Pediatricts (copy)

key points to know for a ped exam

speak to adult first then child, encourage parent to be involved with child, keep medical equipment out of sight, and communicate with simple words

an invasive procedure should always be

last

example of an invasive procedure

bp cuff, ear exam, eye exam

what does invasive procedure mean

test that don’t include touching the child such as counting respirations

the average height an infant should grow per month

1 inch

when should infants eat solids

at 4-6 months

when should a infant be introduced to a new food

once per week

fontanelles should slightly pulsates when

the baby cries, coughs, and lies flat

when should the posterior fontanelle close

2 months

when should the anterior fontanelle close

12-18 months

respiratory distress in an infant

nasal flaring, nonproductive cough, abdominal breathing and accessory muscle use

high pitched crying in an infant indicates

increased ICP or brain damage

when should an infant start growing teeth

at 6-10 months

signs of teething

drooling and irritability

interventions for teething

teeth care with a washcloth

babinski reflex

a reflex that shows within 0-12 months that include toes fanning out once the sole of the foot was stroked

rooting reflex

a reflex that shows within 0-4 months that include the baby sucks in the direction of where a person stroked their mouth

tonic neck reflex

a reflex that shows within 0-4 months that include a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up. Like its fencing

stepping reflex

This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet

moro reflex

a normal reflex for an infant when he or she is startled or feels like they are falling. The infant will have a startled look and the arms will fling out sideways

how much milk should a toddler drink

16-24 oz or 2-3 cups a day

how much juice should a toddler have

4-6 oz per day

safety teaching for car seats

have the car seat rear facing and in a 45 degree angle, use until child is 30lbs or 12, Never put padding behind or under the seat,

a preschooler should grow as tall as

2-3 inches per year

a preschooler should weigh as much as

4.5 - 6.5 pounds per year

heart rate for a neonate (1-28 days)

110-180

heart rate for an infant

110-160

heart rate for a toddler

80-110

resp for a neonate (1-28 days)

30-60

resp for an infant

30-60

resp for a toddler

24-60

bp for a neonate (1-28 days)

systolic is 60-90, diastolic is 20-60

bp for a infant

systolic is 70-105, diastolic is 35-55

bp for a toddler

systolic is 85-105, diastolic is 40-65

what type of infant shouldn’t use a rectal temp

if they’re immunosuppressed, cardiac condition, on chemotherapy or radiation , or fecal impaction

gross motor skills

abilities that let us do tasks that involve large muscles

fine motor skills

The movement and use of hands and upper extremities

gross motor skills for a 1 month old

head lag

gross motor skills for a 2-3 month year old

starts to kick legs

when does a baby start to coo and smile

at 2-3 months

when does head lag diminish

at 4 months

when does a baby start to roll from their front to their back

at 5 months

fine motor skills for a 4-5 month old

grabs rattle

when does a baby mimic sounds that was heard

4-5 month old

when does a baby roll from the back to the front

6 months

gross motor skills for a 6-9 month old

rolls from back to front, can sit up unsupported, and can pull themselves up

when does a baby start holding a big bottle

at 6 months

when does a baby transfer objects from one hand to the other

7 months

a baby starts babbling words such as “mamma” and “dada” and responds to name at

9 months

a child starts to have separation anxiety at

6 months

fine motor skills at 10 months

pincer grasp, grabs rattle or doll by arm, and transfers objects hands to hands

gross motor skills at 12 months

crawls and walks steps while holding someons’s hand

fine motor skills at 12 months

fully developed 2 finger pincer grasp, builds 2 blocks, attempts to turn book pages

language a 12 months old uses

says 3-5 words and nonverbal gestures such as waving

when does object permanence start

at 12 months

gross motor skills for an 18 month old

walks up and down stairs, throws ball

fine motor skills for an 18 month old

turns 2 pages in a book, holds cup and spoon, builds tower of 4 blocks

language for an 18 month old

uses 10+ words, follows commands such as “dont touch”, uses gestures

gross motor skills for a 2 year old

runs and kicks ball, walks up and down stairs

fine skills for a 2 year old

builds a tower of 7 blocks, opens doors, draws vertical lines

language for a 2 year old

says their own name, says 2-3 word sentences, and says 300+ words

when should a kid be toilet trained

at 2 years old

gross motor skills for a 3 year old

uses a tricycle and jumps forward, learns balance

fine motor skills for a 3 year old

draws circles, spoon feeds themselves, undresses themselves, uses scissors

language for a 3 year old

says 3-4 word sentences, asky why alot, follows more complex instructions

gross motor skills on a 4 year old

skips and hops on 1 foot, catches ball 50% of the time, climbs and jumps

fine motor skills on a 4 year old

draws 4 sided shapes, can pour drinks and make foods

kawasaki disease

a rare heart condition that causes a high fever and inflammation of the blood vessels.

kawasaki disease symptoms

• unresolved Fever lasting for at least five days.

• red tongue

• Red or pink eyes without discharge.

• cracking of child’s lips or tongue.

• Swelling and/or redness of your child’s hands or feet.

• Peeling of your child’s skin

kawasaki disease interventions

monitor for gallops, decreased urine output, and check temp regularly

intussusception

a condition in which one segment of intestine "telescopes" inside of another, causing an intestinal obstruction (blockage). Although intussusception can occur anywhere in the gastrointestinal tract, it usually occurs at the junction of the small and large intestines.

pinworms

parasitic worms that live in the intestines and rectums of infected people.

symptoms of pinworms

anal itching that gets worse at night

pyloric stenosis

the pylorus muscles thickens and become abnormally large, blocking food from reaching the small intestine. It can lead to forceful vomiting, dehydration and weight loss.

rheumatic fever

a rare autoimmune disease that causes inflammation of your child’s tissues and organs. Healthcare providers also call it acute rheumatic fever. The condition occurs when your child’s immune system overreacts to an untreated strep throat or scarlet fever infection.

symptoms of down syndrome

cardiac murmur, flat nasal bridge, small mouth and nose

Phenylketonuria

Mutations in both copies of the PAH gene that causes a person to not process the amino acids that people eat. The body is sensitive to phenylalanine andd too much phenylalanine in the body damages your brain.

what does the The PAH gene do

gives your body instructions to make an enzyme (phenylalanine hydroxylase) that's responsible for converting amino acids into components (proteins) that your body can use

marfan’s syndrome

a defect in the gene that enables the body to produce a protein that helps give connective tissue its elasticity and strength. It most commonly affects the heart, eyes, blood vessels and skeleton.

Marfan syndrome symptoms

• scoliosis

• Tall and slender build

• Heart murmurs

• Disproportionately long arms, legs and fingers

• A breastbone that protrudes outward or dips inward

• A high, arched palate and crowded teeth

• Extreme nearsightedness

• An abnormally curved spine

• Flat feet

marfans syndrome interventions

avoid contact sports,

Muscular dystrophy

a group of diseases that cause progressive weakness and loss of muscle mass.

Osteogenesis imperfecta

A disorder that a child is born with may that causes them to have soft bones that break (fracture) easily, bones that are not formed normally, and other problems.

nursing interventions for a nose bleed

sit up and lean forward, put pressure on the nostrils, and put a cold pack on the bridge of the nose

hemophilia

a rare disorder in which the blood doesn't clot in the typical way because it doesn't have enough blood-clotting proteins (clotting factors). A patient would bleed for a longer time after an injury

immunization a baby gets a birth

hepatitis b

immunizations a baby gets at 2 months

• DTaP

• RV

• Hib

• IPV

• PCV (pneumococcal vaccine)

when does a baby get their first flu shot

6 months

immunizations at 12 months

• MMR

• hepatitis a

• DTaP

• Hib

• PCV

• varicella

at what age would a baby get the hepatitis b shot

0, 2, and 6-18 months

at what age would a baby get the rotavirus shot

2,4, and 6 months

at what age would a baby get the IPV shot

2,4,6 months and 4-6 years

at what age would a baby get the pcv shot (pneumococcal conjugate vaccine)

2,4,6, and 12 months

at what age would a baby get the Hib shot

2,4,6, and 12 months

at what age would a baby get the DTaP shot

2,4,6, and 12 months and 4-6 years

at what age would someone get the MMR shot

1 and 4 years old

at what age would someone get the VAR shot

1 and 4 years old

at what age would someone get the hepatitis a shot

1 and 2 years

at what age would someone get the HPV shot

9-12 years old

at what age would someone get the MCV (meningitis)

11-12 years old