Pediatric Nursing - Week 2 - Genetics, Infants Toddlers Preschoolers

Front 1

Turner vs. Klinefelter syndrome

Back 1

Turner - XO - female phenotype
Klinefelter - XXY or XXY - feminized male

Front 2

Genetic testing reveals baby will be born with XO sex chromosomes. What is this called? What are clinical manifestations?

Back 2

Turner's syndrome - webbed neck, low posterior hairline, beefy hands and feet (edema), widely spaced nipples. Puberty - short stature, delayed sexual development, socially awk but normal intelligence.

Front 3

Genetic testing reveals baby will be born with XXY sex chromosomes. What is this called? What are clinical manifestations?

Back 3

Klinefelter's syndrome. Male phenotype with feminized features presented during puberty - gynecomastia, feminized pubic hair pattern, well developed genitalia but small testes, may have high voice. May have lower IQ

Front 4

What is aneuploidy? examples?

Back 4

any deviation from 46 chromosomes. ie klinefelters xxy, turner's xo, trisomy 21

Front 5

What is mosaicism?

Back 5

body is made up of cells with varying genetics - mixed cell populations. ie calico cats

Front 6

What is the pattern of acquiring motor skills?

Back 6

cephalocaudal (head to toe) proximodistal (trunk to extremities)

Front 7

What is the immunologic benefit in breastfeeding?

Back 7

infants are not able to produce IgA, which protects the mucosal lining against infection (GI and GU). Breastmilk transfers mother IgA to baby. It also confers immunity to which the mother was exposed

Front 8

What is the oily white substance coating neonatal body? What is function?

Back 8

vernix caseosa - has immunologic properties that protect from infection, thermal regulation, and prevents transipdermal water loss

Front 9

Milestones for 1 mo.

Back 9

-obligatory nose breathing
-head lag
- hands closed
- watches face

Front 10

milestones for 2 mo.

Back 10

post fontanel closed
- lifts head 45 deg when prone
- strong grasp reflex
- coos, social smile

Front 11

milestones for 3 mo.

Back 11

- holds rattle
- squeals to show pleasure
- "talks" when spokein to
- interested in surroundings
- recognizes familiar objects, faces

Front 12

milestones for 4 mo.

Back 12

- drooling begins
- rooting disappereas
- plays with hands, grasps objects withboth hands
- laughs aloud
- demands attention (fussing)

Front 13

milestones for 5 mo.

Back 13

- birth weight doubles
- begins teething
- rolls belly to back
- grasps objects voluntarily
- object directly to mouth

Front 14

milestones for 6 mo.

Back 14

-rolls back to belly
- sits with support
-hold bottle
- grasps feet and pulls to mouth
- holds arms up to be picked up

Front 15

milestones for 7 mo.

Back 15

- tripods (sit with hands in front for support)
- bears weight on feet
- transfers and rakes objects
- bababa dada kaka
- "talks" when others talk

Front 16

miletsones for 8 mo.

Back 16

regular elimination patterns
- sits without support
- reaches for toys
- stranger anxiety peaks

Front 17

milestones for 9 mo.

Back 17

-crawls
- pulls up to stand
- crude pincer grasp
- comprehends no-no

Front 18

milestones for 10 months

Back 18

- change from prone to sitting
- mama and dada meaning undetood
-says hi & bye, waves bye bye
- object permanence

Front 19

milestones for 11 mo.

Back 19

cruises (walk while holding onto furniture), neat pincer grasp

Front 20

milestones for 12 mo.

Back 20

- birth weight triples
-walks with one hand held
- 3-5 words besides dada nad mama
- undestands simple commands (give it to me)
- security blanket/toy

Front 21

Explain thumb sucking and pacifier use effects.

Back 21

- For preterm babies, sucking increases weight gain, improves pain mangement -
- For infants, It is thought to cause dental maloccusion, but only when secondary teeth are coming in.
- it also is proven to reduce SIDS if used while sleeping.
- American academy of peds recommends limited pacifier use.

Front 22

What are signs of teething?

Back 22

fussiness, drooling, LOW GRADE fever, biting hard objects, inflamed gums

Front 23

How might you suggest a parent treat signs of teething?

Back 23

-frozen teething ring
-ice wrapped in washcloth for inflmmation.
- baby orajel is sometimes used, MUST USE AS DIRECTED. more is not better. benzocaine overdose is lethal.

Front 24

How many teeth should an 8 month old have?

Back 24

for first 2 years of life, can calculate suggested teeth amount : Age (mo.) - 6 = # teeth. so 8 mo. - 6 = 2 teeth.

Front 25

how many teeth should a 15 mo. have?

Back 25

for first 2 years of life, can calculate suggested teeth amount : Age (mo.) - 6 = # teeth. so 15 mo. - 6 = 9 teeth.

Front 26

tooth eruption progresses in what manner?

Back 26

two lower incisors, two upper incisors, two upper lateral incisors, two lower lateral incisors

Front 27

What is recommended length of time for breast milk intake?

Back 27

first 6 mo.

Front 28

What should you tell pt. about feeding their baby?

Back 28

All infants should receive daily supplement of Vit D (200IU) in first 2 mo of life. Iron fortified cereals after 4-6 mo. no water juice. solids between 5-6 mo.

Front 29

When should solids be introduced?

Back 29

5-6 mo

Front 30

when should iron supplements be introduced in baby's diet? why?

Back 30

4-6 mo if breastfed exlusively. this offsets the lack of maternal iron stores. (fortified cereals).

Front 31

what is recommended sequence of types of solid foods introduced into infant's diet?

Back 31

1. iron fortified cereals
2. vegetables (b/c won't eat it if applesauce comes first)
3. fruits
4. meat

Front 32

When can veggies, fruit, meats be introduced?

Back 32

8-10 mo

Front 33

when can eggs and cheeses be introduced?

Back 33

12 mo

Front 34

why should juice be avoided in infants?

Back 34

empty calories. infants need fatty whole milk and other high calorie foods til 2yo for proper brain growth

Front 35

What are kinds of active immunities?

Back 35

natural - diseases. artificial - immunizations. create your own antibodies.

Front 36

What are kinds of passive immunity?

Back 36

ready made antibodies. natural - maternal antib. artificial - from elsewhere.

Front 37

baby teeth aka

Back 37

deciduous teeth

Front 38

how can parents prevent nursing caries in infants and toddlers?

Back 38

don't allow them to take bottle of milk to a bed

Front 39

What is normally used to introduce baby to solid foods and why?

Back 39

Iron fortified cereals. The iron is used to supplement the depletion of fetal iron stores (4-6 mo) and because of weaning from milk.

Front 40

What is the benefit of mixing fruit juices with cereal?

Back 40

vit C enhances iron absorption

Front 41

How does one cultivate a widely-ranged palate for a child?

Back 41

introduce many kinds of foods for first year, when they are more likely to eat them. Toddlers are picky, and less foodventurous.

Front 42

What vaccines should not be given in an immunocompromised patient?

Back 42

live vaccines. ie MMR and varicella (chicken pox)

Front 43

What injections are given at birth

Back 43

VIt K and HepB

Front 44

What childhood immunizations should not be given to pregnant women?

Back 44

Rubella, Varicella

Front 45

When receiving the meningococcal vaccine, an important consideration is?

Back 45

hypersensitvity to diptheria toxoid

Front 46

What are contraindications for Rotavirus?

Back 46

HIV+ mothers, immunodeficiencies

Front 47

hypersensitivity vs allergy vs intolerance

Back 47

- hypersensitivities include both allergies and intolerances.
- allergies produce immune response (inflammation, runny nose, sneezing, wheezing).
- intolerance is malabsorption/digestion, and has no immunologic response.

Front 48

What immunoglobin is responsible for allergies

Back 48

IgE

Front 49

What is the statistrics for atopy?

Back 49

atopy = hereditary tendency for allergies. child with allergic parent = 50% or more. child with 2 allergic parents = 100%.

Front 50

Name two strategies to avoid atopy.

Back 50

breastfeeding and selective introduction of solid foods.

Front 51

What solid foods should parent avoid to prevent allergies?

Back 51

dairy products until 12 mo. eggs until 24 mo. nuts, fish, seafood until 36 mo.

Front 52

What is the method to preventing food allergies?

Back 52

- wait to introduce highly allergic foods until later (nuts, fish).
- breastfeeding exclusively for first six months.

Front 53

When should whole milk be introduced into a child's diet?

Back 53

12 mo.

Front 54

lactose intolerance

Back 54

= lactase deficiency

- may be primary (late onset) or secondary (to diseases that effect GI)

- best treatment is elimination, but Vit D and Ca need supplementation
- probiotics proven to help
- small amounts may be tolerated
- milk may be taken better with a meal rather than alone
- yogurt contains inactive form of lactase, activ by pH and temp of duodenum

Front 55

How can regurgitation be prevented?

Back 55

- frequent burping
- placing on R side, head elevated

Front 56

FTT

Back 56

= failure to thrive = inability to obtain or use calories
- organic = physical cause
- inorganic = psychosocial cause
- idiopathic

Front 57

Positional plagiocephaly

Back 57

= misshapen skull, commonly due to sleeping supine

Front 58

SIDS risk factors

Back 58

- maternal smoking or near infant
- soft beddings, toys, blankets
- co sleeping
- overheating