NCLEX 3000: PEDIA Infant FVD (Dehydration) o Sunken fontanels o Hypotension, Tachycardia, Tachypnea o Inc Specific Gravity (Concentrated)

d) Anteroposterior and lateral diameter 1:1 Cleft Lip o Use BULB SYRINGE with RUBBER TIP in feeding Post Cheiloplasty o Maintain integrity of the operative sire (primary goal) o Clean the suture line carefully with sterile solution after every feeding (to avoid infection) o Side lying position to drain saliva without affecting the suture line o Avoid crying (it puts tension on the suture line) Anticipate the babys needs; comfort the child as quickly as possible o Kept away from suture line the hard objects (can cause damage) o Apply ELBOW RESTRAINTS May cause agitation Must be removed one at a time every 2-4 hours o Fed with RUBBER DROPPER or BRECK FEEDER to prevent sucking or suture line trauma o LOGAN BAR Hold infant semi-upright during feedings to prevent aspiration Must be kept in place at all times to protect suture line Should be burped more frequently to prevent regurgitation and aspiration Increased ICP o Decreased or altered LOC o Bulging fontanel o Bradycardia, Bradypnea o Increased head circumference (early) o Vomiting (late) o Papilledema (late, may not be evident) Inorganic Failure to Thrive o Maintain consistent, structured environment o Should receive social stimulation rather than confined to bed rest o Minimize number of caregivers to promote consistency of care o Do not encourage infant to hold bottle (reinforces an uncaring feeding environment) Tracheoesophageal Fistula o Continuous drooling o Excessive oral secretions o Choking and coughing (pronounced during feeding)

Head elevated at all times NPO Suction regularly to maintain patent airway and prevent pooling of secretions Developmental Milestone: o 1 months head lag; midline vision o 2 months social smile; coos o 3 months carries hand to mouth; peripheral vision; babbles o 4 months no head lag; reaches for objects o 5 months roll over; smiles @ mirror o 6 months sits with support; holds bottle o 7 months transfer objects one hand to another o 7-8 months sits without support o 8 months close open hand o 9 months crawls/creeps; pincer grasp o 10 months object permanence; starts to stand o 11 months cruises; shakes head for NO o 12 months walks with support; drinks from cup o 15 months walks without support; say 2 words o 17 months feed himself with spoon o 2 years old jumps one level o 3 years old walks backward; tricycle o 4 years old button buttons; hold on 1 foot o 5 years old hand dominance (knows right and left); throw/catch a ball; tie shoelaces o 7 years old bicycle Caput Succedaneum vaguely outlined area of scalp edema that crosses the suture line and typically clears within a few days after birth Cephalhematoma swelling of the head that results from SQ bleeding caused by pressure exerted on the soft tissues during delivery; characterized by sharply demarcated boundaries that dont cross the suture lines Metabolic Acidosis tachypnea Myelomeningocele preventing infection (primary preoperative nursing goal) Congenital Hip Dislocation o Ortolanis Sign o Trendelenburgs Sign o Assymetrical thigh and gluteal folds o Limited hip abduction o Femoral shortening Bronchiolitis o At risk for developing ASTHMA o If dx and tx promptly, can recover and return home o Dont have recurrences Capillary Hemangioma Stork Bites

o Appear on upper eyelids, bridge of nose and nape of neck o Result from vascular congestion and disappears as skin thickens Hirschsprungs Disease o Failure to pass meconium within 24 hours after birth Metro Manila Developmental Screening Test evaluates the developmental level of social, motor and language skills in children ages 0-6 years Proximodistal development center of the body to the extremities Cephalocaudal development head to toe Mass to specific/Differentiation occurs as child masters simple operations before complex functions and moves from broad, general patterns of behavior to more refined ones Stools of Infants: o Breast-fed infants soft bright yellow or light green stools without offensive odor o Formula-fed infants pale yellow, semiformed stools with strong odor o Neonates first stool dark green to black, sticky and odorless (meconium) present for 1st 3 days Reflexes: o Startle 4 months o Moro 4 months o Step 4 months o Extrusion 4 months o Sucking 4 months o Rooting 4 months o Tonic Neck 4-5 months o Perez 5 months o Babinski 12 months Necrotizing Enterocolitis (NEC) o Distended abdomen o Gastric retention o Blood in the stool Cystic Fibrosis o TX: Pancrelipase (Pancrease) Weight o 6 months doubles o 12 months triples Lumbar Puncture on Infant o Arched, side lying position to maximize space between 3rd and 4th lumbar vertebrae o Nurses hand should rest on the back of the infants shoulders to prevent neck flexion which could block the airway and cause respiratory arrest o Placed at the edge of the bed or table during the procedure o Nurse should speak quietly to calm the child CPR o Place fingers one fingerbreadth below the nipple line directly over the sternum

F&E Imbalance because of immature kidneys (Inadequate GFR and absorption) Sudden Infant Death Syndrome (SIDS) occur between 1 week and 1 year; peaks at 24 months Infants up to 7 years old abdominal breathers Preterm Infant o Abundant lanugo o Patchy fine hair distribution o Absent plantar creases Postterm Infant o Abundant SQ fats o Long silky hair o Absent vernix caseosa o Dry cracked skin o Long nails