Pediatrics- Normal Flashcards
(161 cards)
1
Q
Most rapid Growth
A
Infant
2
Q
Preterm Weeks
A
28-32wks
3
Q
Preterm Characteristics
A
Frog leg/ Lax Position
Hypotonic Muscle Tone
Square Window Wrist
Scarf sign (elbow passes midline)
Heel to ear sign
Abundant Lanugo
Prominent Labia Minora
Prominent Labia Majora
Prominent Clitoris
4
Q
Post-term weeks
A
> 42wks
5
Q
Post-term characteristics
A
Old man’s face (classic sign)
Desquamation ( peeling of the skin) / (extreme dryness starting from the sole and palm)
6
Q
Normal birth weight
A
2.5-4kgs
7
Q
Weight doubles at
A
6months
8
Q
Weight Triples at
A
12months
9
Q
Weight quadruples at
A
2 and 1/2 years
10
Q
Normal measurements in Newborn
Length:
Head Circumference:
Chest Circumference:
A
Length: 46-54cm
Head Circumference: 33-35cm
Chest Circumference: 31-33cm
11
Q
Neonate in Nursing
A
- Upon receiving- proper identification
- Take anthropometric measurements
- Bath the baby. Full bath if mom is (+) Hepa
- Dress umbilical cord
- Adm. Credes Prophylaxis
- Adm. Vit. K
- Take weight
12
Q
Indication of 2 Vein and 1 Artery in Neonate
A
Suspect Kidney Malformation
13
Q
Indication of 2 Vein and 1 Artery in Neonate
A
Suspect Kidney Malformation
14
Q
Failure of the umbilical cord to fall between the first 7th-10th day
A
Umbilical Granulation
15
Q
30mL blood loss from umbilical cord
A
Ompalagia
16
Q
What drug is adm for umbilical granulation
A
Silver nitrate
17
Q
What does failure of startle/Moro reflex to disappear at 5-6months indicate
A
Brain damage
18
Q
Persistent Primitive Reflex
A
Cerebral Palsy
19
Q
Rapid eyelid closure when strong light is shown
A
Blink reflex
20
Q
Baby grasps solid objects placed on palm
A
Palmas Grasp Reflex
21
Q
Purpose of palmar grasp reflex and when does it normally disappear
A
To Cling to mother for safety
D: 6wks - 2months
22
Q
Neonate places on a vertical position with their face touching a hard surface will take few quick alternating steps
A
Step in/ Walk in Place Reflex
23
Q
Almost the same with step in reflex only that you are touching anterior surface of a newborn’s leg
A
Placing Reflex
24
Q
When newborn lie on their backs, their heads usually turn to one side or the other. The arm and the leg on the side to which the head turns extend, and the opposite arm and leg contract.
A
Tonic- neck reflex
25
When an object touches the sole of newborn’s foot at the base of toes, the toes grasp in the same manner as finger do
Plantar grasp reflex
Disappears at 8-9 months in preparation for walking
26
Test for neurological integrity (jarring crib loud voice) assume a letter C position
Moro Reflex
Disappear at 4-5months
27
When there is pressure at the sole of the foot, the baby pushes back against the pressure
Magnet Reflex
28
When the sole of the foot is stimulated by a sharp object, it causes the foot to rise and the other foot extend (test for spinal cord integrity)
Crossed Extension Reflex
29
While in prone position and the para vertical area is stimulated, it causes flexion of the trunk and swing his pelvis toward the touch
Truck Incurvation Reflex
30
While prone position and the trunk is being supported, the baby exhibit muscle tone
Landau Reflex
-Test for muscle tone and present by 6-9months
31
While on ventral suspension with the sudden change of equilibrium, it causes extension of the hands and the legs
Parachute Reflex
- present by 6-9months
32
When the sole of foot is stimulated by a inverted “J”, it cause fanning of the toes
Babinski Reflex
- disappear by 2months but may persist up to 2years
33
Immediate Care of Newborn
1. Initiation and maintenance of respiration
2. Establishment of extrauterine circulation
3. Control of body temperature
4. Intake of adequate elimination
5. Establishment of waste elimination
6. Prevention of infection
7. Establishment of an infant-parent relationship
8. Development care that balances part and stimulation for mental development
34
Lung function begins
After birth
35
Baby’s head position to facilitate drainage
Side
36
Suction what first?
How many seconds is suctioning
Nose
5-10s
37
Prolong deep suctioning may result to
Hypoxia, bradycardia, and laryngospasm
38
If suctioning is not effective, then?
Laryngoscopy. Then ET is inserted
39
After ET insertion due to airway problems in neonate, what is the pressure and the percent of 02
Positive pressure bag
Mask with 100 % at 40-60 bpm
40
Overdose of oxygen
Retrolental fibroplasia (retinopathy of the prematurity)
Scarring
41
Never adm. O2 when meconium stained because it will force the meconium to the alveolar sac causing
Atelectasis
42
Circulation is initiated by ______ and is completed by _____
Pulmonary ventilation
Cutting of umbilical cord
43
Pressure on left of the heart causes closure of the
Foramen Ovale
44
2 ways to facilitate closure of foramen ovale
1. Tangential foot slap
2. Proper positioning - right side lying
45
Foramen ovale closes at
24hrs complete by 1year
46
Ductus arteriosus closes at
24hrs complete by 1 month
47
Ductus venosus closes at
2months
48
Umbilical arteries
2-3months
49
Umbilical vein
2-3months
50
Best position after birth
Nsd: trendelendberg
Cs: supine or crib level position
51
Signs of Inc ICP
Abnormally large head
Bulging and tense Fontanel
Projectile vomiting ( surest sign of cerebral irritation)
Inc BP but widening pulse pressure
Dec RR
Dec PR
High pitch shrill cry (late sign)
Diplopia ( sign of ICP from 6month to 1 year old)
52
Hypothermia in preterm and sga leads to
Hypothermia and cold stress
53
Factors leading to hypothermia
Poikilothermic (babies are born cold blooded)
Inadequate subcutaneous fats
Not capable of shivering
Born wet
54
Process of heat loss
Evaporation
Conduction
Convection
Radiation
55
Body to air
Evaporation
56
Body to cold solid object
Conduction
57
Body to cooler surrounding air
Convection
58
Body to cold object and in contrast with body
Radiation
59
Effects of hypothermia
Hypoglycemia
Metabolic Acidosis
High risk for kernicterus
Additional fatigue due to stressful heart
60
Prevention of cold stress
Dry and wrapped newborns
Mechanical Measures
Prevent unnecessary exposure
Use tin foil in absence of electricity
Embrace baby (kangaroo care)
61
Due to catabolism of brown fats
Metabolic Acidosis
62
Mechanical measures
Radiant measures
Isolette
63
Square acrylic sided incubator, must be preheated first
Isolette
64
When to breastfeed
Nsd:
CS:
NSD: immediately
CS: after 4hrs
65
When is colostrum present on CS
3rd Trimester
66
Dec. level of _____ and ______ stimulates the _____, that stimulates the ____ of the _____ (alveoli) to produce the foremilk store in _____
Estrogen and progesterone
Anterior pituitary gal d
Prolactin
Acinar cells
Lactiferous tubules
67
Advantages of breast milk
Very economical
Always available
Promotes bonding
Helps in rapid involution
Decrease incidence of breast cancer
Breast fed babies have higher IQs
It contains anti body (IgA) lactobacillus bifidus that interfere attach of pathogenic bacteria in GIT
Contains macrophages
68
Breasmilk available for 2 days after delivery
Colostrum
69
COlostrum contains
Low fat
Low carbohydrates
High protein
High fat-soluble vitamins
High immunoglobulin
High minerals
70
4-14 days breasmillk
Transitional
71
Transitional breastmilk contains
High Lactulose
High minerals
High water-soluble vitamins
72
Breastmilk available for 14 days and above
Mature Milk
73
Mature Mill contains
High Fats
High Carbohydrates
Low Protein
74
Linoleic acid responsible for integrity and development of skin
High fats in breastmilk
75
Lactose, easily digested responsible for sour milk smelling odor of stool
High carbohydrate in breasmilk
76
Protein in breastmilk
Lactalbumin
77
Disadvantages of cow’s milk and breast milk
No iron
Possibility of HIV and Hepa B transmission
Father cannot feed/ bond as well
78
Contents of cow’s milk
High fat
Low carbs
High protein
High minerals
High phosphorus
79
Cow’s milk content in protein that has a courd that is hard to digest
Casein
80
Cow milk content that has traumatic effect on baby’s kidney
High minerals
81
Position for breast feeding
Upright sitting
82
Touch side of lips or cheek and baby will turn to stimulus
Rooting reflex
Purpose- to look for food
83
When does rooting reflex disappear
6weeks because can already feed
84
By touching the mouth of lip then baby will suck
Sucking
85
Purpose of sucking
Take in food
86
Disappear when not stimulated
Sucking
87
Food touches posterior portion of tongue automatically swallow
Swallowing Reflex
88
Food touches anterior portion of tongue and tongue automatically extrude/ protrude
Extrusion/ Protrusion Reflex
89
Purpose of extrusion/ protrusion reflex
Prevent for food poisoning
90
When does protrusion/ extrusion reflex didappear
4months because can already spit
91
When does protrusion/ extrusion reflex didappear
4months
92
Criteria of effective sucking
Baby’s mouth is hike well up to areola
Mother experiences after pain
Other nipple is flowing with milk
93
Breast feeding techniques
Begin 2-3mins/ breast
Inc 1min/ day each breast until you reach 10mins each breast or 20mins/ feeding
94
Proper emptying
Feed baby on the last breast that you fed him
95
Problems in breastfeeding
Engorgement
Sore nipple
Mastitis
96
Management for engorgement
Warm compress
97
Sore nipple manangement
Exposure to air or 20watt bulb
Avoid wearing plastic liner bra, instead wear cotton bra
98
Physiologic stool passed within 24-36hrs
Meconium
99
Meconium characteristics
Blackish free
Odorless
Sticky
Tar like
No bacteria
100
Failure to pass Meconium
Suspect GIT obstruction
-hirschsprung
-imperforate anus
-Meconium ileu (cystic fibrosis)
101
Transitional stool caharacteristic
Green
Loose
Slimy
102
Stool that Appears to be slight diarrhea to the untrained eye
Transitional stool
103
Breastfed stool characteristics
Golden yellow
Soft
Mushy with sour milk smelling odor
104
Bottle fed stool
Light yellow
Formed, hard with typical offensive odor
Passed 2-3times/ day
105
W/ supplementary food added stool
Brown
Odorous
106
Light stool
Jaundice baby
107
Bright green
Phototherapy
108
Mucous mixed with stool
Allergy
109
Clay colored
Obstruction to bile duct
110
Chalk clay/ whitish clad
Barium enema
111
Black stool
GIT hemorrhage
112
Blood flecked
Anal fissure
113
Red currant jelly
Intususception
114
Ribbon-like
Hirschsprung
115
Steatorrhea in stool
Fatty, bulky, foul smelling
Suspect malabsorption
Cystic fibrosis or celiac disease
116
HR of N
110-180
117
I HR
110-160
118
T HR
80-110
119
P HR
70-110
120
S HR
65-105
121
A HR
60-100
122
N HR
30-60
123
I RR
30-60
124
T RR
24-40
125
P RR
22-34
126
S RR
18-30
127
A RR
12-18
128
N systolic BP
60-90
129
I systolic BP
70-105
130
P systolic BP
90-110
131
S systolic BP
97-120
132
A systolic BP
110-130
133
N diastolic BP
20-60
134
I diastolic
35-55
135
T diastolic BP
40-65
136
P diastolic BP
45-70
137
P diastolic BP
45-70
138
S diastolic BP
55-70
139
A diastolic BP
65-80
140
Rectum temp
36.6 - 38 degrees C
141
Rectum temp
36.6 - 38 degrees C
142
Oral temp
35.5 - 37.5
143
Axillary temp
36.5- 37.5
144
Eat temp
36.7-38.0
145
Austrian neurologist
Founder of psychoanalysis
Sigmund Freud
146
Mouth Site of gratification
Oral Phase (0-18months)
147
Oral Phase
Biting, crying, sucking
Provide oral stimulation
Never discourage thumb sucking
148
Under satisfied oral phase
Dependent
Passive
They love kissing more than sex
Antisocial
Stubborn
Nail biting
Drinking
Suspicious person
Pessimistic
Envious
Smoking
149
Oversatisfied oral phase
Full of admiration
Optimistic
Gullible
150
Sigmund Freud theory
Psychosexual Theory
151
Psychosexual Theory
Oral Phase (0-18months)
Anal Phase (18-3yrs)
Phallic Phase (4-6yrs)
Latent Phase (7-12yrs)
Genital Phase (12-18yrs)
152
May show exhibitionim
Phallic Phase
153
Male to mother attachment
Oedipus
154
Female to father
Electra Complex
155
Holding on in anal phase
Child wins, hard headed, antisocial, and stubborn
156
Holding on in anal phase
Mother wins > kind, perfectionist, obedient, obsessive compulsive
157
Strict toilet training (Anal Retentive)
Kind
Perfectionist
Obedient
Very organized
Punctual
158
Lenient (anal expulsive)
Messy
Destructive
Rebellious
Disorganize
Wasteful
Hard headed
159
Period of suppression
Latent Phase
160
Achieved sexual maturity
Genital Phase
161
Achieved sexual maturity
Genital Phase
