Exam 1 Flashcards
Sitting up unsupported?
By 8 months
Rolling over?
4 months back to side
5 months tummy to back
Standing
Supported by 9 months, unsupported around 12 month
Cruising
By 11 months
Walking
By 12 months
Separation anxiety
Btwn 4-8 months
Object permanence
9-10 months
Understands “no”; obeys simple commands by?
9-10 months
Introducing solids
4-6 months
Head lag gone by?
At 4 months there should be almost no head lag, totally gone by 5 months
Tripod sitting?
6 months
By 6 months, birthweight has…
Doubled
By 1 year, birthweight has…
Tripled
By one year, height has increased by…
50%
Ie born 20 inches, now 30 inches
Measure head circumference until…
36 months
Posterior fontanel closed by…
2 months
Anterior fontanel closed by…
By 16 months but varies
Neat pincer grasp by…
11 months
Cleft lip vs cleft palate surgery age?
Lip corrected in first month
Palate done after one year
Referrals needed for cleft lip and palate?
Lactation consultant for help feeding
Early intervention to speech therapist
Audiologist bc ear infections
Pediatric dentist
Priorities for infants post op
Elbow restraints Airway mgmt (sit supine, suctioning) Minimize crying
Symptoms at birth for esophageal atresia?
Drooling and frothy mucus
Different presentations of EA?
Esophagus dead ends
Esophagus connects to trachea
Esophagus goes through trachea
Esophagus…..?
Pre-op EA interventions?
Sit upright. Put on NPO. NG tube to suction. Nexium IV to reduce stomach acid. TPN if needed to stabilize.
Expected care post op for EA?
Gastrostomy tube to protect suture healing.
Chest tube to restore negative lung pressure.
TEF?
???
Pyloric stenosis: what happens?
Pyloric muscle hypertrophic»_space; narrowing btwn stomach and duodenum»_space; buildup and vomit»_space; inflammation and edema»_space; complete closure
What side does stomach empty on?
Right
What are clinical symptoms of pyloric stenosis?
Non bilious projectile vomiting
Hyperistaltic waves from left to right
Is pyloric stenosis a surgical emergency?
No. Medical emergency.
Fluid imbalance risks associated with pyloric stenosis?
Bco vomiting, dehydration, metabolic alkalosis, hypokalemia, hyponatremia
Pyloric stenosis interventions?
NG tube
Keep flat with head elevated
Elbow restraints
IV til fluid labs are ok
Intussuption is what?
Telescoping/invagination of passing matter on ileocecal valve»_space; moves valve along»_space; cramping to push valve back out»_space; if can’t resolve, blood supply blocked and tissue necroses»_space; weeps bloody secretions
Cardinal sign of intussuption?
Currant jelly stool
Is intussuption a surgical emergency?
Yes
How is intussuption treated?
Barium enema via Foley catheter
After third time, tissue surgically repaired.
Interventions for imperforate anus?
Initiate IV NG tube to suction I&O Keep site very clean Zinc oxide if opening exists
Other concerns with imperforate anus?
Full exam bc rarely isolated
Appendicitis presents with pain where?
Starts at belly button and moves to lower right side of abdomen (mcburney’s point)
Antibiotic treatment: perforated vs non perforated appendix?
Triple strength if perforated
Nursing interventions for appendicitis post op?
Strict I&O Monitor for return of bowel sounds Dressing change Ambulate to move leftover gas from surgery Cough and breathe Pain management
Etiology of hirschprung’s?
No ganglia in lower intestine, colon.