ATI PEDIATRICS PROCTORED EXAM

STUDY GUIDE

Chapter 1: Family centered nursing care

1. Parenting styles

-Dictatorial or authoritarian:

-Parents try to control the child’s behaviors and attitudes throughunquestioned

rules and expectations

-Ex: The child is never allowed to watch television on school nights

-Permissive:

-Parents exert little or no control over the child’s behaviors, and consult thechild

when making decisions

-Ex: The child assists with deciding whether he will watch television

-Democratic or authoritative:

-Parents direct the child’s behavior by setting rules and explaining the reasonfor

each rule setting

-Ex: The child can watch television for 1 hr on school nights aftercompleting

all of his homework and chores

-Parents negatively reinforce deviations form the rules

-Ex: The privilege is taken away but later reinstated based on newguidelines

Chapter 2: Physical assessment findings

1. Vital signs

-Usually vital signs are all high except for BP

-Temperature:

-3 – 6 months 99.5

-1 year 99.9

-3 year 99.0

-5 years 98.6

-7 years 98.2

-9 – 11 years 98.1

-13 years 97.9

-Pulse:-Newborn 80 – 180/min

-1 weeks – 3 months 80 – 220/min

-3 months – 2 years 70 – 150/min

-2 – 10 years 60 – 110/min

-10 years and older 50 – 90/min

-Respirations:

-Newborn – 1year 30 – 35/min

-1 – 2 years 25 – 30/min

-2 – 6 years 21 – 25/min

-6 – 12 years 19 – 21/min

-12 years and older 16 – 19/min

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-Blood pressure:

-Low as a baby but increases the older they get

-Infants:

-Systolic: 65-78

-Diastolic: 41-52

2. Head

-Fontanels should be flat

-Posterior fontanel:

-Closes by 6-8 weeks

-Anterior fontanel:

-Closes by 12-18 months

3. Teeth

-Infants should have 6-8 teeth by 1 year old

-Children and adolescents should have teeth that are white and smooth, and begin

replacing the 20 deciduous teeth with 32 permanent teeth

4. Infant Reflexes

Tonic Neck Reflex (Fencer Position) Birth to 3 – 4 months

Sucking and Rooting Reflex Birth to 4 months

Moro Reflex (Fall backward) Birth to 4 months

Startle Reflex (Loud Noise) Birth to 4 months

Plantar Reflex Birth to 8 months

Babinski Reflex Birth to 1 year

Chapter 3: Health promotion of infants (2 days to 1 year)

1. Physical Development

-Weight:

-Doubled by 5 months

-Tripled by 12 months

-Quartered by 30 months

-Height:

-2.5 cm (1 in) per month for the first 6 months

-Length:

-Increases by 50% by 12 months

-Dentition:

-First teeth erupt between 6-10 months

2. Motor skill development

▪ 1 Month

o Head lag

o Strong grasp reflex

▪ 2 Months

o Lifts head when prone

o Holds hand in open position | Grasp reflex fades

Palmar Grasp Birth to 3 months

Stepping Birth to 4 weeks

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▪ 3 Months

o Raises head and shoulders when prone | Slight head lag

o No grasp reflex | Keeps hands loosely open

▪ 4 Months

o Rolls from back to side

o Grasp objects with both hands

▪ 5 Months

o Rolls from front to back

o Palmar grasp dominantly

▪ 6 Months

o Rolls from back to front

o Holds bottle

▪ 7 Months

o Bears full weight on feet | Sits, leaning forward on both hands

o Moves objects from hand to hand

▪ 8 Months

o Sits unsupported

o Pincer grasp

▪ 9 Months

o Pulls to a standing position | Creeps on hands and knees instead of crawling

o Crude pincer grasp | Dominant hand is evident

▪ 10 Months

o Prone to sitting position

o Grasps rattle by its handle

▪ 11 Months

o Walks while holding onto something | Walks with one hand held

o Places objects into a container | Neat pincer grasp

▪ 12 Months

o Stands without support briefly | Sits from standing position without assistance

o Tries to build a two-block tower w/o success | Can turn pages in a book

3. Cognitive development

-Piaget: sensorimotor (birth to 24 months)

-Object Permanence: objects still exists when it is out of view

-Occurs at 9-10 months

4. Language development

-3-5 words by the age of 1 year

5. Psychosocial development

-Erikson: Trust vs. Mistrust:

- Learn delayed gratification

-Trust is developed by meeting comfort, feeding, simulation, and caringneeds

-Mistrust develops if needs are inadequately or inconsistently met or if needsare

continuously met before being vocalized by the infant

6. Social development

-Separation Anxiety: protest when separated from parents

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-Begins around 4-8 months

-Stranger Fear: ability to discriminate between familiar and unfamiliar people

-Begins 6-8 months

7. Age appropriate activities

-Rattles

-Playing pat-a cake

-Brightly colored toys

-Playing with blocks

8. Nutrition

-Breastfeeding provides a complete diet for infants during the first 6 months

-Solids are introduced around 4-6 months

-Iron-fortified cereal is the first to be introduced

-New foods should be introduced one at a time, over a 5-7 day period toobserve for

allergy reactions

-Juice and water usually not needed for 1st year

-Appropriate finger foods:

-Ripe bananas

-Toast strips

-Graham crackers

-Cheese cubes

-Noodles

-Firmly cooked vegetables

-Raw pieces of fruit (except grapes)

9. Injury prevention

-Avoid small objects (grapes, coins, and candy)

-Handles of pots and pans should be kept turned to the back of the stove

-Sunscreen should be used when infants are exposed to the sun

-Infants and toddlers remain in a rear-facing car seat until age 2

-Crib slats should be no farther apart than 6 months

-Pillows should be kept out of the crib

-Infants should be placed on their backs for sleep

Chapter 4: Health Promotion of Toddlers (1 to 3 years)

1. Physical development

-Weight:

-30 months: 4 times the birth weight

-Height:

-Toddlers grow 7.5 cm (3 in) per year

-Head circumference and chest circumference:

-Usually equal by 1 to 2 years of age

2. Cognitive development

-Piaget: sensorimotor stage transitions to preoperational stage 19 – 24 months

-Object Permanence: fully developed

3. Language development

-1 year: using one-word sentences

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