OB/Peds Exam 1 Flashcards
Neonatal period
Birth-28 days
Infant period
1-12 months
Toddler period
1-3 years
Preschool period
3-6 years
School age period
6-12 years
Prepubertal period
10-13 years
Adolescence period
13-18 years
Cephalocaudal
Head to toe
Proximodistal
Near to far
When do you measure length while they’re laying supine?
Under 36 months
Sequential trends
Definite sequence, each child normally passes through every stage. Crawl before standing, stand before walking.
Polymorphisms
Differences within a gene found in more than 1% of a particular population
What is the pattern of inheritance referred to as?
Unifactorial or single-gene because a single gene controls a trait or disorder.
Only one copy of a variant allele is needed to express the disorder
Autosomal Dominant
Both genes must be abnormal for the disorder to be expressed
Autosomal Recessive
Extrinsic mechanical forces on normally developed tissue
Deformations
Breakdown of previously normal tissue
Disruptions
Abnormal organization of cells into a particular cell type. Cause congenital abnormalities of the teeth, hair, nails, or sweat glands
Dysplasia
Abnormal formations of organs or body parts
Malformations
When do most malformations occur?
Before 12 weeks gestation
Recognized pattern of anomalies resulting from a single specific cause
Syndrome
Non random pattern of malformations for which a cause has not been determined
Association
When one anomaly leads to a cascade of others
Sequence
What genetic abnormalities do nurses often note?
Dysmorphic facial features, unusual cry, poor feeding, hypotonia, abnormal reflexes
What do you ask about when you notice a genetic abnormality?
Health history (minimum of 3 generations), sudden cardiac death, early onset cancer, mental illness
Delayed sexual maturation
Turner syndrome
Fragile X
Developmental delays, growth and behavior delays
How many fontanels and when do they close?
Anterior and posterior, posterior closes at 2 months, anterior is almost closed at 12 months, closed by 18 months
Growth of infants
Increases 5-7 oz per week until 6 months when birth weight is doubled. Then it slows and will triple birth weight by 1 year
Height growth
Increases 1 in per month for first 6 months then slows. Height increases in trunk, not legs
Chest circumference equals head circumference when?
By end of 1st year
Fetal hgb is present for how long?
1st 5 months, then adult hgb rises
Maternal iron stores for how long
5-6 months then supplement is needed
Normal GI
Immature digestion, loose stools, strain to have BM
Normal GU
Immature renal system, dehydration because they can’t concentrate urine
When are infants able to see two pictures as one?
6 weeks-4 months
When do infants develop depth perception?
7-9 months
Fine and gross motor skills
pg 865-69
When are infants able to roll from abdomen to back
By 5 months
When are infants able to roll from back to abdomen?
By 6 months
Sitting at 4 months
Rounded back with head control
Sitting at 7 months
Tripod sitting
Sitting at 8 months
Sit unsupported
Sitting at 10 months
Can go from prone to sitting
Coordination of arms
4-6 months
Bears weight on legs with assistance, crawls with abdomen on floor
6-7 months
Crawls with abdomen off floor
9 months
Can stand while holding onto furniture, gets down by falling
9 months
Walks while holding onto furniture
11 months
Walks while holding one hand
12 months
Hands are closed
1 month
Hands mostly open
3 months
Grasp object due to reflexes
2-3 months
Voluntarily grasp an object
5 months
Transfer object from one hand to another
7 months
Crude pincer grasp
8-9 months
Deliberately let go of object and offer
10 months
Fine pincer grasp
11 months
Build a tower of two blocks but fails
12 months
Trust vs mistrust
Birth-1 year. Freud’s oral stage, taking in senses of parent’s trust or mistrust. Result is faith and optimism
Autonomy vs shame and doubt
1-3 years. Freud’s anal stage, ability to control body want to do things themselves, walk, decision making. Outcomes are self-control and willpower
Initiative vs guilt
3-6 years. Development of a conscience. Freud’s phallic stage, outcomes are direction and purpose
Industry vs. inferiority
6-12 years. Latency period of Freud, engage in tasks and complete, cooperate with others, learn rules, Earn a sense of competence
Identity vs role confusion
12-18 years. Freud’s genital period, aware of how others view them, decisions on occupations, inability to solve core conflict results in role confusion. Outcome is devotion and fidelity to others and to values and ideologies.
Piaget
Theory of children’s thinking, intellectual development
Sensorimotor stage
Birth-2 years. Develop cause and offed, problem solving by trial and error, curiosity, object permanence, toward need they begin to use language and representational thought.
Preoperational stage
2-7 years. Can only see things from their own point of view, can’t think abstractly, think all women with big bellies have babies.
Concrete operations stage
7-11 years. Able to organize facts for problem solving, thought becomes less self-centered.
Formal operations stage
11-15 years. Draw logical conclusions from a set of observations, make hypotheses and test them, consider abstract matters.
When does mistrust develop?
When trust-promoting experiences are deficient or lacking or basic needs are inconsistently or inadequately met.
Cooing and crying
Birth-2 months
Single vowel sounds
2 months
Consonants and laugh
4 months
One syllable
6 months
Combo syllables, no meaning, can imitate
7 months
Understands simple commands, no
9 months
Adds meaning to dada and mama
10-11 months
3-5 words besides mama and dada
12 months
Teething
Lower central incisors are first around 6-8 months
Signs of teething
Drooling, swollen gums, irritability, low grade temp
How to soothe teething pain?
Cold, tylenol, teething tabs/orajel
Dental health of infant
Wipe with damp cloth initially, soft bristled brush when teeth erupt, no toothpaste, do not put to bed with bottle or juice
Hep B
?
Hep A
Spread by fecal-oral rough and person-to-person contact, ingestion of contaminated food, rarely by blood transfusion. Abrupt onset with fever, malaise, anorexia, nausea, dark urine, jaundice.
Rotavirus
?
Haemophilus influenzae type b
?
Pneumococcal
?
Poliovirus
?
Measles mumps rubella
?
Varicella
?
Meningococcal
?
When does chest circum. exceed head circum?
In toddler years
How much weight do toddlers gain per year?
4-6 pounds
How much height do toddlers grow per year?
3 inches. Grow in legs and not trunk, makes a pot belly. Adult height is about 2x the 2 year old height
Negativism
Toddlers want to say no to every question asked of them. Do not ask them a yes or no question. Say you’re going to take their vitals now. If you ask and they say no and you do it anyway, they begin to mistrust you.
Ritualism
The need to maintain sameness and reliability, provides a sense of comfort.
Egocentrism
Inability to envision situations from perspectives other than one’s own.
Global organization
Reasoning that changing any one part of the whole changes the entire whole.
Animism
Attributing lifelike qualities to inanimate objects. Example: being mad at the stairs for making you fall
Magical thinking
Believing that thoughts are all-powerful and can cause events
Inability to conserve
Inability to understand the idea that a mass can be changes in size, shape, volume, or length without losing or adding to the original mass.
Domestic mimicry
?
3-5 words, points to objects, holophrases “up,” we can understand about 25% of what they say
12 months
More than 10 words
18 months
300 words, multiword sentences, we can understand 65% of what they say
2 years
Last name and one color
30 months
Simple sentences, 5-6 new words a day, use a lot of gestures
3 years
Physiologic anorexia
At 12-18 months growth rate slows so they need less calories
Eats the same food as family
12 months
When does a child need an oral exam?
By 6-12 months
When can you start using soft bristled toothbrushes?
1 year
When can you start using actual toothpaste?
2 years. Pea sized amount, must learn how to spit it out, need to floss
Major stressors for children
Limited understanding of illness, separation, loss of control, bodily injury/mutilation, pain
Greatest stressor during early childhood
Separation anxiety, try to prevent
