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PEDIATRIC EXIT HESI|

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PEDIATRIC EXIT HESI1 yr old child with neuroblastoma crying continuously and curled into a fetal position. Most important Give a prescribed analgesic Mother brings her newborn to the well clinic for the 1 month check-up. Nurse reviews infant record and identifies that received first dose of HBV...

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  • February 4, 2022
  • 16
  • 2021/2022
  • Exam (elaborations)
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PEDIATRIC EXIT
HESI
1 yr old child with neuroblastoma crying continuously and curled into a fetal position. Most
important
Give a prescribed analgesic

Mother brings her newborn to the well clinic for the 1 month check-up. Nurse reviews infant
record and identifies that received first dose of HBV immunization on discharge. When should
next be
During this visit, one month of age

When obtaining a throat culture from a 6 yr old with possible strep, which action
Swab the child’s erythematous oropharyngeal surfaces or tonsillar pustules

Infant is treated for intussusceptions with hydrostatic reduction. What instructions in parents
teaching plan
Signs and symptoms of recurrence

Mother of 5 yr old boy calls the ER and reports pot of hot soup pulled off stove onto her child’s
right arm and leg. Do first
Place him in a cool bath and remove clothing

Child swallowed corrosive substance. What should mom do immediately
Call poison control

Teen demanding mom to stay in hospital room
Patient is insecure

Question refers to baby soft spot and sutures
Document

Newborn baby with flea-like rash
normal and will disappear

Toddler needing genitals checked, what should nurse do
examine genitals last

Baby acting jittery
check glucose level

Gullain Barre syndrome
Patient with severe cold week ago

Celiac Disease

,Patient with fever of 101-best nursing Dx
r/t temperature elevation

Where to administer shot for 4 year old

RSV needs contact precautions

Cystic Fibrosis
Skin tastes salty

Gullain Barre syndrome
Weakness progresses from legs upward –respiratory arrest

Post strep URI diseases and conditions
Acute
glumerulonephritis
Rheumatic fever
Scarlet fever

Patient in traction
Provide age-appropriate toys

Sweat test used in
Cycstic fibrosis

Current jelly stool with blood and mucus, sausage-shaped mass in RUQ
intussusception

Patient with pyloric stenosis
Olive-shaped mass in epigastric area with projectile vomiting

Milestones to know (several Qs)
Birth weight doubles at 6 months and triples at 12 months
Birth length increases by 50% at 12 months and doubles at 4
years Post fontanel closes by 8 weeks
Anterior fontanel closes by 12-18 months
Moro reflex disappears at 4 months
Steady head control achieved at 4
months Turns over at 5-6 months
Head to hand transfers at 7
months Sits unsupported at 8
months Crawls at 10 months
Walks 10-12
months Cooing at 2
months
Monosyllabic babbling at 3-6 months, linking syllables at 6-9
months Mama/dada and other single words at 9-12 months
Throws ball overhand at 18 months

, Daytime toilet training at 18 months-2
years 2-3 word sentences at 2 years
50% of adult height at 2
years Uses scissors at 4 years
Ties shoes at 5 years

Autosomal Recessive Diseases
CF, PKU, Sickle Cell, Tay-Sachs, Albinism

Autosomal Dominant Diseases
Huntington’s, Marfans, Polydactyl, Achondroplasia, Polycystic
kidney 50% if one parent has the disease

X-linked recessive Diseases
MD, Hemophilia A
Females are carries and never have the
disease Males have the disease

Down syndrome (Trisomy 21)
Simian creases on palms, hypotonia, protruding tongue, upward and outward slant of the
eyes, low ears

PKU
Avoid phenylalanine (aspartame/NutraSweet)

Testing for PKU
Guthrie test

Care of patient with myelomeningocele
Cover with moist sterile water soaked gauze and keep from pressure

Indicators of IICP in infants
Bulging fontanels, high pitched cry, increased head circumference, wide suture lines, lethargy

Avoid in patients with IICP
Suctioning, coughing, straining and bending

Water retention, fluid overload, dilutional hyponatremia
SIADH (too much ADH)

CF kids need enzymes sprinkled on their foods

NO MMR immunization for kids with Hx of allergic rxn to eggs or neomycin

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