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Peds Exam 1
Child Development and Health Promotion Infancy pt 1
| Question | Answer |
|---|---|
| pediatric ages are split into 4 categories | infancy early childhood: toddler and preschool school age adolescence |
| infancy age | birth-12 months |
| neonate age | birth-27-28 days |
| infant age | 1-12 months |
| early childhood age | 1-6 years |
| toddler age | 1-3 years |
| preschooler age | 3-6 years |
| school age age | 6-12 years |
| adolescence | 11-20 years |
| when is prepubescence | 2 years before puberty |
| growth and development is tracked by nurses through | 5 domains |
| the 5 domains | Physical / Biologic Growth Motor/ Physical Development Cognitive Development Social / Emotional Development Language Development |
| Physical / Biologic Growth | objective measurement Height, weight, bone, teeth, organ changes |
| Motor/ Physical Development | Gross and fine motor skills movement |
| Cognitive Development | Thinking, learning, problem solving |
| Social / Emotional Development | Attachment, temperament, self-concept |
| Language Development | Receptive and expressive communication |
| at what point is it a concern that a child misses a milestone | at 1 milestone, refer them and tell PCP and definitely refer is missing more than 1 milestone |
| what percent of kids meet milestones now | 75% |
| anticipitory guidance | giving parents the info before it is needed |
| Theoretical Foundations | Three lenses for understanding how children develop |
| Jean Piaget | Cognitive Development |
| Erik Erikson | Psychosocial Development |
| Lawrence Kohlberg | Moral Development |
| during infancy, there is a | drastic amount of change |
| Weeks of Prematurity | 40 weeks − gestational age at birth |
| Corrected Age | Chronological age − weeks of prematurity |
| Catch-Up Period | # weeks premature × 10 |
| what children should you compare premies to | the corrected age |
| Physical Growth — Infancy | Rapid, predictable change in the first 12 months |
| Birth Weight doubles by | ~5 months |
| Birth Weight triples by | ~12 months |
| infants lose 10% of body weight but | regain by 10-14 days |
| length (height) avg | 20 in |
| length (height) increases 50% by | 1 year |
| how many in of growth in 1 month | 1 in |
| how much of initial length will they gain | 1/2 |
| head circumference compared to chest circumference | head circumf is 2cm bigger than chest circumf |
| head circumference = | brain growth |
| OFC is | occipital frontal circumference |
| OFC = | chest + 2cm at birth |
| at what age do chest and head circumf equal | 1 year |
| fontanel suture | is cartilage so bone in skull can overlap through canal and allows for growth |
| a sunken fontanel in an infant means | dehydration |
| anterior fontanel closes | ~12-18 months |
| anterior fontanel size | of penny, diamond shape, soft, larger |
| posterior fontanel closes | ~6-8 weeks |
| posterior fontanel size | decreased occipital prominence, very small which is why it closes first |
| Infant Reflexes | Primitive reflexes present at birth and their expected disappearance |
| since brainstem is mediate, | babies never return to primitive |
| sucking | Sucks on stimulation of circumoral area, reflexive birth-4mo |
| rooting | Turns head, sucks when cheek is stroked birth-4mo |
| Extrusion | Forces tongue outward when touched birth-4mo |
| Palmar Grasp | Grasps object placed in palm birth-4mo |
| Plantar Grasp | Toes curl when sole is touched Birth – 8 mo |
| Babinski | Big toe up, other toes fan on sole stroke Birth – 12 mo |
| Moro (Startle) | Extends then pulls in arms/legs to noise birth-4mo |
| All Reflexes | Fade as voluntary motor control develops ongoing |
| Neurologic maturation in infancy | Brain growth and myelination of spinal cord (until 2 yo) Involuntary reflexes → voluntary control Crying → speaking |
| Respiratory maturation in infancy | Fast rate initially, then slows Irregular breathing with pauses → more regular Narrow nasal passages; larynx funnel-shaped Compliant trachea/chest wall; fewer alveoli |
| when do humans reach adult lung capcity | at 7yo |
| Cardiovascular maturation in infancy | Heart rate slows, BP increases Respiratory sinus arrhythmia is common Capillaries near skin → heat loss, limited thermoregulation |
| what does HR slow to in infancy | <180 |
| Respiratory sinus arrhythmia | when infants breathe in, the HR increases and when infants breathe out, the HR decreases |
| infants have heat loss because | they don't have much fat storage so the become cool easily |
| hematopoietic | Physiologic anemia of infancy |
| Genitourinary | Greater % body water means dehydration risk Frequent urination, low specific gravity Immature renal structures |
| frequent urination because | kidneys are not developed till 2 years old |
| gastrointestinal | Immature digestion Increasing stomach volume Teeth erupt in preparation for solids Liver is immature |
| Immature digestion so | spit up is typical |
| Increasing stomach volume | 3 meals, 2 snacks at the end of infancy |
| when do infants get teeth | at 6 mo so thats when you intro them to solids |
| liver is immature so BM initially are | dark green, sticky black |
| immune | Passive immunity from mother Colostrum in breast milk is rich in antibodies Vulnerable to infection |
| passive immunity from mom because | babies get immunoglobulins from them the last 3 months of pregnancy so if baby is a premie then they won't have antibodies |
| Integumentary | Mottling decreases over the first few months because CV is not developed fully |
| average age of first tooth eruption | 8 mo, range from 6-10 mo |
| how many teeth at 12 mo | 6-8 teeth |
| signs of teething | drooling, irritability, rubbing ears, sucking/biting finger or objects, difficulty sleeping, decreased appetite for solids, low grade fever (99) |
| what teeth come in at 8 mo | central incisors in lower gums and then 2 front top |
| Gross Motor Milestones occur | Head-to-toe progression across the first year |
| at 2 months, | raises head when prone, moves all 4 extremities |
| at 4 months gross | no head lag, rolls back to side |
| at 6 months gross | rolls to prone and supine, tripod sits |
| how to babies roll first at 6 months | front to back |
| at 9 months, | sits unsupported, gets to sitting |
| at 12 months, | pulls to stand, cruises (walks holding on to something) |
| what should you do when baby is on their belly | SUPERVISE so there is no suffocation |
| head lag | when baby is on their back and you pick them up by their arms and their head stays on the surface |
| Fine Motor Milestones | From reflexive grasp to the neat pincer grasp |
| at 2 months fine | Hands mostly fisted; briefly opens grasp anything put in their hands |
| at 4 months fine | bats at objects, holds toys in hand |
| at 6 months fine | reaches for items, purposeful movements like grabbing things with their palms |
| at 9 months, | rakes, gross (inferior) pincer grasp, transfers hand to hand |
| gross pincer grasp | thumb and pointer |
| at 12 months, | fine pincer grasp |
| fine pincer grasp | holding with finger tips |
| Cognitive Development | Piaget's Sensorimotor Stage: combining motor with senses |
| 0–2 years: learning through the senses | reflexes, repetitive behavior, imitation, cause & effect |
| repetitive behavior | child learns when hungry if they cry they will get food |
| imitation | smile at them and they will smile at you |
| separation emerges at | ~4-6 months |
| children learn body separation from | others |
| object permanence emerges at | ~8 months |
| what is object permanence | child knows something exists even though they can't actively see it |
| at what age do children comprehend meaning of no | between 9-10 months |
| Communication & Language Development at birth | cries, then smiles |
| Communication & Language Development at 2 mo | coos, differential crying |
| if baby not cooing at 2 mo then | problem with hearing |
| differential crying means | different cries for different needs |
| Communication & Language Development at 4-5 mo | vowel sounds, vocalizes to voices, laughs |
| Communication & Language Development at 6 mo | squeals |
| Communication & Language Development at 9 mo | "Dada / mama“ lifts arm responds to name |
| Communication & Language Development at 12 mo | 1–3 words; follows simple commands |
Created by:
leh195