Development Flashcards
Kids exposed early on to alcohol have different _________ as that is developed early
facial features
Kids exposed later in term to alcohol have _________ issues over facial issues
behavioral
Compared to typically developing children, children with ID have been found: (6)
- capable of learning fewer things
- need more repetitions to learn
- more difficulty generalizing skills (transferring to different environments)
- more difficulty maintaining skills that are not practiced regularly
- slower response time
- more limited repertoire of responses
More than half of children with _________ also have at least one other Developmental Disability
visual impairment
what is amblyopia? What causes it?
lazy eye
- due to abnormal development of the neural connections
What is considered preterm?
prior to 38 weeks
What does a decreased ratio of type 1 to type 2 muscle fibers result in?
muscular fatigue - particularly respiratory muscles
What does incomplete ossification of bones, ligamentous laxity result in?
greater effects of positioning and gravity
What are the characteristics of a premature baby?
- hypotonia
- decreased ratio of type 1 to type 2 muscle fibers (results in muscular fatigue)
- incomplete ossification of bones, ligamentous laxity (greater effects of positioning and gravity)
- more reactive to sensory stimuli
What is the evolution of sensory responses?
touch - movement - smell & taste - hearing - sight
________ stimulation is known to enhance behavioral states
vestibular - gentle rocking
When is the vestibular system mature?
full term newborn
Olfactory development begins at ____weeks’ gestation
5 weeks
When does ability to smell begin?
28 weeks
When do taste buds mature?
13 weeks
By what week are the cochlea and peripheral sensory end organs developed?
24 weeks gestation
________ damage can occur due to noise in the NICU
cochlear damage
What sense is the least mature at birth?
vision
What vision develops at 34 weeks?
pupillary reflex - may see brief eye opening and fixation on a high contrast form under low illumination
What vision develops at 36 weeks?
saccadic vision following horizontal and vertical
What is vision at full term?
20/400
Posture, handling responses, and active movements when born 27-28 weeks
Posture - hypotonia, beginning of hip flexion
handling - full PROM w/o resistance, no attempt to align head and body w/ pull to sit, no recoil of arms when extended, no attempt at toe grasp
active movements - spasmodic and involve total extremity
What is scarf sign?
A newborn assessment finding in which the infant’s elbow crosses the body midline without resistance as the examiner draws the arm across the chest to the opposite shoulder
Posture, handling responses, and active movements preterm at 34 weeks
posture - increase hip flexion w/ frog like position
handling - able to grasp and maintain traction w/ UE, LE traction increasing, rights head in supported sitting, some flexion in elbows and knees w/ effort to lift head in suspension, moro reflex
active movements - kick during prolonged awake, purposeful movements, reciprocal and involve trunk flexion
What is moro reflex?
extend and abduct the arm followed by partial adduction; resists passive knee extension
- like scarf sign
Posture, handling responses, and active movements of preterm at 40 weeks
posture - all extremities in flexion
handling response - resists full extension, arm recoil after release, easily bear weight in supported standing
- lack shoulder muscle tone and may not keep head alignment w/ pull to sit
active movement - smooth and purposeful, reflexes consistent and complete, less flexor hypertonicity resulting in greater ROM, less predictable sleep-wake cycles and feeding pattern
T/F: The flexor tone of a preterm infant who has reached full-term is never as great as the flexor tone of an infant born at term.
true
What is gestational age?
Age of infant based on mom’s last menstrual period (GA)
What is post conceptual age?
GA plus the number of weeks since the infants birth – done until 40 weeks of age
What is corrected/adjusted age?
gestational age plus weeks since birth minus 40 weeks
What is considered full term? Postterm? Preterm?
full term - 37-40 weeks
postterm - > 42 weeks
preterm - < 37 weeks
Extremely low birth weight
< 1000 g
Very low birth weight
< 1501 g
Low birth weight
1501 - 2500 g
What is APGAR score? What does APGAR stand for?
scores given at 1, 5 and 10 minutes after birth to assess how the baby is doing
A: activity, postural tone P: heart rate G: grimace response to stimulation A: appearance/color R: respiratory rate
Why is RDS common in premature babies?
- pulmonary immaturity - poor alveolar capillary development, lack of type 2 alveolar cells that produce surfactant
- inadequate pulmonary surfactant
- increased compliance of chest wall - from cartilaginous ribs and decreased type 1 fatigue-resistant muscles
What are factors that increase risk for Respiratory Distress Syndrome? What is used to prevent RDS?
- degree of prematurity (less than 34 weeks)
- maternal diabetes
- thoracic malformations
antenatal steroids to accelerate lung maturity are used for prevention
What are clinical signs of RDS?
- increased RR
- expiratory grunting
- sternal and intercostal retractions
- nasal flaring
- cyanosis
- decreased air entry on auscultation
- hypoxia
- hypercarbia - increased CO2 in blood
What are complications of treatment for RDS?
Barotrauma – increased airway pressure
Volutrauma – large gas volume
Atelectotrauma – aveolar collapse
Biotrauma – increased inflammation
What is bronchopulmonary dysplasia?
Multifactorial pathologic process – acute lung injury from the combined effects of oxygen toxicity, barotrauma and volutrauma from mechanical ventilation – may go on to develop CLD – chronic lung disease
The ____________ closes within 10-15 hours after birth
ductus arteriosus
What is patent ductus arteriosus? What are consequences?
a persistent opening between the two major blood vessels leading from the heart
- hypotension
- poor perfusion
- congestive heart failure
- metabolic acidosis
What is hyperbilirubinemia?
accumulation of excessive bilirubin in the blood
- increased breakdown of RBC
What is retinopathy of prematurity (ROP)? When does it peak?
abnormal development of blood vessels that may lead to scarring and detached retina
- peaks at 34-40 weeks
What is the leading cause of visual impairment in prematurely born children? What are the classification levels?
retinopathy of prematurity (ROP)
- 1-5 w/ 5 resulting in complete detachment of retina (blindness)
What is necrotizing enterocolotits?
Intestines begin to die – needs to be surgically removed
- Can lead to nutritional issues
What is meconium aspiration syndrome?
baby aspirates on own poop
Approximately ____ of bone is produced between 24 and 40 weeks’ gestation. Why does mechanical loading occur during this time that helps with bone formation?
80%
Mechanical loading occurs due to increasing muscle mass and decreased uterine space
What is not recommended for infants less than 30-32 weeks gestation?
taping
The baby must have enough ____________ for the splint as the splint is heavy. Who does the splint?
bone developement
splinting done by orthopedics
What is periventricular leukomalacia (PVL)?
Symmetric, nonhemorrhagic, ischemic lesion to the brain of a premature infant
- affects the white matter due to reduction of blood flow
T/F: The earlier you are born the greater the risk of having PVL
true
What is the most common type of neonatal intracranial hemorrhage?
germinal matrix - intraventricular hemorrhage and periventricular hemorrhage
Grade 1 germinal matrix hemorrhage
isolated germinal matrix hemorrhage (least involved)
Grade 2 germinal matrix hemorrhage
hemorrhage ruptures into the lateral ventricles but they are normal sized
Grade 3 germinal matrix hemorrhage
Hemorrhage into ventricles with dilation
Grade 4 germinal matrix hemorrhage
hemorrhage into the periventricular white matter (most involved)
Period of ______ is when many of the complications that affect the metabolism, function, and structure of the brain occur. What are signs of hypoxic-ischemic encephalopathy?
reperfusion
- signs - seizures, tone, posture, reflexes (suck, swallow, gag, tongue movements), respiratory pattern, autonomic function
What is complete placenta previa?
baby’s placenta blocks moms cervix - requires emergency C section
- can cause severe bleeding before or during delivery
Oligohydramnios vs Polyhydramnios
Oligohydramnios - deficiency of amniotic fluid
polyhydramnios - excessive accumulation of amniotic fluid
