Peds Head to Toe Exam Flashcards
Shortly after delivery newborns are routinely given:
- Erythromycin ointment in eyes to prevent infection
- Vitamin K injection to prevent bleeding
- Full bath
Prior to discharge newborns receive
First hepatitis B immunization
Hearing screen
____ in a Neonate is an emergency!!
Fever - Rectal over 100.4
Common issues at one month check: (3)
- Constipation (perceived)
- Colic (peaks at 1-2 months)
- Congestion
Important topics for first week (2-5 days) newborn visit: (4)
- Sleep on Back
- Vit D supplement for breast fed babies
- no honey for first year of life
- set water heater to 120 deg F
For an infant exam you must be ____ with the ____ and begin with the _____ exam first.
- Flexible
- Sequence
- Hear and Lung
Important topics for the 4 month visit: (3)
- Starting Solids
- Sleep
- Safety = infants can drown in 1 inch of water
Before 9 mo the exam can be done on the ____. After this ______ sets in and the exam can be done on the ______.
- Exam table
- Stranger Danger
- Parent’s Lap
Considerations for a Toddler’s Exam: (4)
- perform on parent’s lap
- allow child to interact with equipment
- use equipment on parent or toy first
- flexible sequence (save less tolerated potions for last)
Number for Poison Control
1-800-222-1222
Topics for 18 month exam: (4)
- Toilet Training
- Temper Tantrums
- Anxiety
- Consistent Discipline
General Considerations for School Aged Child Exam:(3)
- Respect child’s modesty
- Describe what you are doing step by step
- be flexible with sequence
Topics for 10 year old Exam: (5)
- Booster seat recommended until 4’9’’
- 60 min of physical activity/day
- bike & skateboard safety
- sunscreen
- guns
Topics for 11-14 year old exam: (8)
“HEEADSSS”
- Home
- Education
- Eating
- Activity
- Drugs
- Safety
- Sex
- Suicide
Recommended Immunizations for Children: (5)
- RV
(rotavirus) - DTaP
(diphtheria, tetanus, or pertussis) - Hib
(Haemophilus Influenzae Type b) - PCV (Pneumococcal conjugate vaccine)
- IPV
(polio)
The Anterior Fontanel is ____ and closes ____.
- Larger and closes later (12 - 18 mo)
The Posterior Fontanel is ____ and closes _____.
- Smaller and closes early (1-2 mo)
Both the anterior and posterior fontanels should be ____ and ____.
Soft and Flat (AFS/F)
Define: Caput succedaneum
Swelling of a newborn’s scalp appearing as a lump or bump after delivery
Caput succedaneum _____ _____ _____.
Crosses Suture Lines
Define: Cephalohematoma
is a hemorrhage of blood between the skull and the periosteum of a newborn baby
Cephalohematoma does ___ _____ _____ _____.
does not cross suture lines
Bulging of the fontanel indicates _____.
Increased intracranial pressure
Define: Seborrheic Dermatitis
- Baby dandruff
- also known as cradle cap
Tinea capitus Definition and Presentation
- ring worm of the scalp
- perfect circular appearance/ hair clearing
Alopecia Areata presentation
Non-symmetrical/patchy hair loss
Puss around the Eye indicates a ______
Bacterial infection
A red sclera indicates ____
Viral or allergic condition
A yellow sclera indicates ____
icterus
Childeren have _______ as compared to adults which _____.
- Wider, shorter Eustachian Tubes
- predisposes them to otitis media
Otitis Media Presentation
- Red, bulging, no cone of light
What are epstein pearls?
Mucous cysts on hard palate on infants
Define Ankyloglossia
Short, thick lingual frenulum that may limit tongue mobility
General treatment for Torticollis?
Physical therapy
Normal RR for Neonate?
40 -60 breaths/min
Normal HR for Neonate?
120 - 160 beats/min
Apnea in an infant is….
greater than a 15-20 sec pause between breaths
Signs of respiratory distress in infants (4)
- retractions (intercostal and subcostal)
- grunting
- nasal flaring
- accessory mm use
what is diastasis recti?
a gap between the two sides of the rectus abdominis mm
Flexible vs Rigid deformities
- Flexible dt in utero positioning; self correcting
- Rigid usually require intervention
Galeazzi Sign
With child lying supine and with knees/hips flexed to 90 deg, one leg appears shorter than the other
Palmar Grasp
- B to 4 mo
- Place finger in hand and press against palmar surface –> grasp finger
Plantar Grasp
- B to 9 mo
- touch sole at base or toes –> toes curl
Rooting Reflex
- B to 3/4 mo
- stroke perioral skin at corner of mouth –> mouth opens and baby turns head to side of stimulation
Moro (Startle Reflex)
- B to 4 mo
- Hold supine support head, back and legs; abruptly lower 2 feet –> arms abduct and extend, hands open, legs flex
Infancy Milestones at 2 mo
social smile and coo
Infancy milestone at 4 mo
no head lag with pulling infant to a sitting position
Infancy Milestone at 8-9 mo
- pincer grasp
- anticipatory guidance about choking hazards at six month check up
Speech development (3)
- age 2 = 2 word sentences
- age 3 = 75% of speech is understandable by a stranger
- age 4 = 100 % of speech is understandable too all
Hemangiomas (3)
- strawberry red
- 50% resolve by age 5
- 90% resolve by age 9
Mongolian spots (3)
- flat, grey/blue/black large macular lesions
- lumbar/sacral region
- fade during the first few years of life
Impetigo (3)
- “honey crusted lesions”
- staph infections can be secondary to scratching
- Rx: topical antibiotic cream
Ringworm
- elevated rings with central depression/clearing
- Rx: antifungal creams
APGAR stands for:
A- appearance (color) P - pulse G - grimace (reflex irritability) A - activity R - respiratory effort
Most babies score a ___ because they lose a point dt _____.
9/10, peripheral cyanosis
APGAR appearance score
0 = blue, pale 1 = pink, blue extremities 2 = all pink
APGAR Pulse score
0= absent 1 = 100
APGAR Reflex Irritability score
0 = no response 1 = grimace 2 = crying vigorously, sneeze or cough
APGAR Activity score
0 = flaccid 1 = some flexion of arms/legs 2 = active movement
APGAR Resp. Effort score
0 = absent 1 = slow and irregular 2 = good/strong
