Exam (elaborations) NUR 6541 Pediatric

What age can an infant sit up on their own? 6-7 Months What age would a child use a rear facing carseat? Birth up to age 4 or when the out grow the weight or height limit of the carseat. GOAL is as long as possible Forward Facing Carseat After outgrowing rear facing carseat up to age or until they outgrow the carseats weight and height manufacturer limits Booster Seat After outgrowing forward facing carseat or until seat belt fits properly. Proper seat belt fit usually occurs when children are 4 feet 9 inches and age 9 to 12 what kind of fractures would make you suspicious of inflicted injury? · · Classic metaphysical fractures at the end of developing long bones are generally unique to the infant population and have high specificity for maltreatment · Scapular, spinous process and sternal fractures are uncommon accidental fractures and considered suspicious for inflicted injury. Child abuse- When should you be concerned with a child who has multiple bruises and not walking around and/or cruising around the furniture yet? · Unexplained bruising (or bruising without an acceptable explanation) in a child not independently mobile must always raise suspicion of maltreatment. Especially bruising on the child's trunk, ears, and neck. **The parent should be able to reasonably explain any bruise. 7/13/25, 3:51 PM NUR 6541 Pediatric Midterm Exam / 2/5 1. Child abuse- When should you be concerned with child suffering from a long bone fracture? When they are less than 18 months old (humerus) is concerning; if accidental it is usually after a fall and are often supracondylar injuries. .............. inflicted fractures are more likely to be spiral or oblique and midshaft or proximally located. · Femur fracture in a non-ambulatory child is usually inflicted. 1. Child abuse- When is it necessary to report child abuse as a NP? Who do you report to? Do you risk anything by reporting? · As nurses we are mandated reporters of child abuse. · Each state has their own child abuse law. And who it is reported to. But typically, it is a child abuse hotline. There is a national line 1-800-4-A-CHILD · Child abuse is a HIPAA exception. So, no you will not get in trouble. Newborns- what type of vitamin deficiencies might cause certain problems in a newborn Vitamins A, B1, C, D, & K What kinds of problems occur in newborns from Vitamin A deficiency? Common in resource limited countries, associated with xeropthalmia and other ocular signs. Earliest symptom is night blindness, followed by xerosis (dryness of conjunctive and cornea-image). Progression leads to ulcerations, perforation and scarring of cornea. Other symptoms may include hyperkeratosis, pruritus, growth retardation and increased risk to infection. Vitamin B1 deficiency in newborns cause what? o Involved in cellular metabolic activities, and nerve impulses. o Causes: 1. Clinical beriberi= typically between 2-3 months, typically breast fed by women with thiamine deficiency. SS=cardiomegaly, tachy, loud piercing cry, cyanosis, dyspnea, and vomiting 2. Wernicke-korsakoff syndrome=complication of thiamine def. acute syndrome requiring emergent care=two syndrome: 1. Wernicke's encephalopathy- nystagmus, ophthalmoplegia, ataxia and confusion (seen in alcoholics) 2. Korsakoff syndrome=chronic neuro condition as consequence of WE. Foods high in: yeast, legumes, pork, brown rice, cereals with whole grains. 7/13/25, 3:51 PM NUR 6541 Pediatric Midterm Exam / 3/5 Vit C deficiency in newborn/infants · Vitamin C o Ascorbic acid or scurvy=Prominent cutaneous signs: petechiae, perifollicular hemorrhage, and bruising, gingivitis, arthralgias, and impaired wound healing. Typically appears within few months of being deficient. Foods: Citrus fruits, tomatoes, potatoes, Brussel sprouts, cauliflower, broccoli strawberries, cabbage and spinach. Breast milk typically provides adequate source of Vit C! Vit D deficiency in newborns/infants Vitamin D o Dietary deficiency and inadequate exposure to sunlight causing hypocalcemia, hypophos and rickets. This will cause defective bone growths, poorly supported tissue and skeletal abnormalites- enlargement and delayed closure of anterior fontanelle, frontal bossing of skull, delayed eruption of teeth, beading of ribs, bowlegs in older infants, and green stick fractures in long bones.