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NURS 629 PEDS EXAM

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Exam of 18 pages for the course NURS 629 PEDS at NURS 629 PEDS (NURS 629 PEDS EXAM)

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  • October 5, 2024
  • 18
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NURS 629 PEDS
  • NURS 629 PEDS
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leonardmuriithi061
] NURS 629 PEDS EXAM


Proportional changes in infants: weight, height, head, nervous system, chest -
ANSWER Weight increases 6-8lbs, up to 20lbs in the 1st year of life

Posterior fontanelle closes by - ANSWER 2 months of age

Infant eye alignment - ANSWER 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? - ANSWER By 3 months of age

Normal development for boys: - ANSWER Both testicles are descended by 6
months

Note any hydrocele

Normal development for girls: - ANSWER Assess for labial adhesions

Normal infant musculoskeletal development - ANSWER 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 - ANSWER Common - infantile eczema

Lesions

Bruising or burns: Mongolian spots are normal

Feeding difficulties - ANSWER 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 - ANSWER -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 - ANSWER 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 - ANSWER Assess for hip dysplasia, gait, out-
toeing, bowlegged

Normal toddler neurological - ANSWER Deep tendon reflex
Babinski

Normal preschool growth and development - ANSWER -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 - ANSWER 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 - ANSWER Extremities grow faster
than trunk and head

Facial proportions change
● Nose and chin enlarge first

Figure changes
● Pelvis enlarges in females

, ● Shoulders enlarge in male

Subcutaneous fat increases

Increased function of sweat glands

Increased function of sebaceous glands

Puberty begins - ANSWER Girls: 9-13 years

Boys: 11-14 years

Puberty changes in girls - ANSWER -Breast enlargement begins 8-13 years
-Axillary hair develops 11-13 years
-Pubic hair develops 10-12 years
-Menarche begins 10-16 years

Puberty changes in boys - ANSWER -Genital enlargement begins 9-13 years
-Axillary hair begins 12-14 years
-Facial hair develops 11-14 years
-Pubic hair develops 12-15 years

Normal adolescent physical exam findings - ANSWER Obtain vitals, height &
weight with BMI

Head to toe examinations
○ Acne
○ Athletic teens may have lower heart rate
○ Changes related to puberty - including Tanner staging

Neonate normal milestones vs red flags - ANSWER Normal
Strong reflexes. Minimum of 6-8 bowel movements per day. Urinates 8 times a day

Abnormal
Jaundice at birth (hemolysis). High-pitched cry. Irritable. "Floppy" (hypotonic). Poor
reflexes

3rd month normal milestones vs red flags - ANSWER Normal
Smiles. Able to coo. Makes gurgling sounds. Can hold head up. Starts to recognize
parents. Crawls.

Abnormal
Inability to hold head up. Avoids eye contact. Floppy.

6th month normal milestones vs red flags - ANSWER Normal
Sits up without support. Rolls in both directions (front to back, back to front). Says
single-syllable sounds "ba, da, ma." Tries to get things out of reach by "raking" (uses
palms to reach).

Abnormal

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