PEDIA.pdf

PEDIA Developmental Milestones 1-3 months old (mobile toy for lying babies) 1 month (newborn/ neonate) - head slag/ lag, can temporarily lift head, 10 inches vision, no binocular vision (w/ strabismus), cries when uncomfortable and hungry, throaty sounds, fisted hand 2 months - head slag/ lag, can...

PEDIA Developmental Milestones 1-3 months old (mobile toy for lying babies) 1 month (newborn/ neonate) - head slag/ lag, can temporarily lift head, 10 inches vision, no binocular vision (w/ strabismus), cries when uncomfortable and hungry, throaty sounds, fisted hand 2 months - head slag/ lag, can lift head and chest w/ 2 arms support in prone position, w/ binocular vision (less strabismus), cooing sound, open hands (Palmar grasp reflex/ Darwin reflex), can handle the rattle briefly, early social smile 3 months - head slag/ lag, lift head and chest w/ 1 arm support in prone position, sideways roll, eyes follow objects (L-midlle-R), laugh aloud/ giggling, closure of posterior fontanel/ lambda (triangle), hand to mouth coordination, thumb sucking (give pacifier), learned crying 4 months - head slag/ lag, roll from prone-side-supine, hand regard - reaches objects, babbling/ babbles, disappearance of reflexes: Darwin/ Palmar grasp reflex (voluntary grasp development), Moro/ Startle reflex (4-6mons) - MOST important neurologic reflex according to Freud - quick extension and recoil of extremities (falling sensation felt by the head, jarring of the crib, loud noise), Tonic neck/ Boxing/ Fencing, Stepping/ Dancing reflex, Feeding reflexes: rooting (feeding cue), sucking (lips/ mouth), spitting/ extrusion (protective reflex to prevent poisoning; anterior tongue), swallowing (posterior tongue) 5 months - no head slag/ lag, roll over (risk for fall), takes object, handles rattle very well, anger of objects taken, babbles more often. 6 months - 2x BW, complementary feeding and weaning, 1st teeth (2 lower central/ mandibular incisors), 1st dental visit, sits w/ support (high chair), imitates vowel sounds, smiles in front of the mirror (5-6 mons), start of stranger anxiety 7 months - transfer objects hand to hand, throws rattle, toes to mouth, 1st word of the baby 8 months - sit w/out support, starts to crawl (crocodile crawl), peak of stranger anxiety, upper central/ maxillary incisors 9 months - creep and crawl, disappearance of stranger anxiety, starts to develop Pincer Grasp (weak thumb to finger), wave bye bye 10 months - can stand w/ assistance/ pull to stand, well refined pincer grasp, w/ object permanence (the MOST important cognitive milestone of an infant according to Jean Piaget), plays peek-a-boo, apir/ patty cake, 11 months - uses spoon and drink using a cup, cruising - walking while holding the wall/ furnitures w/ 2 hands 12 months - 3x BW, can eat most table foods, uses dada and mama, 2-3 linking words, can stand alone, 1 hand cruising, can walk w/ assistance. 15 months - walk alone, walk backwards, crawl to stairs (still infant) 18 months - transition from infant-toddler (child), losses baby look, large head, protruding abd, lordosis waddling gait, use spoon and fork, run, thinking: pre logical, different individual - ego (reality principle); peak separation anxiety - greatest fear (avoid: sneaking, prolong goodbye, breaking promises; therapeutic: 1 firm goodbye, give security objects, keep promises), temper tantrums due to limited vocabulary (mngt: ignore the tantrums but ensure safety), increase autonomy/ self control (Negativistic - “says no” mngt: sets limit but offer choices; Ritualistic - “uses same object mngt: sets limits, allow rituals; Dawdling - slow mngt: sets limits but reinforce and provide assistance), Egocentric - self centered (“I”, “my”), pile tower of 3 blocks, Parallel/ Side by side play w/out sharing, climb to stairs (same foot first while holding the handles), climb down to stairs (sitting/ same foot first), jump, start Toilet/ Potty training 24 months - run fairly well, climb on furniture, open doorknobs (risk for drowning, electrocution, burns, falls, poisoning), can draw vertical line, can pile 4-6 blocks, 4x BW. 36 months - transition from toddler-preschooler, destructiveness, cooperative w/ playmates, imaginary friends, role fantasy and animism, gender specific behavior, jump from a chair, tip toe and hop, wear t-shirt, ask a lot of questions “why” and “how”, >300 word vocabulary, fondling of genitals/ masturbation according to freud, preschooler exhibitionism for sexual orientation development, Oedipal complex: same sex - rivalry and jealousy; opposite sex - attachment (peak at 5 y/o), rides tricycle, draws circle 4 y/o - >1,500 word vocabulary, use scissors, draw 4-part-man, square, rectangle, can say their full name. 5 y/o - >2000 word vocabulary, tie and untie shoe lace, draws a triangle, print full name, rides bicycle 6 y/o - >3000 word vocabulary, competitive and industrious, uses memory and recall, aware of past, present, and future, permanent perception of death, can play most field games and playground games, inductive reasoning, Mongolian spot disappearance (lower back/ buttocks; bluish) Play, Virtue, Important persons, Fear, Accidents, INFANT - Solitary; Hope; Mother or primary care giver; Stranger fear/ anxiety; Falls, Choking, Aspiration, SIDs; TODDLER - Parallel; Will; Parents, Separational anxiety, Dark, and Punishment; Drowning, Electrocution, Falls, Burns, Choking; PRESCHOOLER - Cooperative/ Associative; Purpose; Family and Friends; Dark, Punishment, Mutilation/ Castration (compromised body integrity); Drowning, Electrocution, Falls, Playground Accidents (Fractures, wounds, bruises) SCHOOLER - Competitive; Competition/ Competitiveness; Teacher (and Schoolmates) and Family; Death, Reprimand, Losing, Losing honor roll, and Bullying; Fractures, Playground accidents, Drowning, MVA ADOLESCENCE - Adventures/ Sports/ Reading; Fidelity (Faithfulness); Peers and Partners; Death, Acne, Obesity, Rejection; MVA, Hazing, Suicide (15-24y/o). Common Pediatric Problems:. Colic - gas in stomach (bottle feeding and motor rides) Ass: – Shrill Cry – Abdominal Guarding – Tympanic sound on percussion – Restlessness Mngt: – (+) abd pain suspect for appendicitis (avoid hot packs/ compress) – NPO and void pain reliever – burp before, during, after feeding (prone position and infant on chest) – one way valve bottle and collapsible bottle, car back sit and back view/ rear view Dx: – UTZ to r/o appendicitis (confirmatory) – Blumberg’s (radiation), rovsings (referred), psoas, obturator – Mcburney’s point - location (1/3 from anterior superior iliac spine (ASIS) to umbilicus. Baby Bottle Syndrome (BBS)/ Tooth decay Mngt: – avoid milk at bedtime – brushing of teeth at least 2/day – dilute formula milk – avoid too much dessert. Physiologic Anemia (