Peds Exam 1 Study Guide PDF

PEDS EXAM 1 STUDY GUIDE **Care of the Infant** **Normal growth and development patterns** - Cephalocaudal principle: development starts from the head moves downward (head to toe), and proximodistal- goes from the center outward - Head lag= an important assessment of neuromuscular dev...

PEDS EXAM 1 STUDY GUIDE **Care of the Infant** **Normal growth and development patterns** - Cephalocaudal principle: development starts from the head moves downward (head to toe), and proximodistal- goes from the center outward - Head lag= an important assessment of neuromuscular development - Should be absent @ 4 months - Lose 10% of body weight the first week of life, but regain it by the end of the second week - Grain 20-30g/day for the first 3 months - Weight doubles by 4-6 months and triples by 12 months - Length increases by 50% by year 1 - Head circumference increases rapidly for the first 6 months and then slows till 12 months - Posterior fontanelle closes around 2 months - Anterior fontanelle closes around 12-18 months RED FLAG: if you can't feel the fontanelles (should not be sunken or bulging) **Psychosocial development** - **Nursing considerations** - Erikson's psychosocial (trust vs mistrust) infants learn to rely on their caregivers - Does someone pick them up when they cry? - Nurse considerations: are we meeting their needs - The infant will develop trust, confidence, and security if they receive consistent, reliable, predictable care (clean, safe, fed) - Interact with an infant, read, sing, and play **Nutritional needs of the infant** - Up to 4-6 months of exclusively breastmilk or formula - Decrease digestive enzymes (breast milk compensates) - Formula feeding- 1L/day they are getting all the nutrients and vitamins they need - Begin solids around 6 months - As pincher grasp emerges, finger foods can be given - Focus on iron and vitamin D! - No honey until 1 year! (there is a risk of botulism- toxins that attack the body's nerves due to a bacteria called Clostridium) **Pain assessment and management** - FLACC scale: Face, legs, Activity, Cry, Controllability - Riley Infant Pain scale: facial expression, sleep, movement, cry, and touch **Fever** - **Pediatric difference in thermoregulation** - At risk for heat loss due to increased body surface area related to their mass - Immature thermoregulatory system- relies on brown adipose tissue to generate heat - Limited sweat glands - Behavioral responses- young children do not recognize their need for shade, drinking fluids, taking off a layer of clothing - Metabolic rate is higher than adults which helps them maintain body temperature - **Management of fever** - **Indications for treatment** - When a child begins to act unnormal/crumpy - If a child is peeing drinking and acting normal you can leave them be! - The main reason to treat a fever is relief of discomfort - **Nonpharmacologic** - Remove excessive clothing, expose skin to air - Reduce room temperature - Cool compress - Rest - Increased fluid - DO NOT cool them down so much that they shiver - **Pharmacologic** - Acetaminophen 10-15 mg/kg/dose - Ibuprofen 10 mg/kg/dose (not given to infants \