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Peds Unit II Flashcards

1
Q

Weight gain at 6 months

A

Double (1.5 lb/ month 1st 6 months)

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2
Q

Weight gain at 12 months

A

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

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3
Q

Height increase at 12 months

A

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

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4
Q

Posterior fontanel fuses how many months after birth?

A

2 (triangular shaped)

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5
Q

Anterior fontanel fuses how many months after birth?

A

12-18 (diamond shaped)

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6
Q

What does a normal fontanel look like?

A

soft/ flat

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7
Q

Infants are obligatory….

A

nose breathers. (abdominal breathing)

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8
Q

Bp difference from utero to birth

A

70/55 to 90/55

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9
Q

HR difference from utero to birth

A

HR slows from 120 to 80

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10
Q

When hemoglobin decreases with decreased RBCs at 2-3 months

A

physiologic anemia

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11
Q

This cannot be digested until 4-6 months

A

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

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12
Q

Rule for determining # teeth appropriate for age

A

age in months -6 = number of teeth

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13
Q

Most immature system at birth

A

Liver: difficulty with bilirubin (hyperbilirubinemia

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14
Q

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

A

Potassium

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15
Q

Hand/ finger play and toys 1 month

A

grasp reflex (rattle) hands are closed

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16
Q

Hand/ finger play and toys 2-3 months

A

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

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17
Q

Hand/ finger play and toys 4-5 months

A

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

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18
Q

Hand/ finger play and toys 6-7 months

A

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

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19
Q

Hand/ finger play and toys 8-9 months

A

start pincer grasp, can start finger foods

releases objects, claps (pat-a-cake)

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20
Q

Hand/ finger play and toys 10-12 months

A

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

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21
Q

Gross motor skills 1 month

A

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

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22
Q

Gross motor skills 2-3 months

A

lifts head 45 degrees when prone, increased head control

slight bobbing, use infant swing

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23
Q

Gross motor skills 4-5 months

A

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

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24
Q

Gross motor skills 6-7 months

A

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

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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

Ivy Tech Nursing (21 decks)

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