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30 Cards in this Set
- Front
- Back
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agpar scale
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heart: 0 absent; 1 <100; 2 > 100
RR: 0 absent; 1 weak/irregular; 2 good/crying Muscle tone: 0 flaccid; 1 arms/legs flexed; 2 well flexed Reflex irritability: 0 no response; 1 grimace; 2 cough/sneeze Skin color: 0 blue/pale; 1 hands/feet blue; 2 completely pink 1 minute - 3-4 severe cardiopulmonary - resuscitative measures needed while 5-6 mild depression repeated at 5 minutes and score 8 or more is normal. |
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common chronic childhood ailments
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Children: asthma, seizures, eczema, recurrent ear infections, UTIs, sickle cell disease, cystic fibrosis, diabetes, GERD, and cerebral palsy.
Preterm: chronic lung disease, nutritional problems, developmental difficulties, or sensory defects. |
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Childhood milestones
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speak their first words? 10-12 months
verbalize up to 10 words? 15 months have a vocabulary up to 200 words? 2 years put multiple words together into a phrase? 2 years have a 1500 word vocabulary? 3 years use most of the grammar of their primary language? 6 years |
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birth notation
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G3 P2-0-0-2 --> Gravid # pregnancies; Para # birth/pregnancy outcomes; #1 – full term births; #2 – miscarriages, #3 – abortions, #4 – living children
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leading causes of death for:
1st year? 1-14 yo? injury related: under 1? 2-14? |
1st year? unintentional injury and SIDS
1-14 yo? injury injury related: under 1? airway obstruction 2-14? airway obstruction |
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age groups of children
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Neonatal: birth- 1 week
Infant: 1 week-1 year Toddler/early childhood: 1-5yrs Late childhood: 6-12yrs Adolescent: 12-22yrs. |
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infant vital signs
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Respiration Rate – Anywhere from 20-80. Avg. 30-50. Monitor 2 minutes
HR – 120 – 140 by auscultation; 190 when crying, lower than 90 is concern PMI – Xiphoid; moves left in development; right = dextrocardia Termperature rectally and variable, get ambient temperature |
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infant measurments
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Length – 18.5 – 20.5”
Head circumference – 13.5 – 14.5” Chest circumference – nipple b/w inhale/exhale – smaller head by ¾ - 1.2” |
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Brachial plexus injuryies:
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Erb’s palsy C5/C6 – can’t abduct/ext rot/fl elbow/sup forearm
Klumpke’s paralysis – C7/C8 – paralysis forearm/hand. Absent grasp reflex. Involvement of T1 = ptosis/miosis horner’s syndrome |
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vitals at various ages
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Neonatal:HR:120-140 b/m Resp: 30-50
Infant:HR: 1st 6 Mo: 130 b/m. 2nd 6 MO: 110 b/m Resp: 20-40 Toddler:HR: 100 b/m (AVG.) Resp: 20-40 Child:HR: 75-125 b/m Resp: 15-20 Adolescent:HR: 60-100 b/m Resp: 12-18 |
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visual accuity milestones
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Age 4wks: Infants eyes should be able to fixate on and follow a target.
Age 8wks: child should be able to visually follow object and coordinate head movement Age 4mth: child can visually follow object in all directions and convergence is present Age 5-6mth: child can focus on objects but is farsighted; ability to reach out and grasp objects Age 1-3: assessed by their ability to ID brightly colored objects and circumnavigate the room. Avg. visual acuity at age 3 is 20/40 Age 4-5: Starting at age 4 children should have routine visual exams using the illiterate E (pediatric eye chart w/ pictures) Avg. visual acuity at age 4/5 is 20/30 In children older than 4 confrontation (using a toy instead of finger), ocular motility, fields of gaze, and cover test as needed when suspicion of decreased acuity |
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congestive heart failure in pediatric patient
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Most important signs are persistent Tachycaardia, tachypnea & enlarged liver.
Tachycardia: more than 200bpm in newborns and 150 in 1yr olds is red flag Feeding problems are often 1st sign that infant has heart problems. (Takes 1hr to ingest 1-2oz) Child will become tired or out-of-breath during feedings Diaphoresis, cyanosis and failure to thrive are also important signs |
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liver - infant, child, adolescent
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infant: 6 mo 1 -1.2"; 1 yr 1.2"
Child: 3 yr 1.5"; 5 yr 2" Adolescent: 8 yr 2 - 2.2"; 2.2 - 2.6" |
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impetigo
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One of the most common skin conditions of young children that is highly contagious. It is a superficial skin infection caused by a group A beta-hemolytic streptococcus or Staph Aureus
Vesicopustulethat once ruptured produces a honey-colored crust surrounded by a rim of erythema. |
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bladder control age? nighttime bladder control
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4 yo
50% dry at night by then |
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HEADS
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H – home – how are things at home? [sometimes do you feel safe at home?]
E – education – how is school going? [fights? Suspensions] A – activities/alcohol – clubs? Sports? Alcohol? D – drugs/depression – how is your mood? Describe mood? Drugs use? S – safety/sex – ever had sex? |
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Vascular nevi
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hemagiomas (MC infant tumors). Flat, dilated capillaries or mass lesions, large blood filled cavities
Port wine – nevus flammeus – permanent, flat, irregular, pink/purple macular Sturge – weber syndrome – port wine of ophthalmic CN5 capillary hemangiomas of ipsilateral meninges/occipital cerebral cortex = MR, seizures, hemiparesis, contralateral hemianopsia, glaucoma |
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Telangiectases
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eyelids, glabella, nape of neck – disappear in 1st year – stork bites, angel
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Strawberry nevus
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cap. Hemangioma – bright red protuberant lesion – face, scalp, back, anogenital area. Develops in 1st 2 months, girls, expand, stationary, then regresses. Disappear b/w 5 – 9 yo.
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Cavernous hemangioma
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deep, cystic, compressible, bluish hue, trachea = life threatening, Klippel-trenaunay syndrome related
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Café au lait
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hypopigmented macules, 1-2 not uncommon, more than 6 greater than 0.5 cm = neruofibromatosis I = freckles, scoliosis, pseudoarthris, pigmented harmatomas (lisch nodules), benign Schwann cell tumors
Ash leaf hypopigmented macules with rough side = tuberous sclerosis complex = adenoma sebacum, shagreen patches, benign brain tumors, kidney, heart, MR, seizures |
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Erythema toxicum
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macules, papules, and pustules 40% healthy newborns. Not on palms/soles. 3-4 days after birth.
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Milia
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50% newborns – tiny white papules cheeks, nose, chin, forehead. Gone 3 wks
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Fingernails
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post term long and yellow if stool was in placenta; fetal Etoh – hypoplastic
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Caput succedaneum
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edema of soft tissues over the vertex of the skull that is related to the birth process during a vertex delivery
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Kawasaki disease-
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Kawasaki disease-mucocutaneous lymph node syndrome. Unknown cause. Most frequent cause of Acquired Heart Disease in children (1-5). Rash, Erythema Multiforme. Fever for atleast 5 days
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Oomphalocele-
Gastrochisis- |
Oomphalocele-severe umbilical hernias in where some abdominal contents are located outside body. Always deals with umbilicus, ALWAYS midline.
Gastrochisis-from embryonic vascular deficiency. Abdominal contents outside body also, but NEVER midline. |
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Hypospadias
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Hypospadias-meatus is located in abnormal ventral position. Contraindication to circumcision.
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Galeazzi Sign
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Galeazzi Sign-checking a short knee to see if it is due to a dislocation of the hip on that side or a congenitally short femur, or both.
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Barlow’s maneuver
Ortolani maneuver- |
Barlow’s maneuver-flex legs 90 degrees at hip and 90 degrees at knee. Hold legs with thumbs over midthigh medially and index fingers over greater trochanters. Bring knee to midline and gently press back toward exam table. Feel for a “clunk” as an unstable femoral head slips past the post. Rim of acetablulum and dislocates from socket (pg. 765)
Ortolani maneuver-sign of relocating the femoral head into the acetablum. Abduct hip whil applying pressure over greater trochanter and push femoral head anterior. A “clunk” indicates that the hip is relocating in the socket. |
