Hair, Skin, Nails, and Abdomen PEDS Flashcards

1
Q

What vital sign do you start with for infants? Why?

A
  • respiration

- it changes very easily; temperature can increase pulse and respiration

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2
Q

How long do you look for respirations in an infant? Where? Why?

A
  • a full minute
  • their belly
  • they are diaphragmatic breathers and they have short apneac periods
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3
Q

What physical measurements happen for an infant?

A
  • weight
  • length
  • head circumference
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4
Q

When do you find the chest circumference of an infant?

A
  • to compare it with the head

- not standard

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5
Q

What are the four growth measurements that warrant further explanation?

A
  • below 5% or above 95% without genetic explanation
  • wide percentile difference between height and weight
  • sudden stop of growth when it has been steady
  • failure of normal growth spurts
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6
Q

What is a Mongolian spot? Who is it common in?

A
  • hyperpigmentation
  • Black, Asian, American-Indian, and Hispanic newborns
  • mostly on the bottom
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7
Q

What is a Cafe au lait spot? When is it usually present?

A
  • a large round or oval patch of light brown pigmentation

- usually present at birth

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8
Q

What is erythema toxicum? Where does it show?

A
  • common rash that appears in the first 3-4 days of life
  • red macules and papule on the cheeks, trunk, chest, back, and buttocks
  • “flea bite rash”
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9
Q

What is cutis marmorata?

A

-a transient mottling in the trunk and extremeties in response to cooler temperatures

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10
Q

What is physiologic jaundice? How often does it occur?

A
  • a common variation in half of all newborns
  • yellowing of skin, sclera, and mucus membrane developed 3-4 days after life
  • because of increased numbers of red blood cells that hemolyze after birth
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11
Q

What is milia and where does it occur? What is it caused by?

A
  • a common variation of white papules on the cheeks, forehead, nose, and other skin
  • caused by sebum that occludes the openings of follicles
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12
Q

What does measles look like? Where does it occur?

A
  • red-purple maculapapular blotchy rash that appears of 3 or 4 day of illness
  • first behind the ears then to the face, neck, trunk, arms, and legs
  • looks coppery and does not blanch
  • Koplik spots
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13
Q

What does German measles look like? Where does it occur?

A
  • pink, papular rash that first appears on the face and then spreads
  • presence of neck lymphadenopathy
  • NO Koplik spots
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14
Q

What does chickenpox look like and where does it occur?

A
  • small, tight vesicles that first appear on the trunk
  • spreads to face, arms, and legs
  • shiny vesicles on an erythematous base
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15
Q

What is seborrheic dermatitis? What is another name for it?

A
  • cradle cap

- scaly, crusty scalp that occurs with seborrheic dermatitis

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16
Q

What might a newborn’s nails look like for the first few hours of life?

A

-may be blue for a few hours but then turn pink

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17
Q

What should the liver span measure at the age of: 2 years, 6 years, and adolescence?

A
  • 2 years: 3.5 cm
  • 6 years: 5 cm
  • adolescence: 6-7 cm
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18
Q

What is an umbilical hernia during infancy? By what age do most of them resolve? When is it its biggest?

A
  • when the umbilicus sticks out
  • 1 year
  • 1 month
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19
Q

Who is an umbilical hernia most common in? What accentuates it?

A
  • black infants

- crying

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20
Q

How do you measure a baby’s weight?

A

-measuring board

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21
Q

What is the average and the range for an infants head circumference?

A
  • average: 34 cm

- range: 32-38 cm

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22
Q

When is a really high fever not as dangerous as for an adult?

A

-up to 6-8 years

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23
Q

What pulse do you take for infants and older?

A
  • apical: infants and toddlers

- radial: 2 years and older

24
Q

What is sinus arrhythmia?

A

-the pulse speeds up when inhaling and slows when exhaling

25
Q

When is blood pressure taking in PEDS?

A
  • anyone at high risk

- annually over 3 years old

26
Q

How do we gage blood pressure as “normal” in PEDS?

A

-related to height; NOT weight or age

27
Q

When do we reevaluate or send for a consult relating to a child’s blood pressure?

A
  • in the 90-95% and not related to height and weight, reevaluate in 6 months
  • above the 95%, send for consult
28
Q

What are some characteristics of a newborn’s skin? What can that lead to?

A
  • thin, elastic, and permeable

- apt to fluid loss

29
Q

What is lanugo?

A

-fine, downy hair that covers the baby at birth

30
Q

What is vernix caseosa?

A

-thick, cheesy substance at birth

31
Q

What is the function of sebum? What can it cause?

A
  • holds water in the skin

- can cause cradle cap and milia

32
Q

Can babies regulate their own temperature?

A
  • no, they cannot warm or cool themselves

- need one more layer than you do

33
Q

What happens to the skin during puberty?

A

-acne

34
Q

What is being checked during a skin history?

A
  • changes
  • rashes/sores
  • new food/formula
  • burns/bruises
  • contagious skin conditions
  • habitual movements
  • sun exposure
35
Q

What can bruises indicate? Where are they “normal” at and where is a questionable spot?

A
  • child abuse
  • normal: bony prominence, head
  • bad: back, wrist, neck, or bottom
36
Q

What should you make sure to do when finding bruises?

A
  • see if the story matches the location, shape, and age of the bruise
  • straight lines can indicate abuse
37
Q

What is harlequin color change?

A

-the babies are red but blanch on the upper half when you turn them

38
Q

What is acrocyanosis?

A
  • bluish color around the lips, hands, and feet

- disappears with warmth

39
Q

What is carotenemia?

A

-orange color from too much vitamin C

40
Q

Where do you assess turgor on a baby?

A
  • on the abdomen

- thick adipose, thin skin

41
Q

What is a storkbite? When does it normally go away?

A
  • a salmon patch on the back of the neck or forehead

- gone within the first year

42
Q

What happens sometimes when a baby is born with hair?

A

-is can fall out weeks after birth

43
Q

What is in the umbilical cord for a baby?

A
  • 2 arteries

- 1 vein

44
Q

What is different about the liver and the bladder in an infant rather than an adult?

A
  • liver: takes up more abdominal space

- bladder: higher up than an adult

45
Q

What causes the abdominal organs to be easier to palpate in an infant?

A

-the abdominal wall is less muscular

46
Q

What is puritis?

A

-itchy skin

47
Q

What is pica? When do kids normally stop?

A
  • eating nonfood items

- they recognize food after two years old

48
Q

What is diastasis recti? When is it prominent?

A
  • a bulging in the middle of the abdomen

- when trying to sit up

49
Q

What should you hear in the abdomen? Do you use auscultation and percussion?

A
  • bowel sounds, no vascular sounds

- percussion has limited usefullness

50
Q

What should you do when palpating an infants abdome?

A
  • flex their knees
  • liver fills RUQ
  • cecum RLQ
  • sigmoid colon left inguinal area
51
Q

How do you prevent tickling when palpating?

A
  • flex knees
  • use their hands with your hands
  • put the stethoscope on their abdomen and palpate
52
Q

When is a protuberant abdomen normal?

A

-under the age of 4

53
Q

What happens to the protuberant abdomen after the age of 4?

A

-protuberant when standing but should go away when lying

54
Q

When does a protuberant abdomen go away completely?

A

-7 years old

55
Q

What is lumbar lordosis?

A
  • when the lumbar portion of the spine curves too far forward
  • causes abdomen to stay protuberant