Newborns & Toddlers Flashcards
1
Q
At what age are babies able to grasp objects? What about Pincer grasp?
A
2-3 months
- 10 months for pincer grasp
2
Q
At what age are babies able to transfer objects between hands?
A
7 months
3
Q
At what age are babies able to take objects out of containers
A
11 months
4
Q
At what age are babies able to stack 2 blocks together?
A
2 blocks - 12 months
5
Q
At what age do babies develop head control?
A
3 months
6
Q
At what age do babies roll over?
A
5-6 months
7
Q
At what age do babies sit alone?
A
7 months
8
Q
At what age do babies crawl?
A
6-7 months
9
Q
At what age can babies go from prone to sitting?
A
10 months
10
Q
At what age can babies walk?
A
With assistance - 11 months
w/o assistance - 12 months
11
Q
What stage does Erikson place infants (birth-1 yr)?
A
Trust vs. mistrust
- stage of developing trust
- good attachment w/ caregiver can help develop a sense of trust
- consistency in care is important
12
Q
What stage does Piaget place infants in?
A
Sensorimotor (0-2yrs)
Birth to 1 month = reflexes
1-4 months = primary circular reactions
4-8 months = secondary circular reactions
8-12 months = coordination of reactions
13
Q
At what age do babies coo and babel?
A
4 months
14
Q
At what age do babies start saying “mama” and “baba”
A
6 months - they are imitating sounds at this point
15
Q
At what age do babies understand a hard “no”
A
9 months
16
Q
How many words should an infant know in 1 year?
A
3-5 words with meaning
17
Q
What type of play do 3-6 month-olds engage in?
A
solitary play
18
Q
When do children develop stranger danger?
A
6-8 months
19
Q
How much weight/height do toddlers gain each year?
A
Weight: 4-6 lbs
Height: 3 inches
20
Q
At what age do children develop sphincter control? What does this mean for the family?
A
18 - 24 months
- start potty training
21
Q
At what age can a child throw a ball?
A
18 months
22
Q
At what age do children learn to run?
A
2.5 years
23
Q
At what age do children learn to walk upstairs
A
2 years
24
Q
At what age do children learn to jump?
A
2.5 years
25
At what stage does Erikson place toddlers
Autonomy vs shame and doubt (18 months - 3 years)
- develop a sense of independence and personal control
- they think they can do many things on their own --> negativism (says NO a lot, as a way to develop independence)
- at this stage, important to develop rituals and routines in tasks
26
What are some developmental tasks of toddlers according to Erikson?
- Have delayed gratification
- Able to differentiate self from others
- Toleration of separation
- Able to control body movements
- Improved communication
27
At what stage does Piaget place toddlers
Sensorimotor (0-2yr) and preconceptual (2-7) stage
Sensorimotor
- awareness of causal relationships between two events through trial and error
- learn spatial relationships
Preconceptual
- transition from self-satisfying behaviors to socialized relationships
- egocentric speech
- symbolic thinker (play pretend)
- problem solve based on what they see or hear at the moment.
28
How many words should a 2 year old know?
at least 300
29
At what age should a child be able to form simple short sentences?
3 years
30
How do you manage a temper tantrum?
- stay calm, let the tantrum happen but ENSURE SAFETY
- develop routines, including naps so that child is less likely to feel tired
- provide positive reinforcements for good behaviour
31
When should you start cleaning your babies teeth?
As soon as they get their first teeth (around 6 months)
- no toothpaste
32
When should you start brushing babies teeth with toothpaste?
1 year
33
When should I book a dentist appointment for my baby?
When baby gets their first teeth (6 months)
34
When should I start flossing my kids' teeth?
2 years
35
When should I transition my baby to cow's milk?
1 year
36
How much cow's milk can I give to my toddler?
No more than 500mL/day
- 2 bottles a day
37
Can I give my toddler cow's milk before bed?
No, it's bad for dental health
38
Why is too much cow's milk bad?
The child becomes picky eaters, or they get too full from the milk so they don't eat other stuff
- high risk for iron deficiency
- fail to meet nutritional requirements
39
What is RSV/Bronchiolitis??
When is it most common?
A lower respiratory tract infection that causes obstruction of the small airways.
- common viral infection in the months of November - January
40
How is RSV/bronchiolitis diagnosed? What are the s/s?
history. + physical examination
Initial - Rhinorrhea, pharyngitis, Coughing, sneezing, Wheezing, Intermittent fever
With progression - Increased coughing and wheezing, Fever, Tachypnea, retractions, Refusal to nurse or bottle feed, Copious secretions
Severe Illness
- Tachypnea >70 breaths/min, Listlessness, Apneic spells, Poor air exchange; poor breath sounds, Cyanosis
41
What are nursing interventions for RSV/Bronchiolitis?
Open/clear airway - positioning, suctioning
Maintain O2 levels - give humidified O2 if needed
Monitor vital signs
Manage fever - give antipyretics
Obtain specimens (blood test, NP swab)
Maintain droplet/contact isolation
Promote hydration - but If RR is at 70 hold feed, iv fluid, or NG tube
Implement comfort measures and promote rest
Educate and involve the family
42
What is AIRVO?
Heated high-flow nasal cannula
For moderate to severe brochiolitis call the RT to bring it
○ 1-3 L/kilo (flow rate)
○ Titrate the FiO2
43
What is the priority assessment when a neonate is presenting with a fever?
SEPSIS
- use differential dx and complications
- implement nursing interventions
44
What are the common causes of fever in toddlers?
Viral infections - Ear and eye infections, Croup
45
What are we concerned about in a neonate experiencing vomiting?
Pyloric stenosis - notify HCP, need surgical intervention
46
How and why do we take pre and post-ductal SpO2?
Preductal - take on the right hand
Post ductal - take on either leg
Done 24-48 hours post-birth; To rule out congenital heart diseases.
- Post and Pre SpO2 should be equal
- If difference >3%, retake again in 1 hour (up to 3X)
- if unresolved, this is a positive test (notify HCP for further screening).
47
How are congenital heart diseases screened?
- Prenatal US
- Postnatal physical exam
- Pre/Post oximetry
48
What is normal head circumference for a newborn?
33-35cm
49
What is normal weight of a newborn
6-9lbs
50
What is the normal length of a newborn
48-53cm
51
Should we be concerned if a baby loses 15% of it's weight within the first week?
YES. Should be no greater than 10%, and the weight should be regained in 10-14 days
52
A mother is worried because her baby is breathing irregularly and regularly has periods of apnea for up to 10 seconds, what do you do?
Tell her: newborn breathing is quite irregular (Apnea – up to 10 sec is okay, and after that, they are going to start breathing rapidly to catch up)
- can provide tactile stimulation during periods of apnea.
53
At what age do you expect the anterior and posterior fontanelle to close?
Posterior - 6-8 weeks
Anterior - 12-18 months
54
When weighing a baby, what is considered "failure to thrive"
- weighs less than the 3rd percentile on a standard growth chart
- weighs 20% below the ideal weight for height
- fall off from established growth curve
55
At what age do babies recognize familiar faces?
6 months
56
At what age do babies develop depth perception?
7-9 months
57
What is the foramen ovale, and when does it close?
Hole between RA --> LA
- once the baby takes a breath, blood flows to the lungs, back to LA
- pressure in the LA > RA = hole closes
- closes soon after birth
58
What is the ductus arteriosus? When does it close?
Connection b/w aorta and pulmonary artery
- increased pulmonary blood flow + reduced pulmonary vascular resistance = closure of this hole
- closes 4 days after birth
59
What is a patent ductus arteriosus?
DA fails to close, which may indicate CHD
Results in a large amount of oxygenated blood going from the aorta back to the lungs --> puts pressure on the lungs.
S/S - oxygenated blood, backups to lung
- trouble breathing and tachypnea
- tachycardia
- easily tired
- doesn’t want to feed
60
What is the expected total blood volume for a full-term baby?
80-85ml/kg - Approx 300mL
61
What are 3 causes of jaundice in infants?
Overproduction bilirubin (rapid break down RBC)
- Baby has metabolic condition
- ABO incompatibility, specifically with mothers 2nd baby, at risk for hemolysis
- Extra RBC breakdown accumulate in body
Decreased conjugation at liver lvl
- If the baby is missing enzyme
Impaired excretion
- It needs to go somewhere, urine or feces, if baby not feeding, not much motility going on (gets reabsorbed into system - worse case scenario)
62
How often should I feed my baby?
q2-3 hrs (8-12 feedings a day)
63
How is milk properly stored?
Fridge - up to 72hrs
Freezer - 1 month
Deep freezer - 6 months
NEVER microwave breastmilk or formula
64
When and how should I start introducing solid foods to my baby?
Start at 6 months
- one food at a time
- starting with rice cereals, then vegetables
65
What is the expected UO for a 1 week old baby?
200-300 mL/day
UO = ____ mL/kg/hr
66
Describe Meconium and transitional stool
1st poop Meconium (sticky and darker)
- Composed of amniotic fluid, intestinal secretions, shed mucosal cells, and possibly blood
- Usually passes first 24 hours
Transitional stool
- Appears by third day after initiation of feeding
- Greenish brown to yellowish brown
- thin and less sticky than meconium and may contain some milk curds
67
Describe milk stools
4th day
Breastmilk - Yellow to golden and pasty and odor of sour milk
Formula-fed: Pale yellow to light brown, firm more offensive
