NR 602 Mid-term LATEST UPDATE 2024
Infant development - ANSWER -1m: dolls eyes, nose breathing, hands closed, sees 20-25cm away, sleeps
16-17 hrs a day
-2m: post fontanel closes, decr head lag, coos,follows toy side to side, sleeps 8.5-10rs/night & 6-7 hrs day
-3m: all primitive reflexes fading, holds head, bears weight on legs, does not reach for rattle, babbling,
mirrors, recognizes familiar objects and faces, sleeps 15-16 hours per day.
Infant development - ANSWER -4m: drooling, no morrow/tonic neck, sits if propped, plays with hands,
pulls on things, shows mood, laughs, focus on things 1/2in from face, regular sleep/wake pattern
- 5m: double birth wt, rolls back to belly, pull objects to mouth, follows dropped object, sleeps 10-11 hrs
& 3 naps.
- 6m: growth slows (3-5oz/week, 1/2in/month), rolls back to belly, sits in chair with back, recognize
parent, definite likes/dislikes, 13-14 hours sleep, 2-3 naps.
- 7m: leans to tripod position, bounce when standing, bang objects, 4 vowels said, knows name, stranger
anxiety
Infant Development - ANSWER -8m: regular b/b pattern, sits unsupported, pincer grasp, knows "no",
more stranger anxiety, sleeps 11-12hrs + 2-3 naps
- 9m: refined pincer grasp, steadily sits unsupported, pulls to stand, wants to please parents, 2 naps
-10m: mature pincer,walks holding on, grabs by the handle, "mama/dada", object permanence, 2 naps
-11m: lower lat incisors, pivots when standing, imitates sounds, rolls ball when asked
-12m: triples birth wt, length by 50%, walks holding 1 hand, 5-7 words, security object
Tanner (pubic hair) - ANSWER 1) no pubic hair
2) initial, scarce pigmented hair along medial border of labia
3) sparse, dark, visibly pigmented curly hair on labia
4) hair coarse and curly, abundant but less than adult
5) lateral spreading, triangle spread of adult hair to medial surface of thighs
, Tanner (Males) - ANSWER 1) Prepubertal
2) enlargement of scrotum & testes & change in scrotum texture. May be reddened
3) further penile growth (length first) & testes & scrotum
4) significantly enlarged ion length & circumference penis. more development of glans penis. darkening
of scrotal skin (facial hair after this only)
5) adult genitals
Tanner (Breasts) - ANSWER 1) prepubertal
2) Breast buds palpable under areola, enlargement of areola
3) breast tissue palpable outside areola- no areolar development or separation of contour
4) Areola elevated above contour of breast forming "double scoop" appearance
5) Areola mound recedes back into single breast contour with areolar hyperpigmentation, papillae
development/ projection & nipple protrusion
chalazion - ANSWER -chronic sterile inflammation of eyelid from a lipogranuloma of the meibomian
gland
- initially, mild redness & swelling, then after a few days, a slow-growing, round, nonpigmented PAINLESS
mass remains.
- Acute tx: hot compress, refer to eye MD
Blepharitis - ANSWER - acute or chronic bacterial (staph) inflammation of eyelash follicle or sebaceous
gland of eyelid. bilateral usually
-flaky, scaly debris over eyelid margin when awakening
- tx: warm compress, scrub with weak shampoo, sometimes bacitracin or erythromycin,
-no contacts during tx
Otitis Media - ANSWER - bulging TM, ear pain, , ETD, fever,irritability, otorrhea, absent TM mobility
-RSV/influenza most common viruses
- s.pneumonia, haemophilus, strep (bacteria)
- Tx: Amoxicillin (1st time), Amox/clavu (when AOM within 30 days), ceftriaxone, azith (penicillin allergy)
