Final Peds Flashcards
Peds age chart
Toddler - 1-3
Preschooler - 3-6
School aged - 6-12
Adolescent - 11-20
Toddler development Erikson
Autonomy vs Shame
Toddler cognitive dev
Uses symbols for communication
Delayed Imitation
Animism
Understands requests and simple directions
Plays pretend
Sorts objects
Withstanding delayed gratification
Toddler motor dev
Gross:
Running
Climbing
Jumping
Increased hand eye coordination
Mastery contributing to self esteem
Refining walking/gait
Pushing/pulling tos
Throwing a ball
Fine:
Working on holding utensils
Zipping/buttoning
Toddler language dev
Receptive language vs expressive language
Echolalia
“What and why”
Telegraphic speech in older toddlers
Toddler emotion dev
Separation
Individuation
Egocentrism
Separation anxiety
Emerging fears
Best way to assess a toddler
Allow for freedom of movement - can stand between caregivers legs or seated in their lap
Use toddlers preferred words for objects or actions
Stories, dolls, books, stuffed animals
Participate in parallel play to help start communication
Best ways to interact with toddlers families
Explain most steps to child and ALL to caregiver
*Allow child to touch instruments
Handle most invasive parts last
Toddler assessment growth
Weight gain is sporadic non linear
3-5 lbs per year
Height about 3 inches per year
*start using standing scale
Intro of teeth
Head size not proportional un 3
13.5 hrs of sleep
Toddler assessment Neuro
Increased myelination
Emerging of protective reflexes
Language dev
*anterior fontenelle closes (9-18 month), primitive reflexes diminish
Toddler assessment respiratory
Increases in physical growth
Increase in alveoli number
Tonsils large in comparison
Eustachian tubers and short and straight
*RR20-30, can use bell on auscultation
Toddler assessment cardio
Heart rate decreases and blood pressure increases
* HR 70-120, can use bell on auscultation, PMI 4IC
Toddler assessment GI
Organ growth in size, inconsistent bowl waste
*short small intestine, stool diff colors, whole pieces of food passed
Toddler assessment HEENT
Vision 20/50 to 20/40
Hearing at adult level
Taste discrimination NOT developed
Toddler assessment GU
Function reaches adult levels by 16-24 months
Increased bladder capacity
Short urethras
*urine output 1 mL/kg/hr
Toddler assessment musculoskeletal
Increased bone length
Increased muscle strength
Weak abdominal muscles
Toddler pain assessment
Looks at:
Facial expression
Cry
Breathing
Torso
Arms and fingers
Legs and toes
State of arousal
Rates:
0 for normal activity
1 for sign of pain
Common toddler diseases
Ear infection
Hand Mouth and Foot
Conjunctivitis
Dehydration
Croup
Safety considerations with toddlers
Cars (car seats)
Tobacco smoke
Preventing injury in daily activities
Preventing poisoning
Drowning - * leading cause of death in children
Lifestyle/nutrition considerations in toddlers
Immunizations
Utensil usage
Food exposure
Establishing healthy feeding patterns
Food jags
Sleep/rest cycle
Toddler promoting early learning
Language
Motor - fine and gross
Reading
**delayed dev detection
Toddler development play
Parallel play
Activities:
Push pull toys
Blocks
Sand
Finger paint
Bubbles
Trucks and dolls
Containers
Cloth books
Wooden puzzles
Preschooler erikson
Initiative vs guilt
Preschooler cognitive dev
Pre operational thought
Magical thinking
Imaginary friends
Transduction
Animism
Understanding concept of right and wrong
Why questions
Preschooler motor dev
Gross:
Continued refinement of musculoskeletal system
Increased voluntary controlled movement
Improving balance
Fine:
Scribble freely
Copy a circle
Trace a square
Feed themselves
Preschooler language dev
Using about 2,000 words by 5
Working on fluency
Concrete communication
Preschooler emotional development
In tune with others moods
Fears
Vivid imagination
Intense emotion
First starting to develop friendship
Developing social skills - kindness, cooperation, sharing, affection display, conversation, expression of feeling
Best way to assess a preschooler
So,e willing to sit on table with caregiver close
*puppets, story telling/imaginative play
*speaking honestly
Allow for choices where appropriate
* simple concrete terms
Prepare an hour ahead
Best way to interact with preschoolers family
Speak to caregiver before and after exam
Preschool common diseases
Fever
Tonsillitis
Whooping cough
Gastroenteritis
Chicken pox
Preschool safety considerations
Ingestion
Car safety
Home safety - weapons, matches, water, bikes
Injury prevention
Poison prevention
Preschool lifestyle/nutrition considerations
Lying
Healthy teeth/gums
Sleep/rest cycle
Promotion of healthy eating habits
Implementing discipline
Preschool promoting early learning
Reading
Variety of experiences
Choosing a preschool
School aged child erikson
Industry vs inferiority
School aged cognitive dev
Concrete operational thinking
Assimilating and correlating info
Seeing from others pov
Categorization
Principal of conservation
School aged child motor dev
Gross:
Advanced coordination/balance/rhythm
Energy levels high and focused
Fine:
Refining
School aged child Language dev
Accelerates and broadens
Reading skills improve upon exposure
Complex grammatical usage starts
Comment on metalinguistics
Understanding methaphors
School aged emotional dev
Self esteem dev
Temperament is in full display
Body image concerns start to arise
Shifting of fears
Concern about peer relationships
Fear become concrete
School aged child play
Communal
Best way to assess a school aged child
Exam table while being able to maintain contact w/ caregiver
* diagrams, illustrations, books, videos
* third party sources - “some children feel…”
Prepare a few days in advance
Allow for questions
Best way to interact with school aged children’s family
Speak to caregiver before and after examination
School aged child neuro assessment
Brain and skull growth slow
Brain gwoth complete by 10yrs old
School aged respiratory assessment
Continued dev
Resp rate decrease
*Abdominal breathing disappears
* Shape of chest shifts to adult features
* retractions
* strider and nasal flaring
School aged cardio assessment
BP increases
Pulse decreases
* HR 60-100, RR 14-26 PMI 51C
School aged GI assessment
All 20 teeth lost and replaced with adult
Caloric needs decrease
Stomach capacity increases
School aged GU assessment
Bladder capacity increases, longer periods between voiding
School aged reproductive assessment
Prepubescence
School aged musculoskeletal assessment
Continued growth
Bones continue to ossify but do not mineralize until maturity
School aged immune assessment
Lymphatic tissue grows until about age 9
Immunoglobulins A and G reach adult levels at 10
School aged child pain assessment
Wong-baker FACES
School aged child common diseases
Asthma
Seizures
Lice
Celiac disease
School aged child safety considerations
Broad safety technique and modifications as it applies to areas of life
School aged child lifestyle/nutrition considerations
Child abuse
Fire/car safety
TV/video games/internet
Bullying
Stealing/lying/cheating
School aged child learning/dev considerations
Promoting growth/dev and learning through play and formal education
Reading
Adolescent dev erikson
Identity vs role confusion
Adolescent cognitive dev
Formal operational period
Abstract thinking
Thinking becomes logical/ consistent
Egocentric to introspective
Moral and spiritual dev
Adolescent motor dev
Gross:
Development of endurance
Coordination challenges due to growth spurts
Speed/accuracy increase
Fine:
Became refined
Complex dexterity
Adolescent language dev
Contrite to develop and refine
Use of colloquial speech
By late adolescence language skills are compared to adults
Adolescent emotional dev
Self concept
Body image
Hobbies
Relationships with parents
Relationships with others
Sexuality
Cultural influences
Hormonal changes
Suicide, violence, drug use
Best way to assess an adolescent
Exam in room w/ or w/out caregiver
*respect need for privacy
*non judgmental demeanor
Use appropriate medical terminology, creativity and humor
* do not force adolescent to speak
Prepare up to 1 week prior to procedure
How to interact with adolescent family
Explain confidentiality, allow time to speak together and separate from family
Adolescent growth assessment
Rapid growth changes different from boys and girls
* body mass to adult size
* male voice deepens
* 9-10 hours of sleep required
Adolescent Nero assessment
Continued brain growth
Size of brain does not increase significantly
Neurons do NOT increase in #
Growth of myelin sheath enables faster processing
Adolescent respiratory assessment
Increase in diameter and length of lungs
* RR decreases to 15-20
* Vital capacity/resp vol increases
* male voice drops
Adolescent cardio assessment
Increase in size and strength of the heart
Systolic BP increases and HR decreases
* HR 60-100
Adolescent GI assessment
Wisdom teeth eruption between 17-20
Organs enlarge in size but do not change in function (they matured in school age)
Adolescent endocrine assessment
Sebaceous and sweat glands become active and gully functional
Adolescent musculoskeletal assessment
Muscle mass and strength increase
Adolescent reproductive assessment
Puberty
* dev of secondary sex characteristics
* menstrual period 2.5 yr after puberty onset
Adolescent integumentary assessment
Skin becomes thick and tough
Oil and sweat glands become more active
Adolescent common diseases
Drug overdose
Blunt trauma
STIs
Anxiety
ADHD
Depression
Adolescent safety considerations
Vehicle
Recreational
Travel
Weapons
Alcohol use
Suntanning
Safe sex
Suicide
Violence
Adolescent nutrition/lifestyle considerations
Drug abuse
Sexual activity
Lying/cheating/steling
Increased independence
Violence
Bullying
Self harm
Adolescent development considerations
Looking toward adult life
Building a life
Choosing preferred activities
Becoming a rounded adult
