Case 3 Flashcards
What nutrition deficiencies are common in 3 year olds?
Pre-schoolers can suffer from poor nutrition. Inadequate fruit, vegetable, and iron intake is quite common.
Calcium and vitaA deficiencies are also common.
What type of vitamin supplementation should children receive?
Vitamin D because it is very difficult to attain he rec. daily allowance through nutritional sources or from sun exposure.
Toilet training for a three year old:
Toddlers at age 3 may not have achieved full toilet “independence” especially toddlers with intense, willful temperaments. Requiring assistance toileting is not a clear sign of developmental delay at this age, but may preclude attendance at child care or preschool.
When do the AAPD and AAP say that all children should be seen by a dentist?
Within 6 mo of the first tooth eruption or by one year of age.
What does the AAP state all children should be screened for by 6 months?
They should be screened by 6 mo to see if they are at a higher risk of developing caries.
When do many dentists feel the first visit should be?
At age 3
What does the National Transportation Safety Board advise for children older than 24 mo?
(or those who have outgrown the weight and height limits on their car seats) should be in a forward-facing car seat
How long should kids over 24 mo stay in a booster seat?
Until they reach a height of 4’9” (142 cm).
What is a major morbidity in the preschool years?
Injuries
Who should evaluate children less than 3 yrs with suspected developmental problems?
Early intervention (state mandated support for children with developmental delays), A developmental-behavioral pediatrician, a child psychiatrist or child psychologist, early childhood learning specialists
Who should evaluate children 3-5 yrs with suspected developmental problems?
If problems detected early, services provided by the school system for 3-5 yr olds can often help these children catch up with their peers.
Socio-emotional developmental milestones for a 3 yr old:
Dresses self and feeds self
Communication developmental milestones for a 3 yr old:
Speaks in 2 to 3 word sentences. 75% understandable.
Cognitive developmental milestones for a 3 yr old:
Knows name and use of “cup, ball, spoon, crayon”
Physical developmental milestones for a 3yr old:
Builds tower of 6-8 cubes, Throws a ball overhand, Rides a tricycle and Copies a circle.
Socio-emotional developmental milestones for a 4 yr old:
Knows gender and age, Friendly with other children, Plays with toys/engages in fantasy play.
Communication developmental milestones for a 4 yr old:
States first and last name, sings a song, most speech clearly understandable.
Cognitive developmental milestones for a 4 yr old:
Names colors, aware of gender, plays board games, draws person with 3 parts, copies a cross.
Physical developmental milestones for a 4 yr old:
Hops on one foot, Balances for 2 seconds, Pours, cuts and mashes own food, Brushes teeth.
Socio-emotional developmental milestones for a 5 yr old:
Listens and attends, Can tell difference between real and make-believe, Shows sympathy/concern for others.
Communication developmental milestones for a 5 yr old:
Articulates well, Tells a simple story using full sentences, Uses appropriate tenses and pronouns, Counts to 10, Follows simple directions.
Cognitive developmental milestones for a 5 yr old:
As children get ready for school, devel. milestones shift to more cognitive processes. Asking parents about school performance is as important as the following: Draws a person with greater than 6 body parts, Prints some letters and numbers, Copies squares and triangles.
Physical developmental milestones for a 5 yr old:
Balances on one foot, Hops and skips, Ties a knot, Has mature pencil grasp, Undresses/dresses with minimal assistance.
What does a typical eczema eruption look like?
Thickened skin and inflammation.
What has eczema been called?
“the itch that rashes” because there is a cycle of irritation leading to scratching, leading to the rash.
What should you educate parents about eczema?
Anything leading to itching (even a child’s rubbing his face on Mom’s sweater) can exacerbate eczema.
How eczema relates to allergies:
Eczema often occurs without a history of allergies. Eczema that occurs with allergies supports an atopic diathesis and should prompt you to ask additional questions about allergic triggers and asthma symptoms.
Family history of eczema?
Eczema tends to be familial, but there are typically multifactorial inheritance patterns and often clear environmental (allergic) triggers.
What are the basic tenets of eczema treatment?
Protecting the skin by lubricating extensively, using anti-inflammatories in short bursts and treating associated skin infections aggressively
What is the best pharmacological treatment for eczema?
Topical hydrocortisone, alternating a higher concentration for severe flares with a lower concentration for minor bouts. Often OTC hydrocortisone is inadequate.