General Ped's and Growth/Development Flashcards
What do the Healthy People 2020 Goals want to Decrease?
- Developmental disabilities
- Obesity
- Iron deficiency in kids/childbearing females
- Tobacco use by kids
- Tobacco smoke exposure in homes
What do the Healthy People 2020 Goals want to increase?
- Vaccinations
- Exercise 30min/5days/week for adolescents
- Good overall nutrition by kids obtaining meals/snacks at school
- Percentage of full term infants to sleep on their backs
- The age and proportion of kids who remain alcohol/drug free
Parents or guardians have authority to make choices about their child’s healthcare except in which situations?
If it’s an emancipated minor; if minor is parent of child receiving treatment; If child is seeking birth control, substance abuse treatment, STD treatment, pregnancy help, or mental health treatment
What type of genetic test do we do here in KY when a newborn is born?
A Newborn Screening test that screens for about 7 or so diseases that will require immediate treatment to prevent death or disability.
If a child/family is identified with a possible genetic disorder, what can we do?
Referral to genetic specialist, support for them regarding potential diagnosis, education regarding potential health problems/issues
What is the leading cause of death for kids over 1 year?
MVA’s
What is the #1 cause of death for all ages?
Unintentional injury.
What is a philosophy of care for kids?
Care of the child is family-centered, atraumatic, and culturally sensitive.
What are some hospital safety measures for kids?
Keep rails up at all times, prohibit spark-producing toys near O2, don’t leave meds or syringes at bedside, watch small objects, teach parents/families.
What are some leading causes of death for young kids?
MVA’s are #1 for all ages; next come drowning, fire/burns, suicide, suffocation, homicide/firearm
What are some safety and prevention techniques for kids?
Utilize growth/development level; anticipate child’s motor abilities and curiosity; teach safety precautions; supervise child’s activities; childproof home environment.
What are some types of genetic tests for newborns?
Diagnostic testing, Prenatal testing, Newborn Screening, Preimplantation testing, Carrier testing, Predictive testing
Used to establish a diagnosis of a genetic disorder in an individual who is symptomatic or has had a positive screening test=
Diagnostic Testing.
Testing to identify a fetus with a genetic disease or condition; usually done due to family history or maternal factors; sometimes routinely offered.
Prenatal Testing.
Testing of a newborn to identify the presence of a condition that needs immediate attention to prevent death or disability =
Newborn Screening.
Following in vitro fertilization, testing is done on embryos to identify the presence of a genetic condition =
Preimplantation Testing.
Testing in an asymptomatic individual to identify carrier status for a genetic condition =
Carrier Testing.
Offered to asymptomatic individuals to detect genetic conditions that occur later in life; may be presymptomatic (ie Huntington’s) or predispositional (ie BRCA 1 & 2) =
Predictive Testing.
What is the importance of “play” for people of all ages?
Gives child choices and sense of control, safety, & security; Fosters growth and development; provides stress relief and distraction; alleviates separation anxiety; allows child to act out fears and concerns.
Why is pain confusing for pediatric patients?
it can be frightening and confusing; don’t understand why it occurs or that relief is right around the corner; lack language skills to tell where it hurts; may think it’s their fault.
What are some pediatric pain misconceptions?
Newborns don’t respond to pain (nervous systems immature); Infants and children cannot tell you where they hurt; Children don’t remember pain; parents exaggerate pain/aggravate it; repeat pain helps kids learn to cope with it better; active children are not in pain; children always tell the truth about pain; we should restrict meds because they can become addicted.
What are some facial s/s of an infant in pain?
bulged brows, brows lowered/drawn together, eyes squeezed shut, furrowed nasolabial creases, taut tongue, open/angular/squarish lips and mouth, quivering chin
Pain scale used to evaluate neonates less than 6 weeks old =
NIPS (Neonatal Infant Pain Scale)
What are the characteristics evaluated with the NIPS scale?
Facial expression, cry, breathing pattern, arm & leg movements, state of arousal
Pain scale used for kids 6 weeks old and up and any non verbal child =
FLACC (face, legs, activity, cry, consolability).
The NIPS pain scale is rated with 0-___; FLACC has a scale of zero-___
7; 10; zeroes are the best scores.
Name some self-report pain scales for kids:
Body outline, Faces, Oucher, Poker Chip
The Poker Chip self-report pain scale is for ages ____
4-7 year olds.
What age group should use the Faces pain scale?
3-5 years and up
What are some indicators of child abuse and neglect?
Hx inconsistent with injuries; hx incompatible with child’s development; hx that changes with time; delay in seeking tx; pathognomonic injuries (patterns of injury so specific that child abuse can be diagnosed regardless of history).
Pain scale based on ethnicity (hispanics, caucasians, AA’s) =
Oucher Pain Scale
What are some pain interventions for a child?
Medication, Comfort measures (holding), Reassurance pain is not a punishment, Band-Aid, Distraction, Sense of Control (give choices), Positioning, Swaddling, Involve parents.
Child abuse “Red Flags” =
Unusual bruises/welts/fractures/burns/bite marks; multiple fractures in various stages of healing; Cranial or abdominal injury can be suspect; Over sedation; Concealing clothing; usual shyness; changes in bx or school performance; avoiding physical contact with adults; fearful around parents
Possible Indications of Abuse:
Contradictory history that doesn’t explain injury; projects cause of injury on sibling or 3rd party; delay in seeking care; inappropriate awareness of seriousness of situation; “Hospital shopping”; unrealistic expectations of child; inappropriate or inadequate care to child’s hygiene or dress
The FDA recommends at least ___ mins of physical activity a day for kids and less than ___ sedentary time.
60; 2 hours.
One chart used to monitor a child’s developmental progress =
Denver II
What are some of the items measured on the Denver II Developmental Screening Test?
Personal-Social; Fine Motor-Adaptive; Language; Gross Motor
Name some factors that can influence growth and development:
Genetics, prenatal care, environment (ie lead in home), nutrition, health status, family, culture.
What things are charted on a growth chart?
Weight, length, and head circumference with the child’s age; except head circumference isn’t charted after 2 years of age
What do you look for on a growth chart?
consistency of the curve; should fall within 10%-90% consistently; deviations from curve are a red flag
What are Piaget’s Stages of Development?
1) The Sensorimotor Period: birth to 2 years: child’s cognitive system is limited to motor reflexes at birth, but the child builds on these reflexes to develop more sophisticated procedures. Learn to generalize their activities to a wider range of situations and coordinate them into increasingly lengthy chains of bx.
2) PreOperational Thought: 2-7 years: Kids acquire representational skills in the areas of mental imagery, and especially language. They are self-oriented and have an egocentric view.
3) Concrete Operational: 7-11: Able to take another’s point of view now. More accurate view of cause and effect. The child can reason quite well if concrete objects are used in teaching. The concept of conservation (that matter does not change when its form is altered) is learned at this age.
4) Formal Operational: 11-Adult: Fully mature thought has been attained; can think abstractly about objects or concepts and consider different outcomes.
A child’s who’s weight is significantly below that of other kids at the same age or can be a sudden decline in growth/weight =
Failure to Thrive (FTT).
Failure to thrive (FTT) can be from what types of causes?
Organic, nonorganic, or mixed causes.
Piaget formulated a theory of ___ development.
Intellectual/Cognitive
Who came up with assimilation and accommodation?
Piaget
Ability to understand that when something is out of sight it still exists =
Object permanence.
Ability to see things only from one’s own point of view =
Egocentrism
Connecting two events in a cause-effect relationship simply because they occur together in time =
Transductive Reasoning
Focusing only on one particular aspect of a situation =
Centration