N331 - Lecture 2 Growth & Development


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Unformatted text preview: . EYES EYES PERRLA = pupils equal, round, reactive to light and accommodation Vision Testing: Snellen chart Strabismus – Extraocular movement – Corneal light reflex – Cover­uncover test Cardiac Assessment Cardiac Assessment Rhythm – Sinus arrhythmia Murmurs: Grade 1­6 Thrill: palpated 2nd intercostal space Capillary refill time Peripheral pulses RESPIRATORY ASSESSMENT RESPIRATORY ASSESSMENT http://www.wilkes.med.ucla.edu/cracklesmain.htm http://www.wilkes.med.ucla.edu/wheezemain.htm Shape of chest Auscultate breath sounds – Rales (crackles)­sound made moving through fluid – Rhonchi­obstruction in large bronchi – Wheeze­air through narrow passages Watch for nasal flaring, retractions, use of accessory muscles, grunting Abdominal exam Abdominal exam Newborn: umbilicus Bowel sounds in 4 quadrants Hernia – Inguinal – Umbilical Musculoskeletal Musculoskeletal Strength and tone Active range of motion Posture and gait Hips and feet NEUROLOGICAL NEUROLOGICAL ASSESSMENT Need to know developmental stages Dysfunction: history of different behavior and/or change in sensorium Infant primitive reflexes – Moro, palmar/plantar, rooting… extinguished by 4 months Coordination and balance Infant reflexes: Babinski Infant reflexes: Babinski Normal: Infancy Dorsiflexion of big toe and fanning of other toes Disappears with ambulation Abnormal after 18 mo ­ 2 years. Health Promotion Health Promotion Provide “anticipatory guidance” at every visit (AAP.org) Safety 2. Nutrition 3. Health care 1. (Review CDC Immunization Schedule) Safety Issues Safety Issues Car safety Pets Lead Poisoning Toys Medicines Airbags…. (brightfutures.org) Mortality Stats Mortality Stats Age 1 to 4 years –Unintentional Injuries –Congenital malformations Age 5 to 14 years –Unintentional injuries –Cancer Age 15 to 24 ye...
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