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Clin Skills > peds: assessment (slides 1-50) > Flashcards

peds: assessment (slides 1-50) Flashcards

1
Q

4 categories of growth (that differ for each age group)

A

physical, cognitive, emotional and social growth

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2
Q

at what age do we generally start to screen BP and BMI

A

BP after age 3
BMI after age 2
*but BP At least once during infancy – digital doppler method is easiest

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3
Q

The best way to conceptualize a single health supervision visit (well visit) is not as one visit but as a visit of multiple encounters encompassing what 4 objectives?

A

disease detection
disease prevention
health promotion
anticipatory guidance

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4
Q

what two phases is infancy divided into?

A

Neonatal period- first 28 days

Postnatal period- 29 days to 1 year

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5
Q

baby: when is the first exam? what is the comprehensive exam?

A

First exam is at delivery

Comprehensive exam within 24 hours

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6
Q

when do kids start having yearly visit?

A

3yr- middle school

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7
Q

when are the doc visits in early childhood?

A

Early childhood- 12 mth, 15mth, 18 mth, 24 mth, 30 mth, 3 yr, 4yr

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8
Q

when are the doc visits in infancy

A

Infancy- 3-5 days, 1month, 2 mth, 4 mth, 6 mth, 9 mth

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9
Q

when is apgar score done? what is included?

A

1 min and 5 min
Heart rate, respiratory rate, muscle tone, reflex irritability, color
(appearance, pulse, grimace, activity, respiration)

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10
Q

what is the scale of apgar score and what does each score mean? (1 min)

A

8-10 - normal
5-7- some nervous system depression
0-4 - severe depression, immediate resuscitation

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11
Q

score of 0-7 on apgar at 5 min means what?

A

0-7 – high risk for subsequent central nervous system and other organ system dysfunction

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12
Q

a baby with a low apgar may need what two things?

A

Oxygen and clearing out the airway to help with breathing

Physical stimulation to get the heart beating at a healthy rate

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13
Q

is apgar meant to predict the future health of the child?

A

no

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14
Q

how off can the ballard score be?

A

accuracy may be off by 2 weeks

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15
Q

what is the ballard score ?

A

estimate gestational age based on baby height, weight + muscle tone

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16
Q

newborn complex behavior: habituation

A

ability to selectively and progressively shut out negative stimuli

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17
Q

newborn complex behavior: attachment

A

A reciprocal, dynamic process of interacting and bonding with the caregiver

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18
Q

newborn complex behavior: state regulation

A

ability to modulate the level of arousal in response to different degree of stimulation

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19
Q

newborn complex behavior: perception

A

ability to regard faces, turn to voices, quiet in presence of singing, track colorful objects, respond to touch, and recognize familiar scents

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20
Q

what ages are early and middle childhood?

A

Early childhood 1-4 years

Middle childhood 5-10 years

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21
Q

late childhood/adolescence is divided into what 3 phases

A

Early- 10-14 year olds
Middle 15-16 year olds
Late 17 to 20 year olds

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22
Q

By 1 year child should _____ birth weight and increase height by ____

A

triple , 50%

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23
Q

Neurologic development progresses from ______ to ________

A

central, peripheral

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24
Q

what are the 3 key stages of language development and what are the 3 ages?

A

cooing at 2 months
babbling at 6 months
one to three words at 1 year

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25
Q

what are the international growth charts for children 0-2 yo

A

WHO

26
Q

pulse at birth and by 12 months

A

birth - 140

12 months- 115

27
Q

what can the RR be for infant?

A

< 2 months anything over 60/min
2-12 months anything over 50/min
*observe at least 60sec
*most reliable when sleeping

28
Q

fever can raise RR in infants up to __ respirations per minute for _____ degree centigrade of fever.

A

10, EACH

29
Q

high RR + fever in infant?

A

Get the fever down THEN check RR again. - switch tylenol and Motrin so they get something every 2-3 hrs

30
Q

at what ages do you do rectal temp?

A

0-2 mo

31
Q

what is acrocyanosis?

A

blue hands/ feet

32
Q

what is central cyanosis a sign of? where do you look for it?

A

(sign of congenital heart disease) at tongue and oral mucosa

33
Q

what is lanugo?

A

fine, downy hair over entire body concentrated more at shoulders and back ( Sheds first few wks)

34
Q

what is miliaria rubra?

A

scattered vesicles on reallyy red base - face and trunk

- from obstruction of sweat glands

35
Q

what is erythema toxicum?

A

rash- red macules, w/ central pinpoint vesicles scattered all over body (looks like flea bites)

36
Q

what is pustular melanosis?

A

more in black infants- small vesicles on brown base

37
Q

what is milia?

A

pinhead white raised bumps - seen on nose + around.

-in sebaceous glands

38
Q

what is normal “physiologic” jaundice? how do you test it?

A

2nd or 3rd day, peaks about 5th day, usually gone within a wk
- yellowish blanching = jaundice

39
Q

when do the anterior + posterior fontanelles close?

A

Anterior fontanelle – closes between 4 and 
26 months of age

Posterior fontanelle – closes by 2 months 
of age

40
Q

eyes may be ____ for the first few weeks of life

A

fixed

41
Q

babies have swelling where from birthing process?

A

eyes

42
Q

Babies can get intermittent strabismus but should be gone by ___ months

A

3

43
Q

how do you check visual acuity in newborn?

A

use visual reflexes to assess vision

- pupil constriction, optic blink reflex, blinking with movement of object toward eye.

44
Q

looking in the eye, red =? black =? white =?

A

red- normal
black- cataract
white- retinoblastoma

45
Q

ears: ______ _______ _______ for several months before becomes cone-shaped

A

Diffuse light reflex

46
Q

how can you look at TM? why might you not be able to see TM in infant?

A

pull pinna down to look- might be full of “stuff” (vernix caseosa)

47
Q

Palpate _______ _______ _____ after birth to ensure it is intact

A

upper hard palate

48
Q

how do teeth come in? (with what frequency? what location comes up first? )

A

1 tooth per month for 6-26 months of age, 
Central and lateral incisors erupt first, molars last

49
Q

if birth extraction was difficult, what should you be sure to check?

A

crepitus of clavicles (maybe fracture)

50
Q

what part of thorax exam is not helpful to do in infants? why?

A

percussion: not helpful in infants; hyperresonant*
NOTE: thorax is more rounded in infants than in older children and adults

51
Q

what do you palpate thorax for?

A

tactile fremitus (if making noise/crying)

52
Q

lung sounds upper vs lower airway?

A

Upper airway: loud, symmetric transmission throughout the chest, loudest as stethoscope is moved upward; coarse during inspiratory phase
Lower airway: loudest over site of pathology; asymmetric; often occur during expiration

53
Q

how is auscultation of lungs different for infants than kids/adults?

A

sounds are louder and harsher generally

54
Q

respiratory problems: what two aspects do we check for infant breathing?

A

audible breath sounds + work of breathing

55
Q

audible breath sounds that indicates resp. problem (4)

A

Grunting
Wheezing
Stridor
Obstruction (often right lung)

56
Q

work of breathing that indicates resp. problems (3)

A

Nasal flaring
Grunting
Retractions- supraclavicular, intercostal, subcostal

57
Q

what is sinus dysrhythmia? is this normal?

A

normal in infant - Inc. rate on inspiration and dec. on expiration

58
Q

PMI in infants

A

located 1 interspace higher than in adults

59
Q

checking pulses in infant- check all 4 extremities for what?

A

coarctation of aorta

60
Q

central cyanosis is what color?

A

Raspberry red (desat) vs. strawberry pink (normal)

61
Q

why might breasts be slightly enlarged in newborn?

A

from estrogen of mother

62
Q

when should umbilical cord fall off by?

A

2 wks

Clin Skills (25 decks)

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