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NU664A Primary Care of Child I QUIZ 1/WEEK 1 EXAM 2024 FALL-SPRING SEMESTER
Typology: Exams
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(covers developmental management, infant care, immunizations, toddler care, head disorders, and ear disorders) Tympanogram - Type A Sharp peak - Normal Immunizations at 4 months RV, DTaP, Hib, PCV13, IPV Immunizations at birth Hep B (1 of 3) usually before hospital discharge **If mom HBsAg-positive, administer immunoglobulin and vaccine within 12 hours of birth Immunizations at 2 months
Hep B, RV, DTaP, Hib, PCV13, IPV Immunizations at 6 months DTaP, IPV, PCV, Hep B, RV, Hib erythema toxicum neonatorum Benign neonatal rash characterized by blanching erythematous papules and/or pustules. Firm, Yellow white 1- to 2-mm papules or pustules with a surrounding erythematous flare that presents right away after birth - Self resolves. It resolves spontaneously within 2 weeks of birth Milia tiny white bumps across the nose - Self resolves after birth 6wks to 4mths Chlamydia conjunctivae signs clear to mucoid exudate from eye ducts
Phenylketonuria (PKU) a musty or mousy odor in newborn infant related to build up of phenylacetate and tend to have lighter skin and hair than typical for their race Urea Cycle Disorders symptoms vomiting, lethargy, irritability, malaise, and potential seizures and coma. newborn vision Limited, but has the ability to focus briefly on a face or bright object when it is brought into visual range (about 8 co 12 inches from their face). Visually track objects to midline. Prematurity developmental tasks During assessment account for time the infant was born early into the developmental process. Pay close attention to developmental delays to intervene early.
Should regain birthweight in 10-14 days, if under, schedule weight check breastfed baby-norms · Let infant breastfeed on demand. · If stools decrease that would be okay. · Gain 5-7oz per week · Need Vitamin D supplement · May sleep at night if infant caught up with feedings during the day · Active and alert state · Developmentally appropriate progress · Age-appropriate height and head circumference · Good skin turgor and color · Sufficient output of at least six wet diapers and several stools per day · Content and satisfied behavior after feeding
start solid foods Around 4-6 months and when they have good head control, be able to sit alone, and have diminished tongue thrust reflex before solids are introduced. full-term weight gain rule of thumb double birth weight by 6 months and triple birth weight by 12 months of age Anterior fontanels close 12 - 18 months Posterior fontanels close 2 - 3 months
Head and chest circumference equal 12 months inguinal hernia the protrusion of a small loop of bowel through a weak place in the lower abdominal wall or groin; Swelling is found in the inguinal area, scrotal area (labia majora in females), or both. incarcerated inguinal hernia hernia that is stuck in the groin or scrotum & cannot be reduced back into the abdomen; caused by swelling; can lead to a strangulated hernia; Palpable bulge, anorexia, nausea, fussy, and vomiting. hydrocele Asymmetry or a scrotal mass present; swelling is usually unilateral. Testes descended. Translucent on transillumination (pink or red glow). Scrotum filled with clear fluid.
tonic neck reflex present 4 to 6 months Immunizations at 12 months HepB, Hib, PCV13, IPV, Influenza, MMR, VAR, Hep A Immunization at 15 months · 3rd dose of Hep B · 4th dose of DTap · 3rd or 4th dose of Hib · 4th dose of PCV · 3rd dose of IPV · Influenza 1 or 2 doses · MMR 1st dose · VAR 1st dose
· 2nd dose series of Hep A Immunizations at 18 months · 3rd dose of Hep B · 4th dose of DTap · 3rd dose of IPV · Influenza 1 or 2 doses · 2nd dose series of Hep A Immunizations at 24- 36 months 1 or 2 doses of Influenza A parent with a toddler questions tantrums Nurse should inform parent that this is normal for this age and encourage routines
organophosphates exposure Acute poisoning results in clinical signs of cholinergic excess (i.e., bradycardia, tearing, salivation, bronchospasm, urination, emesis, diarrhea, and diaphoresis). Neurologic disorders may occur 24 to 96 hours after exposure and delayed neurotoxicity may occur l to 3 weeks after exposure. chelation therapy Used if lead eve is >45mcg/dL if the lead level is 5 mcg/dL what should you do next? Order a venous lead level Lead level .10mcg/dL what should you do next? Venous blood draw and Report to health department
pincer grasp 12 months hold a rattle 1 to 3 months Head lag disappears 4 - 6 months Obesity rates in preschoolers has decreased significantly in recent years Health maintenance visits are scheduled when a. key developmental milestones should occur, not just when vaccines are due
caput succedaneum diffuse edema of the fetal scalp that crosses the suture lines. reabsorbes within 1 to 3 days. observe for jaundice if lesion is large (Diffuse swelling of soft tissue of newborn's scalp, which usually crosses suture lines with possible bruising) bossing Bulging of the newborn skull, in the frontal areas associated with prematurity or rickets. Cephalohematoma hemorrhage between skull-periosteum, may develop jaundice, hypotension- takes weeks to resolve Macrocephaly Evaluate: CT of head (Head circumference greater than 2 to 3 SD from mean for age, sex, and gestation or that increases too rapidly) - Widened suture line
Craniosynostosis cranio / syn / ost / osis skull / together / bone / condition the premature fusing of the skull bones Evaluate: skull x-ray - (Rigid immobile suture lines should be referred to neurosurgery immediately because of concern for this) - Abnormal HC, the ridge along suture lines with abnormal skull configuration Plagiocephaly Flattening or asymmetry of the head risk: sleeping supine education: tummy time 30-60 min/day, alternate babies head position, helmet 23 hrs/day for 3 months Microcephaly Early closure of fontanels, prominent cranial sutures and HC 2 - 3 SD below mean are indicative of this
Otitis Externa Marked ear pain, not wanting anyone to touch his ear. The canal is edematous, and exudate is present. TM is normal. Treatment for otitis externa topical fluroquinolone. Treatment of Otitis Media · Amoxicillin 90 mg/kg/day BID x 10 days Four ear infections in 12 months Refer to ENT Tympanogram Type C
Sharp peak 100-200 Degrees Negative Pressure, Resolving OM Eustachian Tube Dysfunction Tympanogram Type B super flat - Abnormal - tympanic membrane not moving - middle ear effusion/middle ear perforation Hearing development well developed at birth, adult like by about 6 months Hearing delayed equals speech delay What happens if child has a round or spherical object in his ear canal? Refer to ENT
