Class two Flashcards
When is head control developed? Gross/fine?
1-3 months
Gross
When is core strength/rolling/no head lag developed? Gross/fine?
4-6 months
Gross
Tummy to back - 4 m
Back to tummy - 6 m
When can an infant sit w/ or w/o support? Gross/fine?
With support: 6
Without support: 9 months
Gross
When can an infant crawl/cruise? Gross/fine?
9-12 months
Gross
When can an infant walk? Gross/fine?
12-15 months
Gross
When can an infant put hand to mouth? Gross/fine?
2-4 months
Fine
When can an infant hand gasp? Gross/fine?
Palmer: 6 months
Pincer: 9 months
Fine
When can an infant transfer objects between hands? Gross/fine?
6-8 months
Fine
When can an infant track objects and attend voices to faces? Gross/fine?
2-4 months
Fine
How does an infant develop trust?
caregivers consistently meeting their basic needs like feeding, diaper changes
What is separation anxiety and why does it occur?
Separation anxiety is the distress of a baby when the caregiver leave them
Occurs because the until 9 months, baby believes that they are one with the caregiver
When does separation peak? When does it go away?
Separation anxiety peaks at 6 months and goes away around 9 months
Why does separation anxiety go away?
Development of object permanence
What is stranger anxiety?
Baby’s distress around being in the care of someone who is not their caregiver
When does stranger anxiety start? Peak? End? Chronically ill?
Starts at 9 months
Peaks in toddler years
Stops at 2-3
With chronic illness, can be prolonged and not stop until age 5
What are the milestones for language in infants into toddler years?
3 months - 3 letters word (coo)
6 months - 6 letter word (babbles/make noises)
9 months - 9 letter words imitation (repetition babbling: mama, dada)
12 months - 1-2 words (hi, bye)
18 months - 18 words
2 years - 2 word phrases
3 years - 3 word phrases
4 years - 4 or more word sentences
At what age does vocabulary explode?
At the age of 2
What is examined at every well child visit for infants?
- G&D (milestones and physical growth)
- Care needs/patterns like sleep, exercise/play, nutrition, elimination
- Safety
- Vaccinations and health surveillance
What does growth look like in the first year?
Doubles in 6 months
Triples in 12 months
When does teething start? S/S of teething? When can s/s of teething start?
6-12 months
Chewing on hands, drooling
s/s can start as early at 4 months
What are major safety concerns for infants?
Death by accidents
SIDS
Car seat
Smoke exposure
Choking
Baby proof home
How much does an infant sleep during their first 2 months of life?
18-22 hours
When can an infant physiologically sleep through the night?
6-9 months
What does play look like during the first year?
Tummy time
Environmental stimulation
When does an infant get their nutrition form in the first year?
Breast milk/formula for first 6 months
Introduce solids at 6 months
Vitamin D
Iron supplements
How often are feeds for infants?
Frequent every 1-2 hours
What does elimination look like in infants?
Bowel movement with every feed
5-6 wet diapers/day
When should oral care start? What does oral care look like? When should an infant go to the dentist?
Oral care should start with the fish tooth
Wet wash cloth to wipe teeth - no fluoride until can spit it out
Dentist at one year
When should a child go in for health surveillance and vaccine? Why so often?
1-2, 4, 6, 9, 12 months
Milestones and vaccines need to be checked. Vaccines need to be given often because the immune system is not fully developed until 2 years old
What are the risk factors for SIDS?
- Preemies
- History of apnea or CPR
- Low birth weight or Apgar scores
- Second hand smoke exposure
- Cosleeping
- Male sex
- Recent illness
What can help reduce the likelihood of SIDS and promote safer sleep?
A: always sleep you baby
B: on their back
C: in a clear cot or sleep space
When does the posterior fontelle close? Anterior?
Posterior: 2-3 months
Anterior: 18 months
When does an infant begin to socially smile?
2 months
When can infants understand the word no?
8-9 months
What age does babinski and other infant relfexes go away?
9 months
How much weight does a toddler gain every year? Height?
4-5 lbs/year
3 inches/year
When does potty training begin?
18-24 months
What is a major task in toddlers?
potty training
What is a major task in preschoolers?
school readiness
How do toddlers and preschoolers learn?
By mimicking adults and pretend play
What is the difference between the stance of a toddler and preschooler?
Toddler: bull legged
Preschooler: thinner, taller, knee knocks (knees very close together)
What milestones should a 15 months old complete?
Walks without help
Uses cup
Stacks 2 blocks
What milestones should an 18 month old complete?
Throws ball
Clumsy run
Uses spoon
Scribbles
What milestones should a 24 months old complete?
Alternates feet on stairs
2 words sentences
300+ word vocabulary
Body parts
Stack 4-6 blocks
Brush teeth
Jump with both feet
Look at shapes and match
What milestones should a preschooler complete?
Balances/hops on 1 foot
Rides bike with training wheels
Dress and undresses self
Uses scissors
Draws figures
Counting
Letters
What is the speech of a preschooler like?
75% understandable
Stutters when excited
3 word sentences
What vision does a toddler have?
20/20 vision
Why should you approach a toddler with caution?
Stranger anxiety
No emotional regulation
No logical reasoning so best to not try to talk things over
What is Piagets explanation of a child’s response to a new sibling?
Ego centrism (they are the only one that matters) and magical thinking (if they want something bad enough it will come true)
No empathy
Make it go away
How should you approach a toddler?
Give them choices
Make things a game
If parent is in the room, ignore the child and talk with the parent making the toddler feel in control and see that the parents trust you
Therapeutic play
What is animism?
Toys/objects have voices, thoughts and intentions
What is Erikson’s stage for toddlers? What age? What occurs in this stage?
18 months - 3 years
Autonomy vs. shame/doubt
Toddlers exercise will and do things for themselves but doubt their abilities
What is Erikson’s stage for preschoolers? What age? What occurs in this stage?
3 years - 5 years
Initiative vs. guilt
Preschoolers initiate tasks and want to do something for themselves or they feel guilty about the effort they give to be independent
What is going on psychosocially with toddlers?
Independence increases
Egocentrism “MINE”
Negativism “NO”
Temper tandrums escalate
What should the discipline be for toddlers?
Consistent
Encourage good behaviors
Ignore negative and reward positive
What do toddlers have temper tantrums?
Lacking communication so can’t express their needs –> frustration
What is going on psychosocially with preschoolers?
Independence and initiative
Begin to share and develop empathy
Ask “WHY” to figure things out
Tantrums decrease as language develops
Discipline
What is regression? What are some examples?
Returning to a previous or less developed stage
A completely potty trained child begins to have accidents
Only will drink from a bottle
What age is regression common in?
Toddlers and preschoolers
Why do children regress?
A way to cope with stress
Stress can be triggered by a new sibling, hospitalization
What is covered during a well child visit for toddlers and preschoolers?
G&D
Care needs/patterns like sleep, exercise/play, nutrition, elimination (potty training)
Safety
Vaccines and health surveillance
What are some major safety concerns regarding toddlers and preschoolers?
Gross motor skills increase but lack of coordination –> injury
Car seat safety
Falls
Drowning
Poison
Choking
Burns
How long should a child face backwards in a car seat? How long should a child be in a car seat/booster?
Backwards until 2 years due to head/neck control
40 lbs or 12 yoa for booster
What is the sleep for toddlers and preschoolers?
sleep threw the night for 12 hours with a nap during the day but eventually nap is eliminated
What is the nutrition for toddlers and preschoolers?
Decreased need for calories due to slow growing
Picky eaters
Normal serving size is a tablespoon
What is the elimination for toddlers and preschoolers?
Establish potty training
Around 18 the child can physically hold their bladder but usually not emotionally ready yet.
Generally start at 2-3 and might not be fully potty trained until 4
What do vaccines look like in toddler/preschool age? When can they begin getting a flu shot?
Catch up
Pre-k
Flu shot at 6 months
What occurs in toddler/preschool age
Body image develops
Genital exploration
School readiness
What often should toddler/preschool get health exam? Should the get dental exams?
Annual health exams
Yes dental exams
What are the functions of play?
Physical development
Cognitive development
Emotional development
Social development (how to interact, rules, teamwork)
Moral development
What is familiarization and symbolic play?
Type of play used to relieve fears of children
Primary play used in healthcare setting
Familiarization: engage with medical equipment like hands on stethoscope or BP cuff
Symbolic: game or activity
What is solitary play? When does this play occur?
Infants
Independent play
Child plays alone with toys
Self-entertaining
Rattles, balls, blocker, moles
What is parallel play? When does this play occur?
Toddler
Kinds are playing NEAR each other but are NOT interacting with each other
Different toys
Not sharing (egocentric)
Stay in your lane play with own mind and boundaries
What is associative play? When does this play occur?
Preschool
Group play without group goals
Sharing toys without formal organization
Playing together but not working together - instead working on own thing with same toy
What is cooperative play?When does this play occur?
School age
Joint goal to activity
Games with concrete rules and formal organization
Builds problem solving skills
What is onlooker play?
Child observes play
Child may asks questions but does not attempt to join
Can turn into associate or cooperative play
Generally child with shy to warm up temperament
What is the physical growth of a school age child?
5 pounds/year
2 inches per year
What marks entering school age?
Loses baby teeth
What is the physical growth of an adolescent?
Pubertal growth spurt –> final 20-25% of linear growth
Girls: 2-8 inches
Boys: 4-12 inches
Weight: 15-60 pounds
When do we grow?
We grow in our sleep which is why extra sleep is needed during the rapid growth periods such as infancy and puberty
What is the sexual maturity rating based on?
Primary and secondary sex characteristics
Primary: present at birth
Secondary: develop during puberty (thelarche and pubarche)
What are the tanner stages for girls sexual maturation?
Thelarche: 1st sign of puberty (tanner 2)
Adrenarche: adrenal glads wake up and increased production of androgen –> testosterone –> oily skin, pimples, body oder, voice deepens (tanner 3-4)
Menarche: 2 years after thelarche (tanner 3-4)
When is the most common time for menarche in girls?
10 -14 years old
What is a precocious puberty and what age for girls?
Puberty that is too early than what is health
Less than 8 years old
When do girls achieve their adult height?
2 years after menarche
What are the tanner stages for boys sexual maturation?
Pubarche w/ or w/o thelarche (tanner 2)
Gonadal development: testicular enlargement (tanner 3-4)
Does boys or girls growth spurt occur first?
Girls first
Boys growth spurt occurs later
When is the most common age for boys to hit puberty?
10.5 - 16 years old
When is a precocious puberty for boys?
earlier than 9 years old
When do boys reach their adult height?
Their adult height is reach between 18-20 years old and their growth spurt is longer than girls
What are developmental milestones that occur in school age children?
Gross and motor skills become more refined
Athletic skills/coordiation increases
Why is there an increased risk of injury in school age children?
Center of gravity is changing because they are growing
Growing –> more stress on tendons, ligaments, and bones so they aren’t very strong
Sports are getting competitive early on
What are some safe issues with sport? What can be used to prevent this? What does this specifically prevent?
Head injuries
Helmets can be worn
Helmet prevent skulls fractures
What does concrete operations cognitive development in school age looks like?
Thought becomes logical so a lot of magical thinking goes away
Understand math and conservation
Tells time
Problem solving
Empathy and morals (right or wrong no grey area)
Classification/grouping objects
Collections
Rules
Kids jokes
What does formal operations cognitive development in adolescents look like?
Abstract thinking
Decision-making increases
Understand implication of choices
Plan for future
Moral and ethical development is more complex
Logic understands grey areas
Deeper thoughts
Determines self-value and identity
What age is industry vs. inferiority? What does it mean?
6 years - 11 years
Eager to please and participate, want to be good at something and feel good about themselves when they do something, parental/peer approval is strong motivator
OR
Inferiority develops if there’s is a lack of sense of accomplishment. All children feel some inferiority about a skill they can’t master
What age is identity vs. confusion? What does it mean?
12 years to 18 year
Child find their identity and understands who they are
OR
Becomes confused about who they are
What age is intimacy vs. isolation? What does it mean?
18 years to 35 years
Struggle to form intimate and meaningful and loving relationships
OR
Socially isolated
Why are school age children considered the honeymoon of childhood?
Move past the tantrums and are eager to please
Not ready to abandon parental control and increasing importance of peer approval
Sex roles emerge - co-ed play and relationships develop
Formation of groups and clubs
What are early teens? Middle teens? Late teens?
Early: 11-14
Middle: 15-17
Late: 18-20
What is a task while in the identity vs. role confusion stage as an adolescent?
Standing out while fitting in
Why are adolescents most likely to be non adherent to medications?
Wants independence
Feel invincible
What is personal fable? What age does this affect?
No consequences
Their experience is completely unique to them and no one has even experienced what they have before
Adolescent
What is imaginary audience? What age does this affect?
Person believes that people around them are watching them enthusiastically. Believes everyone knows and is judging them and teens do not want attention for the wrong thing
Adolescents
What areas of health promotion are important in adolescent age groups?
Sex education
Substance use
Diet/exercise
Mental health
What health promotion can be done in school age and adolescents?
BP, ht, wt, BMI and compare for age, generally and height
Vaccinations
Depression beginning at 12
SI/HI and self harm
Dylipidemia - high cholesterol testing at 9-11 and 17-21
Hearing 11-14 and 15-17
Vision at 12
Tabacco/vaping/alcohol/drugs
Piercing/tattoos
What is childhood obesity defined by?
at or above the 95th percentile
How can a nurse encourage an adolescents participation?
What are your thoughts?
Face the teen
Important that at this age there is time to talk w/o parents so can tell parents to pleas leave the room
What is the HEADDS assessment?
Home
Education
Activity
Despression/Drugs/Diet
Sexuality/Suicide/Self esteem/sleep
