peds: growth and development Flashcards
what ages do you use growth charts for?
birth to 24 months
what three groups use different growth charts (compared to normal use)?
1) . ages 2-20 yrs
2) . down’s syndrome
3) . premature infants
what three things do growth charts plot?
weight, length, head circumference
when do concerns come up with growth charts?
concerns arise when there is a fall off in one or more measurements over 2-3 visits
what are some things to think of if head circumstance is too large?
spinal fluid build up or hydrocephalus
what are five developmental domains?
gross motor fine motor language cognitive social, emotional, behavioral
what are 7 components of gross motor?
movements with large muscles, head control, pushing up with arms when prone, sitting, crawling, standing, walking
what are 6 components of fine motor?
movement using small muscles, palmar grasp, pincer grasp, transferring hand to hand, picking objects up, place objects/stacking
what are 4 components of language/communication?
receptive communication
expressive communication
speech
non verbal communication
what are 3 components of cognitive domain?
memory, reasoning, problem solving
what are 3 components of social, emotional, behavioral domain?
1) . attachment to family, caregivers
2) . self-regulation
3) . interaction with others
what is anticipatory guidance?
Advice and recommendations given by health care provider to help parents understand the expected growth and development of their children.
what are 5 components of anticipatory guidance?
1) . family adjustment, cultural issues
2) . nutrition- age related and adequacy
3) . developmental milestones- constant progression
4) . health maintenance- vaccines, oral health, screenings
5) . safety- travel, home, visiting, risk behaviors
newborns prefer what position? sleeps for about how many hours? feeds every __-__ hrs
preferred flexed position, sleeps 20 hrs on average, feeds every 2-4 hrs
anticipatory guidance for newborns (7)
1) . feeding expectations
2) . elimination- voiding, stooling
3) . crying, settling, soothing
4) . skin care, newborn rash
5) . bathing, cord care, circumcision care
6) . sleep position
7) . parent rest, traveling, siblings
one month milestones (7)
1) . turns head when in supine position
2) . hands fisted, near face
3) . strong, well coordinated suck
4) . follows face, gazes at black/white objects
5) . startles to sound, voice (mom)
6) . recognizes mom’s voice
7) . throaty noises
anticipatory guidance one month visit
1) . Parental adjustment, stress, rest/sleep
2) . Baby sleep, sleep position
3) . Feeding, feeding schedule
4) . Crying, consoling, pacifier use
5) . Time on tummy- build up different muscles
6) . Expected milestones next month
7) . Signs of illness, when to call or have checked
8) . Safety, car seat use, smoke exposure
9) . Assess cultural issues, parental knowledge
2 signs of serious illness in one month old
loss of interest in feeding or development of a fever
one month red flags (3)
1) . no response to loud noises
2) . low muscle tone, poor feeding
3) . caregiver indifference
when is most congenital hearing loss discovered?
most congenital hearing loss picked up in the nursery (screening)
two month milestones (8)
1) . Chest up in prone position
2) . Head bobs when held sitting
3) . Hands open at times, brings to mouth
4) . Opens mouth at sight of breast, bottle
5) . Recognizes mom’s face, follows movements
6) . Reciprocal smile
7) . Alerts to voice, sounds, contrasting objects
8) . Early vocalizations, coos,
Anticipatory Guidance Two Month Visit (8)
1) . Parental adjustment, stress, rest, siblings
2) . Sleep schedule, position, safe bed
3) . Feeding, show, discuss growth, weight gain
4) . Tummy time, social interaction
5) . Baby temperament, fussy times, soothing
6) . Milestones next two months
7) . Safety, car seat, smoke, water heater temp
8) . Parent return to work, childcare, age expected illnesses
developmental red flags at 2 months (3)
1) . Does not alert to sound
2) . Inability to raise head when prone- weakness or poor muscle tone
3) . Not focusing, fixating on faces- visual impairment or decreased neurological development
four month milestones (7)
1) . Sits with chest support
2) .No head lag when pulled to sit
3) . Rolls tummy to back
4) . Hands open, reaches, plays with rattle
5) . Mouths objects, smiles at pleasurable sights, sounds
6) . Stops crying to parents voice, laughs, babbles, increasing vocalization
7) . Turns to voices, calms with soothing voice
Anticipatory Guidance Four Month Visit (7)
1) . Parent/sibling adjustment, stress, rest
2) . Feeding, nursing, formula, solids
3) . Sleep position, put down drowsy
4) . Tummy time, sit up time, talking, singing, play
5) . Assess temperament, how parents managing
6) . Safety, car seats, changing table, small objects
7) . Child care, travel, age expected illnesses
developmental red flags for four months (4)
1) . no cooing, gurgling sound
2) . not bringing hands to midline
3) . lack of smiling
4) . overall low muscle tone
six month development (6)
1) . Sits propping with hands, rolls back to front
2) . Reaches with one hand, transfers hand to hand, brings object to mouth, shakes toy
3) . Regards object dropped in front, rakes, attempts to grasp
4) . Responds to name, forming attachment to caregivers
5) . Expanded types of vocalizations, facial expressions
6) . Stranger “wariness”, strong caregiver attachment
anticipatory guidance for 6 months (7)
1) . Parent/sibling adjustment, stress, changes
2) . Feeding routines, solid food intro plan, sippy
3) . Sleep position, location, routines, changes
4) . Tummy, sit up time, talking, reading, play
5) . Anticipating mobility, walkers, stairs, safe toys
6) . Safe environment, travel, choking hazards
7) . Child care, expected illnesses
