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Clin Med/Spec > Peds Exam 1 Lecture 3: Growth, Development, & Health Promotion > Flashcards

Peds Exam 1 Lecture 3: Growth, Development, & Health Promotion Flashcards

1
Q

How do you measure a 1 y/o child’s length/stature?

A

In the recumbent position using a foxed headboard with a movable footboard. Measure from the vertex of the skull to the soles of the feet.

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2
Q

Can you use a device on a balance beam scale to measure the stature of children over 2 y/o?

A

NO - this does not allow for proper posture

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3
Q

What is the best way to weigh an infant?

A

Naked

can leave on CLEAN diaper for older infants only

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4
Q

What is the best anthropometric indicator of adiposity in children and adolescents?

A

BMI

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5
Q

Is BMI at the 86th percentile considered normal, overweight, or obese?

A

Overweight

BMI >85-95 = overweight, BMI >95 = obese

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6
Q

How do you measure an infants head circumference?

A

Using a narrow, non-stretchable tape measure - start just above the supraorbital ridges & go around the head at the same level as the prominence of occiput.

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7
Q

For a growth chart, shifts across how many percentile lines may indicate abnormality?

A

2+

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8
Q

How do you calculate a child’s genetic potential/mid-parental height?

A
  • Correct mother’s height by adding 5 in for boys
  • Correct father’s height by subtracting 5 in for girls
  • Average corrected heights of parents
  • Target height = +/- 2 in
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9
Q

When looking at a weight for height growth chart for a patient who’s short & underweight for age, how do you determine b/w familial short stature and failure to thrive/constitutional delay?

A
  • Family short stature: height & weight will be proportional to each other
  • Failure to thrive: will have a pronounced drop in weight initially, followed by a less pronounced drop in height (may have decrease in head circumference if severe)
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10
Q

In a predominantly breastfed infant, which growth chart is the best predictor for their growth? (CDC or WHO)

A

WHO - pt may appear as if underweight on the CDC growth curve.

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11
Q

True or False: Healthy breastfed infants typically put on more weight than formula-fed infants in the first year.

A

False

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12
Q

Growth “Rule of Thumb”

A
  1. Term infants are back to birth weight by 2 wks of age, then gain 20-30 g/day for 1st 3 months
  2. Term infants triple birth weight by 1 y/o
  3. Term infants gain 2 kg/yr ages 1-10
  4. Height doubles by 3-4 y/o
  5. Normal head circumference for full-term infant = 35 cm
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13
Q

Major difference in presentation of plagiocephaly vs craniosynostosis

A

In plagiocephaly, the infant’s ear is displaced anteriorly. In craniosynostotis, the ear is displaced posteriorly.

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14
Q

What are the four major differences b/w macrocephaly and hydrocephalus?

A

Macrocephaly is the enlargement of the head. On the growth curve it is >97th percentile but parallels growth curve. There are no split sutures <12 mo old. There is NO increased ICP.

Hydrocephalus is the dilation of the ventricular system. On the growth curve, it crosses percentiles. There is both split sutures <12 mo old & increased ICP.

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15
Q

Management of plagiocephaly

A

Tummy time, reposition in crib, PT, and helmet therapy

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16
Q

What does helmet therapy do in plagiocephaly?

A

Applies custom corrective pressure to redirect the baby’s natural head growth and normal shape.

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17
Q

At what ages (months) do babies need developmental screenings?

A

9 mo, 18 mo, & 30 mo

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18
Q

At what month should an infant be able to sit without support?

A

7 months

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19
Q

At what month will an infant begin creeping (crawling on hands and knees) and pulls to stand?

A

9 months

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20
Q

At what month do infants typically begin standing well and taking independent steps?

A

12 months

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21
Q

At what month can a child use a spoon well?

A

22 months

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22
Q

When is a child typically able to pull his/her pants off?

A

24 months

23
Q

At what month does a baby listen and then vocalize when an adult stops talking?

A

6 months

24
Q

Around what month does a baby typically say his/her first word?

A

11 months

25
Q

When does a baby begin reciprocal smiling (in response to adult face/voice)?

A

2 months

26
Q

When a baby seeks an object after it falls silently to the floor, what does this demonstrate?

A

Object permanence & problem solving (this typically happens around 8 months)

27
Q

What is protoimperative pointing?

A

Pointing to something because they want it (typically around 12 months)

28
Q

What is protodeclarative pointing?

A

Pointing to something/someone to share an experience (typically around 14 months)

29
Q

What cues do infants contribute to the development of attachment?

A

Prefers looking at faces, social smile (selective), selective eye contact, crying in distress, babbling, stranger/separation anxiety

30
Q

What are the four components of joint attention?

A
  1. Orienting and attending to a social partner
  2. Coordinating attention b/w ppl & objects
  3. Sharing affect and emotional states w/ ppl
  4. Being able to draw others’ attention to objects or events to indicate need or to share experiences
31
Q

What does theory of mind indicate?

A

That the child has developed an appreciation that other people don’t think/feel the same way that he/she does.

32
Q

Indications to screen for iron deficiency at 1 y/o

A

Prematurity, exclusively breastfeeding>4 mo w/out supplementation, early weaning to cow’s milk (or non-iron fortified foods), feeding problems, poor growth, low SES

33
Q

Neurotoxic effects of lead poisoning

A

School failure, cognitive loss, hyperactivity, aggression, inattention, distractibility, and delinquent behaviors

34
Q

Manifestations of lead poisoning

A

Most are asx, but may have: abd colic, constipation, growth failure, hearing loss, microcytic anemia, dental caries, spontaneous abortions, renal dz, osteopenia, CVD

35
Q

When do you use chelation for lead poisoning? And with what?

A

BLL>45 mcg/dL, Succimer

36
Q

Appropriate size BP cuff in children

A

Bladder length should be 80-100% of arm circumference, width at least 40&

37
Q

What position should infants be in while taking BP? Older children/adolescents?

A

Infants should be supine, older children/adolescents should be seated

38
Q

When should yearly vision screening begin?

A

Age 4 (or cooperative 3 y/o)

39
Q

Why you should identify hearing loss by?

A

3 months

40
Q

What are typically the first teeth to erupt?

A

Front bottom central incisors (b/w 6 & 10 months)

41
Q

When do you become concerned that a patient has not developed any teeth?

A

At one year

42
Q

What are the best ways to prevent dental caries?

A
  • no night bottle
  • no juice/soda via bottle or sippy cup
  • encourage cup use at early age
  • limit sweet snacks & drinks
  • limit juice & sweets to mealtimes
  • fluoride
43
Q

How much toothpaste should you be using for a child under 3 y/o?

A

The size of a grain of rice

44
Q

How much toothpaste should you be using for a child over 3 y/o?

A

The size of a pea

45
Q

Until when should an infant be in a rear facing car seat?

A

Until 2 y/o AND when reach the max weight by manufacturer

46
Q

Booster seat should be used until a child is:

A

4 ft 9 in

47
Q

When should a child learn to sleep alone?

A

6-8 months (before separation anxiety starts)

48
Q

At what age do you begin the discussion of toilet training?

A

18-24 months

49
Q

Signs of toilet training readiness (there are a lot…)

A
  • asks to use potty chair or wear big kid undies
  • can put on/take off clothes
  • demonstrates independence, uses “no”
  • follows parent to bathroom, expresses interest
  • has regular/predictable BMs
  • imitates parent behavior
  • is able to follow simple instructions
  • reports soiled diaper, wants a clean diaper
  • stays dry for 2 hrs or after naps
  • uses words, facial expressions, or movements indicating the need to urinate/defecate
50
Q

What is the child-oriented approach to toilet training?

A
  • when child shows readiness, start allowing him/her to accompany parent to bathroom
  • child then becomes interested
  • let them voluntarily use potty chair
  • once interest, take them to potty chair 2-3x a day
  • praise success
  • make the process relaxed & pleasant
51
Q

How long is the “operational conditioning” toilet training program designed to take?

A

24-48 hrs (LOL)

52
Q

What is the association b/w media and child development?

A

Earlier age of media use & greater cumulative hrs in front of a screen is associated w/ poorer executive functioning (working memory, cognitive flexibility, inhibitory control)

53
Q

What are the media recommendations for a child 18-24 months?

A

High quality programming, have parent watch with child and make into an interactive event

54
Q

True or False: Positive reinforcement is associated with effective discipline at any age (infant, toddler, school-age, adolescent).

A

True

Clin Med/Spec (11 decks)

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