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MSS - PCM 2 Exam 1 > Pediactric Exam 1 - Birth to Infancy > Flashcards

Pediactric Exam 1 - Birth to Infancy Flashcards

(92 cards)

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1
Q

well child exams

A

physical development
cognitive development
social/emotional development

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2
Q

newborn

A

0-28 days

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3
Q

infancy

A

0-12 months

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4
Q

toddler/early childhood

A

1-4 years

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5
Q

school-aged/middle childhood

A

5-10 years

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6
Q

adolescence

A

11-20 years

further separated to early, middle, and late

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7
Q

development and health of child

A

affected by physical, social, emotional factors, and disease

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8
Q

APGAR

A 
appearance
pulse
grimace
activity
respiratory effort

measured at birth - looks at neurologic recovery
-at 1 minute and 5 minutes

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9
Q

appearance score?

A

blue, pale = 0
pink body, blue extremities = 1
pink all over = 2

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10
Q

pulse score

A 
absent = 0
100 = 2
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11
Q

grimace score

A

aka reflex irritability

no response = 0
grimace = 1
crying, sneezing, coughing,

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12
Q

4 principles of child development

A

1 predictable pathway
2 wide range of normalcy
3 physical, social, environmental, disease all affect
4 childs level determines how you H and P

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13
Q

activity score

A

flaccid = 0
flexion of arms/legs = 1
active movement = 2

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14
Q

respiratory effort score

A 
absent = 0
slow/irregular = 1
good/strong = 2
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15
Q

levels at 1 minute

A

0-4 - severe depression
5-7 - some NS depression
8-10 - normal

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16
Q

levels at 5 minutes

A

0-7 - high risk for CNS and other organ system dysfunction

8-10 - normal

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17
Q

hospital evaluation

A

within 24 hours of delivery

  • review moms hx
  • review delivery record
  • full head-to-toe exam
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18
Q

given after delivery

A

erythromycin - eyes prevent infection

vitamin K - injection to prevent bleeding

full bath

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19
Q

gestational age and birth weight

A

help preduct medical problems in future

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20
Q

gestational age

A

neuromuscular sign and physical characteristics that change with gestational age

ballard scoring system

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21
Q

ballard scoring system

A

neuromuscular maturity
-1 to 5

physical maturity
-1 to 5

add numbers together to determine gestational age

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22
Q

preterm

A

< 37 weeks

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23
Q

term

A

37-42 weeks

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24
Q

post term

A

> 42 weeks

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25
extremely low birth weight
<1000 grams
26
very low birth weight
<1500 grams
27
low birth weight
< 2500 grams
28
normal birth weight
> or = 2500 grams
29
small for gestation age
SGA | <10th percentile
30
appropriate for gestational age
AGA | 10-90th precentile
31
large for gestational age
LGA | >90th percentile
32
neonate feeding
every 3 hours - breast feeding - initial colostrum - milk come in after 2-3 days
33
colostrum
initial small volume of breast milk
34
formula
15-30 ml (0.5-1 ounce)
35
weight change
normal to lose up to 10% of body weight | -should regain after 10-14 days
36
voiding regularity?
3-4 /day in 1-3 days | day 4-5 - should see 6-8/day
37
meconium
initial stool -first 24 hours dark, black, tarry
38
breast fed stool
yellow, seedy
39
formula fed stool
green/yellow
40
initiate phototherapy
levels high or rising quickly | >5mg/dl per day
41
jaundice
elevated bilirubin prior to 24 hours no good | -more than just physiologic jaundice
42
high risk bilirubin zone
repeated 4-8 hours
43
high intermediate bilirubin risk zone
repeated 8-12 hours
44
low-intermediate bilirubin risk zone
repeated within 48 hours
45
low risk bilirubin zone
3-5 days
46
hospital discharge
vaginal 48 hours | c section 3 days
47
prior to discharge of newborn
hep B hearing screen newborn screening blood test circumcision, if desired
48
follow up care after delivery
24-48 hours after discharge
49
well child visits
continued assessment of growth as infant ages - immunizations - parent information - parent questions
50
components of well child visit
``` HPI -feeding, stooling, voiding, sleeping, development, safety, parental concerns PMH -med problems, injuries, hosp, surgery Meds Allergies Fam Hx Social Hx ```
51
well visit intervals
``` 3-4 days of life - growth only 2 weeks (with screen #2) 1 month 2 month 4 month 6 month 9 month - Hg 1 year ``` all look at growth and development
52
growth review
weight length head circumference
53
growth chart
need 3 points | -look at trend
54
development through infancy
physical - fine/gross motor language/cognitive personal/social
55
physical development
central to peripheral gross to fine motor head control > trunk control > arms > legs > hands and fingers
56
language development
2 month cooing 6 months babbling 1 year 1-3 words
57
cognitive development
cause/effect, object permanence, use of tools 9 months - recognize strangers, seek comfort from parent during exam, actively manipulate object
58
personal social development
understanding self and family matures bonding/attachment to caregivers temperament - adaptability to changes, variable
59
gross motor milestones
large groups to sit | stand, walk run, balance
60
fine motor milestones
drawing, eating, dressing, playing, writing
61
language milestones
speaking, body language and gestures, communicating, understanding
62
cognitive milestones
problem solving, reasoning, remembering
63
social milestones
interacting with others, friends, family, teachers, cooperating
64
at 9 months
no more exam on table - do it on parent lap
65
exam sequence for infant
heart/lung first | HEENT last
66
head circumference
measured up to 3 years (36 months) shape, symmetry, tilt, lesions, hair
67
respiratory infant exam
signs of distress - nasal flaring, retractions, accessory muscles auscultate lung fields
68
blood pressure in child
not measured in child < 3 years
69
pulse in infant
brachial and femoral | -compare B/L
70
CV don't miss
benign murmurs
71
GI don't miss
``` normal: no spleen palpable can feel kidney anal fissures liver tip palpable below costal margin ```
72
GU infant exam
descended testicles B/L swelling of testicles normal inguinal or femoral hernias don't miss labial adhesions
73
neuro exam infant
cranial nerves strength/muscle tone deep tendon reflexes primitive reflexes
74
palmar grasp reflex
birth to 4 months | -grasp finger
75
plantar grasp reflex
birth to 9 months | -toes curl
76
moro reflex
birth to 4 months startle reflex -lower quickly - arms abduct and extend, hands open, legs flex, maybe cry
77
asymmeric tonic neck reflex
birth to 4 months supine, turn head to one side with jaw over shoulder arm/leg same side extend opposite side flex
78
positive support reflex
birth to 2 month or 6 months feet touch surface -hip, knee, ankle extend, partial weight bearing
79
rooting reflex
birth to 3-4 months | stroke corner of mouth - turns head toward stimuli
80
galants reflex
birth to 3 months galants stoke one side of back - spine curves toward stimuli
81
placing/stepping reflex
one foot on surface -hip/knee that foot flex and other foot step forward birth to variable disappear
82
landau reflex
suspend prone -head up and spine straigten birth to 6 months
83
parachute reflex
suspend prone, slowly lower head arms/legs extend in protective fashion 4-6 months - doesn't disappear
84
infant hip exam
barlow and ortolani maneuvers -for signs of dislpcation can indicate developmental hip dysplasia effective until around 3 months -look for other signs - galeazzi
85
ortolani test
test for posteriorly dislocated hip will relocate the hip finger anterior pressure
86
barlow test
test for ability to sublux or dislocate hip -indicates intact but unstable hip press hip posteriorly, to dislocate hip
87
galeazzi test
flex knees, feet to butt measure heights of knees lower is posterior dislocated hip
88
HEENT exam in infant
big difference - sutures and fontanelles red reflex in eyes
89
fontanelles
anterior - closes later (18 mo - 2 yr) posterior - closes early (1-2 mo) should be soft and flat
90
red reflex
light on retina - should reflect red light - symmetrical reflection with light 18 inches away
91
epstein pearls
mucus cyst in mouth | -normal
92
immunizations 0 - 6 years
hospital - hep B office - RV, DTaP, HIB, PCV, IPV, influenza, MMR< varicella, Hep A lots 2 months, 4 months, 6 months - RV, DTaP, HIB, PCV, IPV

MSS - PCM 2 Exam 1 (7 decks)

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