What Jacobson said to focus on: Part 1 Flashcards Preview

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Flashcards in What Jacobson said to focus on: Part 1 Deck (94):
1

What may be seen on an infants tongue? What are ways they get it? How can it be treated?

White coatings on their tongues from milk= easily removed

Oral candidiasis coating= not easily removed

Oral candidiasis: can get from birth canal or antibiotics
Treat with mycostatin PO and systemic

2

Elicited by stroking an infants cheek or edge of an infants mouth--the infant turns her head toward the side that is touched and starts to suck

Sucking and rooting reflex

3

Elicited by placing an object in an infants palm--infant grasps object

Palmar grasp

4

Elicited by touching the SOLE of an infants foot--infants toes curl DOWNWARD

Plantar grasp

5

What is moro reflex?

Elicited by allowing head and trunk of an infant in a semi-sitting position to fall backward to an angle of at least 30 degrees--> infants arms and legs symmetrically extend, then abduct while fingers spread to form C shape

6

Elicited by clapping hands or by a loud noise--newborns will abduct arms at the elbows, and the hands will remain clinched

Startle reflex

7

What is the tonic neck reflex (fencer position)?

Elicited by turning an infants head to one side---the infant extends the arm and leg on that side and flexes the arm and leg on the opposite side

8

Elicited by stroking the OUTER EDGE of the sole of an infants foot up toward the ones--infants toes fan UPWARD and OUT

Babinski reflex

9

Elicited by holding an infant upright with his feet touching a flat surface--infant makes stepping movements

Stepping reflex

10

Expected age of moro?

Birth-4 m

11

Expected age of tonic neck reflex?

Birth- 3or4m

12

Expected age of babinski reflex?

Birth-1y

13

Expected age of plantar grasp?

Birth-8 m

14

Expected age of palmar grasp?

Birth-3 m

15

Expected age of sucking/rooting reflex?

Birth-4 m

16

Expected age of startle reflex?

Birth-4m

17

Expected age of stepping reflex?

Birth-4weeks

18

What does infant do at 1 month?

Demonstrates head lag
Has a grasp reflex

19

What does infant do at 2 months?

Lifts head off mattress when prone
Holds hands in a open position

20

What does infant do at 3 months?

Raises head and shoulders off mattress when prone
Slight head lag
No longer has grasp reflex
Keeps hands loosely open

21

What does infant do at 4 months?

Rolls from back to side
Places objectes in mouth

22

What does infant do at 5 months?

Rolls from front to back
Uses palmar grasp dominantly

23

What does infant do at 6 months?

Rolls from back to front
Holds bottle

24

What does infant do at 7 months?

Bears full weight on feet
Moves objects from hand to hand

25

What does infant do at 8 months?

Sits unsupported
Begins using pincer grasp

26

What does infant do at 9 months?

Pulls to standing position
Creeps on hands and knees instead of crawl
Crude pincer grasp

27

What does infant do at 10 months?

Changes from prone to sitting position
Grasps rattle by its handle

28

What does infant do at 11 months?

Walks while holding onto something (cruising)
Places objects into container
Neat pincer grasp

29

What does infant do at 12 months?

Sits down from standing position w/o assistance
Tries to build a 2 block tower w/o success

30

What are 3 important tasks accomplished during birth-24 months, according to Piaget?

1. Separation
2. Object permanence
3. Mental representation

31

What are good toys for infants?

Rattles
Teething toys
Nesting
Pat-a-cake
Playing with balls
Reading books
Mirrors
Brightly colored toys
Playing with blocks

32

What provides a complete diet for infants during the first 6 months?

Breastfeeding

-Iron fortified formula=acceptable alternative to breast milk

Cows milk= not recommended

33

When do we begin vit. D supplements for babies?

During first few days of life

34

When are iron supplements recommended for infants who are being exclusively breastfed?

If they are being exclusively breastfed after age of 4 m

35

Do we need juice or water during first 4 m of life?

Not needed

36

When should 100% fruit juice be limited to 4-6 oz per day in infants?

After age 6 m

37

When are solids introduced?

Around 4-6 m of age

38

What are indicators for readiness in solids?

-Interest in solids
-Voluntary control of head and trunk
-Disappearance of extrusion reflex

39

What solid is typically introduced first?

Iron fortified cereal

40

How do we introduce new foods?

One at a time, over 4-7 day period to observe for allergy or interolerance (fussiness, rash, V/D, constipation)

41

When are vegs and fruits started?

Between 6-8 months; after both have been introduced, meats may be added

42

What foods are NOT started until after 6 months?

Citrus fruits
Meats
Eggs

43

Should breastmilk/formula be increased or decreased as intake of solid foods increase?

Decreased--but should remain primary source of nutrition through first year

44

When can infants get table foods that are cooked, chopped, and unseasoned?

9 m

45

What are good finger foods?

Ripe bananas
Toast strips
Graham crackers
Cheese cubes
Noodles
Peeled chunks of apples, pears, or peaches

46

When can weaning be accomplished?

When infants show signs of readiness
Able to drink from a cup

*somewhere in second 6 months

47

What are the last feedings to be stopped?

Bedtime

48

What age often use negativism?

Toddlers

49

What age often uses ritualism?

Toddlers

50

Toddlers are unable to see things from the perspectives of others; they can only view things from their personal points of view. What is this?

Egocentric thinking

51

When do toddlers develop gender identity?

3 years

52

What kind of play do toddlers do?

Parallel

53

What are good toys for toddlers?

-Filling/emptying containers
-Playing with blocks
-Looking at books
-Push/pull toys
-Tossing balls
-Finger paints
-Large piece puzzles
-Think crayons

54

Nutrition for toddlers: ____ occurs, resulting in toddlers becoming fussy eaters because of a decreased appetite

Physiologic anorexia

55

How much milk per day should toddlers consume?

24-30oz

56

When can toddlers switch from drinking whole milk to drinking low fat milk?

After 2 years

57

How much fruit should toddlers get?

1 cup daily

58

What is food serving size for toddlers?

1 tbsp for each year of age, or 1/4-1/3 of an adult portion

59

Why do toddlers generally prefer finger foods?

Increasing autonomy

60

What does a 3 year old do?

Rides tricycle
Jumps off bottom step
Stands on one foot for a few seconds

61

What does a 4 year old do?

Skips and hops on one foot
Throws ball overhead

62

What does 5 year old do?

Jump rope
Walks backward with heel to toe
Throws and catches ball with ease

63

Preschoolers make judgements based on visual appearances. Variations in thinking during this age include what 3 things?

Magical thinking
Animism
Centration

64

Preschoolers consume about ____ amount of energy that adults do

Half (so 1800kcal)

65

When do preschoolers become more willing to sample different foods?

5

66

How much protein do preschoolers need?

13-19g/d + adequate calcium, iron, folate, and vit A and C

67

Saturated fats should be less than ____ of preschoolers total caloric intake

Total fat over several days should be ____ of total caloric intak

10%

20-30%

68

By the end of the school-age years, children should eat ____ portions of foods.

Adult portions

69

What is an increasing concern for school age regarding nutrition?

Obesity!!

-Avoid food as reward
-Emphasize physical activity

70

What is sexual maturation order for girls?

1. Breast development
2. Pubic hair growth (some girls experience hair growth before breast development)
3. Axillary hair growth
4. Menstruation

71

What is sexual maturation order for boys?

1. Testicular enlargement
2. Pubic hair growth
3. Facial hair growth
4. Vocal changes

72

During times of rapid growth in adolescent, what additional supplements are needed?

Calcium
Iron
Zinc

73

Adolescents tend to stay up late, sleep in later in the morning. Do they need more or less sleep than school age years?q

MORE

74

When is it acceptable to give opioids? Ex?

Moderate-severe pain

Morphine sulfate
Oxycodone
Fentanyl

75

What does combining nonopijoid and an opioid med do?

Treats pain peripherally and centrally---this offers greater analgesia with less adverse effects

76

Are IM injections recommended for pain control in children?

No

77

What is EMLA and when should we apply?

Eutectic mixture of local anesthetics---equal quantities of lidocaine and priolocaine in the form of cream or disc

60 min prior for superficial puncture
2.5 hours prior to deep puncture

78

What age gets fentanyl?

Children older than 12

*used to provide continuous pain control
*onset of 12-24 hours, duration of 72 hours

79

How do we treat respiratory depression?

Naloxone

80

What are nonpharmalogic measures for pain control?

-Distraction
-Relaxation
-Guided imagery
-Positive self talk
-Behavioral contracting
-Containment
-Nonnutritive sucking
-Kangaroo care
-Complementary and alternative meds

81

A multidisciplinary approach that focuses on the process of dying rather than prolonging life in cases in which cures are no longer possible

Palliative care

82

What is focus of palliative care?

Control of managing the clients manifestation and offering supportive care

83

What is focus of hospice care?

-Family members are primary caregivers
-Nursing focus: pain control and comfort
-Family and client needs are EQUAL
-Provide support for family grieving process, which can continue after clients death

84

When death is expected or a possible outcome

Anticipatory grief

85

Grief that extends for more than a year following the loss

Complicated grief

86

CSF analysis for bacterial meningitis?

-Cloudy color
-Elevated WBC count
-Elevated protein content
-DECREASED glucose content
-Positive gram stain

87

CSF analysis for viral meningitis?

-Clear color
-Slightly elevated WBC count
-Normal-slightly elevated protein content
-Normal glucose content
-Negative gram stain

88

How long should client remain in bed after a lumbar puncture? What position?

Remain in bed 4-8 hours in a FLAT position to prevent leakage and a resulting spinal headache

*may not be possible for an infant, toddler, or preschooler

89

What vitamin can be given as a medication for the treatment of Reyes?

Vitamin K--improves synthesis of blood clotting factors in the liver

90

Signs of increased ICP in infant? (7)

-Bulging fontanel
-Separation of cranial suture
-Irritability
-Increased sleeping
-High pitched cry
-Poor feeding
-Setting sun eye

91

Signs of increased ICP in child? (7)

-N/V
-Headache
-Blurred vision
-Increased sleeping
-Inability to follow simple commands
-Seizures

92

What are late signs of increased ICP? (7)

-Alterations in pupillary response
-Posturing (decorticate and decerebrate)
-BRADYcardia
-Decreased motor response
-Decreased sensory response
-Cheyne-stokes respirations
-Coma

93

What is the dysfunction if child is in decorticate posture?

Cerebral cortex

94

What is the dysfunction if child is in decerebrate posture?

Midbrain