Peds Growth and Development

Question 1

What measurement are the best indicators of general health

Answer 1

serial measurements

Question 2

What helps identify children at risk

Answer 2

failure to conform to expected patterns of growth

Question 3

When are well child checks preformed

Answer 3

• 2 weeks and/or 1 month
• 2, 4, 6 mos
• 9 mo
• 12, 15 mos
• 18 mos
• 2 yrs
• annually after 2
• 4 yo

Question 4

In premature infants, when does catch-up growth occur

Answer 4

the first 2-3 years of life

Question 5

What should be measured at all office visits

Answer 5

• weight
• height
• head circumference (under 2)

Question 6

3 different growth charts

Answer 6

• newborn (based on gestational age)
• birth to 3 years
• 2 years to 18 years

Question 7

What special growth charts are there

Answer 7

• turner syndrome
• down syndrome
• other syndromes
• prematurity

Question 8

Can expect weight loss when? How much

Answer 8

during the first 3-4 days of life, about 10%

Question 9

When should infants regain their birth weight by

Answer 9

day 14

Question 10

How should infants be weighted

Answer 10

only wearing a dry dipaer

Question 11

How much weight should a child gain a month (up to 3 years)

Answer 11

0-3 mnth: 1kg
3-6 mnth: 0.6 kg
6-9 mnth: 0.5 kg
9-12 mnth: 0.4kg
1-3 yrs: 0.25 kg

Question 12

How much should a child grow a month (up to 6 years old)

Answer 12

0-3mnths: 3.5 cm
3-6mnths: 2cm
6-9mnth: 1.5 cm
9-12 mnth: 1.2 cm
1-3 yrs: 1cm
4-6 yrs= 3cm /yr

Question 13

Head circumference in an indicator of what

Answer 13

brain growth up to 2 years old

Question 14

When do most cranial sutures close

Answer 14

by 6 months

Question 15

BMI greater than what is a risk factors for obesity

Answer 15

greater than 95%

Question 16

When should children be tested for lead

Answer 16

between 9 and 12 months and again at 2 and 3

Question 17

When should children be tested for iron deficiency

Answer 17

Hgb or Hct at 12 months and again at 2,3,4,5 and 6 years

Question 18

When is STD testing started? When is HIV testing started

Answer 18

STD: 11

HIV: 16-18

Question 19

What is the definition of development

Answer 19

the acquisition of skills considered appropriate for a given age, based on population standards

Question 20

What is the importance of developmental screening

Answer 20

• identify delays and their etiologies
• maximize potential of a child with appropriate interventions when available
• provide support and reassurance to the family

Question 21

Four parts of development

Answer 21

gross motor

fine motor

language

social

Question 22

When does the greatest progress of gross and fine motor skills occur

Answer 22

during the first 3 years of life

Question 23

Gross motor and fine motors skills during the first year

Answer 23

rapid acquisition of gross and fine motor skills

Question 24

Gross motor and fine motor skills at 12 months to 3 years

Answer 24

• reaction time quickens

- improved hand eye coordination and manual dexterity

Question 25

Gross motor and fine motor skills at 4 years and older

Answer 25

- large muscle movement and coordination are being perfected | - fine motor skills are gradually improving

Question 26

Early gross motor milestones? When do they occur

Answer 26

rolls back to stomach: 4-10 months sits steadily: 6-9 months pulls to standing: 7-12 months stands alone: 9-16 months

Question 27

Complex gross motor patterns and when they occur

Answer 27

``` walks well: 13 months stoops and recovers: 15 months kicks ball forward: 2 years throws ball overhand- 3 years balances on 1 foot- 4 years catches a ball- 5 years ```

Question 28

Fine motor skills and when they occur

Answer 28

rake: 5-7 months radial digital grasp between side of index finer and thumb: 8-10 months perfection of pincer grasp: 10-12 months scribbles: 15 months vertical or circular strokes, tower of 6 cubes: 24 months

Question 29

Two universal hearing screening tests

Answer 29

Auditory brainstem response (ABR) Otoacoustic emissions (OAE)

Question 30

What population is the ABR used in? How does it work?

Answer 30

used in newborns and infants -sounds are played into the baby's ears and the brains response to the sound is measured

Question 31

What is the OAE used for? In who? How does it work?

Answer 31

in newborns and infants to assess cochlear fx -sounds are played into the ear and cochlear response is measured

Question 32

What questions to ask parents about their childs hearing at 0-3 months. 4-6 months. 7-9 months.

Answer 32

0-3: does your baby startle to loud noises? 4-6: does your baby turn his eyes or head at the sound of your voice 7-9: does baby make string of sounds like "ba ba ba, da, da, da"

Question 33

What is the number one cause of speech delay

Answer 33

hearing loss

Question 34

When should you refer a child for a profession speech or language assessment

Answer 34

- not talking by 2 years old - unintelligible speech by 3 - no sentences by 3 - child is embarrassed by their speech at any age - other known disorder is present such as mental retardation, hearing loss, autism, dysarthia, stuttering

Question 35

Assessment of vision in infants

Answer 35

- red reflex - eye alignment - eye movements

Question 36

Assessment of vision in older children

Answer 36

observe how they fixate and track until more formal vision testing can be done (after age 3)

Question 37

What does the corneal light reflex help assess for

Answer 37

misalignment of the eyes

Question 38

How to check for strabismus?

Answer 38

cover/uncover test

Question 39

Vision in a full term newborn

Answer 39

focuses on face and briefly track objects

Question 40

Vision at 1 month

Answer 40

follow a moving object 60 degrees horizontally and 30 degrees vertically

Question 41

Vision at 2 mnths

Answer 41

track across midline, responsive smile, follows movement 6 feet away

Question 42

Vision at 3 months

Answer 42

track 180 degrees, looks at hands

Question 43

Vision at 4-5 months

Answer 43

reaches for object 12 inches away, notices raisin 1 foot away, familiar smile

Question 44

``` Personal social skills for: 2 mos 6 mos 9 mos 12 mos 18 mos 2 years 4 years ```

Answer 44

``` 2 mos: social smile 6 mos: reaches for objects 9 mos: feeds self, passes object hand to hand 12 mos: plays appropriately with toy 18 mos: drinks from cup 2 years: uses spoon 4 years: puts on t shirt ```

Question 45

What is the pneumonic for communicating with children

Answer 45

ONE VOICE O: one voice should be heard during the procedure N: need parental involvement E: educate patient before the procedure about what is going to happen V: validate child with words O: offer the most comfortably, non threatening position I: individualize your game plan C: choose appropriate distraction to be used E: eliminate unnecessary people not actively involved with the procedure

Question 46

What is something you need to take into account when assessing an infant;s growth and development

Answer 46

if they were premature or not and the degree of prematurity they may only have the skills appropriate to their gestational age

Question 47

Three leading causes of death in adolescents

Answer 47

- unintentional - suicide - homicide

Question 48

Four questions to ask in a suicide triage

Answer 48

- in the past few weeks have you wished you were dead? - in the past few weeks, have you felt that you or your family would be better off f you were dead? - in the past week, have you been having thoughts about killing yourself - have you ever tried to kill yourself?