Exam 3 Flashcards

Question

USDHSS recommended 4 steps

Answer 1

get childcare list do your homework call providers take the tour

Answer 2

toddlers shaped by family values/beliefs toddlers do not question cultural values of family refusal usually stems from need for autonomy older children may question cultural values healthcare practices are culturally influenced provide culturally competent care

Answer 3

legislation -safety and injury prevention -abuse and neglect protection -assistance for handicapped children 0-3 years state laws directed at child safety -bicycle helments, car seats, define abuse -nurses by law required to report sustpected abuse economics -toddler mortality/morbidity rates increase in poverty -medicaid, uninsured, SCHIP prorgam

Answer 4

adequacy of system significantly affects health of toddler routine assessment needed growth/development immunizations - CDC recommendations discussion of developmental concerns anticipatory guidance vaccination remains an issue no evidence to support vaccination promote autism

Answer 5

provide education focused on the physical and developmental changes for toddler teach health-promotion activites to toddlers engage in screeing activites promote routine health examinations and childhood immunization schedule educate parents about resources available in the community - may free or low cost

Answer 6

age 3-6 years - more developed body structure ability to control and use body increasing fluidity with language - closer to adults major thrust: mastery of self as independent being - extends experience beyond family in US many gein formal schooling starting with preschool vs kindergarten or 1st grade start many healthy people 2030 goals aimed at preschooler

Answer 7

protuberant abdomen of toddler disappears pelvis begins to straighten; mild in-toeing may remain may show transient genu valgum (knock knee) and flat feet growth 2kg (4lb) and 7 cm (2in) per year skin matures; negligible sebum, eccrine glands functional, apocrine glands nonsecretory tooth development: finish primary; start secondary tooth eruption head <2 circumfrence change

Answer 8

full maturity; voluntary control

Answer 9

increased capacity

Answer 10

change shape, less otitis media

Answer 11

boosted immune response

Answer 12

advances fine/gross motor skills, abdominal muscles develop

Answer 13

boys; more illnesses; more accidents

Answer 14

health care cultural preferences dietary choices health-promoting behaviors

Answer 15

cycstic fibrosis, duchenne muscular dystrophy, fragile x syndrome, william's syndrome

Answer 16

body concepts -curious about body of opposite sex vauge/inacucurate ideas of internal body anxiety: fear of mutilation, death health beliefs and health management -family influence - context for health beliefs -upset ove rminor injuries; pain/illness is viewed as punishment -contribute to health managment (brushing teeth) health promotion - help failies --> healthy lifestyle

Answer 17

nutritional guidelines -variety of foods: MyPlate replaces pyramid -attention to iron, calcium take -limit fat and sugar behavioral/motor aspects -food preferences/refusals - may cause conflicts -learning utensil use -helping with meal preperation begin to eat meals away from home - preschool/childcare center requirements oral health prevention: fluoride toothpaste, water flouridation, dental sealants self care, population based and professional care needed food allergies : increasing prevalence -most develop before age 2 - high-risk allergens: milk, eggs, peanuts -allergy prevention, exposure prevention, action plan

Answer 18

toilet traning: developmental milestone -must be developmentally ready -as skills develop they insist on performing this skill independently supervise washing hands, flushing toilet soiling -handle in gentle / encouraging way - preschooler responsible for changing clothes

Answer 19

play - engage in more interactive play primary activity for the preschooler important role social/physiological development play reveals child's reality and perceptions promotes problem solving, creativity, collaboration toys chosen for age appropriateness imitation play - mimic others - usually older window into social competency -fantasy -imaginary companion, imaginary scenario time orientation -idea of past/future -enjoy planning for family activities tv and media -limit time disengages mind -less learning -less active lifestyle - obesity socialization via group activites requires outlets for high energy

Answer 20

8-12 hrs/night; nap or quiet time bedtime ritual -prolonged bedtime routines -honor reasonable rituals -be firm and consistent sleep disturbanes -night terrors vs nightmares -night terros: not fully awake no recall of incident in am -nightmares : frightening dreams can describe and recall helping child understand "real" vs "pretend" stories/ideas - lessen nightmares

Answer 21

can internalize family rules; sense of time piaget : preoperational stage -ability to function symbolically with language -concrete thought process -egocentrism -irreversibility -transductive reasoning imaginary friends -controlled by child not a threat -way to practice social interactions

Answer 22

amblyopia (infancy to age 4) refractive errors -myopia (near sighted) - elongated eyeball -glasses always indicated strabismus (crossed-eyed) - cover test color blindness detection vision problems: screening -denver eye screening test - visual defects -snellen E screening test - visual acuity -ishihara's test - color-blindness -pupillary light reflex - heterotropia

Answer 23

audiometry: screening; speech delays

Answer 24

receptive/expressive skill development speech maturation: issues of speech rhythm and fluency

Answer 25

affects language development, learning enhanced by grouping iterms, verbally naming iterms, rehersal

Answer 26

CDC identifies 1 in 68 children on spectrum more common in boys (4-5 times) prevalence increasing (NOT caused by vaccines) genetically determined disorders - only rarely nongenetic factors risk factors: atypical birth weight, low Apgar, hemolytic disease, juandice, respiratory distress, advanced parental age screening tests available: modified checklist for autism in toddlers (M-chat)

Answer 27

self concept emerges from struggle for autonomy -refined through taks-oriented and societally oriented experiences erikson: initiative vs guilt -sense of initiative: viagouours activity and active imagination -parental role: promote initiative; nurtue ideas, encourage behaviors for positive self-concept

Answer 28

expanding influences -peers becoming increasingly significant -gender expectations -older siblings social interaction -play with peers - learn to negotiate "the rules" -acquires readiness for group situations -follow directions - recognize others' rights -demonstrate increasing independence parental divorce -disruption in family relationships -regression, confusion, irritability common response -need for closeness, patience, consistency child abuse -complex contributory factors -family stressors important trigger -primary and secondary prevention -recognize sings - mandatory reporting

Answer 29

gender identification body image -perception of sex organs -curiousity about bodies/sexual functioning -encourage addressing questions simply/factually -resources: preschool recommended books many good children's books available as resource

Answer 30

play approaches -doll or puppet play -mutual storytelling coping -similar coping mechanisms to toddler -maturing coping skills: fewer tantrums -more problem-solving abilities -use of projection.fantasy -controlling behavior -gentle consistent adult direction recomended

Answer 31

lack fully developed conscience -age 4-5 some internal controls modeling and inductive explanations -moving from specific to general preschool typical behavior -control behavior to retain parental love/approval -express likes/dislikes, ask endless questions death -fascinated by life beginning/death concepts -needs support, possible counseling, to cope with loss

Answer 32

injuries : leading cause of death -MVA: car seats; ride in back -household furniture/tools/equipment -firearm safety: child access protection burns: scald/direct flame burns teach danger of matches, open flames, hot objects drowning: swimming pool greatest risk -fencing, flotation device, water survival, supervision

Answer 33

bikes - age appropriate limits needed - helmet: with brain transition from tricycle to bicycle automobile-related risk -teach proper street-crossing techniques -supervision when crossing the street -consistent and proper use of restraint devices in car -forward facing car seat with 5 point harness -transition to booster seat when Ht and Wt indicated

Answer 34

boosters -DTaP - fourth year -MMR: between 4-6 immunization concerns -religious -safety of immunizations -importance of accurate information additional considerations -new and combined vaccines -under-vaccination, "catch-up" schedules

Answer 35

factors impacting risk exposure lead: folk remedies, old paint, pottery poisonings : poison control number -more than half occur in children <6 years old -teach children about poisons -solids: pills, vitmans, aspirin, lipstick -liquids: cleaning products, fuel, alcohol -sprays: furniture polish, oven cleaner -invisibles: carbon monoxide, space heater fumes

Answer 36

acute lymphocytic leukemia -most common; incidence rises ages 2-5 wilms' tumor < age 5 -correlated with congenital malformations retinoblastoma :

Answer 37

incidence -more rapid rate increase than other ages -higher in black and hispanic populations causes -genetic predisposition, allergens -precipitants: infections, exercise, weather, stress exacerbation factors: -tobacco smoke pollutants allergens -poverty contributes significantly to disability and death -dust mite, pet/rodent, dander, cockroach particles

Answer 38

social factors and environment: -variance in degree, type of outside contact -preschool: wider social contacts; skill development for group interaction culture and ethnicity: notice differences in cultural practice socialization to ethnic differences family culture may differ from playmates _> confusion

Answer 39

health care delivery system -recommendations for preventive care -early and periodic screening, diagnosis and treatment (EPSDT) - medicaid program Affordable care act ensures health coverage CHIP programs guarentee coverage for all children medicaid provides for one screening per year

Answer 40

preschoolers interested in tools/procedures -explains the test in age-appropriate terminology -expect child to cooperate for most of the visit -play with stethoscope, otoscope, equipment include preschooler in the history-taking -direct questions about diet and health -examples: tooth brushing, favorite activities, and friends need parents close during injections

Answer 41

entrance to kindergarten to beginning of asolescence 6-10 years of age wide range of growth, development, and cognitive ability growth is slower vs infancy and adolescence motor skills perfected- cognitive abilities greatly increase - read,write, math peer groups develop increasing ability for self-care

Answer 42

5-12 years: calm before storm body systems reach adult level function overall slimmer appearance thoracic muscles develop elevated blood pressure - screen yearly -ID and treatment prevents adult organ damage -black and mexican american children at greater risk for organ damage -prevalence : 5 out of 100 children

Answer 43

physical growth: slower steadier pace standardized growth charts but consider family height alternating "spurts" and minimal growth height: 5cm (2in) per year; weight 2-3kg (4.4-6.6 lb) per year differ by race, gender, genetics head growth slows until puberty preadolescent growth spurt: earlier in girls than boys menarche: occuring earlier releated to genetics, sufficient body fat - normal: age 11-15

Answer 44

tooth eruption: transistion form deciduous to permanent teeth; occurs earlier for girls - orthandontic care is common lost in same order they initially erupted 4 teeth/year potential for dental caries, peridontal disease, malocclusion school sealant program reduce caries by 60% - in line with healthy people 2030 initiatives

Answer 45

lymphoid tissue -grows rapidly; stronger immune system -enlarged tonsils are normal -lymphoid tissue increases to 10 years then decrease -children may have more lymphoid tissue than adults

Answer 46

increase proportionately with body size

Answer 47

maturated nervous system by age 7-8 brain heisphere articulation - more control lengthening long bones - risk fracture, joint pain muscle mass increase: potential for more complex fine and gross motor function ossification - bone replaces cartilage -occurs throughout childhood completed in adulthood avoid excessive weight, backpacks propersized shoes, desk, and chairs

Answer 48

health perception -correlated with cognitive development -stage is concrete operation: can grasp germ theory -illness often viewed as punishment -cultural influences: karma, "evil eye", talismans facilitating health promotion - healthy people 2030 -monitor/reinforce preventive practices -parents to model health promoting behaviors -teach healthy behaviors at home and school

Answer 49

nutritional guidlines include a well balanced diet: 1200-1800 kcal/day factors influencing food intake -access to food: lack of nutritious good, make own snacks, fast food issues: promotes obesity influences - mass media, billboards, TV, peers, family contemporary busy lifestyles: skip meals, eat out nutritional education -school programs: 35% low income are food insecure -dietary guidelines obesity : BMI >95th percentile for age/gender or BMI >30 overweight BMI> 85th but <95th percentile -genetic and cultural issues contribute -environmental: use of food as reward; lack of physical activity, living conditions, financial constraints -postparandial hyperinsulinemia may contribute hazards: HTN, BM, heart disease, sleep apnea

Answer 50

two or more portions of vegetables and fruit 3-4 cups daily

Answer 51

low self esteem psychosocial ridicule and discrimination

Answer 52

reasonable caloric restriction physical exercise peer counseling habit changes few overweight children achieve or maintain weight loss

Answer 53

phyiscal ability: most have achieved full bowel/bladder control

Answer 54

primary vs secondary nocturnal vs diurnal enuresis behavior management strategies; drug therapy

Answer 55

common complicaition of chronic constipation psychosocial component bowel management program and counseling recommended 90% have history constipation & painful stool -> hold BM -> fecal impacation and rectal distension with leaking stool

Answer 56

critical time to acquire and foster activity behaviors types of activites - tend to be naturally active group: little league individual: gymnastics, ballet unorganized bike riding rollerblading play activities promotes social, personal, cognitive development focus on fun connection to peers and family

Answer 57

8-12 hours of sleep/night fewer difficulties with going to bed sleeping arrangments -culturally influenced : own bed vs bed sharing sleep disturbances -most outgrow with CNS maturation -sleepwalking and sleep talking -disorder of arousal: immaturity of nervous system -consider safety, relaxation techniques, sleep preparation consistency

Answer 58

piaget: concrete operations stage -learn by manipulating concrete objects -lack of abstract thinking -less egocentric - consider others' views expanded conceptual understanding -conservation of substance -time major operation: classifying and ordering example: can separate beads by color and/or material requisite for reading and math

Answer 59

vision: optimal function by age 6 or 7 -visual acuity (at least 20/30) eye changes -farsighted to normal vision -vision screening needed to detect abnormalities vision problems: 25% of school children -myopia (nearsightedness) -astigmatism (uneven focusin) -correcting vision promotes more effective learning

Answer 60

hearing auditory acuity nearly complete by 7 years chronic serous otitis media - hearing deficit periodic hearing evaluations - tympanograms education on hearing protection sensory perception most learn via combo of patterns and sense auditory learners - learn from audio kinesthetic learners - learn by doing visual learners - learn by seeing increasing ability to differentiate detail- needed to read

Answer 61

language - rapid development during school years capacity to imitate sounds complex sentences; multiple meanings reading: letter and sound recognition; combos to form words handwriting skills - hand-eye coordination memory - improved ability -organizing, classifying, labeling facilities retention

Answer 62

debate: intelligence quotient (IQ) traditional IQ test short comings -don't test all forms of intelligence -culturally insensitive -may measure achievement vs ability environmental factors affect achievement nutrition, sociocultural, environmental stimuli programs: WIC, head start

Answer 63

14% age 6-17 have learning disability attention-deficit/hyperactivity disorder (ADHD) difficult to assess treatment controversial: behavior mangement, counseling, nutrition, medication

Answer 64

includes detection, referral, collaboration on plan, counseling, liason with family, socialization needs

Answer 65

individual with disabilities educaation act of 1997 section 504 of rehabilitation act of 1973

Answer 66

a disturbance of at least 6 months exists during which at least six of the criteria for either inattentive behavior or hyperactivity-impulsivity behavior are met some inattentive or hyperactive-impulsive symptoms that caused impairment existed before age 7 years some impairment for the symptoms exists in two or more settings clear evidence of clinically significant impairment exists in social or academic functioning

Answer 67

erikson: industry vs inferiority major task: mastery of whatever the child is doing develops sense of industry and avoids inferiority sense of industry: success in personal/social tasks sense of inferiority: occurs with repeated failures self concept develops over time -self esteem sense of control and body concept

Answer 68

family environment provides sense of security increasing independence and maturity -begin to reduce parental authority/structure -broaden interests outside home (clubs, sports, gangs) -more responsibility in home and community (pets, chores, earn allowances) learn socially accepted behaviors limit setting - discipline nonviolent resolutions to conflict behavioral contracts strategies positive reinforcement effective limit setting punishment - negative reinforcement -greater use in lower socioeconomic class parents -temporarily stops behavior but only until repeated behavior is not caught

Answer 69

physical, sexual, or emotional exploitation and/or neglect increased of child repeating cycle may occur with or without recognized risk factors consider cultural factors in detecting abuse nurses are mandated to report sexual abuse - becoming more common but hidden -abuser typically known by child; often authority figure -males report less often but more negative effects

Answer 70

strong identification with parent of same gender -affects concepts of role and self-concept desire for knowledge of sexual function -exploration of others' sexual organs or strong attachment -desire for privacy - discuss sexuality with peers sex ed

Answer 71

childhood stresses: multiple new stressors -school expectations -peer relationships -cultural differences -bullying may respond to stress with negative behavior coping strategies: buffer stressful events very stressful situations may need referral, counseling

Answer 72

childhood stresses: multiple new stressors -school expectations -peer relationships -cultural differences -bullying may respond to stress with negative behavior coping strategies: buffer stressful events very stressful situations may need referral, counselingd

Answer 73

stressful - after affects may result in juvenile behavior problems or require counseling school: role of advocate for child

Answer 74

somatization: transfer of feelings to physical problems depression: symptoms include anorexia, sleeplessness, lethargy, changed affect, aggressive behavior, crying, withdrawal - 2-3% treatment: individual and family counseling, medication

Answer 75

kohlbergs theory: decisions on moral development younger school age: preconventional - moral behavior based on self-interest older school age: conventional - concern about group interests/values moral behavior problems -lying stealing, cheating -comon developmental behaviors -guidance needed to choose more socially acceptable ways to cope with stressors

Answer 76

accidents leading cause of death for children > 1 year environmental factors -seasonal -SES (physical environment, access dangers) -social environment - family stress, playmates drowning -fewer incidents than younger children - racial differences -prevention: water safety heavy backpacks -common with school aged children -associates with musculoskelertal and neuroproblems burns firearms sports and recreation

Answer 77

motor vehicles - car dafety (age appropriate) -no requirement for seat belts in buses -pedestrian-car accidents bicycles, motorized skateboards, and all terrain vehicles (ATVs) - safely helmets needed -rollerblades, skateboards, skate scooters - more severe than pedestrian injuries -more boys than girls injured -AAP reccomends 16 yo

Answer 78

fewer infections than preschool child - common -upper respiratory infections (viral) -streptococcal infection, otitis media (bacterial) -gastroenteritis (viral) -scabies, pediculosis and lice immunization -meningoccoccal vaccination (11-12) -hep B serires -human papilloma virus (HPV) -varicella (if not history of chickenpox) -covid 19 approved for children 12 yrs and older

Answer 79

food additives drugs -alcohol -inhalants -tobacco exposure/smoking -experimentation with ilicit drugs pollution lead exposure: clothes soil pipes older homes asthma higher rates in cities chemicals for insects/weed control

Answer 80

xray exposure -natural and human made ionizing radiation -risk of breast and thyroid cancer, leukemia cancer -most common types: leukemia, cancers of brain/nervous system, lymphomas -may be cured: potential for later health effects -nurses roles physocial/emotional support; assists in meeting goals

Answer 81

community and work peers - strongest relationship outside family other adults - influential role models working parents - after school care latchkey children - left alone until parents return (work) culture and ethnicity attitude toward racial differences develops TV video computer challenges -violent images, sedentary activity, internet, dangers -need to limit screen time

Answer 82

public law 94-142 education for all handicapped children act: individualized educatoin plan (IEP) no child left behind (2001) - aims to improve the disadvantaged

Answer 83

poverty - 18% of children below poverty level homeless depression developmental delay more disease

Answer 84

state children's health insurance program (SCHIP) medicaid and ACA

Answer 85

well-child evaluations learning disabilities

Answer 86

vision, hearing, scoliosis

Answer 87

lifestyle choices safety