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Peds Exam 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

when is the fastest growth period in peds?

A

infancy is the fastest growth period, followed by adolescence

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2
Q

cephalocaudal

A

head to tail (brain develops first)

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3
Q

proximodistal

A

center to periphery (control of trunk first, then fine motor control of hands and feet comes at the end of infancy)

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4
Q

head lag

A

at one month

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5
Q

head should come in line with body when you pull baby to sitting

A

2 mos

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6
Q

baby can help you pull them to sitting by pulling arms inward

A

4 mos

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7
Q

able to maintain a 90 degree angle when prone

A

4 mos

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8
Q

can turn head while prone

A

6 mos

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9
Q

start to put arms out to support upper body

A

2mos

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10
Q

can maintain sitting pos with help

A

4 mos

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11
Q

sits lopsided without assistance

A

7 mos

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12
Q

sits upright on his own

A

8 mos

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13
Q

when can an infant stand holding onto furniture?

A

9 mos

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14
Q

can toddle and walk

A

7 mos

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15
Q

can maneuver a certain direction when walking with assistance

A

10 mos

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16
Q

when should you stop using a mobile that secures to the side of the crib?

A

6 mos

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17
Q

when is a child ready for solid foods?

A

7 months

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18
Q

when do first teeth typically sprout?

A

7 mos

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19
Q

When should you expect a baby to say “mama” and “dada”?

A

8-9 mos

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20
Q

when does an infant smile and laugh

A

3 mos

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21
Q

knows object permanence

A

9 mos

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22
Q

finds hidden objects easily

A

10 mos

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23
Q

imitates other’s activities

A

12 mos

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24
Q

when do kids start to see color?

A

3 mos

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25
Q

uses cup well

A

15 mos

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26
Q

binocular vision developed

A

15 mos

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27
Q

refers to self and knows own name

A

15 mos

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28
Q

jumps in place

A

18 mos

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29
Q

identifies geometric forms

A

18 mos

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30
Q

50% of adult height, brain 90% adult size; goes up stairs (with two feet on each step), runs well with wide stance, holds crayon, follows simple directions, can use short sentences; able to speak 300 words

A

24 mos

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31
Q

4 times birth weight, good hand finger coordination

A

30 months

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32
Q

can copy a circle and remembers/repeats three numbers

A

36 mos

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33
Q

skips and hops on one foot

A

4 yrs

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34
Q

throws and catches balls

A

5 years

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35
Q

gains 4-5 lbs/year and 2-3”

A

preschool growth and development

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36
Q

imitative and dramatic play; associative play (interaction with each other) imitates same sex roles in play, provide toys to develop skills (tricycle, clay, paints, swings, balls,) parental supervision of TV (an hour a day-TV takes away from gross and fine motor development)

A

preschool play

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37
Q

parallel play

A

toddlers

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38
Q

gains 5 lbs a year, height 1-2”/year
vision 20/20 by 6-7 years old, myopia may appear by 8 years old. secondary sex characteristics begin at age 10 for girls, 12 for boys, greenstick fractures common, loose first teeth around age 6

A

school age growth and development

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39
Q

cooperative play on a team, develops sense of accomplishment

A

school-age play

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40
Q

oral temp at what age?

A

4 yrs

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41
Q

where is the apex of heart in kids

A

4-5th intercostal space, midclavicular line (heart shifted up and to the left)

42
Q

posterior fontanel closes

A

2-3 mos

43
Q

anterior fontanel closes

A

12-18 mos

44
Q

losa ears

A

indicator of down’s syndrome or other neuro/genetic d/o

45
Q

why are respiratory probs so prevalent in children?

A 
preemies lack surfactant 
shorter distance between structures
smaller airway diameter
fewer alveoli
neonates are obligate nose-breathers
less cartilage in airway walls
immature breathing muscles
thinner chest wall
higher metabolic rate (requires more oxygen)
total body response to respiratory infection (high fever, vomiting, diarrhea)
46
Q

major signs of respiratory distress

A

tachypneic, anxiety, expiratory grunting, use of accessory muscles, nasal flaring, retractions, tachycardia

47
Q

what causes wheezing?

A

inflammation, constriction of airway

48
Q

what causes rhonchi?

A

obstruction, often fluid, sounds rough

49
Q

respiratory assessment

A 
respirations
skin color
cough
LOC
pulse
hydration
50
Q

Respiratory Failure

A

is a clinical state of inadequate oxygenation, ventilation, or both

51
Q

Respiratory Arrest:

A

the absence of breathing

52
Q

how do you determine LOC in a non-communicable child?

A

Pediatric GCS
alertness
verbal
movement

53
Q

preventing respiratory distress in children

A

Avoid exposure to known infection
Good handwashing and hygiene
Good hydration to keep secretions thin
Identify known triggers for asthma
Outline dosage, administration, and adverse reactions to medications
Explain rationale for breathing exercises for all hospitalized patients

54
Q

Otitis Media

A

most common illness in infants and young children
rare after age 6
risk Factors: young age, day care, formula feedings, smoking exposure
If over age 2, palliative care 3 days and reassess (AAP); no OTC Rx other than Tylenol
USUALLY OF VIRAL ORIGIN!!!! WHAT?!?!

55
Q

Cystic Fibrosis

A

most important characteristic of the disease for a nurse to teach about is thick respiratory mucous. (ALL secretions are thickened: GI, reproductive, etc)

CF is a multisystem disorder of exocrine glands
First sign of Disease: meconium ileus (no stool in the first 24-48 hours of life)

sweat test:

frequent respiratory infections, dyspnea, clubbing, fatty stools, stunted growth

56
Q

Asthma

A

chronic inflammation of airway as reaction to “triggers”
calm them down, bronchodilator (albuterol-smooth muscle relaxer) or Xopenex (levalbuterol) if allergic to albuterol. ensure circulation.

57
Q

Acute LTB

A

Inflammation of airway following viral infection
Gradual onset*
Symptoms worsen at night
Discharge when able to take oral fluids and no stridor at rest
croupy seal cough

58
Q

Epiglottitis

A 
Inflammation of epiglottitis, usually after respiratory infection
Sudden onset*
Usually 2-8 years
DO NOT EXAMINE THROAT!** may further irritate throat and constrict airway more; drooling (cant swallow), cherry red epiglottis, tongue hanging out with stridor, coughing
Constant respiratory assessment
Always be ready for intubation
give bronchodilators
#1 cause is Hflu (vaccine avail)
59
Q

Pneumonia

A

Inflammation of the lungs
Mild fever and runny nose  wheezing, retractions, tachypnea
Usually due to RSV, M. pneumoniae

60
Q

Bronchitis/Bronchiolitis

A

Inflammation of Bronchioles OR trachea/bronchi
RSV
Recent URI (anorexia, thick secretions, distress)
Copious secretions
Educate parents on how to use bulb syringe and suction

61
Q

Foreign Body Aspiration

A

Inhalation of foreign body
Most common age is 1-3 yrs
Most common objects: hot dogs, coins, raisins, grapes, toys, rocks
Usually lodges in right main stem bronchus
Sudden coughing/gagging –>symptoms of respiratory infection
Education!

62
Q

meconium ileus

A

first sign of CF in a newborn: abd distension, vomiting, failure to pass stools, rapid development of dehydration

63
Q

pulmonary manifestations of CF

A

initial sign: wheezy respirations, dry, nonproductive cough

Eventually: increased dyspnea, paroxysmal cough, evidence of obstructive emphysema and patchy areas of atelectasis

Progressiove: overinflated, barrel-shaped chest, cyanosis, clubbing, repeated episodes of bronchitis and bronchopneumonia

64
Q

sweat test

A

(pilocarpine iontophoresis) consistent finding of abnormally high sodium and chloride concentrations in sweat is a unique characteristic of CF; a sweat chloride > 60 mEq/L is diagnostic of CF

65
Q

treatment of CF

A

aggressive pulmoanry toileting, diet 150% RDA, pancrease enzyme with meals

66
Q

what is overall goal of asthma?

A

prevent attacks

67
Q

RSV vaccine

respiratory synctial virus

A

synagis

68
Q

RSV

A

fever, copius secretions, respiratory distress, decreased appetite.

69
Q

tracheostomy

A

usually seen with vocal cord paralysis, BPD, or neuro deficit
Must have extra trach (one same size and one a size smaller), suction catheters, and vent bag at bedside.

70
Q

Normal Denver II

A

no delays and only 1 caution

71
Q

Suspect Denver II (retest in 1-2 weeks)

A

2+cautions, 1+delay

if suspect after retest, then consider referral

72
Q

Untestable Denver II

A

3+refusals to left of age line (retest in 1-2 weeks)

73
Q

what do you tell parent before administering Denver II?

A

not an IQ test
purpose of test compares your child’s development to other children
reassure that the child is not expected to perform ALL items

74
Q

What do you ask before administering Denver II?

A

were they premature, and what is their birthday

75
Q

What do you ask after completing Denver II?

A

was your child’s behavior today typical?

76
Q

when do you score a test item with NO?

A

no opportunity. when child has not been given a chance to learn that item: prepare cereal

77
Q

What is the difference between a caution and a delay?

A

a delay is a futured item that lies completely to the left of the age line (shade it), and a caution is a futured item that lies ON the age line. mark this with a C to the right of the item.

78
Q

The “Art” of pediatric nursing

A

learn to build on a family’s strengths
minimize physical and psychological pain (atraumatic care)
Balance involvement with families

79
Q

healthy people 2010 victories

A

access to quality health services
environmental health
immunization and infectious diseases
occupational safety and health

80
Q

healthy people 2010 defeat

A

nutrition and overweight

81
Q

peds health indicators

A 
immunization status
second hand smoke exposure
infant deaths and preterm births
obesity
teen depression
oral care
82
Q

number one cause of death in children over 1 year

A

injuries and accidents; teach parents about safety and accident/injury prevention!!

83
Q

biggest preventable health concerns today for children

A

nutrition, obesity and DM II
immunizations
dental care (low-income families)

84
Q

what is the most common cause of death in children UNDER 1 year?

A 
disorders relating to short gestation and unspecified low birth weight
SIDS
maternal complications of pregnancy
sepsis
respiratory distress
circulatory diseases
accidents
**educate on good prenatal care and genetic screening!
85
Q

2 essential areas of focus for parents

A

interpersonal skills and a basic understanding of childhood growth and development

86
Q

3 basic types of parenting/discipline

A

authoritarian: do what i say without question
permissive: only intervenes if danger is imminent
authoritative: leader of the family, allow some freedom, but with limits. Prevalent parenting style in our American society

87
Q

3 special concerns for adoptive families

A

attachment
telling the child he/she was adopted
identity formation during adolescence

88
Q

a child’s self-concept is influenced by

A

his or her beliefs about who he/she is and how he/she fits into society

89
Q

what families are at highest risk for health problems?

A

homeless, migrant, and poverty-affected families

90
Q

mormon/LDS children religious consideration

A

may refuse to remove sacred gowns

91
Q

Hindu religious consideration

A

don’t remove the red/colored thread around wrist

92
Q

Muslim children

A

same sex bathing

93
Q

Christian Science and Jehovah’s Witnesses

A

medical care refusal-document!!

94
Q

moxibustion

A

Moxibustion is a form of heat therapy in which dried plant materials called “moxa” are burned on or very near the surface of the skin. The intention is to warm and invigorate the flow of Qi in the body and dispel certain pathogenic influences.

95
Q

emancipated minor

A

1) TX resident
2) 17 years of age, or at least 16 yrs, living separate and apart from parents
3) must be self-supporting and managing their own financial affairs
* *Emancipated minors can give consent for their own medical procedures

96
Q

mature minor doctrine

A

mature minors may give consent to medical procedures

97
Q

number one need of caregivers

A

information

98
Q

to be legal, informed consent must be

A
  1. competent and sound mind
  2. recieve relevant information in order to make such a decision
  3. act voluntarily and without coersion
99
Q

gold standard for sterile urine collection in pediatrics

A

suprapubic tap

100
Q

order of blood draw

A

blood culture tube gets filled first so as not to contaminate the sample

Peds Exam 1 (3 decks)

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