Toddler development milestones

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Questions and Answers

According to Erikson's stages of psychosocial development, what is the primary conflict toddlers face?

  • Initiative vs. Guilt
  • Trust vs. Mistrust
  • Industry vs. Inferiority
  • Autonomy vs. Shame (correct)

Parallel play is a type of play where toddlers actively share toys and engage in cooperative activities with each other.

False (B)

What is a common emotional response seen in toddlers when they are faced with separation from their parents or caregivers?

Separation anxiety

According to Freud's psychosexual stages, toddlers are in the ______ stage, which is associated with toilet training.

<p>anal</p> Signup and view all the answers

Match the following congenital heart defects with their descriptions:

<p>Atrial Septal Defect (ASD) = Opening between the left and right atria Ventricular Septal Defect (VSD) = Opening between the left and right ventricles Patent Ductus Arteriosus (PDA) = Failure of the fetal shunt to close after birth Coarctation of Aorta = Narrowing of the aorta</p> Signup and view all the answers

In acyanotic heart defects, what is the general direction of blood flow?

<p>Left to right (A)</p> Signup and view all the answers

Acyanotic heart defects always present with cyanosis (bluish skin) in affected individuals.

<p>False (B)</p> Signup and view all the answers

What is the primary cause of congestive heart failure (CHF) in the context of congenital heart defects?

<p>Diminished cardiac output</p> Signup and view all the answers

In left-sided heart failure, a common respiratory symptom is ______ due to pulmonary hypertension and edema.

<p>dyspnea</p> Signup and view all the answers

Which of the following is an early sign of digitalis toxicity in children with CHF?

<p>Nausea (A)</p> Signup and view all the answers

An atrial septal defect (ASD) always presents with a loud, easily detectable murmur.

<p>False (B)</p> Signup and view all the answers

What is the primary goal of using diuretics in the management of atrial septal defects (ASD)?

<p>To allow the defect to close spontaneously</p> Signup and view all the answers

A classic finding in ventricular septal defect (VSD) auscultation is a ______ murmur heard at the left lower sternal border.

<p>holosystolic</p> Signup and view all the answers

Which of the following is a common medication used to address the symptoms of increased blood flow in a patient with patent ductus arteriosus (PDA)?

<p>Furosemide (D)</p> Signup and view all the answers

In coarctation of the aorta, blood pressure is typically lower in the upper extremities compared to the lower extremities.

<p>False (B)</p> Signup and view all the answers

What physical assessment finding is considered a pathognomonic sign (a sign specific to the condition) for coarctation of the aorta?

<p>Absent or weak femoral pulses</p> Signup and view all the answers

The mechanism behind coarctation of the aorta involves migration of ______ tissue into the wall of the fetal thoracic aorta.

<p>ductal</p> Signup and view all the answers

What is the primary goal when prescribing furosemide?

<p>Addressing the symptoms of the increased blood flow (C)</p> Signup and view all the answers

Tetralogy of Fallot is considered an Acyanotic Heart Disease.

<p>False (B)</p> Signup and view all the answers

What action should you take to manage a toddler's temper tantrum?

<p>Ignore behavior and direct them to activities they can master</p> Signup and view all the answers

Flashcards

What defines a toddler?

Age 1 to 3 years. Key developments include toilet training, asserting autonomy, and engaging in parallel play.

How to handle toddler tantrums?

Acting out to control self and others. Manage by ignoring behavior and redirecting to other activities.

Congenital Cardiac Malformation

Structural heart defects present at birth, categorized as either acyanotic or cyanotic.

Acyanotic Heart Disease

Blood shunts from left to right side of heart. Results in increased pulmonary blood flow but no cyanosis.

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What is CHF in infants?

The left side of the heart weakens and cannot pump effectively, leading to inadequate oxygen and nutrient delivery.

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Signs of Left-sided Heart Failure

Feeding difficulty, pallor, dyspnea, and tachypnea.

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Signs of Right-sided Heart Failure

Hepatomegaly, anorexia, JVD, diaphoresis, and edema

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Pharmacologic treatment for CHF

Digitalis (digoxin). Monitor for toxicity signs like nausea, vomiting, anorexia and X if HR is low.

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Atrial Septal Defect (ASD)

An opening between the left and right atria, often resulting in limited blood flow due to lower pressure.

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Symptoms of Atrial Septal Defect (ASD)

Dyspnea on mild exertion, fatigue, retarded growth, and high risk for respiratory infections.

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Ventricular Septal Defect (VSD)

An opening between the left and right ventricles detected via holosystolic murmur.

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Symptoms of very small VSDs

Audible murmur but no symptoms of pulmonary overcirculation.

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Patent Ductus Arteriosus (PDA)

Occurs when the fetal shunt (ductus arteriosus) fails to close after birth, resulting in continued fetal circulation, more common in premature infants.

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Key signs of Patent Ductus Arteriosus (PDA)

Continuous machinery murmur in left infraclavicular area and prominent radial pulse.

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Manage PDA symptoms with...

↑ Caloric intake to promote weight gain. Medically manage with furosemide to address increased blood flow.

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Coarctation of the Aorta

Narrowing of the aorta, often at the level of the ductus arteriosus insertion and more common in males.

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Signs of Coarctation of the Aorta

Femoral pulse, High BP in upper extremities, bounding pulses, low BP in lower extremities, leg pain, cold feet

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How does a constricted aorta affect other parts of the body?

Pulse is weak, delayed or absent. Myocardial Hypertrophy occurs.

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How can a coarcted aorta be treated?

Balloon angioplasty or surgical intervention (left thoracotomy incision).

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Study Notes

  • The toddler stage is between the ages of 1 and 3.
  • Freud's anal stage corresponds to toilet training during the toddler years.
  • Erikson's stage of autonomy vs. shame is relevant to toddlers, often characterized by the word "no".
  • Toddlers are in Piaget's preoperational thought period, specifically stage 1.
  • Parallel play is characteristic of toddlers.
  • Common toddler activities include push-pull toys, building blocks, and riding toys.
  • Separation anxiety is the greatest fear for toddlers.
  • Love and consistency are important in child rearing during this stage.
  • Toddlers may have temper tantrums as a way to control themselves and others.
  • Ignoring the behavior and redirecting them to other activities can help with temper tantrums.

Atrial Septal Defect

  • It involves an opening between the left and right atria.
  • Atrial pressure is generally lower than ventricular pressure.
  • The amount of blood flow through the defect may be limited.
  • An ASD may not have an associated murmur, potentially going unnoticed without clinical symptoms.

Signs and Symptoms - Atrial Septal Defect

  • Dyspnea on mild exertion
  • Fatigue
  • Retarded growth
  • High risk for Respiratory Infection

Management - Atrial Septal Defect

  • Defects less than 5 mm often do not need to be closed and produce no clinical symptoms.
  • Diuretics can be used in an effort to allow spontaneous closure for defects less than 5mm.
  • Referral for closure is necessary if the defect remains 5 mm or greater to decrease the incidence of supraventricular dysrhythmias and prevent pulmonary vascular disease.
  • Immediate closure is required if the defect is 8 mm or larger with evidence of increased pulmonary blood flow.

Types - Atrial Septal Defect

  • Sinus venosus defects are located high in the septum.
  • Secundum defects are located in the center of the septum.
  • Primum defects are located in the low portion of the septum.

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