NUR 320 Exam 1 Study Guide
NUR 320 Exam 1 Study Guide NUR 320
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This 10 page Study Guide was uploaded by Serena Buckley on Friday March 6, 2015. The Study Guide belongs to NUR 320 at University of Miami taught by Deborah Salani in Winter2015. Since its upload, it has received 175 views. For similar materials see Pediatric Health Nursing in Nursing and Health Sciences at University of Miami.
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Date Created: 03/06/15
University of Miami School of Nursing and Health Studies NUR 320 Study Guide For Exam 1 Spring 2014 Directions Use this as a template to guide your study by reading the text to supplement the guide By providing this guide the instructor in no manner guarantees that all topics on the study guide will be included in the examination OR that this study guide should replace reading and studying the textbook This exam will cover the following chapters Chapters 1 5 15 and 16 Please do not expect the instructor to provide answers to these questions as the answers can be found in the lecture notes and in your text These exact questions will NOT appear on the exam The topics and questions are to guide your study Remember that the majority of these questions are APPLICATION so make sure you know the material and how to apply it versus MEMORIZING the material I would suggest studying in groups so that you can quiz each other and clarify points that you do not understand The exam will consist of 80 multiple choice questions You will be expected to choose the BEST answer There are some questions where you will be required to quotselect all that applyquot 1 Preparing infants children and adolescents for hospitalization providing teaching etc for each age group How can we make hospitalization less stressful a Stressors of Hospitalization i Separation from parents ii Loss of self control iii Painful or invasive procedures iv Fear of bodily injury b Toddlers experience the most stress in the hospital c Enhancing Hospitalization i 247 parental visitation ii Parental involvement with care iii Keep phones beepers and locations of family members iv Contact parents for changes in condition and procedures v Provide parents with updates on the plan of care and after rounds d Minimizing stressors i Give choices except for an IV ii Encourage independence iii Therapeutic play to address fears and concerns iv Therapeutic recreation with interactive activities v Minimize fears and anzieties vi Incorporate familiar routines into hospitalization vii Support family and loved ones viii Minimize loss of control promote autonomy e Preparation for Procedures i Communication based on the development level should be clear honest and developmentally appropriate ii Try to schedule infants surgeries rst because they need to eat iii Manage their pain appropriately and they will think favorably of hospitals 2 When is it appropriate to let them play with equipment Use a transitional object Show them anatomical models vs dolls etc a Allow transitional objects such as teddy bears and blankets before surgery b Allow preschoolers to handle medical equipment or models when preparing for a procedure c Use dolls and models with planned hospitalization 3 Cause of death among infants Why are they the highest risk age group a Causes of death in infants rst 28 days of life i PrematurityLow birth weight ii Congenitalgenetic abnormalities iii Pregnancy complications 4 Providing care for dying children what are the major goals a Goal setting i Make a wish foundation b Competencies for highquality end of life care c Special concerns i Pain management ii Trust iii Anger iv Education v Desired religious or cultural practices d Arrange for parents and others to say goodbye e Provide momentos 5 Differentiating care provided by a nurse practitioner vs RN What is appropriate for the NP to do What is appropriate for the RN to do a Nurse practitioners have more responsibility for the care of client and client outcomes 6 The importance of family centered care what is it How can it be used Family is always constant Collaboration between the healthcare team and the family Sharing information with the family The family should always be treated with respect and dignity e Include the family in treatment i Shift report at bedside 7 Differentiating high risk versus low risk children If I give you children of various ages and ethnic groups which one would you consider to be the highest risk for negative health outcomes a Grosst premature babies are high risk infants b The most important risk factor that in uences the health of children is poverty i Children less than 5 have a higher risk ii Single parents have higher risk iii Black and Hispanic have higher risk c Children represent 25 of the homeless population i At risk for 1 Lack of health insurance 2 Physical and mental health problems 3 Abuse and violence 4 Neglect 5 Substance use 8 Causes of death of children of all age groups a Infants rst 28 days of life i Prematurity congenital abnormalities complications b 1 and 12 months i SIDS unintentional injuries drowning fireburns poisonings 1 Put children on their back to sleep do not smoke around children never put pillows in crib on om c 14 years i Unintentional injuries drowning foreburns and poisoning d 59 years i Unintentional injuries MVA traffic drowning re burns homicide e 1014 years i Unintentional injuries MVA suicide homicide drowning f 1519 years i Unintentional injuries MVA traffic homicide suicide poisoning drowning 9 How to establish rapport with children of all ages and their families 10 Providing anticipatory guidance for each age group a Newborn i Presence or absence of re exes ii Attachment behaviors iii States of alertness iv Highrisk status b Infant i Appropriate serial weight and height measurements ii Presence of tooth eruptions iii Ability to walk and talk c Toddler i Increasing verbal ability and skill at walking ii They do not have an understanding of time teach about procedure right before iii Short clear explanations d Preschooler i Presence of preoperational thought ii Use of dramatic play iii Increasing command of language and a corresponding increase in curiosity about the environment e Schoolage i Growing interest in peer group extracurricular activities and sexuality ii Growth spurt occurring earlier in girls than boys iii Ability to think about solutions and determine the best among several alternatives iv Understanding the concept of conservation f Adolescence i Undergoes identity formation ii Sexual maturity nearing completion iii Formal operational thought processes possible iv Body image v Privacy con dentiality and honesty are means to gain trust in adolescents 11 When is it appropriate for someone less than 18 years to give consent for care a STI testing 12 Knowing how to order your physical assessment based on the age of the child 13 When is it appropriate for parents to stay for procedures like exams IV insertion or other procedures In the ICU a Allow parents to hold the child in their lap for exapinations and procedures when possible 14 Decreasing stressors for hospitalized toddlers Decreasing stressors for hospitalized school age children a Toddlers i Keep parents with child ii Respect child s routine iii Expect regression bed wetting b School age i Privacy and modesty are important ii Family and friends iii Very concerned with body integrity iv Fear loss of control over their bodies v Allow child to make decisions if possible 15 What are the different stages of separation anxiety a Protest i Screaming crying clinging ii Resists attempts to comfort b Despair i Sad withdrawn quiet ii Crying when parents return c Denial Detachment i Protest subsides shows interest in setting ii Appears happy and content 16 Decreasing stressors for hospitalized children a Stress Reduction The 4 Rs i Recreation toys games etc ii Rest calm quiet bedtime rituals iii Relationships family members siblings peers iv Routines follow normal routine provide transitional objects provide constant caregivers 17 Dealing with denial among parents a Do not reinforce their denial 18 What is the main priority in providing care to children of all ages and their families a Family centered care 19 Providing safety for children when parents are not present a If a parent needs to leave for a while it is smart for a nurse to call the volunteer office and see if there is anyone who will sit with the child 20 When is it appropriate for parents to do procedures give medications etc while their child is hospitalized a It is always best but you must supervise 21 Make sure you know Erickson s stages of development a Trust v Mistrust i Infancy birth1 year ii Are their basic needs met b Autonomy v Shame and Doubt i Toddler 13 years ii Learning how to go to the bathroom etc c Initiative v Guilt i Early childhood 36 years d Industry v lnferiority i School Age 612 years ii Age 7 is the year of reason e Identity v Identity confusion i Adolescence 1218 years f Intimacy v Isolation i Early Adulthood 1830 22 What defense mechanisms do children use when confronting stressors such as hospitalization a Regression return to earlier behavior bed wetting b Repression involuntary forgetting abused child c Rationalization unacceptable becomes acceptable he hit me rst d Fantasy mind creation to protect self special powers superman 23 Make sure you know the major developmental milestones that we discussed in class When should they lift head Roll over Walk independently Etc a Infant i Should double weight by six months and triple weight by one year ii Begin feeding food from 46 months Rice cereal rst then vegetables and then fruits Yellow and orange vegetables have less allergies Introduce a new food every 23 days iii 68 months 1 Bangs objects held in hands 2 Transfers objects from one hand to another 3 Beginning pincer grasp at times 4 Recognizes own name and responds by looking and smiling 5 Sits alone steadily without support by 8 months 6 Likes to bounce on legs when held in standing position iv 810 months 1 Picks up small objects 2 Uses pincer graps 3 Crawls or pulls whole body along by arms 4 Creeps by using hands and knees to keep trunk off of oor V b Toddler 1 i Pulls self to standing by 10 months Recovers balance when sitting Understands few words Says mama and dada Recognizes sound without difficulty 1012 months 1 May hold crayon or pencil and make mark on paper Places objects into containers through holes Stands alone Walks holding onto furniture Sits down from standing Plays peek a boo and patty cake years 12 years Builds a tower of four blocks Scribbles on paper Can undress self Throws a ball runs Walks down stairs a few months after learning to walk 6 Likes push and pull toys 23 years 1 Draws a circle and other rudimentary forms 2 Learns to pour 3 Can dress self 4 jumps kicks ball throws ball underhand wm ew mweww U39lbUUNH c Preschooler 36 years of age I ii iii iv v vi vii viii ix x xi xii Uses scissors Draws circle square cross Draws at least a six part person Enjoys art projects Learns to tie shoes Buttons Brushes teeth Uses spoon fork knife Throws ball overhand Climbs wall Rides tricycle Can focus on and learn letters and numbers d Schoolage child 612 years iii 39 jumps rope v V Enjoys crafts Plays card and board games Rides two wheeler Roller skates vi Can read 24 Make sure you know how to promote growth and development of each age group and to provide anticipatory guidance of the parents a Infant i Encourage parental presence ii Adhere to infant s home routine as much as possible iii Utilize topical anesthetics or preprocdeural sedation as prescribed iv Promote a quiet environment and reduce excess stimuli b Toddler i Encourage Parental presence ii Allow parents to hold the child in their lap for examinations and procedures when possible iii Allow choices when possible iv Utilize topical anesthetics or preprocedural sedation as prescribed v Explain all procedures using simple developmentally appropriate language vi Provide a night light c Preschooler i Encourage parental presence ii Allow choices when possible iii Utilize topical anesthetics or preprocedural sedation as prescribed iv Explain all procedures v Provide a night light or ashlight d SchoolAge child i Encourage parental participation ii Allow the childs choices when possible iii Explain all procedures and offer reassurance iv Utilize topical anesthetics or preprocedural sedation as prescribed v Encourage peer interaction via the internet phone calls and other modes of communication e Adolescents i Include the adolescent in the plan of care ii Encourage discussion of fears and anxieties iii Explain all procedures iv Ask the adolescent his or her desire for parental involvement v Encourage peer interaction 25 What is attachment How can parents know if their child is attached to them 26 How can you as a nurse make hospitalized infants feel secure i Encourage parental presence ii Adhere to infant s home routine as much as possible iii Utilize topical anesthetics or preprocdeural sedation as prescribed iv Promote a quiet environment and reduce excess stimuli 27 What is swaddling a Wrapping infants up like a burrito 28 What is appropriate discipline for each age group What is inappropriate discipline for each age group 29 Know how to assess parentchild interactions which ones are appropriate and which ones are inappropriate 30 When should solid foods be introduced into the diet a Begin feeding food from 46 months Rice cereal rst then vegetables and then fruits Yellow and orange vegetables have less allergies Introduce a new food every 23 days 31 Which developmental stages contain periods of rapid physical growth a lnfant b Adolescent 32 How can you make a physical assessment less stressor for a toddler 33 What are the types of play Which age group engages in each type of play a Parallel play i Toddler b Dramatic play i Preschooler c Cooperative play children play in groups to achieve a goal or play a game i School age child 34 Make sure you know injury prevention interventions for each age group a Basic safety precautions b Helmets car seats c Street safe skills d Violence prevention and intervention 35 Ethical perspectives of child health nursing review terms discussed in class a Beneficience decisions that bene t the patient b Nonmaleficience reduce the risk of harm c Autonomy right for self determination d Justice treat all with fairness and respect 36 What is responsible for declining mortality and morbidity of children of all ages a Healthy people 2020 37 What age group is most concerned with body integrity Body image a Body integrity school age b Body image adolescents 38 What is object permanence How do you know when it has been developed a Something exists even when out of site 39 What are selfsoothing behaviors of infants What are self reguating behaviors a Swaddling 40 Why do infants cry when there is quotnothing wrongquot 41 When is it appropriate to tell children that they are dying 42 What is magical thinking How does this apply to children a The belief that wishes become reality 43 Providing information to parents about their child s medical condition 44 What type of hospital bed is appropriate for each age group a Children less than 2 should be in a crib 45 Therapeutic vs nontherapeutic relationships with children and families 46 Temper tantrums a Walk away 47 Review how to promote therapeutic communication with the children and families 48 Providing care to children and families using Erikson s and Freud s theories
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