NURS 629 PEDS EXAM 1 QUESTIONS WITH COMPLETE SOLUTIONS VERIFIED GRADED A+
Proportional changes in infants: weight, height, head, nervous system, chest
Weight increases 6-8lbs, up to 20lbs in the 1st year of life
Posterior fontanelle closes by
2 months of age
Infant eye alignment
Some chil...
Proportional changes in infants: weight, height, head, nervous system, chest
Weight increases 6-8lbs, up to 20lbs in the 1st year of life
Posterior fontanelle closes by
2 months of age
Infant eye alignment
Some children get cross eyed at times, but usually resolve close to 4 months
Red reflex should be symmetrical
When do infant abdominal muscles close?
By 3 months of age
Normal development for boys:
Both testicles are descended by 6 months
Note any hydrocele
Normal development for girls:
Assess for labial adhesions
Normal infant musculoskeletal development
Leg fold symmetry
Hip abduction: To make sure there are no hip clicks. Barlow maneuver and Ortolani
maneuver will assess for hip click
Foot shape and flexibility
Skin: rashes
Common - infantile eczema
Lesions
,Bruising or burns: Mongolian spots are normal
Feeding difficulties
Regurgitation and spitting-up
○ Acid reflux is prevalent d/t sphincters are not mature
○ Encourage parents to break up feeding after ~15mL. burp the child and then return to
feeding
○ Spitting up can be large amount and it is normal for it to come out of the nose
Colic
○ Common during newborn period, usually resolves by 6 months of life
Normal Toddler growth and development
-Weight gain 4-6lbs per year
-Height: 3 inches per year
-Visual acuity 20/40
-Brain growth is 75% completed
-Respiratory tract is rapidly developing closer to that of an adult, but still anatomically is
much smaller.
-Immune system is weakened, increased risk for any kind of complications
-Measurements: height, weight, head circumference up until 2 years of age
-Physical exam
Normal toddler HEENT
Anterior fontanel - make sure it is getting smaller and closing
● It usually closes by 18 months - 2 years
Screen for strabismus
Look for tooth eruption and/or dental decay
● If by 18 months they do not have a first tooth eruption, order x-ray
Normal toddler musculoskeletal
Assess for hip dysplasia, gait, out-toeing, bowlegged
Normal toddler neurological
, Deep tendon reflex
Babinski
Normal preschool growth and development
-Weight gain 5 lbs/year
-Height 2-3 inches/year
-Head circumference, no needed since the anterior fontanelle should have closed 18
months - 2 years
-Screening: vision and hearing
Normal school aged growth and development
Slow but steady growth:
● Height: increases 2 in/year
● Weight: 4 ½ - 6 ½ lbs/year
● Skeletal lengthening & fat diminution
● Strength increases yet muscles remain functionally immature
● Start to lose those primary teeth and develop their permanent teeth
● GI system, cardiovascular system becomes that of an adult
● Bladder capacity increases
● Immune system improves
● Bones become hard and they are not as pliable as it was in the early ages
● Prepubescent
Vital signs: approaching adult values by the end of the school age:
● Blood pressure
● Vision screening
● Hearing screening
Normal adolescent growth and development
Extremities grow faster than trunk and head
Facial proportions change
● Nose and chin enlarge first
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