CMN 571 EXAM STUDY GUIDE
When should a child not be vaccinated? - Answer -In a few cases, it's better to wait to
get a vaccine. Some children who are very sick should not get a vaccine at all. Reasons
that you should wait or not get a vaccine may include:•Being sick with something more
serious than a cold.
•Having a bad reaction after the first dose of a vaccine
.•Having a convulsion that is thought to be caused by a vaccine.
Vaccination information sheets basics - Answer -•Must provide a copy of the VIS sheet
to the patient / explain before giving the vaccine. •Document the vaccine given, who
gave it, where, lot # and manufacture #.
active immunity - Answer -Active immunity is usually permanent.Acquired through
exposure and infection with the disease or artificially acquired through
immunization.Onset is a few weeks and usually last a lifetime
passive immunity - Answer -A person is given antibodies to a disease rather than
producing their own & it is short -term immunity. ( Example Mother to baby).
herd immunity - Answer -This occurs when a significant portion of the population
isvaccinatedandthat provides a portion of immunity for those that havenot developed
immunity. The population (herd) helps prevent disease in the unprotected population.
The herd protects those who can not safelyget vaccinations. Generally 90 -95% of the
population should bevaccinated to haveeffective Herd immunity.
covid-19 highlights for parents & vaccinations - Answer -Encourage parents to keep
children's recommended immunizations UTD. Identify children who have missed well
child visits and / or vaccinations and recommend they catch-u p. Strongly encourage in-
person appointments for those newborn - 24 months.
covid 19 teaching for patients about spreading - Answer -Practicepreventionstrategies
tohelpmitigatethespread of the virus: Wash hands, Social distance, keep home clean
and children 2 and above wear a cloth face mask when around people they don't live
with.
multi system inflammatory syndrome (MIS-C) - Answer -Multisystem Inflammatory
Syndrome (MIS-C) is a condition where different body parts can become inflamed,
including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.Children
with MIS-C may have a fever and various symptoms, including abdominal (gut) pain,
vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. Thisis a
medicalemergencyandtheseschildrenneedemergencycare immediately.
,Your child may still be vaccinated if he or she has: - Answer -• A low-grade fever (less
than 101 degrees) • A cold, runny nose, or cough • Ear infection (otitis media) • Mild
diarrhea
medical home - Answer -medical home is defined as the setting that provides
consistent, continuous, culturally competent, comprehensive, & sensitive care to
children & their families. It is a setting that advocates for all children, whether they are
typical or have developmental challenges or disabilities. By incorporating the principles
of child development—the concept that children are constantly changing—the medical
home is the optimum setting to underst& & enhance typical development & to address
variations, delays, & deviations as they may occur in the life trajectory of the child & the
family
Autism Spectrum Disorder - Answer -ASD is a neurologic disorder characterized by
Two core features: Persistent deficits in social communication and social interaction
across multiple contexts AND Restricted, repetitive patterns of behavior, interests, or
activities.
grouped under the pervasive developmental disorders in the DSM-IV with Asperger
disorder, childhood disintegrative disorder (CDD), and Rett syndrome. DSM-5 combines
autism, PDD, and Asperger syndrome into ASDs
specific current severity of ASD - Answer -Severity is based on social communication
impairments and restricted, repetitive patterns of behavior.
1-2 mo - Answer -Activities to be observed:
Holds head erect and lifts head.
Turns from side to back.
Regards faces and follows objects through visual field.
Drops toys.
Becomes alert in response to voice.
Activities related by parent:
Recognizes parents.
Engages in vocalizations.
Smiles spontaneously.
3-5 mo - Answer -Activities to be observed:
Grasps cube—first ulnar then later thumb opposition.
Reaches for and brings objects to mouth.
Makes "raspberry" sound.
Sits with support.
Activities related by parent:
Laughs.
Anticipates food on sight.
Turns from back to side.
6-8 mo - Answer -Activities to be observed:
,Sits alone for a short period.
Reaches with 1 hand.
First scoops up a pellet; then grasps it using thumb opposition.
Imitates "bye-bye."
Passes object from hand to hand in midline.
Babbles.
Activities related by parent:
Rolls from back to stomach.
Is inhibited by the word no.
Parental Well-being - Answer -It is of utmost importance that parents seek help if they
are feeling overwhelmed, sad or depressed after the birth of a baby. Instruct mom to get
rest when she can. Sleep when baby sleeps and take help from trusted
friends/family.CAUTION:'Baby Blues may appear suddenly in three or four days of
delivery. Bringing on spells of crying, anxiety, irritation and restlessness. Other
symptoms of 'Baby Blues' includeimpatience, feeling extremely tired, difficulty sleeping,
frequent mood swings, poor concentration, appetite loss, trouble making decisions,
feeling inadequate as a mother.. Due to the rapid hormonal changes some women
become depressed or worse psychotic. (this can be a danger for not only the mother but
the baby as well)
feeding the baby - Answer -Babies should be fed only breast milk or Iron fortified
formula for the first 6 months.
Teaching for the parent with feed their baby: - Answer -Do not give your baby plain
water.Try to feed the baby when they display signs of hunger.Signs of hunger: sucking
or rooting, fussing, or putting hands in mouth. Baby is full when: closes mouth, turns
head away,baby will bite the nipple or fuss when you try to offer the bottle.
Follow these five steps for a good latch with breastfeeding - Answer -1.Find a
comfortable position for you and your baby. You can use pillows if needed for extra
support.
2.Gently support your baby's head and shoulders so he/she is facing you chest to chest.
3.Use your nipple to tickle your baby's upper lip until babies mouth is open wide.
4.Pull your baby onto your breast so that they take the whole nipple and about 1 inch of
your breast into their mouth. Theirlips should be turned outward.
5.To remove your baby from the breast, gently insert your pinky finger into the corner of
your baby's mouth to break the suction and remove baby from your breast.
Breastfeeding baby education - Answer -Breastfeed 8-12 x per dayExpect 6-8 wet
diapers a day.
Avoid spicy food.
Breastfed babies' stools will often be yellow, green seedy/ pasty texture.
May have about 3-4 stools a day or one after each feeding.Remember: All babies' first
stool will be a meconium stool
.Vit D-( 400 IU daily if breast feeding- adequate if bottle)
, formula feeding a baby - Answer -Teaching for the parents:Offer 2oz of formula every
2-3 hours; From birth to one month a baby needs 2 - 4 oz. of formula every 2 -4 hours
or 16 - 24 oz. per day. -if still hungry can give more.
Never prop the bottle.
Look at baby when feeding to promote bonding.
Bottle-fed babies should also have 6-8 wet diapers daily.
Their stools are usually yellow brown pudding texture3- 4 a day.
Newborn care - Answer -Teaching the parent:
FEVER IS VERY SERIOUS IN BABIES 3 MONTHS AND UNDER!!!!
FEVER 100.4 F/38.0 C or higher-This must be evaluated
.Avoid crowds, wash hands frequently and always before touching the newborn.
Babies should avoid the sun. Only use sunscreen if shade is not available.
newborn baby comforting and sleeping - Answer -Comfort baby by rocking and gently
touching the head.Begin regular routines of bathing, feeding, playing and
sleeping.Assist baby with waking by rubbing back, changing diaper, and
clothing.BABIES SHOULD BE PUT TO SLEEP ON THEIR BACKS!Babies should be
placed in a crib in your room without loose bedding, padding or toys.ABC's for Babies
sleep: A= Alone, B= Back, C= Crib babies needs the ABCs of sleep to remain safe and
avoid Sudden Unexplained Infant Death (SUID). It is particularly important during the
first six months, when the incidence (SUID) is the highest.
9-11 mo - Answer -Activities to be observed:
Stands alone.
Imitates pat-a-cake and peek-a-boo.
Uses thumb and index finger to pick up pellet.
Activities related by parent:
Walks by supporting self on furniture.
Follows 1-step verbal commands, eg, "Come here," "Give it to me."
1 year - Answer -Activities to be observed:
Walks independently.
Says "mama" and "dada" with meaning.
Can use a neat pincer grasp to pick up a pellet.
Releases cube into cup after demonstration.
Gives toys on request.
Tries to build a tower of 2 cubes.
Activities related by parent:
Points to desired objects.
Says 1 or 2 other words.
18 mo - Answer -Activities to be observed:
Builds tower of 3-4 cubes.
When should a child not be vaccinated? - Answer -In a few cases, it's better to wait to
get a vaccine. Some children who are very sick should not get a vaccine at all. Reasons
that you should wait or not get a vaccine may include:•Being sick with something more
serious than a cold.
•Having a bad reaction after the first dose of a vaccine
.•Having a convulsion that is thought to be caused by a vaccine.
Vaccination information sheets basics - Answer -•Must provide a copy of the VIS sheet
to the patient / explain before giving the vaccine. •Document the vaccine given, who
gave it, where, lot # and manufacture #.
active immunity - Answer -Active immunity is usually permanent.Acquired through
exposure and infection with the disease or artificially acquired through
immunization.Onset is a few weeks and usually last a lifetime
passive immunity - Answer -A person is given antibodies to a disease rather than
producing their own & it is short -term immunity. ( Example Mother to baby).
herd immunity - Answer -This occurs when a significant portion of the population
isvaccinatedandthat provides a portion of immunity for those that havenot developed
immunity. The population (herd) helps prevent disease in the unprotected population.
The herd protects those who can not safelyget vaccinations. Generally 90 -95% of the
population should bevaccinated to haveeffective Herd immunity.
covid-19 highlights for parents & vaccinations - Answer -Encourage parents to keep
children's recommended immunizations UTD. Identify children who have missed well
child visits and / or vaccinations and recommend they catch-u p. Strongly encourage in-
person appointments for those newborn - 24 months.
covid 19 teaching for patients about spreading - Answer -Practicepreventionstrategies
tohelpmitigatethespread of the virus: Wash hands, Social distance, keep home clean
and children 2 and above wear a cloth face mask when around people they don't live
with.
multi system inflammatory syndrome (MIS-C) - Answer -Multisystem Inflammatory
Syndrome (MIS-C) is a condition where different body parts can become inflamed,
including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.Children
with MIS-C may have a fever and various symptoms, including abdominal (gut) pain,
vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. Thisis a
medicalemergencyandtheseschildrenneedemergencycare immediately.
,Your child may still be vaccinated if he or she has: - Answer -• A low-grade fever (less
than 101 degrees) • A cold, runny nose, or cough • Ear infection (otitis media) • Mild
diarrhea
medical home - Answer -medical home is defined as the setting that provides
consistent, continuous, culturally competent, comprehensive, & sensitive care to
children & their families. It is a setting that advocates for all children, whether they are
typical or have developmental challenges or disabilities. By incorporating the principles
of child development—the concept that children are constantly changing—the medical
home is the optimum setting to underst& & enhance typical development & to address
variations, delays, & deviations as they may occur in the life trajectory of the child & the
family
Autism Spectrum Disorder - Answer -ASD is a neurologic disorder characterized by
Two core features: Persistent deficits in social communication and social interaction
across multiple contexts AND Restricted, repetitive patterns of behavior, interests, or
activities.
grouped under the pervasive developmental disorders in the DSM-IV with Asperger
disorder, childhood disintegrative disorder (CDD), and Rett syndrome. DSM-5 combines
autism, PDD, and Asperger syndrome into ASDs
specific current severity of ASD - Answer -Severity is based on social communication
impairments and restricted, repetitive patterns of behavior.
1-2 mo - Answer -Activities to be observed:
Holds head erect and lifts head.
Turns from side to back.
Regards faces and follows objects through visual field.
Drops toys.
Becomes alert in response to voice.
Activities related by parent:
Recognizes parents.
Engages in vocalizations.
Smiles spontaneously.
3-5 mo - Answer -Activities to be observed:
Grasps cube—first ulnar then later thumb opposition.
Reaches for and brings objects to mouth.
Makes "raspberry" sound.
Sits with support.
Activities related by parent:
Laughs.
Anticipates food on sight.
Turns from back to side.
6-8 mo - Answer -Activities to be observed:
,Sits alone for a short period.
Reaches with 1 hand.
First scoops up a pellet; then grasps it using thumb opposition.
Imitates "bye-bye."
Passes object from hand to hand in midline.
Babbles.
Activities related by parent:
Rolls from back to stomach.
Is inhibited by the word no.
Parental Well-being - Answer -It is of utmost importance that parents seek help if they
are feeling overwhelmed, sad or depressed after the birth of a baby. Instruct mom to get
rest when she can. Sleep when baby sleeps and take help from trusted
friends/family.CAUTION:'Baby Blues may appear suddenly in three or four days of
delivery. Bringing on spells of crying, anxiety, irritation and restlessness. Other
symptoms of 'Baby Blues' includeimpatience, feeling extremely tired, difficulty sleeping,
frequent mood swings, poor concentration, appetite loss, trouble making decisions,
feeling inadequate as a mother.. Due to the rapid hormonal changes some women
become depressed or worse psychotic. (this can be a danger for not only the mother but
the baby as well)
feeding the baby - Answer -Babies should be fed only breast milk or Iron fortified
formula for the first 6 months.
Teaching for the parent with feed their baby: - Answer -Do not give your baby plain
water.Try to feed the baby when they display signs of hunger.Signs of hunger: sucking
or rooting, fussing, or putting hands in mouth. Baby is full when: closes mouth, turns
head away,baby will bite the nipple or fuss when you try to offer the bottle.
Follow these five steps for a good latch with breastfeeding - Answer -1.Find a
comfortable position for you and your baby. You can use pillows if needed for extra
support.
2.Gently support your baby's head and shoulders so he/she is facing you chest to chest.
3.Use your nipple to tickle your baby's upper lip until babies mouth is open wide.
4.Pull your baby onto your breast so that they take the whole nipple and about 1 inch of
your breast into their mouth. Theirlips should be turned outward.
5.To remove your baby from the breast, gently insert your pinky finger into the corner of
your baby's mouth to break the suction and remove baby from your breast.
Breastfeeding baby education - Answer -Breastfeed 8-12 x per dayExpect 6-8 wet
diapers a day.
Avoid spicy food.
Breastfed babies' stools will often be yellow, green seedy/ pasty texture.
May have about 3-4 stools a day or one after each feeding.Remember: All babies' first
stool will be a meconium stool
.Vit D-( 400 IU daily if breast feeding- adequate if bottle)
, formula feeding a baby - Answer -Teaching for the parents:Offer 2oz of formula every
2-3 hours; From birth to one month a baby needs 2 - 4 oz. of formula every 2 -4 hours
or 16 - 24 oz. per day. -if still hungry can give more.
Never prop the bottle.
Look at baby when feeding to promote bonding.
Bottle-fed babies should also have 6-8 wet diapers daily.
Their stools are usually yellow brown pudding texture3- 4 a day.
Newborn care - Answer -Teaching the parent:
FEVER IS VERY SERIOUS IN BABIES 3 MONTHS AND UNDER!!!!
FEVER 100.4 F/38.0 C or higher-This must be evaluated
.Avoid crowds, wash hands frequently and always before touching the newborn.
Babies should avoid the sun. Only use sunscreen if shade is not available.
newborn baby comforting and sleeping - Answer -Comfort baby by rocking and gently
touching the head.Begin regular routines of bathing, feeding, playing and
sleeping.Assist baby with waking by rubbing back, changing diaper, and
clothing.BABIES SHOULD BE PUT TO SLEEP ON THEIR BACKS!Babies should be
placed in a crib in your room without loose bedding, padding or toys.ABC's for Babies
sleep: A= Alone, B= Back, C= Crib babies needs the ABCs of sleep to remain safe and
avoid Sudden Unexplained Infant Death (SUID). It is particularly important during the
first six months, when the incidence (SUID) is the highest.
9-11 mo - Answer -Activities to be observed:
Stands alone.
Imitates pat-a-cake and peek-a-boo.
Uses thumb and index finger to pick up pellet.
Activities related by parent:
Walks by supporting self on furniture.
Follows 1-step verbal commands, eg, "Come here," "Give it to me."
1 year - Answer -Activities to be observed:
Walks independently.
Says "mama" and "dada" with meaning.
Can use a neat pincer grasp to pick up a pellet.
Releases cube into cup after demonstration.
Gives toys on request.
Tries to build a tower of 2 cubes.
Activities related by parent:
Points to desired objects.
Says 1 or 2 other words.
18 mo - Answer -Activities to be observed:
Builds tower of 3-4 cubes.
