MidTerm Material Flashcards
Lag warning signs @ 6m
–General:
- -no smiling
- -jerky/spastic movements
- -does not recognize parents
Lag warning signs @ 6m
–Hearing & speech
- -failure to turn toward sound
- -does not laugh, squeal, or vocalize sounds
Lag warning signs @ 6m
–Vision
–failure to fix or follower & far objects
Lag warning signs @ 6m
–Arms:
- -failure to keep head steady when pulled to sitting position
- -persistent fisting
- -failure to push up or roll over
normal child developments
3/4/6/9/11/12m
3 = hold head up 4 = roll over 6 = sits up w/ help & grabs things 9 = ~crawl/ sits 11 = stands & throws ball 12 = walk/crawl freely
history taking tips
- -open ended Q’s
- -connect w. parents & child
- -periodically summarize info
- -ask “is there anything else I should know”
Ill infant
- -fever, vitals, rash? and SEARCH signs, mental status abnormalities
- -growth normal?? *anterior frontanelle
- -BM 1/2 to 3-6/day, urine 6-8 wet dipers/day, feeding 2-4 hours
caput succedaneum =
- -diffuse swelling of soft tissues
- -extends across suture lines
- -disappears w/in first few days of life
cephalohematoma-subperiosteal hemorrhage
- -never crosses suture lines
- -visible swelling
- -may not be visible for a few hours
- -disappears in ~6wks
languo =
fine body hair on shoulders, forehead, and back
milia-
small white papules on nose, cheeks, and chin
erythema toxic =
macular eruption common in light skin newborns
– ~1 wk
stork’s bite-birthmark
upper eyelids, forehead, nape of neck.
–disappear by 1 year
mongolian spots
- -dark blue
- -lower back/butt
- -MC = darker complexioned infants of all races
- -disappear w/in first 4 years
primitive reflexes
- -grasp
- -magnet
- -rooting
- -sucking
- -babinski
- -galant
- -moro
- -fencer
- -placing
- -stepping
grasp
-primitive reflexes
- -finger in infant’s palm = they grab it.
- -grabs stronger as finger is pulled upward.
- -disappears by 2-4m
Magnet
-primitive reflexes
–placing a finger just proximal to the toes on the sole of the foot
(btw ball of foot & toes)
–causes toes to flex around the finger
–disappears by 2-3m
Rooting [awake]
-primitive reflexes
touch corner of infant’s mouth = lower lip drops ipsilaterally & tongue moves towards stimulus.
–disappears by 3-4m
Sucking
-primitive reflexes
placing something in the mouth = baby sucks
babinski
-primitive reflexes
–firm stroke from heel toward the toes
= great toe to flex up & other toes fan out
NORMAL in kid <18m
…past = pyramidal tract lesion
Galant
-primitive reflexes
- -stroking the infant’s paravertebral skin causes lateral flexion of the trunk toward the ipsilateral side
- -disappears 2-3m
Moro
-primitive reflexes
–allowing the infant’s head to drop back suddenly causes abduction and upward movement of arms, followed by adduction & flexion
–disappears <4m
…maybe brain damage or brachial plexus
Fencer
-primitive reflexes
(asymmetric tonic neck)
- -supine
- -rotate head to one side causes ipsilateral ext of the extremities & contra flex of the extremities
- -Disappears by 3-4m
Placing
-primitive reflexes
–stroking the anterior tibia or dorm of the foot against a table causes the infant to raise the leg as if to step onto the table
denver development chart =
- -gross motor
- -fine motor
- -personal-social
- -language
growth chart =
- -height
- -weight
- -head circumference
APGAR =
- -appearance-color
- -pulse-heart rate
- -grimace-reflex irritability
- -activity-muscle tone
- -respiratory effort
stepping
–primitive reflex
holding the infant upright & leaning slightly forward causes alternate flexion & extension of the legs which mimics walking.
–disappears by <3m
Newborn screening tests
- -PKU
- -Sickle cell anemia
- -congenital hypothyroidism
- -galactosemia
- -biotinidase deficiency
- -congenital adrenal hyperplasia
- -cystic fibrosis
- -hearing loss
PKU-babies:
= cannot process phenylalanine
–w.o Tx = build up of phenylalanine in blood & causes brain damage & mental retardation
SIDS prevention
- -place baby on back on firm, tight fitting mattress
- -remove all pillows, quilts & comforters
- -never put baby to sleep in waterbed, sofa, soft mattress, pillow…etc.
- -if at risk: there are monitoring devices for heart & respiratory rate to use while baby sleeps
infant colic syndrome
excessive, inconsolable crying episodes in a healthy infant.
- -0-3months old
- ->3hrs/day
- ->3hrs/wk
- ->3 weeks
- -usually occurs at the same time each day.
possible nursing advice
- -keep infant in upright position during feeding
- -burp more often
- -nursing more often: small & frequent
- -keep the infant in an upright position about 30 mins after feeding
pyloric stenosis
- -congenital stenosis of valve b/w ST & SI
- -linked to poor neuromuscular control & poor breastfeeding
- -projectile vomiting from 1st wk/m up until 5m
- -immediate referral…surgical approach may be needed
intussusception
- -intestines are more mobile in infancy and can fold in on itself causing obstruction
- -MC cause of bowel obstruction in <2y.o.
dehydration
- -signs: loss of skin turgor, dry mucous membranes, depression of anterior fontanelle.
- -diarrhea-feed babies over 6m the “BRAT” diet which is bananas, rice, applesauce, toast
doll eye relfex
3m
clonus
<4m
palmar grasp
3-4m
blink reflex
3-6m
plantar grasp
8-10m
rooting [asleep]
7-8m
plantar grasp
8-10m
sucking
10-12m
Heart Rate =
120-140
sleeping = 100
crying = 180
respiration
30-60
blood pressure
systolic = 60-80
diastolic 40-50
