Exam 4 Flashcards
Childhood Mortality: Under age 1
Airway - suffocation
Childhood Mortality: Ages 1-3
Motor vehicle; Drowning
Childhood Mortality: Ages 4-11
Motor vehicle
Drowning
Homicide
Childhood Mortality: Ages 12 - 19
Motor vehicle
Homicide (may be more intentional)
Suicide
The prevalence of specific illness in the population at a particular time
Morbidity
Pais:
Latin for Child
1912
Childrens Bureau
1st study on infant mortality rate
1935
Social Security
1938
Fair labor standards→child labor laws
1940’s
Isolation: kids not placed in the same ward
1974
WIC: Woman Infant and Children <5yo
1993
FMLA- Family Medical Leave: 12 weeks unpaid leave w/o fear of loosing your position
Barriers to Health Care for Children
- Financial: Insurance
- Systems: Transportation
- Lack of knowledge
- DRG’s: Dx dictates time of stay
In the first 12mo birth wt
Triples
Ave 21-22lbs
Biggest Change
Birth wt doubles by
4-6 mo
Ave 16 lb
Birth Length during the first 12mo
increases by 50%
Posterior Fontanel typically closes by
3 mo
Anterior Fontanel typically closes by
8-18 mo
Babies are placed on back
to sleep
Babies are prone when
playing
Cephalocaudal development
head –>trunk–>LE
Infants
Proximodistal development
Near to far (Midline to peripheral)
Fine motor development
Coordination of hand and finger movements
Psychosocial Development: Trust vs Mistrust Age
Birth to 18 mo
Characteristics of Trust vs Mistrust
attachment to mothering figure
needs max comfort w/ min. uncertainty to trust self, others, and environment
Desired outcome=hope
Meet basic need–>trust
S/S of teething
low grade fever increased drooling irritable chewing on everything disturbed sleep
number of teeth=
age of child in mo - 6
Tx for Teething
Cold=soothing –>frozen teething rings, frozen washcloth
Non-Rx topical anesthetic (baby ora-jel)
Tylenol/ Ibuprofen
Begin Flouride at
6 mo of age
Dental Care
begins as soon as 1* teeth erupts w/ soft wash cloth over gums & teeth; progress to toothbrush
Goal of Dental Care
Promote healthy tooth formation and prevent decay
Teething discomfort is common when
the crown of the tooth breaks thru the periodontal membrane
Thumb Sucking & Pacifier
1* Pleasure
Strong Normal Need
Peaks @ 18-20 mo
The first teeth erupt
lower central incisors
~6 mo
followed by upper central incisors
Major problem of Pacifier
Cleanliness
Not well made–> come apart–> aspirate
Do NOT allow to wear on string around neck
Solid Foods
After 4-6 mo
R/t immaturity of GI
Extrusion Reflex
Causes food to be pushed out of mouth
- put food on back of tongue
- Fades after 3-6 mo
Introduce New Foods
1 at a Time (for entire week)
Sm amts (1-2tsp) at a time
Low salt, sugar, and additives
Use a +Attitude
DO NOT put food in bottles with Formula
May Aspirate
NB stomach holds
~2Tbsp (30mL)
1 yo stomach holds
~2 cups (240mL)
First Solid Food to Introduce to NB
Iron fortified infant cereal
5-6 mo
Introduce Vegetables at
7 mo
Introduce Fruits at
8 mo
Introduce Meats at
9 mo
Introduce Egg Yolks at
10 mo
Table food may be introduced by
1 yr
Reflexive Period
Birth to 1 mo - Sucking
Asc. btwn an action and sequential response
Ex: Hunger–>nipple in mouth–>sucking–>satisfaction
Primary Circular Reaction
1 - 4 mo - Replace reflex w/ voluntary acts
Asc Nipple with Mothers Voice
Hand-eye coordination
Sounds (Cooing) start
Primary Circular Reaction
1-4 mo
Grasp Object w/in sight
Out of sight, out of mind
Primary Circular Reaction
1-4mo
Secondary Circular Reactions
4-8 mo
Begin object permanence
Mastery volunteer actions (shake rattle to hear noise)
Secondary Circular Reactions
4-8 mo
Coordination of 2ndary Circular Reactions
8-12 mo
Object permanence is demonstrated (actively seeks obj)
Secondary Circular Reaction
8-12 mo
Stop alcohol how many months prior to conception
3 mo
Abstinence scoring system
objectively w/d symptoms
Initiate w/in 2h of birth, then q4h
Toddler (age)
12-36mo
“Terrible & Loveable Twos”
Average Wt Gain for Toddlers
4-6lb per yr
Birth wt quadrupled
Ave Wt @ 2 yrs
27lb
Average Ht Increase for Toddlers
3 inches per year
Walks w/o help
15 mo
usually since 13 mo
Creeps up stairs
Knees w/o support
Can’t walk around corners/ stop suddenly w/o loosing bal
Can’t throw ball w/o falling
15 mo
Gross Motor
Autonomy vs Shame and Doubt
Psychosocial Development of a toddler (12-36mo)
Has Vocabulary of about 300 words
24 mo
Talks incessantly
2-3 word sentences
Gives first and last name
30 mo
Stage of Parallel Play
-Pulls people to show them something
24 mo
Dresses self in simple clothing
No regard to Rt or L, Front to Back
24 mo
Voluntary control of rectal and urethral sphincters
18-24 mo
Highest incidence of poisoning
Highest incidence occurs in 2yo
d/t improper storage
Average wt @ 3 yo
32 lbs
Average wt @ 4 yo
37 lbs
Average wt @ 5 yo
41 lbs
Average wt gain from 3-5 yo
5lbs per year
Ht Changes 3-5 yo
2.5-3 in/ yr
legs elongated rather than trunk
growth slows & stabilizes
Average ht @ 3 yo
37 in
Ave ht @ 4 yo
40 in
Ave ht @ 5
43 in
Initiative vs Guilt
Psychosocial Development Age
3-6 yo
Animism
Belief that obj. have some kind of consciousness…. i.e. “The car is tired”
Common in 2-7 yo
Language Development 3 yo
900 words telegraphic speech (3-4 word sent) Talks incessantly (rather paying attention or not) Repeats sent of 6 syllables Many questions
1500+ word vocal Tells exaggerated stories Knows simple songs 1+ colors Comprehends analogies Questioning Peaks
4 yo
Skips and hops on 1 foot
4 yo
Catches ball reliably
4 yo
Throws ball overhand
4 yo
Walks downstairs using alternate footing
4 yo
Skips and hops on ALT feet
5 yo
Throws & catches well
5 yo
Jumps Rope
5 yo
Walks backward w/ heel to toe
5 yo
Jumps from height of 12 inches and lands on toes
5 yo
3 yo girl w/ imaginary friend named Emma
Normal - Encourage
4 yo uses curse words at the dinner table….
We don’t use those words
There are better words you could use..
Balances on alt. feet w/ eyes closed
5 yo
Rides tricycle
3 yo
Jumps off bottom step
3 yo
Stands on 1 foot for a few secs
3 yo
Up stairs alternating feet
May come down using both feet on one step
3 yo
Broad jumps
3 yo
Tries to dance, but balance not adequate
3 yo
Goal of Initiative vs Guilt
to develop a sense of purpose & ability to initiate & direct own activities
Characteristics of Preoperational Stage
Egocentrism
Animism
Centration
Tends to be a perfectionist (age)
7 yo
Repeats performances to master
7 yo
Movement fluid/ graceful
Likely to overdo
Hard to quiet down after recess
8-9 yo
Makes common use of tools such as hammer, saw, screwdriver, sewing implements
8-9 yo
May steal
7 yo
Industry vs Inferiority Success
–> virtue of competence
completion of projects
Pride and achievement
Unsuccessful –> unworthy/ inadequate
Infant Psychosocial Development
Birth-12mo (18 mo)
Trust vs Mistrust
Infant Cognitive Piaget (0-24mo)
Sensory Motor Stage
Reflexive Period
Birth-1 mo
Sucking- asc. btwn an act & sequential response
Primary Circular Reactions
1-4 mo
Reflex becomes voluntary acts
Asc. nipple w/ mothers voice
Grasp objects within sight
Primary Circular Reactions
1-4 mo
Sounds (cooing) starts
Primary Circular Reaction
1-4 mo
Secondary Circular Reactions
4-8 mo
Mastery vol. actions
Learns from intentional behavior
Begin object permanence
Begin object permanence
4-8 mo
Can turn head from side to side when prone
Lifts head momentarily from bed
Marked head lag
Gross Motor Development
1 mo
Rolls from back to side
4 mo gross motor
When held in standing position, able to bear slight fraction of wt on legs
3 mo gross motor
Can turn over from and to back
5 mo gross motor
Rolls from back to abd
6 mo gross motor
Sits, leaning forward on both hands
7 mo gross motor
Sits steadily unsupported
8 mo gross motor
Pulls self to standing position & stands holding onto furniture
10 mo gross motor
Walks w/ 1 hand held
May attempt to stand alone/ first steps
12 mo gross motor
Hands Predominately Closed
Grasp Reflex Strong
1 mo
Fine Motor
3 mo fine motor
Actively holds rattle, but will not reach for it
Grasp reflex absent
Grasp objects voluntarily
Plays w/toes
Takes objects directly to mouth
5 mo fine motor
Pulls feet to mouth
6+ mo fine motor
Holds Bottle
6 mo fine motor
Preference for dominent hand evident
9 mo
Pick up game: drops item deliberately to be picked up
11 mo
Manages spoon w/out rotation
18 months
Up & Down the stairs alone w/ 2 feet on ea. step
24 months
Manages spoon w/out rotation
18 months
Chest circumference exceeds the abd measurement;
Legs appear slightly bowed & walks with wide base gait
Toddler
2X ht of a 2 yo
adult ht
Picks up objects w/o falling
18 mo gross motor
Manages spoon w/o rotation
18 mo fine motor
Uses cup well, but rotates spoon
15 mo fine motor
In drawing, imitates vertical & circular strokes
24 mo fine motor
Holds crayon with fingers rather than fist
30 mo fine motor
Preconventional Morality Level- Stage 1
Punishment & Obedience Orientation
Conformity to rules based on fear of punishment rather than authority– More severe the punishment, the more “bad” the act.
Conform to rules based on fear of punishment
More severe the punishment, the more bad the act.
Toddlers
Tertiary Circular Reactions
12-18 mo
Interest in novelty & repetition
Understands causality
Inquisitive and curious
Continually hitting toy hammer on a variety of surfaces/ objects represents which level of cognitive development
Tertiary Circular Reactions
12-18mo
“If I throw my toy out of the crib, I cannot reach it”represents which level of cognitive development
Tertiary Circular Reactions
12-18mo
Understands Causality
Differentiate self from others
Tertiary Circular Reactions (12-18 mo)
Think before acting
Egocentric
Imitations become more symbolic
Metal Combinations
Cognitive Development
18-24 mo
Measles, mumps, rubella - MMR
2 doses: 12-15 mo & 4-6yrs
Polio- IVP vaccine
2,4 6-18 mo
Booster 4-6 yrs
Varicella (chickenpox) vaccine
1 dose: 12-18 mo
