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SAC Peds Exam Test#3
Module 6,7,8
| Question | Answer |
|---|---|
| What is growth? | physiologic increase in size |
| What is development? | Psychological, physiological, cognitive changes during life span |
| Biologic infant milestone (0-3mos) | Sleeps a lot, improved head lag, head support in prone position |
| Biologic infant milestone (3-6mos) | Improved head control, Posterior fontanel closes (2mos), Grasping, Sitting w/out support, rolls abd-back, 2x BIRTH WEIGHT (6mos), Teething, Social smile (2-5mos) |
| Biologic infant milestone (6-9mos) | Sits without support, rolls back-abd, scoots, pull up to walk, pincer grasp, Object Permanence |
| Biologic infant milestone (9-12mos) | crawls, stands, may walk, 3x BIRTH WEIGHT, imitates expressions, first words |
| Biologic Toddler milestone (1-3yrs) | Growth slows, anterior fontanel closes (15-18mos), head proportional, fine motor skills improve, bones lengthen/straighten, walk (15mos), climbs (18mos) |
| Biologic Preschooler milestone (3-5yrs) | slow growth, body systems control, hop/skip/jump, tricycle, improved fine motor, dresses self |
| Biologic School-age milestone (6-12yrs) | Steady, physical growth, inc. skeletal growth, Inc/strengthening muscles, improving motor skills |
| Biologic Adolescent milestone (13-18+yrs) | Puberty, growth spurt |
| Key to Erikson's Psychosocial development | Inter-relationship between emotional/ physical variables, conflict resolution stages |
| Key to Piaget's Cognitive development | Shaped by actions/consequences, follows orderly progression |
| Psychosocial developement - Infancy (birth - 1 1/2yrs) | TRUST VS MISTRUST - basic needs met, Stranger/ Separation Anxiety (6mos - 3yrs) |
| Psychosocial developement - Toddler (1 1/2 - 3yrs) | AUTONOMY VS SHAME/DOUBT - sense of control, "no", ritualism, parallel play |
| Psychosocial developement - Preschooler (3 - 6yrs) | INITIATIVE VS GUILT - behavior goal-directed and imaginative, criticism = guilt |
| Psychosocial developement - School-Age (6 - 12yrs) | INDUSTRY VS INFERIORITY - mastery of skills (fosters self esteem), rules important, predictability |
| Psychosocial developement - Adolescent(12 - 21yrs) | IDENTITIY VS ROLE CONFUSION - egocentric, peers important, independence from parents |
| Piaget's Cognitive development Period 1 (birth - 2yrs) | SENSORIMOTOR PERIOD - reflexive-intentional behavior, egocentric, Object Permanence |
| Piaget's Cognitive development Period 2 (3-7yrs) | PRE-OPERATIONAL - magical thinking, animism, NO reversibility, thoughts cause actions |
| Piaget's Cognitive development Period 3 (7-11yrs) | CONCRETE OPERATIONS - systematic/logical, fact from fantasy, sense of time, transductive reasoning (cause/effect), reversibility |
| Piaget's Cognitive development Period 4 (11yrs-adult) | FORMAL OPERATIONS - abstract thinking, analytical, new ideas |
| What hinders advancing to Piaget's Formal operations stage? | poor comprehension, lack of education, learning disabilities, substance abuse |
| Different screenings throughout childhood | Apgar, newborn, lead, vision/hearing, scoliosis |
| What do well child check-ups check for? | Height, weight, head circumference |
| How long do infants need breastmilk or Fe-fortified formula? | 12mos |
| When should infants start to eat solids? Progression? | 4-6mos; rice cereal--> veggies--> fruits--> meats |
| When can infants start finger foods? Restrictions? | 8+mos; nuts, raisins, hot dogs, peanut butter, raw honey |
| When do Toddlers need whole milk? | 1-2yrs |
| What should the daily intake of milk be for toddler? why? | 16-24oz; so they can eat other food as well |
| Key to nutrition for pre-schooler? | Establish good eating habits/schedule |
| Keys to nutrition for school age children? | Inc. appetite, busy schedule = rush eating to play, independent food choices |
| Keys to nutrition for adolescents? | Growth--> inc. protein, Fe, Ca needs (especially for athletes), appearance and peer acceptance |
| What concepts contribute to childhood obesity? | Genetic influence AND environmental exposure |
| Cardio affects of obesity? | HTN, CAD, Lt ventricle hypertrophy, dyslipidemia, MI, stroke |
| Respiratory affects of obesity? | Asthma, PE, enlarged tonsils/adenoids, sleep apnea |
| Endocrine affects of obesity? | IDDM, insulin resistance, Polycystic Ovarian syndrome |
| GI affects of obesity? | Steatohepatitis (fatty liver), cirrhosis, gall bladder disease (cholecystitis) |
| Acanthosis nigricans | Hyperpigmentation d/t insulin resistance in axilla or back of neck |
| AAP prevention of childhood obesity 5-2-1-0 | 5 servings fruit/vegs, <2hrs screen time, 1+hrs phys activity, 0 sugared bevs |
| Psychosocial affects of obesity? | Depression, social isolation, anxiety, poor self-esteem, bullying, suicidal, eating d/o, discrimination |
| Why are childhood immunizations given? | Primary prevention of many communicable diseases |
| what are live, attenuated vaccines? examples? | Weakened form of disease; MMR, Varicella, Nasal flu vaccine |
| what are inactivated vaccines? examples? | killed/synthetic bacteria/virus; DTaP, Polio (IPV), HepB |
| How long to attenuated vaccines last? | 20+ years for single dose |
| Disadvantage of inactivated vaccine? | Need frequent boosters |
| Disadvantage of attenuated vaccines? | Can't give to immunocompromised (can give inactivated vacc) |
| When is HepB vaccine given (hint: 3stages) | birth--> 1-2mos--> 6-18mos |
| What is RV vaccine? When given? | Rotavirus vaccine against severe diarrhea; given @ 2,4,6mos |
| what is DTaP vaccine? When given? | Diptheria (resp dz that causes paralysis, heart failure, death), Tetanus (lockjaw; causes muscle spasms & death), Pertussis (whooping cough); given @ 2,4,6, 15-18mos, and 4-6yrs |
| what is Hib vaccine? When given? | Haemophilus influenzae type B (can cause illnesses that affect brain, lungs, and bones or joints); given @ 2,4,6, & 12-15mos |
| Difference between DTaP and Tdap? | DTaP for <7yrs old; Tdap for 8+yrs old |
| what is PCV vaccine? When given? | Pneumococcal Conjugate Vaccine (against bacteria that causes PNA); given @ 2,4,6, 12-15mos |
| what is IPV vaccine? When given? | Inactivated Polio Vaccine (against Poliomyelitis virus that causes inflammation of spinal cord that leads to paralysis/death); given @ 2,4,6-18mos, 4-6yrs |
| what is MMR vaccine? When given? | Measles, Mumps, Rubella attenuated vaccine given @ 12-15mos & 4-6yrs |
| what is Varicella vaccine? When given? | Chicken Pox attenuated vaccine given @ 12-15mos & 4-6yrs |
| When is HepA vaccine given? | Given in 2 doses between 12-24mos |
| When is flu shot given? Key thing to know? | Yearly starting at 6mos; if 1st time between 6mos-8yrs, given in 2 doses, 4 wks apart; if only 1 dose given, next season, give 2 doses |
| What if vaccine is missed? | Provider will catch up with next vaccination with first dose |
| Contraindications for vaccinations? | Immunocompromised (oncology pts, chronic steroid meds), allergies, illness, pregnancy |
| What immunizations can be given at 2mos? | HepB, RV, DTaP, Hib, PCV, IPV |
| What immunizations can be given at 4mos? | RV, DTaP, Hib, PCV, IPV |
| What immunizations can be given at 6mos? | HepB, RV, DTaP, Hib, PCV, IPV, flu shot |
| What immunizations can be given at 12mos? | HepB, Hib, PCV, IPV, flu shot, MMR, Varicella, HepA |
| What immunizations can be given at 4-6yrs? | DTaP, IPV, flu shot, MMR, Varicella |
| What allergies can contraindicate vaccine to be given? | allergy to eggs, poultry, latex, gelatin, neomycin |
| Vaccine site for infants/children? | Vastus lateralis |
| When to call healthcare provider after vaccine? | High fever over night (>100.5F), Bx changes, severe adverse reaction |
| #1 injury for infants? | Scalding burns |
| How to prevent scalding burns in bath tubs? | Adjust thermostat on water heater |
| Leading causes of injuries for toddlers? | Drownings and burns |
| When should 1st dental exam be done? | 3yrs old |
| What to know about water? | need fluoride supplements if drinking water <0.7ppm |
| Leading cause of death for School age children? | Accidents |
| Leading cause of injury for adolescents? | MVA, firearm accidents, sports |
| When is deceased diagnosed as SIDS? | autopsy is inconclusive |
| When does SIDS usually occur? what time of year? to who? | 95% before 6mos; peak at 2-4mos; more in winter; preemies/low birth wt babies |
| #1 intervention for SIDS? | Supine sleeping; "back to bed" |
| Where is Pb absorbed? | Thru GI, accumulates in bones, teeth, brain, kidneys |
| Acceptable Pb level? when needed to treat? | <10mcg/dl; must treat >20mcg/dl |
| What does Pb poisoning lead to? | Pb absorbed into bones instead of Ca and breaks down RBCs, = Anemia (dec H&H) |
| How is Pb poisoning treated? | EDTA chelating agent given IV that absorbs Pb out of bones back into blood and excreted thru kidneys |
| When possible poisoning, first questions? | 1. What was it? 2. When did it happen? |
| If bolus is ordered for unknown poisoning, what fluid used? why? | NS, because other fluids can alter labs and may cause reaction |
| How does activated charcoal help in poisoning? | absorbs agent and expels thru GI |
| When/What age do you usually see Separation Anxiety? 3 phases? | Infancy to pre-school age (6mos - 4yrs); Protest, Despair, Detachment |
| Child concept of death by age? | Infant= none; Preschool= temporary separation; School-age= sad,irreversible; Adolescent= inevitable, irreversible, distant |
| Most common type of child abuse? | Neglect (then physical, sexual [usually not reported], psycho, medical, other) |
| Most common trigger for Shaken Baby Syndrome? What's it lead to? | Crying; leads to whiplash induced intracranial/retinal bleed |
| What are pregnant teens at an increased risk for? | Pre-eclampsia, CPD, preterm labor/birth, low birthweight, depression |
| Lack of growth and development leads to what? | Failure to Thrive - decline on growth curve in ht/wt |
| Organic, physical factors of Failure to thrive? | GI d/o, cardiac, chronic infxns, endocrine d/o, metab d/o |
| Inorganic, psychosocial factors of Failure to thrive? | Poverty, poor social support, family stress, inadeq nutrition, diff bonding, maternal depression |
| Failure to thrive interventions? | treat cause, multidisciplinary, observe, MONITOR HT/WT,I&O, teach, referrals |
| What is neonatal sepsis? | Viral or bacterial infection of the blood in newborn |
| #1 cause of Neonatal Sepsis? | Group beta streptococcus |
| Labs/Diagnostic tests for Neonatal sepsis? | Urine, CSF, and Blood test |
| Blood tests in Neonatal sepsis? | CBC w/ diff, CRP, ESR, Bands |
| What is CSF panel looking for in neonatal sepsis? | Elev. WBC, low glucose |
| Common problems w/ Downs Syndrome? | Cardiac problems, pyloric stenosis, hypothyroid, compromised immunity, sensitive skin, audio/visual impairment |
| Clinical manifestations of Down's syndrome? | Low set ears, protruding tongue, hypotonia, simian crease, inner epicanthial folds, short,broad neck, wide, flat nasal bridge |
| Otitis Media? How treated? | Inflammation of MIDDLE ear; oral antibiotics |
| How is child's eustachian tube different from adults which leads to more Otitis media infections? | child's is more horizontal and shorter |
| S/S of Otitis media? | DIFFICULTY FEEDING/SUCKING, pain, pulling at ears, fever, irritability, ear drainage |
| What is OME? | Otitis media w/ effusion; middle ear inflammation w/ fluid behind tympanic membrane |
| What can chronic otitis media lead to? Usually at what age? | can lead to hearing loss and delayed speech; older than 3mos |
| What is myringotomy w/ PE? | Inserting pressure equalizing tubes to treat frequent otitis media infections |
| what may be needed for chronic OM? | audiologist referral |
| Treatment for varicella? | Acyclovir IV, fever mgmt, skin care, comfort measures |
| When can kid w/ chicken pox go back to school? | After all vesicles are crusted over |
| What is Roseola? | Virus that causes fever, then rosy pink macular rash to trunk that lasts a week in 6-18mos old |
| 3 stages of pertussis? Complication? | Catarrhal (URI symptoms), Paroxysmal (cyanosis; whopping cough), Convalescent (less coughs); PNA |
| What is impetigo? Complication? | Superficial bacterial infection; cellulitis |
| 3 Cs of Rubeola? | Coriza (runny nose), Cough, Conjunctivitis |
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