Peds: Test Two: Growth/Development, Infectious Disease Flashcards
How long should a newborn only have breast milk or formula before adding in new foods?
up until 4 months when you can add cereal/baby food
What type of play do newborns like?
Faces, mobiles, black & white
What type of anticipatory guidance should you expect with a newborn?
Nutrition, NB care safety, infant stimulation
What are the effects of hospitalization for a newborn until 8 months?
Separation, disruption of routines, regression
What are some safety hazards for ages newborn through at least 10 months?
Positioning, choking, falls, aspiration, suffocation, car safety, burns, choking, pulling objects.
What ages are Erikson’s Trust vs. Mistrust stage occuring?
Birth until 1 year.
What ages is Erikson’s Autonomy vs Doubt & Shame occurring?
1-3 years.
What ages does Erikson’s Initiative vs. Guilt occur?
3-6 years.
What ages does Erikson’s Industry vs. Inferiority occur?
6-12 years.
What ages does Erikson’s Identity vs. Role Confusion occur?
12-18 years.
What ages is Piaget’s Sensorimotor Stages?
birth until 2 years.
What ages are Piaget’s Preoperational Stage?
2-7 years
What ages are Piaget’s Concrete Operational stage?
7-11 years.
What ages are Piaget’s Formal Operational stage?
11-adulthood
What are Kohlberg’s Stages of Moral Development?
Preconventional (4-7 years); Conventional (7-11 years); Postconventional (12+)
What are the gross and fine motor skills of a 2 month old?
Gross=lift head; Fine=open hands
When does a baby begin to follow with their eyes?
2 months.
When does a baby coo and have different cries?
2 months.
What types of play do babies at 2 months like?
Colors, talk, rattle.
What is some anticipatory guidance for a 2 month old?
Dtap, IPV, Hib, Hep#2
What are some gross and fine motor skills for a 4 month old?
Gross=head control, rolls, plays with feet; Fine=regards hands, reaches
When does a baby turn its head to locate sound?
4 mos
When do babies chuckle?
4 months.
When can you add cereal/baby food to the baby’s diet?
4 months
What is some anticipatory guidance for a 4 month old?
Dtap, IPV, Hib
What are some gross and fine motor skills for a 6 month old?
Gross=sits with support; fine=palmar grasp, transfers hand-hand
When can a baby fixate on a small object?
6 months.
What age can a baby do 1 syllable babble & vowel sounds?
6 months
When does a baby have stranger anxiety?
6 months & 15-18 months
What does a baby at 6-7 months like to play?
peek-a-boo
What is the anticipatory guidance for a 6-7 month old?
Dtap, IPV, Hib, injuries, diet
At what age does a baby pull to stand?
8-10 months.
At what age do babies have depth perception?
8-10 mos.
At what age can babies say “dada” and understand simple commands?
8-10 mos
What age do babies have object permanence?
8-10 mos.
At what age can you add fruits/veggies & soft table foods?
8-10 months.
What age do babies like to play with balls, books, & food?
8-10 months.
What anticipatory guidance do you expect at 8-10 months?
HBV #3, IPV, Dtap, diet, safety
What age do babies get separation anxiety?
8-10 months.
What age can a baby begin to walk and then run?
12 months=cruises; 15-18=walks/runs
What age does a baby have fine motor skills like finger foods, holding crayons?
12 months
What age does a baby follow moving objects and have symbol recognition?
12 months
How many words does a baby have at 12 months?
3-5 words
At what age does a baby search for objects?
12 months
At what age do you stop bottle and do whole milk?
12 mo
What are the effects of hospitalization for ages 1-2?
Separation, confusion, regression, loss of control.
What are the safety concerns for 12 month olds?
falls, outlets, pulling objects.
What are the gross and fine motor skills for 15-18 mos?
Gross=walks, runs; Fine=2 cube tower, scribbles, spoon
How many words does a 15-18 month old have?
10-15
What types of toys do 15-18 month olds like?
push-pull toys and balls
What anticipatory guidance do you expect at 15-18 months?
safety, nutrition
What safety concerns do you worry about at 15-18 months?
choking, falls
What age can a child go up and down stairs with 2 feet?
2 years.
When can a baby walk backwards/forwards?
2 years.
What are the gross and fine motor skills of a two year old?
Gross=narrow gait, up and down stairs with 2 feet, walks forward/backwards; fine=increased manual dexterity, circle.
When does a baby begin to explore with all senses?
2 years.
What is the vocab of a baby at 2 years old?
“No”; 200-300 words; 2 word sentences
What age do babies develop sibling rivalry, temper tantrums, and negativism?
2 years (terrible twos)
What do kids at 2 years like to play with?
parallel, water.
What safety concerns do you have with a child at 2 years of age?
falls, burns, collision injuries, poisoning
What are the gross and fine motor skills of a 3-5 year old?
Gross=rides bike, walks on tip toes, jumps; fine=refinement of eye-hand coordination, O (3yr) + (4yr)
What are the vocal capabilities of ages 3-5?
900 words, 4-5 sentences, talks incessantly, stutters, sings songs
At what ages do kids start to show off and begin to have fears?
3-5 years
What what age is it important to start a low fat, high calcium diet?
3-5 years
What do 3-5 year olds like to play with?
imaginary friend, associate play, imitative, imaginative
What are the effects of hospitalization for ages 3-5?
Loss of control, regression, fear of altered body image, mutilation, aggression, fantasies
What are the safety concerns of ages 3-5?
MVA’s, drowning, falls, poisoning, burns, fire prevention
What are the gross and fine motor skills of ages 6-11?
Increased muscle mass & coordination, tie shoes, cut with scissors, etc.
What are the vocal capabilities of 6-11 year olds?
Increased language skills, love jokes/puns.
At what ages do boys associate with boys/girls with girls?
6-11 years
What nutrition is important for 6-11 year olds?
low fat food guide pyramid.
What type of play do 6-11 year olds like?
cooperative, rules, teams, games
What is the anticipatory guidance for 6-11 year olds?
Nutrition, physical fitness, dental care, hygiene, smoking and drug edu, Bike safety
What are the effects of hospitalization for 6-11 year olds?
Fear of loss of family place, fear of harm/body injury, fear of death, loss of control, regression, boredom, concerns for privacy
What are the safety concerns with ages 6-11?
bikes, risk taking activities, latchkey kids, firearms.
What are the gross and fine motor skills of ages 12-18?
awkwardness develops into muscle control and coordination; adult fine motor control
At what ages do kids define independence, peers are very important, emotional/social turmoil, and interested in the opposite sex?
ages 12-18
What is the anticipatory guidance for 12-18 year olds?
areas of mental health, sexual bx, violence, MVA’s, nutrition/eating d.o’s, fad diets.
Effects of hospitalization for ages 12-18?
Loss of independence and control, loss of identity, body image disturbance, separation of peers
Safety concerns for ages 12-18?
Risk taking activities, MVA’s, drugs, sun protection
What is the expected weight gain for the new infant?
1.5/month for first 5 months; should double by 5-6 months; should triple by 12 mos.
What is the height increase amount for the new infant?
increase 1 inch/mos; increase by 50% by 12 mos.
What is average head growth for the new infant?
increase 1.5 cm/mo; by one year, has increased 33%
Binocularity (fusion of 2 ocular images into one cerebral picture) begins to develop by ___weeks and well developed by ___ mos.
6; 4
Fetal hemoglobin is present for the first ___ mos. Results in shortened survival of RBC’s and results in ___
5; physiologic anemia.
Maternal iron stores are present for ___ mos and gradually diminish.
5-6.
The digestive process in the infant is immature because ___ & __ are deficient.
amylase (responsible for digestion of complex carbs); lipase (limited amt makes if difficult to digest fats).
Infants have an inability to conjugate bilirubin and secrete bile until _____
couple weeks old
The infant receives passive immunity (maternal IgG) until about ___; has 40% adult levels by age ____
3 mos; 1 year.
Production of IgA, IgD, and IgE not attained completely until _____
early childhood (6 yo)
Moro Reflex aka _____
startle reflex
The Moro Reflex begins when? fades by about ___ mos and disappears by ___
at birth; 4; 6
The Stepping Reflex is usually gone by about ___
4-8 weeks
How do you elicit the Moro Reflex and what is the expected result?
Startle the infant with a sudden noise or change in position; The arms should extend and the fingers form a C as they spread. The arms slowly move together as in a hug. The legs may make a similar motion.
The Palmar grasp reflex begins and ends when?
present at birth; disappears by about 3 months.
How do you find the Palmar grasp reflex? What is the expected result?
Place finger across infant’s palm and avoid touching the thumb. A strong grip around the finger is normal.
How do you elicit the Plantar grasp and what is the expected result?
Place finger across the foot at the base of the toes. The toes normally curl as if gripping the finger.
When does the Planter grasp reflex start and end?
present at birth; disappears at about 8 months.
How do you elicit the Stepping Reflex and what is the expected result?
Hold the infant erect and touch the bottom of one foot on the surface of the table or chair. The feet lift in an alternating pattern as if to walk.
When does the Stepping Reflex begin and end?
Begins at birth and disappears between 4-8 weeks
How do you elicit the Tonic Neck reflex and what is the expected result?
Place infant in supine position and, when relaxed, turn the head to one side. Repeat by turning the head to the opposite side. The arm and leg on the face side normally extend and the opposite arm and leg flex, as if to assume a fencing position.
Tonic neck reflex aka ____
fencing reflex.
When does the tonic neck reflex begin and end?
Appears about 2 mos of age; decreases by 4 months; disappears no later than 6 months; it must disappear before the infant can turn over.
What is nutrition like for the newborn?
2-3 ounces breast or bottle every 2-3 hours.
How long does it take for the umbilical cord to fall off?
about 10-14 days
What is the average amount of sleep for a newborn?
16-18 hours.
What is a schedule for a follow-ups with the MD after the newborn is discharged?
2-3 days, then week after that, then 2 weeks age, then 1 month, then 2 months.
At what age can the newborn start daycare?
At about 6-8 weeks (after they’ve started their immunizations)
How long should the car seat face backwards for a child?
until 1 year of age or 20 lbs.
How long should you keep a baby out of the sun?
until at least 6 mos when they’re allowed to wear sunscreen
What is some umbilical cord care?
Don’t put over diaper; practices vary according to region/institution; objectives are to prevent infection and promote cord separation; Practices include: no care, application of triple dye, application of povidoneiodone, isopropyl alcohol, or antimicrobial ointments. Aseptic care decreases bacterial colonization but delays cord separation.
What are three types of formula?
Ready to feed (won’t have needed fluoride like others bc you don’t mix it with water), Concentrated (add H2O), Powder (add H20 and shake well).
Where is the most accurate temperature taken in babies?
Rectally.
Any temp greater than ___ rectally is a fever.
100.4
The anterior fontanel is ___ shaped and smaller than ___ in diameter at 6 months and then becomes progressively smaller. It close between ____
diamond shaped; 5 cm (2 in.); 12-18
The posterior fontanel close between ___ months.
2-3
What is some circumcision care for the newborn?
Cover head of penis with petroleum jelly with each diaper change until redness goes away (and keeps it from sticking to diaper); Pale yellow crust around the incision and on glans is normal for several days; use cotton ball moistened with tap water to gently clean head; contact MD if increased redness, bleeding, or swelling of head occurs.
It would be a red flag if there was no responsive smile at ____ weeks.
8
What age are the following motor skills beginning: Open hands often, brings hands to midline, holds rattle, positive head lag, holds head and supports weight on forearms while prone, turns from side to back?
2-4 months
What age are the following motor skills beginning: draws arms and legs to trunk with cry, holds hands in fist, may lift head briefly?
newborn.
What age does the baby know the parent’s voices and follows them?
2-4 months.
How do you heat up a baby’s bottle?
Not in microwave (creates “hot spots”); use bowl of water and put it in microwave/boil, then put bottle inside bowl to warm it
At what age do teeth begin to erupt?
4-6 mo
When does the baby double its weight?
by 6 months.
May be a red flag if the baby doesn’t reach for objects by ___
5 mo
What age is the following motor skills: Regard hand, reaches and grasps, mouths objects, holds feet (“find their feet”), intentional palmar grasp, lift head/chest 90, rolls back to stomach, pos. head control?
4-6
When does a baby watch the course of a falling object, respond readily to sounds, explores objects with mouth and all senses?
4-6 mo
When does a baby laugh out loud and babble using consonant sounds (HNGKP)?
4-6
When does a baby’s play become more manipulative behaviors and solitary play?
4-6 mo
What is the extrusion reflex and when is it gone?
When something touches the baby’s lips/mouth, the tongue extends forward; it is gone by 4-6 mo
What should you delay feeding the infant until 1 year of age to prevent allergic reactions?
Eggs, strawberries, tomatoes, wheat, corn, fish, nuts
What age can you introduce fruits/veggies?
6-8
What age can you introduce meats?
8-10 mo
How long should you avoid giving babies honey?
until 1 year old because of botulism (after 1, body can handle spores)