University of La Salette

Graduate School

FINAL EXAMINATION
MATERNAL and CHILD NURSING (Pedia)

1. Stephen is a 5 month infant visiting the well clinic for his second series of
immunization.
a. Stephen weighed 7lb and was 20 inches long at birth. Based on normal
growth and development parameters, what should his weight be at this
visit?
ANSWER: Stephen is a boy. He should be weighing 13lbs- 20lbs at the
time of visit.

b. List a normal set of vital signs that may be assessed from Stephen.
ANSWER: Pulse rate, Respiratory rate, Temperature, Weight, and Height.

c. On what physiologic principle might the physician prescribe a vitamin

with in iron?
ANSWER: Stephen’s case is considered to be underweight considering his
age and present weight. An underweight child/ malnourished child is
prone to anemia due to lack of iron in the body. Hence, iron vitamin
would be prescribed to prevent iron deficiency.

d. Stephen’s mother is eager to feed him solid foods and asks the nurse if it
would be recommended. What response would the nurse give? Why?
ANSWER: Based on the feeding development of a child, introduction of
solid foods should start at 6 months. So, the nurse should advice the
mother to at least increase his child’s intake of breastmilk or a formula
milk if breastmilk is not enough. She will explain it well the theory on
feeding development of a child. However, if it is advised by the physician
to start feeding Stephen solid foods then they may do so.

2. Formulate a nursing care plan for the following case scenario:

a. David, a 7 month old infant is experiencing diarrhea. His weight was 18lb before
the diarrhea, now it is 16lb, his anterior fontanel is slightly sunken, mucous
membrane are dry, urine output is diminished, and specific gravity is 1.035.
ANSWER:
Assessment Nursing Planning Intervention Rationale Evaluation
Diagnosis
Objective: Fluid Within 8 -Encourage -to After 8
-weight volume hours of mother to prevent hours of
decrease deficit doing breastfeed/give dehydrati nursing
from 18 lb related to interventi formula milk/fluid on. intervention
to 16 lbs diarrhea as ons, the frequently. s, the
-slightly evidenced patient patient’s
sunken by decrease should -Monitor vital -Basis for shows no
anterior weight, have no signs, especially effective signs of
fontanel sunken signs of his weight. interventi sunken
-dry fontanel, sunken ons. fontanel,
mucous and anterior dry mucous
membrane decrease fontanel -Assess physical -Basis for membrane,
-urine urine and will be appearance(muco signs of and increase
output output able to us membrane, complicat urine
diminished increase fontanel, skin ions such output.
urine turgor) as
output dehydrati
on.
-Monitor and -to assess
record urine signs of
output. dehydrati
on.

b. Contrast the developmental milestone occurring infancy relating to fine and

gross motor skills and physiologic and cognitive development.
ANSWER: Fine and gross motor skills developmental milestone of an infant and
their physical changes is orderly and predictable wherein we can identify their
changes/ development according to their months. Motor skills includes crawling,
sitting, standing, walking, hopping, writing, and etc. Physical development also
includes changes in their weight, height, and body shapes.
However, cognitive development are not precisely tied to a particular age.
This depends on the adaptation of the child to his environment because
cognitive development can be observed in the ways they play, use language,
interact with people and construct objects and materials. Nevertheless, there are
still predictable actions/thinking of a child.

3. A 3 year old boy with leukemia you met his parents tell you that the disease has put
them through a great deal of strain. What should be important topics to discuss with
these parents?
ANSWER:
As a nurse, dealing with parents who have a child with leukemia is a very
challenging part of a health provider. With this case, a very important topics to be
discussed to the parents will be the coping mechanisms. You have to give/ present
ways on how they can cope with the situation and so with the advantages and
disadvantages of the actions once applied. This will guide them on what coping
mechanism they can use. However, in discussing the different coping mechanisms
you should never give a false assurance.
In addition, you can also discuss support functions in terms of seeking
spiritual and financial support because at times like this parents are preoccupied
 especially on where they can get finances to support the treatment. So, you can
advise them to seek help from proper authorities whom they can ask financial help.

4. Parents are both 50 years old and live on ranch, finances are tight, and they have no
insurance. Two grown children have expressed resentment at their parents for
spending so much time and money trying to find a cure. Does this family have risk
factors that might make adjusting to a child with a long term illness more difficult
than usual?
ANSWER:Considering the age, financial situation, and the eagerness of the parents
to find a cure to their child who has long term illness can be very depressing. The
longer time they still continue finding a cure, the more money they will spend and
more trials to encounter. Thus, resentment from children may be very difficult to
handle. However, as a parent, adjusting to a child with this needs patience. Patience
to explain everything and patience to understand their attitude towards the present
situation.

5. You notice boy’s parents in the waiting room of the hospital comforting parents
whose child was just hit by a car and killed instantly; you hear them say that losing a
child is better than that what they are experiencing. What stage of grief could they
be experiencing? How could you help them with their feelings?
ANSWER:
Boy’s parents are in acceptance stage of grieving process. I say so because
they were able to verbalize their feelings that way. They feel frustrated and
depressed in other present situation they are experiencing but not in their loss.
As a nurse, I can help them by encouraging them to speak or tell more how
they feel though they have already accepted it. I want to assess how far they have
accepted the loss. I can also advise them to share their feelings to people whom they
trust because sharing your feelings and verbalizing beautiful things shows
acceptance.

KHEROVINE C. TAYABAN
Student