Exam 1 Flashcards
What age is infancy? What type of growth occurs?
0-1
Rapid growth
What age is toddler? What type of growth occurs?
13 months - 35 months
growth slows down
What age is preschool?
35 months - 5/6 years
What age is school age? How many pounds are gained each year? How many inches?
6 - 12 years
5 lbs/year
2 inches/year
What age is adolescence? What type of growth occurs?
Older than 13 years
Pubertal growth spurt
What happens to weight and height in adolescence? Boys? Girls?
Final 20-25% of linear growth occurs
Boys: 4-12 inches
Girls: 2-8 inches
Weight: 15-60 pounds
When do children lose all of their baby teeth?
School age: 6 - 12 years
What is a major task for toddler age? What else occurs during toddler age?
potty training
Language rapidly increases
Children learn by mimicking adults and pretend play
What is a major task for preschool?
school readiness
What is object permanence?
Object still exists even if you can’t see it or touch it
What is stranger/separation anxiety? When does it develop?
Infants ability to distinguish between caregivers and others so infant becomes distressed when separation of caregivers occur
6-8 months, 1-2 years
Why does separation/stranger anxiety go away?
Separation of self from caregiver without distress is based on development of object permanence even if the parent is out of sight
What is regression? Why does regression occur?
appearance of behavior that is from earlier stage of development
Often used to cope with stress or anxiety
When does regression typically occur?
Children who welcome a new sibling
Toddlers
Preschoolers
What is autonomy
The ability to function independently without the control of others
Act with own free will
What is negativism?
the attitude of opposing or resisting direction of others
What is egocentrism?
Complete absorption of self
Inability to understand that others have a different point of view
What is magical thinking?
A Childs belief that he/she wishes or expects can affect what really happens
What is animinsm?
inanimate objects gave human feeling sad emotions
What is concrete operations? When does this occur?
a logical way of thinking/operating such as build things, problem solve, and symbolism
Occurs in school age
What is formal operations?When does this occur?
systematically solve a problem in a logical and methodical way - abstract thinking and scientific thinking
Occurs in teens and young adults
What is conservation?
ability to understand that properties of an objects do not change because of the order, form or appearance has changed
What is imaginary audience?
individual believes that people around them are watching them
What is family centered care?
innovative approach to planning, delivery and evaluation of healthcare that is grounded in mutually beneficial partnership among patients, families, and healthcare professionals
Parents are experts on childcare
Parent and child are co-client
What is a personal fable?
an adolescents belief that they are special and invulnerable
they are the only person that understands what they are going through
EX: “ nothing happens to anyone else like it does to me”
What is hydrocephaly? What is a possible reason for this?
abnormally large head
Fontanelles may be full of fluid
What is microcephaly
abnormally small head
What is plagiocephaly? What can it be due to? How do you fix it?
when a baby develops a soft spot or flat spot on the head
Can be due to sleeping in same position most of the time
Can be fixed with a helmet and can lead to facial asymmetry if not fixed
What is development?
a fluid sequence of conditions that leads to a new skill, new motives for activities and patterns of behavior
What are two ways development occurs?
Cephalocaudal - head to toe
Proximodistal - core strength and trunk body movements before fine motor skills
What are milestones?
activities expected by a certain age
What is the authoritarian parenting style
Negative relationship
Control
Differing perspective not allowed
Communication generally only one way
What is the authoritative parenting style?
Positive relationship
Build mutual trust and respect
Both perspectives honored
Communication both ways
What is the permissive parenting style?
Negative relationship
Indulges child
Entitlement
Little control exercised
What is the uninvolved/neglectful parenting style?
Negative relationship
Non-existent
No communication
No parenting
What is level of activity?
intensity and frequency of motion during play, eating, bathing, dressing, or sleeping
What is adaptability?
ease or difficulty in adjusting to a new stimulus
What is the response to stimuli?
The amount of stimulation necessary to invoke a response
What are the characteristics of an easy child temperament?
Approachable
Positive mood
adaptable but predictable
Console easily
What are the characteristics of a slow to warm up child temperament?
Shy
Less adaptable
Irregular routines
What are the characteristics of an difficult child temperament?
Negative
Avoid interactions
Highly active
Reacts poorly to change
What is a good discipline method for an infant?
redirection
6 months - they understand the word “no”
What is a good discipline method for a preschool?
reasoning
What is a age is time out an appropriate form of discipline?
Toddler, preschooler
When is modeling good behavior an appropriate way to discipline?
Toddler and above
What is a good discipline method for early adolescent?
consequences
When is a behavior modification a good discipline method?
School age/adolescent
What does a successful family need?
Provide basic needs for child - food and shelter
Provide emotional needs
Provide safety and structure for growth and development
What are risk factors for a dysfunctional family?
Martial conflict Violence even if not occurring to child Substance abuse Adolescent parents Chronically ill child/special needs
What are some traits of high risk families and how do they display at the bedside?
Poor communication skills – arguing
Lack of flexibility/adaptability – withdrawn child with poor coping skills and fear
Poor conflict resolution – child w/ poor coping skills
Operate in crisis mode – chaotic routine
What the effects of a child with a chronic illness?
Impacts child growth and development
Care can change rapidly to meet the growth and development
What are 6 child risk factors for child abuse/neglect
- Under 3 years old
- Separation at birth
- Unplanned/unwanted pregnancy
- SGA, congenital abnormalities, or chronic medical condition
- Difficult temperament (ADHD)
- Foster and adopted children
What are 7 parental risk factors for child abuse/neglect?
- Hx or previous abuse/neglect as a child
- Poor socialization/emotional and social isolation
- Poor parenting skills
- Limited ability to deal w/ stress/negative emotions (poor conflict resolution)
- Alcohol or substance abuse
- Rigid family roles - dominant parent
- Sudden life crisis (loss of job)
What are some red flags of abuse in a patients history?
- Injury unexplained by hx
- Injury or explanation inconsistent with age
- Absent, changing or evolving hx
- Caregiver delay in seeking medical care
- Unusual affect of caregiver in response to child’s injury
What are 9 warning signs of abuse?
Change in behavior of the child such as
- Distrust
- Fearful
- Acting out
- Resists going home/with caregiver
- Loss of interest in activities
- Depression
- Detachment
- Poor sleeping/eating
- School failure when previously excelled
What is the nurse’s role in suspect abuse (6)?
- Report (mandatory)
- Recognize abuse
- Assess for injuries (photos)
- Refer
- Educate
- Prevent
What are some triggers for abuse?
Prolonged crying of an infant
Potty training
What are some types of abuse?
- Physical
- Emotional
- Sexual
- Neglect
What are some medication absorption considerations for pediatrics?
- Gastric pH is HIGH in neonates
- Gastric emptying is intermittent and unpredictable in infants
- Gastric emptying is slower in older children
- Intestinal motility is decreased in neonates
- Intestinal motility is increased in older infants/children
- Bile acid/biliary fx is diminished in neonates
- Pancreatic enzymes are variable in infants < 3 m.
What are some medication metabolism considerations for pediatrics?
- Metabolism is less mature in premature/newborns
- The younger the child, the more doses needed to achieve 24 hour stability (smaller doses at greater frequency)
- Adult level renal fx takes 1-2 years to develop
What are some medication distribution considerations for pediatrics?
- Neonates have a higher proportion of total body water
- Protein count in lower in preterm/newborns
- BBB matures around 2 years old
What is the concern regarding BBB taking 2 years to mature regarding drug therapy?
- Side effect considerations
- Drug to treat sepsis will penetrate the brain
- Drugs can accumulate in the brain tissue
What is the leading cause of death in children 1-19 years old?
unintentional injuries
How is growth evaluate in the pediatric population? What is the normal range?
interpreted via percentiles
5%-85% is normal
What is the height increase during the first year? 2-5 years?
1/2 inch (2-3 cm)/month for the first year
2-3 inches/year
How does weight change during the first year?
Average 30gram/day (1oz/day)
Doubles birth weight in 6 months
Triples birth weight in 12 months
How long do you measure head circumference? Why on until then?
The first 2 years of life - should measure in portion to rest of body
Fontanelles and the suture lines should be fused together by 12-18 months but most importantly by 2 years old
What is the purpose of milestone monitoring? How is it done?
The purpose is to screen
Done by parents or non-clinical caregiver Subjective <30 minutes Ages and stages questionaire Milestone tracking
What is the purpose of milestone screening and assessments?
Purpose is to diagnose
Specific intervals (9,18,24 months)
Denver II (DDST)
Increased objectivity
> 1 hour/comprehensive
What are nature factors that influence growth and development?
Non-modifiable
Genetics