peds again Flashcards
MMRV reaction
rash fever swelling erthema irrabilty restlness so dont need to bring to clinic if these are the symtoms but DO ASK WHAT THE TEMP IS
when to be careful with MMRV symtoms
fever can sometimes lead to febrile seizures so determine the childs temp to evalute the risk
-adm actea for fever above 102 F
time frame of when MMRV symtoms occur
5-12 days
school age children
posess concrtete thinking
and fear losing control
when adm injection to shcool age do
task based coping and speicific
- count loudly
- breathe deeply
adm injection to toddler
hide it
ability to use spoon
18 months
copying shapes
5 year olds
autism 2 core symtoms
abnormalities ins ocial interations and communicaiton (verba and nonvernal)
-patterns of behavior, interests, or activities that can be restricted and repetitive.
what is often devlaye in autism
social skills escapilly communiaction
healthy 2 year old vocab
300 words and should be able to string 2 or more words together in a meaningful phrase
children with austism behavior whne playing
resricted interest in and peoccuptation with a single toy , repetive behaviors when plahing with tor and insist on the same play routine
finger grasp dev what age
8-10 months and this is the time to start offering small finger foods such as crackers and cut up pieces
important qusetio to ask autism
how many words
allergenic foods can be introduced when
4-6 months (eggs, fish , pb)
whole milk
12 months and its WHOLE MILK not low fat
involntary bedeweeting aka noctural enuresis
nonpharm should be done first
noctureal enrusis mangment
-limit caff and sugar
-void before going to bed
-avoid punishing, scolding or ridiculing the child
-encourage child to assist with changing soiled pajamas and linens
-postive reinforcements (calender showing wet and dry night rewards)
=awaken the child nightly at specific time to void
-use an enursis alarm
what should parents avoid with noctural enursis
avoid disposable training pants and diapers at bedtime because this deicosrges motication to get up and void
-dont restrict fluids throughout the day, only after the evening meals.
by 7 months
bear their full weight by standing wtih support and sit with minimal support from their hands (tripod poistion)
-can roll over
prone to sitting position
10 months
pull themselves up into stadning poustion
9-10 months
walking while holding on to furniture
11 months
puzzles
app for school age (6-12)
stack blocks
toddler (1-3)
infleunza vistors
facemask before entering room
contact with peers
adolscent (12-19)
failure to thrive
low eight and height ration
falling below 5 th percitle
risk factors for FTT
young parnt age
- unplanned or unwanted preg
- lower educaiton
- single parent
- social isolatio
- chronic life stresses and anxiety
- substance abse
- domestiv violence
- povety
- parents with negative peception of child
what is not riskf actor for FTT
parent working outside of the home
-having sibilings
pediatric clients who consume vegan diet are at risk for
nutritonal deficienciens (protein, calories, calcium, vit D, iron, vit b12)
icp
vomitng
headache
vision changes
changes in mental status
impact of shaking causes
bleeding within the brain or eyes
why is it common for disogniss of shaken baby syndrome to go unnoticded
vimiting irratbility lethagy inability to suck or eat seizures inconsable cruing -often no external signs of trauma except for ocassional small burises on the chest or upper arms where they were held
hearing impairment causes
fam history
infection
meds
congenital disorder
toddlers with hearing deificts appear
shy timid withdrawn avoid social interacton may seen inattentive --appear dreamy -speech montone where it is diff to understand =talk loud -use gestures and faical expression
mama and dada
by 7 months
when to ,make referal for hearing test
absence of well formed syllabues by 11 months or inteligble speech not present by 24 months
fantasy play with puppets
preschool becuase of imaginary play and magical thinking
school age deal with what stage of eriksoton
inducstry vs inferiority so they like to do howmowrk and learn new skills
school age and peer
not as imp as adolscents so school age rather do homwowrk
12 months weight
thirpled
sitting from standing position
shhould have mastered by 12 months
stranger anxiety
8 months and continues into toddler years
at 12 months child prefers parents and exhbiits fear when seperated
skipping and hopping on one foot
4years
puberty maturation stages in bous
1) testicular enlargement and scrotal changes are the firs tsigns (9-14 yrs)
2) appearance of pubic, axillary, faical and body hair
- 3)penis increases in size 4)and voice changes
head circumference
at birth head is bigger than chest circumference but by 12 months it equalizes
fontanelles should be
flat and slight oulsations
temporary bulges when infant cries, coughs or lying down
posterior font closes
2 months
anterior closes
18 months
phargntitis is caused by
group A
phaegitis can lead to
renal (glomerulonephritis) or cardiac complications (rheumatic fever) if not treated.
children with phatyntitis
-may refuce to eat due to pain
-ofer soft diet and cool liquids such as ice chips instead of solid foods
-tooth burshes should be replaced 2 hours after starting abx
-test bilings
-may return to school or daycare aftert they have completed 2 hours of abx and is afrbirile
=dont give lozenges
-actea or ibuprhen for pain
when can kids with [haryngitis return to school
after 24 hours of abx
whe doing physcial exmaination for a toddler
least to most invasive
(ears, then nose, and mouth at end)
-allow to inspect peices of equip
-minimal physical contact initially
risk of teeth misalightment and malocclusion occurs
when child uses pacifier or sucks the thumb after eruption of permanaent teeth
intussecption treastment
passage ofbirnak vriwn sttol means reduction in instusscption
-can be treated sucesfully witout surgery using saline or air enema
associate play
prescolers (3-6)
- they engage in similar actv or play witht he (play and burrow with each other without directing others)
- Preschoolers also enjoy play involving motor activities and imaginative, pretend play.
cooperative play
school age (6-12)
- play with one another with specific goal (building castles from block) and theres set urles
- requires orgizational skills that presccolers dont have only school age
parallel
toddlers (1-3)
-play next to each other and are happy to be in the prescence of peers but do not play directly with one another
solitary play
infants (birth -1 year)
-focused on own actv and play alone in the prescence of others
behaviors associated with negatism and ritualism
toddlers
health promoteion in toddler parents should
avoid giving options that allow the toddler to say “no” so instead of saying “do you want dinner” say “tikme for dinner”
if child refuses meal
parents should wit to offer foods utnil the next snack time or meal time
-dont ask within couple mins
when to eat afer kid just played
15-30 mins to calm down before eating
by 30 months
4X birth weight
wegain gain slows
toddler years with weight gain yealry of 4-6 lb
bowel and sphinter control by
24 months
chest circfuernce exceeds abdominal circulfernce
after 2 resulting in taller and more slender app
head circum ncreases by
1 in during second ur and then slows to 0.5 in until 5 years
egocentric approch
toddlers diaply this approch to strive for autonmy by displaying emotional (temper tentrums, NO)
hospitalizations in toddler results in
regreesive beh
concept of time
school age not prescool
voluntary control of anal and urethral sphincters
18-24 months
readiness to toilet train
ambulate to and sit on the toilet
-remina fry for several hours or though the nap
-pull clothes up and down
=understand 2 step command
=expresses the need to use the toilet
-imitate the toilet habits of adults or older sibliings
-express an interest
toddlers trive on
home rituals and routines
who has egocentric and magical thinking
preschool
who thinks they might have caused the disease
preschool
parents role in hospitalization of toddlers
rooming in, stating overnight and alleviate serpateion anxiety
fetal etoh sydrome signs
microcephaly short palpebral fissures =epicanthal folds -flat midface -smooth philtrum -thin upper lip
what is the leading cause of diability and dev delay
etoh dysndrome
advanced maternal age can be assoicated with higher incidence of
triosmy 21 (down syndrome)
down sydnrome characteristic
=single palmar crease
=short neck with excessive skin(nuchal fold)
valporate (depakote) can cause
spina bidifa
FDA preg D
seziure precation
pillow to protect head side rails up privacy provided side lying o2 and apparatus avilable DONT USE ORAL BITE DEVICE DONT USE RESTRAINTS
severe dehydration signs
increase cap refill
increased HR
increased RR
introduction of sold foods
4-6 months
process of starting solid foods
iron firtfied infant cereal first
-allow 5-7 days bewttwen foods for allergies
(allergeies often worsen with subsequent exposure)
best foods to introuce
carrots
peas
banans
when are purred fruits and veg introudced
6-8 months
after introducing pureed fppds
offer simple finger foods such as teething crackers, small pieces of fruits, soft veg or cheese
cows milk introduced
after 1 st year
finger foods intro
6-9 month
meds used to treat noctural enuresis
desmopressin
-tricylic antidepressants such as imipramine, amitriptyline, and desipramine improve functional bladder capacity.
parralel
associate
solitary
cooperative
toddlers
prescoolers
infants
school age
accidents assoicated with child walkers
rolling down stairs (most common)
- burns
- drowning
- positiong
safer alternatvies to mobile baby walkers
stationary walkers (no wheels)
optimal position for baby lumbar puncure
head and knee tuckers in abd back rounde dout
-flexed sitting with arms and legs immbolized
imitating and dramatic
preschoolers
dress up, housekeeping toys, telephones, med kits, dollas and puppets
preachoolers
finger paints crayons books puzzles with large pieces and clay
prescoolers
va=oard games
schol age
soap bubbles
toddlers
stacking and nesting toys
toddlers
headlag till
4-6 months
headlag after 6 months
abnoramal and could be associated with cerebral palsy or autism
peek a boo and patty cake
10-12 months
the posterior fontanel should not be palpable in
8-month-old clients.
when do infants begin expiercing seperation anxiety
6 months
seperation anxiety can be hiegtening during
hospitlization due to unfamilar stresors
how to relieve indants stress
adhere to routine at home (meals and sleep times)
-provide fav toy or pacifier
=enouage caregivers to remain
-quiet enc
-offer familar object (caregivers shirt, blanket, voice recording)
when should children have their first dental visit
6 months or by their first birthday
when do childs first teeth abrupt
6 months
pirmary teeth by
2-4 years
when do children start preschol
age
regression during hospitialization
normal and will regain lost milestones after discharge
snacks and meals for toddlers
safety small, hard, sticky and/or slippery foods pose a choking risk and should not be offered to children under age 3. Examples include hot dogs, grapes, nuts, raw carrot sticks, popcorn, peanut butter, hard candy, and raisins.
- Potential for food-borne illness – children are at higher risk for developing a food-related infection if given raw, unpasteurized foods such as juice, partially cooked eggs, raw fish, or raw bean sprout
- dont give empty calories
examples of healthy snakcs for children under 3
pieces of cheese whole wheat crackers bana slices yogurt COOKED veg mini pizza cottacheese with cut up fruits
adolscents psychosocial development is marked by
risk taking
-sense of invincibility
-need for independence
=strong connection to peers
