test 4

Question 1

What visits should you discuss toilet training at

Answer 1

9 mos
12
15
18

Question 2

most kids potty train between

Answer 2

2 1/2 - 3 1/2

Question 3

Physiological readiness for potty training

Answer 3

18 mos

Question 4

what is the order of potty training/control

Answer 4

1) nocturnal bowel control
2) daytime bowel control
3) daytime bladder control
4) nocturnal bladder control

Question 5

average age for kids to be fully potty trained

Answer 5

3-4 years

Question 6

guidelines to assess child physical skill readiness for potty training

Answer 6

has voluntary sphincter control
stays dry for 2 hrs, may wake from naps still dry
is able to sit, walk and squat
assists in dressing self

Question 7

guidelines to assess child cognitive skills for toilet training readiness

Answer 7

recognizes urge to urinate or defecate
understands meaning of words used by family in toileting
understands what the toilet is for
understands connection between dry pants and toilet
is able to follow directions
is able to communicate needs

Question 8

guidelines to assess child interpersonal skills for toilet training readiness

Answer 8

Demonstrate desire to please parent
expresses curiosity about use of toilet
expresses desire to be clean and dry

Question 9

Guidelines to assess parental skills for toilet training readiness

Answer 9

expresses desire to assist child with training
recognizes childs cues for readiness
has no compelling factor that will interfere with training (new job,move, newborn, family loss

Question 10

Awakening in first ⅓ of night with confused thinking and slow speech

Answer 10

Confusional arousals

Question 11

Awakening 1-3hr after falling asleep w/ characteristic behaviors

Answer 11

Sleep walking/sleep terrors

Question 12

Stage N3 (deep sleep) instability
-Genetic predisposition

Answer 12

Sleep walking/sleep terrors

Question 13

sleep cycle length in newborns

Answer 13

Sleep cycles are 60 minutes, gradually increase to 90 minutes in child/adults

Question 14

How long per day do full term infants sleep

Answer 14

(16-18hrs) sleep per day in intervals day/night

Question 15

Neonates begin sleep cycle in

Answer 15

REM

Question 16

REM comprises ___ of total sleep time in newborns and gradually decreases to ____ by adolescence

Answer 16

50%

25-30%

Question 17

From 6-12 months- adulthood REM changes to last

Answer 17

1/3 of the night

Question 18

Infants capable of sleep through night without feed by

Answer 18

6 mos

Question 19

Within 4hrs of bedtime, DEEP NREM sleep

Confused, disoriented, does NOT remember, unaware of caregiver attempts to console, returns to sleep QUICKLY

Answer 19

sleep terror

Question 20

Later in night, LIGHT REM sleep

Scared, upset, DOES remember, receptive to comforting measures, delayed returning to sleep d/t fear

Answer 20

nightmare

Question 21

Associated with genetics and iron deficiency

Answer 21

restless leg syndrome

Question 22

Colic often diagnosed using Wessel’s rule of threes

Answer 22

Crying for more than 3 hrs/day, at least 3 days/wk, for more than 3 wks

Question 23

Colic usually resolves by

Answer 23

3 mos

Question 24

echniques for calming infants include Dr.Harvey Karp’s “5 Ss”

Answer 24

swaddling, side or stomach holding, soothing noises( ie. shushing, singinging, white noise), swinging, or slow rhythmic movement (rocking, walking, or riding a car), and sucking on a pacifier.

Question 25

Atypical tantrums (destructive or injurious) may be indicative of a more serious underlying condition such as

Answer 25

sleep disturbances, ADHD, mood disorders, or family stressors.

Question 26

Hot water heater temperature

Answer 26

No higher than 120 degrees F. Always test water before bathing or showers to prevent burns.

Question 27

Riding correctly without a car seat usually occurs

Answer 27

8-12 yrs old & at about 4’9 in height

Question 28

Children should always sit in a car seat or booster seat and ride in the backseat of the car as this is the safest place for them until the age of

Answer 28

13

Question 29

enuresis can be a sign of

Answer 29

Endocrine- diabetes mellitus, diabetes insipidus, hyperthyroid, abnormal release of nighttime vasopressin,

Question 30

what meds are approved for nocturnal enuresis

Answer 30

Desmopressin and Imipramine approved for nocturnal enuresis

Question 31

when do you take Desmopressin

Answer 31

2 hours before bedtime

Question 32

need to know about Imipramine

Answer 32

Higher success rate but high side effects
Lethal if overdose-fatal cardiac arrhythmia
Suicide black box warning
Anticholinergic side effects
Cardiac dysrhythmias (need baseline EKG)
Anticholinergic properties
Increased sphincter tone
Can treat comorbid anxiety/depression & ADHD

Question 33

reasons for encopresis

Answer 33

Commonly caused by delayed physical maturation 
Harsh toilet training 
IBS
Spinal cord trauma/injury
Hirschsprung disease
Lead poisoning
Hypothyroid
Hypokalemia
Hypercalcemia 
Diabetes 
Intestinal smooth muscle disorder (Scleroderma)
Pain medication use 
Chronic laxative use

Question 34

Meconium stool by

Answer 34

48 hours old

Question 35

stools per day for infant

Answer 35

Typically 3-4 small stools per day

Question 36

breastfed stool

Answer 36

Breastfed- sticky, light yellow, curdy, sour
Many small stools/day for first few weeks then decrease to 1-6 stools/day
Infrequent stools not problematic in exclusively breastfed infants if thriving (may go 8-14 days without stool)

Question 37

formula stool

Answer 37

darker, firmer, smellier

2-4 stools/day first month