Infancy 10-24 months Flashcards
1
Q
Developmental theories of infants 10-24 months?
A
Trust v. Mistrust
- the infant needs should be met
2
Q
When do teeth first erupt?
A
9-12 months
- bottle fed babies: look for carries and tooth decay
3
Q
When can babies first raise their heads?
A
10 months
4
Q
When is the birth weight doubled and tripled?
A
Doubled: 6 months
Tripled: 1 year
- weight loss is bad, physiological sign
5
Q
Average weight and height of 2 year old?
A
weight: 12 kg or 26.5 lbs
height: 86.6cm or 34 inches
6
Q
When does the anterior fontanel close?
A
18 months
- if not, hypothyroidism
7
Q
When can toilet training begin?
A
22-24 months
8
Q
When can a child hold urine for more than 2 hours?
A
By 14-18 months
9
Q
How should motor development look?
A
Symmetrical and progressive
Gross motor to fine motor
Crawling to walking to running to jumping
10
Q
Sleeping pattern of 10-24 month old?
A
sleeps total of 10-15 hours/day
11
Q
Nutritional pattern of 10-14 month old?
A
less interested in food
wants to explore world
12
Q
Nutritional pattern of 15-18 month old?
A
refuses meals to show power
small servings advised
13
Q
Nutritional pattern of 19-24 month old?
A
Increased ability to concentrate on meals
Restrict milk to 16 oz to save room for other foods
14
Q
Elimination abilities of 10-14 month old?
A
Muscle control of sphincter not sufficiently developed to start toilet training
15
Q
Elimination abilities of 15-24 month old?
A
Has BM at appropriate time when placed on a potty.
Indicated wet pants
16
Q
Elimination abilities of 18-24 month old?
A
- more regular pattern of elimination
- toilet training successful if pattern established
17
Q
Activity of 9-12 month old?
A
- Creeps and crawls
- scoots on bottom
- walks holding onto furniture
- starts holding spoon
18
Q
Activity of 12-15 month old?
A
- Walk on own/holding hand
- can only crawl upstairs
- can throw a ball
19
Q
Activity of 15-18 month old?
A
- Walking, may run/climb
- scribbling on paper
- feeds themselves
20
Q
Activity of 18-24 month old?
A
- runs, falls often
- kicks balls
21
Q
What needs to happen at every infant physical exam?
A
VS: temp, RR, HR Height, lying down Weight: infant scale in a diper Head circumfrence - growth chart every visit
22
Q
Normal HR
- 0-12 months
- 1-11 years
A
HR
- 0-12 months: 100-160 bpm
- 1-11 years: 70-120 bpm
23
Q
Normal RR
- 6-12 months
- 1-5 years
A
RR
- 6-12 months: 24-30bpm
- 1-5 years: 20-30bpm
24
Q
Normal temp
A
98.6 F
25
What systems need to be examined at every visit?
```
HEENT
Heart
Lungs
Neuromusular- symmetrical
Developmental Milestones
```
26
What history needs to be reviewed at every visit?
```
Eating
Sleeping
Bowel/bladder
Developmental milestones
Illnesses/ ER visits
```
27
When should rolling occur?
4-6 months
28
When should sitting occur?
6 months
29
When should walking occur?
12 months
30
When should toilet training occur?
Not before 24 months
31
When does babbling occur?
6-9 months
| - if not, may have hearing problem or delay
32
When should their first word occur?
10-12 months
33
What are signs of cardiac disease in an infant?
- Poor feeding
- Growth failure
- Respiratory distress
- Lethargy, should be active
- Cyanosis, circumoral
34
What are the signs of respiratory distress in an infant?
- Cyanosis
- Elevated RR
- Use of accessory muscles
- Head bobbing…more common in younger children
- Nasal flaring
- Retractions
- Wheezing
- Stridor
- hearing a thud on inspiration, probably object
- Rales, rhonchi, wheezing
35
How and when to introduce solid foods to an infant?
- Not before 6 months
- One at a time
- No cows milk before 12 months
- eats with fingers, holds cup and spoon
36
what needs to be check with kids on formula?
- check hemoglobin every 3 months
| - if constipated, give low iron formula
37
How will teething appear?
drooling
difficulty sleeping
irritable
38
What is atopic dermatitis?
- most common childhood skin disorder
- disseminated rash on face, arms and butt
- easily infected because kids scratch with dirty nails
- Red rash, papular lesions
- Associated with childhood asthma
39
Atopic dermatitis treatment:
- steroid cream, use mild potency to avoid changes in skin pigmentation
- bathe daily
- secondary infection: and anti-staph antibodies
- kids should wear gloves at night, keep nails short
- use mild soap and keep moisturized
- avoid sun and extreme temp changes
40
Who should not get vaccinated?
- allergies/ allergic rxn
- immunocompromised- for live vaccine
- chronic kidney disease
- if toxic (fever, diarrhea)
41
What is toilet training usually dependent on? Around what age?
Dependent on emotional and physical readiness
- walks well
- can stay dry for periods of time
- discomfort when soiled
Rarely before 18 months
42
When does AAP recommend children to be screened for developmental delays?
9 months
18 months
24 or 30 months
43
When should children be screen specifically for ASD?
Autism Spectrum Disorder
18 months
24 months
44
When is hemoglobin checked?
9-12 months
| If anemic look for: lead, diet, sickle cell
45
When are lead levels checked?
12 months, venous testing
46
What is some general anticipatory guidance you can give parents for 9-15 month kids?
- Consistent schedule is important
- reward good behavior, don't give attention to bad behavior
- They have broader emotional reactions: fear, stubborn
47
What is some general anticipatory guidance you can give to parents for 15-18 months kids?
time of temper tantrums and power dynamics
48
What is some general anticipatory guidance you can give to parents for 18-24 months kids?
- time of language acquisition
| - child is still very active, will run and jump
49
What is some nutritional anticipatory guidance you can give to parents for 9-15 months kids?
less interest in food
50
What is some nutritional anticipatory guidance you can give to parents for 15-18 months kids?
eating may become a battle
51
What is some nutritional anticipatory guidance you can give to parents for 18-24 months kids?
- encourage an interest in different foods
| - never use food as punishment/reward
52
What is some elimination anticipatory guidance you can give to parents for 9-15 months kids?
too early to potty train
53
What is some elimination anticipatory guidance you can give to parents for 15-18 months kids?
may begin practice potty training
54
What is some elimination anticipatory guidance you can give to parents for 18-24 months kids?
- girls generally train earlier than boys
- smaller kids train faster than larger kids
- bladder training is usually after bowel training
55
What is some safety anticipatory guidance you can give to parents for 9-15 months kids?
Childproof the home so kid can explore home freely
56
What is some safety anticipatory guidance you can give to parents for 15-18 months kids?
Maintain vigilance
57
What is some safety anticipatory guidance you can give to parents for 18-24 months kids?
Maintain vigilance for choking, burns, fires
58
What is the most preventable pediatric health problem?
High lead levels aka lead poisoning
59
What does high lead levels lead to?
- decreased intelligence
- impaired neurobehavioral development
- decreased growth
- seizures
60
What is a high lead level?
In NYC = 10+
| In NY state = 5+
61
Why are kids at higher risk for lead poisoning?
- more hand to mouth activity
| - absorption is greater in kids
62
What are sources of lead?
- Lead based paint
- Soil ,dust
- Drinking water
- Parental /hobbies..stained glass,furniture repair,finishing
- Toys
- Occupations..battery recycling,building demolition etc
63
How to reduce lead exposure?
- wash hands before eating
- wash toys/pacifiers
- have parents change before coming in house
- eat frequent meals
- increase iron and Ca in diet
64
When are high lead levels followed up on?
3 months after initial venous test
65
What lead level requires hospitalization?
70+g/dL
66
Otitis media
- acute infection of middle ear
- Common in 6-36 month kids
- Organisms: S.pneumo, H.influenza, Moraxella catarrhalis
- watch and wait for 72 hours
67
What is persistent acute OM?
persistent otitis media symptoms after 48-72 hours of antibiotics
68
What is chronic OM
persistent s/s for 3 months or more
| - anatomical problem
69
What are toxic markers for otitis media?
- decreased activity
- dehydration
- decreased feeding
- fever
70
When should parents see an improvement with OM?
| When is follow up scheduled?
- improvement within 24 hours of treatment
- f/u in 48 hours
- chronic f/u in 3-4 weeks
