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Pedi Test 1
Chapters 1, 3-5, 7-11, 18, 19, 21, 31, 32
Terms in this set (153)
What are the 4 top causes of infant mortality?
LBW/ short gestation
Complications of pregnancy (diabetes, eclampsia)
What are the top 3 causes of 1-4 year old's mortality?
What are the top 4 causes of 15-24 year old mortality?
What are some injuries or accidents that causes mortality in the 1-4 age group?
They are in danger of everything because they are climbing, crawling and walking
Parents might forget to buckle a certain part of the car seat
Might leave baby in the high chair and they rock and fall on their face
Drown in pools
What are the three stages a child goes through when their parents leave them in the hospital?
When does separation anxiety peak?
8-10 months and 16-30 months
When does stranger anxiety start?
10 months and stays
What is the three step check for administering meds?
What is the dose?
Is it safe for their size?
Have you drawn it up correctly?
What does play promote?
physical and motor development
lessening of symptoms
What is the type of play that infants do?
What is the type of play that toddlers do?
They do not share
What is the type of play that preschoolers do?
Magical thinkers. Makes up rules or there are no rules.
What is the the of play that school aged kids do?
Cooperative, team, organized, same sex
What type of play do adolescence do?
Peer interactions, gaming, sports
What is the most feared symptoms for children and family?
What are the three ways to assess for pain?
How do vitals change with pain?
increase in HR, RR, and systolic BP
decrease in O2
What age group do you use objective pain tools?
What age group is good for FLACC?
7 months to 7 years
What is an example of a behavioral pain assessment tool?
Face, Legs, Activity, Cry, Consolability
What are two tools to assess for pain in babies?
CRIES and NIPS
When can you start using the numerical pain measurement?
5-7 years old
What are examples of subjective pain assessment tools?
numerical, FACES, poker chips
What age is good to start the FACES pain rating scale?
3 and up
What is QUESTT?
Questions, Evaluate pain frequently, Use panicles, Secure parental involvement, Take action and be aggressive, Take responsibility
What are some differences between adults and children?
Childs airway is smaller
Obligate nose breathers
Head is large can occlude airway
Poor intercostal muscles
Larger body surface area
High glucose need and poor storage
Less circulating blood
Immature temp regulation
Immature immune system
Less organ maturation (kidneys)
What are common features of hospitalization?
overwhelming an complex environment
What are the 6 major outcomes of hospitalization?
What is the pediatric assessment triangle or PAT?
to maintain a fast initial assessment for kids.
What are the three points in the PAT?
2. Work of breathing
3. Perfusion of the skin
How to assess appearance?
AVPU or TICLS
A-alert, V-arousable to voice, P-pinch, unresponsive
T-tone, I-interativeness, C-consolability, L-look or gaze, S-speech/cry
Why is the first 24 hours for a newborn key?
For launching a respiratory pattern and sustaining it.
What are signs of respiratory distress?
increased work of breathing, tachypnea, decreased lung sounds at bottom bases
What are factors that initiate and maintain the newborns res system?
Chemical factors: increased acidosis
Thermal factors: sudden chill, cold stress
Tactile stimulation: change in environment and stimulation, handling and drying
What are the APGAR scores?
0-3= severe distress
4-6= moderate distress
7-10= absence of difficulty
What are the categories of the APGAR scoring?
When is the APGAR scoring done?
1 minute then 5 minutes
What are the three fetal shunts?
When does the foremen ovale close?
changes in pressure after birth
When does the ductus venosus close?
when the umbilical cord gets cut
When does the ductus arteriosus close?
When the lungs start to work
What are the 4 mechanisms of heat loss in an infant?
What is conduction?
When a cold object its ouching them
What is convection?
When air currents sweep the body temp away
What is evaporation?
When loose heat via moisture
What is radiation?
Larger cooler object is near but not touching
Regarding fluid and electrolyte balance what is the newborn susceptible to?
dehydration, acidosis, and H20 intoxication
Newborn weight loss?
newborns loose 10% of birth weight by 3-4 days
Hen are the babies back to their original birth weight?
By 2 weeks
What does it mean if you are below the 5% mark on the growth chart?
What does it mean to be above 90% on the growth chart?
How long do you measure head circumference?
up to 2 years
What is considered them?
What is considered preterm?
How much does a LBW baby weight?
How much does a VLBW baby weight?
How much does an ELBW baby weight?
When mortality greatest for a premature neonate?
the first 72 hours
What are the routine newborn procedures?
newborn blood screening
vaccines (hep B)
What doe set newborn blood screening test for?
Inborn errors of metabolism like PKU
What are the primitive reflexes in babies?
Moror, Babinski, Startle, Tonic neck, Dance or step, Crawling
When are these primitive reflexes done?
between 4-6 months
How much should you feed a newborn?
15ml/24 hours adding about an oz a week
How often do you need to feed a newborn in the hospital?
Every 3 hours
Need to wake them up to feed if they are sleeping
What should you feed a newborn?
Breast milk or formula. No free water
When should the newborn void?
17% void in the delivery room
92% void in the first 24 hours
Failure to void within 48 hours requires workup
How many dirty diapers should a baby go through in a day?
At least one diaper added on per day of life
I's and O's for newborns?
Strick I's and O's on formula
Record minutes of breastfeeding
Wight diapers for Output
What corrects dehydration?
What type of patients would get 1/2 maintenance?
pts wit cardiac problems
What type of patients would get 2x maintenance?
renal pts or pts on chemo or powerful drugs
How many calories do babies 0-30 days need?
How many calories of babies 1-4 months need?
How many calories do children 5 months-5 years need?
How many calories do kids >5 years old need?
70-90 kcal/kg/day depending on the activity level
What is physiologic jaundice?
Normal in the 2-3rd day of life
Disappears after a few days
No treatment is needed
What is non physiologic jaundice?
High levels int eh first 24 hours
Rise is >5mg in 24 hour period
Can be very dangerous
What is it called when the hyperbilirubinemia is neurotoxic?
Can be deadly
What level does the bilirubin need to be at to be admitted?
What level does the bilirubin need to be at for a blood exchange?
What should you encourage to bring dent eh bilirubin level?
What might need to be added to the child diet to help treat hyperbilirubinemia?
protein because it is needed to transport to the liver
How often do you draw up the bilirubin?
every 6 hours
When can the baby go home from the hospital?
After the billionths have been turned off for 6 hours because there can be a rebound effect after the lights are turned off
What age does apnea of prematurity usually happen?
<35 weeks gestation
What is a sign of apnea of prematurity?
ALTE (acute life threatening event)
baby turns blue or pale and limp
what does the apnea monitor test for?
HR and RR
Look for A and B (apnea and bradycardia)
When should the mom initiate BFing?
30 min after birth
What should the baby eat the first 6 months?
nothing but MBM
How many feedings of BF should you give to the baby in one day for the first weeks?
Binkys and the first week of life?
None the first week
When should you start weaning?
the second half of the first year
When can the baby have cows milk?
not until 1st birthday
How often should you introduce a new food?
one new food every 4-7 days to watch for allergies
When can the child have egg whites?
after 1 year
When can the baby have honey?
after 1 year because of botulism
Until when are meats not allowed?
8 months even tofu
When can you start giving solid food?
Why can't young kids have cows milk?
allergies can develop or cause GI bleeding
what is the fist solid food you should give to the baby?
Rice cereal mixed with BM
Then add veggies in it
When does the posterior fontanel close?
When does the anterior fontanel close?
When does the child get lower incisors?
1st by 6 months
How many teeth do you get by the first year?
What does 8/8/50 mean?
8 teeth the first year, 8 more the second, 50 words minimum by second birthday
What does 6/20/300 mean?
6 teeth 1st year, all 20 by second, 300 min by end of 2nd birthday
What fontanel is diamond shape?
What fontanel is triangle shape?
When can the infant palmer grasp?
When can the infant raise head?
When can the infant roll over?
When can the infant transfer objects?
When can the infant sit unsupported?
When can the infant walk?
When can the infant smile?
When can the infant babble?
When are the 1st words?
What are some contradictions for immunizations?
Febrile illness, allergy, immunocompromised
When do you give MMR and what does the baby get before?
1 year and they should get tylenol before
How much does the infant sleep the first few weeks?
How much sleep does the infant get after the first few weeks?
16 hours a day
How many naps during the first year?
2 a day
When does separation anxiety intensify?
What are some safety rules about sleeping?
No pillows in the crib
No waterbeds or comforters
What are some risk factors for SIDS?
Sibling died of SIDS
Who is at risk for dying of SIDS?
Infants with ALTE
How old is colic most common?
What defines colic?
>3 hours x 3 days/week
What works for colic babies?
change in temperature
Vibrating baby chairs or swings
Colic hold (arm on abdomen)
no milk in diet (if allergic)
What is OFTT?
organic failure to drive
What is NOFTT?
non organic failure to thrive
nothing found that leads us to believe there is a pathological reason for it
What are the different special needs conditions?
chronic, life threatening, or disabled
What are the most common definitions related to special needs?
respiratory tract d/o
What are new trends for caring for special needs children?
developmental focus to care
family centered care
What is normalization?
efforts to make a normal life
It could be hobbies, or going to school, or working
What is mainstreaming?
integrating children with disabilities into regular classrooms
What are some signs of denial the parented show?
Refusing to believe dx
Not asking questions
Not telling family/friends
Attributing symptoms to minor contitons
What are the 4 types of parental involvement in the child care?
Silent (stay back, limited involvement)
Recipients of care (stay close and watch)
Monitors of care (keep tract of everything)
Managers of care (do everything and are control)
What is cognitive impairment?
synonymous with MR
any type of mental deficiency
sub average general intellectual functioning
What are some causes to cognitive impairment?
infection or intoxication
inadequate nutrition or PKU
What is considered profound CI?
IQ of 20-25
Not a lot of movement or communication
What is considered severe CI?
What is considered moderate CI?
What is considered mild CI?
What are some signs of DS?
low set ears, slanted eyes, palmer creases, large tongue, flat forehead and bridge of nose
What are the three causes of death for DS?
aspiration pneumonia or choking
What maternal ages contribute to DS babies?
unger than 16 and older than 35
What happens to a toddler during their growth and development?
appetite fall and they can get physiological anorexia
height increases 2-4 inches a year
all 20 teeth in
can walk up steps
throws ball underhand
What are some toddler interventions?
Dont force them to share
Give them choices; like to say no
For how long does the infant need to be in a rear facing car seat?
1 year old and 20lbs
How long does the infant need to be in the center of the car?
4 and 40lbs
How long does the child need to be in a booster?
6 years old and 60lbs
When can the child be in a seat with an airbag?
over 5' and over 120lb if under 18
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