Pediatrics Final Exam Content Review

Flashcards for vocabulary review

Growth

Increase in physical size, including height, weight, and head circumference, often plotted on a standardized chart.

Development

The sequential process by which infants and children gain various skills and functions, often measured using models like the Denver model.

Infant Weight Growth

Weight doubles by 4-5 months and triples by 1 year.

Infant Length Growth

Increases by 50% during the first year.

Posterior Fontanel

Closes by 2 months.

Anterior Fontanel

Closes by 12-18 months.

1-month-old Gross Motor Skill

Lifts and turns head when prone; head lag.

2-month-old Gross Motor Skill

Raises head and chest; improving head control.

3-month-old Gross Motor Skill

Raises head 45 degrees when prone; slight head lag.

4-month-old Gross Motor Skill

Lifts head and looks around, rolls prone to supine.

5-month-old Gross Motor Skill

Rolls supine to prone to back; sits upright with support.

6-month-old Gross Motor Skill

Tripod sits.

7-month-old Gross Motor Skill

Sits alone with hand support.

8-month-old Gross Motor Skill

Sits unsupported.

9-month-old Gross Motor Skill

Crawls, abdomen off floor.

10-month-old Gross Motor Skill

Pulls to a stand and cruises.

12-month-old Gross Motor Skill

Moves from sitting to standing walks independently.

1-month-old Fine Motor Skill

Fists mostly clenched, involuntary hand movements.

3-month-old Fine Motor Skill

Holds hand in front of face, hands open.

4-month-old Fine Motor Skill

Bats at objects.

5-month-old Fine Motor Skill

Grasps rattle.

6-month-old Fine Motor Skill

Releases object in hand to take another.

7-month-old Fine Motor Skill

Transfers object from one hand to the other.

8-month-old Fine Motor Skill

Gross pincer grasp (raking).

9-month-old Fine Motor Skill

Bangs objects together.

10-month-old Fine Motor Skill

Fine pincer grasp, puts objects into container and takes them out.

11-month-old Fine Motor Skill

Offers objects to others and releases them.

12-month-old Fine Motor Skill

Feeds self with cup and spoon, makes simple mark on paper, pokes with index finger.

Atraumatic Care

A philosophy of providing therapeutic care through interventions that minimize physical and psychological distress for children and their families.

Toddler Neurologic Development

Brain reaches about 90% of size by age 2; Increased myelinization improves coordination, balance, and sphincter control.

Toddler Respiratory Development

Alveoli increase in number until age 7; Trachea and airways small compared to adult; tonsils and adenoids are large relative to size of oral cavity.

Toddler Cardiovascular Development

Heart rate decreases; blood pressure increases.

Toddler Gastrointestinal System Development

Stomach increases in size; small intestine lengthens; less frequent stools; bowel control typically achieved by end of toddler period.

Toddler Genitourinary System Development

Bladder and kidney reach adult function by 16 to 24 months; bladder capacity increases; urine output 1 mg/kg/hour; urethra remains relatively short.

Toddler Musculoskeletal System Development

Bones increase in length; muscle matures; swayback and “pot belly” due to weak muscles until 3 years old.

School-Age Neurologic Development

Brain and skull grow very slowly; cognitive processes mature.

School-Age Respiratory Development

Respiratory rates decrease; respirations are diaphragmatic in nature.

School-Age Cardiovascular Development

Blood pressure increases and pulse rate decreases.

School-Age Immune Development

System matures to adult level around 10 years of age; fewer infections.

School-Age Gastrointestinal Development

Deciduous teeth replaced by permanent teeth; fewer GI upsets; stomach capacity increases; caloric needs are lower but appetite may increase.

School-Age Genitourinary Development

Bladder capacity increases (age in years + 2 ounces); prepubescent occurs.

School-Age Musculoskeletal Development

Greater coordination and strength; muscle still immature and easily injured.

Risk Assessment

Includes objective and subjective data to determine likelihood child will develop a condition; performed by the provider with the child and/or parent

Universal Screening

Screening of an entire population regardless of the child's individual risk.

Selective Screening

Done when a risk assessment indicates the child has one or more risk factors for a disorder.

Newborn Screenings (Metabolic)

Looks for metabolic and other disorders (CF, CAH, sickle cell, thyroid, PKU etc)

Newborn Screenings (Hearing)

Universal screening of all infants and children

Newborn Screenings (Vision and color discrimination)

All infants and children, performed at every scheduled health supervision visit.

Newborn Screenings (Iron-deficiency anemia)

Routine screening in all children; assessing for risk factors related to iron-deficiency anemia at 4, 15, 18, 24, and 30 months, then annually and performing a hematocrit or hemoglobin at 12 months.

Newborn Screenings (Lead)

Risk assessment, screening if positive at 6, 9, 12, 18, and 24 months and at 3, 4, 5, and 6 years.

Newborn Screenings (Hypertension)

Routine screening > 3 years or risk factors.

Newborn Screenings (Hyperlipidemia)

Universal screening 9 and 11 years, 18 and 21 years or risk factors.

Newborn Screenings (Mental Health)

Annual screening beginning at age 11.

Testicular Torsion Priority Interventions

Surgical emergency to prevent ischemia that may lead to infertility.

Sepsis Priority Interventions

Intravenous antibiotics are started immediately after the blood, urine, and cerebrospinal fluid cultures have been obtained.

Epiglottis Priority Interventions

Airway maintenance and support, IV abx.

Meningitis Priority Interventions

Positive Brudzinski and Kernig signs can indicate irritation of the meninges; not reliable in children under age 2; Abx; Lumbar puncture; Airway maintenance; Droplet transmission precaution.

Mild Dehydration

alert and oriented, soft and flat fontanels, normal eyes, pink and moist oral mucosa, elastic skin turgor, normal heart rate and blood pressure, warm pink and brisk cap refill extremities, slightly increased urine output

Moderate Dehydration

alert to listless, sunken fontanels, mildly sunken orbits eyes, pale and slightly dry oral mucosa, decreased skin tugor, may be increased heart rate and normal blood pressure, delayed capillary refill extremities, less than 1 mL/kg/hr urine output

Severe Dehydration

alert to comatose, sunken fontanels, deeply sunken orbits eyes, dry oral mucosa, Tenting skin tugor, increased or bradycardia heart rate and normal or hypotension blood pressure, cool mottled or dusky significantly delayed capillary refill extremities, significantly less than 1 mL/kg/hr urine output

Oral Rehydration Therapy

ORS (oral rehydration solution) should contain 75 mmol/L sodium chloride and 13.5 g/L glucose.

NOT appropriate solutions for oral rehydration therapy

tap, water broth, undiluted fruit juice, milk, and soup

Preschoolers time-out period

1 minute of time-out per year of age

Warning signs of autism

Does not imitate, lack of interest in joint attention, eye contact abnormalities, delayed language development, failure to develop symbolic-imaginative play, Losing language skills or social skills at any age

FLACC Pain Scale

intended for 2 months to 7 years of age, Nonverbal or preverbal patients who are unable to self report pain

Wong-Baker Faces Pain Scale

pain rating scale (ages 3+, emoticon-like faces) ,3 years and older, Pain rated on a scale of 0-5 using diagram of faces

Oucher Pain Scale

(ages 3+, actual photos of children, must know number values)

Non Communicating Children’s Pain Checklist

(ages 3+, behaviors observed for 10 minutes then six subcategories rated 0-3 vocal, social, facial, activity, body and limbs, physiological,

Hepatitis A (Hep A) Inactivated Vaccine

Prevents liver infection caused by the hepatitis A virus.

Influenza (Flu shot) Inactivated Vaccine

Protects against the seasonal influenza virus

Polio (IPV) Inactivated Vaccine

Prevents poliovirus infections that can cause paralysis.

Rabies Inactivated Vaccine

Protects against the rabies virus, especially post-exposure.

Measles, Mumps, Rubella (MMR) Live Vaccine

Protects against these three viral infections.

Rotavirus Live Vaccine

Prevents severe rotavirus gastroenteritis in infants

Smallpox Live Vaccine

Protects against the smallpox virus (now largely historical use).

Varicella (Chickenpox) Live Vaccine

Prevents chickenpox.

Yellow Fever Live Vaccine

Protects against yellow fever, particularly for travelers to endemic areas.

IM: Diphtheria, Tetanus, Pertussis (DTaP, DT, Tdap)

Prevents bacterial infections affecting the respiratory system and nervous system.

IM: Haemophilus Influenzae Type B (Hib)

Prevents bacterial meningitis and other Hib diseases.

IM: Meningococcal (MenQuadfi and MenB)

Prevent meningitis caused by meningococcus

s/s Otitis media (without effusion)

Resulting from infection (bacterial or viral) of fluid in the middle ear

s/s: Otitis media with effusion

Otitis media with fluid within the middle ear space, without signs or symptoms of infection

s/s Otitis externa

Infection and inflammation of the skin of the external ear canal and Moisture in the canal contributes to pathogen growth

abnormal heart sound VSD:

loud, harsh murmur auscultated at the left sternal border

abnormal heart sounds ASD:

systolic murmur (fixed split second heart sound may be heard)

abnormal heart sounds PDA:

systolic murmur (machine humming)

Pulmonary stenosis heart sounds:

systolic ejection murmur

Aortic stenosis heart sounds:

possible ejection murmur

Tetralogy of Fallot heart sounds:

systolic murmur

Pulmonary stenosis tetralogy of fallot

narrowing of the pulmonary valve and outflow tract, creating an obstruction of blood flow from the right ventricle to the pulmonary artery

VSD- ventricular septal defect tetralogy of fallot

opening in the heart between right and left ventricle (allowing for mixing of oxygenated and deoxygenated blood within the heart; blood is shunted left to right)

Overriding Aorta tetralogy of fallot

enlargement of the aortic valve the extent that it appears to arise from the right and left ventricles rather than the anatomically correct left ventricle.

Right Ventricular Hypertrophy tetralogy of fallot

the muscle walls of the right ventricle increase in size due to continued overuse as the right ventricle attempts to overcome a high-pressure gradient (from stenosis)

Clinical manifestations of Tetralogy of Fallot

cyanosis at birth, progressive over first year of life; systolic murmur; episodes of acute cyanosis and hypoxia

tet spells intervention

Knee-chest position- FIRST ACTION (this decreases amount of deoxygenated blood circulating from lower extremities and increases afterload)

Active immunity:

Antibodies received from exposure to disease or immunizations Long lasting

Passive immunity

Antibodies received from an external source (mother to baby, IVIG)

Cellular immunity

Antibodies produced by native T-cell lymphocytes. Activiated at birth

Humoral:immunity

Antibodies produced by native B-cell lymphocytes.

Febrile seizures:

Most common type in children younger than 5 years; Peak: 12 and 18 months; Boys > Girls Family history; Viral illness; Benign; complications are rare