Peds Exam 1
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| psychosocial theorist | Erikson
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| psychosexual theorist | Freud
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| moral theorist | Kohlberg
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| cognitive theorist | Piaget
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| spiritual theorist | Fowler
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| Largest single influence on growth | Nutrition
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| Neonatal time span | 1-28 days
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| Infant time span | 1-12 months
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| Toddler time span | 1-3 years
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| Preschool time span | 3-6 years
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| School-age time span | 5-11 years
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| Adolescence time span | 11-19 years
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| Sequencing of vital signs in infants and toddlers | respirations, apical pulse, BP, then temp
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| length versus height: when do you switch from one to the other | length up to 36 months (3 years)
height after 3 years
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| Describe FLACC scale | pain measurement tool for nonverbal patients >100 days old
facial grimace, leg kicking/drawn up, activity arched rigid/jerking, crying, consolable
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| Describe N-Pass scale | pain measurement tool for infants <100 days old
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| 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
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| 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.
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| describe how monitoring changes for patients during end of life care | no more vital signs or monitors used in end of life
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| Describe abnormal grieving | more than a year post-loss with intense grieving
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| Describe what the weight of a 6 month old should look like | double the birth weight
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| describe what the weight of a 12 month old should look like | triple the birth weight
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| infants are obligatory nose breathers until what age | at least 6 months
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| 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
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| describe the ductus arterious in neonates | a "bridge" between arteries of the heart. Expected to close within 28 days of birth
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| Posterior Fontenelle | closes at 4-8 weeks
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| anterior Fontenelle | closes at 9-18 months
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| Fine motor development in infants: hands are closed at | 1 month
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| Fine motor development in infants: hands open at | 3 months
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| Fine motor development in infants: able to grasp objects at | 3 months
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| Fine motor development in infants: able to transfer objects between hands at | 7 months
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| Fine motor development in infants: pincer grasp at | 9 months
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| Fine motor development in infants: remove objects from containers at | 11 months
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| Fine motor development in infants: attempts to build tower of 2 blocks at | 12 months
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| Gross motor development in infants: able to roll over | 5-6 months
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| Gross motor development in infants: able to sit alone | 7 months
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| Gross motor development in infants: able to move from prone position to sitting | 10 months
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| Gross motor development in infants: development of head control | 4-6 months
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| Gross motor development in infants: sitting with support | 4 months
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| Gross motor development in infants: sitting in the tripod position | 7 months
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| Gross motor development in infants: sitting independently | 8 months
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| Gross motor development in infants: crawling (army crawling) | 6-7 months
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| Gross motor development in infants: creping (hands and knees) | 9 months
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| Gross motor development in infants: walking with help | 11 months
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| Gross motor development in infants: walking alone | 12 months
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| Cognitive development in infants: age to finalize object permanence | 12-18 months
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| Cognitive development in infants: age of start of stranger danger/separation anxiety in infants | 6-18 months
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| Language development in infants: 5-6 weeks | small throaty sounds
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| Language development in infants: 2 months | single vowel sounds "ah"
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| Language development in infants: 3-4 months | consonants added "mah"
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| Language development in infants: 8 months | imitation and syllable combination "dada" "mama"
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| Language development in infants: 9-10 months | understand "No"
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| Language development in infants: 12 months | 3-5 words with meaning
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| Expected eruption of first teeth | bottom central incisors around 6-10 months
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| what is positional plagiocephaly | flat head; caused by too much back time; not enough tummy time
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| what is torticallis | stiff shoulders; caused by too much back time not enough tummy time
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| Vaccination schedule: times for hep B vaccine | birth, 1-2 months, 6-18 months
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| Vaccination schedule: times for rotavirus vaccine | 2 months, 4 months, 6 months
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| Vaccination schedule: times for DTap (diphtheria, tetanus, pertussis) | 2 months, 4 months, 6 months, 15-18 months, 4-6 years
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| Vaccination schedule: times for Hib (influenza B) | 2 months, 4 months, 6 months, 12-15 months
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| Vaccination schedule: times for PCV (Pneumococcal) | 2 months, 4 months, 6 months, 12-15 months
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| Vaccination schedule: times for IPV (polovirus) | 2 months, 4 months, 6-18 months, 4-6 years
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| Vaccination schedule: times for influenza vaccine | yearly starting at 6 months
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| Vaccination schedule: times for MMR (measles, mumps, rubella) | 12-15 months, 4-6 years
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| Vaccination schedule: times for varicella | 12-15 months, 4-6 years
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| Malnutrition: describe kwashiorkor | protein deficient but with enough calories, usually starches. Looks thin, distended belly, fluid retention, with vitamin deficiency
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| Malnutrition: describe marasmus | general malnutrition, physical and emotional deprivation, gradual wasting away
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| describe the difference between a cow's milk allergy and lactose intolerance | allergies are immune regulated; intolerances are not immune regulated
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| What age is an infant at greatest risk for SIDS | 2-4 months
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| what is the treatment for apnea of infancy | caffeine (theophylline)
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| Erikson's stage: 0-1 year | trust versus mistrust: when basic cares are consistently met
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| Erikson's stage: 1-3 years | autonomy versus shame and doubt: establishing independence within limits
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| Erikson's stage: 3-6 years | initiative versus guilt: imagination play and learning to cooperate within a group
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| Erikson's stage: 6-12 years | industry versus inferiority: budding social relationships, achieving and competing at school
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| Erikson's stage: 12-18 years | identity versus role confusion: physical changes, trying to fit in and incorporate new roles
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| Freud's stage: 0-1 year | oral: exploring everything with every sense available
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| Freud's stage: 1-3 years | anal: learning to potty train and control own body
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| Freud's stage: 3-6 years | phallic: vigorous and invasive behaviors to explore world and self
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| Freud's stage: 6-12 years | latency: lack of interest in sexuality
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| Freud's stage: 12-18 years | genital: rapid physical changes, emergence of sexual identity and interest
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| Piaget's stage: sensorimotor | 0-2 years: cause and effect, object permanence, ends with language and representational thought
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| 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)
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| 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
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| 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
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| Kohlberg's stage: pre-conventional | 2-7 years: morals viewed in terms of punishments or rewards received for acts
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| 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
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| Kohlberg's stage: post-conventional | 12+ years: able to evaluate own beliefs and values and determine morality base on personal moral code
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| Gross motor development in toddlers: jumps in place with two feet | 2 years
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| Fine motor development in toddlers: uses a spoon without rotation | 18 months
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| Fine motor development in toddlers: draws circles | 2.5 years
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| At what age do children learn to recognize sexual differences | 2 years
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| At what age do children have a fully developed gender id (freud's gender id) | 3 years old
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| Language in toddlers: 1 years | 2-4 words
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| Language in toddlers: 2 years | 300 words, 2-3 word sentences
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| Language in toddlers: 3 years | 3000-4000 words, simple sentences
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| Gross motor development in preschoolers: ability to stand on one foot | 3 years
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| Gross motor development in preschoolers: ability to skip/hop on one foot | 4 years
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| Gross motor development in preschoolers: ability to swim/skate/jump rope | 5 years
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| 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
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| a 5 year old has an imaginary friend, is this developmentally concerning? | No, imaginary friends common in preschool age 3-6 years
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| What is a major event of stress for preschool aged children | transition into kindergarten
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| At what age are children approx. 1/2 their adult height ? | 2 years
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| early childhood is at increased risk for otitis media, what is it | ear infection
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| about what time is a child physically ready for potty training | 18-24 months
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| Gross motor skills in early childhood: walks/stands with wide stance | 12 months
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| Gross motor skills in early childhood: walks without help, climbs up stairs | 15 months
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| Gross motor skills in early childhood: tries to run, but sometimes falls | 18 months
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| Gross motor skills in early childhood: jumps in place, momentarily stands on one foot, goes up/down stairs | 2 years
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| gross motor skills in early childhood: jumps with two feet and covers distance | 2.5 years
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| gross motor skills in early childhood: stands on one foot, tip toes, walks stairs with alternating feet | 3 years
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| fine motor skills in early childhood: grasps small objects | 12 months
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| fine motor skills in early childhood: drops raisin in bottle, uses cup | 15 months
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| fine motor skills in early childhood: spoon without rotation, turns book pages 2-3 at a time, throws ball | 18 months
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| fine motor skills in early childhood: build 6-7 block tower | 2 years
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| fine motor skills in early childhood: draws circle | 2.5 years
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| when do kids start to recognize negative body image comments | 2-3 years
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| what type of play do infants do | solitary play
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| a 2 year old does what type of play | parallel play
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| 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
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| how often should a child see the dentist | every 6 months
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| drawing a circle, square, and 6-part person happens in what age range | 3-6 years preschoolers
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| Magical thinking is common with what age group | preschoolers 3-6 years
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| 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
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| 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
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| Erythema (parvovirus or 5th disease)what it looks like | slapped face appearance (1-4 days), body rash (7+ days)
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| treatment for Erythema (parvovirus/5th disease) | tx symptoms with Motrin/Tylenol; generally a benign infection
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| Roseola (herpes virus) what it looks like | high fever for 3-4 days, then rash on trunk, face, then extremities
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| treatment for Roseola (herpes virus) | Tylenol for fever; risk for febrile seizures, usually resolves on its own
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| Measles (virus) what it looks like | koplik spots in mouth 2 days before body rash. Droplet transmission
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| treatment for measles and biggest complication | tx symptoms with Tylenol/bed rest; risk for pneumonia: tx with humidified O2
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| Mumps (virus) what it looks like | fever, headache, parotitis (gland swelling), may cause secondary orchitis (testicular swelling); droplet transmission
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| treatment for mumps | treat symptoms; gargle with salt water
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| Pertussis (whooping cough)(bacterial) what it looks like | uncontrolled short coughing followed by whoop sound -- risk for pneumonia -- droplet transmission
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| treatment for pertussis | erythromycin, O2 with high humidity, fluids. **greatest risk in patients <12 months; prevention with DTap vaccine at 2, 4 & 6 months
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| Rubella (virus) biggest complication | birth defects/fetal death -- contact transmission
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| Scarlet fever (bacterial) what are the complications | rheumatic fever, carditis, kidney failure
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| treatment for scarlet fever | antibiotics
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| scarlet fever what it looks like | concentrated rashes under arms and around groin area in skin folds
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| Intestinal Parasites diagnoses and treatment | stool culture; tx with antibiotic to kill parasites
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| 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
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| what is the current data on use of ipecac? | do not use ipecac in children
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| when should gastric lavage be used for poisoning | only within 1-2 hours of poison ingestion
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| what is the most common treatment for poison ingestion in children | activated charcoal
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| what is the most common age for poison ingestion | <6 years
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| batteries, drain cleaner, and bleach are examples of what type of poison | corrosive substances
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| what is the danger with corrosive poisoning | damage to tissues in the GI tract
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| 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
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| gasoline, lighter fluid, and paint thinner are examples of what type of poison | hydrocarbons
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| what is the biggest risk with hydrocarbon poisoning | **chemical pneumonia
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| treatment for hydrocarbon poisoning | oxygen with humidity, fluids, antibiotics to prevent pneumonia
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| what is the most common poison in children | acetaminophen
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| 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
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| what is the biggest risk with acetaminophen poisoning | hepatic failure
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| treatment for acetaminophen poisoning | activated charcoal and **Mucomyst (foul smelling)
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| 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
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| 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)
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| What is the biggest concern with lead poisoning | neurotoxicity
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| treatments for lead poisoning | iron; chelation therapy **monitor urine output closely
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| what are the markers beginning/end for school-aged children | losing first baby teeth; ends with final permanent teeth
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| What is the average age of puberty for girls and boys | 12 for girls; 14 for boys
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| what is a major social concern for school-aged children | bullying
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| 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
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| 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
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| 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)
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| What are the markers for beginning/end of Puberty | begins with secondary sex characteristics, ends with sexual maturity
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| what are the markers for beginning/end of adolescence | begins with sexual maturity, ends with emotional maturity
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| development of breasts, voice dropping, and pubic hair are examples of | secondary sex characteristics
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| development of enlarged testes, start of menses, and sperm production are examples of | primary sex characteristics
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| what is a big challenge when it comes to educating adolescents on risk-taking behaviors | adolescents feel invincible
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| when does a person determine their sexual orientation | early adolescence
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| which minerals are especially important for adolescent females and why | iron (blood loss during menses) and calcium (risk for osteoporosis later in life)
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| treatment for obesity in childhood/adolescence | treat as a family issue; diet modification, therapy, and exercise
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| what is the mean onset of anorexia | 13-14 years old
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| 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
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| what is the biggest concern with anorexia | cardiac status
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| 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
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| 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
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