Pediatric Reflexes and Development Proctored Q&A: Ace the Exam with Verified Answers [Guaranteed A+ for 2024/2025]

Pediatric Reflexes and Development Proctored Q&A: Ace the Exam with Verified Answers [Guaranteed A+ for 2024/2025] Tonic Neck Reflex - ANS turning the head to one side, extending the arm and leg on that side, and flexing the limbs on the opposite side Birth to 3-8 months Babinski Reflex - ANS Reflex in which a newborn fans out the toes when the sole of the foot is touched First year Baby's birth weight - ANS Double: 6 months Triple: 12 months Infant height - ANS 1 inch (2.5 cm) for first 6 months of life 12 months: Birth length increased by 50% Head lag - ANS By 3 months old - baby should only have SLIGHT____________ 4 months - ANS Reaches out to people; Drools/places objects in mouth Rolls from back to side 5 months - ANS Sleeps thought night Can tell family from strangers Roll from *Front to back* 6 months - ANS Roll back to front Hold bottle 7 months - ANS Moves objects from hand to hand 8 months - ANS Sit unsupported 9 months - ANS Crude pincer grasp (uses all fingers to grab object) Pulls to standing position; cooked, chopped, and unseasoned foods 10 months - ANS Prone to sitting position Grasp rattle by handle 11 months - ANS Put objects into container Neat pincer grasp 12 months - ANS attempt 2 block tower - without success Piaget Birth - 24 months - ANS Senorimotor stage Idea of object perminence; 9 months - know the object exists even though they cannot see it Speaking by 1 year: - ANS 3-5 words Separation Anxiety - ANS 4-8 months Stranger fear - ANS 6-8 months Activities for infants up to 1 year - ANS - Patty cake - Blocks - Rattles - Bright colored toys 2 month visit - ANS 2nd hep B IPV RV PCV DTAP Hib 3 month visit - ANS IPV RV PCV DTAP Hib 6 months visit - ANS IPV RV PCV DTAP Hib and hep B Flu shots start: - ANS 6 months and 1 year Foods for the first 6 months - ANS ONLY breast milk No juice or water for 1st year Introducing new foods - ANS 1 at a time over 4-7 days (checking for allergies) Be mindful of choking (grapes, coins, candy) Crib slats: - ANS No more than 6 cm apart 30 months (2.5 years) of age; weight - ANS 4x their birth weight Toddlers Height - ANS 3 in (7.5 cm) per year Head and chest circumference - ANS Should be equal 15 months skills - ANS Walk without help Build tower of 2 blocks 18 months - ANS Throw ball over hand 2 years - ANS Up and down stairs (placing both feet on each step) Build 6-7 block tower 2.5 years - ANS Jump with both feet Draw circles Speaking 1 year: - ANS 1 word sentence; holophrases Speaking 2 year: - ANS 2-3 word sentence Age appropriate activities for toddlers - ANS - Filling and emptying containers - Playing with blocks - Looking at books - Push-pull toys - Tossing balls - Finger paints - Large-piece puzzles - Thick crayons 12-15 months visit - ANS IPV PCV MMR Varicella Hib 12-23 month visit - ANS Hep A 15-18 month visit - ANS DTAP Flu vaccine Nutrition - ANS Birth-1: breast milk 1-2: full fat milk (whole) 2: Low-fat milk Limit juice 4-6 oz/day Choking hazards: nuts, grapes, raw carrots, peanut butter, tough meat, popcorn Height in preschool children - ANS 2.5 - 3.5 in/year Gross-motor skills preschool - ANS 3 years: - Ride tricycle Jump off bottom step 4 years: - Skip/hop on 1 foot - Throw ball over head 5 years: - Jump rope Piaget Intuitive thought - ANS Age 4 Preschoolers; magical thinking - think something they did can cause something to happen based on what they did - Think inanimate objects are alive (doll, stuffed animal) has feelings and does things Preschool: Initiative vs. Guilt - ANS Preschoolers learn to initiate tasks and carry out plans, or they feel guilty about their efforts to be independent If another baby is born may regress to: thumb sucking, bed wetting Preschool appropriate activities - ANS - Puzzles - Throwing ball - Tricycle (age 3) - Dress up - Role playing 4-6 year visit - ANS DTaP MMR IPV Annual flu shot Preschoolers need sleep - ANS 12 hours Consistent bed time routine; encourage sleeping by themselves Preschool and School age children; weight - ANS 4.4-6.6 lbs per year School age children; height - ANS 2 in/year Permanent Teeth - ANS School age children (6 years) Piaget Concrete operation - ANS Able to see perspective of others vs. egocentric Erikson's School Age - ANS industry vs inferiority (6-11) - Meaningful contribution to society - Competitive/cooperative play Appropriate activities for school age children - ANS - Hop scotch - Jump Rope - Board games - Bicycles - Organized sports 11-12 years visit - ANS DTAP HPV (series of 3) School age children Sleep - ANS 9 hours Female maturation - ANS First: breast development Then: - pubic hair growth - axillia hair - Menstration Male Maturation - ANS First: testes enlarge Then: - pubic hair - facial hair - voice changing Piaget Adolescence - ANS Formal operation Erikson: Adolescence - ANS identity vs role confusion 16-18 year visit - ANS Menningicoccal vaccine Medication Administration; Infant/child - ANS - Oral route is preferred - Smallest measuring device - Do not mix with bottle because if they do not finish bottle they will not get all the medication - Insert medication into side of mouth, hold cheeks together, stroke mouth Instilling Ear Drops - ANS Less than 3 years: Pull pinna down and straight back Over 3 years of age: upward and back Injections - ANS IM: preferred vastus lateralis ventrogluteal or deltoid acceptable IM: 22-25G & 0.5-1 in SubQ: 26-30G (1mL syringe) Keep equipment out of sight until ready to administer Pain self report - ANS 4 years or older Pain assessment tools - ANS - FLACC (2 months - 7years) - Faces (3 years and above) - Ouchers scale (3 years - 13 years) - Numeric scale (5 and up) Nursing interventions - ANS - Play therapy to explain procedures - Give meds on a schedule (get ahead of pain) EMLA - ANS Apply 60 min for superficial puncture or 2.5 hours before deep puncture After placement - place ecclusive dressing Clean skin before procedure Toddler; playing - ANS "parallel play" Will play along side another child but not with them Preschoolers; associative play - ANS Playing with other children - not organized School age; cooperative play - ANS Play in groups; more organized Types of grief - ANS - Normal - Anticipatory - Complicated (longer than 1 year - Disenfranchised Toddler; Death and dying - ANS Toddlers do not have a concept of death and dying - May mimic parent's emotions and can regress - Think death is temporary - Magic Thinking School age; Death and dying - ANS Pretty much adult understanding May exhibit fear through uncooperative behavior Menningitis - ANS Viral: More supportive care Bacterial: Life sustaining; more risk Vaccines: HPV and Hib s/s: photophobia, n/v, irritability, headache infants: seizure risk, high pitch cry, bulging fontanels (late sign) 2 years + is Indicative: Positive Brudzinski sign (flex head, extremities also flex) & positive Kernigs sign Bacterial Menningitis; test results - ANS Cloudy Elevated WBC Elevated protein Decreased glucose pos. Gram stain Viral Meningitis; results - ANS Clear SF Slightly elevated WBC Normal or slightly elevated protein Normal Glucose content Negative gram stain Spinal Tap - ANS - Empty bladder - EMLA cream - Side laying position Remain in bed, flat, for 4-8 hours Meningitis precautions - ANS - Droplet - NPO if decreased consciousness - Quiet, dark environment - Seizure precautions - Monitor for ICP Signs of ICP - ANS Infants: - Bulging fontanels - Increased head circumference - High pitched cry - Bradycardia - Resp changes Children: - Irritability - Headache - n/v - Seizures - Bradycardia - Resp changes Reye's syndrome - ANS - Liver dysfunction - Cerebral edema *Associated with giving aspirin for fever* Follows viral illness AST and ALT (elevated), ammonia elevated, *liver biopsy*, CSF tap Seizure diagnosis - ANS EEG Do not have caffeine before EEG - wash hair Seizure precautions - ANS Pad side of bed Suction and oxygen ready plus all other precautions Post Seizure - ANS - Vital signs - Neuro check - Side lying - Do not offer food/liquid until know swallow reflex is back Might administer: - carbamezipine - Valproic acid - phenytoin - diazepam ICP signs - ANS First sign; irritability - Vomiting - Nausea - Headache - Blurred vision LATE: Delayed or impaired pupilary responses, posturing (decorticate (cortex issue) and decerebrate(brain stem issue)