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NUR 221 Exam 1 Study Guide | 2024
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Skill development in children proceeds in two processes: - ✔✔cephalocaudal proximodistal Erikson's stages of development: - ✔✔Trust vs. Mistrust (birth to 1 year) Autonomy vs. Shame & Doubt (1 to 3 years) Initiative vs. Guilt (3 to 6 years) Industry vs. Inferiority (6 to 12 years) Identity vs. Role Confusion (12 to 18 years) During the toddler years, the child moves from the _______________ to the _________________ stage of development. - ✔✔sensorimotor preoperational Preschoolers grow slowly & steadily, with most growth occurring in: - ✔✔long bones of the arms & legs Accurate assessment of growth throughout childhood is essential to : - ✔✔ensure health perform proper medication dosage calculation identify the impact of disease on the child A tuft of hair at the base of the spine may indicate: - ✔✔a pilonidal cyst An unusually low hairline on the neck or forehead may indicate: - ✔✔a congenital disorder (ex. hypothyroidism)
Significant facial asymmetry may result from: - ✔✔paralysis of trigeminal or facial nerves in utero positioning swelling r/t infection/allergy/trauma A shift of the trachea from the midline may indicate: - ✔✔tumor collapsed lung The primary breathing muscle in infants & children under 6 years: - ✔✔diaphragm Heart murmurs are classified by: - ✔✔intensity location radiation timing quality In infants and young children, the most important pulses to evaluate: - ✔✔femoral brachial The group most at-risk for a stressful experience as a result of hospitalization: - ✔✔toddlers Common stressors for the hospitalized toddler: - ✔✔parental separation schedule disruption fear of pain fear of invasive procedures fear of mutilation fear of change Significant stressors for the hospitalized preschooler: - ✔✔fear of being alone
physical preparation The major stressor for an infant or young child & their parents during pre-op: - ✔✔the child's need to be NPO To meet developmental needs during hospitalization, adolescents require: - ✔✔a therapeutic recreation program School-aged children that are hospitalized often: - ✔✔regress developmentally Manifestations of emotional or verbal abuse & emotional neglect: - ✔✔anxiety/fear/depression shame/aggression poor physical growth failure to meet developmental milestones difficulty relating to adults impaired communication skills Five categories of neglect: - ✔✔medical care neglect gross safety neglect physical neglect emotional neglect educational neglect Sexual abuse in children can manifest as: - ✔✔UTI/STI difficulty walking or sitting genital redness/pain/itching/bruising somatic complaints excessive sexual play or curiosity excessively seductive behavior
bed-wetting night terrors The most common poisons ingested by children under 6: - ✔✔cosmetics/personal care products household cleaning products analgesics topical preparations foreign bodies Complications r/t poisoning depend on the ______________ and can include: - ✔✔toxin respiratory arrest cardiac arrest liver failure renal failure seizures esophageal/tracheal burns Emergency care of the poisoned child focuses on: - ✔✔airway stability hemodynamic stability removal of toxic agents support of the family The anterior chamber of the eye is filled with: The posterior chamber of the eye is filled with: - ✔✔aqueous humor vitreous humor
Freud's developmental stages: - ✔✔infant oral toddler anal preschooler phallic school-age latency adolescent genital Piaget's developmental stages: - ✔✔infant sensorimotor toddler sensorimotor to pre-operational preschooler pre-operational school-age concrete operational adolescent formal operational Untreated vision defects in children can lead to: - ✔✔inadequate school performance blindness Neurosensory deficits impact pts by: - ✔✔limiting ability for self-care/ADLs impaired mobility impaired communication risk for injury social isolation Behavioral indications r/t strabismus: - ✔✔squinting turning head sir to side to see an object appears clumsy/unable to pick up small objects Infection of the eyelid & surrounding tissues: - ✔✔periorbital cellulitis Serious complications r/t periorbital cellulitis can lead to: - ✔✔bacterial meningitis
brain abscess loss of vision S&S of periorbital cellulitis: - ✔✔fever edema/tenderness of orbit red or purple eyelid limited eye movement When the lens of the eye becomes cloudy & scatters light rays, reducing vision, the pt has: - ✔✔cataracts A group of ocular disorders r/t damage to the optic nerve: - ✔✔glaucoma Clinical manifestations of glaucoma: - ✔✔discomfort around eyes headache blurred vision/halos loss of peripheral vision difficulty focusing/adjusting in low light __________________ is farsightedness. __________________ is nearsightedness. - ✔✔hyperopia myopia A lazy eye is called: - ✔✔amblyopia Crossed eyes or deviation of the eyes is: - ✔✔strabismus As the eyes age, the pt experiences decreases in: - ✔✔tear production visual acuity
vertigo fluctuating hearing impairment To test for conductive hearing loss, the _____________ test uses a tuning fork placed on the mastoid bone. - ✔✔Rinne The _____________ test for hearing uses a tuning fork placed atop the skull. Sound that lateralizes to one ear indicates _________________ hearing loss in that ear, or _________________ hearing loss in the opposite ear. - ✔✔Weber conductive sensorineural Surgical procedure to implant tubes in ears: - ✔✔myringotomy Be aware of these things during assessment of the adolescent pt: - ✔✔modesty & privacy pt decides whether or not to have parent present head to toe sequence address concerns r/t body development The fundoscopic exam uses an ____________. Should see the _________________ first. A ________________ may indicate retinoblastoma. - ✔✔opthalmoscope red reflex white reflex Vision assessment in infants & toddlers includes checking for a ________________ & ______________. When the child is old enough to read letters, assess vision with the __________________. - ✔✔blink reflex tracking Snellen chart
A rounded chest in a child over 2 is ________________ and may indicate a chronic lung condition, like ________________ or _______________. - ✔✔abnormal asthma cystic fibrosis In a child with croup, breath sounds will likely include__________________, while an asthmatic child will display _________________. - ✔✔stridor wheezing It is _________________ for toddlers to display bowlegs or knock knees. - ✔✔normal To asses the hip placement in an infant, use the ________________. A normal finding is ________________. Abnormal findings include: - ✔✔Ortolani-Barlow Maneuver equal hip abduction resistance to abduction a clunk felt on palpation It is crucial that teens and pre-teens are regularly screened for - ✔✔depression Informed consent for minors must be given: - ✔✔by a legal custodian that is at least 18; before treatment; & must be voluntary Between ages 14 & 18, minors can give consent when it is r/t: - ✔✔sexual information or procedures drug & alcohol related problems psychotherapy The parental exceptions to giving consent include: - ✔✔when there is parent/child disagreement r/t Tx when parental choice is not lifesaving when there is a conflict of interest (abuse/neglect)
Tx of the child with periorbital cellulitis includes: - ✔✔hospitalization IV antibiotics drainage of infection application of heat packs Tx of pts with cataracts includes: - ✔✔eyeglass prescription changes UV coated glasses surgical removal of lens Care of the post-op cataract pt includes: - ✔✔observation of dressing monitor for increased IOP/pain/nausea/vomiting administration of topical antibiotics & corticosteroids administration of eye drops & acetaminophen Complications r/t cataract surgery: - ✔✔hemorrhage infection macular edema retinal detachment Activities that increase IOP: - ✔✔Valsalva maneuver blowing nose/sneezing/coughing/vomiting driving lifting more than 15 lbs sex bending at waist golfing tight shirt collars
R/t vision, sudden onset of flashes of light or floating shapes indicate: - ✔✔retinal detachment Symptoms to report after cataract surgery: - ✔✔sharp/sudden eye pain increased discharge/bleeding lid swelling decreased vision flashes of light/floating shapes Effects of increased IOP: - ✔✔can begin at any age damages vision gradually causes optic nerve atrophy causes peripheral vision loss ____________________ measures the angle & depth of the anterior angle of the eye. - ✔✔gonioscopy ____________________ is used to inspect the optic nerve. - ✔✔ophthalmoscopy Measurement of IOP is done via: - ✔✔tonometry The preferred medications for Tx of glaucoma are________________ because they: - ✔✔beta blockers decrease the production of aqueous humor Additional meds used in the Tx of glaucoma: - ✔✔prostaglandins alpha adrenergic agonists carbonic anhydrase inhibitors miotic cholinergics
__________________ to measure the IOP. __________________ to inspect the optic nerve. - ✔✔tonometry opthlamoscopy Two more exams to asses glaucoma are: _______________ to measure the filtration angle. _______________ to assess the visual fields. - ✔✔goniometry perimetry Clinical monitoring of developmental milestones in infants & children uses the: - ✔✔Denver II Screening Test Categories of critical milestones listed in the Denver II Screening are: - ✔✔gross motor fine motor language personal/social ______________ & sympathomimetics decrease pupil size, facilitate outflow of___________________ & lower IOP, but they also cause ________________. - ✔✔miotics aqueous humor altered focus S&S of increasing IOP & post-op infection: - ✔✔excessive eye pain sudden change in vision fever lid swelling conjunctival or corneal redness bleeding
Macular degeneration is characterized by: - ✔✔tiny, yellowish spots beneath the retina The main anti-fungal eye medication given: The main antiviral eye medications: - ✔✔amphotericin B acyclovir & ganciclovir Most anti-glaucoma medications affect the _________________ of the lens. - ✔✔accommodation Eye medications that affect the CNS are _______________ & _________________ agents. - ✔✔mydriatics cycloplegics Pharmacologic therapy in pts with Meniere's Disease includes. - ✔✔antihistamines tranquilizers anti-emetics Some ototoxic medications are: - ✔✔aminoglycoside antibiotics (neomycin, streptomicin) aspirin diuretics (furosemide) erythromycin, vancomycin quinine
