Peds- Growth & Devo I- Dr. Magie Flashcards
when is routinely the first office visit after a newborn is released from the hospital?
48 to 72 hours
what kind of patient should you treat first-time moms or first-time breast feeding mothers like?
“high risk” patient
the mom’s inexperience is a high risk to the infant.
what important specifics should be evaluated and recorded on the first office visit?
- mom’s appearance
- the infant’s appearance
- vital signs- Length, weight, head circumference, temperature
is the weight of a 5-7 day old important?
it is truly important!! make sure the baby hasn’t lost more than 10% of its weight and that breastfeeding is giving infant proper feeding. (starting to regain its weight)
what should you always always always check for on physical exam? HEENT portion
Red Reflex
screening for retinoblastoma
what are the things you are checking in the thorax portion of the physical exam?
symmetrical motion with respirations
respiratory pattern
heart rate, PMI (left lower sternal border), rhythm, murmur
what should you always check about 3 months using the Ortloni/ Barlow maneuvers?
HIPS
questions to ask parents at first office visit?
Sleep pattern of infant
feeds/day, stool production
ask mom is she has concerns
was Hep B vaccine given in hospital to infant
what is the best sleep position for infant at this age?
Back is best
at one month visit: what should you warn the mother against?
propping up the bottle and feeding the baby in prone position- leads to aspiration!!
what feeding concerns should be addressed at one month visit?
baby on Vit. D supplement if breastfed
feeding remains very frequent
what are some signs of illness in the infant?
poor feeding
fever (rectal is “gold” standard)
forceful vomiting
he said that the baby should be what upon one month visit? and if they aren’t this overall then its concerning to him.
At peace
a very unhappy baby upon visit to office is not a good start to exam
what is it good to remind/ advise the parents about?
car seat use
avoid smoking, strong perfumes around baby
what stool pattern is seen at two month visit?
stools-highly variable but one every 1-3 days or so should be occuring
what major development milestone is at 2 months visit?
baby is lifting head and chest while prone. (like superman while on stomach)
at 2 months, what part of the thorax physical exam should be coming apparent by this time?
congenital murmurs. listen closely
general precautions at 2 months:
avoid smoke/fumes
car seat use
sun exposure- protective clothing
immunizations
what can be introduced into babies diet at four month visit?
Solids. in this order WHOLE GRAIN CEREL (OATMEAL) veggies fruits meats
development at 4 months, the baby rolls front to back or back to front?
F–> B (front to back)
at what age should you pat particular attention to muscle tone and range of motion?
4 months. can start doing stretches 2-4 times/day
what age will you begin to see signs of cerebral palsy?
4 months
what test is done at 4 month visit to test infants gaze
Cover Test
what should you warn the parents of at 4 months?
the infant is “mobile and dangerous”!!!
what is a new onset finding at 6 month visit? Grandmas use this as an excuse for many symptoms. Oh they are just ________
Teething.
most eruption of teeth between 5 and 10 months
what key developments are seen at 6 months?
baby anticipants spoonfuls (opens mouth, grunts, etc.)
Baby anticipates being picked up
may tolerate strangers but starting to define its own space
due to increased mobility and that everything goes in the mouth what first infection is usually seen at 6 months?
first Upper respiratory infection.
how long should breastfeeding and/or feeding w/ formula continue until?
One year of age
what are the stages of foods available at nine month age?
stage one- fine puree and small jars
stage two- larger jars, still finely pureed
stage three- larger chuncks, often mixed, more have fillers, aimed at parental “tastes”
what is the standard testing of development?
Denver II
what are the four components that the Denver II test is checking?
- personal/social development
- language
- fine motor
- gross motor
what postural development is seen at 9 months?
baby goes from sitting to prone w/o assistance
warn parents that baby gets more dangerous the older they get. start getting curious and can get into anything. kitchen, bathroom
so many dangers
at what age does the AAP recommend that weaning begin from the bottle/breast?
12 months
how much sleep does a 12 month old still need?
12 to 14 hrs /day
what mobility development wise is the infant displaying at 12 months?
moves rapidly, crawls, walks
look for social interaction at 12 months
eye to eye contact
does child play with self or others?
does child like being hugged/ touched?
this is checking for signs of autism
There is no substitute for watchful, interested adult supervision!!
Bad parents are everywhere
what is the recommened educational toy to play with?
balls and blocks
what age does the infant begin to imitate parents/caretakers?
15-18 months
