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Summary NURS 328 EXAM 1 STUDY GUIDE

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EXAM 1 STUDY GUIDE for Nurs 328. *Essential!! *For you ,at a price that's fair enough!!

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  • August 30, 2024
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  • 2020/2021
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Exam 1 Blueprint

Chapter 4- Communication, Physical, and Developmental Assessment

1. Perform a complete age-specific head-to-toe assessment
 FIRST SUPINE POSITION: to examine heart, lungs, abdomen, & hips
 NEXT PRONE POSITION: to examine spine, back, and sacrum
 Auscultate, percuss, and palpate while quiet
 Minimal physical contact first to establish that you’re not scary. Distract with play
 In older children/adolescents: assess genitalia last

2. Identify how to obtain physiologic measures in the pediatric patient
 VITALS: go from least to most invasive. In this order:
1) Count respiration
2) Count apical heart rate
 Less than 2 yrs? Measure apical for FULL MINUTE
 Compare redial and femoral pulses (coarctation of aorta)
 Increasing age = decreasing heart rate
3) Blood pressure
 Use correct cuff size
4) Temperature
 Oral, axillary, tympanic, temporal.
 Method based on facility, age, development, & illness severity

3. Review atraumatic care and how we incorporate that in a physical assessment
 Atraumatic = going from least to most invasive.
 Useful when palpating abdomen region
 Minimizes physical and psychological stress that health promotion & illness can inflict

4. Identify birthmarks (e.g., café au lait, Mongolian spot)
 Mongolian spot: bluish- bruise like spot on the back
 Café au lait: note size and number. 5+ could mean neurofibromatosis

5. Review apical heart rate, location, and duration of assessment in pediatric patients and why
 Apical heart rate = apex of heart (5th midclavicular space)
 Duration of assessment: 1 whole minute if less than 2 yrs.
 Why? In case you cant get radial pulse, and to assess heart sounds




Chapter 5- Pain Assessment and Management in Children

, 1. Identify influencing factors on pain assessment
 Age
 Developmental level (cognitive ability)
 Cause and nature of pain
 Ability to express pain
 Cultural consideration

2. Understand how to appropriately assess pain in children based on age and cognitive
development.
 Behavioral Pain Assessment tools:
 CRIES (neonates): looks at physiological changes (O2, HR. BP) and listens to
the baby’s cry to understand if the baby is in pain. Helps to ask mother
about child’s cry and whether its normal because she know baby’s cry the
best.
 FLACC (2mo-7yrs): face, legs, activity, cry, consolability
 COMFORT: for children in critical care setting
 CHEOPS: used in recovery room
 For children w/ communication & cognitive impairment:
 NCCPC: non-communicating children’s pain checklist (for cognitively
impaired)
 PICIC: pain indicator for communicatively impaired children
 Self-Report:
 Numeric pain scale (8 yrs+): 0-10 scale
 FACES (4-16 yrs): peds exam

3. Identify how and when to evaluate pain relief
 HOW? Use OLDCARTS! (onset, location, duration, characteristics, aggravating &
relieving factors, timing, severity). Assess of treatment is effective
 WHEN? 15-30 minutes after intervention




Chapter 22- Family Centered Care of the Child During Illness and Hospitalization

, 1. Understand the effects of hospitalization on the child and the family
 ON INFANT/CHILD: goes through separation anxiety consisting of the following
stages:
 Stage of protest: crying and screaming for parent
 State of despair: depression, crying stops, withdrawals, less active
 Detachment/denial: NOT COPING MECHANISM, but child accepts that parents are
gone & gets used to new environment
 ADOLESCENTS
 Loneliness & isolation
 Fear of treatment, losing self-determination, and choices
 Anger, sad, stress, regression
 Special needs: more emotional consequences possible
 FAMILIES
 Parents feel loss of control and helplessness
 Fam-centered care must also include siblings too
 Siblings may feel hospitalization is their fault (siblings need support too and
parents may forget that)
 Jealousy & anger may result



Chapter 10- Health Promotion of the Infant and Family

1. Describe the major physical, growth, and developmental milestones expected in the first year
as discussed in class
 Fine/motor skills?
 Locomotion:
o Walk alone: 12-13 motnhs
o Run clumsily: 18 months
o Walk up and down stairs: 2 years
 Fine motor development: improved dexterity, scribble, and throw ball by ages 12 – 18
months

2. Discuss appropriate toys to choose to foster development and when they would be
appropriate (TABLE 10.2, page 428). * = both age groups can use
 Birth to 6 mo.
o Nursery mobiles
o Unbreakable mirrors
o Music boxes*
o Rattles*
o Squeaky animals and dolls*
o Stuffed animals*

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