Fine Motor Develop
Begin hand/eye coordination
Grasp with 2 hands
4 months
Hold head up while laying prone
6 weeks
Formula for fluid replacement
1000mL/kg for first 10kg
50 mL/kg for second 10kg
20mL/kg for remainder of weight
The first change you see when a child presents with a respiratory problem
Tachycardia
Absence of meconium in newborn, bilious vomiting, abd distention, poor weight gain, ribbon or pellet like stool
Hirschsprung's disease
Pincher grasp
What can we start when this is intact?
8 - 10 months
Finger foods
Can roll front to back, then back to front
6 Months
Pale, decreased turgor, dry mucous membranes, flat fontanelles, BP/HR normal
Mild dehydration
Inability to maintain adequate oxygenation with hypercapnia
Respiratory failure
Profuse watery diarrhea, Dehydration, skin breakdown on perineum, oral aversions
Short bowel syndrome
Scribble, string beads, holds a cup well
2 years
Sit up without support
8 Months
Gray, poor skin turgor, oliguria, fontanelles sunken, low BP, increased pulse
Moderate dehydration
Normal venous blood gas levels
pH: 7.25-7.45, pCO2: 41-51, pO2: 30-49, HCO3: 24-28, O2 Sat: 70-75
Viral infection causing airway swelling, increased mucous production, retractions, fever, rhinorrhea, decreased breath sounds and vomiting
RSV
Uses scissors and ties shoe laces
4 years
Stands alone and starts walking
1 year
Mottled, tenting, anuria, fontanelles depressed, low BP, rapid and thready pulse
Severe dehydration
Nursing management of respiratory problems
Monitor respiratory status, maintain clear airway, maintain normal body temperature, watch LOC, Monitor Labs, Monitor I&O's
Chronic disorder with abrupt onset, no fever, wheezing, retractions, chest tightness, cough
Asthma
Holds bottle, retrieves dropped items
6 months
Stands on one foot, hop with both feet, walk up and down stairs alternating feet while holding hand rail
3 years
This type of dehydration is the most difficult to correct. Seen most commonly in tube fed kids
Hypertonic dehydration
Describe proper trach suctioning
Do for no more than 10 seconds, suction on the way out, ensure you know how far you are allowed to go, watch O2 level during and after
Disorder of mucous producing cells, barrel shaped chest, frequent respiratory infection, chronic cough, thick honey mucous
Cystic Fibrosis