Ch 7 Flashcards
In general, the younger the person, the __ his or her pulse and respiratory rates should be
Faster
Blood pressure values tend to ___ with age
Increase
From birth to 1 month of age, a person is called a
Neonate
From 1 month to 1 year of age, a person is identified as an
Infant
At birth, a neonate usually weighs between 6 and 8 pounds (3 to 3.5 kg). The head accounts for about__ of this weight.
During the first week, a neonate’s body weight decreases by 5% to 10%, due to fluid loss. By the second week, the neonate begins to gain weight. From there on, infants grow at a rate of about 1 ounce (30 g) per day, doubling their weight by 4 to 6 months and tripling it by the end of the first year.
25%
Because their heads account for 25% of their total body weight, neonates and infants often land ___ when they fall
Headfirst
Prior to north, fetal blood supply comes from the mother via the
Placenta
During the birthing process,___changes help the neonate make the transition from fetal circulation to independent circulation
hormones and pressure
The leading cause of death for the neonate and infant age group is
Congenital abnormalities (ie, birth defects)
is illustrated when neonates are caught off guard and startled, at which time they open their arms wide, spread their fingers, and appear to be grabbing for something.
The Moro reflex (commonly called the startle reflex)
An infant’s upper airway is quite different from that of an adult. The infant’s tongue is larger in proportion to the size of the oral cavity, and the airway is proportionally__ and narrower. As a result, airway obstruction is more common in infants than in older children and adults.
Shorter
Due to factors such as the proportionally oversized occiput, the increased flexibility of the trachea, and the infant’s limited or absent ability to reposition himself or herself, it is crucial that the EMT preserve the airway’s patency through proper positioning. ___the infant’s head and neck can easily produce an airway obstruction
Hyperextending or hyperflexing
Forceful ventilations and overinflation increase pressure in the lungs and can result in pressure-induced trauma, referred to as__.
The muscles that infants use to breathe are immature, and the number of alveoli in their lungs is relatively low.
barotrauma
The__ fontanelle normally closes by the third month. The__ fontanelle closes between 9 and 18 months. When present, the fontanelles can provide the EMT with valuable information about the child’s condition. For example, a depressed fontanelle may indicate dehydration, whereas a bulging fontanelle is often a sign that pressure inside the cranium has increased.
Posterior
Anterior
By __ months of age, infants can track objects with their eyes and recognize familiar faces.
2 months of age
At _ months, they can sit upright , and they begin to make cooing and babbling sounds.
6 months
By the time an infant is _ months of age, the infant can walk with minimal assistance and knows his or her name
12 months of age
While still in the womb, the neonates immune system is supported by the mothers __, delivered through placental blood flow. Infants continue to carry some of this immunity. This passive immunity is further strengthened by __ contained in breast milk
Antibodies
For most infants, the primary method used to communicate distress is
Crying
The pace at which infants develop relationships with their parents or caregivers varies greatly from one child to the next.
Bonding, the formation of a close, personal relationship, is generally fostered by a___, which results when the infant understands that his or her parents/caregivers will respond to his or her needs. Having this confidence that his or her parents will provide a “safety net” inspires the child to venture out and explore.
secure attachment
The___ is displayed when something touches the neonate’s cheek and he or she intuitively turns his or her head in the direction of the touch.
rooting reflex
The__ is illustrated when a breastfeeding mother strokes her baby’s lips with her nipple, prompting the child to latch on.
sucking reflex
At birth, the bones of the cranium are not yet fully developed or fused together. Instead, the gaps between these bones are connected by relatively flexible fibrous tissue. These areas, called__, allow the newborn’s head to change shape slightly as it passes through the narrow birth canal
fontanelles
By contrast,___ is the result of recurring rejection. Infants who acquire this form of attachment show little emotional response to their parents/caregivers and treat them as they would a stranger. These children may compensate by developing an isolated lifestyle wherein they avoid having to depend on the support and care of others.
anxious-avoidant attachment
In older infants,___ is common. Characterized by clingy behavior and fear of unfamiliar places and people, it typically reaches its peak between the ages of 10 and 18 months. Crying as a means of protest is normal at this age. As they grow accustomed to their homes and families, infants have an inherent need for a secure, stable environment.
An environment that is too unpredictable may trigger feelings of despair, causing the child to become withdrawn. This experience may even lead to trust issues later in life.
separation anxiety
___refers to the stage of psychosocial development beginning at birth and concluding at approximately 18 months of age. As the name implies, it is a time when children learn whether they can trust the people around them.
Because infants depend entirely on their parents/caregivers, a crucial element in the formation of this trust is the quality of care the infant receives from them. When their needs are met consistently in a stable environment, children learn to trust those responsible for their well-being. Conversely, if their parents/caregivers are inconsistent, emotionally unavailable, or rejecting, children may develop a sense of mistrust
Trust versus mistrust
Physiologically , by __ months of age, toddlers possess the neuromuscular capability to control the bladder. However , many are not psychologically prepared until about 18 to 30 months of age. The average age when toddlers complete toilet training is 28 months.
12 to 15
A type of reasoning in which a child acts almost purely to avoid punishment or to get what he or she wants
Preconventional reasoning
A type of reasoning in which a child looks for approval from peers and society
Conventional reasoning
With __ the child’s moral compass is directed by external forces,such as parental discipline
Preconventional reasoning
A type of reasoning in which a child bases decisions on his or her conscience
Post conventional reasoning
Neonates are primarily known as __ breathers
Nose breathers
A neonates __ allow the head to be molded. They eventually fuse to form the skull
Fontanelles
An __ tongue is larger in proportion to the oral cavity , and the airway is proportionally shorter and narrower
Infant
The __ fontanelle normally fuses by the third month of life
Posterior
The ___ fontanelle fuses between 9 and 18 months of age
Anterior
By __ months, the infant is able to track objects with his or her eyes and should recognize familiar faces
2 months
At __months, the infant is able to sit upright and begins to make cooing and babbling sounds
6 months
By _months ,the infant can walk with assistance and even knows his or her name
12 months
___,or the formation of a close personal relationship is based on a secure attachment
Bonding
__is observed in infants who are repeatedly rejected. Children show little emotional response. Often develop an isolated lifestyle
Anxious-avoidant attachment
(ages 1 to 3 years):
• Pulse rate is normally 90 to 150 beats/min.
• Respiratory rate is 20 to 30 breaths/min, slower than the corresponding vital signs in infants.
• Systolic blood pressure is higher (80 to 100 mm Hg).
• Average body temperature is 96.8°F (36°C) to 99.6°F (38°C), usually leveling off at 98.6°F (37°C) by school age.
Toddlers
(ages 3 to 6 years):
• Pulse rate is 80 to 140 beats/min.
• Respiratory rate is 20 to 25 breaths/min.
• Systolic blood pressure is 80 to 100 mm Hg.
• Weight gain levels off.
Preschoolers
_peaks between 10 and 18 months of age
Separation anxiety
___ months of age, basic language is mastered. By the age of 3 or 4 years, most children can use and understand full sentences
36 months
By __ to __ months, toddlers begin to understand cause and effect
18 to 24
School aged children (6 to 12) children act almost purely to avoid punishment and get what they want
Preconventional reasoning
School aged children (6 to 12) children look for approval from their peers and society
Conventional reasoning
School aged children (6to12) children make decisions guided by their conscience
Post conventional reasoning
Is our perception of ourselves
Self concept
Is how we feel about ourselves and how we fit in with our peers
Self esteem
From ages 6-12, school age children’s vital signs and body approach those observed in adulthood. Most children grow about __ and __ each year
4 Ib and 2.5 inches
__(ages 12 to 18 years):
• Systolic blood pressure is generally between 90 and 110 mm Hg.
• Pulse rate is between 60 and 100 beats/min.
• Respirations are in the range of 12 to 20 breaths/min.
• Growth begins with hands and feet, then moves to the long bones of the extremities, and finishes with growth of the torso.
• Boys typically experience this growth spurt later in life than girls.
• Secondary sexual development and enlargement of the external reproductive organs begins.
• Menarche usually occurs during this time.
adolescents
The need for privacy and personal space from siblings and parents becomes an important issue for adolescents.
• Self-consciousness also increases.
• Antisocial and high-risk behavior and peer pressure tend to peak at around age 14 to 16 years.
• Many adolescents are fixated on their public image and are terrified of being embarrassed.
• A code of personal ethics is developed based partly on parents’ ethics and values and partly on the influence of the adolescent’s environment.
Adolescents
__range in age from 19 to 40 years.
• Pulse rate will average around 70 beats/min.
• Respiratory rate will stay in the range of 12 to 20 breaths/min.
• Systolic blood pressure will be between 90 and 120 mm Hg.
• Lifelong habits are solidified.
• At the beginning of this period, the body is working at peak efficiency, but as adulthood continues, subtle wear and tear and changes in body tissues and muscles begin.
• The disks in the spine begin to settle.
• Fatty tissue increases, which leads to weight gain.
• Muscle strength decreases.
• Reflexes slow.
• Despite the amount of stress and change, this age group enjoys one of the more stable periods of life psychologically.
Early adults
__are ages 41 to 60 years.
• This group is vulnerable to:
• Vision and hearing loss
• Cardiovascular issues
• Greater incidence of cancer
• In women, menopause begins in the late 40s or early 50s.
For ages 45 to 60, the leading cause of death is cancer.
•In addition to supporting children, middle adults may experience an overlapping period during which they must also care for their aging parents.
Middle adults
__(61 Years and Older):
• In the early 1900s, the average human life expectancy was 47 years of age.
• In more modern times, that number has increased to approximately 78 years, with a maximum life expectancy of approximately 120 years, leading to more older adults (61 years and older).
How long an individual lives is determined by many factors, including:
• Birth year
• Country of residence
• Thanks to medical advances, older adults are often able to overcome numerous medical conditions but may need multiple medications to do so.
Older Adults
Cardiac function declines with age as a result of anatomic and physiologic changes largely related to atherosclerosis.
• Cholesterol and calcium build up inside the walls of coronary blood vessels, forming plaque, which leads to a partial or complete blockage of blood flow.
• More than 60% of people older than 65 years have atherosclerotic disease, leading to decreased blood supply to the organs of the body.
Other age-related changes typically include:
• Decrease in heart rate.
• Decline in cardiac output.
• Inability to elevate cardiac output to match the demands of the body.
• Because heart muscle may weaken with age, the increase in heart rate can damage the heart.
• The vascular system becomes stiff and diastolic blood pressure increases.
• Bone marrow is replaced with fatty tissue.
• Results in a decrease in the ability of the bones to manufacture more blood cells.
Older adults
A disorder in which cholesterol and calcium build up inside the walls of blood vessels, eventually leading to partial or complete blockage of blood flow
Atherosclerosis
The size of the airway increases and the surface area of the alveoli decreases.
• As the elasticity of the lungs decreases, the overall strength of the intercostal muscles and diaphragm decreases.
• This rigidity makes the chest more fragile.
• The older person will then have less respiratory reserve to use to maintain adequate breathing.
The structures that protect the upper airway decrease in function.
Results in making it more difficult to maintain the upper airway, resulting in a greater risk of aspiration and airway obstruction.
• Collapsing airways result in low flow rates and air trapping, because air does not completely exit the alveoli (incomplete expiration).
Immune cells are less functional, leading to an increased risk of lung infections.
By age 75, vital capacity decreases and residual volume (the amount of air left in the lungs after expiration of the maximum possible amount of air) increases with age.
• Vital capacity may amount to only 50% of the vital capacity of a young adult.
Factors contributing to this decline include:
• Loss of respiratory muscle mass.
• Increased stiffness of the thoracic cage.
• Decreased surface area available for the exchange of air.
Older adults
Glucose metabolism slows, while insulin production decreases.
• Sexually, men continue to produce sperm long into their 80s (although the rigidity of the penis typically diminishes over time).
The size of a woman’s uterus and vagina decreases.
Hormone production in both sexes gradually declines.
Older adults
Taste bud sensitivity to salty and sweet sensations decreases.
Saliva secretion decreases, which reduces the body’s ability to process complex carbohydrates.
Older people may have loss of teeth that impacts their ability to chew.
The ability of the intestines to contract and move food along diminishes.
Gastric acid secretion diminishes.
Blood flow may drop by as much as 50%, decreasing the ability of the intestines to extract vitamins and minerals from digested food.
Gallstones become increasingly common.
Anal sphincter changes reduce elasticity and can produce fecal incontinence.
Older adults
Filtration function declines by 50% from age 20 to 90 years.
• Kidney size decreases by 20%, due in part to the decreased effectiveness of the blood vessels that supply blood to the nephrons.
• Loss of renal function means:
• A decrease in the ability to clear waste from the body.
• A decreased ability to conserve fluids when needed.
Older adults
The basic filtering units in the kidneys
Nephrons
Brain weight shrinks 10% to 20% by age 80.
Motor and sensory neural networks become slower and less responsive.
The metabolic rate in the older brain does not change and oxygen consumption remains constant throughout life.
Brain cells (neurons) decrease, but there is great flexibility in the operation of the brain.
• Interconnections between brain cells continue as people age and provide redundancy, allowing for loss of neurons without loss of knowledge or skill.
Sleep patterns change.
• Age-related shrinkage creates a void between the brain and the outermost layer of the meninges, which creates room for the brain to move when stressed.
Functioning of the peripheral nervous system slows.
Sensation becomes diminished and misinterpreted.
Kinesthetic sense diminishes.
Slower reactions cause longer delays between stimulation and motion.
• Nerve endings deteriorate.
• The ability of the skin to sense the surroundings fails.
Older adults
Pupillary reaction and ocular movements become more restricted.
• Pupils are smaller, and the opacity of the eye’s lens diminishes visual acuity and makes the pupils sluggish when responding to light.
• Visual distortions are common.
• Hearing loss is four times more common than loss of vision in late adulthood.
• Changes in several hearing-related structures may lead to a loss of high-frequency hearing or even deafness.
Older adults
In _ adults, insulin production decreases but a slowdown in the metabolism increases the need for insulin, and diabetes can result. Making this age group most likely to suffer from diabetes
Older adults
