MidTerm Material

Question 1

Lag warning signs @ 6m

–General:

Answer 1

• -no smiling
• -jerky/spastic movements
• -does not recognize parents

Question 2

Lag warning signs @ 6m

–Hearing & speech

Answer 2

• -failure to turn toward sound

- -does not laugh, squeal, or vocalize sounds

Question 3

Lag warning signs @ 6m

–Vision

Answer 3

–failure to fix or follower & far objects

Question 4

Lag warning signs @ 6m

–Arms:

Answer 4

• -failure to keep head steady when pulled to sitting position
• -persistent fisting
• -failure to push up or roll over

Question 5

normal child developments

3/4/6/9/11/12m

Answer 5

3 = hold head up
4 = roll over
6 = sits up w/ help & grabs things
9 = ~crawl/ sits
11 = stands & throws ball
12 = walk/crawl freely

Question 6

history taking tips

Answer 6

• -open ended Q’s
• -connect w. parents & child
• -periodically summarize info
• -ask “is there anything else I should know”

Question 7

Ill infant

Answer 7

• -fever, vitals, rash? and SEARCH signs, mental status abnormalities
• -growth normal?? *anterior frontanelle
• -BM 1/2 to 3-6/day, urine 6-8 wet dipers/day, feeding 2-4 hours

Question 8

caput succedaneum =

Answer 8

• -diffuse swelling of soft tissues
• -extends across suture lines
• -disappears w/in first few days of life

Question 9

cephalohematoma-subperiosteal hemorrhage

Answer 9

• -never crosses suture lines
• -visible swelling
• -may not be visible for a few hours
• -disappears in ~6wks

Question 10

languo =

Answer 10

fine body hair on shoulders, forehead, and back

Question 11

milia-

Answer 11

small white papules on nose, cheeks, and chin

Question 12

erythema toxic =

Answer 12

macular eruption common in light skin newborns

– ~1 wk

Question 13

stork’s bite-birthmark

Answer 13

upper eyelids, forehead, nape of neck.

–disappear by 1 year

Question 14

mongolian spots

Answer 14

• -dark blue
• -lower back/butt
• -MC = darker complexioned infants of all races
• -disappear w/in first 4 years

Question 15

primitive reflexes

Answer 15

• -grasp
• -magnet
• -rooting
• -sucking
• -babinski
• -galant
• -moro
• -fencer
• -placing
• -stepping

Question 16

grasp

-primitive reflexes

Answer 16

• -finger in infant’s palm = they grab it.
• -grabs stronger as finger is pulled upward.
• -disappears by 2-4m

Question 17

Magnet

-primitive reflexes

Answer 17

–placing a finger just proximal to the toes on the sole of the foot
(btw ball of foot & toes)
–causes toes to flex around the finger
–disappears by 2-3m

Question 18

Rooting [awake]

-primitive reflexes

Answer 18

touch corner of infant’s mouth = lower lip drops ipsilaterally & tongue moves towards stimulus.
–disappears by 3-4m

Question 19

Sucking

-primitive reflexes

Answer 19

placing something in the mouth = baby sucks

Question 20

babinski

-primitive reflexes

Answer 20

–firm stroke from heel toward the toes
= great toe to flex up & other toes fan out
NORMAL in kid <18m
…past = pyramidal tract lesion

Question 21

Galant

-primitive reflexes

Answer 21

• -stroking the infant’s paravertebral skin causes lateral flexion of the trunk toward the ipsilateral side
• -disappears 2-3m

Question 22

Moro

-primitive reflexes

Answer 22

–allowing the infant’s head to drop back suddenly causes abduction and upward movement of arms, followed by adduction & flexion
–disappears <4m
…maybe brain damage or brachial plexus

Question 23

Fencer

-primitive reflexes

Answer 23

(asymmetric tonic neck)

• -supine
• -rotate head to one side causes ipsilateral ext of the extremities & contra flex of the extremities
• -Disappears by 3-4m

Question 24

Placing

-primitive reflexes

Answer 24

–stroking the anterior tibia or dorm of the foot against a table causes the infant to raise the leg as if to step onto the table

Question 25

denver development chart =

Answer 25

- -gross motor - -fine motor - -personal-social - -language

Question 26

growth chart =

Answer 26

- -height - -weight - -head circumference

Question 27

APGAR =

Answer 27

- -appearance-color - -pulse-heart rate - -grimace-reflex irritability - -activity-muscle tone - -respiratory effort

Question 28

stepping | --primitive reflex

Answer 28

holding the infant upright & leaning slightly forward causes alternate flexion & extension of the legs which mimics walking. --disappears by <3m

Question 29

Newborn screening tests

Answer 29

- -PKU - -Sickle cell anemia - -congenital hypothyroidism - -galactosemia - -biotinidase deficiency - -congenital adrenal hyperplasia - -cystic fibrosis - -hearing loss

Question 30

PKU-babies:

Answer 30

= cannot process phenylalanine | --w.o Tx = build up of phenylalanine in blood & causes brain damage & mental retardation

Question 31

SIDS prevention

Answer 31

- -place baby on back on firm, tight fitting mattress - -remove all pillows, quilts & comforters - -never put baby to sleep in waterbed, sofa, soft mattress, pillow...etc. - -if at risk: there are monitoring devices for heart & respiratory rate to use while baby sleeps

Question 32

infant colic syndrome

Answer 32

excessive, inconsolable crying episodes in a healthy infant. - -0-3months old - ->3hrs/day - ->3hrs/wk - ->3 weeks - -usually occurs at the same time each day.

Question 33

possible nursing advice

Answer 33

- -keep infant in upright position during feeding - -burp more often - -nursing more often: small & frequent - -keep the infant in an upright position about 30 mins after feeding

Question 34

pyloric stenosis

Answer 34

- -congenital stenosis of valve b/w ST & SI - -linked to poor neuromuscular control & poor breastfeeding - -projectile vomiting from 1st wk/m up until 5m - -immediate referral...surgical approach may be needed

Question 35

intussusception

Answer 35

- -intestines are more mobile in infancy and can fold in on itself causing obstruction - -MC cause of bowel obstruction in <2y.o.

Question 36

dehydration

Answer 36

- -signs: loss of skin turgor, dry mucous membranes, depression of anterior fontanelle. - -diarrhea-feed babies over 6m the "BRAT" diet which is bananas, rice, applesauce, toast

Question 37

doll eye relfex

Answer 37

3m

Question 38

clonus

Answer 38

<4m

Question 39

palmar grasp

Answer 39

3-4m

Question 40

blink reflex

Answer 40

3-6m

Question 41

plantar grasp

Answer 41

8-10m

Question 42

rooting [asleep]

Answer 42

7-8m

Question 43

plantar grasp

Answer 43

8-10m

Question 44

sucking

Answer 44

10-12m

Question 45

Heart Rate =

Answer 45

120-140 sleeping = 100 crying = 180

Question 46

respiration

Answer 46

30-60

Question 47

blood pressure

Answer 47

systolic = 60-80 | diastolic 40-50