fat = 2 years |
| What kinds of food do preschoolers and toddlers like | Finger foods |
| What dietary needs tend to be low in school aged children | Protein, calcium, vitamin A, ascorbic acid |
| What may help an adolescent develop good nutrition | Stress how important nutrition is to physical appearance and fitness |
| In an adolescent, what should be suspected if fatigue, irritability, and a lack of appetite occur | Anemia |
| What might an adolescent female take that increases the requirements for folic acid, vitamin B6, and ascorbic acid | Oral contraceptives |
| Who do the National Cholesterol Evaluation Program (NCEP) recommendations apply to | Adolescents and children over 2 |
| According to the NCEP, how much saturated fat should be taken in by children | Less than 10% of total calories |
| According to the NCEP, how much cholesterol should be taken in by children | Less than 300mg/day |
| In what stage of a dietary plan can parents help children follow the NCEP guidelines | Selection and preparation |
| What can schools do to help children follow the NCEP guidelines | modify school food service |
| What can health care clinics do to help children follow the NCEP guidelines | provide health education |
| What can the government do to help children follow the NCEP guidelines | mandate improvement of food labeling |
| What can the food industry do to help children follow the NCEP guidelines | develop appealing healthy food |
| Who does NCEP recommend for blood cholesterol screening | Children and adolescents whose parents or grandparents (at 55 or younger) were found to have coronary atherosclerosis, myocardial infarction, PVD, cerebrovascular disease, sudden death, invasive cardiac therapy, or parents levels over 240mg/dl or greater |
| What is an acceptable level of total cholesterol | < 170 mg/dl |
| What is the borderline level of total cholesterol | 170 – 199 mg/dl |
| What is a high level of total cholesterol | > 199 mg/dl |
| What is an acceptable level of LDL cholesterol | < 110 mg/dl |
| What is the borderline level of LDL cholesterol | 110 – 129 mg/dl |
| What indicates a high level of LDL cholesterol | > 129 mg/dl |
| At what rate should new foods be added to a child’s diet | One at a time in 1 week intervals |
| How many US children are overweight | 1/3 |
| How many US children are obese | 15% |
| What can obesity cause | Increased cholesterol, orthopedic problems, sleep apnea, high blood pressure, diabetes, social isolation (that can lead to depression) |
| What is the formula for calculating BMI | (weight in pounds / height in inches) X 705 = BMI |
| What BMI scores for children ages 5 to 9 indicate an overweight status | > 18 |
| What BMI scores for children ages 13 to 17 indicate an overweight status | > 22 to 24 |
| What are the characteristics of a well nourished child | Steady growth-alert-shiny hair-no under eye circles-good color-flat abdomen-erect posture-developed muscles-firm/pink mouth/gum membranes-no oral lesions-proper teeth eruption-good appetite-regular elimination-sleep well-have energy/vitality-not irritable |
| What can cause the hospitalized child to have a poor appetite | Nature of illness, type of diet, strange food, strange environment, trying to manipulate parents |
| What does a nurse check a child’s food tray for | Appropriate consistency, serving sizes, proper utelsils |
| How is food served to a child | Warm with sufficient time to eat |
| How much food should be served to a child | Less than expected to eat – 1 level tablespoon per year of age |
| What treatment should not be scheduled immediately after a meal | Chest physiotherapy |
| What should be given to an infant who is NPO | A pacifier for nonnutritive sucking |
| In regards to medication, what is the nurse responsible for monitoring | Drug/drug interactions, drug/environment interactions, drug/food interactions |
| What must a nurse have knowledge of to be able to monitor drug/drug interactions | Side effects of medications |
| What do drug/environment interactions involve | How the medication effects the response of a patient to their environment |
| What is an example of a drug/environment interaction | Photosensitivity |
| When should a food high in vitamin K not be given to a patient | when taking Coumadin |
| What is the formula to assess how many teeth a child under 2 should have | Age in months – 6 = number of expected teeth |
| What does good dental care begin with | Proper diet while teeth are developing, especially during prenatal period |
| What essential elements does milk contain that promote dental health | Calcium, phosphorus, vitamins A/B/D/C, protein |
| What is the sunshine vitamin | D |
| Which vitamin is found in citrus fruits | C |
| What foods should parents limit the frequency of regarding dental health | Fermentable carbs, sticky foods - sugared gum, dried fruits, sugared soft drinks, cake, and candy |
| What are recommended snacks to promote dental health | =cheese, milk, sugarless gum, raw vegetables |
| What is milk caries | Tooth decay caused by being put to sleep with a bottle in the mouth AKA bottle mouth caries, nursing caries |
| Why are teeth more vulnerable to decay during sleep | Saliva decreases |
| What is the most important thing to do to prevent caries | PO fluoride after 6 months of age |
| How long can supplemental systemic fluoride be offered | Until the last permanent tooth erupts – 13 years |
| What may too much fluoride cause | Mottled teeth/fluorosis |
| Besides PO, how can fluoride be obtained | Applied directly to the teeth by a dentist |
| Children in which age group are most commonly seen with nursing caries | Between 18 months and 3 years |
| What may untreated dental caries or malpositioning of teeth cause | Later periodontal disease |
| What may delayed or early eruption of teeth indicate | Endocrine disorders or other pathological conditions |
| When should regular toothbrushing start | At tooth eruption |
| What education should parents receive about toothbrushes | Replace every 3 months and after illness, avoid rinsing in hot water, do not use a closed container for storage, avoid sharing |
| Approximately how much toothpaste do children need | Size of a pencil eraser |
| What motion should be used for flossing | Up and down |
| What should be done if a primary/deciduous tooth is avulsed | Get a spacer from the dentist |
| What should be done of a permanent tooth is avulsed | It should be placed in milk and brought with the child to the dentist for immediate care |
| If there are open wounds or oral tissues in the mouth due to avulsion, what might be given | Tetanus prophylaxis or antibiotics |
| What are some dental problems that occur with adolescence | Puberty, drug related, or hyperplastic gingivitis |
| At what platelet count should children receiving chemotherapy or radiation replace a toothbrush with moist gauze for oral care | < 20,000/mm^3 |
| What may be prescribed to a child receiving chemotherapy or radiation to reduce oral lesions | Chlorhexidine |
| What effect can asthma have on teeth | Sucrose content of medication can cause decay |
| What effect can hemophilia & cancer have on teeth | can cause oral bleeding, impaired healing |
| What effect can seizure disorders have on teeth | causes decreased saliva, gingival overgrowth (use of diphenylhydantoin) |
| What effect can medications that depress the central nervous system have on teeth | decrease salivary flow, increasing susceptibility to dental caries |
| What effect can juvenile rheumatoid arthritis have on teeth | sucrose containing medications increase risk of cavities |
| What effect can bulimia have on teeth | erosion of teeth caused by acid contact during vomiting episodes |
| What effect can chemotherapy have on teeth | oral ulcerations |
| What effect can fluoride ingestion have on teeth | fluorosis (mottling) |
| What is the work/business of children | Play |
| Who may use hospital playrooms | children who do not have a communicable illness, such as measles or a draining wound |
| What form of play allows for creative expression | Art |
| What form of play provides problem solving games, manipulative skills, and opportunities for new learning | Computer games |
| What should nursing interventions regarding play focus on | encouraging optimal play activities that are age appropriate, helping parents select age and illness appropriate toys |
| An asthmatic child should not be given a _________ to play with. | Stuffed animal |
| What type of play to infants engage in | exploring, imitating |
| What type of play engages children ages 1 to 2 years | parallel play |
| What type of play engages children ages 3 to 5 years | cooperative, creative play |
| What type of play engages children ages 5 to 7 years | symbolic group, secret club play |
| What type of play engages children ages 7 to 10 | competitive play |
| What type of play engages children ages 10 to 13 years | group sports and explorative internet activities, electronic/computer games |
| What type of play engages children ages 13 to 18 years | fantasy play, cliques |
| What are suggested play activities for infants | Visual and touch stimulation |
| What are suggested play activities for children ages 1 to 2 | Toys that reflect ADLs |
| What are suggested play activities for children ages 3 to 5 | Role play |
| What are suggested play activities for children ages 5 to 7 | Secret codes, knock knock jokes, rhymes |
| What are suggested play activities for children ages 7 to 10 | Competitive games with structured rules and physical activity |
| What are suggested play activities for children ages 10 to 13 | Monitored internet use |
| What are suggested play activities for children ages 13 to 18 | Leadership activities, daydreaming, board games, interactive social activities |
| At what age do children play with each other, taking a specific role, and what is this type of play called | 3 to 5 – cooperative/creative play |
| At what age do children play next to each other but not with each other, and what is this type of play called | 1 to 2 – parallel play |
| At what age do children start to accept competition with structured rules and highly interactive physical activity, and what is this type of play called | 7 to 10 – competitive play |
| What age group needs visual stimulus | Newborns |
| What age group needs touch stimulus | Infants |
| What age group needs toys involving manipulation | 1 year olds |
| What age group would most enjoy a box | 3 to 5 |
| What age group benefits from monitored internet use | 10 to 13 |
| What age group is most likely to play with toys that reflect activities of daily living | 1 to 2 |
| What is therapeutic play | Play that assists in the recovery process |
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