Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Assessment & Testing Of Infant & Child Development > Flashcards

Assessment & Testing Of Infant & Child Development Flashcards

1
Q

Name 3 criteria neonatal babies must meet prior to neurological assessment:

A

Needs to be able to tolerate gentle handling, Be in a calm alert state, on room air/ in open crib (modified assessment done when baby is on ventilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do parents need to know on initial assessment?

A

Typical developmental milestones and newborn behaviors, Kangaroo Care, proper positioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Proper positioning of neonatal baby:

A

Prone is best. Neutral head & neck position w/ slight chin tuck and slightly to the side. Scapular protraction to promote UE flexion & hands in midline. Trunk flexion w/ pelvic tilt, flex LE w/ neutral AB/Adduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define gestational age. Define AGA, LGA, SGA.

A

Gestational age: length of time baby was in the womb. AGA, LGA, & SGA: appropriate, small or large for gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define NBW, LBW, MLBW, VLBW, ELBW

A

NBL, LBW, MLBW, VLBW, ELBW: normal, low, moderately low, very low and extremely low birth weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define APGAR

A

Scoring system to evaluate the physical condition of newborns. APGAR: Appearance, Pulse, Grimace, Activity, Respiration; recorded at minute 1 & 5, higher number is better (8-10 is typical for healthy newborns); 6 is typically acceptable. Review test on pages 123-125 in book.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define radiant warmer:

A

A type of incubator used to for babies who are very unstable or extremely premature to keep them warm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define isolette:

A

An enclosed incubator where you can access infant through side port holes; keeps away sound and light.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define nasal cannula:

Define CPAP:

A

Nasal cannula: Humidified gas delivered via flexible tubing inserted into nose
CPAP: Used to prevent alveolar and airway collapse, and to treat respiratory distress syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define ECMO

A

Extracorporeal membrane oxygenation: heart-and-lung bypass procedure involving draining venous blood, supplementing it w/ O2, and removing CO2. Returns blood to either venous or arterial circulations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Purpose of phototherapy

A

Used to reduce jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gavage or G-tube

A

Oral or nasogastric tube used for feeding directly into the stomach. Transpyloric tubes used when infants are at risk for aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PICC

A

Long catheter inserted into a peripheral vein and threaded to superior vena cava. Used for prolonged parental feeding, antibiotics, or to draw blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define Respiratory Distress Syndrome and list symptoms

A

Insufficient surfactant production & structural lung immaturity.
Symptoms: increased RR, intercostal retractions, nasal flaring, cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is respiratory distress syndrome indicative of?

A

insufficient surfactant production & structural immaturity of lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the role of surfactant in infants?

A

prevents collapse of air space (future site of alveolar development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Symptoms of RDS

A

increased RR, intercostal retractions, nasal flaring, cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Patent Ductus Arteriosus (PDA)

A

When ductus arteriosus doesn’t close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When does ductus ateriosus usually close?

A

10-15 hours after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

symptoms of PDA

A

murmur, increased HR, respiratory distress, failure to gain weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hyperbilirubinemia or “jaundice”

A

build of bilirubin in blood by immature liver function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

symptoms of hyperbilirubinemia

A

dec level of arousal & activity, lethargy, hypotonia, poor sucking ability; alters visual, social-interactive and neuromotor abilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gastroesphageal Reflux (GER)

A

movement of gastric contents into esophagus and above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does frequent GER lead to?

A

inflammation of esphogas & lead to poor oral feeding patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

symptoms of GER

A

irritability, extension and arching of trunk to R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Necrotizing Entercolitis (NEC)

A

acute inflammation of immature intestines causing necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

risk of developing NEC is doubled with

A

prenatal cocaine exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

symptoms of NEC

A

abdominal distention & vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

most common type of brain lesion in premature infants

A

Germinal Matrix-Intraventricular Hemorrhage (GM-IVH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What happens when GM-IVH extends it damage to the periventricular white matter?

A

significant neurological issues including CP, mental retardation, and seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Periventricular Leukomalacia (PVL)

A

Death of small areas of brain tissue around ventricles. The damage creates “holes” in the brain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

spastic diplegia

A

form of CP condition of hypertonia & spasticity- high constant tightness or stiffness in muslces of LEs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Premies with PVL are at high risk for developing what complications & conditions?

A

motor, visual, & cognitive functions; spastic diplegia, hyrdocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Retinopathy of Prematurity

A

abnormal BV development in retina of eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

symptoms of Retinopathy of Prematurity

A

abnormal eye movements, crossed eyes, severe nearsightedness, white looking pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the effects of cocaine during the prenatal period?

A

uterine contractility, maternal hypertension, placental vasoconstriction and decreased uterine blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

symptoms of prenatal drug exposure

A

congenital anomalies, abnormal sleep patterns, tremors, poor organized response, irritability and inability to be consoled.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

most common cause of preterm labor

A

chromioamnionitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Chorioamnionitis

A

Bacteria invades amniotic cavity causing an inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Chorioamnionitis babies at risk for

A

neurological impairments and brain damage

41
Q

80% of bone produced between..

A

24-40 weeks

42
Q

Large amounts of calcium and magnesium delivered in which trimester?

A

3rd/last trimester

43
Q

full term babies in cramped uterus receive what bone density effects?

A

mechanical stimulation of bones–> bone growth

44
Q

bone formation can be promoted by what intervention?

A

PROM

45
Q

Most common chronic lung disease associated with prematurity

A

Bronchopulmonary Dysplasia (BPD)

46
Q

greatest contributing factor for BPD

A

under-developed lungs

47
Q

symptoms of BPD

A

bluish skin, rapid breathing, shortness of breath

48
Q

Assessment / Intervention tips for BPD

A
  • Be very cautious of symptoms of distress during assessment
  • Decrease stimulation in environment
  • Position child to support respiration
  • Use gentle handling and mobilization techniques
  • May need to provide scar massage
  • Develop activities into routines and play times
49
Q

What is always the first priority in assessment/intervention for BPD?

A

BREATHING

50
Q

Congenital Diaphragmatic Hernia

A

Congenital malformation of the diaphragm

51
Q

Congenital diaphragmatic hernia has a high incidence of..

A

sensorineural hearing loss, GER, failure to thrive, feeding problems, developmental delay, seizure and scoliosis

52
Q

What are signs of Stress in an infant?

A 
Skin is pale, mottled, cyanotic, gray, flushed
Glassy eyes, gaze aversion, staring
Grasping for air
Grimacing, fussing, irregular breathing
Fluctuating muscle tone
Flaccidity or hyper-tonicity
Frantic movements
53
Q

What are things that you can do to minimize stress in the NICU?

A

Decrease noise/light
Minimize handling
Protect sleep states
Help parents understand behavior al cues
Promote relationship-based caregiving (skin-to-skin if possible)
Autonomic and motor subsets are foundational for ability to achieve state and attention

54
Q

What can you do when families are in cricis and grieving

A
  1. Facilitate bonding process
  2. Reflect family’s and child’s strengths
  3. Use baby’s name
  4. Provide info that is consistent and sensitive
55
Q

What does a preterm infant present with compared to a full term?

A
  • Hypotonia
  • Decreased flexor tone
  • Decreased extension and head control
  • Increased PROM and AROM
  • Increased reactivity and startle response
  • Former pre-terms may also demonstrate toe walking (have lots of room in uterus to move and not squished)
56
Q

What is the evolution of Tone, Reflexes and MSK Development–When do a lot of changes happen, When does development start to slow

A

Sequential pattern: LE to UE, Distal to Proximal

20-26 weeks many changes happen quickly

By 32 weeks, development slows; preterm infant after 32 weeks looks more like term infant

57
Q

What are some environmental and behavioral strategies for pain reduction?

A
  • Dim lights/shade eyes
  • Reduce noise
  • Reduce frequency of handling
  • Swaddle
  • Non-nutritive sucking
  • Kangaroo Care (skin to skin)
  • Facilitated tucking (prone, midline and flexion with head slightly turned)
  • Try to mimic uterus as much as possible!
58
Q

What is our biggest sensory organ

A

Skin

59
Q

What are examples of the tactile system

A

Skin
Pain, proprioception, temp, and touch
*Think 2P’s and 2T’s

60
Q

When do pain receptors develop?

A

At 7 weeks gestational age: pain receptors first appear around mouth
At 22 weeks: pain pathways are myelinated
At 134 weeks: painful procedure in the first 2 weeks of life

61
Q

Describe the Vestibular System

A

At 20 weeks: vestibular nerve is full-size and tracts have begn to myelinate
Womb provides constant vestibular stimulation

62
Q

What are the different vestibular stimulations known to enhance states of arousal? (slow and rhythmic vs. fast and erratic)

A

slow and rhythmic=calming

fast and erratic=stimulating

63
Q

Describe the Olfactory and Gustatory Development

A
  • Able to smell at 28 weeks
  • taste buds mature at 13 weeks
  • from 24 weeks until term, fetus swallows 1L of amniotic fluid/day
  • Preterm infant has g-tube and no practice swallowing making coordination of SSB (suck, swallow, breathe) difficult
64
Q

Auditory Development

A

At 28 weeks GA: able to hear 40 dB
Normal convo: 60 dB
NICU: noise not exceed 45
Noisy NICU may cause cochlear damage as well as sleep disturbances, disrupting growth

65
Q

What is normal auditory conversation? in dB?

A

60

66
Q

At what level does NICU recommend the level of sound?

A

Not exceed 45 dB

67
Q

Visual Development

A

23-24 Weeks: major eye structure and visual pathways in place
24 weeks to term: retina and visual cortex maturing
24-28 weeks: eyelids separate
34 weeks: pupillary reflex present
32 weeks: percieve 1/2” stripes at 12 in

68
Q

What are the 6 states ofNeonatal behavioral Assessment? (according to Brazelton)

A

State 1: Deep sleep, w/o movement, breathing regularly
State 2: Light sleep, closed eyes, some corporal movement
State 3: sleepy, eyes opening and closing
State 4: awake, opened eyes, minimum corporal movement
State 5; completely awake, strong corporal movement
State 6: Cry

69
Q

Omphalocele

A

birth defect; intestine or other abdominal organs stick out of belly button; intestines only covered by small layer of tissue

70
Q

Gastroschisis

A

birth defect; intestines stick out of body through defect on one side of umbilical cord

71
Q

Tracheal Esophageal Fistula (TEF)

A

abnormal connection (fistula) b/w esophagus and trachea; g-tube needed during healing after surgery

72
Q

Asphyxia

A

lack of oxygen to organs; handle baby with care; intent is to minimize stress and avoid sensory overload

73
Q

Seizues

A

difficult to recognize and Dx; usually manifests as chewing, lip smacking, sucking, apnea, gaze abnormalities

74
Q

Medical issues in term/near term infants

A

Maconium aspiration syndrome; persistent pulmonary HTN of the newborn; infections; toxoplasmosis; Rubella; cytomegalovirus; Herpes simplex virus; HIV; Group B strep; fetal alcohol syndrome (FAS); Neonatal abstinence syndrome

75
Q

Brachial Plexus Injury

A

waiter’s tip position (shoulder add and IR, elbow ext, forearm pronation, flex wrist and fingers); nerves stretched during birth; 80% spontaneous recover in first 2 months; Tx: PROM, prevent contractures, promote AROM, strengthening

76
Q

Congenital Hip Dysplasia

A

unstable hip d/t abnormal formation of hip jt during early stages of fetal development; Ortolani test and Barlow test; tests only accurate prior to 3 months; 95% success rate with Pavlik harness if started before 7 wks

77
Q

Ortolani Test

A

hip is abd, examiner feels clunk as femoral head moves into socket

78
Q

Barlow Test

A

from flex and abd position, the hip is add while applying pressure in posterior direction; dislocation of femur indicates unstable hip

79
Q

Metatarsus Adductus

A

front of foot is bent or angled in toward middle of foot, back of foot and ankle are normal; can be treated with passive stretching, taping, corrective shoes, bracing or serial casting depending on severity

80
Q

Talipes Equinovarus (club foot)

A

affected foot appears to have been rotated internally at ankle; without tx- often appear to walk on their ankles or on side of feet; with tx- most recover completely during early childhood; Tx- serial taping and casting, splints

81
Q

Arthrogryposis

A

congenital joint contractures in 2 or more areas of body; goal of functional ROM; Tx- serial casting, splinting, stretching, surgery

82
Q

Interventions for orthopedic issues include

A

ROM- indicated for stable infants w/ loss of motion; taping- improve jt alignment in wrist/foot drop, club foot, not for infants

83
Q

When does discharge planning begin?

A

1st day the child is admitted to NICU

84
Q

What will qualify infant to transition home?

A

Weight gain pattern, normal body temp in open air, oral or tube feeding, no episodes of apnea or bradycardia in 5 days

85
Q

When does NICU follow-up begin?

A

at 4 months AA

86
Q

How often do follow-ups occur?

A

every 3 months for 1st year; every 6 months for 2nd year; annually until child goes to school

87
Q

4 reasons for developmental testing?

A
  1. Early identification of delays
  2. Help determine diagnosis
  3. Facilitate treatment planning (where to begin)
  4. Re-testing provides concrete data about progress
88
Q

4 methods of developmental testing?

A
  1. Parent/Child Interview
  2. History (review of med records)
  3. Clinical Observation (in child’s natural environment)
  4. Standardized tests
89
Q

What do Norm-Referenced or Standardized Tests compare?

A

compare one child with the “norm” of a group of other children

90
Q

What 4 things should guide your decision of which test to choose?

A
  1. Purpose of the test - diagnose, research, plan program
  2. Child - age, presenting limitations/disability, suspected dx
  3. Concerns to be addressed - gross/fine motor, speech, strength, functional tasks
  4. Examiner constraints - time, training, space, equipment, cost
91
Q

When would you use a screening test? Examples?

A

To identify typical and atypical development and need for further assessment

  • Denver II
  • Harris Infant Neuromotor Test (HINT)
  • Bayley Infant Neurodevelopental Screener (BINS)
92
Q

What are the tests that specifically examine motor function?

A
  • Test of Infant Motor Performance (TIMP)
  • Alberta Infant Motor Scale (AIMS)
  • Gross Motor Function Measure (GMFM)
  • Peabody Developmental Motor Scales: 2nd Ed. (PDMS-2)
  • Bruininks-Oseretsky Test of Motor Proficiency: 2nd Ed. (BOT-2)
93
Q

When would you use comprehensive developmental scales? Examples?

A

When you want to look at the child across all areas of development.

  • Bayley Scales of Infant and Toddler Development: 3rd Ed. (Bayley-III)
  • Battelle Developmental Inventory: 2nd Ed (BDI-2)
94
Q

When would you use an assessment of functional capabilities? Examples?

A

These tests look at the child’s ability to perform skills that are essential in their natural environment.

  • Pediatric Evaluation of Disability Inventory (PEDI)
  • Functional Independence Measure for Children (WeeFIM)
  • School Function Assessment
95
Q

What are 4 things you can do with the info gathered from the eval?

A
  1. Plan treatment program
  2. Identify progress/lack of progress
  3. Identify or rule out a specific problem
  4. Provide diagnostic information
96
Q

When did early intervention programs emerge and board certified sub specialty of neonatology?

A

1970s

97
Q

When were states required to provide early intervention under Education for All Handicapped Children Amendments?

A

1986

98
Q

Describe the 4 levels of Newborn Intensive Care?

A
  1. Basic care facility for healthy newborns
  2. Additional personnel, able to care for infants from 32 weeks, short-term respiratory assistance, some mechanical ventilation
  3. Full range of subspecialties and surgical services
    • > 1000g or >28 weeks
      -

Pediatrics (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions