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USA-FNP: CMN 571 > Unit 1: vaccines, universal screenings, developmental milestones, bright futures. > Flashcards

Unit 1: vaccines, universal screenings, developmental milestones, bright futures. Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

universal screenings at birth?

A

hearing, bilirubin, PKU, congenital hypothyroid, sickle cell, CHD

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2
Q

PKU screen was done <24h of age. When should it be re-tested?

A

by 2nd week

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3
Q

untreated hyperphenylalaninemia results in?

A

intellectual disability, light complexion, eczema, seizures, hyperactivity

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4
Q

institute _____ dietary restrictions shortly after birth to prevent neurodevelopmental effects of ???

A

PKU

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5
Q

3 screening methods for PKU?

A

BIA: Guthrie Bacterial Inhibition Assay (BIA)
AFA: Automated fluorometric assay (AFA)
TMS: Tandem mass spectrometry (TMS)

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6
Q

newborn screening tests mandatory?

A

thyroid function & PKU

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7
Q

T or F: PKU testing should only be performed after the infant has ingested b.milk or formula

A

True. Abnormal results should be f/u w a venous T4 &; TSH

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8
Q

infant w abnormally pitched cry may indicate which genetic disorder?

A

hypothyroidism. due to lethargy & delayed mental responsiveness

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9
Q

two tests for sickle cell?

A

NO SOLUBILITY TESTS

  • *hgb electropheresis
    • HPLC: High performance liquid chromatography
  • *DNA analysis
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10
Q

T or F? IEF & HPLC are both sensitive and specific for sickle cell?

A

true

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11
Q

what age do you perform confirmatory testing for sickle cell?

A

2 months

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12
Q

What prophylactic med should be started by 2mo for a sickle cell baby?

A

PCN

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13
Q

Important immunization for sickle cell babies?

A

Pneumococcal

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14
Q

at what age MUST hearing be confirmed by?

A

3 months

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15
Q

what well-checks include maternal depression screening?

A

1,2,4,6 months

“1,2,4,6, lets make sure that moms not sick!”

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16
Q

what age do primary teeth usually erupt?

A

7 months

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17
Q

when do you start oral health screenings?

A

6 months

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18
Q

which well-check visits include oral health screenings?

A

6 & 9mo. Dental home to be established by 12mo but PCP can continue to screen at every visit if child does not establish w dental home

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19
Q

child stands alone, follows 1-step commands, imitates peek-a-boo. age?

A

9-11mo

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20
Q

child lifts head, turns side-to-back, & smiles. what age?

A

1-2mo

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21
Q

child develops a mature pincer grasp. age?

A

12mo

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22
Q

child is building blocks w 3-4 cubes, can scribble, follows 2-step commands. age?

A

18mo

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23
Q

child verbalizes need to potty. age?

A

2y

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24
Q

child sits independently. age?

A

6-8mo

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25
Q

child crawls. age?

A

9mo

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26
Q

child runs. age?

A

18mo per CDC. unclear in Hay

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27
Q

child walks backwards. age?

A

30mo
(as if you’re making fun: “only a Thirrrrtyyyy moonnnth old would think walking backwards is cooooool”)
or
(“you take those 30 snakes right BACK where they came from)

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28
Q

child begin to use pronouns. age?

A

24mo

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29
Q

child holds crayon w fist. age?

A

30mo (“that kid has 30 crayons in his fists!”)

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30
Q

child holds crayon w fingers. age?

A

3y (takes 3 fingers to hold a crayon)

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31
Q

can a 4-5yo tie shoes?

A

no, only lace

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32
Q

child COPIES drawing a circle at what age?

A

3y

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33
Q

child copies a cross at what age?

A

4y (4 quadrants in cross)

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34
Q

child copies a triangle at what age?

A

5y

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35
Q

child draws vertical lines at what age?

A

2y (2 lines… parallel lines… parallel play)

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36
Q

child can scribble at what age?

A

18mo

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37
Q

child will imitate scribbling at what age?

A

15mo

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38
Q

child uses tricycle at what age?

A

3y

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39
Q

child alternates feet up the stairs. age?

A

4y

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40
Q

child kicks ball. age?

A

2y (takes 2 feet to kick a ball)

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41
Q

child throws ball. age?

A

18mo

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42
Q

child engages in parallel play. age?

A

2y

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43
Q

child engages in cooperative play. age?

A

4y (double that of parallel play milestone at 2)

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44
Q

child reaches w one hand. age?

A

6-8mo (passes from hand to hand. babbles)

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45
Q

child reaches w both hands & puts object in mouth. age?

A

3-5mo (drooly baby)

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46
Q

child has 4-word phrases. age?

A

4y (4 words, 4 years)

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47
Q

child says “you, me, and I” & makes 3 cube bridge. age?

A

3y (3 pronouns, 3 cubes)

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48
Q

child jumps w 2 feet. age?

A

2y (takes 2 feet to jump with 2 feet…..)

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49
Q

child has 4-20 words. age?

A

18mo (w/i word count range)

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50
Q

child has 1-2 word vocabulary at least. age?

A

12mo

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51
Q

child coos. age?

A

3-5mo

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52
Q

child babbles. age?

A

6-8mo

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53
Q

child draws person as circle. age?

A

4y (4 arcs make up a circle)

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54
Q

child draws a person w appendages & eyes but no torso. age?

A

4-5y (4-5 appendages = 4-5y)

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55
Q

child follows 1-step commands. age?

A

9mo

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56
Q

child follows 2-step commands. age?

A

18mo (double their 1-step @ 9mo)

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57
Q

when do you conduct anemia & lead testing?

A

12mo & 24mo (or 1 & 2y)

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58
Q

what ages do you perform developmental screening?

A

9, 18, 30mo (memory tool: some kids develop at 9, some at 18, some not until 30)

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59
Q

what ages are screened for ASD?

A

18 & 24mo

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60
Q

earliest age a child can be dx’d w ASD?

A

2y

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61
Q

4 most common EARLY characteristics of autism?

A
  1. consistent failure to orient to one’s name
  2. failure to regard people directly
  3. failure to use gestures
  4. failure to develop speech
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62
Q

what age should universal VISION screenings start?

A

3y (they can use a chart now, you no longer have to test red reflex to assess if the pt can see)

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63
Q

what tests are used for vision screening?

A

visual acuity using HOTV (letters) LEA (shapes)

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64
Q

what age can you stop screening for red reflex?

A

3y: when they start reading the chart

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65
Q

what is assessed in vision screening for birth-3y?

A

inspection, alignment, visual acuity, red reflex

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66
Q

what age should audiometry be performed?

A

birth, 4y

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67
Q

by age 3 what vaccines should you have?

A 
4 Dtap
4 pvc13
3-4 HiB
3 hep B
3 RV
3 IPV
2 Hep A
1 influenza
1 varicella
1 MMR

(3 years ago, 3-4 Horses split 4 Dr. Peppers and 3 RIBs, 2 Ate 1 INch of VegeMite)

10 types total. 25-26 doses total (when counted uncombined)
4 = D&amp;P 
3-4 = H 
3 = B, RV, IPV 
2 = A
1 = In, V, M
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68
Q

3 allergies contraindicated for vaccine?

A

egg, yeast, gelatin

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69
Q

what vaccine should not be given for current gastroenteritis or hx of intussusception?

A

rotavirus

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70
Q

what vaccine should NOT be given to people w serious allergic rxn to YEAST?

A

Hep B (think B for bread or bakers’ yeast)

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71
Q

what vaccine has a small increased chance of febrile seizures when given w the flu vaccine?

A

PVC (think PNA + FLU would be a HIGH fever)

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72
Q

what vaccines are contraindicated in pregnancy?

A

“Vagina Is A Monster” =

Varicella, IPV, Hep A, MMR

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73
Q

children or adolescents receiving long-term Aspirin therapy should NOT receive what vaccine?

A

LAIV (flu)

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74
Q

What law requires VIS?

A

NVCIA: national vaccine childhood injury act (federal law)

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75
Q

Severe allergic reaction or encephalopathy not attributable to another cause w/i 7d of admin is a TRUE contraindication for which vaccine?

A

Dtap

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76
Q

What documentation is required for every vaccine admin?

A

manufacturer, vaccine lot #, expiration date, injection site, nurse signature, parent signature

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77
Q

T or F. Polyvalent pneumococcal vaccine (PNA23) is recommended for children under 2y w chronic disease (including DM)?

A

False.
polyvalent = PNA23 = 2y+
PVC13 = 6w+

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78
Q

only contraindication to Hep B vaccine?

A

prior anaphylactic rxn or severe hypersensitivity

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79
Q

live attenuated virus vaccines include?

A

MMR, RV, varicella

to stayin alive: “M-M-R-R, VARI alive, VARI alive”

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80
Q

severe allergy to _____ is contraindication for MMR?

A

the mycins

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81
Q

what type of immunity is developed after contracting chickenpox?

A

active natural

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82
Q

8 month old should have what vaccines?

A

3 Hep B
3 RV
3 PCV
2 IPV

“for 8 months, 3 Boys Raced Perilously 2 INdiana”

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83
Q

immunocompromised adults require which type of vaccine?

A

inactivated

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84
Q

a 2mo got vaccines & mom calls 12h later. states infant has fever 101F. what is most likely cause?

A

PERTUSSIS immunization

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85
Q

what vaccine can be given to kids <7 if they cannot tolerate the pertussis component?

A

TD

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86
Q

complete primary dentition (20 teeth) is usually present btwn what ages?

A

30-36mo

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87
Q

safest place in car for all kids <13?

A

middle back seat

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88
Q

how long should kids stay rear facing?

A

as long as possible. til they max out height, weight indicated by carseat

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89
Q

what age would be sitting w a booster?

A

8-12yo

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90
Q

when can child use lap & shoulder belt?

A

when belt lies across middle of chest & shoulder. lap belt lies across upper thigh. child is tall enough to sit against back seat w knees bent over edge of seat without slouching. TYPICALLY 10-11YO

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91
Q

whats an indication child has outgrown booster seat?

A

shoulders are above top harness slots, tops of ears reach top of seat

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92
Q

when should carseats be replaced?

A

after moderate-severe car crash

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93
Q

crib bars should be no more than _____ inches apart?

A

2 & 3/8 inches

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94
Q

crib mattresses should have no more than ____ fingers fitting btwn mattress & side of crib?

A

2

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95
Q

when should you remove crib bumpers?

A

when child can push up

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96
Q

what temp should water heater be set at?

A

120

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97
Q

signs of hunger in infant?

A

sucking, rooting, fussing, hands in mouth, crying is late sign

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98
Q

signs baby is full?

A

closes mouth, turns head

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99
Q

if baby sleeps past 4h what should mom do?

A

wake baby to eat

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100
Q

how often should mom breastfeed baby per day?

A

8-12x

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101
Q

how many wet diapers do you expect to see in babies?

A

6-8 wet diapers

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102
Q

how many stools should babies have a day?

A

3-4x (1/2 amount of wet diapers)

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103
Q

what color poops do you expect from breastfed baby?

A

yellow/green, seedy, pasty

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104
Q

if mom is vegan or had gastric bypass what does she need to supplement?

A

b12

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105
Q

moms exclusively breastfeeding need to supplement?

A

vitamin D

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106
Q

first 6mo of life diet should be?

A

breastmilk or iron-fortified formula ONLY

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107
Q

how often should mom bottle feed?

A

2oz Q2-3h (20oz/day)

108
Q

what is essential for mom to do while bottle feeding?

A

look at baby to promote bonding. dont prop bottle

109
Q

normal stool color for formula-fed baby?

A

yellow-brown pudding

110
Q

how should temp be checked?

A

rectal

111
Q

what temp warrants eval?

A

100.4 or higher (especially in <3mo)

112
Q

babies should always be placed on _____ to sleep

A

back. “put baby BACK to sleep”

113
Q

cord clamp is removed after ____ hours?

A

24

114
Q

how long does it take for stump to dry up and fall off?

A

10-12d

115
Q

how should mom clean umbilical stump?

A

water, air dry, keep diaper below stump

s/s infection = purulent drainage, foul odor, redness

116
Q

circumcised babies need to keep what applied to wound for the first 24h?

A

petroleum gauze

117
Q

how should mom care for circumcision?

A

clean with water, DOESNT NEED SOAP, monitor for infection

118
Q

how long does it take circumcision to heal?

A

5-7d

119
Q

T or F. pt must be given VIS before EVERY vaccine in a multi-dose series?

A

TRUE

120
Q

pt has low-grade fever, runny nose, mild diarrhea. can they be vaccinated?

A

YES. mild illness is NOT contraindication

121
Q

what medication is a reason to defer vaccination?

A

TAMIFLU

122
Q

reasons to NOT receive vaccine?

A

chronic health condition (CA), weakened immune system (chemo, certain meds s/p transplant), prior severe allergic rxn to same vaccine

123
Q

when is it ok for a child w cancer to receive a vaccine?

A

remission or 90d post chemo

124
Q

how long should live virus vaccine be delayed if an immunoglobulin or blood product was given?

A

3-11mo

125
Q

should a congenitally immunodeficient child be immunized with live vaccines?

A

Nooooooo

126
Q

barriers to vaccines?

A

parental concerns, need for multiple visits, cultural differences, financial constraints

127
Q

what type of immunity is developed in response to infection?

A

active

128
Q

example of artificially acquired active immunity?

A

vaccines

129
Q

T or F. active immunity is permanent

A

True

130
Q

onset of active immunity is ?

A

2-4 weeks

131
Q

passive immunity is short term or long term?

A

short term

132
Q

how does a person get passive immunity?

A

given antibodies to a disease

133
Q

how does passive immunity artificially occur?

A

injection of antibodies (gamma globulin- IVIG)

134
Q

onset of passive immunity is? what is duration?

A

24h (immediate). 4-6mo

135
Q

when a significant proportion of the population is vaccinated, what does this provide?

A

herd immunity

136
Q

what specific population is herd immunity effective for?

A

the population who cannot safely receive vaccines (immunocompromised, etc)

137
Q

when checking a newborns reflexes, what are you ensuring?

A

brain & nervous system function

138
Q

how do you elicit the rooting reflex?

A

stroke corner of babies mouth, baby turns head & opens mouth

139
Q

how long does ROOTING REFLEX last?

A

4mo (4 baby piglets rooting in the mud)

140
Q

how do you elicit sucking reflex?

A

touch roof of mouth

141
Q

when is sucking reflex fully developed?

A

36 weeks in utero (premies will have week suck)

142
Q

how do you elicit moro reflex?

A

startle baby in response to sound

143
Q

how long does MORO REFLEX last?

A

2 mo (“fool me twice shame on you”)

144
Q

what is TONIC REFLEX?

A

“fencing” head is turned to one side & extends that arm, opposite arm bends up at elbow (they look like a fencer “on guard”)

145
Q

how long does tonic reflex last?

A

5-7mo (fencing for 5-7 months)

146
Q

how do you elicit grasp reflex?

A

stroke baby’s palm

147
Q

how long does grasp reflex last?

A

5-6mo (“baby grasps onto 5-6 fav toys)

148
Q

how do you elicit stepping reflex?

A

hold upright with feet touching solid surface

149
Q

how long does stepping reflex last?

A

about 2mo (“twostep”)

150
Q

when is developmental surveillance conducted?

A

EVERY PREVENTATIVE VISIT THRU CHILDHOOD

151
Q

when is developmental screening conducted?

A

9, 18, 30mo

152
Q

why is developmental surveillance important?

A

catch developmental disabilities

153
Q

what are 3 things developmental surveillance & screenings promote?

A

healthy development, prevent delays, identify children w delays/disabilities EARLY

154
Q

key components of developmental surveillance?

A

ask about child’s learning, development, behavior

155
Q

at what age should a child walk and at what age should you be worried they are NOT walking?

A

12mo, 18mo

156
Q

when should thyroid hormone replacement start for infants with congenital hypothyroidism?

A

within 2 weeks of birth. at LEAST within first month

157
Q

what labs are monitored in sickle cell screening?

A

hemoglobin & reticulocytes

HGB’s: FS, FSC, FSA (S>A)

158
Q

what is the name of the test that confirms sickle cell?

A

hgb electrophoresis

159
Q

should soluability test be used to confirm sickle cell?

A

no, they won’t identify hgb variants except for S

160
Q

what age group kids w sickle cell should be taking PCN prophylactically?

A

2mo-5y

161
Q

what immunizations should be given for sickle cell kids?

A

PCV & polysaccharide vaccine

162
Q

when do infants need to be referred to a dentist?

A

6m or 1st tooth, def by ONE YEAR

163
Q

what common bacteria colonizes baby’s mouth and increases risk of carries?

A

streptococcus mutans

164
Q

when should all babies have a carries risk assessment done?

A

6mo

165
Q

when should oral hygiene start?

A

birth. clean gums w moist cloth. when teeth erupt brush w soft toothbrush & fluoride toothpast

166
Q

when should kids be weaned from the bottle?

A

12-18mo

167
Q

child lifts head with good head control. age?

A

3mo

168
Q

child has ulnar grasp. age?

A

3-5mo (uses 3-5 fingers)

169
Q

when do kids start to show signs of dominant hand?

A

not before 1y. most 18-30mo

170
Q

when do you stop measuring head circumference?

A

2y

171
Q

when do kids typically start to stay on the same growth curve on the growth chart?

A

18mo

172
Q

when should BP screening start?

A

3y if not high-risk

173
Q

when can kids have first TB test?

A

3mo

174
Q

most common cause of death in kids?

A

MVA

175
Q

what is the most common initial symptom of sickle cell? occurs in up to 50% of children before age 3.

A

hand-foot syndrome (dactylitis)

176
Q

along with prophylactic PCN, what other daily med is recommended for sickle cell kids?

A

oral hydroxyurea

177
Q

what are some risks AW bilateral congenital hearing loss?

A

family hx, facial/cranial abnormalities, being in NICU >2d

178
Q

at which point should a child switch from the harness system to a booster with the seat belt?

A

5y. booster til 8 &/or 4’9”.

179
Q

hepatitis b immune globulin (HBIG) provides?

A

passive immunity

180
Q

what vaccine should be referred for a child with progressive neurological disorders until they are stable?

A

DTAP

181
Q

baby is born to HBsAG-positive mother. what should you do for baby?

A

give hep B immune globulin (HBIG)

182
Q

people who have not HAD chickenpox or the vaccine and should be targeted to do so include?

A

daycare workers, >8yo HIV patients with CD4 count >200

183
Q

pregnancy should be ruled out and prevented for 3mo with what vaccine?

A

MMR, MMRV

184
Q

should a child ride in a carseat on an airplane?

A

yes

185
Q

needle length for newborns?

A

5/8”

186
Q

needle length for 1-20mo?

A

1” in thigh

187
Q

needle length for 1y-18y?

A

1 & 1/4” in thigh

188
Q

untreated PKU leads to?

A

intellectual disability

189
Q

hep B should not be given to a person w a hx of anaphylactic rxn to?

A

bakers’ yeast

190
Q

most common route of Hep A transmission?

A

contaminated food or water

191
Q

baby can roll from back-to-stomach. age?

A

6-7mo

192
Q

when do they grasp cubes with raking motion?

A

3-5mo (ulnar grasp)

193
Q

when to perform PKU screen for premature or ill infants?

A

7d

194
Q

treatment for congenital hypothyroidism?

A

levothyroxine 10-15mcg/kg/day with serum monitoring done by 2w of life.

195
Q

when is the latest confirmatory testing for sickle cell can be performed?

A

2mo

196
Q

what can reduce the number of cariogenic bacteria? how often recommended?

A

CHG oral rinse, 3mo intervals

197
Q

what is ankyloglossia?

A

tongue tie

198
Q

parent edu for fluoride varnish?

A

don’t brush teeth til next morning. soft foods.

199
Q

when does separation anxiety start?

A

8-9mo

200
Q

milestones: laughs, anticipates food on sight, turns from back-to-side. age?

A

3-5mo

201
Q

milestones: walks backwards, begins to hop on 1 foot, uses prepositions. age?

A

30mo

202
Q

understands 2-step command, carries & hugs doll, feeds self. age?

A

18mo

203
Q

throws ball, seats self in chair, dumps pellets from bottle?

A

18mo

204
Q

oldest a baby can receive their 1st RV vaccine?

A

<15w

205
Q

what blood lead level is considered abnormal? at what level would chelation be indicated? what level is considered urgent?

A

> 5 = abnormal. >45 chelation. >70 URGENT

206
Q

when does word “no” affect child?

A

6-8mo

207
Q

what age can infant track object with BOTH eyes?

A

3mo

208
Q

when are universal screenings for lead?

A

1 & 2y

209
Q

what can excessive fluoride intake cause?

A

dental fluorosis or mottled enamel

210
Q

children taking what dose of corticosteroids should NOT be given a live vaccine?

A

> 20mg/day x14+d

211
Q

when is flu vaccine given?

A

6mo then annually. <9 getting first vaccine should get 2 vaccines that flu season 1 month apart

212
Q

when can children start receiving the the LAIV flu vaccine?

A

2y, under 2 must receive inactive

213
Q

live virus admin?

A

can be given together. if NOT given together then MUST wait 4w

214
Q

what is the difference btwn DTaP & Tdap?

A

Tdap has the booster dose of diptheria while Dtap is the initial immunization

215
Q

what vaccines should be stored frozen?

A

varicella, MMR,

216
Q

at what age do infants develop the concept of object permanence

A

9-12mo

217
Q

what are the triad symptoms of ADHD?

A

impulsivity, innatention, hyperactivity

218
Q

what subtype of ADHD do girls have a higher prevalence of? what about boys?

A

girls- innatention. boys-hyperactive

219
Q

what does the AAP recommend regarding screen time?

A

none under age 2, over age 2 only 2h/d

220
Q

newborn universal screenings:

A

hearing, bilirubin, PKU, congenital hypothyroidism, sickle cell, CHD

221
Q

3-5d universal screenings

A

hearing, blood confirmations

222
Q

1 & 2 month universal screenings (they’re the same)

A

hearing & blood if not done. MATERNAL DEPRESSION

223
Q

4 month universal screening

A

MATERNAL DEPRESSION

224
Q

6 month universal screenings

A

MATERNAL DEPRESSION, oral health, VERIFY early intervention for hearing

225
Q

9 month universal screenings

A

DEVELOPMENTAL SCREEN

oral health

226
Q

12 month universal screenings

A

ANEMIA
LEAD
oral health

227
Q

15 month universal screenings

A

oral health

228
Q

18 month universal screenings

A

DEVELOPMENTAL SCREEN
AUTISM SPECTRUM DISORDER SCREEN
oral health

229
Q

2 year universal screening

A

AUTISM SPECTRUM DISORDER
LEAD
oral health

230
Q

2.5y (30mo) universal screening

A

DEVELOPMENTAL SCREEN

oral health

231
Q

3y universal screening

A

VISION (use HOTV or LEA)

oral health

232
Q

4y universal screening

A

HEARING
VISION
oral health

233
Q

vaccine schedule DR HIP mnemonic

A

Birth: B for Hep B
2m: B DR HIP (hepB, dtap, rv, hib, IPV, pnuemo)
4m: DR HIP (dtap, rv, hib, IPV, pneumo)
6m: B IN DR HIP (hepB, influenza, dtap, hib, IPV, pneumo)
12-18m: MAD HPV (MMR, hepA, dtap, hib, IPV, varicella)
4-6y: VARI DIM (varicella, dtap, IPV, MMR)

234
Q

flu vaccine stuff

A

starts at 6m, goes until forever. if you’re under 9y and you’ve never had it you get 2 that year, 1 month apart.
contras = egg allergy
SE’s: fever, malaise, myalgia
RISK FOR febrile seizures when given w pneumo)

235
Q

MMR vaccine stuff

A

ITS ALIIIIIIIVE.
contras: PREGNANCY, high-dose steroids, immunocomp, LATEX, NEOMYCIN, GELATIN
SE’s: FEBRILE SEIZURE, transient thrombocytopenia, encephalitis

236
Q

IPV stuff

A

contras: PREGNANCY, mod-severe illness w or w/o fever, allergy to POLYMYXIN B, NEOMYCIN, STREPTOMYCIN
SE’s: uncommon

237
Q

PVC13 stuff

A

contras: mod-severe illness w or w.o fever

SE’s: SITE RXN, fever, irritability, sleep changes, SEIZURES when given w flu vaccine

238
Q

HiB stuff

A

nada. well tolerated. no contras.

239
Q

Dtap stuff

A

contra: NEUROMUSCULAR dxs until clarified

SE’s: INCONSOLABLE CRY, fever, hypotonic-hyporesponsive episodes

240
Q

RV stuff

A

ITS ALIIIIIIIVE. contras: mod-severe acute gastroenteritis, hx INTUSSUSCEPTION, severe combined immunodeficiency (SCID), LATEX ALLERGY

241
Q

hep B stuff

A

contras: serious yeast allergy

SE’s: uncommon

242
Q

hep A stuff

A

contras: PREGNANCY, mod-severe illness

SE’s: SITE rxn, HA, loss of appetite

243
Q

varicella stuff

A

ITS ALIIIIIIVE. contras: PREGNANCY, febrile seizures, T cell abnormalities, allergy to gelatin, neomycin.
SE’s: site rxn

244
Q

vaccines to defer for moderate-severe illness

A

moderate-to-severe like a hangover
“IPA beers”
IPV, PCV13, hepA

245
Q

vaccines cause minor site rxn

A

“A Painful Vaccine To Me”

hepA, PCV13, varicella, tdap, meningicoccal

246
Q

vaccines to defer for neuro issues/febrile seizure

A

“Mental Defects Matter”

MMR, Dtap, mening

247
Q

vaccines w no rxns

A

“Baby is Happy”

hepB, IPV, HiB

248
Q

1-2mo milestones (per Hay)

A 
LIFTS &amp; holds head
turns SIDE-BACK
follows objects with eyes
drops toys
alerts to voice
recognizes parents
vocalizes
smiles spontaneously
249
Q

3-5mo milestones (per Hay)

A 
ulnar grasp
reaches (2 hands) &amp; bring to mouth
raspberry sounds
sit w support
laughs
anticipates food on sight
turns BACK-SIDE
250
Q

6-8mo milestones (per Hay)

A 
sits alone for short period
reaches w one hand
scoops first then uses thumb
"bye-bye"
passes object hand-to-hand
babbles
ROLLS back-stomach
inhibited by "NO"
251
Q

9-11mo milestones (per Hay)

A 
stands alone
imitates pat-a-cake &amp; peek-a-boo
thumb &amp; index to pick up pellet
uses furniture to walk along
follows 1-step commands
252
Q

12mo milestones (per Hay)

A 
walks alone
"mama/dada"
PINCER GRASP
releases cube to cup after demonstration
gives toys when asked
builds 2-cube tower
points to desired object
says 1-2 other words
253
Q

18mo milestones (per Hay)

A 
3-4 cube tower
throws ball
seats self in chair
dumps pellet from bottle
walks up &amp; down stairs WITH HELP
says 4-20 words
follows 2-step commands
carries &amp; hugs doll
feeds self
254
Q

24mo milestones (per Hay)

A 
short phrases (2+words)
kicks ball
6-7 cube tower
points to named objects or pictures
2-foot jump
stand on 1 foot
uses pronouns
verbalizes toilet needs
puts on simple garment
turns single pages
domestic mimcry
255
Q

30mo milestones (per Hay)

A 
walks backwards
hops on 1 foot
uses prepositions
copies circle crudely
points to objects described by use
refers to self as "I"
holds crayon in FIST
helps put things away
carries on convos
256
Q

3y milestones (per Hay)

A 
holds crayon w FINGERS
builds 9-10 cube tower
3-cube bridge
copies circle
gives first &amp; last name
rides tricycle
dresses w supervision
257
Q

3-4y milestones (per Hay)

A 
climbs stairs with alternating feet
buttons/unbuttons
answers questions w plurals, personal pronouns, verbs
places toy properly as instructed (in, on, under, etc)
draws circle when asked to draw person
knows own sex when asked
gives full name
draws circle on own
feeds self
takes of shoes &amp; jacket
258
Q

4-5y milestones per Hay

A 
runs &amp; turns without losing balance
can stand on 1 leg for 10s
buttons &amp; laces (doesn't tie)
counts to 4
able to give 2 of something by direction
draws a person as a head, 2 appendages, possibly 2 eyes, NO TORSO IS THE IDEA HERE)
knows days of the week 
answers questions appropriately
copies a + sign in imitation
self toilets (may need help wiping)
plays outside at least 30m
dresses self except for tying
259
Q

PKU

A

phenylketonuria (PKU). autosomal recessive trait.
test at birth. state mandated.
dx = 240-1200 uM (4-20 mg/dL) but pterin levels normal
tx = if consistenly >360uM (6mg/dL) then treat w R-tetrahydrobiopterin & diet
untx = intellectual disability, hyperactivity, seizures, light complexion, eczema
MUST be tested by 2nd week of life if done <24h

260
Q

congenital hypothyroidism

A

MUST BE SCREEN SHORTLY AFTER BIRTH.

dx: T4 & TSH. abnormals confirmed by venous sample (baby blood draw is usually heel stick)
tx: start hormone replacement asap
untx: thick tongue, large fontanels, poor muscle tone, hoarseness, umbilical hernia, jaundice, intellectual retardation

261
Q

sickle cell

A

**sickle cell anemia & sickle B0 thalassemia =
ONLY hgbs S, F, A2
tx: PCN daily 2mo-5y
**sickle B+ thalaseemia = hgb S > hgb A & A2
**sickle hbg C = equal amts hgb S & C (but quantity of S
slightly > C)
DX GOLD STANDARD = hgb electrophoresis, HPLC, DNA analysis (NOT SOLUBILITY TESTS)

262
Q

passive immunity per Dr Townsend

A

A person is given antibodies to a disease rather than producing them through his or her own immune system. This is short term immunity through introduction of antibodies to a disease. Can occur naturally as in the passage of antibodies from the mother to the fetus during pregnancy or artificially acquired through injection of antibodies such as gamma globulin. Onset is within 24 hours of the dose and duration is about 4-6 months.

263
Q

active immunity per Dr Townsend

A

resistance developed in response to infection with an agent resulting in antibody production. Active immunity is usually permanent. Can be either naturally acquired through exposure and infection with the disease or artificially acquired through immunization. Onset is 2-4 weeks and duration is years to lifetime

264
Q

Herd Immunity per Dr Townsend

A

This occurs when a significant portion of the population is vaccinated and that provides a portion of immunity for those that have not developed immunity.The population (herd) helps prevent disease in the unprotected population. The herd protects those who can not safely get vaccinations. Generally 90 -95% of the population should be to be vaccinated to have effective Herd immunity.

265
Q

Vaccines for Children program

A

The Vaccines for Children (VFC) program is designed to help overcome cost as a barrier to childhood vaccination that can be a barrier for some. Under insured children must visit a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) to receive the covered vaccines.

266
Q

permanent molars erupt at approximately what age?

A

12y

USA-FNP: CMN 571 (5 decks)

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