Age groups and milestones Flashcards
(243 cards)
1
Q
Caloric requirements: birth to 6 months–
A
120 kcal/kg/day
2
Q
Caloric requirements: 7 mo to 1 year–
A
100 kcal/kg/day
3
Q
Caloric requirements: 2 yo to 10 yo:
A
70 to 100 kcal/kg/day
4
Q
Caloric requirements: Adolescents (greater than 10)
A
45 kcal/kg/day
5
Q
Breastfeeding during painful procedures provides _______
A
analgesia
6
Q
The longer the mother breastfeeds, the ____ chance of the child to be overweight independent of education and socioeconomic status.
A
Less
7
Q
How is adequate nutrition confirmed in infants?
A
Weight gain
8
Q
Within the first three months of life, there should be weight gain of __ g/day
A
30 grams/day equivalant to 1 oz/day
9
Q
After the first three months, the NEXT three months should have weight gain of __ to __ g/day
A
15 to 20 grams/day
10
Q
For infants that are exclusively breast fed, when should you start Vitamin D supplementation? What is the dose?
A
Should start at 2 months and continue throughout adolescence. The does is 400 IU/day
11
Q
For exclusively breastfed infants, when should iron supplementation be started? What is the dose? Where does the iron typically come from?
A
Iron is started after 6 months of age. The dose is 1 mg/kg/day. The iron typically comes from fortified cereals.
12
Q
What is the accepted amount of initial weight loss following birth?
A
10%
13
Q
The first initial weight loss is typically regained within __ to __ days?
A
7 to 14 days
14
Q
The infants weight should double by ___ months
A
Five
15
Q
The infants weight should triple by ___ months
A
12
16
Q
The infants weight should quadruple by ___ years of age
A
2
17
Q
How much weight should three-year-olds through school-aged children gain?
A
4 to 6 pounds a year
18
Q
School aged children should gain how many pounds annually?
A
5-7 lbs./year
19
Q
Primary teeth eruption begins at ___ months and lasts until ___ months:
A
6 months
24 months
20
Q
Permanent tooth eruption begins at __ years and ends at __ years
A
6 years
13 years
21
Q
Tooth eruption mnemonic: Come Little Children Munch Meat — is used for primary teething. What is the order at which you would expect to see tooth eruption?
A
Central Incisor Lateral Incisor Cuspid First Molar Second Molar
22
Q
What is the order in which the permanent teeth erupt?
A
Central Incisor (6 to 8 years) Lateral Incisor (7-9 years) Cuspid (9-12 years) First Bicuspid (10-12 years) Second Bicuspid (10-12 years) First Molar (6 to 7 year) Second Molar (11-13 years)
23
Q
What nursing theorists concentrated on sensorimotor stages and what the brain knows?
A
Jean Piaget
24
Q
Sensorimotor stage: ____ to __ years
A
Birth to 2 years
25
In the sensorimotor stage, infants rely on their _______ _______.
Primitive reflexes
26
Preoperational/Preconceptual Stage: Ages __ years to __ years. This phase focuses on ________.
2 years to 4 years old
| Fantasy
27
Piaget: Intuitive/Preoperational thinking: ___ years to __ years. This is the beginning of __________.
4 - 7 years
| Causation
28
Concrete thinking (Piaget) is ages ___ to ___. Provide an example of concrete thinking.
7 to 11 years
Memorization
29
Formal operational thought (Piaget) is ages __ to __ years. Children in this stage are capable of _____ conclusions.
11 - 15 years
Logical
30
Erikson's stages: infancy
birth to 1 year
| Trust vs. Mistrust
31
Erikson's stages: Toddler
1 - 3 years
| Autonomy vs. Shame/doubt
32
Erikson's stages: Preschool
3 to 6 years
| Initiative vs. Guilt
33
Erikson's stages: School age
6 to 12 years
| Industry vs. Inferiority
34
Erikson's stages: Adolescence
12 to 18 years
| Identity vs. Role confusion
35
Freud: Principle of pleasure:
Id
36
Freud: Principle of reality/self-interest
Ego
37
Freud: Principle of morality/conscience
Superego
38
According to Freud, what stage are infants in?
Oral stage
39
Birth to 6 months, Freud says infants are what?
Orally passive
40
7 to 18 months, Freud says infants are?
Orally aggressive (teething, oral satisfaction)
41
Freud: What stage are toddlers in? (1.5 - 3 years)
Anal
42
Freud: Preschoolers (3 - 6 years old) are in this stage:
Phallic stage (love opposite sex, Oedipal complex)
43
Freud: School age children (6 to 12 years) are in this stage:
Latency stage
44
Freud: Adolescence (12 to 18 years) are in this stage:
Genital Stage
45
What is the adjustment of developmental expectations for premature infants through the age of 2 years?
Corrected gestational age (CGA)
46
Head circumference is measured until what age?
2 years old
47
When do you begin measuring body mass index (BMI)?
2 years old
48
What is the equation for body mass index?
weight (kg) / height (m) squared
49
Generalized assessment tool used from birth to 6 years of age that measures: gross motor development, fine motor development, language, and personal/social development.
Denver II
50
When does the infant have good head control?
2-3 months
51
When does the infant roll back to front?
5 to 6 months
52
When does the infant sit alone?
7 months
53
When does the infant pull to stand?
9 to 10 months
54
When does the infant stand alone?
11 to 12 months
55
When does the infant walk?
12 to 14 months
56
When does the infant walk up and down stairs?
22 to 24 months
57
When does does the infant jump?
24 to 48 months
58
When can the infant grasp and shake a rattle?
2 to 3 months
59
When can the infant reach for objects?
3 to 4 months
60
When can the infant complete hand-to-hand transfer?
5 to 6 months
61
When can the infant perform a raking grasp?
6 to 7 months
62
When can the infant perform a finger grasp?
7 to 9 months
63
When do you see the pincer grasp?
8 to 10 months
64
When can the infant mark on paper?
10 to 12 months
65
When can the infant stack 3 blocks?
17 to 18 months
66
When can the infant stack 6 to 7 blocks?
22 to 24 months
67
When can the infant smile and coo?
2 to 3 months
68
When can the infant laugh?
4 to 5 months
69
When can the infant babble?
5 to 6 months
70
When does the infant say "mama-dada"
8 to 9 months
71
When can the infant wave bye-bye?
8 to 9 months
72
When does the infant understand "No"
9 to 10 months
73
When does the infant point to body parts?
15 to 18 months
74
When can the infant form 2-word sentences?
18 to 22 months
75
When does the infant have a 30 to 50 word vocabularly?
22 - 24 months
76
Children should remain in a backward facing carseat until what age?
12 months
77
All children under the age of __ years or __ pounds must be in a car seat.
4 years
| 40 pounds
78
What is the dose for IM vaccines typically?
0.5 mL
79
Vaccine intervals need to be at least __ weeks apart?
6 weeks
80
HBV: when is the first dose? Second dose? Third dose?
First dose after birth before discharge
Second dose: 2 months
Third dose: 6 months
81
If an infant is born to a hepatitis B positive mother, what should happen in addition to receiving the HBV?
Hepatitis B immunoglobulin within 12 hours of birth
82
If the mother's hepatitis status is unknown then what happens?
Patient receive hepatitis B within 12 hours of birth, if mom tests positive, HBIG should be given no later than 1 week of age
83
Rotavirus is a series of __ vaccines given from __ weeks to __ weeks.
3
| 6 to 36 weeks
84
You do not give Rotavirus after 8 months due to the increased risk of what?
Intussusception
85
DTaP is a series of ___ vaccines
3 vaccines
86
DTaP is not indicated for children greater than __ years old.
7
87
Tdap is a series of _ vaccine(s) given at age __ with recommended boosters every __ years.
1 vaccine given at age 11 with booster given every 10 years
88
Hib is a series of __ vaccines given at what ages?
3 vaccine series given at 2, 4, and 6 months
89
When should you receive a Hib booster?
12 months
90
Hib is not recommended for children greater than __ years old?
5 years
91
Pneumococcal vaccine is a series of __ vaccines, given at what ages? When do you get the booster?
3 vaccine series given at 2, 4, and 6 months with 1 booster at 12 months
92
If a child has special disease processes, such as splenic dysfunction or HIV, they should receive an additional pneumococcal vaccine at ___ months
24 months
93
IPV is a series of __, given at:
4
| 2, 4, 6 months and 6 years
94
When do you begin the annual flu shot for infants?
6 months
95
What is the dose for influenza vaccine for children aged 6 to 35 months?
0.25 ml
96
When do children get the full 0.5 mL vaccine?
3 years
97
Children younger than __ years receive __ doses 1 month apart
9 years receive 2 doses
98
MMR vaccine: Series of __ given when? What is the EARLIEST age of administering MMR?
2 vaccine series
given @ 12 months and 12 years
6 months, but will still need dose @ 12 months
99
Varicella is a series of __ given when?
2, 2 doses between 12 months and 12 years
100
What vaccine is typically avoided when giving MMR?
Varicella
101
HAV- _ dose series given between __ months and __ months with a minimum interval of __ months.
2 dose series given between 12 months and 24 months with a minimum 6 month interval
102
Meningococcal vaccine: series of __ given at age __ with a booster at the age of __.
2 vaccine series given at age 11 or 12 with a booster given at age 16.
103
When is the earliest you can receive the HPV vaccine?
9 years but recommended at 11 or 12 years
104
If you receive the HPV vaccine before the age of __ it is a 2 dose series, otherwise it is a 3 dose series.
15 years
105
What are reportable events that should be reported to the vaccine adverse events reporting system (VAERS)?
Anaphylaxis
Encephalitis
Death
106
What percent of genetic defects are identified before the age of 6 months?
80%
107
When obtaining a pedigree history (genogram), how many generations should be included?
Three
108
This genetic disorder occurs in 1:660 births and has an association with increased maternal/paternal age with retardation ranging from mild to severe.
Trisomy 21
109
These findings indicate what genetic disorder: Eyes set wider apart than usual, protruding tongue, single palmar crease, hypotonia, and Brushfield spots?
Trisomy 21
110
Klinefelter's syndrome is seen only is ____ and is caused by an extra ___ chromosome.
males
| X
111
Klinefelter's syndrome occurs in every 1: _____ births
1:1000
112
Klinefelter's syndrome is the most common cause of ___________ and _________ in men.
Hypogonadism
| Infertility
113
These phenotypical manifestations exhibit what genetic disorder? Tall stature, gynecomastia, learning disability, personality impairment
Klinefelter's syndrome
114
_____ Syndrome is the most common sex-chromosome anomaly seen in females.
Turner's Syndrome
115
Turners syndrome occurs in ever 1:_____ births
1:2,000
116
These findings indicate what genetic disorder?
Webbed neck, "shield" shaped chest with widely spaced nipples, hypertension, and bicuspid aortic valve/coarctation of the aorta?
Turner's Syndrome
117
Inherited connective tissue disorder affecting skeletal, cardiac, and ophthalmic body systems which occurs in 1:20,000 births.
Marfan Syndrome
118
These phenotypical presentations indicate what genetic disorder? Arm span exceeds height, hyperextension of joints, kyphoscoliosis, aortic aneurysms, ectopia lentis and iridonesis
Marfan Syndrome
119
This genetic disorder is found in Ashkenazic Jewish population and occurs in 1:2,500 births
Tay-Sachs Disease
120
What is the biggest red flag to warrant testing for Tay-Sachs disease?
Decreased muscle tone. Will learn to crawl then stops with arms/legs laid out
121
Tay-Sachs disease is a ______ disease leading to death
progressive
122
These are typical manifestations of what genetic disorder? Decreased muscle tone, cherry red macula, blindness, deafness, seizures, dementia, death
Tay-Sachs disease
123
Congenital defect of the parathyroid glands, thymus, and the conotruncal region of the heart?
DiGeorge (Velocardiofacial) Syndrome
124
In DiGeorge syndrome, there is an increase susceptibility to _______ due to thymus aplasia.
Infection
125
DiGeorge syndrome has significant neonatal morbidity and mortality associated with ____ defects.
Cardiac
126
DiGeorge syndrome reveals [hypo/hyper] parathyroidism with [hypo/hyper] calcemia
hypoparathyroidism
| hypocalcemia
127
Low birth weight is defined as:
Less than 2,500 g
128
Very low birth weight is defined as :
less than 1,500 g
129
Extremely low birth weight (ELBW) is defined as:
less than 1,000 g
130
Appropriate for gestational age (AGA): between __ and __ percentile.
10-90%ile
131
Large for gestational age (LGA):
greater than 90%ile
132
Small for gestational age:
less than 10%ile
133
when are APGARs calculated?
1 and 5 minutes
134
Prematurity is defined as being born before __ weeks
37
135
Congenital growth disorder shown by hemihypertrophy, large organs, and other symptoms
Bewith-Wiedemann Syndrome
136
Fatal condition defined as an abnormal accumulation of fluid in two or more fetal compartments
Hydrops fetalis
137
Normal newborn heart rate:
120 to 170 BPM
138
Normal newborn respiration rate:
30-80 breaths per minute
139
Pinpoint white papules on face, prominent on cheeks, nose, chin, and forehead that spontaneously disappear within 3-4 weeks of life
Milia
140
Obstructed sweat (eccrine gland) ducts; sometimes referred to as "prickly heat"
Miliaria
141
Most common newborn rash; usually appears between days 2 to 5 after birth; characterized by blotchy red spots on the skin with overlaying white or yellow papules or pusutues; resolves by the 14th day
Erythema toxicum
142
Typically a subtle shade discoloration located on either flank; may not be present at birth but likely to increase in size with age; suspect neurofibromatosis if there are many large spots or if more than 6 spots in a child older than 5
Cafe au lait spots
143
Benign, flat, congenital birthmark with wavy borders and irregular shape; common color is blue; may last up to 3 to 5 years after birth, almost always dissappear by puberty
Mongolian spots
144
Vascular birthmark (malformation) consisting of superficial and deep dilated capillaries in the skin; produce a reddish to purplish discoloration of the skin; permantent
Port-wine stain
145
Raised, soft red lumps on the skin, more common in premature babies, usually shrinks/fades after 6 months
Strawberry mark (hemangiomas)
146
When does rooting disappear
3 to 4 months
147
When does sucking disapear
3 to 4 months
148
When does Moro disappear
3 to 4 months
149
When does palmar grasp disappear
3 to 6 months
150
When does plantar grasp disappear
4 months
151
When does placing/stepping disappear
1 to 2 months
152
When does tonic neck disappear
3 months
153
When does babinski disappear
12 months or when walking
154
This type of head swelling crosses the midline and usually resolves in 2-3 days
Caput succadaneum
155
This does head swelling does not cross the midline, usually requires closer monitoring
Cephalohematoma
156
To be categorized as microcephaly or macrocephaly, your head must be smaller or larger than __ standard deviations
two
157
More than one hair whorl could indicate what
poor brain growth
158
This is the largest fontanel
Anterior
159
When does the anterior fontanel close?
18 months
160
when does the posterior fontanel close?
2 to 3 months
161
Salt and pepper speckling (Brushfield spots of the iris) are associated with:
Down Syndrome
162
What should you consider if you note a radio-femoral pulse delay?
Coarctation of the aorta
163
What is it called when you cannot retract the foreskin?
Phimosis
164
How do you check for developmental dysplasia of the hip?
Ortolani's click and Barlow's maneuver
165
This occurs 1:10,000 to 25,000 newborns, causing developmental delays, seizures, retardation
PKU
166
This occurs in newborns causing liver dysfunction, coagulapothies and occurs every 1:60,000 to 80,000 births
Galactosemia
167
Irreversible condition characterized by brain damage and developmental problems resulting from prenatal alcohol exposure
Fetal alcohol syndrome
168
How is FAS diagnosed?
Physical examination
169
What manifestations does this indicate: birth defects of the heart, bone, kidney, joints, ears/eyes. Abnormal facial features: small eye openings, thin upper lip, smooth philtrum, upturned nose, small head size, poor weight gain, intellectual disability
Fetal Alcohol Syndrome
170
The newborn period is from __ to __ months; while infancy is __ to __ months.
1 to 2 months
| 1 to 12 months
171
According to the Bright Futures guidelines, what is the schedule for well-child checks?
2 weeks, 2 mo, 4 mo, 6 mo, 9 mo, 12 mo
172
At what well child check would you not expect to provide any vaccines if the child is on time with vaccinations?
9 mo visit
173
At what visits would you check a child's hematocrit?
6 mo, 9 mo, and 12 mo
174
What is a vitamin deficiency that causes fissures at the corners of the lips?
cheilosis
175
Pigeon chest
Pectus carinatum
176
Sunken chest; and the most common congenital deformity of the anterior wall of the chest.
Pectus excavatum
177
T or F: Gynecomastia and galactorrhea is a normal finding in males up to 3 months old?
True
178
In a toddler, where should the liver edge be palpable?
1 to 2 cm below the right costal margin
179
At what age should the testes be fully distended into the scrotum?
3 months
180
What is Galeazzi sign and when is it seen?
Unequal knee height seen in developmental hip dysplasia
181
What is the most alarming type of enlarged lymph nodes?
Supraclavicular
182
At what point is there considered to be hearing loss in an infant?
At a loss of 20 to 30 decibels
183
When does "Stranger Danger" develop?
6 months
184
When does an infant develop separation anxiety?
8 months
185
What is an affective bond that develops over the first year and will differentiate into other emotions later?
Attachment
186
When should the infant's first dental appointment be scheduled?
By 1 year old
187
From age two months to 1 year, how much should you expect the infant to sleep?
8-12 hours/night
188
What is the recommended screen time for children younger than 18 months?
The AAP does not recommend screen time for this age group.
189
Any baby younger than ___ weeks that develops a fever should have a full septic work-up done.
4 weeks (30 days)
190
Within the first two months of life, __% of fevers are viral.
40%
191
When assessing the degree of illness in an infant, it is important to remember that responses are ________.
Behavioral
192
The toddler age group is ages:
1 to 3 years
193
The preschool age group is ages:
4 to 5 years
194
IF a family has a history of dyslipidemia or CV disease, at what age should you check the child's cholesterol?
2 years
195
Beginning in the toddler age group (age 12 mo), what is the schedule for WCC?
12 mo, 15, mo, 18 mo, 24 mo, 30 mo, and 36 mo
196
At what age will the child begin having a WCC annually?
Age 3
197
Height and weight should be documented at every well child check until age __, then annually.
Age 2
198
Where should you be able to palpate the liver in a toddler/preschool aged child?
1-2 cm below the right costal margin
199
"Bowed legged" (normal variant in toddlerhood)
Genu varum
200
"Knock-knees" (normal variant in preschooler)
Genu valgum
201
What age does tibial torsion typically resolve?
Age 4
202
This is in-toeing, which is normal until adolescent stage
Femoral anteversion
203
What age should the toddler be able to run with wide gait, up and down steps, and kick a ball without falling?
Age 2
204
When should a child be able to ride a tricycle?
Age 3
205
When should the child be able to ride a bicycle without training wheels and go up and down stairs with alternating feet?
Age 4
206
When can the child jump rope and skip?
Age 5
207
What age can the child turn a doorknob?
Age 2
208
At what age can the child copy a circle?
Age 3
209
What age can a child: tie their shoes and copy a squate?
Age 5
210
The tendency of children to cognize their environment only in terms of their own point of view:
Egocentrism (Piaget)
211
What should the visual acuity be by age 5?
20/30
212
What age should the hearing test be changed to the pure tone audiometry?
Over 3 years
213
What type of play do toddlers involve in?
Onlooker and parallel play
214
Preschoolers partake in what type of play?
Associative, cooperative, dramatic, and physical play
215
What is the gold standard for the diagnosis of developmental delays in infants/toddlers to 42 months of age with separate mental, motor, and behavioral rating scales?
Bayley Scales of Infant and Toddler Development
216
When should the spoon be introduced to the child for use?
15-17 months
217
How many hours/night should the toddler sleep?
10 to 12 hours with daily naps
218
What age do nightmares begin?
Age 3
219
Night terrors typically occur between __ to __ years; most outgrow as they get older
2 to 6 years
220
When does physiologic and psychological readiness for toilet training begin?
1.5 - 2.5 years
221
What is the AAP recommendation for screen time for children aged 2-5 years?
No more than 1 hour per day
222
At what age would there be a concern for a patient not being toilet trained during the day time hours?
At age 4
223
Stuttering can be normal and last as long as __ months. If last longer than this, you should refer.
6 months
224
What is characterized by altered response to environmental stimuli and impaired social interactions?
Autism Spectrum Disorder (ASD)
225
School-aged children is considered what age?
6 years to 12 years
226
What is the average growth of weight and height in this age group?
Weight: 5 to 7 lbs/year
Height: 2 - 3 inches/year
227
BMI greater than __ percentile is considered obesity
95th
228
When should the screening for scoliosis begin?
Age 9
229
What stage has the development of self esteem?
School-aged group
230
In the school age group, how many hours would they be expected to sleep per night?
8-10 hours/night
231
This age group should begin having conversations about sex, STI's, menarche, hormonal/body changes
School-aged group (ages 6-12)
232
What is the AAP recommendation for screen time for the school-age group?
PCP/patient/family should develop a Family Media Use Plan
233
What is the most common form of child abuse?
Neglect
234
__% of abusers in child abuse are the parents
80%
235
Adolescent age group:
12 - 20 years
236
When should pelvic exams begin (if sexually active)?
Age 21
237
HEADSS format assessment stands for what?
Home environment, Employment/education, Activities, Drugs, Social, and Sexuality
238
PACES format for interviewing adolescents:
Parents/peers, Accident, alcohol & drugs, Cigarettes, Emotional issues, School/sexuality
239
SAFETEENS format for interviewing adolescents:
Sexuality, Accidents/abuse, Firearms/homicide, Emotions, Toxins, Environment, Exercise, Nutrition, Shots
240
Menarche between breast development in stages __ to __; but predominately in stage __.
3 to 4; 4
241
At what age is puberty considered precocious for girls? boys?
Girls before age 8
| Boys before age 9
242
How often should you have dental cleanings?
Every 6 months
243
What are the peak ages for anorexia and bulimia?
14 to 18 years
