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ADN005 Pediatrics > Week 1 Chapter 25 > Flashcards

Week 1 Chapter 25 Flashcards

1
Q

Developmental changes include:

A

Growth - Increase in physical size

Development- Sequential process of skill attainment

Maturation- Increased functionality of body systems or developmental skills

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2
Q

How do we measure physical growth?

A

Weight
Length
Head Circumference

Each plot on standardized growth chart

Also plot weight for length

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3
Q

What are the other measurements?

A

Chest at nipple line

Abdomen at the umbilicus

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4
Q

Growth percentiles measurements usually in approximately the same growth percentiles over time

A

True

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5
Q

When there are significant deviations from previous percentiles it may indicate ?

A

Further assessments needed

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6
Q

Children with down syndrome need a

A

Specialized chart.

Special populations

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7
Q

Average weight of infant is

A

3.4 kg

Doubles at 4 to 6 months

Triples by 12 months

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8
Q

Length average is about

A

50 cm (20 in) at birth

Increases by 50% by 12 months

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9
Q

Head circumference at birth is

A

35 cm (13.5in)

Increases by 10 cm by 12 months

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10
Q

How do we assess developmental milestones?

A

Ask the parents

Observe skill during assessment

Screening tools include:
ASQ
ITC
IDI
PEDS-DM

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11
Q

Name the systems immature at birth and somewhat mature over the first year

A

Neuro
Respiratory
CV
GI
Renal
Hematopoietic
Immunological
Integumentary

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12
Q

Neurologic system is fully myelinated at birth

A

False

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13
Q

Primitive Reflexes at birth

A

Step
Root
Suck
Moro
Asymmetric Tonic
Plantar
Palmar Grasp
Babinski

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14
Q

Step Reflex disappears at

A

4-8 weeks

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15
Q

Root disappears at

A

3 months

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16
Q

Suck Reflex disappears at

A

2-5 months

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17
Q

Moro and Asymmetric disappears at

A

4 months

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18
Q

Plantar Grasp disappears at

A

9 months

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19
Q

Palmar grasp disappears at

A

4-6 months

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20
Q

Babinski disappears at

A

12 months

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21
Q

A positive Babinski sign can indicate what?

A

Damage to corticospinal tract

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22
Q

As primitive reflexes disappear what appears ?

A

Protective reflexes appear

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23
Q

Protective reflexes are

A

Involuntary motor responses maintaining equilibrium and persist throughout life

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24
Q

Name Protective Reflexes

A

Neck Righting
Parachute (sideways)
Parachute ( forward)

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25
Q

Neck righting occurs at

A

4-6 months

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26
Q

Parachute Sideways occurs at

A

6 months

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27
Q

Parachute Forward occurs at

A

6-7 months

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28
Q

What is neck righting?

A

Baby will try to roll over to the side that the head is turned

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29
Q

What is parachute?

A

Extend arms to brace the fall either forward to protect the head or to the side

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30
Q

Differences between infant and adult respiratory

A

Nasal passages narrower
Larynx is funnel shaped
Trachea and chest wall is more compliantv
Bronchi and bronchioles are shorter and narrower
Respiratory fast and will decrease as child matures

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31
Q

The heart doubles in size the first year

A

TRUE

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32
Q

Pulse rate newborn is

A

120-140

Decreases to 100 at 1st year

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33
Q

Average blood pressure of newborn is

A

60/40

at 1st year increases to 100/50

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34
Q

Peripheral Capillaries are closer to the skin surface

A

Newborn and young infants more susceptible to heat loss
Thermoregulation becomes more effective over first few months

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35
Q

GI System

A

Tongue is large relative to oral cavity size

  • Allows nipple to latch so infant can feed
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36
Q

Stomach capacity increases as infant grows

A

True

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37
Q

When do first teeth emerge?

A

Incisors at 6-8 months

Predictable pattern

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38
Q

Stool as newborn is

A

Meconium

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39
Q

Change of stools are based of what in the first year?

A

Intake ( Breast, Bottle, solid foods)

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40
Q

GU System compared to Adults

A

Frequent Urination
Low specific gravity
All renal functions reduced
More prone to dehydration

Poorer urine concentration daily

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41
Q

Acrocyanosis is

A

Blueness of hands and feet

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42
Q

Mottling

A

Pink and white marbled appearance due to immature circulatory systems , decreases over first few months

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43
Q

Integumentary system of newborns

A

Lanugo and vernix may be present

Acrocyanosis is normal and decreases over the first few days of life

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44
Q

Infant’s skin compared to adults is

A

Thinner
Peripheral capillaries are more superficial
Increased absorption of topical medications

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45
Q

High what is present at birth?

A

Hemoglobin

Decreases over the first 2-3 months

Stabilizes by 6-9 months w/ adequate iron intake

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46
Q

What IG is trasnmitted and protects the infant in first 3-6 months of life ?

A

IgG

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47
Q

What Ig reaches adult level at 9 months?

A

IgM

48
Q

What Ig reaches adult level at 12 months?

A

IgG

49
Q

What is Erikson’s Psychosocial approach?

A

Ego makes positive contributions to development by mastering attitudes, ideas, and skills

This mastery helps children to grow into successful members of society

Psychological conflict that must be overcome for child to be healthy, well adjusted adult

50
Q

Erkison 0-1

A

Infancy
Trust vs Mistrust

51
Q

Erikson 1- 3 yrs

A

Toddler
Autonomy vs Shame

52
Q

Erikson 3- 6yr

A

Preschooler
Initiative vs Guilt

53
Q

Erikson 6-12 yr

A

School age
Industry vs Inferiority

54
Q

Erikson 12 yr- 20 yr

A

Adolescence
Identity vs Role Confusion

55
Q

Cognitive development refers to long term changes in thinking and memory processes

A

Piaget’s

56
Q

In Piaget’s Learning precedes to ?

A

Assimilation and Accommodation

57
Q

Cognition is developed through

A

Stages

Happen in same order
No stage skipped
Stage is transformation from previous
Each later stage incorporates the early stages

58
Q

Name Piaget’s Theory Stages

A

Sensorimotor
Preoperational
Concrete
Formal

59
Q

Infant explores the world through direct sensory and motor contact. Object permanence and separation anxiety develop in this stage

A

0-2 y

Sensorimotor

60
Q

Child uses symbols to represent objects. No logical reasoning. Pretends a lot. Egocentric

A

2-6 yr

Preoperational

61
Q

Child thinks logically and can add and subtract. Understands conservation.

A

7-12 yr

Concrete operational

62
Q

Think abstractly and think in hypothetical terms

A

Formal Operational

12yrs- Adult

63
Q

Newborn Erikson is

A

Psychosocial approach - social devlopment, role of play.

64
Q

Newborn Piaget

A

Senses and motor actions

65
Q

When does stranger anxiety develop ?

A
  • months

Infant recognizes self from others

66
Q

Separation Anxiety

A

Develops later infancy
Infant distressed when parent leaves

67
Q

Temperament ranges between

A

Low to moderate active, regular, and predictable

High active; more intense, and less adaptable

68
Q

When doing assessment have infant ….

A

Caregiver’s lap due to stranger and separation anxiety

69
Q

Where do gross motor skills develop?

A

Cephalocaudal fashion

70
Q

Fine motor skills develop

A

Proximodistal

Center- periphery

71
Q

Lifts and turns head with lag

A

1 month

72
Q

2 months Gross motor skill

A

Raises head and chest, improves head control

73
Q

Raises head 45 degrees in prone , slight lag

A

3 months Gross motor

74
Q

Lifts head and looks around, rolls from prone to supine

A

4 months Gross motor

75
Q

Rolls supine to prone and back, can sit with support

A

5 months Gross Motor

76
Q

Tripod sits

A

6 months gross motor

77
Q

7 Months Gross Motor

A

Sits alone with some use of hands

78
Q

Sits unsupported

A

8 months Gross Motor

79
Q

Crawls and abdomen off the floor

A

9 months Gross Motor

80
Q

Pulls to stand and “ cruises”

A

10 months Gross Motor

81
Q

12 Months gross motor

A

Sits from standing position, and walks independently

82
Q

1 month Fine motor skill

A

Fists mostly clenched, involuntary hand movements

83
Q

3 months Fine Motor Skill

A

Holds hand in front of face, hands open

84
Q

Bats at objects Fine motor skill at what month?

A

4 Month

85
Q

Grasps rattle

A

5 months Fine Motor Skill

86
Q

6 Months Fine Motor Skill

A

Releases object in hand and takes another

87
Q

7 Month Fine motor skill

A

Transfers objects from one hand to another

88
Q

Gross pincer grasp develops at

A

8 Months fine motor skill

89
Q

9 month Fine motor skill

A

Bangs objects together

90
Q

Fine pincer grasp, puts objects into container and takes them out

A

10 month fine motor skill

91
Q

Feed self with cup, spoon, and makes simple mark on paper, pokes with index finger

A

12 months fine motor skill

92
Q

Toys for 0 -2 months

A

Mobiles

93
Q

2- 4 mo toys

A

Rattles, cradle gym

94
Q

Toys 4-6 mo

A

Bright toys small to grasp and large enough for safety

95
Q

6- 9 months toys

A

Large toys with bright colors, movable parts, and noisemakers

96
Q

9-12 mo toys

A

Books with large pictures, large push- pull toys, teddy bears

97
Q

Infants born at less than 36 weeks are known as

A

Premature

98
Q

List problems for premature infants

A

Immature respiratory and nervous systems
Lack adequate iron stores
Lack of adequate immunoglobulins

Immature GI system
- May not be capable or oral feeding
May not tolerate enteral feeding

98
Q

G and D of Premature Infant

A

Use infant’s adjusted age to determine expected outcomes

Plot growth parameters and assess developmental milestones om adjusted age

98
Q

Early warning signs for hearing

A

Does not respond to loud noises
Does not make sound or babble at 4 months of age
Does not turn to locate sound at age 4 months

98
Q

How to calculate adjusted age

A

Subtract number of weeks infant was premature from chronological age

98
Q

Early warning signs of vision

A

Crosses eyes most of time at age 6 months
Does not track interesting item
Does not try to study an object in visual field

99
Q

Warning signs : Problems with language and development

A

Does not make sound at 4 months age
No laugh or squeal by 6 months
No babble by 8 months of age
Does not use single words with meaning at 12 months of age ( mam, dada)

100
Q

Breastfeeding is heavily decided by

A

Cultural preferences

Breastfeeding best type nutrition for both mother and infant

101
Q

Name benefits of breastfeeding

A

Increased bonding with mother

Immunologic protection

Possible enhancement of cognitive development

Decreased incidence of obesity later in life

Decreased incidence of :
Diarrheal Diseases
Asthma
Otitis Media
Bacterial Meningitis
Botulism
UTIs

102
Q

Benefits of breastfeeding for Mothers

A

Increased bonding with Infants
Lessens maternal blood loss postpartum
Decreases risk of ovarian and premenopausal breast cancers
Possible delay of ovulation
Economic advantage; convenience of use

103
Q

What are some exceptions of breastfeeding?

A

Infants with galactosemia
Maternal use of illicit drugs and a few prescription medications
Maternal untreated active TB
Maternal HIV infection developed countries

104
Q

Unable to break down simple sugar galactose

A

Galactosemia

Can cause damage to the liver, brain, kidneys, and eyes

105
Q

When can one add solids into feeding?

A

Tongue extrusion reflex has disappeared

Soft or mashed food until teeth erupts

May require 20 exposures to accept food

Introduce cup early- 6 months

Family models acceptable eating behaviors
Parent provides the food, child decides how much to eat

106
Q

What are common developmental concerns in infancy

A

Colic
Spitting up
Thumb Sucking
Teething

107
Q

Place newborns and young infants on back to sleep to prevent

A

SIDS

108
Q

How many hours do newborns sleep?

A

20 hours

109
Q

By 3 months infants sleep about

A

7- 8 hours per night with 2-3 naps per day

110
Q

Around ____ months establish a bedtime routine

A

4 months

Facilitates relaxation and predictable sleep time

111
Q

By 12 months infants sleep

A

8-12 hours per night

Takes 2 naps per day

112
Q

Ways to Promote Safety

A

Car Seat- type, positioning, securement
Safe Crib and Changing table
Avoid use of baby walkers
Safety in home
- Safety gates
- Outlet Covers
Identify and avoid choking hazards
Water safety

ADN005 Pediatrics (21 decks)

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