CPN Exam Cards Flashcards
Cephalocaudally
from head to toe (head control, then sitting, then walking)
Proximodistally
from the trunk to the tips of the extremities (moving arms and legs before picking things up with fingers)
General to the Specific
crawling, then walking, then skipping
Chronologic Age
Years or months since birth date
Mental Age
Level of cognitive function
Bone Age
Determined by X-ray of tarsals and carpals
Adjusted/Corrected Age (for growth charting)
Chronologic age minus # of weeks born prematurely– Prematurity = < 37 weeks post gestational age– Used for first 2 years of life
Length
0-36 months
Height
2-18 year
Weight at birth
Some genetic components
Largely a measure of maternal nutrition
Weight at 6 months
Double birth weight (minimally)
Weight at 1 year
Triple birth weight(minimally)
Weight > 1 year
Genetic Influence
Environmental Influence
Illness/Health Influence
BMI ≥95%
obese (30 or more)
BMI 85% - <95%
overweight (25-29.9)
BMI 5% - <85%
healthy weight (18.6- 24.9)
BMI ≤ 5%
underweight (≤18.5)
Average Birth length
20 inches
Length by Age
1st year: 10 inches
2nd year: 5 inches
3rd year - puberty: 2.5 inches
Infant
0-12 months
Infant 2 Month Social
Instinctual Smile
Infant 3 Month Social
Social Smile
Infant 4 Month Social
Laughts
Infant 4-6 Month Social
Stranger Danger
Infant 7-9 Month Social
Peek-a-boo, look in mirror
Infant 10-12 Month Social
Claps hands, waves bye-bye
Infant 3 Month Cognition
Babbles, turn to rattling noise, notices own hands
Infant 6 Month Cognition
continuous babbling: babbles in response to sounds as in conversation
Infant 7-9 Month Cognition
understands cause and effect
Infant 10-12 Month Cognition
points to objects when named; says “mama” “dada”; says 5 words but understands many more
Infant 2 Month Motor
lift head; follows to midline; posterior fontanel closes
Infant 3 Month Motor
eyes can track objects 180 degrees; raises head and neck when lying on stomach; notices own hands
Infant 4 Month Motor
rakes objects; grasps rattle; begins to roll over (first from stomach to back
Infant 5-6 Month Motor
rolls over from back to front; transfers objects from hand to hand; reaches; pushes up on knees and hands and rocks back and forth; sits with support
Infant 8 Month Motor
sits without support
Infant 9 Month Motor
develops pincer grasp; feeds self bottle or cheerios; crawls; stands holding on
Infant 10-12 Month Motor
claps hands; waves bye-bye; pulls self up to a stand; cruises; walks with support; may take first steps
Infant Reflexes
Present at birth, disappear by 4 months
Root Reflex
Corner of the baby’s mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and “root” in the direction of the stroking
Suck Reflex
Roof of the baby’s mouth is touched, the baby will begin to suck
May not be present or weak in premature babies
Moro Reflex
Often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out the arms and legs, cries, then pulls the arms and legs back in
Tonic Neck Reflex
When a baby’s head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the “fencing” position
Grasp Reflex
Stroking the palm of a baby’s hand causes the baby to close his or her fingers in a grasp
Babinski Reflex
When the sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out
Step Reflex
Baby appears to take steps or dance when held upright with his or her feet touching a solid surface
Parachute Reflex
When a baby senses that they’re about to fall, their arms reflexively extend to break the fall
Toddler
1-2 years old
Toddler Social
Egocentric
Separation Anxiety
Temper Tantrums
Lacks concept of sharing
Points to body parts
Toddler 12 Month Cognition
says 5 words; understands many more
Toddler 18 Month Cognition
says 50 words; understands many more
Toddler 24 Month Cognition
says 400 words; uses 2 to 3-word phrases
Toddler 12-18 Month Motor
anterior fontanel closes
Toddler 12-16 Month Motor
walks
Toddler 21 Month Motor
Climbs Stairs
Toddler 24 Month Motor
Runs and Jumps
Toilet Training
18-24 Months shows interest
24 months bladder reaches adult function
Daytime Dryness
2-3 years
Nighttime Dryness
3-5 years
Preschool
3-5 Years
Preschool Social
Awareness of others increases
Begins to share, follow rules, take turns
Develops a conscience
People Pleaser
Preschool 3 Year Cognition
Uses 3-4 word phrases, 75% of language is intelligible
Preschool 4 Year Cognition
Uses 4-5 word phrases
Preschool 5 Year Cognition
Uses 5-6 word phrases; tells long stories
Preschool 3 year Motor
rides a tricycle; dresses self; uses scissors; builds a tower of more than 6 blocks
Preschool 4 Year Motor
throws ball overhead; hops and stands on one foot for up to 5 seconds
Preschool 5 Year Motor
dresses self well; runs, jumps, skips, hops, somersaults
School Age
6-12 Years
School Age Social
School focal point of activities
Parent is greatest influence
Teacher greatest non-parent influence
Develops true friends
Group Activities
Cooperate and Compromise
Morality
6-9: sense of right and wrong
10-12: sense of “shades of Gray”
School Age Cognition
Develops sense of time and space
Understands cause and effect
Reads and spells
Enjoys games with strategy
School Age Motor
Child is Limber - bones grow faster than muscles, prone to bone fractures
Physical activity important to avoid overweight
Breast Development
1st sign of female puberty - 10 years
Pubic Hair Development - Girls
2nd sign of female puberty - 11 years
Height Spurt - Girls
3rd sign of female puberty - 12 years
Menarche
last sign of female puberty - 13 years
Precocious Puberty
< 7 years Caucasian
< 6 years African American
Testicular Enlargement
1st sign of male puberty - 11 years
Pubic Hair - Male
2nd sign of male puberty - 12 years
Height Spurt - Male
3rd sign of male puberty - 14 years
Precocious Puberty - Male
1st sign of puberty <9 years
Adolescent
13-18 years
Adolescent Social
Intense interest in peer group and perception of others
Peer contact and involvement becomes increasingly important
Adolescent Sexuality
Sexuality emerges– Sexual behavior and experimentation may be homosexual and heterosexual and is NOT necessarily related to sexual orientation
Adolescent Cognition
Self-image concept changes with changing body
Egocentric
Uses past experiences when making decisions
Adolescent Motor
Rapid increase in height and weight
Infant Psychosocial Development
Focus is trust - consistency
Toddler Psychosocial Development
Focus is autonomy - mastering new tasks
Preschool Psychosocial Development
Focus is initiative - dressing self
School Age Psychosocial Development
Focus is achievement
Adolescent Psychosocial Development
Focus is Identity Development
Infant Cognitive Development
learns through interaction with the environment
Toddler Cognitive Development
Egocentric
Preschool Cognitive Development
Thinking is non-logical, non-linear
School Age Cognitive Development
Thinking is logical, linear, concrete
Adolescent Cognitive Development
Thinking is adaptable, flexible, abstract
Infant Communication
parental presence, routines, consistency
Toddler Communication
avoid separation from parents, flexibility, autonomy, gross motor activity
Preschool Communication
promote initiative, give choices, short explanations, demonstrate to reduce anxiety
School Age Communication
involve, explain, assess understanding, promote peers and school
Adolescent Communication
promote privacy and modesty, promote peer contact, open-ended questions, remain objective
Discipline
Based on Development
Toddler Discipline
focus on distraction and redirection, positive reinforcement, consistency
Preschool Discipline
people-pleasers”; ignore bad behavior and reward good behavio
School Age Discipline
give independence and encourage personal responsibility; discuss consequences of actions
Adolescent Discipline
promote and reinforce good choices; save battles for important things
Pain Scale Infant, Toddler, Preschool
FLACC Pain Assessment Scale
Pain Scale 4-8 Years
Wong Baker Faces Scale
Pain Scale >8
Numeric Scale
Vitamin D
Supplementation begins within a few days after birth
Toddlers will get adequate amounts from dietary intake
Iron
4 months until solid foods - breast-fed ONLY
Milk
Breast Milk - 1st 4 months
Formula - 20-30 ounces (4-6 months)
Whole Milk - 1-2 years (sippy cup)
Lower fat Milk - >2
Infant Meals
Pureed solid foods - 4 months old introduce
Limit rice, Oats, barley and mixed grains
Table Food - 4-12 months
Toddler, Preschool, School Age meals
3 meals + 2 snacks
Toddler Developmental Issues
slow growth, picky eaters– Focus on: socialization, time-limit, avoiding battles
Preschool Developmental Issues
slow growth, food jags are common– Focus on: avoiding battles
School Age and Adolescent Developmental Issues
develop habits, make choices, engage in social media and electronics– Focus on: promotion of healthy lifestyle
Teething
3-4 Months
First Tooth
6 months
20 Teeth
By age 3
Tooth Loss
Loses first tooth at 6 years
Loses and replaces 4 teeth a year until 12
Infant Sleep Safety
Back to Sleep
Bare Crib
Adolescent HEEADSSS Assessment Tool
Home
Education
Employment
Activities
Drugs
Sexuality
Suicide
Safety
Adolescent Mortality
- Motor Vehicle Accident
- Homicide
- Suicide
