Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fall 2020 Primary Care FNP > Infant/Toddler 10-24 Months > Flashcards

Infant/Toddler 10-24 Months Flashcards

You may prefer our related Brainscape-certified flashcards:
Family Nurse Practitioner (FNP) flashcards
1
Q

Infant/Toddler Dynamic w Parent or Caregiver

  • Interaction
    • ​Provider should observe what?
    • Provider needs to develop _____ relationship with parent
    • _____ is key
A
  • strength and characteristics of parent/child relationship
  • trusting
  • listening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Physical Milestones

  • Eruption of first teeth: ___-___ months
  • Able to raise head at ___ months
  • Birth weight ______ by 1 year
  • Average 2 year weight is ___ kg (26.5 lbs)
  • Average height is ___ cm (34 inch)
  • By 14-18 months, child may hold _____ for > 2 hrs
  • 18 months: _____ _______ closed
  • 22 months: Control of (2) sphincters, toilet training may begin normally around ___ months
  • ____ circumference exceeds head circumference
A
  • 9-12m
  • 10m
  • Tripled
  • 12kg
  • 86.6cm
  • urine
  • Anterior Fontanel
  • Anal and urethral sphincter, 24
  • Chest > Head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Growth and Developmental Milestones

  1. Growth​
    1. ​10-12m (1)
    2. 12m (4)
    3. 14-18m (3)
    4. 18-24m
A
  1. lateral incisors erupting
  2. Loses Babinski, Triples birth weight, Equal circumference of head and neck, Develops lumbar curve
  3. Long trunk, Legs short and bowed, abdomen protruding
  4. Anterior fontanels closed, appears thinner and taller
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Growth and Developmental Milestones

  1. Motor ​​​​​​

  • 10m:
  • 12mm:
  • 13-14m:
  • 18m:
  • 19-24m:
A
  • Masters crawling, picks up objects well, pulls self to standing while holding, sits by falling down, extends toy to another person but doesnt release it
  • Stands erect, walks with help, uses spoon, crayons, drops objects deliberately, shakes head “no”, recovers balance when falling down
  • Walks without help, creeps up stairs, develops hand dominance, able to push toys, place objects in containers, drinks from cup, but still rotates spoon, gets into everything
  • Runs and clumsily falls down
  • Walks upstairs without help, turns pages of book, throws ball over head. Fills and uses spoon without flipping, but spills frequetly, Scribbles with pen and pencil. Places objects into holes and slots. Good pincer movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Growth and Development Milestones

  1. Vision​
    • ​​10-12m =
    • 12-24 =
  2. Hearing
    • ​​14-18m =
A
  1. Vision
    • ​​Able to look for concealed items. Converges on objects in close proximity. Peripheral vision is well developed. Judges distance well.
    • Smooth ocular movements, good eye-hand coordination, improved depth perception
  2. Hearing
    1. ​Reacts to sounds by tracking the source, likes to be whispered to.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Growth and Developmental Milestones

  1. Speech
    1. ​Has a vocabulary of seven true words.
    2. Slow vocabulary growth due to increased interest in walking. Uses “dada” and “mama” labels for correct person.
    3. Imitates definitive speech sounds. Says “da-da, ma-ma”
    4. Develops a vocab of 25 words, learns words important to him/her first.
A
  1. 16-18m
  2. 12-15m
  3. 10-12m
  4. 19-24m
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Growth and Developmental Milestones

  1. Intellect/Emotional
    1. ​Strong attachment to mother/older adults in own family. Increased self awareness. Plays interactive game. Increased ability to express emotions.
    2. Has short attention span. Begins to test limits. Becomes very communicative and social. Strong, clear development of individual personality traits.
    3. Understandable “bye bye” Looks at and follows pictures in book. Pays attention to own name.
A
  1. 11-18m
  2. 19-24m
  3. 10m
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Growth and Developmental Milestones

  1. Sleep
    1. Sleeps a total of 10-15 hrs/day
  2. Nutrition
    1. Uses refusal of meals to show power, small servings advised.
    2. Less interest in food, too busy investigating world. A well balanced diet is more important
    3. Increased ability to concentrate on meals. Restrict milk intake to 16 oz to save room for other foods.
  3. Elimination
    1. Has bowel movement at appropriate time when placed on potty. Indicates wet pants.
    2. More regular pattern of elimination. Toilet training will be successful, if regular pattern is established.
    3. Muscle control of sphincter not sufficiently developed to start toilet training.
A
  1. Sleep
    1. ​10-24m
  2. Nutrition
    1. ​15-18m
    2. 10-14m
    3. 19-24m
  3. Elimination
    1. ​15-24m
    2. 18-24m
    3. 10-14m
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Activity

  • Match to 9-12, 12-15, 15-18, or 18-24m.
    • Runs, falls, kicks ball
    • Creeps, crawls, scoots on bottom, walks holding onto furniture, starts holding spoon
    • Walking, may run/climb, scribbling on paper, feed themselves
    • Walks on own/holding hand, can only crawl upstairs, can throw ball
A
  • 18-24m
  • 9-12m
  • 15-18mg
  • 12-15m
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Physical Exam

  • VS =
  • Height =
  • Weight =
  • HC up until age ___
  • With every visit (3)
  • Switch to CDC growth cart at?
A
  • Temp, RR, HR
  • lying down until age 2 then measure height standing
  • Naked weight although some offices will check with dry diaper
  • 2y
  • Growth chart w (Ht, Wt, HC) every visit
  • 2y
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

RR, HR, BP

  • 0-3m
    • RR
    • HR
    • BP
  • >12 yrs
    • RR
    • HR
    • BP
A
  • 0-3m
    • 35-55
    • 100-150
    • 65-85/45-55
  • >12 yrs
    • 12-18
    • 55-85
    • 110-135/65-85
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

History

  • Review n____/inf____/___-in history
  • Every visit
    • ​E_____
    • S_____
    • B____/bl____…..____ trained?
    • Developmental _____
    • Ill____, E_ visits
A
  • newborn/infant/walk-in
  • Every visit
    • Eating
    • Sleeping
    • Bowel/bladder…toilet
    • Milestones
    • Illness, ER
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Developmental Milestones

  • R______ 4-6m?
  • S______ 6m?
  • W______ 12m?
  • Toilet trained: most not before ___ months
  • Babbling? __-__ m
  • One word: __-__m
A
  • Rolling
  • Sitting
  • Walking
  • 24
  • 6-9
  • 10-12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Physical Exam Documentation​

(5)

A

HEENT: Teeth, Ears

Heart

Lungs

Neuromuscular

Developmental Milestones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ears

(2)?*

A

Ear infections

Language Delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cardiac

  • Any m_____ needs evaluation
  • Signs of cardiac disease (5)​
A
  • murmur
  • Signs of cardiac disease
    • Poor feeding
    • Growth failure
    • Respiratory distress
    • Lethargy
    • Cyanosis
17
Q

Respiratory Distress

Signs

A

Cyanosis

Elevated RR

Use of accessory muscles

Head bobbing.. more common in younger children

Nasal flaring

Retractions

Wheezing

Stridor

Thud..object

Rales, rhonchi, wheezing

18
Q

Food

  • When can you begin giving solid food?
    • ​Can you introduce a few at a time?
  • When can you introduce cow’s milk?
    • ​Why can’t you give it before then?
  • Eats with f_____, holds, c___, sp____ are things that can effect when to start certain foods
A
  • 6 months
    • One at a time
  • >12 months
    • bc contraindicated dt high protein content, composition/nutrition risk of GI bleed, anemia, allergic reaction (Cow’s milk interferes with iron binding site)
  • fingers, hold’s cup, spoon
19
Q

Teething

  • Objective: dr_____. b____ on hard objects, gum ____/sen_____, irr_____, ____ problems
  • Assessment: H/P
    • ​Differential: diagnosis to rule out: O____ M_____, H_____ Gingivostomatitis, ____ infection, G____
  • Tx
    • ​Pain relief measures? (2)
    • Never give what med?
    • What med can you give?
A
  • Objective
    • ​Drooling, biting, swelling/sensitivity, irritability, sleeping
  • Assessment
    • RO Otitis Media, Herpes, Viral, GERD
  • Tx
    • Rubbing gums with cool wet wash cloth, cool object to chew on “teething ring”
    • NO ASPIRIN! Reyes syndrome
    • Tylenol 15mg/kg q4-6, nonprescription topical anesthetic (benzocaine)
20
Q

Teeth Eruption Times

  • Starts around what months? ends around what months?
A

Starts around 5-12 months, Ends around 24-33 months

21
Q

Atopic Dermatitis “The Itch That Rashes”

  • ​Subjective:
  • Objective:
  • Assessment:
  • Plan:
    • ​Maintenance: B____ daily, May add _____ cream
    • Secondary infection: Anti-_____ antibodies
    • Education: control itching by _____, keeping nails ____, wearing ____ at night (which is when children have exacerbations). Use ____ soap and moisturize immediately _____. Avoid ___ expsoure and extreme _____ changes.
  • Atopic dermatitis is associated with childhood _____
  • Common food allergens triggering AD are ____ and milk products, p____, e___, s___, wh____, ___food, sh_____
A
  • personal/family hx of atopic dermatitis, chronic or relapsing eczema
  • Xerosis, excoriations, secondary infection, confluent, erythematous, papular lesions, atypical vascular response, facial palor, signs of allergic rhinitis, asthma, or conjunctivitis, regional lymphadenopathy with secondary infection
  • based on hx and clinical findings, differentials include contact derm, sebhorrhic derm, psoriasis, scabies
  • control itching, rash, decrease inflammation, repair skin, prevent infection and treat current infection​
    • ​bath, steroid
    • staph
    • moisturizing, short, gloves, mild, moisturize after, sun, temp
  • Asthma
  • Milk, peanuts, eggs, soy, wheet, seafood, shellfish
22
Q

Immunization Refusal

  • What is New York State’s rule on immunization refusal?
    • Be familiar with AAP statement and IDSA guidelines for immunocompromised host, stay up to date on potential ______ of disease
A

NYS eliminates religious exemption for vaccine refusal Aug 2019

outbreaks

23
Q

Immunizations

  • CIR =
  • NYC Immunization Hotline _ _ _
    • ​is a _____ event
    • signficant clinical question
  • Recommendations when not to immunize
    • ​Who should NOT get vaccinated with these vaccines from CDC
A
  • Critical Incident Report
  • 311
    • Reportable event
24
Q

Toilet Training

  • ______ and _____ Readiness​
    1. ​​_____ to potty train
    2. Ability to?
    3. Awareness of?
  • Rarely before ___ months
  • KEY: are they ____ well? stoop
    • ​Ability to stay ____ for periods of time
    • ______ when messy
A
  • Emotional, Physical
    • Desire
    • hold urine?
    • need “to go”?
  • 18
  • Walking
    • dry
    • discomfort
25
Q

Anticipatory Guidance

  • Immunizations…wh___?
  • Lead at __ mos by _____ puncture
  • Hgb usually __-__ mos, may be doen earlier if needed WIC
  • Review: F____, Sl_____, Developmental ______
    • ​Safety….b___/cr___/wa____, ___ seats/t___/m____
  • F/U visit in __, ___, __-__, ___ months
  • __ visits…_ _ distress, f____, G _ , acc_____
  • When to call clinic - ______ with your Contact, Review AAP For Screening (Bright Futures)
A
  • when
  • 12, venous
  • 9-12
  • Feeding, Sleeping, Milestones
    • bed/crib/water, car seats/toys/months
  • 9, 12, 15-18, 24 m
  • ER, RR, fever, GI, accidents
    • LEAVE
26
Q

Anticipatory Guidance for Parents/Caregivers

A
27
Q

Lead

  • Prevalence?
  • Effects?
A
  • Most common preventable pediatric health problem… (3-4mil btwn 6m-6y have blood level abov >15)
  • Decreased intelligence, impaired neurobehavioral development, decreased growth
28
Q

Lead

  • Why are children at more risk?
A

More hand to mouth activity

Absorption is greater in children

Review Pregnant women (cdc)

29
Q

Lead Sources

  • lead based _____
  • S___, D____
  • Drinking ______
  • Parental h_____ (ie. stained ____, f_____ repair, finishing)
  • T___
  • Occupations such as _____ recycling, b_____ demoltion, etc
A
  • pain
  • Soil, Dust
  • water
  • hobbies, glass, furniture
  • Toys
  • battery, building
30
Q

Lead Education

  • R_____ Exposure
  • IDENTIFY SOURCE
    • ​_____ hands before eating
    • Damp m_____
    • Wash t____ and pa_____ etc. frequently
    • S____ around house plant scrubs
    • Parents ____ before coming in
A
  • Reduce
  • Source
    • Wash
    • mopping
    • toys, pacifiers
    • Soil
    • change
31
Q

Nutrition: Lead Education

  • Meals should be?
  • Diets high in (2)
  • Know ___ that are high in iron and calcium
  • May need vitamin _______
A
  • Regular meals, bc lead absorbs best on empty stomach
  • Iron, Calcium
  • Foods
  • Supplement
32
Q

Lead Levels

  • 10-14 Lead education
    • ​D_____, E_____
    • Follow up ____-lead monitoring
  • 15-19 Lead education
    • ​D____, E_____
    • Follow up ____-lead monitoring
    • Proceed according to actions for 20-44 if a follow up blood lead concentration is in this range at least ___ months after initial venous test
A
  • 10-14
    • Dietary, Environmental
    • blood
  • 15-19
    • Dietary, Environmental
    • blood
    • 3 months same -> escalate
33
Q

Lead Levels

  • 20-44 Lead Education
    • D_____, En_____
    • Follow up blood l____ monitoring
    • Complete __ and __
    • L___ work (3)
    • Lead hazard r_____
    • N______ monitoring
    • Abdominal _____ (if particulate lead ingestion is suspected) with bowel ______ if indicated
A
  • Dietary, Environmental
  • lead
  • H and P
  • Lab (Hgb/Hct, Iron)
  • Reduction
  • Neurodevelopmental
  • Radiography, decontamination
34
Q

Lead Levels

  • 45-69 g/dl
    • Lead Education =
    • Treatment=
  • 70 g//dL
    • Tx =
A
  • 45-69
    • Dietary, Environmental, Follow up lead monitoring and hazard reduction, complete H&P, Lab work (Hgb/Hct, Iron), Neurodevelopmental monitoring, Abdominal radiography with bowel decontamination if indicated
    • Chelation Therapy
  • 70
    • Hospitalize and commenc chelation therapy
      • ​then proceed with same actions above
35
Q

Lead MUST KNOW

  • Elevated level….screen for?
  • ____ -always include Lead in differential
  • Elevated musy be by _____ not fingerprick
  • Labs ____ report elevated lvl
  • Safe _____ available
  • Lead _____ for financial, legal assistance
  • NYC DOH _________
  • States have specific regulations based on _____
A
  • Anemia
  • Anemia
  • Venipuncture
  • Must
  • Houses
  • Clinics
  • Hotline
  • CDC
36
Q

Otitis Media

=

  • Peak = __-__m age group
  • Organisms (4)
  • Uncomplicated =
  • Persistent acute =
    • AAP guidelines for ___ referral, tympanostomy _____
  • > ___ episodes in ___ months of __ episodes in __ years with one episode in the preceeding 6 months
A

Acute infection of middle ear

  • 6-36m
  • S.pneumoniae, H.flu, Moraxella catarrhalis, Virus 10-20% aspirates
  • Single episode
  • persistence of symptoms 48-72 hrs of antibiotics or completion of antibiotics
    • ENT, tubes
  • 3 in 6m, 4 in 1 yr
37
Q

Otitis Media Follow Up

  • Improvement within ___ hrs of treatment
  • When can the child return to school?
  • Education on: po____ factors/_____ in bed
  • Importance of taking m___/ ___ profile
  • ___ hr f/u
  • ___ week f/u/ ear check
A
  • 24
  • 24 hrs fever free
  • postural, feeding in bed
  • med/SE
  • 48
  • 2 wks
38
Q

SUDC

=

  • In what age?
  • Remains unexplained even with?
    • According to CDC, in 2015, 393 children died between ages 1-18 without a clear cause of death determined, most were 1-4 y
A

Sudden Unexplained Death in Childhood

  • Sudden death of child 12 months of age or older
  • Even after thorough investigation

Fall 2020 Primary Care FNP (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions