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Pediatrics > Development > Flashcards

Development Flashcards

1
Q

Kids exposed early on to alcohol have different _________ as that is developed early

A

facial features

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2
Q

Kids exposed later in term to alcohol have _________ issues over facial issues

A

behavioral

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3
Q

Compared to typically developing children, children with ID have been found: (6)

A
  • 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
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4
Q

More than half of children with _________ also have at least one other Developmental Disability

A

visual impairment

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5
Q

what is amblyopia? What causes it?

A

lazy eye

- due to abnormal development of the neural connections

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6
Q

What is considered preterm?

A

prior to 38 weeks

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7
Q

What does a decreased ratio of type 1 to type 2 muscle fibers result in?

A

muscular fatigue - particularly respiratory muscles

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8
Q

What does incomplete ossification of bones, ligamentous laxity result in?

A

greater effects of positioning and gravity

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9
Q

What are the characteristics of a premature baby?

A
  • 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
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10
Q

What is the evolution of sensory responses?

A

touch - movement - smell & taste - hearing - sight

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11
Q

________ stimulation is known to enhance behavioral states

A

vestibular - gentle rocking

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12
Q

When is the vestibular system mature?

A

full term newborn

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13
Q

Olfactory development begins at ____weeks’ gestation

A

5 weeks

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14
Q

When does ability to smell begin?

A

28 weeks

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15
Q

When do taste buds mature?

A

13 weeks

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16
Q

By what week are the cochlea and peripheral sensory end organs developed?

A

24 weeks gestation

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17
Q

________ damage can occur due to noise in the NICU

A

cochlear damage

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18
Q

What sense is the least mature at birth?

A

vision

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19
Q

What vision develops at 34 weeks?

A

pupillary reflex - may see brief eye opening and fixation on a high contrast form under low illumination

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20
Q

What vision develops at 36 weeks?

A

saccadic vision following horizontal and vertical

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21
Q

What is vision at full term?

A

20/400

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22
Q

Posture, handling responses, and active movements when born 27-28 weeks

A

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

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23
Q

What is scarf sign?

A

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

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24
Q

Posture, handling responses, and active movements preterm at 34 weeks

A

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

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25
Q

What is moro reflex?

A

extend and abduct the arm followed by partial adduction; resists passive knee extension
- like scarf sign

26
Q

Posture, handling responses, and active movements of preterm at 40 weeks

A

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

27
Q

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.

A

true

28
Q

What is gestational age?

A

Age of infant based on mom’s last menstrual period (GA)

29
Q

What is post conceptual age?

A

GA plus the number of weeks since the infants birth – done until 40 weeks of age

30
Q

What is corrected/adjusted age?

A

gestational age plus weeks since birth minus 40 weeks

31
Q

What is considered full term? Postterm? Preterm?

A

full term - 37-40 weeks
postterm - > 42 weeks
preterm - < 37 weeks

32
Q

Extremely low birth weight

A

< 1000 g

33
Q

Very low birth weight

A

< 1501 g

34
Q

Low birth weight

A

1501 - 2500 g

35
Q

What is APGAR score? What does APGAR stand for?

A

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
36
Q

Why is RDS common in premature babies?

A
  • 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
37
Q

What are factors that increase risk for Respiratory Distress Syndrome? What is used to prevent RDS?

A
  • degree of prematurity (less than 34 weeks)
  • maternal diabetes
  • thoracic malformations

antenatal steroids to accelerate lung maturity are used for prevention

38
Q

What are clinical signs of RDS?

A
  • increased RR
  • expiratory grunting
  • sternal and intercostal retractions
  • nasal flaring
  • cyanosis
  • decreased air entry on auscultation
  • hypoxia
  • hypercarbia - increased CO2 in blood
39
Q

What are complications of treatment for RDS?

A

Barotrauma – increased airway pressure
Volutrauma – large gas volume
Atelectotrauma – aveolar collapse
Biotrauma – increased inflammation

40
Q

What is bronchopulmonary dysplasia?

A

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

41
Q

The ____________ closes within 10-15 hours after birth

A

ductus arteriosus

42
Q

What is patent ductus arteriosus? What are consequences?

A

a persistent opening between the two major blood vessels leading from the heart

  • hypotension
  • poor perfusion
  • congestive heart failure
  • metabolic acidosis
43
Q

What is hyperbilirubinemia?

A

accumulation of excessive bilirubin in the blood

- increased breakdown of RBC

44
Q

What is retinopathy of prematurity (ROP)? When does it peak?

A

abnormal development of blood vessels that may lead to scarring and detached retina
- peaks at 34-40 weeks

45
Q

What is the leading cause of visual impairment in prematurely born children? What are the classification levels?

A

retinopathy of prematurity (ROP)

- 1-5 w/ 5 resulting in complete detachment of retina (blindness)

46
Q

What is necrotizing enterocolotits?

A

Intestines begin to die – needs to be surgically removed

- Can lead to nutritional issues

47
Q

What is meconium aspiration syndrome?

A

baby aspirates on own poop

48
Q

Approximately ____ of bone is produced between 24 and 40 weeks’ gestation. Why does mechanical loading occur during this time that helps with bone formation?

A

80%

Mechanical loading occurs due to increasing muscle mass and decreased uterine space

49
Q

What is not recommended for infants less than 30-32 weeks gestation?

A

taping

50
Q

The baby must have enough ____________ for the splint as the splint is heavy. Who does the splint?

A

bone developement

splinting done by orthopedics

51
Q

What is periventricular leukomalacia (PVL)?

A

Symmetric, nonhemorrhagic, ischemic lesion to the brain of a premature infant
- affects the white matter due to reduction of blood flow

52
Q

T/F: The earlier you are born the greater the risk of having PVL

A

true

53
Q

What is the most common type of neonatal intracranial hemorrhage?

A

germinal matrix - intraventricular hemorrhage and periventricular hemorrhage

54
Q

Grade 1 germinal matrix hemorrhage

A

isolated germinal matrix hemorrhage (least involved)

55
Q

Grade 2 germinal matrix hemorrhage

A

hemorrhage ruptures into the lateral ventricles but they are normal sized

56
Q

Grade 3 germinal matrix hemorrhage

A

Hemorrhage into ventricles with dilation

57
Q

Grade 4 germinal matrix hemorrhage

A

hemorrhage into the periventricular white matter (most involved)

58
Q

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?

A

reperfusion
- signs - seizures, tone, posture, reflexes (suck, swallow, gag, tongue movements), respiratory pattern, autonomic function

59
Q

What is complete placenta previa?

A

baby’s placenta blocks moms cervix - requires emergency C section
- can cause severe bleeding before or during delivery

60
Q

Oligohydramnios vs Polyhydramnios

A

Oligohydramnios - deficiency of amniotic fluid

polyhydramnios - excessive accumulation of amniotic fluid

Pediatrics (5 decks)

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