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Peds Exam 1

QuestionAnswer
psychosocial theorist Erikson
psychosexual theorist Freud
moral theorist Kohlberg
cognitive theorist Piaget
spiritual theorist Fowler
Largest single influence on growth Nutrition
Neonatal time span 1-28 days
Infant time span 1-12 months
Toddler time span 1-3 years
Preschool time span 3-6 years
School-age time span 5-11 years
Adolescence time span 11-19 years
Sequencing of vital signs in infants and toddlers respirations, apical pulse, BP, then temp
length versus height: when do you switch from one to the other length up to 36 months (3 years) height after 3 years
Describe FLACC scale pain measurement tool for nonverbal patients >100 days old facial grimace, leg kicking/drawn up, activity arched rigid/jerking, crying, consolable
Describe N-Pass scale pain measurement tool for infants <100 days old
Describe normalization in the chronically ill child encourage parents to treat the child as normally s possible. Setting limits, keeping up with school, discouraging handicap behavioral patterns
Describe palliative care for end of life patients focuses on quality of life not quantity of life. Symptom control. May over medicate to its own fault.
describe how monitoring changes for patients during end of life care no more vital signs or monitors used in end of life
Describe abnormal grieving more than a year post-loss with intense grieving
Describe what the weight of a 6 month old should look like double the birth weight
describe what the weight of a 12 month old should look like triple the birth weight
infants are obligatory nose breathers until what age at least 6 months
Describe the foramen ovale in neonates a hole between the atriums of the heart from the prenatal period. expected to close within 28 days of birth
describe the ductus arterious in neonates a "bridge" between arteries of the heart. Expected to close within 28 days of birth
Posterior Fontenelle closes at 4-8 weeks
anterior Fontenelle closes at 9-18 months
Fine motor development in infants: hands are closed at 1 month
Fine motor development in infants: hands open at 3 months
Fine motor development in infants: able to grasp objects at 3 months
Fine motor development in infants: able to transfer objects between hands at 7 months
Fine motor development in infants: pincer grasp at 9 months
Fine motor development in infants: remove objects from containers at 11 months
Fine motor development in infants: attempts to build tower of 2 blocks at 12 months
Gross motor development in infants: able to roll over 5-6 months
Gross motor development in infants: able to sit alone 7 months
Gross motor development in infants: able to move from prone position to sitting 10 months
Gross motor development in infants: development of head control 4-6 months
Gross motor development in infants: sitting with support 4 months
Gross motor development in infants: sitting in the tripod position 7 months
Gross motor development in infants: sitting independently 8 months
Gross motor development in infants: crawling (army crawling) 6-7 months
Gross motor development in infants: creping (hands and knees) 9 months
Gross motor development in infants: walking with help 11 months
Gross motor development in infants: walking alone 12 months
Cognitive development in infants: age to finalize object permanence 12-18 months
Cognitive development in infants: age of start of stranger danger/separation anxiety in infants 6-18 months
Language development in infants: 5-6 weeks small throaty sounds
Language development in infants: 2 months single vowel sounds "ah"
Language development in infants: 3-4 months consonants added "mah"
Language development in infants: 8 months imitation and syllable combination "dada" "mama"
Language development in infants: 9-10 months understand "No"
Language development in infants: 12 months 3-5 words with meaning
Expected eruption of first teeth bottom central incisors around 6-10 months
what is positional plagiocephaly flat head; caused by too much back time; not enough tummy time
what is torticallis stiff shoulders; caused by too much back time not enough tummy time
Vaccination schedule: times for hep B vaccine birth, 1-2 months, 6-18 months
Vaccination schedule: times for rotavirus vaccine 2 months, 4 months, 6 months
Vaccination schedule: times for DTap (diphtheria, tetanus, pertussis) 2 months, 4 months, 6 months, 15-18 months, 4-6 years
Vaccination schedule: times for Hib (influenza B) 2 months, 4 months, 6 months, 12-15 months
Vaccination schedule: times for PCV (Pneumococcal) 2 months, 4 months, 6 months, 12-15 months
Vaccination schedule: times for IPV (polovirus) 2 months, 4 months, 6-18 months, 4-6 years
Vaccination schedule: times for influenza vaccine yearly starting at 6 months
Vaccination schedule: times for MMR (measles, mumps, rubella) 12-15 months, 4-6 years
Vaccination schedule: times for varicella 12-15 months, 4-6 years
Malnutrition: describe kwashiorkor protein deficient but with enough calories, usually starches. Looks thin, distended belly, fluid retention, with vitamin deficiency
Malnutrition: describe marasmus general malnutrition, physical and emotional deprivation, gradual wasting away
describe the difference between a cow's milk allergy and lactose intolerance allergies are immune regulated; intolerances are not immune regulated
What age is an infant at greatest risk for SIDS 2-4 months
what is the treatment for apnea of infancy caffeine (theophylline)
Erikson's stage: 0-1 year trust versus mistrust: when basic cares are consistently met
Erikson's stage: 1-3 years autonomy versus shame and doubt: establishing independence within limits
Erikson's stage: 3-6 years initiative versus guilt: imagination play and learning to cooperate within a group
Erikson's stage: 6-12 years industry versus inferiority: budding social relationships, achieving and competing at school
Erikson's stage: 12-18 years identity versus role confusion: physical changes, trying to fit in and incorporate new roles
Freud's stage: 0-1 year oral: exploring everything with every sense available
Freud's stage: 1-3 years anal: learning to potty train and control own body
Freud's stage: 3-6 years phallic: vigorous and invasive behaviors to explore world and self
Freud's stage: 6-12 years latency: lack of interest in sexuality
Freud's stage: 12-18 years genital: rapid physical changes, emergence of sexual identity and interest
Piaget's stage: sensorimotor 0-2 years: cause and effect, object permanence, ends with language and representational thought
Piaget's stage: preoperational 2-7 years: egocentric thought, imaginative thought, intuitive thought (might not be logical), transductive reasoning (2 separate events or things may seem to be related)
Piaget's stage: concrete operations 7-11 years: able to sort, classify, arrange in logical order (serration), understand conservation, inductive reasoning (logical, concrete, follows rules), black and white thinking, less egocentric
Piaget's stage: formal operations 12+ years: able to adapt, see other viewpoints, think abstractly, draw logical conclusions from their own experiences, think hypothetically, and debate philosophically
Kohlberg's stage: pre-conventional 2-7 years: morals viewed in terms of punishments or rewards received for acts
Kohlberg's stage: conventional 7-11 years: morals viewed in terms of what the family believes, what they are taught, following rules, maintaining social order, can begin to judge actions on intentions
Kohlberg's stage: post-conventional 12+ years: able to evaluate own beliefs and values and determine morality base on personal moral code
Gross motor development in toddlers: jumps in place with two feet 2 years
Fine motor development in toddlers: uses a spoon without rotation 18 months
Fine motor development in toddlers: draws circles 2.5 years
At what age do children learn to recognize sexual differences 2 years
At what age do children have a fully developed gender id (freud's gender id) 3 years old
Language in toddlers: 1 years 2-4 words
Language in toddlers: 2 years 300 words, 2-3 word sentences
Language in toddlers: 3 years 3000-4000 words, simple sentences
Gross motor development in preschoolers: ability to stand on one foot 3 years
Gross motor development in preschoolers: ability to skip/hop on one foot 4 years
Gross motor development in preschoolers: ability to swim/skate/jump rope 5 years
Should a 2.5 year old be able to draw a 6 part person? When does this skill develop? No, preschool age 3-6 years
a 5 year old has an imaginary friend, is this developmentally concerning? No, imaginary friends common in preschool age 3-6 years
What is a major event of stress for preschool aged children transition into kindergarten
At what age are children approx. 1/2 their adult height ? 2 years
early childhood is at increased risk for otitis media, what is it ear infection
about what time is a child physically ready for potty training 18-24 months
Gross motor skills in early childhood: walks/stands with wide stance 12 months
Gross motor skills in early childhood: walks without help, climbs up stairs 15 months
Gross motor skills in early childhood: tries to run, but sometimes falls 18 months
Gross motor skills in early childhood: jumps in place, momentarily stands on one foot, goes up/down stairs 2 years
gross motor skills in early childhood: jumps with two feet and covers distance 2.5 years
gross motor skills in early childhood: stands on one foot, tip toes, walks stairs with alternating feet 3 years
fine motor skills in early childhood: grasps small objects 12 months
fine motor skills in early childhood: drops raisin in bottle, uses cup 15 months
fine motor skills in early childhood: spoon without rotation, turns book pages 2-3 at a time, throws ball 18 months
fine motor skills in early childhood: build 6-7 block tower 2 years
fine motor skills in early childhood: draws circle 2.5 years
when do kids start to recognize negative body image comments 2-3 years
what type of play do infants do solitary play
a 2 year old does what type of play parallel play
a parent is concerned that his 5 year old is still wetting the bed at night what should you tell them night time wetting is normal until age 6
how often should a child see the dentist every 6 months
drawing a circle, square, and 6-part person happens in what age range 3-6 years preschoolers
Magical thinking is common with what age group preschoolers 3-6 years
describe the difference between sleep terrors and nightmares and when these problems generally start arising sleep terrors may have screaming, awake-like behaviors even though the child is still sleeping, nightmares are bad dreams. 3-6 years
a mother of a 4 year old provides her son with 3 bottled waters every day - what should you educate her on fluoride is not present in bottled water which is necessary for dental health
Erythema (parvovirus or 5th disease)what it looks like slapped face appearance (1-4 days), body rash (7+ days)
treatment for Erythema (parvovirus/5th disease) tx symptoms with Motrin/Tylenol; generally a benign infection
Roseola (herpes virus) what it looks like high fever for 3-4 days, then rash on trunk, face, then extremities
treatment for Roseola (herpes virus) Tylenol for fever; risk for febrile seizures, usually resolves on its own
Measles (virus) what it looks like koplik spots in mouth 2 days before body rash. Droplet transmission
treatment for measles and biggest complication tx symptoms with Tylenol/bed rest; risk for pneumonia: tx with humidified O2
Mumps (virus) what it looks like fever, headache, parotitis (gland swelling), may cause secondary orchitis (testicular swelling); droplet transmission
treatment for mumps treat symptoms; gargle with salt water
Pertussis (whooping cough)(bacterial) what it looks like uncontrolled short coughing followed by whoop sound -- risk for pneumonia -- droplet transmission
treatment for pertussis erythromycin, O2 with high humidity, fluids. **greatest risk in patients <12 months; prevention with DTap vaccine at 2, 4 & 6 months
Rubella (virus) biggest complication birth defects/fetal death -- contact transmission
Scarlet fever (bacterial) what are the complications rheumatic fever, carditis, kidney failure
treatment for scarlet fever antibiotics
scarlet fever what it looks like concentrated rashes under arms and around groin area in skin folds
Intestinal Parasites diagnoses and treatment stool culture; tx with antibiotic to kill parasites
You enter a patient room and see a 3 year old sucking on the tip of a sharpie marker. What do you do first? assess the patient for need of CPR or VS, remove the toxin, if the patient does not need immediate care call poison control and administer an antitoxin to prevent poison absorption
what is the current data on use of ipecac? do not use ipecac in children
when should gastric lavage be used for poisoning only within 1-2 hours of poison ingestion
what is the most common treatment for poison ingestion in children activated charcoal
what is the most common age for poison ingestion <6 years
batteries, drain cleaner, and bleach are examples of what type of poison corrosive substances
what is the danger with corrosive poisoning damage to tissues in the GI tract
what is the treatment for corrosive poisoning treat the pain, dilute the poison with water or milk; surgery may be indicated for scar tissue damage later in life
gasoline, lighter fluid, and paint thinner are examples of what type of poison hydrocarbons
what is the biggest risk with hydrocarbon poisoning **chemical pneumonia
treatment for hydrocarbon poisoning oxygen with humidity, fluids, antibiotics to prevent pneumonia
what is the most common poison in children acetaminophen
what does acetaminophen poisoning look like 1. N&V, sweating, pallor (2-4 hours after ingestion) 2. latency; like they are getting better (24-36 hours) 3. hepatic involvement (up to 7 days after) 4. recovery
what is the biggest risk with acetaminophen poisoning hepatic failure
treatment for acetaminophen poisoning activated charcoal and **Mucomyst (foul smelling)
Salicylate poisoning (aspirin) biggest concern kidney damage, prolonged bleeding. Peaks in 2-4 hours and lasts up to 18 hours. Can be acute or chronic
Iron/Mineral poisoning stages 1. initial: up to 6 hours (blood in vomit, stool, pain) 2. latency: 2-12 hours 3. systemic toxicity: 4-24 hours (bleeding, shock, death, acidosis, hyperglycemia) 4. hepatic injury: 48-96 hours (seizures, coma)
What is the biggest concern with lead poisoning neurotoxicity
treatments for lead poisoning iron; chelation therapy **monitor urine output closely
what are the markers beginning/end for school-aged children losing first baby teeth; ends with final permanent teeth
What is the average age of puberty for girls and boys 12 for girls; 14 for boys
what is a major social concern for school-aged children bullying
A 9 year old on a soccer team presents to the ER with a broken leg from falling during the game, this type of injury would be an acute overload injury: one time incidents
A 10 year old who has been playing football for the past 3 years presents to his physician with chronic shoulder pain in his throwing arm, this type of injury is called over-use syndrome: repetitive micro-traumas resulting in inflammation
treatment for MRSA and precautions with treatment contact precautions; Bactrim (topical) or *Vancomycin (Vanco may cause Red-Man's syndrome: pre-treat with Tylenol and benedryl)(Vanco can cause hearing damage)
What are the markers for beginning/end of Puberty begins with secondary sex characteristics, ends with sexual maturity
what are the markers for beginning/end of adolescence begins with sexual maturity, ends with emotional maturity
development of breasts, voice dropping, and pubic hair are examples of secondary sex characteristics
development of enlarged testes, start of menses, and sperm production are examples of primary sex characteristics
what is a big challenge when it comes to educating adolescents on risk-taking behaviors adolescents feel invincible
when does a person determine their sexual orientation early adolescence
which minerals are especially important for adolescent females and why iron (blood loss during menses) and calcium (risk for osteoporosis later in life)
treatment for obesity in childhood/adolescence treat as a family issue; diet modification, therapy, and exercise
what is the mean onset of anorexia 13-14 years old
what would you expect a patient with anorexia to be like type A personality, controlling, organized, good student, "perfectionist" -- easily conforming, not leaders; below average body weight
what is the biggest concern with anorexia cardiac status
what would you expect a patient with bulimia to be like depressed, self-loathing, poor impulse control, history of unsuccessful dieting; normal to above normal body weight
What is a change to watch for in a group of adolescents where one member has recently committed/attempted suicide parasuicide: cutting/suicidal behaviors in the rest of the group
Created by: jperrault9941