W12_07 common problems in toddlers

Question 1

note: temper tantrums are normal

Answer 1

kids are frustrated - can’t do what they want to do

Question 2

what are the 4 areas of limit setting for temper tantrums?

Answer 2

selective;
explicit;
firm;
consistent

Question 3

what’s the approach for a child with temper tantrum?

Answer 3

allow child to blow off steam;
distraction;
physical restraint (if you have to prevent danger);
time outs;
reinforce teaching principle

Question 4

note: positive reinforcement is always better than negative reinforcement!

Answer 4

ok

Question 5

recall breath-holding spells

Answer 5

usually 12-18 months;
5% of kids;
decreased oxygen/blood to brain;
tx: disregard the child

Question 6

recall sibling rivalry

Answer 6

no cure;
bound to happen

Question 7

recall headbanging/rocking

Answer 7

self-stimulatory;
calming;
tx: disregard

Question 8

when do kids start to have control over external sphincters?

Answer 8

12-18 months;
mature control by 18-24 months

Question 9

what’s the pain-retention cycle of bowel movements?

Answer 9

voluntary withholding of stool;
rectal impact/drying;
painful bowel movement;
voluntary witholding of stool

Question 10

what’re the causes of diarrhea?

Answer 10

usually infectious;
sometimes extraintestinal, or drugs

Question 11

what’re the factors that make diarrhea more of a bacterial cause than viral?

Answer 11

contacts;
travel;
blood in stool;
severity (bacteria usually more serious)

Question 12

how much fluid intake is requried for every 1 degree increase in body temp?

Answer 12

12 percent

Question 13

what’s the gold standard for dehydration assessment in acute diarrhea?

Answer 13

weight loss

Question 14

what do dry tears or dry mouths represent in fluid loss estimate?

Answer 14

5 percent (3 in adults)

Question 15

what do decreased urine output, sunken eyes, fontanelle depression, apathy represent in fluid loss estimate?

Answer 15

10 percent (6 in adults)

Question 16

how much fluid loss has to occur before shock sets in?

Answer 16

15 percent (9 in adults)

Question 17

how to treat acute diarrhea?

Answer 17

water, electrolytes, oral rehydration therapy;
limit intake for vomiting, limit complicating foods for diarrhea; ondansetron for nausea

Question 18

when do sphenoidal sinuses develop?

Answer 18

5 years

Question 19

when do frontal sinuses develop?

Answer 19

7-13 years

Question 20

what’s the timespan of acute bacterial sinusitis?

Answer 20

< 30 days

Question 21

what’re some recommendations for diagnosis of acute bacterial sinusitis?

Answer 21

persistent past 10 days;
worsening after initial improvement;
fever of 39+, purulent discharge after 3-4 days (this is severe)

Question 22

what’s the first line therapy for acute bacterial sinusitis?

Answer 22

amoxicillin

Question 23

what can cause diaper rash?

Answer 23

irritation due to increased pH from urine;
contact dermatitis;
candida albicans;
bacterial (e.g. strep);
seborrhea

Question 24

what are treatments for diaper rash

Answer 24

no diapers;
creams;
powder;
cortisone;
antifungals;
antibacterials

Question 25

how many baby teeth are there?

Answer 25

twenty 20

Question 26

how do the first 4 pairs of baby teeth come in?

Answer 26

lower central incisor;
upper central incisor;
upper lateral;
lower lateral

Question 27

when do the first baby teeth come in?

Answer 27

7 months (then 1 per month)