NURSING PEDIATRICS EXAM 1 GUIDE

NURSING PEDIATRICS EXAM 1 GUIDE

The anterior fontanel most often closes when? Correct -between 12 - 18 months of age.-It may normally close as early as 9 months of age.

Where do primary teeth first erupt? Correct The lower central incisors are usually the first to appear, followed by the upper central incisors.

Start brushing them as soon as they come in at 5-7 or 6-8 months.

Car Seats Correct Infant - 2 years of age: Rear-facing car seat.

5-point harness seat is made for children up to 40 pounds (18 kilograms) & the booster seat for children from 40 to 80 pounds (18 to 36 kilograms).

Infants at 4 months Correct Infants typically turn over front to back at 4 months, enlarging the area of the house that needs to be childproofed.

Primitive Reflexes: at what point do they disappear? Correct -Step reflex: 4-8 weeks

-Suck: 2-5 months

-Root Reflex (Stroke cheek): 3 months

-Moro: 4-6 months

-Tonic neck reflex: 4 months

-Palmar grasp reflex: 4-6 months

-Tongue Extrusion reflex: 4-6 months

-Plantar grasp: 9 months

-Babinski reflex (fanning of toes when sole of foot stroked) by 12 months. [last to go]

Protective Reflexes & emergence Correct -Neck righting: 4-6 months

-Parachute (sideways): 6 months

-Parachute (forward): 6-7 months

-Parachute (backward): 9-10 months

Infants at 7-10 months Correct -Sit up *w/ assistance* by 7 months -Transferring an object from one hand to the other expected at 7 months.

-*8 months: sit up independently*

-8 months: *Stranger Anxiety* starts, gets worse

-*Crawl at 9 months*

-Pull to standing at 10 months.

Gross & fine motor skills develop Correct in a cephalocaudal fashion

Capacity of the normal newborn's stomach is Correct between 1/2 - 1 ounce

Babies are considered newborn (or perinatal) Correct birth - 28 days, then they are infants (till 12 months).

By 1 year of age, the infant's weight should Correct have tripled their birth weight & grown 10 to 12 inches (25 to 30 cm) or length increases by 50%.

-Most infants double their birth weight by 4-6 months of age & triple their birth weight by

• year old.

Toys - age appropriate: birth - 4 months Correct Birth - 1 month: -mobile w/ contrasting colors -unbreakable mirror -soft bright colored toys

1-4 months: (all toys above +)

-bright mobile -rattles -singing parent -high contrast in books/images

What age does a child start playing with their hands? Correct Around 3 months

Toys - age appropriate: 4 - 12 months Correct 4-7 months: -Fabric or board books -Different types of music -Easy-to-hold toys that do things/make noise (fancy rattles) -Floating, squirting bath toys -Soft dolls/animals

8-12 months:

-Plastic cups, bowls, buckets, unbreakable mirror -Large building blocks -Stacking toys -Busy boxes (w. buttons/knobs that make things happen) -Balls -Dolls -Board books with large pictures -Push-pull toys (older infants)

What age can a child use a spoon? Correct 18 months

Colic Correct -Inconsolable crying lasting 3 or more hours/day w/ no physical cause, more prevalent in evenings.-May begin as early as 2 wks -Treatment is a restful, soothing environment.

-Typically resolves by 3 months of age.

When is the first social smile? Correct 2 months

Maturation, Growth & Development Correct Maturation = increase in functionality of various body systems or developmental skills.Growth = increase in physical size.Development = sequential process by which infants & children gain various skills & functions.

Foods commonly associated with ALLERGIES in infants/young children Correct - Cow's milk -Peanut butter -Strawberries -Wheat -Egg Whites

+any small foods child can choke on (hot dog slices, popcorn, etc)

Erikson's psychosocial developmental task for the infant is Correct to develop a sense of trust (Trust vs Mistrust)

Ch 26: Average Toddler Weight & Height Correct -Average toddler weight gain is 1.36 to 2.27 kg (3 - 5 lb) per year.-Length/height increases by an average of 7.62 cm (3 inches) per year.-Toddlers generally reach about half of their adult height by 2 years of age!

Ch 26: Toddler Head Circumference Correct -Increases about 2.54 cm (1 inch) b/t 1 &

• years age, then increases avg of 1.27 cm (1/2 inch) per year until age 5.

-Head circumference (reflective of brain growth) reaches about 90% of its adult size by

• years of age, when it is measured until.

-Head size becomes more proportional to rest of body near age of 3 years.

Ch 26: Typical toddler appearance Correct Rounded abdomen (d/t still-weak

abdominal muscles), a slight swayback, & a wide-based stance.

Infant HR & RR Correct HR: 80-150

RR: 25-55

-Infants normally display uneven/irregular breathing pattern, w/ short pauses b/t some breaths.-This may be accentuated when they are ill

Toddler HR & RR Correct As a child grows into a toddler, their:

-HR decreases

-BP increases

HR Norm: 70-120

RR Norm: 20-30

Preschooler HR & RR Correct HR: 65-110

RR: 20-25

BP taken usually once per visit starting at age 3, unless issue present. (text pg 1170)

School Age HR & RR Correct HR: 60-100

RR: 14-22

Adolescent HR & RR Correct HR: 55-95

RR: 12-18

Erikson defines the toddler period as a time of Correct -Autonomy vs Shame & Doubt.

• a time of exerting independence

-struggle for self-mastery

Toddler Walking heel to toe by age Correct 3 years

DTaP Correct -Diphtheria, Tetanus and Pertussis

Given as a series of five injections:

—at 2, 4, & 6 months; -between 15 & 18 months, -between 4 & 6 years

Newborn hearing test Correct Auditory brainstem response (ABR) or the brainstem auditory-evoked response (BAER) is used for newborns.

Hearing Test 4 & 6 year olds Correct -Pure tone & Whisper test are used to assess auditory acuity in children who are 4 years or older.-Weber & Rinne tests are used in children who are ages 6 or older.

Frequency of Child Health Supervision Visits Correct Health supervision visits for children without health problems & appropriate growth/development are recommended

at:

-Birth & within first week of life -1 month -2 months -4 months -6 months -9 months