PEDS Week 2 (Ch 2/4)

Family systems theory

change has a domino effect on families (asses their abilities to accept change)

Family stress theory

Stress affects families (asses ability to cope)

Duvall's Development Stages Theory

Families develipe and change, we need to provide anticipatory guidance

infant communication tips

smile, use soft voice, use eye contact, make animated faces, talk out loud (tactile sitmulaiton is swaddling and rocking)

Todler communicaiton tips

Get down to eye level, use cheerful voice, allow play with equipment, offer simple choices

Preschool communicaiton tips

allow them to participate in care, rememebr they think they cause things by thinking or saying it.

School aged communication tips

offer choices, explain to them the answers to the 5 w's questions

antrhopometric measures

height, weight, head circumfrance, proportions, skinfolds, arm circumfrance

dehydration may cause

sunken top of head

vitals order

rr hr o2 temp bp height and weight

accurate cuff size

width is 40% of upper arm, length is 80% circumfrance of arm

physical assessment of children

lymph nodes are large, craniosynostosis and torticollis may be seen, tonsils typically large until 8

Cardiac placement

Aortic 2nd ics, LSB

Pulmonic 2nd ics RSB

Erb’s point 3rd ics RSB

T 4th ics, RSB

Mitral <7 years old 4th RMCL, >7yo 5th RMCL

When is a murmur ok?

if you hear it laying down but not sitting up

where do you feel pulses?

breastmilk only until what age

4-6 months

what percent of reactions are sensitivities and not allergies

50-90%

Calorie intake for older infants

primary calorie intake is fluids

Why is rice cereal good?

not alot of allergies, good iron intake

When do you wean babies off of pacifiers

6 months

Positional Plagiocephally is often with

torticollis, put a toy on the otherside of the crib or do passive ROM as the parent

tummy time conditions

parents much watch baby and baby must be awake

posterior fontanelles close at

2 months

anterior fontanelles close at

18 months

female pubery abnormals

< 8yo, >15yo

female puberty breasts, pubic hair ages

breasts between 8-12 pubic hair between 11-14

tanners stages od breast development

stage 0= nothing

stage 5=full woman maturation

female puberty order

breast development, pubic hair, armpit hair, discharge, menstration

tanngers stages for pubic hair

1=nothing

2=long straight downy hair

3= darker and curly

4 = entire pubic area

5= thighs

Male puberty abnormals

less than 9 more than 14

male puberty normal ages

pubic hair between 12-16

Male Puberty order

testical enlargment, pubic hair, penile enlargement, armpit hair, increase muscles, voice changes, facial hair

gynecomastia is becuase of

increased estrogen, usually lasts less than 1 year but worry if its above 2 years

expected teeth math

age in months - 6

feeding per day math

baby weight in lbs x 2.5

gestational age math

(current age into weeks 1m=4.5w) - (40w - gestational age) = #of weeks/4.5 = age to plot measurement

go over vitals

OK

oral prob should not be used in

less than 5

ear pulling

down and back less than 3 up and back above 3

normal breathing for ages

less than 7 diaphramatic breahting above 7 thoracic breathing

young infancy ages

0-6 months

young infancy physical ability (5)

grasps and shakes toys

sits with support

supports whole weight on legs

transfers object hands to hand by 6 months

(belly to back 5 months back to belly 6 months)

young infancy social ability (3)

enjoys playing with people

imitates some movments or expressions

responds to emotions

young infancy sensory ability (2)

follows moving objects

recognizes familiar objects or people

coo and babble by

3 months and 6 months

older infancy ages

7-12 months

older infancy physical ability (6)

sit without hel

crawls on belly,

hands and knees position,

pulls self up to stand,

walks holding furniture,

feeds self with fingers

older infancy social ability

shy or anxious with strangers, cries when parents leave, prefers certain people and toys

older infancy cognitive ability

finds hidden options easily, looks at correct picture when image is named, immitates gestures, begins to use objects correctly

infancy head sizes

0-3m = 2cm/m 3-6m = 1cm/m 7-12m = 0.5cm/m

infancy weights

0-5m = 1.5lb/m, birthweight doubles by 5 months, tripples by 12 months, quadruples by 30 months

infancy heights

0-6m = 2.5cm(1inch)/m, increases by 50% by 12 months

infancy dentition

6 - 8 teeth by 1 year, all teeth by 2 years, signs of teething can be rubing their ears

todler ages

1-3 years

todler physical ability

walks alone, pulls toys, begins to run kicks a ball and begins to dress themselves by 24 months, two foot jumps tippy toes by 30 months

todler social ability

tolerates some seperation, immitates behaviors, temper tantrums, increase independence, parallel play

todler cognitive ability

forms memories of events by 13 months, object pertinent is fully developed, sort by colors and shapes and plays make believe by 24 months

2 year old vocab

2 word sentences, 20-200 words, 50% understood, draws lines and circles

3 year old vocab

3 word sentences, 75% understood, draws cricles and triangles

4 year old vocab

4 word sentences, 100% understood, draws squares

todler weights

gain 1.8-2.7kg per year (4-6lbs)

todler heights

grow 7.5 cm per year (3inch)

Todler toileting signs of readyness at

18 months to 3 years

signs of toileting readyness

dry for atleast 2 hours of time

should have dental provider by

1 years old

preschool ages

3-6 years, young child is less than 5

preschool phsycial ability

climbs walls, walks on stairs, pedals tricycle, bends over without falling, ties shoes by 5

preschool social ability

shows affection, can take turns, knows mine vs his, 3-4 piece puzzles, computer games

preschool cognitive ability

makes mechanical toys work, matches objects in hand to piuctures, sorts obejcts by shapes/colors

school aged ages

young=6-9, old=10-12

school aged phsycial ability

perminent teeth emerge

school aged social ability

peer group play, sports, bullying, need for privacy

school aged cognitive ability

conceptual thinking, learn to tell time

early school age congnition

judgement guided by reard/punishments

older shcool aged cognition

opinons of peers/teachers are more valuable

Adolecsent ages

12-20

adolescent social/cognitive ability

self view as invisible causing risky behaviors

small bp cuff causes

increased bp

big bp cuff causes

decreased bp

iron stores provided by mom decreases by age

4 months in full term babies