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ATI Pediatrics-MJ > What Jacobson said to focus on: Part 1 > Flashcards

What Jacobson said to focus on: Part 1 Flashcards

1
Q

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

A

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

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2
Q

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

A

Sucking and rooting reflex

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3
Q

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

A

Palmar grasp

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4
Q

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

A

Plantar grasp

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5
Q

What is moro reflex?

A

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

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6
Q

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

A

Startle reflex

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7
Q

What is the tonic neck reflex (fencer position)?

A

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

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8
Q

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

A

Babinski reflex

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9
Q

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

A

Stepping reflex

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10
Q

Expected age of moro?

A

Birth-4 m

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11
Q

Expected age of tonic neck reflex?

A

Birth- 3or4m

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12
Q

Expected age of babinski reflex?

A

Birth-1y

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13
Q

Expected age of plantar grasp?

A

Birth-8 m

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14
Q

Expected age of palmar grasp?

A

Birth-3 m

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15
Q

Expected age of sucking/rooting reflex?

A

Birth-4 m

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16
Q

Expected age of startle reflex?

A

Birth-4m

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17
Q

Expected age of stepping reflex?

A

Birth-4weeks

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18
Q

What does infant do at 1 month?

A

Demonstrates head lag

Has a grasp reflex

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19
Q

What does infant do at 2 months?

A

Lifts head off mattress when prone

Holds hands in a open position

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20
Q

What does infant do at 3 months?

A

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

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21
Q

What does infant do at 4 months?

A

Rolls from back to side

Places objectes in mouth

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22
Q

What does infant do at 5 months?

A

Rolls from front to back

Uses palmar grasp dominantly

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23
Q

What does infant do at 6 months?

A

Rolls from back to front

Holds bottle

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24
Q

What does infant do at 7 months?

A

Bears full weight on feet

Moves objects from hand to hand

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25
Q

What does infant do at 8 months?

A

Sits unsupported

Begins using pincer grasp

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26
Q

What does infant do at 9 months?

A

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

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27
Q

What does infant do at 10 months?

A

Changes from prone to sitting position

Grasps rattle by its handle

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28
Q

What does infant do at 11 months?

A

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

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29
Q

What does infant do at 12 months?

A

Sits down from standing position w/o assistance

Tries to build a 2 block tower w/o success

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30
Q

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

A
  1. Separation
  2. Object permanence
  3. Mental representation
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31
Q

What are good toys for infants?

A 
Rattles
Teething toys
Nesting 
Pat-a-cake
Playing with balls
Reading books
Mirrors 
Brightly colored toys
Playing with blocks
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32
Q

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

A

Breastfeeding

-Iron fortified formula=acceptable alternative to breast milk

Cows milk= not recommended

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33
Q

When do we begin vit. D supplements for babies?

A

During first few days of life

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34
Q

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

A

If they are being exclusively breastfed after age of 4 m

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35
Q

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

A

Not needed

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36
Q

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

A

After age 6 m

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37
Q

When are solids introduced?

A

Around 4-6 m of age

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38
Q

What are indicators for readiness in solids?

A
  • Interest in solids
  • Voluntary control of head and trunk
  • Disappearance of extrusion reflex
39
Q

What solid is typically introduced first?

A

Iron fortified cereal

40
Q

How do we introduce new foods?

A

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

41
Q

When are vegs and fruits started?

A

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

42
Q

What foods are NOT started until after 6 months?

A

Citrus fruits
Meats
Eggs

43
Q

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

A

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

44
Q

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

A

9 m

45
Q

What are good finger foods?

A 
Ripe bananas
Toast strips
Graham crackers
Cheese cubes
Noodles
Peeled chunks of apples, pears, or peaches
46
Q

When can weaning be accomplished?

A

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

*somewhere in second 6 months

47
Q

What are the last feedings to be stopped?

A

Bedtime

48
Q

What age often use negativism?

A

Toddlers

49
Q

What age often uses ritualism?

A

Toddlers

50
Q

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?

A

Egocentric thinking

51
Q

When do toddlers develop gender identity?

A

3 years

52
Q

What kind of play do toddlers do?

A

Parallel

53
Q

What are good toys for toddlers?

A
  • Filling/emptying containers
  • Playing with blocks
  • Looking at books
  • Push/pull toys
  • Tossing balls
  • Finger paints
  • Large piece puzzles
  • Think crayons
54
Q

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

A

Physiologic anorexia

55
Q

How much milk per day should toddlers consume?

A

24-30oz

56
Q

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

A

After 2 years

57
Q

How much fruit should toddlers get?

A

1 cup daily

58
Q

What is food serving size for toddlers?

A

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

59
Q

Why do toddlers generally prefer finger foods?

A

Increasing autonomy

60
Q

What does a 3 year old do?

A

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

61
Q

What does a 4 year old do?

A

Skips and hops on one foot

Throws ball overhead

62
Q

What does 5 year old do?

A

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

63
Q

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

A

Magical thinking
Animism
Centration

64
Q

Preschoolers consume about ____ amount of energy that adults do

A

Half (so 1800kcal)

65
Q

When do preschoolers become more willing to sample different foods?

A

5

66
Q

How much protein do preschoolers need?

A

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

67
Q

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

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

A

10%

20-30%

68
Q

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

A

Adult portions

69
Q

What is an increasing concern for school age regarding nutrition?

A

Obesity!!

  • Avoid food as reward
  • Emphasize physical activity
70
Q

What is sexual maturation order for girls?

A
  1. Breast development
  2. Pubic hair growth (some girls experience hair growth before breast development)
  3. Axillary hair growth
  4. Menstruation
71
Q

What is sexual maturation order for boys?

A
  1. Testicular enlargement
  2. Pubic hair growth
  3. Facial hair growth
  4. Vocal changes
72
Q

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

A

Calcium
Iron
Zinc

73
Q

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

A

MORE

74
Q

When is it acceptable to give opioids? Ex?

A

Moderate-severe pain

Morphine sulfate
Oxycodone
Fentanyl

75
Q

What does combining nonopijoid and an opioid med do?

A

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

76
Q

Are IM injections recommended for pain control in children?

A

No

77
Q

What is EMLA and when should we apply?

A

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
Q

What age gets fentanyl?

A

Children older than 12

  • used to provide continuous pain control
  • onset of 12-24 hours, duration of 72 hours
79
Q

How do we treat respiratory depression?

A

Naloxone

80
Q

What are nonpharmalogic measures for pain control?

A
  • Distraction
  • Relaxation
  • Guided imagery
  • Positive self talk
  • Behavioral contracting
  • Containment
  • Nonnutritive sucking
  • Kangaroo care
  • Complementary and alternative meds
81
Q

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

A

Palliative care

82
Q

What is focus of palliative care?

A

Control of managing the clients manifestation and offering supportive care

83
Q

What is focus of hospice care?

A
  • 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
Q

When death is expected or a possible outcome

A

Anticipatory grief

85
Q

Grief that extends for more than a year following the loss

A

Complicated grief

86
Q

CSF analysis for bacterial meningitis?

A
  • Cloudy color
  • Elevated WBC count
  • Elevated protein content
  • DECREASED glucose content
  • Positive gram stain
87
Q

CSF analysis for viral meningitis?

A
  • Clear color
  • Slightly elevated WBC count
  • Normal-slightly elevated protein content
  • Normal glucose content
  • Negative gram stain
88
Q

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

A

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
Q

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

A

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

90
Q

Signs of increased ICP in infant? (7)

A
  • Bulging fontanel
  • Separation of cranial suture
  • Irritability
  • Increased sleeping
  • High pitched cry
  • Poor feeding
  • Setting sun eye
91
Q

Signs of increased ICP in child? (7)

A
  • N/V
  • Headache
  • Blurred vision
  • Increased sleeping
  • Inability to follow simple commands
  • Seizures
92
Q

What are late signs of increased ICP? (7)

A
  • Alterations in pupillary response
  • Posturing (decorticate and decerebrate)
  • BRADYcardia
  • Decreased motor response
  • Decreased sensory response
  • Cheyne-stokes respirations
  • Coma
93
Q

What is the dysfunction if child is in decorticate posture?

A

Cerebral cortex

94
Q

What is the dysfunction if child is in decerebrate posture?

A

Midbrain

ATI Pediatrics-MJ (41 decks)

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