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70 Cards in this Set
- Front
- Back
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four principles of child develpment
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- child development proceeds along a predictable pathway
- range of normal development is wide - various physical, social, and environmental factors, disease can affect child development and health - child's developmental level affects how to conduct history and PE |
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screening procedures for all children
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growth parameters, developmental screening, bP after infancy, vision and hearing at certain ages
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screening for high risk patients
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tests for lead poisoning, TB exposure, anemia, cholesterol, URIs, STDs
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infancy
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first year of life
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neonatal period
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first 28 days
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postneonatal period
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29 days to 1 year
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when are newborns most responsive
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1-2 hours after feeding
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when is the APGAR calculated
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1 and 5 minutes after birth
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apgar score of normal, some nervous system depression, and severe depression on 1-minute apgar score
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- normal 8-10
- moderate 5-7 - severe 0-4 (immediate resuscitation) |
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apgar score of normal and high risk for subsequent CNS and other organ system dysfunction at 5 minutes
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- normal 8-10
- high risk 0-7 |
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heart rate score of 0, 1, 2
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0= absent
1= <100 2= >100 |
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respiratory effort of 0,1,2
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0= absent
1= slow, irregular 2= good, strong |
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muscle tone of 0,1,2
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0= flaccid
1= some flexion of arms and legs 2= active movement |
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reflex irritability of 0,1,2
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0= no responses
1= grimace 2= crying vigorously, sneeze, or cough |
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color score of 0,1,2
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0= blue, pale
1= pink body, blue extremities 2= pink all over |
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classification for preterm, term, and postterm gestational age
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preterm <37 weeks
term= 37-42 wks postterm >42 wks |
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extremely low, very low, low, normal birth wts
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- <1,000 g
- <1,500 g - <2,500 g - >/= 2,500g |
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SGA, AGA, LGA percentiles
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SGA= <10
AGA= 10-90 LGA= >90 |
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commonly seen in LGA infants
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- diabetic mother
- metabolic abnormalities shortly after birth and congenital abnormalities |
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preterm AGA infants are more prone to
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RDS, apnea, PDA with L->R shunt, infection
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preterm SGA infants more likely to experience
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asphyxia, hypoglycemia, and hypocalcemia
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extremities of breech babies
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legs and head extended
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extremities of frank breech babies
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abducted and externally rotated
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position of normal newborns lying down
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symmetric position, with limbs semiflexed and legs partially abducted at the hip
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tremors present 4 days after birth
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signal CNS disease from many causes- asphyxia to drug withdrawal
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asymmetric movements of arms or legs at any time suggest
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central or peripheral neurologic deficits, birth injury, or congenital abnormalities
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core elements: what a newborn can do
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- use all 5 senses
- have a personality - interact dynamically with caregiver |
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complex newborn behavior
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- habituation: selectively shut out negative stimuli
- attachment: reciprocal bonding with caregiver - state regulation: modulate level of arousal in response to different degrees of stimulation - perception: regard faces, turn to voices, quiet when hear singing, track colorful objects, respond to touch, recognize familiar scents |
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newborn without core or complex behavior could indicate
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neurologic condition, drug withdrawal, serious illness
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infants birth weight and height change by 1 year
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weight should have tripled and height increased by 50%
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how old when infants can lift the head and clasp hands
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3 months
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infant can roll over, reach for objects, turn to voices, sit witout support
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6 months
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infant standing and putting everything in it's mouth
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1 year
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age when recognize examiner as a stranger deserving wary cooperation, seek comfort from parents during exam, actively manipulate reachable objects
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9 mo
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language progression
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cooing at 2 months
babbling at 6 months 1-3 words by 1 year |
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known reasons for developmental delays
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prenatal insult, hereditary and genetic disorders, environmental and social problems, pregnancy or perinatal problems, childhood diseases
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sensitivity and specificity of DDST (which areas particularly are weak)
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very specific but not very sensitive; language section misses children with mild language delay
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recommendation for health supervision visits at what ages
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birth, within first week, 1,2,4,6,9,12 months
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reduced growth velocity
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drop in height percentile on growth curve- signifies chronic condition
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growth velocity is less in first or second year?
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less during second year
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chronic conditions causing reduced length or height
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neurologic, renal, cardiac, endocrine disorders
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common scenarios indicating failure to thrive
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growth <5th percentile for age
growth drop >2 quartiles in 6 months weight for height <5th percentile |
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small head size can indicate
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premature closure of sutures or microcephaly
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microcephaly can result from
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familial or chromosomal abnormalities, congenital infections, maternal metabolic disorders, neurologic insults
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macrocephaly and causes
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>97th percentile
- hydrocephalus, subdural hematoma, brain tumor, inherited syndromes |
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familial megaloencephaly
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benign familial condition with normal brain growth
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best method to obtain BP from an infant
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Doppler method
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normal systolic pressure in male babies at birth, 1 month, 6 months
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70 mmHg
85 mmHg 90 mmHg |
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heart rates for birth-2 mo
0-6 mo 6-12 mo |
90-190 (140)
80-180 (130) 75-155 (115) |
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pulse rate that is too fast to count indicates what
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paroxysmal supraventricular tachycardia
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bradycardia results from
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drugs, hypoxia, intracranial or neurologic conditions, cardiac arrhythmia
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range or RR for infants
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30-60
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extremely rapid and shallow respirations
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cyanotic cardiac disease and R to L shunting; also metabolic acidosis
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fever on RR
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raise RR by up to 10 resp/min for each degree Centrigrade
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tachypnea and increased RR in an infant signs of
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possible pneumonia
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tachypnea for birth-2 months and 2-12 months
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>60/min
>50/min |
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what types of temperatures are inaccurate in infants and children
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axillary and thermal-tape
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fever that warrants prompt evaluation
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>100.0 F in infants <2-3 months
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temperature instability in a newborn may result from
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sepsis, metabolic abnormality
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cutis marmorata
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premature infants and infants with congenital hypothyroidism and Down syndrome
- persistent in Menke's disease |
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cutis marmorata description
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vasomotor changes in dermis and subcutaneous tissue- response to cooling or chronic exposure to radiant heat- latticelike, blue mottled appearance on trunk, arms, legs
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acrocyanosis
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blue cast to hands and feet when exposed to cold- common in first few days
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when is acrocyanosis worriesome
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if does not disappear within 8 hours or with warming- think cyanotic congenital heart disease
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harlequin dyschromia
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transient cyanosis of one half of the body or one extremity from temporary vascular instability
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skin desquamation can indicate
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placental circulatory insufficiency or congenital ichthyosis
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erythema toxicum and pustular melanosis
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look like vesicular rash or herpes or staph aureus but are benign
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jaundice within 24 hours of birth
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hemolytic disease of newborn
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normal physiologic jaundice occurs in half of newborns when
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appears on day 2 or 3; peaks at 5th day; gone by week
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salmon patch
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nevus simplex, telangiectatic nevus, capillary hemangioma- flat, irregular, light pink patches on nape of neck, upper eyelids, forehead, upper lip- disappear by 1 year
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sturge weber syndrome
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port wine stain on ophthalmic nerve of V distribution
- seizures, hemiparesis, glaucoma, mental retardation |
