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PD Block 3 > Pediatric patient > Flashcards

Pediatric patient Flashcards

1
Q

What age do you measure child in length

A

0-24mnths (use appropriate growth curves to assess percentile)

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2
Q

What age do you measure child in height

A

2 years and up

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3
Q

Up to what age do you measure head circumference

A

2-3 years

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4
Q

How do you measure head circumference

A

From the occiput to the front (supraorbital prominence)

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5
Q

What is normal head circumference

A

32.5-37.5cm, at 2yrs the head is 2/3 that of an adult sized head

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6
Q

What is a typical HR in a newborn

A

120

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7
Q

Expected BP for newborn/infant

A

60-96/30-62

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8
Q

What age can you start testing visual acuity at?

A

3 years, play the senile E game

can also do EOM at this age

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9
Q

What should the visual acuity be in 3-5year olds

A

20/40 or better

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10
Q

What should the visual acuity be in 6yr olds and older

A

20/30

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11
Q

Which way do you pull the ear for otoscopy in children

A

Down and back

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12
Q

Which hearing test can you do on a young child (2-3)

A

Whisper test with familiar words to them. Or ask them to perform tasks and see if they respond appropriately

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13
Q

How can you test the hearing of an infant

A

Clap hands, ring a bell, make some kind of noise and watch for response from child

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14
Q

What is important to note with the nutritional assessment of infants and young children

A
  1. Breast feeding frequency and duration
  2. Type and amount of formula (method of prep, powder, etc)
  3. Time it takes to complete feeding
  4. Vitamins, supplements
  5. Any hospitalizations, congenital anomalies (cleft palate)
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15
Q

What age does child usually say first word at

A

10-12 months

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16
Q

What age does child babble at

A

4-6months

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17
Q

What age does the child form sentences that are understood by most people

A

36-48mnths (3-4yrs)

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18
Q

Common difficulties with pediatric assessments

A
  1. Crying baby/child
  2. Child may not speak yet
  3. Child may be ticklish
  4. Wiggling around
  5. Family dynamics
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19
Q

Goals/topics of prenatal interview

A
  1. Get acquainted and gain info
  2. Establish rapport
  3. Discuss breast/bottle feeding
  4. Any pregnancy issues
  5. Discuss plan for birthing process
  6. Ask about any prior pregnancies and deliveries
20
Q

Topics included in social history with pediatric patient

A
  1. Interactions with peers
  2. School progression
  3. School readiness
  4. Habits (eating, sleeping, play)
21
Q

Topics included in PMI

A
  1. Current/active health problems
  2. Previous problems
  3. Prior hospitalizations
  4. Surgery
  5. Trauma
22
Q

ROS

A

5 big thing to ask at EVERY WELL BABY and pediatric exam

  1. Nutrition
  2. Elimination
  3. Sleep
  4. Immunizations
  5. Development
23
Q

Development assessment

A

Should see age appropriate development in terms of height, weight, head circumference. Always include the 5 big things.

24
Q

PE in infants vs children

A

Mostly about height, weight, head circumference in infants. In young children gait, spinal alignment and other functions should be assessed once walking

25
Q

What does anticipatory guidance mean

A

Teaching the parents about the development and growth of their child.

26
Q

Anticipatory guidance prenatally

A

Breast feeding/bottle feeding. Circumcision, plans for labor

27
Q

Anticipatory guidance at well baby

A

Nutrition, safety, development, immunizations

28
Q

What order might you do the pediatric exam in

A
  1. Heart/lungs first
  2. Abdomen
  3. Upper/lower extremity
  4. Reflexes, neuro testing
  5. Ears

Basically start with things that need the most cooperation first

29
Q

At what age to infants double their birth weight

A

5-6months

30
Q

What age do you start looking for strabismus

A

6months

31
Q

Anterior fontanelle

A

Closes around 9-18months, largest fontanelle and forms at the junction of the sagittal, coronal, and frontal suture.

32
Q

Posterior fontanelle

A

Closes around 2 months, junction of the sagittal and lambdoidal suture.

33
Q

What happens if fontanelles close too soon

A

Can limit the ability of brain growth and often causes frontal bossing.

34
Q

Rooting reflex

A

Mouth will open when you stroke the premolar skin at corners of mouth. Occurs from birth to 3/4 mnth olds

35
Q

Palmar grasp reflex

A

Baby will flex fingers around your finger. Birth to 3/4 mnths

36
Q

Placing response

A

Hold baby upright from behind, have one sole touch table, the baby should flex and other foot will step forward

37
Q

Tonic neck reflex

A

Pirate pose:) Turn head to one side with jaw over shoulder. Arm and leg on that side will extend, while opposite side will flex. 2-6month olds

38
Q

Startle reflex (moro)

A

Baby will extend and abduct arms with hands open when abruptly moved. Lift off table and let fall. Birth to 4-6mnths

39
Q

Cephalohematoma

A

Swelling (bleeding) within the cranium and is separated/bound by suture lines (often caused during vaginal birth from the birth canal pressure)

40
Q

Caput succedaneum

A

Subcutaneous edema (swelling) of the entire soft tissue of head (also seen as a result of birth canal trauma)

41
Q

Milia

A

Small whitish, discrete papule on the face, usually found in 2-3 month olds

42
Q

Port wine stain

A

A birthmark in which swollen blood vessels create a reddish-purplish discoloration of the skin

43
Q

Hemangioma (stork bite)

A

Common type of vascular birthmark. Sometimes go away, but may be see for life.

44
Q

Mongolian spots

A

Flat, blue, gray skin marking near buttocks that show up at birth or shortly after. Often seen in babies with darker skin

45
Q

Failure to thrive

A

Baby does not maintain an established pattern of growth and development. Not usual due to neglect

46
Q

Strabismus (findings in infants)

A

0-1 year you are looking for strabismus that is constant. It is not uncommon for infants to have flickers of strabismus, just can’t be constant.

47
Q

When should all of the primitive reflexes be gone

A

12 months of age

PD Block 3 (10 decks)

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