Exam 1 Flashcards
(103 cards)
1
Q
infant stage
A
newborn - 12 mo
2
Q
cephalocaudal pattern
A
attainment of skills from head to toe
3
Q
infant- proximal pattern
A
attainment skills trunk out to extremities
4
Q
gross v fine motor skills- infant
A
gross dev before fine
5
Q
newborn appointment times
A
(w/in 2 days of discharge), 1 mo, 2 mo, 4 mo, 6 mo, 9 mo and 12 mo (1yr)
6
Q
newborn assessment
A
perform invasive last
auscultate first
assess for hip dysplasia at 3 mo
ears- pull pina back and DOWN
7
Q
newborn- fontanelles
A
palpate (should be soft and flat)
if raised due to crying or inc ICP
if sunken = dehydration
8
Q
infants- strabismus
A
crossing of the eyes
common till 6 mo
9
Q
newborns- respiratory variants
A
1:1 anteroposterior transverse diameter common
diagramatic breathing
irreg. respirations (breath w/ pauses)
10
Q
newborn- acrocyanosis
A
hand and feet blue
11
Q
cardiovascular- newborn
A
murmurs common, heart rate fast and can be irreg., S3 may be audible
12
Q
infant- benign metatarsus adductus
A
curvature of feet (normal)
13
Q
infant- immunity
A
passive immunity until 6 mo
passive= natural form from maternal antib in breast milk
(monoclonal antibodies)
14
Q
infant- integumentary
A
born w/ high levels fetal hbg (HgbF), and physiological anemia
salmon patches- dilation in micro vessels (raspberry on forehead)
Mongolian spots- non-blanching hyperpigmentation, dissap in childhood
15
Q
infant- primitive reflexes
A
sucking, rooting, babinski (fanning/dorsiflexion normal till 2 yrs)
stepping, palmar grasp
dissap after first year of life
16
Q
infant- protective reflexes (secondary)
A
dev after 1 yr
toddlers/older children
17
Q
stool- meconium, breastfed, formula and constipation
A
meconium- first stool, thick, green and tarry
breastfed- thinner consistency, seedy/yellow
formula- green/brown yellow and pastier
constipation- norm 1 stool every o day and max 10 stools daily
consistency! not quantity
grunting not assoc. w/ constipation
18
Q
FLACC scale
A
face, legs, activity, cry and consolability
e/ 0-2
score 0-10= higher= more pain
19
Q
NIPS scale
A
neonatal infant pain scale facial expression, cry, breathing pattern, arms, legs, and state of arousal 0-1 except cry 0-2 max score 7, higher = more pain
20
Q
infant- physical growth
A
head circum- inc first 6 mo then slows down until 1 yr
length inc 1-2 cm/mo
weight doubles 4-6 mo and triples by 1 yr
21
Q
infant- comm.: cooing, copies, words and gestures
A
cooing- 2 mo
copies- 9 mo
words- 12 mo
gestures and follows simple directions- 12+
22
Q
infant- vision, hearing, taste and touch
A
vision- 20-400 at birth, no color vision till 7 mo
hearing- prefer high pitched
taste- sweet over sour
touch- soft, gentle touch
23
Q
infant- temperment
A
easy- happy and adapts
difficult- need high levels act., crying is common
24
Q
infant- protective factors
A
support networks, + family relationships, adequate childcare
25
infant- play
like to play alone
reading, singinig
kicked/batted, unbreakable mirrors, contrasting patterns
older ex. 10 mo= block books
26
infant - sleep
room sharing in own bed till 6 mo
SIDS high risk 1-2 yr
always sleep on back
sleep 16 hr/day
27
vaccine types- live attenuated
live attenuated- living weakened virus MMR, varicella and rotavirus
28
vaccine types- inactivated
killed virus
| rabis, flu, polio
29
vaccine types- toxoid
contains toxins, chemical made by bac/virus
| ex. tetanus, diptheria
30
vaccine types- conjugate
polysacc coating binds to protein
| ex. prevnar (pneumococal strep)
31
infant- barriers to care
transportation, financial concerns and safety
32
infant- nutrition
vitamin D supplements, OTC multivitamin
solid foods- start at 6 mo
ability to sit in chair w/ good head control
start w/ iron-fortified cereal, then add pureed foods
(first exposure not always catalyze allergic rxn)
33
infant- oral health
first tooth at 4-7 mo
signs teething: fussy, inc salivation, low grade fever, difficulty sleeping
use frozen rings,
wash gums w/ soft washcloth or infant toothbrush until tooth errupts
avoid refined sugars
34
infant- colic
self limiting condition
peaks 6 wks, resolves 3-6 mo
worse in evenings
lay infant in crib when frustrated
35
BRUE- brief resolved unexplained events: s/s, and high risk
s/s- cyanosis or pallor, slowed/irreg heart beat, hyper/hypotonia, altered level of responsiveness
episodes last less than 60 sec
need to be eval by provider
high risk for more episodes when: less than 2 mo, hx of prematurity, hx 1+ BRUE
36
diaper dermatitis
```
skin breakdown around diaper region
eryhtematous and sore
SKIN FOLDS NOT AFFECTED
leave diapers off, allowing skin to dry
use zinc oxide cream
concern if odor, fever, or purulent drainage (yeast infection)
```
37
seborrhea
```
"cradle cap"
scales and erythema
resolves by 12 mo
remove scales w/ soft brush
not painful or itchy
```
38
infant- fever
temp > 100.4
only admin antipyretic if symptomatic and irritable not give < 6 mo olds
tachypnea, tachycardia common
monitor for changes in ventilation
39
toddler assessment dates-
15 mo, 18 mo, 2 yrs, 2.5 yrs, and 3 yrs
* do not ask permission
pull pinna down and back
40
toddler stage
12-36 mo or 1-3 yrs
41
toddlers- physical variants
```
all 20 baby teeth by 3 yrs
myelination brain complete at 2yrs
hand preference 2-3 yrs
diaphgramatic breathing
blood p inc and hr dec
dec stool freq.
big abdomen
wide gait, flat feet
bowed legs, lordosis
immature adaptive immunity
```
42
pain assessment- toddlers- FLACC
toddlers react to painless procedures the same as painful
| encourage use of words for pain expression
43
toddlers- physical growth
do sitting weight until 3 yrs
gain 5lb per year
measure standing height at 3 yrs
44
toddlers- communication/speech (language types)
receptive language dev faster than expressive
| understands before verbalizes
45
toddlers- echolali
repeat words w/out understanding their meaning
46
toddlers- telegraphic speech
2-3 word sentences
47
toddlers- egocentric
believe world revolves around themselves
| focused on self
48
toddlers- social/emotional dev
understand actions, can hurt others at 3 yrs
imitate beh
encourage independence
may have separation anxiety
49
toddlers- risk factors for emotional and beh problems
poverty, maternal depression, exposure to toxic substances
50
toddlers- car seats
forward-facing in 5 point harness from 2-4 yrs
| rear-facing < 2 yrs
51
toddlers- play
parallel- play alongside, not together
| do not share
52
toddlers- toys used to dev fine and gross motor skills
```
push/pull toys
tunnels
stackable blocks, large puzzles
fat crayons
household objects that can be used to make noise
*musical instruments and outside play
```
53
toddlers- sleep and consequences
```
needed for growth, dev and cog. functioning
11-13 hrs
9 hr at night, 2 naps until 18 mo
9 hr 1 nap after 18 mo
consistent bedtimes
consequences of not enough sleep-
irritability, poor beh, irritability
```
54
toddlers- discipline
```
cannot understand rules fully
approach as teaching, not punishment
reward positive beh, ignore negative
be consistent
nonphysical measures
```
55
toddlers- nutrition
```
cow milk at 1 yr
whole milk till 2yrs
use cup instead of bottle
NEVER ALLOW CUP AT NAPTIME OR BEDTIME
picky eating is common
do not force child to eat
limit milk 24 oz/day to prevent anemia
```
56
toddlers- food jags
times toddler will only eat certain foods, then sudden refuse the same foods
common around age 3
57
toddlers- toilet training
begin at 2 yrs
signs of readiness: dry for 2 hr at time, words for urine, bring clean diaper to parent, voicing discontent w/ dirty diaper
use positive reinforcement
58
toddlers- temper tantrums
```
result of receptive lang dev
can being at 1 yr
usually 2-3 yrs
use time-outs
disruption in routine and inconsistency inc occurrences
```
59
atopic dermatitis- toddlers
eczema
dry skin, extreme itching, thickened skin
id triggers and void
keep skin hydrated (can use corticosteroids)
60
toddlers- acute otitis media (risk and protective factors)
ear infection
inflamm of middle and inner ear
at risk for speech delay if freq or untreated
risk factors- exposure to tobacco smoke, exposure to o/ chldrn, birth defects
protective factors- breast feeding, pneumococcal vaccine
surgery if recurrent (myringotomy)
61
preschool stage
3-6 yrs
imagination
more coordinated
fine motor inc exponentially
62
prek- health assessment
begin to ask child questions, give choices
perform most invasive last
implement visual acuity testing at 4
pull pinna up at back at age 3
use radial pulses for heart rate assessments
63
prek- physical varients
```
20/20 vision 4-5yrs
thoracic breathing at 5yrs
daytime bladder control- 3yrs
nightime bladder control- 4-5yrs
ab muscles stronger (no alien or potbelly)
```
64
prek- pain assessment- description
able to locate pain
| cannot describe quality
65
prek- oucher scale
0-10
| six columns w/ corresponding pics for diff pain levels
66
FACES scale- prek
0-10
six cartoon faces w/ different expressions
2,4,6,8,10
67
prek- physical growth
avg 4 yr old- 40 in, 40 lb
| brain growth slows from 3-18 yrs
68
prek- speech
uses concrete lang
lang is learned through exposure to words
screen for lang delays at each check-up
69
prek- causes speech delay
```
autism
cog impairment
emotional delays
low socioeconomic status/neglect
underlying neuro disorders
```
70
prek- social dev
learn to share
| interested in basic sexuality 5-6 yrs
71
prek- emotions
have imaginary friends
cooperate more often
learn to cope w/ emotions
72
prek- comprehension of risks/safety
```
do not understand risks
like new experiences
enforce stranger and street safety
teach home addy and phone #
caution w/ choking, poisoning and firearms
```
73
prek- school readiness
```
read to children (books w/ few words)
ask open ended questions
provide structured environm w/ few choices
encourage social interaction w/ peers
if low income use headstart
```
74
prek- play
help kids articulate feelings r/t frustration and anxiety
use arts/crafts for fine motor (cutting)
learn to share/take turn (board games)
outdoor activities at least 1hr/day
75
prek- toys to avoid
lead paint, small parts, small magnets or excessive electronics.
76
prek- sleep
10-13 hrs
naps end at 4yrs
est. bedtime routine
77
prek- nightmare v night terror
nightmare- wakes up scared and wants comfort, remembers event
terror- does not remember event, can scram or thrash (don't wake up)
78
prek- discipline
use rountines/consistency
explain consequences if break rules
use time outs (1 min / year of age)
don't spank
79
prek- nutrition
three meals, 1-2 snacks
do not fix separate meals
do not force intake
1200-1400 cal/day
80
prek- lying
stems from overactive imaginations TO avoid punishment
praise kids for telling the truth
reasons for lying as kids get older
81
prek- fifth disease
```
erythema infectiosum
caused by parvovirus B19
bright red cheeks, rash on belly/back
avoid pregnant women
trtment- supportive trtmnt
```
82
prek- Hand-Foot and mouth disease
```
caused by coxsackle virus
spread fecal oral route
prevention- WASH HANDS
lesions on Hands, feet and pharynx
can have fever and pain
resolves in 1 wk
monitor for dehydration
```
83
prek- conjuncitvitis
```
pink eye
can be bacterial, viral or allergic
bacterial has purlence
viral has fluid draining
very contageous
vision changes if not treated
viral is self-limiting
```
84
school age
```
6-12
inc coord and balance
logical thinking dev
inc emphasis on peers and independence
like to participate in clubs/sports
```
85
school age- health assesment
```
annual visits 6-12 yrs
ask questions to kid but verify w/ parent
make kid sit on exam table
head-toe assessment
begin hyperlipidemia screening at 11 yrs
```
86
school age- physical varients
```
frontal sinuses fully dev age 7
tonsils hypertrophy
face elongates
fully dev respir system at 10yrs
acne can dev
```
legs/arms grow faster than the rest of the body
87
school age- tooth eruption
incisors and first molars come in first
88
puberty
monitor for precocious puberty (premature)
males dev later 9-14, testes first
females earlier 8-13 breast bud dev (thelarche)
menarche occurs 2yrs after thelarche
89
school age- pain assessment
use oucher or FACES < 7yrs
numerical rating scale > 7 yrs
non-pharm methods work good (breathing, distraction , music)
inc. cul. considerations
90
physical growth- school age
girls taller than boys at 12 yrs
intermittent growth spurts
weight varies based on diet, physical act, home environment
begin plotting BMI to check for obesity
91
school-age: gross motor
musc coordination, balance and rhythm improve
| ride bike by age 7-8
92
school-age: fine motor
improved hand eye coordination
| may become frustrated as skills dev
93
school age- communication
ability to think about lang and how it is used
reading skills inc
inc use humor
ability to think and talk about thoughts/feelings
94
metalinguistic awareness
ability to think about lang and how it is used
95
school age- social/emotional
shift away from parents and towards peers
have a bff by 7
very subject to peer pressure
kids w/ negative self esteem more prone to peer pressure
peer groups same sex
96
gender dysphoria
```
id w/ gender not same as biological sex
first seen in 9-10 yr olds
can be short or long term
just bc individual has confusion at school age does not mean the dysphoria will continue on into adulthood
could change later in life
```
97
school age- sleep
9-12 hr
only use bed for sleep
no electronics before bed
consistent times
98
school age- good sleep associated w/
improved academics
improved beh
overall better mood
healthy immune system
99
school-age: discipline
teach societal rules
understand rules/consequences
remain consistent
100
school age- nutrition
encourage family eating together
have kids help
explain benefits of healthy breakfast
monitor ca and vitamin D (effects mental health, bone dev and immune system)
101
school refusal
5-7 and 12-14 yrs
multiple short absence or one prolonged absence
may be assoc. w/ life stressors
use multidisciplinary approach
102
school age- cheating/stealing
can be result of peer pressure, competitiveness
kids w/ siblings more likely to cheat
understand ownership and property at 7yrs old
103
school age- pharyngitis/ tonsiliitis
viral or bacterial
s/s- sore throat
strep pharyngitis can have sandpaper-like rash
trt w/ antibodies
tonsillitis (viral)
tonsillar hypertrophy can lead to sleep apnea and airway obstruction
