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Flashcards in Well Child 1 Deck (45)
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1

What are the 5 types of developmental milestones?

  • Physical (maturation, growth, puberty)
  • Motor (gross & fine motor skills)
  • Cognitive (achievement of milestones, language, school performance)
  • Emotional (self efficacy, self esteem, independence, morality)
  • Social (social competence, self responsibility, integration w/ family & community)

2

AAP recommends well visits at what ages? (10)

  • birth
  • 1 month
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 2 years
  • Then annually --> adolescence

3

Newborn & Pediatric Growth Curves

  • Compares what 4 measurements to the population?
  • Measured in percentiles %%%
  • BMI is used starting at approximately what age?

  • height, weight, head circ., BMI
  • 2 yrs

4

Newborn & Pediatric Growth Curves

  • Head circumference is tracked until about __ - ___ y/o
  • Head circumference is important to assess for what?

  • 2 - 3 yrs
  • Brain growth

5

Growth charts vary based on what?

Gestational age

  • premature infants
  • syndromes (Down syndrome, fragile X)

6

Give the %

  • Overweight
  • Obesity
  • Underweight

  • Overweight: 85-95%
  • Obesity: >95%
  • Underweight: <5%
  •  

7

Give the %

  • Microcephaly
  • Macrocephaly

  • Micro: <3%
  • Macro: >97%

8

How many weeks?

  • Preterm
  • Term
  • Post-term

  • Pre: <37 weeks
  • Term: 37-42 weeks
  • Post: >42 weeks

9

Classification of Birth Weight (g)

  • Extremely low BW: ___ g
  • Very low BW: ___ g
  • Low BW: ____ g
  • Normal BW: ___ g

  • Extreme L: <1000 g
  • Very L: <1500 g
  • Low: <2500 g
  • Normal: >2500 g

10

Give the %

  • Small for gestational age (SGA)
  • Appropriate for gestational age (AGA)
  • Large for gestational age (LGA)

  • SGA: <10%
  • AGA: 10-90%
  • Large: >90%

11

Give the ages

  • Infancy
  • Neonatal period
  • Postneonatal period

  • Infancy: 1st yr of life
  • Neonatal: 1 - 28 days
  • Postneonatal: 29 days - 1 year

12

What is the key assessment of the newborn immediately after birth?

Apgar

13

  • The apgar is scored how long after birth?
  • What do the scores range from?
  • Scoring may continue at __ minute intervals until the score is what?

  • 1 and 5 minutes after birth
  • Range: 0 - 10
  • 5 min intervals until >7

14

Describe the population wide testing for metabolic & genetic diseases

Blood sample from heel stick:

  • before discharge
  • again at 7-14 days 

(varies from state to state)

15

General PE 

  • T/F: mild cyanosis can be normal at birth
  • Peripheral cyanosis (finger tips) can be normal for how many days?
  • Jaundice- can be difficult based on what?

  • True, but baby should pink soon thereafter
  • Peripheral: 1 - 2 days
  • Baby's race

16

Terminology?

  • Cheesy white covering
  • Decreases as term approaches
  • Made from fetal corneocytes / sebaceous gland activity
  • "rich lipid matrix"

Vernix Caseosa

17

Condition?

  • Pinpoint white papules w/o surrounding erythema
  • Caused by what?
  • Commonly on noase, chin, forehead, cheeks
  • Usually appears within the first few weeks & disappears over several weeks

Milia

  • blocked sebaceous glands

18

Condition?

  • aka congenital dermal melanocytes
  • blue patches of pigment
  • commonly seen over lumbar area, buttocks, extremities
  • generally fade w/ time
  • Common which 5 races?

Mongolian Spots

  • Asian
  • Native American
  • Hispanic
  • East Indian
  • African Americans

19

Diagnosis?

Mongolian Spots 

  • aka: "congenital dermal melanocytes"
  • blue patches
  • fade over time
  • Asian, Native American, Hispanic, East Indian, African descent

20

Condition?

  • yellow eosinophillic papules on red base
  • may appear on 2nd to 4th day of life
  • mostly seen on trunk
  • unknown etiology but thought to be due to what?
  • typically disappear w/in 1 week of birth

Erythema Toxicum

  • due to: the immaturity of the pilosebaceous follicles

21

Diagnosis?

Erythema Toxicum

  • yellow eosinophilic papules on red base
  • 2nd - 4th day of life
  • trunk
  • d/t immaturity of pilosebaceous follicles
  • disappear within 1 w of birth

22

Sutures

  • Name the 4 sutures
  • Birth process can result in what?
  • What is a sign of elevated ICP (due to meningitis or hydrocephalus)
  • What sign suggests craniosynostosis (which needs neurosurgery)

  • 4: sagittal / coronal / lambdoid / frontal
  • Birth process: molding / overriding of sutures
  • Incr ICP: widely split sutures
  • Cranio: raised, bony ridge at a suture line

23

Fontanelles

  • Areas where major sutures intersect
  • ALWAYS palpate (should be soft/flat)
  • Bulging may indicate what?
  • Sunken may indicate what?
  • Large fontanelle can be 1st sign of what?

  • Bulging: increased ICP (bleed vs. meningitis)
  • Sunken: dehydration
  • Large: 1st sign of hypothyroidism

24

Fontanelles

  • Anterior is located at the juncture of what 3 sutures?
  • Posterior at juncture of what 2 sutures?

  • Anterior: Metopic, sagittal, coronal 
  • Posterior: sagittal & lambdoid

25

Which Extracranial Finding?

  • Swelling/collecting of blood over one or both parietal bones
  • Does NOT cross suture lines
  • Resolves in weeks to months

Cephalohematoma

26

Which Extracranial Finding?

  • Edema of the scalp
  • CAN cross suture ines
  • Resolved in days

Caput succedaneum

27

Diagnosis?

Bilateral Cephalohematoma

  • Does NOT cross suture lines
  • swelling/collection of blood over one or both parietal bones
  • resolves in weeks to months

28

Diagnosis?

Caput succedaneum

  • CAN cross suture line
  • edema of the scalp
  • resolves in days

29

Eyes

  • Term for abnormally wide eyes
  • What is common from birth trauma
  • Red reflexes should be present/symmetrical

  • Hypetelorism
  • Subconjunctival hemorrhages

30

Nose/Ears

  • Infants under what age are nose breathers (ensure no obstructions)
  • Over 2-3 yrs old: pull auricle which way?
  • Under 2-3 yrs old: pull auricle which way?
  • Preauricular pits/tags are common
  • ALWAYS screen for hearing

  • Nose breathers: < 1 month
  • >2 yrs: pull upward
  • <2 yrs: pull down