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Flashcards in Peds Unit II Deck (75):
1

Weight gain at 6 months

Double (1.5 lb/ month 1st 6 months)

2

Weight gain at 12 months

Triple (3/4-1 lb/ month for 2nd 6 months)

3

Height increase at 12 months

50% (1 inch/ month first 6 months, 1/2 inch per month for second 6 months)

4

Posterior fontanel fuses how many months after birth?

2 (triangular shaped)

5

Anterior fontanel fuses how many months after birth?

12-18 (diamond shaped)

6

What does a normal fontanel look like?

soft/ flat

7

Infants are obligatory....

nose breathers. (abdominal breathing)

8

Bp difference from utero to birth

70/55 to 90/55

9

HR difference from utero to birth

HR slows from 120 to 80

10

When hemoglobin decreases with decreased RBCs at 2-3 months

physiologic anemia

11

This cannot be digested until 4-6 months

Complex CHO (good carbs) amylase/ lipase/ trypsin enzymes must be increased

12

Rule for determining # teeth appropriate for age

age in months -6 = number of teeth

13

Most immature system at birth

Liver: difficulty with bilirubin (hyperbilirubinemia

14

What must never be given to a newborn due to immature kidneys

Potassium

15

Hand/ finger play and toys 1 month

grasp reflex (rattle) hands are closed

16

Hand/ finger play and toys 2-3 months

almost voluntary grasp, hands open, have hand regard, startle reflex fading

17

Hand/ finger play and toys 4-5 months

plays with hands, hands to mouth, grasp voluntary, use textured toys

18

Hand/ finger play and toys 6-7 months

holds bottle, feeds self crackers
transfers objects between hands, unidextrous
has repetitive movements
peek-a-boo, large toys/ moveable parts, noise-makers

19

Hand/ finger play and toys 8-9 months

start pincer grasp, can start finger foods
releases objects, claps (pat-a-cake)

20

Hand/ finger play and toys 10-12 months

strong pincer grasp, large crayons, turn pages of books, squeeze toys
attempts to stack 2 blocks but fails: large puzzles, nested blocks
can pick up cheerios

21

Gross motor skills 1 month

moves head side-to-side, marked head lag, weakest head will be

22

Gross motor skills 2-3 months

lifts head 45 degrees when prone, increased head control
slight bobbing, use infant swing

23

Gross motor skills 4-5 months

raises head and chest to 90 degrees, slight head lag
rolls from abdomen to back, back to side
sits with a prop
scoots backward

24

Gross motor skills 6-7 months

sits alone with support of hands
rolls from back to abdomen
no head lag, bears weight on feet
develops parachute reflex, newborn reflexes gone

25

Gross motor skills 8-9 months

sits unsupported, stands with help
crawls, usually in reverse first stronger extensors than flexors

26

Gross motor skills 10-12 months

crawls forward
pulls self to sitting position, sit-stand
walks with support, push toys (only when walking), ball

27

Psychosocial development: Erikson
Trust vs. Mistrust

feeling of physical comfort and security, basic needs met by caregiver

28

Psychosocial development: Erikson
Trust vs. Mistrust
Narcissism

Total concern for oneself

29

Psychosocial development: Erikson
Trust vs. Mistrust
RESULTS

trust or inability to trust
lack of forming meaningful relationships
dependency problems/ feeding disorders

30

Cognitive development: Piaget
Infants learn

separation (others control the environment)
object permanence
use of symbols for mental representation
time/ space concepts start at end of stage

31

Cognitive development: Piaget
Sensorimotor stage
1st substage 0-1 month

REFLEXES: ROOTING, SUCKING, GRASP, CRY FENCING, REFLEXIVE STAGE

32

Cognitive development: Piaget
Sensorimotor stage
2nd substage 1-4 months

Primary circular reactions
reflexes become voluntary
stimulus produces response (cry, hear moms voice, stop crying)
Place rattle in hand, grasp and shake it

33

Cognitive development: Piaget
Sensorimotor stage
3rd substage 5-8 months

Secondary circular reactions
repeated acts for certain results, shaking and banging rattle repeatedly
begin imitation play
beginning to develop object permanence/ stranger and separation anxiety
6 months, preference for mom or primary caregiver

34

Cognitive development: Piaget
Sensorimotor stage
4th substage 9-12 months

Coordination of secondary schemata and application to new situations
begins intellectual reasoning, starts to associate symbols with events (bye-bye)
does intentional acts, can remove obstacles

35

Social development
1 month

watches parents face

36

Social development
1-2 months (6 weeks)

eyes move forward

37

Social development
2 months

social smile

38

Social development
3 months

stops crying when parent is seen
recognized familiar objects

39

Social development
4-5 months

laughs out loud
smiles at mirror image
can discriminate family/ stranger

40

Social development
6-7 months

imitates, starts biting
peek-a-boo
starting object permanence/ stranger anxiety

41

Social development
8-9 months

separation/ stranger anxiety
wants to please
fear of bed and being alone
sibling jealousy
starts to remove obstacles

42

Social development
10-12 months

joy when task mastered
frustrated if not mastered
may have security object

43

Language development
1 month

cries, makes throaty sounds

44

Language development
2-3 months

cooing, "ah", vocalizes as if in response, squeals

45

Language development
4-5 months

laugh, varies tone
can pronounce n,k,g,p,b

46

Language development
6-7 months

imitates sounds
vowels in 1-2 syllables (ma, da, hi, da-da, baba)
talks to self

47

Language development
8-9 months

no-no
pronounces t,d,w

48

Language development
10-12 months

3-5 words
starts to comprehend meaning of words and objects

49

Sensory development
1 month

fixates on moving objects (tracking tube)
follows to midline
quiets to voice
objects at 8-10 inches in front of face (faces)
black and white mobiles

50

Sensory development
2-3 months

binocular fixation (eyes fixate together; if they are social smiling, they are looking at you)

51

Sensory development
4-5 months

localizes sounds
beginning to have hand-eye coordination

52

Sensory development
6-7 months

adjust posture to visual search (beginning of object permanence)
responds to name (autism by 6-18 months if they don't)
begins to understand depth and space
can fixate on very small objects
taste preference

53

Sensory development
8-12 months

increased understanding of depth and space
follows rapidly moving objects
nursery rhymes, imitates animal sounds (repeating)

54

Play development

solitary play/ social interaction enhances play
teach infant ways to play
explores with mouth/ increasing abilities to move about

55

Patient teaching with nipples and pacifiers that stick together when squeezed

throw away

56

Breast feeding regimen in the first month

3-4 hrs X 6 per day (breast or bottle)

57

Breast milk storage: refrigerated/ frozen

8 days/ 12 months

58

At 4-6 months, first food considerations

First rice/ wheat last (allergies): rice easiest to digest
Mix cereal with formula or breast milk or fruit juice
***try one new food at a time 14-7 days (allergies)
wheat, nuts, eggs, and milk often manifest allergies

59

Immunizations HBV: IM

birth, 1-2 months, 6-18 months
(hepatitis B; don't give if allergic to baker's yeast)

60

Immunizations DTaP: (IM)

2 months, 4 months, 6 months, 15-18 months, 4-6 years
- diphtheria: no absolute immunity (last 10 years)
- tetanus lasts 10 years
-pertussis: acellular, more allergic reaction >7 years, do not give to neurologically impaired child

61

Immunizations IPV: (SC or IM)

2 months, 4 months, 6-18 months, 4-6 years
(polio vaccine)
- don't give with anaphylaxis to neomycin, streptomycin or pregnancy

62

Immunizations Hib: (IM)

2 months, 4 months, 6 months, 12-18 months
(Haemophilous influenza-type B; meningitis, epiglottitis, bacterial pneumonia, septic arthritis, sepsis)

63

Immunizations Rotavirus (Oral)

2 months, 4 months, 6 months
Oral most common in Peds; diarrhea is associated with oral med

64

Immunization PCV (IM)

2 months, 4 months, 6 months, 12-18 months
(pneumococcal-conjugate vaccine)

65

Immunization Influenza (IM, Nasal)

every year starting at 6 months to 5 years

66

Common reactions to immunizations

101 degree fever, soreness, redness at injection, behavior changes
Pertussis: allergic temp > 105 degrees, seizures, shock

67

Common reaction to MMR immunization

MMR: anorexia, malaise, rash, fever

68

Immunization nursing care

-Tylenol q 4-6 hrs X 3 doses
-EMLA cream prn, treatment room, sugar water/ passifier
-give injections simultaneously/ comfort immediately after

69

Contraindications to Immunization

-fegrile illness/ temp over 101
-blood transfusion within 3 months
-pregnancy
-known allergy

70

S/S ICP

-altered LOC, pupil changes (fixed/ dilated)
-headache, dizzy, visual disturbance, bulging fontanel, dilated scalp veins, high-pitch cry, increased BP, bradycardia
-Increase between systolic/ diastolic: brain edema

71

Hyperpyrexia (fever)

elevated set point so the body is regulated at a higher level (infective agent)

72

Hyperthermia

body temp exceeding set point (Usually heat, not infection)
Tylenol ineffective due to altered set point/ use cooling measures

73

Temperature to begin administering febrile meds

101 F

74

First line anticonvulsants (fever)

Phenobarbitol (Dilatin has serious S/E)
-valium/ Ativan if seizing (Status Epilepticus)

75

Feeding ESSR

Enlarge nipple
Stimulate suck
Swallow fluid
Rest