GROWTH AND DEVELOPMENT Flashcards
Physical growth occurs in an elderly, predictable sequence; the direction of growth as what?
Cephalo to caudal
Proximal to distal
Caloric requirements for birth to 6 months are?
120 kcal/kg/day
Caloric requirements for seven months to 1 year?
100 kcal/kg/day
Caloric requirements for 2 to 10 years?
100 to 70 kcal/kg/day
Caloric requirements for the adolescent?
45 kcal/kg/day
____ _____ is the perfect food for humans; cannot be duplicated it helps with
a) decrease illness in infants
b) Maternal antibodies are transferred to infants
c) Decreased gastrointestinal problems such as gastroesophageal reflux disease (GERD)
d) decreases allergies as breast milk contains anti-inflammatory agents to decrease atopy; fewer allergies in children who are this
e) This during painful procedures provides analgesia
f) The longer the mother does this the fewer chances of the child to be overweight independent of education and socioeconomic status
Breastfeeding
Adequate Nutrition confirmed by weight gain of ___g/day (1 oz/day) for the first three months
30g/day
The gain of ____ to 20g/day during the subsequent 3 months
15
Vitamin D supplements [____ international units (IU) per day] at 2 months of age to adolescence
400
Vitamin B12 for breastfeeding mothers who are strict ________ worry about neurological abnormalities
vegetarians
Iron for exclusively breastfed infants approximately ___mg/kg/day of iron is recommended for 6 months of age
1 mg/kg/day
_____ feeding should contain iron supplementation
Bottle
Ideally, the iron should come from fortified _____
cereals
Fluoride supplements only when the local water supply is deficient (less than _____ parts per million/ppm)
0.3
Fluoride supplementation is ____ recommended for the first 6 months of life?
not
Rapid deceleration growth followed by consistent growth
a) initially ___ loss
b) regained within 7 to 14 days
c) doubles by 5 months of age
d) triples by ___ years of age
e) quadruples by 2 years of age
f) three years old through school-age; gain 2.5 inches annually
g) school-age children gain five to seven pounds annually
a) 10%
d) 1 year
Age of eruption for central incisor (primary teeth)
6 to 7.5 months
Age of eruption for the lateral incisor (primary teeth)
7 to 9 months
Age of eruption for cuspid (primary teeth)
16 to 18 months
Age of eruption first molar (primary teeth)
12 to 14 months
Age of eruption second molar (primary teeth)
20 to 24 months
Age of eruption for central incisor (permanent teeth)
6 to 8 years
Age of eruption for the lateral incisor (permanent teeth)
7 to 9 years
Age of eruption for cuspid (permanent teeth)
9 to 12 years
Age of eruption first bicuspid (permanent teeth)
10 to 12 years
Age of eruption second bicuspid (permanent teeth)
10 to 12 years
Age of eruption first molar (permanent teeth)
6 to 7 years
Age of eruption second molar (permanent teeth)
11 to 13 years
Sensorimotor stage of Jean Piaget’s is from birth to __ years
What will you see:
a) Reflexes ______
b) Adapts inborn ______ to the environment
c) Object ________
d) Sensory abilities improve; become increasingly aware of ______
e) Trial and ____ learning
f) Simple ____ solving
2 years
a) Inborn
b) reflexes
c) permanence
d) environment
e) error
f) problem
Preoperational/ Preconceptual Stage: ___ to 4 years
a) Can focus on a single _____ of a situation
b) No ________ reasoning
c) Egocentrism
d) Development of _____ thought
e) Difficulty distinguishing fact from _____ (magical thinking)
a) aspect
b) cause- and- effect
d) intuitive
e) fantasy
Intuitive/Preoperational thinking: ___ to 7 years
a) Capable of ______ thinking
b) Logical _____
4 years
a) Logical
b) operations
______ operational thought: 11 to ___ years
a) ability to ______
b) Capable of complex ___ solving
c) Reality _____
d) ____ conclusions
Formal 15 years a) abstract b) problem c) based d) Logical
Eric Erikson = Primary Theorist
Stages
a) Infancy ( birth to 1 year): ____ vs _____
b) Toddler ( 1 to 3 years): Autonomy vs. ____ and doubt
c) Preschool ( 3 to 6 years): _____ vs guilt
d) School Age ( 6 to 12 years): Industry vs. _______
e) Adolescence (12 to 18 years): Indentity vs. _______
a) trust vs mistrust
b) shame
c) Initiative
d) inferiority
e) role confusion
Successful _________ development requires successful resolution of these developmental tasks
psychosocial
Sigmund Freud = Psychosexual Theorist
Three components of personalities are developed (or not) by experiences in particular stages of development
a) ___: Principle of pleasure
b) ___: Principle or reality/ self- interest
c) ___: Principle of morality or conscience
a) Id
b) Ego
c) Superego
Stages of psychosexual development
Infancy: _______ stage
a) Birth to 6 months: _____ passive (development of the id; biological pleasure principle)
b) Toddler ( 1.5 to ____ years): Anal stage
c) Preschool ( 3 to ___ years): Phallic stage (lover of the opposite sex, Oedipal complex); ego development
d) School-age (6 to ____ years); Latency stage (sexual drive repressed, socialization occurs, superego and morality development)
e) Adolescence (12 to ___ years): Genital stage
Oral
a) Orally
b) 3 years
c) 6 years
d) 12 years
e) 18 years
Measurement tools for growth and developmental landmarks
Growth Parameter
a) Growth ____
b) Norms expressed as the percentile of ____, weight, and head circumference for age
c) ____ measurements
d) Any child who crosses over multiple sequential _____ lines needs further evaluation
e) _________ (BMI) should be calculated and plotted for children over 2 years old
f) BMI = weight in ____/ Height in meters
g) Bone age: X-ray of ____ and carpals determines the extent of ossification
a) charts
b) height
c) Sequential
d) percentile
e) Body Mass Index
f) kg
g) tarsals
Cognitive Development
a) Measurement of various standardized _____ test (IQ)
b) Need at least ___ separate test results to make an assessment of intellect
c) Can use ____ and language-based assessment based on mental age
a) intelligence
b) two
c) toys
Denver 2
a) Generalized _____ tool
b) Used from birth to ___ years of age
c) Measures:
1) Gross motor development
2) ____ motor development
3) Language
4) Personal social development
d) Not an _______ test
a) assessment
b) 6 years
c)
2) Fine
d) intelligence
Good head control (gross motor) in ____ months
2 to 3 months
Rolls back to front (gross motor) in _____ months
5 to 6 months
Sits alone (gross motor) in _____ months
7 months
Pulls to stand (gross motor) in ____ months
9 to 10 months
Stands alone (gross motor) in ___ months
11 to 12 months
Walks (gross motor) in ____ months
12 to 14 months
Walks up and down stairs (gross motor) in ____ months
22 to 24 months
Jumps (gross motor) in ___ months
24 to 28 months
Grasp and shakes rattle (fine motor) in ____ months
2 to 3 months
Reaches for the object (fine motor) in ____ months
3 to 4 months
Hand to hand transfer (fine motor) in ____ months
5 to 6 months
Raking grasp (fine motor) in ___ months
6 to 7 months
Finger grasp (fine motor) in ____ months
7 to 9 months
Pincer grasp (fine motor) in ____ months
8 to 10 months
Marks on paper (fine motor) in ____ months
10 to 12 months
Stacks 3 blocks (fine motor) in ____ months
17 to 18 months
Stacks 6 to 7 blocks (fine motor) in ___ months
22 to 24 months
Smiles and coos in ____ months
2 to 3 months
Laughs in ____ months
4 to 5 months
Babbles in ___ months
5 to 6 months
“Mama-Dada” in ____ months
8 to 9 months
Waves bye-bye in ___ months
8 to 9 months
Understands “No” in ___ months
9 to 10 months
Points to body parts in ____ months
15 to 18 months
2-word sentence in ____ months
18 to 22 months
30 to 50 words vocabulary in ____ months
22 to 24 months
At what age is this ______ months
a) smiles and coos
b) watches a person’s face intently
c) follows people and objects with eyes
d) laughs aloud
e) lifts head/chest when on the stomach
f) hold head steady when pulled to sit
g) grasps rattle placed in the hand
h) startles to loud noise
2 to 5 months
At what age is this _____ months
a) Babbles and combines vowel/ consonant sounds
b) turns to sounds
c) responds to name
d) rolls over
e) sits independently
f) transfers objects
g) supports weight on feet
h) uses thumb and fingers to pick up objects
i) crawl
6 to 9 months
At what age is this ____ months
a) takes simple action upon request
b) purposefully say “Mama” or “Dada”
c) sits independently
d) pulls to standing/ cruise furniture
e) communicated by reaching and pointing
f) moves purposefully to get the desired object
g) has increasing curiosity
h) recognizes people
i) uses both hands equally well
10 to 12 months
At what age is this _____ months
a) Scribbles with a large crayon
b) Walks alone
c) Feeds self with fingers and begins using a spoon
d) 4 to 10-word vocabulary
e) follows simple directions
f) coordinates the use of both hands
g) responds to name
h) points to 2 pictures upon request
i) long jabbering sentences
j) throw the ball overhead
13 to 18 months
At what age is this ____ months
a) walks up/downstairs
b) jumps with both feet
c) completes simple puzzles, circle shapes first
d) Stacks 6 to 7 blocks
e) Uses 2 words sentences
f) 30 to 50-word vocabulary
19 to 24 months
____ ______ _____ (WCC)
- Specific Tools of Health Screening
a) Parent/ caregiver interview
b) Physical examination
c) developmental monitoring
d) specific, stage-appropriate screening
e) assessment of strengths/ weaknesses
f) individualized and evidence-based interventions
Well Child Checks (WCC)
_________ data from Well Child Check include:
a) nutrition/ appetite
b) elimination
c) sleep
d) development
e) parental/ caregiver concerns
f) interval history: health since last visit, emergencies, illness, medications
Subjective data
______ data for well-child check include
a) physical exam
b) screening
1) development screening (Denver Developmental Screening Test, second edition (Denver 2) for children less than or equal to 6 years of age
Objective data
________ plan is part of the Well Child Check (WCC)
a) immunization: initiation of primary series
b) illness management with medications
c) health promotion strategies with anticipatory guidance
Management plan
The ________ in Well Child Check
a) ascertain who will be present
b) ensure privacy
c) inform parents ahead of time if you are recording data
d) keep child clothed until necessary to remove clothing
e) phrase your questions purposefully
f) convey interest/listening
g) employ cultural sensitivity
h) ensure accurate perception of patents’ concerns
i) Use a non-judgmental approach
j) keep child clothed until PE
k) talk at eye level
l) play to enhance comfort
m) use projective techniques
n) use non-threatening words
o) allow adequate time for response
The interview
_____ prevention in well-child check
a) car seat
b) poison control number
c) electrical exposure protection
d) all poisons out of reach
e) gates to barricade unsafe areas
f) smoke/ carbon monoxide detectors
g) pool safety
h) crib safety
i) hot water safety
j) sun safety
k) passive/ secondary smoke
l) abuse/ neglect potential
m) domestic violence
n) sexual abuse
o) firearms
Injury prevention
________ Discussion/ Guidance of well-child checks
a) how to perform simple tasks
b) when to call a health care provider
c) expected response to immunizations and procedures
d) time management
e) discipline
Developmental discussion/ guidance
Children are ____ to exposure and toxicity (agents that are heavier to closer to the ground than are such as sarin gas and chlorine)
vulnerable
_____ Body Mass
a) less fat, less elastic connective tissue, and close proximity of the chest to abdominal organs
b) flying objects, falls, blunt or blast trauma may result in increased injury to multiple organs
a) body surface area to mass ratio is highest at birth and diminishes with age
b) BSA is of the head to the limbs is higher, affecting burn injuries and hypothermia management
c) the higher BSA leads to more rapid absorption and systemic effect of toxins absorbed through thinner, less keratinized, higher permeable skin
Small
______ circulating blood volume /less fluid reserve
a) even small amounts of volume loss may lead to hemorrhagic shock in the child
b) children are more vulnerable to bacterial agents; staphylococcal enterotoxins and Vibrio cholera lead to diarrhea/vomiting, hypovolemic dehydration, and shock, especially in infants, small children, and children with special health care needs
Smaller
Skeletal
a) Bones are more ______, incompletely calcified skeletal system with active growth venters more susceptible to fracture
b) Orthopedic injuries often are missed in preverbal children (less than ___ years)
c) Additional organ damage (cardiac, lung) without incurred rib fractures are common and may be present
d) Cervical spine distortions may render x-ray interpretation as confusing; spinal cord injury may be noted without x-ray abnormalities
pliable
______
a) larger and heavier head compared to body proportion, accounting for a larger BSA than in the adult
b) A major heat loss source
c) short neck and lacking well-developed musculature are common
d) the cranium is thinner and vulnerable to penetrating injury
e) The brain, which doubles in size by 6 months and is 80% of adult size by age 2, continues to do the following, which are a risk for arrest and permanent changes
1) Myelination
2) synapse formation
3) neuronal plasticity
4) biochemical stability
Head
_____
1) mobile, pliable and offer little protection
a) Risk of compromising cardiovascular flow, significant
blood loss, and hypovolemic shock
chest
________
1) The tongue is relatively large to the oropharynx, creating the potential for obstruction
2) The airway is narrow and angular, leading to difficulties with intubation need
3) Lungs are small and subject to barotraumas resulting in pneumothorax
Airway
______ system
1) Compensate with raising heart rate and respiration during the early phase of hypovolemic shock (false impression of normalcy leads toward too little fluid resuscitation)
a) May be followed by a precipitous deterioration with
little warning
Circulating
_______ stability and regulation
1) affected by BSA to mass ratio, thin skin, lack of subcutaneous tissues with evaporative heat loss, and increased caloric/energy expenditure
2) hypothermia is a significant risk factor for poor outcome s
3) use of thermal blankets, warmed resuscitation rooms and fluids, and warmed inhaled gases may be required
Temperature
_______
Effects
1) Infants and young children have a higher minute ventilation per kilogram of body weight than adults and thus, can be exposed to a relatively larger dose of aerosolized biological and chemical agents
2) more likely to feel effects and absorb more of the toxins from the lungs prior to clearing with ventilation
3) Resuscitation with fluids, drugs, and equipment are based on weight
4) The use of Broselow/Hinkle pediatric resuscitation measuring tape is recommended for a quick assessment
5) Fluids need to be administered with caution due to large volumes of hypotonic fluid that may place the child ar trick of hyponatremia and seizures
Ventilation
__________ stores
A limited store of glycogen with higher relative metabolism puts children at risk for hypoglycemia
Glycogen (Energy) Stores
_________ differences
1) An immature immunologic system creates a greater risk of infection
2) Less her immunity from infections such as smallpox, and a unique susceptibility to some agents such as Venezuelan equine encephalitis
Immunologic
_______ differences
1) Limited verbal abilities. May not be able to describe symptoms or localized pain
2) Dependent on caretakers; may be more vulnerable to food source limitations when they are unavailable or contaminated
3) Limited motor skills to escape injury
4) Limited cognitive abilities to figure out how to flee from danger, follow directions from others or even recognize a threat
5) Emotionally unstable due to the developing brain, especially in stressful encounters
6) Reactions to danger and threats may be dictated by developmental stage
7) There are additional concerns when the child has special health care needs that require interventions
Developmental Differences
__________ differences
1) Often gain cues from the caretakers or adults available to them; parental fears and feelings may impact and magnify their emotions
a) Younger children may exhibit regressive behaviors, increased temper tantrums, symptoms of clinginess, and difficulty with separation or sleep, which may increase crying, irritability, separation anxiety, and hyperactive startle responses
b) School-age children may exhibit depression, anger, and despair, which may be exacerbated by unrealistic fears of parents, families, and friends; school problems, physical somatization may occur
c) Adolescence (due to the dramatic and complex physical, psychological, and social transitions) may be vulnerable to the development of major psychiatric disorders such as depression; also, risk-taking behavior (alcohol, tobacco, and other drug usage or suicide) may surface, as adolescents often hide their feelings or symptoms for fear of being perceived as abnormal
Developmental
____________ differences
1) Often gain clues from the caretakers or adults available to them; parental fears and feelings may impact and magnify their emotions
2) Development stage alters emotions
Psychological differences
Psychological differences
a) _____ _______ may exhibit regressive behaviors, increased temper tantrums, symptoms of clinginess and difficulty with separation or sleep, which may increase crying, irritability, separation anxiety, and hyperactive startle responses
Younger children
Psychological differences
b) ____ _______ may exhibit depression, anger, and despair, which may be exacerbated by unrealistic fears of parents, families, friends; school problems, physical somatization (headache and stomach ache) may occur
School-age children
Psychological differences
c) ________ (due to the dramatic and complex physical, psychological; and social transitions) may be vulnerable to the development of major psychiatric disorders such as depression; also, risk-taking behavior (may surface, as adolescents often hid their feelings or symptoms for fear of being perceived as abnormal
Adolescence
