peds G&D Flashcards
well child visits up to one year
- 2 weeks
- 1 mo
- 2 mo (i)
- 4 mo (i)
- 6 mo (i)
- 9 mo
- 12 mo (i)
well child visits after 1 year old
- 15 months (i)
- 18 months- final autism screen
- 2 years (i), then yearly
- 4 years= significant immunization visit
at what age can you predict a childs final height
- by 3 years
- premies catch up growth occurs during first 2-3 years
what objective measurements are taken at all pedi visits
- height
- weight
- head circumference/ FOC
vital trends in peds
- HR should be between 60-160
- pulse decreases over time
- SBP increases over time
what should kids weigh at their 2 week check up
- their birth weight
how do you weight babies/ kids
- dry diaper only
- no shoes
- no things in pockets
when should babies double their birth weight
- 5 months
when should babies triple their birth weight
- by 1 year
what should you do if you get a measurement that you do not expect
- remeasure
when should birth length double
- by 4 years
head circumference
- aka fronto-occipital circumference
- avg increase by 1 cm/ mo in first year
- reliable indicator of brain growth for up to 2 years*
when do cranial suture close
- 6 mo
- dont ossify until early adulthood
when do anterior fontanels close
- 9-18 months
BMI in children
- measure/ predictor for obesity and assoc health risks
- BMI > 95%= significant RF for nutritional abnormalities
why are developmental screenings important
- ID delays and their etiology
- maximize potential of child with appropriate intervention
- provide support/ reassurance
- dont ignore screening results*
- dont rely on informal screening*
- dont assume that dx a disorder is unnecessary because there is nothing that can be done
important parts of development
- gross motor
- fine motor
- language
- social
when do gross motor and fine motor skills progress
- greatest progress= first 3 years of life
- first year: rapid acquisition of gross and fine motor skills
- toddler/ preschooler: rxn time quickens, hand-eye coord, manual dexterity
- early childhood: lg muscle mvmt, coord is perfected, fine motor skills improve
when do babies sit alone momentarily
- 4-6 mo
when do babies roll on back to stomach *
- 5 mo (4-10 mo)
when do babies sit steadily*
- 7 mo (6-9 mo)
when do babies get to sitting
- 6- 11 mo
when do babies pull to standing*
- 10 mo (7-12 mo)
when do babies walk 3 steps alone
- 9-17 mo
when do babies walk well
- 13 mo
when do babies stoop and recover*
- 15 mo
when do babies walk backwards
- 18 mo
when do kids kick ball forward*
- 2 years
when do kids throw ball overhand*
- 3 years
when do kids balance on 1 foot, 2 seconds, hop
- 4 years
when do kids balance on 1 foot, 3 sec, skip
- 5 years
when do kids catch a ball
- 5 years
when are babies able to rake*
- 6 mo (5-7 mo)
when do babies make lobster claw/ pincer*
- 9 mo (8-10 mo)
when do babies perfect the pincer*
- 11 mo (10-12 mo)
when do babies scribble *
- 15 mo
when do babies imitate vertical or circular strokes, tower of 6 cubes? *
- 2 years
what is the most common cause of speech delay
- hearing problems
auditory brainstem response
- assessment of hearing in newborns and infants
- sounds played in baby’s ear
- measures brain responding to sound
otoacoustic emissions
- assess newborns and infants for cochlear function
- sound played into ear- cochlear response measured
- if hears normally, echo is reflected back into microphone
questions to ask when assessing hearing
- 0-3 mo: does baby startle to loud noise
- 4-6 mo: does baby turn eyes/ head at sound of your voice
- 7-9 mo: does baby make string of noise
when to refer for speech and/or language assessment
- not talking by 2 y/o
- unintelligible speech by 3
- no sentences by 3
- child is embarrassed by speech at any age
- hearing loss, mental retardation, autism, dysarthria, stuttering
assessment of vision
- red light reflex* in babes
- corneal light reflex
- cover/uncover for strabismus
vision assessment in new borns
- focus on face
- briefly track object
vision assessment at 2 mo
- tracks across midline
- responsive smile
- follows mvmt 6 ft away
vision assessment at 3 mo
- tracks 180 degrees
- looks at hand
vision assessment at 4-5 mo
- reaches for obj 12 inches away
- familiar smile
at what age do babies have a social smile
- 2 mo
at what age do babies reach for objects
- 6 mo
at what age do babies feed themselves, pass object hand to hand
- 9 mo
at what age do babies play appropriately with toy
- 12 mo
at what age do babies drink from cups
- 18 mo
at what age do kids use spoons
- 2 years
at what age do kids put on t shirts
- 4 years
considerations for premie
- account for degree of prematurity when assessing G&D
- may only have skills appropriate for their GA
- more complicated neonatal course have more delays
- det G&D based on adjusted age
early adolescence
- 10-13 yo
- rapid physical change
- concerned if dif from peers
- concrete thinking: vague, unrealistic goals
middle adolescence
- 14-16 y/o
- rapid pubertal growth subsides
- mood swings
- formal operation thinking
- sense of omnipotence
- self centered
- estab identity/ experiment with dif image
late adolescence
- 17+ y/o
- less self centered
- social interest shift from peer group to individual
- dating more intimate
- more indep from family
- abstract thinking
- realistic future plans
leading cause of death in adolescents
- accidents
- suicide
- homicide
- 50% involve drugs and/or alcohol
at what point can kids be seen alone
- 11ish
what tx can minors consent to
- medical tx except abortion
- family planning
- HIV and STI tx
- substance abuse if 12+ y/o and found to be drug depended by 2 drs
- mental health tx
what is the average age of menarche
- 12.8 years
- ranges from 10-16 y/o
