Examl1:lNU664A/lNUl664Al(LatestlUpdate)l
PrimarylCareloflChildlIlGuide|lQsl&lAsl|
lGradelA|l100%lCorrectl(VerifiedlAnswers)-
lRegis
Q:lVisionlforlnewborns
Answer:
-
Limited,lbutlhaslthelabilityltolfocuslbrieflylonlalfacelorlbrightlobjectlwhenlitlislbroughtlintolvis
uallrangel(aboutl8lcol12lincheslfromltheirlface).l
-Visuallyltracklobjectsltolmidline
-
Infantlseeslandlrespondsltolchangelinlillumination;lrefusesltolreopenleyeslafterlexposureltolbrig
htllight;lincreasinglalertnessltolobjects;lfixesltolcontrastsl(blacklandlwhite);ljerkylmovements;lp
upillarylreactionlpresent
-Disordersltheylarelatlrisklforl
1.lRetinopathyloflprematurityl-
lretinallvascularlpathologicldiseaselcausedlbylearlylgestationallagelwithllowlbirthlweight;labnor
mallgrowthloflthelretinallvesselslinlincompletelylvascularizedlretinasloflprematurelinfantsl
-Eyelexams
1.lNewbornltol3lmonthsl-
locularlhistory,lredlreflex,linspection;lreferliflabnormallorlasymmetric;lstructurallissue
2.l3-6lmonthsl-locularlhistory,lfixlandlfollow,lredlreflex,linspection
3.l6-12lmonthsl-
locularlhistory,lfixlandlfollow,lalternatelocclusion,lcornealllightlreflex,lredlreflex,linspection,lph
otoscreening
4.l3lyearsloflagelandleveryl1-2lyearslafterl5lyearsloflagel-
lvisuallacuity,lcornealllightlreflex/cover&uncover,lredlreflex,linspection,lattemptlophthalmoscop
yl
-
Inabilityltolfixlandlfollowlafterl3lmonthsloflagelwarrantslalreferralltolophthalmologistlorlanleye
,lspecialist;lsubsequentltestinglshouldloccurlatl4lyearslandl5lyearslandlyearlylorlbiannuallyluntill
agel18lyearslold
Q:lPrematurityl&ldevelopmentalltasks
Answer:
-
Duringlassessmentlaccountlforltimelthelinfantlwaslbornlearlylintoltheldevelopmentallprocess.lP
aylcloselattentionltoldevelopmentalldelaysltolintervenelearly
-
Demonstrateladequatelweightlgain,ltemperaturelcontrollinlopenlcriblforl24lhours,lcompetentlfee
dingslwithoutlcardiorespiratorylcompromise,landlmaturelandlstablelcardiorespiratorylfunctionlf
orl5-7ldayslwithoutlcaffeine
-Ensureladequacyloflimmunizationslbasedlonlinfant'slchronologicallagel
-Conductlfundoscopiclevaluationliflnecessary
-Screenlforlanemialandlnutritionalltasks
-Risklforleyelissues
Q:lBreastfeedinglbabyl-lnorms
Answer:
·lLetlinfantlbreastfeedlonldemand.
·lIflstoolsldecreaselthatlwouldlbelokay.
·lGainl5-7ozlperlweek
·lNeedlVitaminlDlsupplement
·lMaylsleeplatlnightliflinfantlcaughtluplwithlfeedingslduringlthelday
·lActivelandlalertlstate
·lDevelopmentallylappropriatelprogress
·lAge-appropriatelheightlandlheadlcircumference
·lGoodlskinlturgorlandlcolor
·lSufficientloutputloflatlleastlsixlwetldiaperslandlseverallstoolslperlday
·lContentlandlsatisfiedlbehaviorlafterlfeeding
-Tolthelbreastl8-12ltimeslalday,leveryl2-3lhours
-Successfull-l0.5-1lozlalday/lorl4-7oz/week
,-Inlthelfirstldayslofllife,l1-
3lpeeslinl24lhours;lbyldayl3l3lorlmorelwetldiaperslinl24lhours;lbyldayl4;l4-
6lwetldiapers;loverltimel-l6-8
-Stoolsl-linlthelfirstl24lhoursl-lonelmeclfollowedlbylanotherlonlsecondlday;lbylthirdl-
ltransitionallstoollandl2-3/24lhours;linfrequentl-lcalllforlalweightlcheck
-Increasedlsleepiness,llesslstool,ljaundicel-lbabylneedsltoleatlmore
Q:lTwolweeklvisit
Answer:
-
Shouldlregainlbirthweightlbyl2lweeks;lShouldlgainl0.5/1lozlperldaylorl2lpounds/monthlforlnext
l5lmonths
-Onelinchlperlmonthlforlfirstl6lmonths
-HClincreasesl0.5lcm/monthlinlfirstlyearl
-Moveslalll4lextremities;lstartlelresponseltolnoises;lmaylhavelalsmile;ltummyltime
-Discourageltakingltolmanylplaces
-Immunizationsl-lHeplBlifldidn'tlgetlinlhospital;lbeforeltwolmonths
Q:lOne-monthlvisit
Answer:
-Shouldlhavel1-6lyellowlpastylstools/24lhours
-Shouldlvoidl1-3lhourslorlwithleachlfeedingl
-Awakelandlalertlforlfeedings,leveryl2-4lhours;l15-20lminuteslthenlfalllbackltolsleepl
-
Weightlinfantlnakedlonlinfantlscales;lcompareltollastlandlcalculatelrateloflgain;lmeasurellengthl
onllengthlboardlandlHC;lplotlonlNCHSlgrowthlcharts;lshouldlgainl0.5-
1lozlperldaylorl2lpoundslperlmonth;lgrowsl1linchlperlmonth;lHCl0.5/month
-Respondsltolhumanlfacelandlfollowslwithleyes;lattentiveltolpatientslvoice
-
Maylbelableltollifelheadlofflbedliflonltummy;lmaylhavelalsmile;llooklforlthrush;lpalpatelforlma
sseslinlabdomen;lkeepslhandslfisted;lmaylbelcolicy;lneedsladditionallcomfort
, -Immunizationsl-lGetlHeplBlifldidn'tlgetlitlandlHBsAglislnegative
Q:lTwo-monthlvisit
Answer:
-6-8lounceslalfeeding,l4-6lfeedings/24lhours;lsleepsl3-4lhourslatlaltime
-90lmllinlfirstl20lminutesloflfeedings
-1-5lyellow,lpasty,lbutlformedlstoolslinl24lhours;lbreastfedlbabieslmaylhavelmore
-Voidleveryl1-3lhoursl
-Sleepl16-18lhourslalday;lmaylsleeplthroughlnightlandlawakelperiodslduringlthelday;l
-Plotlgrowthl-lshouldlgainl0.5-0.75loz/daylorl2lpoundslalmonthlforlthelfirstl4-
5lmonths;lgrowsl1linchlperlmonth;lHCl0.5/monthl
-
Holdslheadluprightlforlshortlperiods;lrespondsltolsmilinglwithlreturnlsmile;lbabbles;lshowslinte
rest;lmoveslalllfourlextremities;lmaylcrylbutlparentslarellearninglwhatltheylmean
-Immunizationsl-lHepatitislBl#2,lrotavirus,lDTaP,lHib,lPCV13,landlIPV
Q:lFour-monthlvisit
Answer:
-Infantleasilyldistracted
-Iflexclusivelylbreastfedl-lironl1lmg/kg/dayluntilliron-richlfoodslinldietl
-26-34loz/dayloflformula
-6-8lwetldiaperslalday;lbreastfedl-l1lstoollperldayltol1lstoolleveryl7-10ldays;lsoft,lsemi-
formedlodorlnotloffensive;lformulal-l1lorlmorelstools/day,lmaylbelmorelodoriferousl
-Sleepsl12-15lhourslperlday;lnightl9-12lhours;lnapsl2-4ltimes/day
-Consistentlbedtimelroutine;lputltolbedldrowsy;lnightllightliflwant
-Shouldlgainl0.5-1lozlaldaylorl2llbslalmonth;ldoubleslbirthlweightlbyl4-
6lmonths;lgrowsl0.8lin/month;lHCl0.4lcm/month
-
Graspslobjects,lbeingslwithinlrakinglmotion;lbringslhandsltogether;lfollowslobjectslwithleyesl1
80ldegrees;lgoodlheadlcontrol,lliftslheadlandlchestlwhenlprone;lbearslweightlonllegs;lrollslfrom
lfrontltolback;lrootinglandlpalmarlgraspldisappear;lMoro,lBabinski,landltoniclnecklnollongerlasl
prominent,lmayldisappearlbyl4lmonths;lbeginsltollinklwithlaction,labilityltolwaitlbeginsltoldeve
