Peds exam 2 cram

Principle of child growth and development

Myelination in cephalocaudal & proximodistal direction

this means that baby gains proper control from top to bottom. Baby can hold head and neck up first, then can sit up, then can walk.

Plagiocephaly

Back of the skull becomes flat because baby has been laying on back too much. Do TUMMY TIME to prevent this and to strengthen neck muscles

Pierre Robin syndrome

Displaced, small chin, bird like facies.

basically kiddo has a weak chin and will get mogged later in life :(, jk but surgery can correct it because it can start to cause breathing issues

Craniosynostosis/craniostenosis

Skull closes before its supposed to. Brain keeps growing but skull isnt accommodating. can cause eye swelling and bruising bcs of pressure. Surgery is the treatment, dont get sutures wet

capillary hemangiomas (strawberry hemangiomas)

Basically a benign tumor of blood capillaries that goes away naturally at 5-12 years old. Bright red and rubbery but not dangerous at all. No tx needed

Mongolian spot

Hyperpigmentation spot on body (commonly lower back), that looks like a bruise that fades by 3 years old. Make sure to document/take photos because this could be mistaken for abuse if not documented at birth.

Milia

Small bumps on skin caused by oil glands being blocked. Goes away at 2 months.

Erythema Toxicum Neonatorum

Benign rash that babies get in the first few days of life. Called "Flea-bite dermatitis" and "Newborn rash", resolves within 1 week.

Herpes Simplex

If mom has it we try to do C section to prevent transmission

Apnea of Prematurity

Premature baby stops breathing for more than 20 seconds bcs their body cant recognize they are hypoxic.

Tx: aminophylline, Caffeine (WAKE UP HO, but be careful of toxicity which increases hr, vomiting, and restlessness), CPAP, and tactile stimulation (whack it a little bit)

Respiratory distress syndrome

Baby lacks surfactant (which keeps the alveoli open), lungs gets stiff and moves less, fluid increases and resp distress occurs. Tx is INO or ECMO

Bronchopulmonary Dysplasia

Chronic lung condition when baby is on vent for too long and lungs get damaged.

RF: premie, pneumonia, pulmonary HTN, congenital heart disease, vent for too long

Tx: stay on vent, fluid restriction, diuretics, inhaled steroids, reduce o2 concentration

Retinopathy of Prematurity

Premie babies on oxygen's blood vessels in the eyes get weird and can pull the retina away and cause retinal detachment and blindness.

Seizures in babies

Main cause is hypoxic-ischemic encephalopathy. During birth baby doesnt get enough oxygen and brain gets injured.

Seizures look like lip smacking, tongue movement, and eye rolls.

Jitteriness is hypoglycemia NOT a seizure!!!

Necrotizing Enterocolitis (NEC)

baby has immature intestines with bad blood flow and weak immune system. bacteria can take over very easily (esp if formula fed). Tissue can become necrotic and cause peritonitis.

tx: NPO, breast feed, NGT decompression, IV abx and fluids, TPN.

Fetal alcohol syndrome

Shawty looks like syndey sweeney. Thin upper lip, flat middle section of face (maxilla), failure to thrive, poor muscle tone, developmental delays. (ig she doesnt have great jeans :P)

Phenylketonuria

Body cant breakdown an amino acid(phenylalanine). Just know this is autosomal recessive and can caused diet and growth issues.

Growth and development of an infant

Double birth weight by 6 months

Triple birth weight by 1 year

Posterior fontanel closes at 6-8 weeks

Anterior fontanel closes at 12-18 months

Questions about infants the homies remembered

When a 6 month old hears a sound how will it react: will roll head to side.

When can it imitate sounds: 6 months (sounds has 6 letters idk)

When a baby understands the word "no": 9 months (you should have said NO to having that baby 9 months ago)

When does it say mama or dada: 10 months (mama is a 10 #futuremilf)

When does it get object permanence: 12-24 months

Erickson stage for infants

Trust vs mistrust.

Parent should start to recognize cues of baby anxiety

Infant pacifier use

increases risk of otitis media, but decreases SIDS risk bcs sucking keeps that brain active. ALSO KEEP BABY SUPINE TO DECREASE SIDS RISK

Teeth in babies

Number of teeth should be age in months (<2 years) - 6

example: 18 months old - 6 = should have 12 teeth

Heating up formula/breast milk

Microwaving formula: take lid off so heat escapes

Microwaving breast milk: DONT DO IT (it kills the antibodies or something)

Important vitamins for babies

D, B12, A, D, E, K

basically all of them but C ig

Kwashiorkor

Basically baby gets enough calories but not enough protein (me asf), this causes acites and muscle wasting due to the lack of protein. Kiddo gets a big belly

Marasmus

Low calories and protein. loose and wrinkled skin, small head

What to do with left over breast milk after it has been used once

Throw it away bcs babies mouth can contaminate it and introduce bacteria

What vitamins should you give to a patient with anemia?

Iron, B12, Vit C

SIDS

My brother almost had this but my mom shook him upside down and homie started breathing again.

Risk factors: smoke, alcohol, sleeping prone, too tightly swaddled, Upper resp infection, hx of sids, cosleeping

Apnea in infants born after 37 weeks

get cpr certified bcs you cant stop this, can only react.

Diaper dermatitis

Diaper rash

tx: steroid creams, antifungals, ointment, barrier cream, fragrance free products

Sleep issues

Dyssomias: trouble sleeping, trouble staying awake through the day.

Parasomnias: confusion, sleep walking, night terrors.

Seborrheic Dermatitis (Cradle Cap)

Thick yellow scaly patches on scalp, wash kiddos hair and scrape plaques off gently

Atopic Dermatitis (Eczema)

Keep nails short/clean, bathe every other day to avoid overdrying, topical steroids and histamines, abx, emollients

Head size of babies 1-3

Head circumference = chest circumference

Block stacking milestones

15 months: 2 block tower

18 months: 3-4 block tower

24 months: 6-7 block tower (hehe)

30 months: 8 block tower

12-36 month erickson stage and development

Autonomy vs shame and doubt

Negativism: offer kiddo 2 choices so it cant say no.

Kiddos like routines and find comfort in them, read a book to them every night

Potty training criteria

Willingness to please parents

Kiddos throwing tantrums

Its how they deal with frustration, illness, hunger, fatigue (kiddo cant fully communicate with words so this is how they communicate)

duration should be less than 15 minutes, and should stop by 5 once they can communicate better

Milk choices

12 months: whole/2% milk to help myelination

>24 months: low fat milk bcs its done developing that stuff so STOP BEING FAT

3-5 years old erikson stage

Initiative vs guilt

Shift from me me me thinking into social awareness (some people we know never developed this !!!)

Increased awareness of self and others, normal sexual exploration and curiosity of their bodies

Temperament affects adaptability to new situations, can start to have aggression.

3-5 year olds issues

Speech: kiddo got a speech issue= early detection and therapy for best outcome

Stress: kiddo starts to regress to a younger age when the stress wasn't happening

Fears: the dark (me too little dude)

3-5 year olds sleep and dental

Bedtime rituals and quiet activities are important like a story or bath to help decrease sleep issues

Primary teeth fully come out in preschool years, give oral fluoride supplements if needed, make sure they dont get fluorosis

3-5 year olds injury prevention

dont give them legos yet

Intra-thecal injection site

into the CSF

Nightmares vs sleep terrors

Nightmares: REM (deep sleep)

Sleep terrors: NON-REM (you arent in deep sleep which is why kiddo can start moving/feels more real to them, ensure safety)

Kiddo ingests something bad

They wrote something about an opaque cup and plastic straw idk

Acids or aspirin: GIVE ACTIVATED CHARCOAL

Heavy metal poisoning: IV chelation therapy (EDTA or BAL if level >70)

Child abuse

Risk factors: substance abuse

Shaken baby syndrome: Causes retinal hemorrhaged, subdural hemorrhade, and no external trauma

Munchausen syndrome by proxy: just think of gypsy rose

Physical abuse: injuries in various healing stages, stories inconsistent with development (baby got hurt riding bike)

Sexual abuse: often by MALE caregiver/trusted adult

Nursing care for a pt facing abuse

Be caring but dont act as a substitute parent

Iron deficiency

Give fortified cereals

Idiopathic thrombocytopenic purpura

Acquired hemorrhagic disorder following an URI with decreased platelets