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78 Cards in this Set
- Front
- Back
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age able to walk without help
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13 mo
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milestones 15 mo
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- walks w/o help (by 13 mo)
- uses cup - 4-6 words - asks by pointing - tolerates some separation - less fear of strangers |
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When does the ant fontanelle close?
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12 - 18 mo
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milestones 18 mo
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- AF closed (12 - 18 mo)
- throws ball overhand - use spoon - > 10 words - points to objects and body parts - inc temper tantrums - dependency on transitional objects |
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Rough estimate of height
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2x height at 24 mo
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milestones 24 mo
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- calculate adult health 2x
- toilet training ready - stairs climbing - kick ball, turn doorknob - 300 words, 3 phrases - develops awareness that feelings/desires f others are different |
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when are are baby teeth complete?
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- 30 months, 20 teeth
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milestones 30 mo
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- 20 teeth
- stand on 1 foot - give first and last name - name color - may attend toilet needs w/o help (minus wiping) |
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UTI in children
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may cause frequent urges and accidents, especially in young girls
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nighttime wetting is a concern when
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6 yo or older
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sibling rivalry
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- most pronounced in first born
- dethronement |
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temper tantrums
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- consistency - popular during bedtime - ie can provide consistency and expectations w/ "after story, bedtime"
- time outs - best to ignore behavior, but provide comfort once over - positive reinforcement |
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negativism
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- is not a sign of stubbronness
- a way of asserting self control - present choices rather than giving yes or no questions |
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regression
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- child unable to cope with threats to autonomy
- a source of comfort, however may lose newly acquired skills - best to ignore, while praise behavior that is appropriate |
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physiologic anorexia
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- 12 - 18 mo, slow growth rate, dec need for calories,
- 18 mo dec appetite - picky, fussy eaters |
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precaution for feeding toddlers
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- using food as rewards may cause overeating for nonnutrivtive reasons
- forcefeeding may hinder development of pleasure associated with eating - toddlers will generally eat the necessary amt for growth. ie during growth spurts is parallelled with increased interest in food |
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toddler mv safety
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- toddlers may transition to forward facing when 20lbs AND 1 yo
- don't use addt'l blankets and paddings under car seat - need to fit snugly against seat |
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a child should be able to dress oneself at what age
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3yo
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When does a child transition from parallel play to associative play?
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3-4 yo
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a child should be able to dress oneself at what age
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3yo
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sexual exploration
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- usually occurs 4yo
- best to get rid of curiosity, then move on |
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milestones 3yo
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- night time bladder control
- tricycle, up down stairs using both feet - 900 words, asks many questions - dresses self - play is parallel and associative - begins understanding of time (past present future) |
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amblyopia
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- lazy eye - decreased ability to see in a certain eye
- caused by brain ignoring visions from an abnormal eye - high potential at 4yo |
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strabismus
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- eyes not properly aligned
- muscular or neuro |
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strabismus vs amblyopia
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- not the same
- strabismus is improper alignment - amblyopia is decreased ability to see in one eye - strabismus may cause amblyopia (brain ignores one eye because of misalignment) |
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A child should be able to catch a ball by
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4yo
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milestones 4 yo
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- max potential for amblyopia
- catches ball reliably - uses scissors, adds 3 parts to stick figure - 1500 words, tells exxag stories - associative play - sexual exploration - obeys but does not know right from wrong |
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when do permament teeth erupt?
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starts at 5yp
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when can a child skip and hop on 1 foot
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5 yo
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When can a child tie
shoelaces |
5 yo
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milestones 5 yo
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- eruption of perm teeth
- skip on one foot, tie shoelaces - 2100 words - more responsible, eager to please, cheat to avoid losing - tolerates others differences, more able to see from another point of view |
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discipline preschooler
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- requires consistency, and immediate discp after action bc don't make assoc with wrong for long
- time out - 1 min / years of age ie 2 yo, 2 min time out |
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Parent's 4 yo has been eating less and less. What to do?
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- it is normal for 3-5 year old to decrease appetite, because of decrease caloric need
- never force feed, may contribute to overeating later in life - quality much more important than quality |
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Sleep terror vs nightmares
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sleep terror,
- child is partially aware, and inconsolable - little intervention is needed. guide child back to bed. it is a normal phenomenon. nightmares - child is aware, and is reassured by presence of others - console child - don't allow to sleep in bed (child may be unable to develop confidence in tackling fears by herself). |
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Milestones 6yo
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- loses first tooth
- describes object rather than counting them - bathe w/o supervision - steal money/attractive items, difficulty owning misdeeds - cheat to win, more indpendeint - has own way of doing things |
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Milestones 7yo
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- jaw expansion
- concept of time to nearest 1/4 hour - likes to help and have a choice - single sex play |
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milestones 8-9 yo
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- fluid graceful movement, cursives writing
- has collections - routine chores - interested in boy-girl relationships but won't admit it - enjoys organizations, clubs, group sports |
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milestones 10-12 yo
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- girls - puberty
- raises pets - able to look after oneself or other children - has best friend, developing interest in opposite sex |
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What to do when permanent tooth falls out?
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= avulsion
- best results when reimplant tooth (reestablish blood flow to tooth) - also can place under tongue (child or parent), or in cold milk |
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Sexual maturation in girls
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= stages of development of secondary sex charac
- thelarche - breast buds, 9-13 yo - adrenarche - pubic hair, 2-6 mo later - menarche - 2 years after thelarche, 10.5-15 yo |
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Sexual maturation in boys
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= stages of development of secondary sex charac
- early puberty - testic enlarg, scrotal changes, pubic hair, 9.5 - 14yo - middle puberty - inc mucle, voice, facial hair - gynecomastia in 1/3 - late puberty - inc L&W of penis, first ejac, axillary hair |
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incidence of gynecomastia
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1/3 of boys during middle puberty
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milestones of early adolescence
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- 11-14 yo
- peak velocity growth - comparison of normality with same sex peers - trying out roles, conformity - attractiveness - mood swings, anger - intense daydreaming |
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milestones middle adolescents
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- 15 - 17 yo
- enjoys intellect, concern with political, soical, philosph problems - rich fantsy life, IDEALIST - Plural relationships, feeling of being in love |
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milestons late adolescents
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- 18-20 yo
- abstract thought, intellectual and func identity established - body image, gender role nearly secure, mature sexual identity - dating, emotions more constant |
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enuresis
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bed wetting
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bed wetting
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= enuresis
- impt to figure out cause - investigate organic before psychological causes (stress, sexual abuse) |
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criteria fo bed wetting
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2x a week for at least 3 mo, past 5 yo
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treatment for enuresis
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1. bladder training, fluid restrictionbefore bet, devices to condition a reflex response, interruption of sleep to void
2. meds second line - triciyclic antidepressants - antidiuretics (DDAVP) - Anticholinergics (Ditropan - dec bladder contractions and urgency) |
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BMI formula
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weight in kg/ height in meters^2
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overweight, obese BMI for children?
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overweight - 85-95%
obese > 95% |
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criteria for ADHD diagnosis
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- symptoms must be present before 7yo
- must be present in at least 2 settings (ie school and home) - must not symptom of another disorder |
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ADHD drugs
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psychostimulants - inc dop and nor, stim inhibition of CNS
- ritalin - methylphenidate hydrochloride - dexedrine - dextramphetamine sulfate non stimulant - nor inhibitor - strattera |
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side effects of ADHD medication
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psychostimulants
- nervousness, tic, insomnia, inc BP - decreased appetite and subsequent weight loss |
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chicken pox
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- cause - varicella zoster virus
- highly pruritic rash - macule --> papule --> vesicle --> dried crust - distrubution - sparse on distal limbs and less on areas not exposed to heat - nursing - contact, airborne isolation - bathe, clean clothes, keep cool, apply pressure rather than scratch - avoid use of aspirin (Reyes's sundrome) |
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roseola
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- cause - herpes human virus type 6
- fever, rash - discrete rose pink macules, nonpruritic, fades on pressure - distrub - starts on trunk, then neck, face, extremities - nursing - antipyretics |
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measles
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- aka rubeola (virus)
- koplic spots on bucal mucosa before rash - rash - maculopapules begin in face, spreads downward - as it progresses, earlier sites become confluent and later sites (legs) are discrete - nursing - isolate until 5th day of rash |
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small irregular red spots with minue bluish white center seen in bucal mucosa
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koplik spots
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koplik spots
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- small irregular red spots with minue bluish white center seen in bucal mucosa
- prodromal for measles (rubeola) |
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mumps
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- paramyxovirus
- prodromal - fever, headache, malaise, "earache" aggravated by chewing - parotid glands infected, enlarged, painful |
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pertussis
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- cause - bordatella pertussis
- short, rapid coughs followed by whooping inspiration - paroxysms continue until thick mucous plug dslodged - nursing - provide oxygen during paroxysms |
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rubella
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- aka german measles
- low grade fever, cough - pinkish red maculopapule rash appears on face, spreads rapidsly down (covered by 1st day) - rash leaves in order of appearance, gone by 3rd day |
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rubella vs rubeola
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rubella = german measles
- pinkish red maculopapular exanthema - rash first appaears face, spreads rapidly down - rash leaves in order of appearance - benign - fever malaise, cough rubeola = measles - koplik spots, then maculopapular on face, spread downwards - progression leads to confluence in face, and discrete lesions in extremities - fever malaise, cough |
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pinkish red maculopapules. first appears on face, spreads to neck arms trunks legs by first day. leaves in order of appearance. gone by 3rd day
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German measles aka rubella
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maculopapules on face, gradually spreads down. pgroression leads to confluence in face and chest, and discrete lesions in extremities.
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measles aka rubeola
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fever headache, malaise, earache. swollen , painful parotid glands
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mumps
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discrete rose pink macules first on trunk, spread outwards. nonprutic and fades with pressure
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exanthem subitum (roseola)
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pruritic rash, centripital distribution.
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varicella
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newborn conjunctivitis usually caused by
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- Neisseria gonorrhea and chlamydia
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pinworms aka
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enterobiasis
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most common helminthic infection
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pinwors aka enterobiasis
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treatment and diagnosis for pinworms
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- tape test for diag
- mebendazole, not recoommneded for <2yo |
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when caretakers deliberately exxagerate or fabricate histories and symtoms or induce symptoms in a child
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munchausen syndrome by proxy
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munchausen syndrome by proxy
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when caretakers deliberately exxagerate or fabricate histories and symtoms or induce symptoms in a child
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where does lead settle inthe body
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- bones and teeth
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imp factor for lead poisoning in children
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iron def anemia makes lead more readily absorbed
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acute signs of lead poisoning
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- nausea vomiting, constipation anorexia and abdominal pain
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effects of lead poisonint
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- in children, susceptible to neurological effects because of developing brain and nerv sys
- hearing impairment, mental retardation, paralysis, blindness, coma death |
