Peds Exam 1 Flashcards
infants experience stranger anxiety between __ to __ months of age
6 to 8
Can experience sleep deprivation due to these 3 things
strange noises, monitoring devices, and procedures
type of separation anxiety:
screaming, clinging to parents, verbal and physical aggression toward strangers
protest
type of separation anxiety:
withdrawal from others, depression, decreased communication, developmental regression
despair
type of separation anxiety:
interacting with strangers, forming new relationships, happy appearance
detachment
Each child’s understanding of illnesses and hospitalization is dependent on the child’s stage of _____ and ______
development and cognitive ability
things to listen for during assessment of the family
their unique stressors
Place infants whose parents are not in attendance close to ____ ____ so that their needs can
be quickly met.
nurses’ stations
Provide ______ in assigning caregivers
consistency
Encourage family members to stay with the child during the hospital experience to _____ __ _____
reduce the stress
Provide _______ appropriate activities
developmentally
Infant stage of growth and development: (neonatal)
Newborn through 12 months of age
Attainment of skills from head to toe
Cephalocaudal pattern:
Attainment of skills from trunk out to extremities
Proximodistal pattern
Gains ____ motor before ____ motor skills.
gross before fine
What motor development milestones would you expect an infant to attain first?
Opens and closes hands
An infant learns to open and close their hands at __ months of age.
2
infants use a raking grasp at __ months
6
infants learn a pincer grasp at __ months
9
infants feed themselves with a spoon at __ months.
12
what months do babies get appointments
newborn, 1 month, 2 months, 4 months, 6 months, 9 months, 12 months
Assess infants on the ______ lap.
caregivers
t/f: Perform the most invasive procedures last.
true
Assess for hip dysplasia until __ months of age.
3
posterior fontanelles (smaller) close between __ and __ months of age
2 and 3
anterior fontanelles (larger) close between __ and __ months of age
12 and 18
Strabismus is common until __ months of age.
6
To inspect the pinna of the ear, pull it ___ and ____
down and back
t/f: Heart rate and respirations are often irregular in newborns
true
misalignment of the eyes, causing one eye to deviate inward (esotropia) toward the nose, or outward (exotropia), while the other eye remains focused.
stribasimus
bluish discoloration of the extremities due to decreased amount of oxygen delivered to the peripheral part, that is often common in newborns
acrocyanosis
The top of the pinna should align along an imaginary line with the ___ _____ of the eye
outer canthus
A pinna that sits below the imaginary line between the outer canthus of the eye could indicate _____ _____
chromosomal abnormalities
a common foot deformity noted at birth that causes the front half of the foot, or forefoot, to turn inward, NORMAL in infants
Benign metatarsus adductus
Passive immunity until __ months of age
6
sunken fontanelle=
dehydration
swollen fontanelle=
increase pressure, fluid build up
Myelination of spinal cord from newborn to ___ months
24
reflexes the child is born with, disappear over first year of life
primitive relfexes
which type of reflexes are sucking, rooting, Babinski, Moro (startle), stepping, palmar grasp, plantar grasp, tonic neck
(fencer).
primitive
Babinski reflex normally lasts until __ months.
24
relfexes that Develop after the disappearance of primitive reflexes, not until after 12 months
protective reflexes
Newborn’s first stool, Thick and green
Meconium
If breastfed, stool is
Thinner consistency, Seedy and yellow
If fed formula, stool is
Pastier consistency, Darker in color
Normal to have __ stool every other day and up to __ stools daily
1, 10
FLACC scale stands for
Face
Legs
Activity
Cry
Consolability
higher score on FLACC scale indicates:
more pain
NIPS stands for:
Neonatal Infant Pain Scale
t/f:
A FLACC score of 8 indicates mild pain.
false. 0 is no pain and 10 is worst pain possible
LENGTH:
Grow ___ to ___ cm per month for first 6 months.
1.5 to 2.5
LENGTH:
Grow __ cm per month for months 6 to 12.
1
Lose __% body weight the first week of life but regained by end of the 2nd week.
10%
infants Gain __ to __ g per day for the first 3 months
20 to 30
babies weight doubles by __ to __ months, and triples by __ months
4 to 6, 12
head circumference Increases rapidly the first __ months, then slows until __ months.
6, 12
babies begin “cooing” at __ months of age.
2
baby Babbles by __ months of age.
6
babies Copy sounds at __ months of age.
9
By __ months of age, babies can use simple gestures and follow simple directions.
12
what are babies vision at birth
20/400
No color vision until __ months of age
7
t/f: babies Prefer high-pitched voices
true
t/f: infants prefer sweet tastes over sour tastes
true
easy temperament=
Quickly establishes routines, adapts easily
Difficult temperament=
Requires high levels of activity, fussiness, crying
Slow to warm up temperament=
Middle level of fussiness, initial negative reactions, adapts over time
Risks to newborns and infants are found in
Tobacco exposure, Food and housing insecurity, Parental substance abuse
Room sharing in own bed until __ months of age is recommended.
6
how should infants sleep?
sleep on back
Newborns sleep about __ hours per day (or more!).
16
A nurse is working with occupational therapy to plan what developmentally-appropriate toys should
be given to her 10-month-old patient. What is the most appropriate?
Board books
solid foods start at __ months of age
6
Start with iron-fortified cereal, then add other pureed foods slowly (every 3 days) to prevent _____
allergies
first tooth at __ to __ months
4 to 7
signs of teething:
Fussy and irritable, Increased salivation, Low-grade fevers, Difficulty sleeping
Self-limiting condition of increased fussiness and inconsolable crying
colic
colic Peaks at __ weeks of age and resolves by __ to __ months of age.
6, 3-6
t/f: colic is worse in the evening time
true
Brief Resolved Unexplained Events
BRUE
symptoms of BRUE:
Cyanosis or pallor, Irregular, slowed, or absent breathing, Hypertonia or hypotonia, Altered level of responsiveness
Any skin breakdown in the diaper region, erythematous and excoriated
diaper dermatitis
Treat diaper dermatitis by:
leaving diapers off and allowing skin to dry.
Scales and erythema, usually only in scalp. (“cradle cap”)
seborrhea
Seborrhea usually resolves by __ months
12
Defined as a temperature over 100.4 F (38 C)
fever
visits for toddlers are conducted at:
15 months, 18 months, 2 years, 2.5 years, and 3 years.
toddler ear (pinna) inspection:
pull it back and down.
things toddlers may be afraid of:
new people and places, dark, intrusive procedures and flushing stool down toilet because there is not a clear separation of self from body
toddler stage is
12 to 36 months of age
All 20 baby teeth should be present by __ years of age.
3
___ increases and ____ decreases as toddler grows and develops.
BP, HR
toddler stool frequency:
usually 1 per day
Normal hemoglobin ratio at __ months of age
12
Most common chronic skin condition in children, eczema
- Symptoms:
Severely dry skin
Erythematous patches
Extreme pruritus
Thickening of the skin
atopic dermatitis
Is the inflammation of the middle ear and middle ear effusion, ear infections
acute otitis media
risk factors for ear infections:
Exposure to tobacco smoke, Exposure to other children, Congenital anomalies
Protective factors for ear infection:
Breastfeeding, Pneumococcal vaccination
HEIGHT:
Grow 5 inches (12.7 cm) from __ months to __ years of age.
12, 2
HEIGHT:
Grow 2 to 3 inches (5-7.6 cm) from __ to __ years of age.
2 to 3
Measure standing height at __ years of age.
3
Perform sitting weight until __ years of age.
3
Gain __ pounds (2.3 kg) per year.
5
toddlers head circumference Increases by __ cm from 12 to 24 months.
2 cm
stage of autonomy vs. shame and doubt
Erikson
symbolic thinking develops at 2 years of age
Piaget
belief that inanimate objects have a consciousness and other life-like properties
animis
Preconventional level: Avoidance of punishment as motivation for obedience, Not focused on right and wrong
Kohlberg
The nurse is explaining Kohlberg’s theory of moral development to the parent of a toddler. The nurse
tells the parents that in the preconventional level of moral development, what factor motivates
obedience?
avoidance of punishment
The nurse is assessing gross and fine motor development in a 2-year-old child. What developmental milestones would the nurse expect to observe in this child?
stacks objects
______ language develops quicker than _____ language.
receptive, expressive
Repetition of words and phrases without understanding meaning
Echolalia
Two- to three-word sentences, Only contain enough words to get the point
across.
telegraphic speech
Believe the world revolves around them, Focused on self only
Egocentric
Ride forward facing in back seat in five-point harness from __ to __ years of age (rear facing before 2 years of age).
2 to 4
Change from formula or breastmilk to cow’s milk at __ months.
12
Use nonflavored whole milk until __ years of age.
2
Times a toddler will only eat certain foods then suddenly refuse to eat those foods anymore, Common around age 3
food jags
Limit milk to ___ oz per day or less to prevent anemia.
24
The mother of a 3-year-old child tells the clinic nurse that her child insists on having a bottle at
naptime and bedtime. What intervention should the nurse suggest to the
mother?
Do not allow the child to have the bottle.
playing alongside one another but not with each other.
parallel play
9 hours at night and __ naps until 18 months
2
9 hours at night and __ longer nap after 18 months
1
potty training usually begins at what age
2
Result of receptive language development versus expressive language development, starts at 12 months
temper tantrums
what is the preschool stage
3 to 6 years (3,4 and 5 year olds)
2 key characteristics in preschoolers
imagination and creativity
_____ motor skills become more coordinated in preschoolers, ____ motor develops exponentially
gross, fine
2 coping mechanisms for preschoolers
aggressive responses and scatology
when do you begin to involve child in health history during physical assessment?
preschool age
t/f: do NOT allow preschoolers to make choices or play with safe medical equipment during assessment
false
Implement visual acuity testing at age __?
4
To inspect the pinna of the ear at age 3, pull it ___ and ____.
up and back
Assess hearing with _______ emissions test at preschool age
optoacoustic
