Download NURS 629 EXAM 2 | QUESTIONS AND ANSWERS | 2025-2026 | GRADED A+ and more Exams Nursing in PDF only on Docsity!
NURS 629 EXAM 2 | QUESTIONS AND ANSWERS |
2025 - 2026 | GRADED A+
Weight changes in 1st year of life Weight increases 6-8lbs, up to 20lbs in the 1st year of life When does the posterior fontanelle close? Anterior? posterior- 2 months, anterior- 9 - 18 mo when do the abdominal muscles close? 3 years When are the testicles descended? usually descended at birth, but spontaneous descent may occur in the first year after birth. (usually 6 months) what do you assess for with infants musculoskeletal system? leg fold symmetry
hib abduction- no clicks Ortolani maneuver check hips for congenital dislocation, done until 1 yr old, should be smooth with no sounds , abnormal= feels like a clunk as head of femur pops back into place- positive ortolani sign Barlow maneuver place your index and middle finger over the greater tronchanter. Gently push both knees together at midline downwards. Positive:"Clunk" sounds or palpating trochangter being displaced by the index/middle finger Infantile eczema atopic dermatitis is an inflammation of genetically hypersensitive skin
- local vasodilation in affected areas spongiosis or breakdown of dermal cells and formation of intradermal vesicles
- rarely seen in breastfed infants until they begin to eat additional food
- it is a symptom rather than a disorder
- DTRs
- Babinski + (dorsiflex) normal in infant less than 24 mo what age do you screen for hearing and vision? at 3 years School age children grow more steadily? 2 in/year 4 - 6lbs/ year In adolescence when does puberty begin in girls? 9 - 13 years when does puberty begin in boys? 11 - 14 years At what ages do puberty changes develop in girls?
breast enlargement 8-13 yr axillary hair 11-13 yrs pubic hair 10-12 years menarche 10-16 years at what ages do puberty changes develop in boys? genital enlargement 9-13 yrs axiallary hair 12-14 yrs facial hair 11-14 yrs pubic hair 12-15 yrs Tanner Stages Girls
- Preadolescent breasts, breast papilla elevated above breast wall. no pubic hair.
- puberty starts Breast buds with areolar enlargement, papilla forms small mound. scant pubic hair, light pigment.
- Breast and areola grow together in one mound. no separation. pubic hair more abundant.
- Areola and nipple project as secondary mound. pubic hair abundant but smaller area than adult. menstruation starts.
- Adult breast: Areola recedes, nipple retracts
Red flags at 9 months Cannot sit without support, not indicating wants (Niner needs recliner, but doesn't want it) if infantile reflexes remain strong. does not bable does not bear weight on legs 2 year red flags Unable to speak meaningful two-word "sentences." Does not understand simple commands. Loss of speech, social skills, previously learned behaviors and/or does not say words by 16 months (autism). 1 year red flag Unable to support own weight. Lack of babbling. No response to smiles, poor eye contact, loss of previously learned skills (autism). 3 yr red flags Speech hard to understand or unclear speech. Unable to understand simple commands. Fall down often. Does not speak in sentences. No eye contact. Losses skills he or she once had.
4 yr red flags Unable to speak in full sentences. Inability to skip, run, hop. Cannot put on clothes without help. Unable to play with other kids. Unable to follow three- part commands. 5 yr red flags Unusually withdrawn. Not active. Trouble focusing on one activity for more than 5 minutes. 2 year normal activities Walks. Runs. Climbs stair up and down on own by holding onto handrails. Speech mostly understood by family. Follows two or three step instructions. Copies a line. PMH to address in sports physical โ Look at PMH, meds and supplements, steroid use, previous injuries, immunization status, weight concerns, allergies, concussions, dizziness or fainting with physical exertion, family history related to sudden death, cardiac death, death with activity, and history of asthma, contacts or dental appliances
who needs referral for f/u before clearance from sports physical? โ History of or current cardiac anomalies โ Family cardiac history (cardiomyopathies, prolonged QT, Marfan syndrome, significant dysrhythmias, cardiac death in 1st or 2nd degree relative before age 40, connective tissue disorders) โ History of or current concussions โ History of or current injuries โ Hernia โ Hypertension โ Murmur โ Irregular heart rate or rhythm โ Deformity, asymmetry, instability โ Poor visual acuity โ Liver or spleen enlargement โ Hernia โ Contagious skin conditions Red flags during sports physical? โ Hypertension indicated by BP >135/85 mm Hg โ Coarctation of aorta indicated by decreased intensity of pulse in femoral pulse
โ Hypertrophic cardiomyopathy indicated by systolic ejection murmur that intensifies with standing or Valsalva maneuver โ Marfan syndrome indicated by aortic (decrescendo diastolic murmur) or mitral insufficiency (holosystolic murmur) what conditions automatically disqualify teens from sports physical? carditis, diarrhea, fever? Questions related to concussion history? โ Location of hit (hit to front of head and on back of head when landed on the ground) โ Any LOC, seizures, amnesia Concussion Assessment
- Cranial nerves 2. Pupillary dilation and reactivity 3. Balance and coordination
- Motor Strength 5. Cognitive function 6. Sport concussion Assessment Tool Tx for concussion
what information is included in history of 2 year old? โ Include birth history in documentation of history of children until age 2, then when relevant after age 2 โ Prenatal and birth history โ Complications โ Feeding history- Breast, bottle, solids โ Developmental history- Developmental delays or parent concerns/ Milestones โ Psychosocial history- Sleep habits, behaviors, โ Social history- Where they live, other ppl in the home โ Environmental risks- Smoking, lead exposure โ Immunization history what is the HEADSS Assessment โ H - home โ E- education โ A- activities โ D- drugs โ S- sexuality โ S- suicide and depression โ Drug and alcohol use
what do you look at for ROS in 6-9 months? โ Temperament โ Nasal symptoms โ Cough โ Vomiting or spitting up โ Frequency & consistency of stools โ Number of wet diapers โ Use of extremities - equal? โ Rashes โ Immunizations ROS in toddlers? โ Temperament โ Frequency & consistency of stools โ Number of wet diapers โ Immunizations โ Lead exposure โ Nutrition โ Sleeping and eating patterns
4 month old vaccines DTaP Hib IPV PCV RV 6 months vaccines Hep B DTaP Hib PCV Flu vaccine (yearly beginning at age 6 months) Anticipatory Guidance: Sleeping sleep on back with no stuffed animals, only small blankets anticipatory guidance for injury/illness prevention
- Injury and Illness Prevention o Hot water thermostat less than 120 degrees o Small parts / toys o Poison prevention o Safety locks o Stair gates o No standing water A healthy infant at age 9 to 11 months is expected to:
- Roll back to stomach
- Bring hands together
- Reach for an object with one hand
- Feed self cracker x Roll back to stomach A healthy 6 to 7-month old infant is able to:
- Roll back to stomach
- Crawl on Abdomen
- Reach for an object with one hand
- feed self cracker
Has a crude pincer grasp Dominant hand preference evident able to point and pick up small objects. feeds self with finger fine motor skills 6 months
- Grasps objects with both hands
- Transfers objects from hand to hand
- Shakes, bangs and drops objects gross motor skills 9 months
- Sits independently
- Crawling or creeping
- May pull to stand Red Flags
- Persistent standing on tip toes
- Scissors motion of lower extremities
- Persistence of primitive reflexes
anticipatory guidance for new born?
- Social determinants of health: living situation, environment, family support, WIC
- Parent and family health and well-being: maternal health and nutrition, transition home, sibling relationship, accept help, spend time with other children
- Newborn behavior and care: infant capabilities, baby care, illness prevention, calming your baby
- Nutrition and feeding: general guidance, 8-12 feedings for BF in 24hrs, at least 8 time if formula fed. anticipatory guidance first week?
- Social determinants of health: same
- Parent and family health and well-being: ask for help, rest and sleep when baby sleeps, spend time with other children
- Newborn behavior and care: early brain development, adjustment to home, calming, when to call MD, illness prevention, sing/read/talk to baby, avoid TV/Digital media, help baby wake for feedings/diaper changes/undressing, calm baby by stoking head or gentle rocking, never hit/shake baby, take temp rectally, not by ear or skin, wash hands, avoid sun
- Nutrition and feeding: same, should have 5-6 disposable wet diapers a day, 3- 4 stools
- Breast feeding every 1-3hrs daytime, 3 hours nighttime for 8-12 feedings
- Formula feed 2 oz. every 2-3 hours
- Safety: car seat safety, heat stroke prevention, safe sleep, rear facing car seat
