NUR3503 End of Sem Exam - Paediatrics
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1. How are children - Head is large compared to the adult
physically differ- - Often in newborns it exceeds the circumference of the
ent to adults? chest
- Anterior and posterior fontanelles
- Muscles lack tone, power and coordination
- Arms and legs are shorter and underdeveloped at birth
- Midpoint in length on a child is umbilicus
- Midpoint in length on an adult is the symphysis pubis
- Disproportionate abdomen is due to the large liver and
small pelvis
2. What are mus- - Skeletal strength and endurance increases with age
culoskeletal sys- - Protuberant abdomen
tem differences -At birth spinal column has only the anterior curvature
between the - Cervical and lumbar curvature begin with holding head
adult and child? up and walking
- Small facial sinuses (10-12 years)
3. What are Central The brain of the neonate is relatively large
Nervous System - 1/10 of the weight as compared to 1/50 of adult
differences be- - The brain grows rapidly commensurate with age
tween the adult - Fontenelle's close at 18 months to 2 years as the brain
and child? grows
Spinal Cord
- Neuronal development finishes at age 12
- Myelination is not complete until age 3
- Primitive reflexes (Moro, grasp) disappear with myelina-
tion
*THEY HAVE Higher metabolic rate, higher oxygen
needs, higher calorie need
4. What are Integu- Growth is regulated and adjusted to variations in surface
mentary system area
differences be- Thin structure - 1mm thick at birth
tween the adult 4% of Total Birth Weight in the newborn
and child? Body Surface Area measurement important in children
-why?
- Functionally matures during early childhood
, NUR3503 End of Sem Exam - Paediatrics
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- Production of sebum is minimal
- Eccrine glands are functional but immature
5. Cardiovascular At birth the right & left ventricles are essentially the same
differences in size & wall thickness
During the 1st month of life Right Ventricle dominant
4-6 months Left Ventricle dominant
• By four weeks the LV weighs more than the RV (2
months twice the weight)
• Cardiac muscle fibres increase over childhood
• Cardiac Output is related to Heart Rate not only Stroke
Volume
• Blood pressure rises
• Total blood volume 70-80mls/kg
6. Respiratory sys- Trachea is short and soft
tem differences Large tongue
Airway resistance is high
Epiglottis is horseshoe shaped, posterior at 45 degree
angle
Infants <6 months - obligate nasal breathers
Rely on diaphragm
Compliant chest wall
Outward recoil of the thorax is very low
5 yrs to puberty lung weight increases three fold
Lung and alveolar growth and size and maturation of
tissues by 8 yrs
7. Why is fluid Newborn 70 - 80 % Water
homeostasis im- Full term infants have a large % of TBW (total body water)
portant? & Extra Cellular Fluid
TBW decreases with age mainly as a result of loss of
water in ECF fluid
Fluid turnover is 7 times greater than that of an adult
Altered fluid balance can have catastrophic conse-
quences
Organ perfusion and metabolism count on adequate hy-
dration
, NUR3503 End of Sem Exam - Paediatrics
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Infants and children are at a much higher risk for devel-
oping rapid dehydration
9. Answering Con- Listen, most questions answered by nurses, access infor-
cerns about vac- mation sites
cinations Don't push
Keep up to date
Anticipated reactions
- Links to Autism, asthma
- Developmental delays
- Unanticipated adverse reactions
10. Maslow's Hierar- (level 1) Physiological Needs, (level 2) Safety and Secu-
chy of Needs rity, (level 3) Relationships, Love and Affection, (level 4)
Self Esteem, (level 5) Self Actualization
What do children need for health development?
11. Common age Neonate: 0-4weeks
groups terminol- Infancy : 0-1year
ogy Toddler : 1-3 years
Early childhood: 1-5 years
Pre-schooler : 4-6 years
School-aged : 6-11 years
Childhood : 5-13 years
Adolescence (varies) : 12-19 years of age
12. What is the full 40 weeks
gestational age? Less than 38 week is pre-term
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