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RB Y2 Child Health > Development and Adolescence > Flashcards

Development and Adolescence Flashcards

1
Q

average age for a girl to enter puberty

  • reason for precocious
A
  • 11
  • 8-13 considered normal
  • there is a secular trend in which girls are entering puberty earlier than previous generations, this may be due to increased leptin (fatter)
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2
Q

stages of female puberty

A
  • adrenarche - greasy skin, spots, hair
  • therlarche - breast development
  • menarche
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3
Q

how long after thelarche does menarche usually occur

A

2- 3 years

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4
Q

average age for boys to enter puberty

A
  • 11.5
  • ≥14 - delayed
  • <9 - precocious
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5
Q

delayed puberty in boys an girl s

A

boys ≥14

girls ≥13

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6
Q

average age for boys to have their pubertal growth spurt

A

14

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7
Q

how is abnormal growth indicated

A

crossing centiles on growth chart

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8
Q

define adolesence, youth and young person

A
  • Adolescence: 10-19 years
  • Youth: 15-24 years
  • Young people: 10-24 years
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9
Q

what is used as a scale of physical development in children

A

Tanner stages

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10
Q

how is the developmental stage assessed

A

STEP

  • sexual maturation and growth
  • thinking
  • education/employment
  • peers/parents
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11
Q

guidance if a young person aged 0-18 refuses treatment

A
  • always act in best interests of young person
  • Parents cannot override the competent consent of a young person to treatment that you consider is in their best interests
  • In Scotland, parents cannot authorize treatment a competent young person has refused.
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12
Q

define competence

A
  • Ability to understand simple terms and nature, purpose and necessity for proposed treatment
  • Understand benefits, risks and effects, as well as alternatives to, non-treatment
  • Understand that the information applies to them
  • Retain information long enough to make a choice
  • Make a choice free from pressure
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13
Q

in scotland, a person over which age can consent to their own medical treatment when deemed competent

A

16

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14
Q

can parents authroize treatment a young person has refused

A

no

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15
Q

what happens if the treatment is in the best interest of the young person and they refuse

A

seek legal advice

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16
Q

what age do confidnetiality rules apply to

A

irrespective of age

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17
Q

when can confidentiality be broken

A
  • health, safety or welfare of patient or others would be at grave risk without disclosure
18
Q

what might we want to discuss with young people

A
  • Home
  • Education/employment
  • Eating – weight, body image
  • Activities
  • Drugs
  • Sex – activity, orientation, STI
  • Suicidality
  • Safety
19
Q

what is the clinical relevance of being an adolescent

A
  • many disease states begin in adolescence
    • obesity
    • mental health
  • gains in childhood are negated by losses at adolescent stage
  • poorly managed morbidity in adolescence carries over into adulthood
20
Q

pros and cons of adolescent units

A

Pros:

  • Developmentally appropriate care and environment
  • Staff are used to discussing and dealing with risk behaviours
  • Increased independence from parents

Cons:

  • Mimicry of others’ harmful behaviours
  • Inappropriate behaviours
  • Ward too comfortable – may not want to go home
  • Loss of expertise and experience outwith the unit
21
Q

what is the average height difference between boys and girls, and why

A
  • 13cm
  • testosterone makes one grow gaster
  • boys pre-existing years of normal growth means that their epiphyses fuse later
22
Q

obesogenic environment

A
  • term used to describe the modern environment that encourages foods high in energy density but low in nutrients and decreased physical activity levels
  • chronic positive energy imbalance
23
Q

how many hours of screen time per day are recommended

A

no more than 2

24
Q

prescribing Orlistat

A

only in severely obese adolescents (BMI>99.6th percentile) with comorbidities attending a special clinic

regular reviews and monitoring required

25
Q

bariatric surgery

A
  • BMI >40 or >35 with severe co-morbidities
  • nutritional assessments must be made after
26
Q

3 phases of child growth

A

infant

child

pubertal

27
Q

what drives each stage of child growth

A
  • Infant – nutrient led
  • Child – growth hormone led
  • Pubertal – sex steroid led
28
Q

what is the mean intake for protein like

A

above the RNI for each age group

29
Q

how are children doing on estimated average requirement for energy

A

over half are exceeding it

30
Q

vitamin intake in children

A
  • vitamin A and C are above RNI
  • vitamin D are below RNI - also found in oily fish and eggs
31
Q

what is recommended for all children consumin <500mls/d of infant formula

A

that from 6 months, they should take vitamin A C and D supplements

32
Q

what is recommended for breast feeding mothers

A

that they take vitamin D supplements of 10ug per day

33
Q

soidum intake in children

A

exceeded RNI

34
Q

UK physical activity guidlines

A
  • those not yet walking: encouraged and minimise time spent sedentary
  • those walking: walk for 180 min throughout day and again minimise sedentary time
  • 5-18 year olds: ≥60 min of moderate-vigorous intensity physical activity, 3days a week vigorous
35
Q

what is recommended for the first 6 months of an infants life

A

exclusive breast feeding

  • increase IQ?
  • lower obesity risk later in life
  • aids post pregnancy weight loss
  • lower maternal breast cancer risk
36
Q

when should cow milk be introduced

A
  • breast milk is no longer enough to meet nutritional needs from 6 months
  • full fat intoroduced slowly
  • semi skimmed can be given after 2y
  • skimmed can be given after 5 y
37
Q

foods rich in what are recommended in babies

A

rich in absorable iron eg red meat, canned fish and well cooked eggs

38
Q

consequences of late weaning

A
  • complemenary feeding is important in the development of gross motor, fine motor and oral motor development/speech elements
  • inadequate energy and nutrients - growth faltering and malnutrition
39
Q

when are children vulnerable to chronic disease, and disordered eating patterns

A
  • school age - learning to be independent and developing eating and behaviour patterns
  • adolesence - eating disorders, obesity and pregnancy
  • susceptible to faddism
40
Q

what is an early introduction into solid foods associated with

A
  • deprived areas
  • influence
  • personal opinion
  • food availability
41
Q

name a child dental programme

A

childsmile

RB Y2 Child Health (7 decks)

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