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Peds > Growth and developmentinfant – Toddler – preschooler – school-age – adolescent > Flashcards

Growth and developmentinfant – Toddler – preschooler – school-age – adolescent Flashcards

Exam 1

1
Q

Growth

A

Increase in physical size

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2
Q

How is growth plotted on a graph?

A

Plotted on standardized growth charts to assess adequate growth for age and gender

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3
Q

How are children typically seen on growth charts?

A

Children typically remain in same percentiles over time. Major deviations warrant investigation

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4
Q

What kinds of growth charts exist?

A

Specialized growth charts for children with specific diagnoses (i.e. Downs Syndrome) and breastfeeding infants

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5
Q

Development

A

Sequential process by which infants and children gain various skills and functions

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6
Q

What is used to assess development?

A

Utilize screening tools to assess (i.e. Denver II, Ages and Stages, etc.)

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7
Q

Maturation

A

Increase in functionality of various body systems or developmental skills

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8
Q

When are the two greatest growth changes in pediatrics?

A

Adolescence and first year of life are two greatest growth changes in pediatrics.

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9
Q

For newborn and infants, how do you measure physical growth?

A

Weight

Height

Head circumference

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10
Q

Average weight of a newborn

A

Average is 7.5lbs

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11
Q

How does weight of newborn change in 4-6 months?

A

Doubles by 4-6 months

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12
Q

How does weight of newborn change in 1 year?

A

Triples by 1 year

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13
Q

Average height of newborn baby?

A

20 inches

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14
Q

By 1 year, how much does the average length increase?

A

By 1 year, length increases by 50%

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15
Q

What is the average head circumference of a newborn?

A

Average is 14 inches

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16
Q

How much does head circumference grow in a year?

A

4 inch gain by 1 year

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17
Q

List of reflexes of a newborn (hint: there are 9)

A
  1. Moro,
  2. Root,
  3. Suck,
  4. Asymmetric Tonic Neck,
  5. Plantar Grasp
  6. Palmar Grasp,
  7. Step,
  8. Babinski.
  9. Grasp
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18
Q

What happens to baby reflexes?

A

Diminish over first few months (except Babinski which takes 1 year)

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19
Q

What does newborn reflexes give way to?

A

Gives way to protective reflexes (righting and parachute reactions)

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20
Q

During the first few months of life, reflexive behavior is replaced by what?

A

Purposeful action

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21
Q

Respiratory rate of newborns

A

30 -60 in newborn

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22
Q

How much is respiratory rate of a 12 month old?

A

20-30 breaths

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23
Q

Why is respiratory rate higher in infants than adults?

A

Babies have high metabolic demand so respiratory rate is faster

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24
Q

When does respiratory system reach full maturity?

A

Respiratory system do not reach full maturity until about 7 years old

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25
Q

How does nasal passages of newborns compare to adults?

A

Nasal passages are narrower

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26
Q

How does trachea and chest wall of newborns compare to adults?

A

Trachea and chest wall are more compliant

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27
Q

How does bronchi and bronchioles of newborns compare to adults?

A

Bronchi and bronchioles are shorter and narrower

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28
Q

How does alveoli of newborns compare to adults?

A

Significantly fewer alveoli

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29
Q

What happens to the heart size in the first year of life?

A

Heart doubles in size in the first year

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30
Q

What happens to the average pulse rate of a newborn? and 1 year old?

A

Average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1 year old

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31
Q

What happens to blood pressure of newborn?

A

Blood pressure steadily increases, from an average of 60/40 in the newborn to 100/50 in the 12 month old

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32
Q

How are the peripheral capillaries in newborns?

A

Peripheral capillaries are closer to the surface of the skin, making the newborn and young infant more susceptible to heat loss

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33
Q

What becomes more effective in newborns as they grow?

A

Thermoregulation becomes more effective

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34
Q

GI system: Tongue of new born; why is it this way?

A

Tongue is larger relative to oral cavity size; it must be able to latch onto the nipple for the infant to feed

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35
Q

GI: Stomach of newborn

A

Stomach capacity increases as the infant grows

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36
Q

When does first primary teeth erupt? What teeth are they? How do teeth emerge?

A

First primary teeth erupt between the ages of 6 and 8 months

(incisors).

Teeth emerge in a predictable pattern

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37
Q

How is the stool of infants in the first year of life? Why?

A

Consistency and frequency of stools change over the first year of life based on intake (breast or bottle) and age (i.e. meconium)

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38
Q

Genitourinary and Integumentary Systems: Infants are more susceptible to what?

A

Infants more susceptible to dehydration

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39
Q

Genitourinary and Integumentary Systems: How is urine of newborn and infant?

A

Frequent urination with low specific gravity (not concentrated until glomeruli mature)

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40
Q

Genitourinary and Integumentary Systems: What is seen on newborns usually?

A

Lanugo and vernix may be seen in the newborns

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41
Q

Genitourinary and Integumentary Systems: How is the skin color of newborns?

A

Acrocyanosis is normal in the newborn and decreases over the first few days of life

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42
Q

Genitourinary and Integumentary Systems: How is the skin of newborns?

A

Skin is relatively thinner than that of adults with peripheral capillaries more superficial

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43
Q

Hematopoietic and Immunologic Systems: What happens to iron stores during pregnancy?

A

Maternal iron stores are transferred to the fetus throughout the last trimester of pregnancy.

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44
Q

Hematopoietic and Immunologic Systems: What happens to premature infants iron stores?

A

Therefore, premature infants miss this transfer and are at increased risk of iron deficiency anemia.

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45
Q

Hematopoietic and Immunologic Systems: How do newborns receive immunity?

A

Newborns receive immunity through the placenta and

utilize those antigens for first 3-6 months of life until they synthesize their own IgG, reaching adult levels by 9 months.

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46
Q

When do infants reach adult levels of IgE?

A

reaching adult levels by 9 months.

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47
Q

Three Developmental Theorists:

A
  1. Erikson
  2. Piaget
  3. Freud
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48
Q

Erikson Developmental Theory INFANT stage:

A

Trust v Mistrust (birth to 1 year)

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49
Q

Trust v Mistrust

A

Caregivers respond to infant’s basic needs, this creates a sense of trust in the infant.

Infants realized they are separate from their caregivers. They learn to tolerate small amounts of frustration and trust that although gratification is delayed, it will eventually be provided

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50
Q

Piaget Developmental Theories INFANT STAGE:

A

Sensorimotor

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51
Q

Sensorimotor

A

Infant uses senses and motor skills to learn about the world

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52
Q

Freud Developmental Theories Infant stage:

A

Oral stage: birth to 1 year

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53
Q

Oral stage

A

Pleasure is focused on oral activities; feeding and sucking

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54
Q

Newborn and Infant sensory development: Sight

A

View objects 8-15 inches away, prefer human face

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55
Q

Newborn and Infant sensory development: Sight- when does binocularity occur?

A

Binocularity – ability to fuse 2 ocular images into 1, begins at 6 weeks and established by 4 months. Color vision, distance, tracking by 7 months.

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56
Q

Newborn and Infant sensory development: Hearing

A

Intact at birth

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57
Q

Newborn and Infant sensory development: Smell and Taste:

A

Newborns can smell and prefer sweet tastes

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58
Q

Newborn and Infant sensory development: Touch:

A

Touch: Most important

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59
Q

Newborn and infant motor skill development: How do Gross motor skills develop?

A

*GROSS MOTOR Skills develop CEPHALOCAUDAL –> HEAD TO TOE

*slide 13

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60
Q

Newborn and infant motor skill development: How do FINE motor skills develop?

A

*FINE MOTOR Skills develop PROXIMODISTAL –> CENTER TO PERIPHERY

*Slide 14

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61
Q

Newborn and Infant: Communication and language development
What are infants mode of communication?

A

First several months, crying is only form of communication

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62
Q

Newborn and Infant: Communication and language development (1-2 months)

A

cooing

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63
Q

Newborn and Infant: Communication and language development (4-5 months)

A

vowel sounds, laughs, responds to voices, responds to name

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64
Q

Newborn and Infant: Communication and language development (6 months)

A

squealing and yelling

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65
Q

Newborn and Infant: Communication and language development (7 -10 months)

A

babbling, saying mamma dada without meaning

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66
Q

Newborn and Infant: Communication and language development (9-12 months)

A

attach meaning to words, recognizes objects by name, imitates words

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67
Q

Newborn and Infant: Communication and language development (12 months)

A

babbles with inflection

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68
Q

Newborn and Infant Social and Emotional Development: Stranger anxiety

A

Indicates infant recognizes self as separate from others

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69
Q

Newborn and Infant Social and Emotional Development: Separation anxiety

A

Infant becomes distressed when parent leaves

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70
Q

Newborn and Infant Social and Emotional Development: Temperament

A

Ranges from low to moderately active, regular, and predictable, to highly active, more intense, and less adaptable

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71
Q

What must assessments for growth and development include?

A

Assessments of growth and development must include adjustments for prematurity

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72
Q

What do you use to determine expected outcome of newborns and infants growth and development?

A

Use the infant’s adjusted age to determine expected outcomes

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73
Q

How to determine newborn and infant adjusted age?

A

Subtract the number of weeks that the infant was premature from the infant’s chronological age

Plot growth parameters and assess developmental milestones based on adjusted age

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74
Q

Newborn and Infant: Promoting healthy growth and development-

A

Safety

Nutrition

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75
Q

Newborn and Infant: Promoting healthy growth and development-Safety includes: list 4

A

Correct positioning and securing children in car seats

Positioning infants “back to sleep” to decrease risk of SIDS

Use of current recommendations for infant furniture

Safety on the changing table and use of mobility devices for infants

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76
Q

Newborn and Infant: Promoting healthy growth and development-Safety includes: list 3

A

Safety in the home using safety gates, outlet covers

Identify choking hazards (small toys, foods)

Water safety (bathrooms, buckets, and tubs)

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77
Q

Newborn and Infant: Promoting healthy growth and development-Nutrition

What does AAP, NAPNAP, WHO, ACOG, ADA recommend as the natural and preferred method of infant feeding

A

AAP, NAPNAP, WHO, ACOG, ADA all recommend breastfeeding as the natural and preferred method of infant feeding.

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78
Q

Newborn and Infant: Promoting healthy growth and development-Nutrition

How long does AAP recommend newborns be breastfed, when to introduce solids?

A

AAP recommends newborns to be breastfed exclusively for the first 6 months of life, then introducing solids with the continuation of breastfeeding until 1 year of age.

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79
Q

Newborn and Infant: Promoting healthy growth and development-Nutrition

Benefits of breastfeeding

A

Benefits for both mother and baby

Perfectly matched nutrition

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80
Q

Newborn and Infant: Promoting healthy growth and development-Promoting Healthy Eating Habits:

How do infants and newborns feed?

A

Newborns and young infants feed “on demand”

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81
Q

When can solid food be introduced to diet?

A

Can start to introduce solids at 4-6 months of age

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82
Q

How many times does infants require exposure to new food before accepting the food?

A

Infants can require exposure to new foods up to 20 times before accepting the food

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83
Q

How to introduce new food to infants?

A

Introduce a new food and wait 3 to 4 days before introducing a different food to observe for any allergies

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84
Q

Who decides how much child will eat?

A

The child will decide how much to eat—the parent provides the food

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85
Q

When should you introduce the cup?

A

Introduce the cup early (~6 months) to start

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86
Q

How should solid food be given to infants?

A

Solid food should be soft and mashed until teeth erupt

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87
Q

Newborn and infantcommon developmental concerns

A

Colic
Spitting up
Thumb sucking, pacifiers, security items
Teething

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88
Q

How long is toddlerhood

A

1-3 years

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89
Q

How does physical growth of toddler occur?

A

Height and weight increase steadily in spurts at a slower rate than the infant

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90
Q

By age 2, what is a toddlers height indicative of?

A

Generally reach half adult height by age 2

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91
Q

Average weight gain of toddler

A

Average weight gain is 3 to 5 lb per year

92
Q

Average height gain of toddler per year

A

Height increases by an average of 3 in per year

93
Q

When does anterior fontanelle close?

A

Anterior fontanelle closes by 18 months

94
Q

By age 3, what happens to head size?

A

Head size more proportional to body by age 3

95
Q

Neurologic system of toddler

A

Brain reaches about 90% of size by age 2.

Increased myelination improves coordination, balance, and sphincter control

96
Q

Respiratory system of toddler

A

Alveoli increase in number until age 7;

trachea and airways small compared to adult;

tonsils and adenoids are large relative to size of oral cavity

97
Q

Cardiovascular system of infants

A

Heart rate decreases; blood pressure increases

98
Q

GI system of infants

A

Stomach increases in size;

small intestine grows in length;

less frequent stools;

stool color may be variable based on diet;

bowel control typically achieved by end of toddler period

99
Q

Genitourinary system of toddlers

A

Bladder and kidney reach adult function by 16 to 24 months;

bladder capacity increases;

urethra remains relatively short

100
Q

Musculoskeletal system of toddler

A

Bones increase in length; muscle matures;

swayback and pot belly appear due to weak muscles until 3 years old

101
Q

Erikson Toddler Developmental theories:

A

Psychosocial theory describes the toddler period as a time of Autonomy vs. Shame and Doubt (1-3 years)

102
Q

Autonomy vs. Shame and Doubt (1-3 years) in toddlers

A

Toddler is learning to do for herself what others have been doing for her.

Ambivalence about the move from dependence to autonomy causing emotional lability.

103
Q

Toddler Developmental theories: Piaget

A

Cognitive development: Preoperational (2-7 years old)

104
Q

Toddler Cognitive Development: Preoperational means?

A

Differentiates self from objects (increased object permanence)

Think before acting, time space causality understanding, make believe, connections with past

Symbolic play – Animism: human feelings attached to objects

105
Q

Toddler Developmental theory: Freud

A

Anal stage:

focus on achieving anal sphincter control

106
Q

Toddler Gross motor skills development

A

Initial walking with “toddler” gait

Later includes running, climbing, jumping, pushing or pulling a toy, throwing a ball, and pedaling a tricycle

107
Q

Toddler Fine motor skills development

A

Progress from holding and pinching to the ability to manage utensils, hold a crayon, string a bead, work a puzzle, and use a touch screen

108
Q

Toddler Speech development- Receptive language

A

the ability to understand what is being said or asked

109
Q

Toddler Speech development- Expressive language

A

The ability to communicate one’s desires and feelings

110
Q

Toddler Speech development- How does Receptive Language compare to Expressive language

A

Receptive far more advanced early on than expressive language development

111
Q

Toddler Speech development-Bilingual children

A

Bilingual children: may have simultaneous acquisition of languages, first word may be slightly delayed but still in normal range

112
Q

Common language occurrences

A

Echolalia

Telegraphic speech

113
Q

Echolalia

A

repetition of words/phrases without understanding

114
Q

Telegraphic speech:

A

Want Cookie

2 word sentences

115
Q

How do infants explore their environments

A

With all five senses (including taste)

116
Q

What happens to visual acuity during toddlerhood? Hearing?

A

Visual acuity continues to improve

Hearing likely to be at adult levels

117
Q

How is sense of smell in toddlers?

A

Although not fully developed, toddlers may express preferences for certain smells

118
Q

How is toddlers sense of touch?

A

May prefer certain textures (soft vs. scratchy clothes)

119
Q

In toddlers, emotional development is focused on what?

A

Separation
Individuation
Egocentrism
Focus on self
Need for control leads to emotional lability
Rely on routines or security items to provide stability and comfort

120
Q

Emotional and social development in toddlers: Separation

A

Separation (Seeing oneself as separate from the parent)

121
Q

Emotional and social development in toddlers: Individuation

A

Individuation (Forming a sense of self and learning to control one’s environment)

122
Q

Emotional and social development in toddlers: Egocentricism

A

Focus on self

123
Q

Toddler Emotional and Social Development- Typical behaviors

A

May rely on a security item

Becomes aware of gender differences

May display aggressive behaviors

Consider the role of temperament in developing behaviors

May show fear of loss of parents and of strangers

Becomes more self-aware; does not have clear body boundaries

Separation anxiety may reoccur

May resist invasive procedures

124
Q

Toddler development: Moral and Spiritual

A

During toddler years, children may feel comfort by praying;

Don’t understand morality base actions on pleasure or punishment, but older toddlers beginning to understand empathy

125
Q

Toddler development: Cultural influences

A

Some parents may “baby” them for a longer period or the opposite;

some discourage crying in boys, “be a man”; ridicule for crying

126
Q

Toddlerhood: promoting health growth and development. - Wha tis a major socializing medium at this age?

A

Play is the major socializing medium at this age

127
Q

Toddlerhood: Promoting Health growth and development- what should parents do

A

Typically need 30 minutes of structured physical activity and 1 to 3 hours of unstructured physical activity per day

Parents should limit television and encourage creative and physical play instead

Engage in parallel play (playing alongside another child) instead of cooperative play

128
Q

Toddlerhood: Promoting Health growth and development- How do toddlers play

A

Toddlers are egocentric and do not like to share

Short attention span of toddlers will make them change toys frequently

Toys that engage multiple senses with creative play need not be expensive!

129
Q

Toddlerhood: Promoting Safety

A

Increasing mobility requires increased vigilance
Provide a childproof environment
Use a safe car seat in back seat of the car
Provide a safe home environment
Avoid exposure to tobacco smoke
Prevent injury; water safety
Prevent poisoning

130
Q

Toddler: Promoting Nutrition- when should weaning from bottle occur? Why?

A

Weaning from the bottle should occur by 12 to 15 months old, continuation can lead to dental caries

131
Q

Toddler: Promoting Nutrition- how much mg of Calcium do toddlers require?

A

Toddler requires 500 mg of calcium per day

132
Q

Deficiency in what can lead to developmental and psychomotor delays in toddlers?

A

Iron-deficiency anemia in first 2 years of life can lead to developmental and psychomotor delays

133
Q

Toddler: Promoting Nutrition- What should NOT be restricted in children younger than 2 years

A

Fat or cholesterol intake should not be restricted in children younger than 2 years

134
Q

Toddler: Promoting Nutrition- What is the daily recommended intake of fiber?

A

Daily recommended fiber intake for 1-3 year old is 19 g

135
Q

How much juice should a toddler drink? Milk? How should they drink and what about water?

A

Limit juice to 4-6 oz per day

Milk should be limited to 16-24 oz per day
Juice and milk should be offered along with meals or snacks

Water should be offered in between meals

Toddlers should drink from a cup (no sippy cup with a valve)

136
Q

Toddlerhood: Promoting Self-feeding

A

Use a child-sized spoon and fork with dull tines

Ensure the portion size, type, and texture of the food is appropriate for the toddler considering dentition

Seat the toddler in a high chair or at a comfortable height in a secure chair

Include the toddler in family mealtimes; praise attempts at self-feeding

Never leave the toddler unattended while eating

Minimize distractions during mealtime

137
Q

Toddler: Health Promotion. Healthy Sleep

A

A typical toddler should sleep through the night and take one daytime nap

Consistent bedtime rituals help the child prepare to sleep

Most children discontinue daytime napping at around 3 years of age; eliminating naptime is highly individualized

138
Q

Toddler: Health Promotion. Healthy Teeth and Gums

A

Cleaning teeth with water progressing to small amount of fluoride toothpaste at 2 years old.

Weaning from bottle and no-spill sippy cup by 15 months

Visit dentist by 1 year, discuss fluoride supplementation

139
Q

Toddlerhood: Promoting Appropriate Discipline

A

Limit setting

Negotiation

Techniques to assist the toddler to learn problem solving

Offer realistic choices

Keep instructions simple

Reinforce desirable behaviors

Extinction and “Time-outs” for negative behaviors

140
Q

Toddlerhood: Common Developmental Concerns

A

Toilet teaching

Negativism

Temper tantrums

Thumb sucking and pacifiers

Sibling rivalry

Aggression and regression

Weaning to cup

141
Q

Toddlerhood: Toilet teaching

A

Toilet teaching – myelination of spinal cord at 2 years old achieved, capability of sphincter control develops

142
Q

Preschooler: Physical Growth- What is the average growth? (weight and height)

A

Average growth of 2.5 to 3 inch per year

Average weight gain around 4-5 lb per year

143
Q

How do preschoolers grow?

A

Loss of baby fat and growth of muscle

Length of skull increases slightly; lower jaw more pronounced; upper jaw widens

144
Q

How would preschoolers grow on a growth chart?

A

Expect the child to remain on the same or similar growth curve on the growth chart as from previous visits (large changes in percentiles require additional assessments)

145
Q

Preschooler organ system maturation

Bladder and Heart

A

Myelination of the spinal cord allows for bowel and bladder control completion usually around 3 years old

Heart rate decreases, blood pressure increases

Heart murmur and split heart sounds

Stool 1-2 times per day

Short urethra resulting in risk of UTI, still have accidents at 4-5 years old

146
Q

Preschooler organ system maturation
Lungs, Teeth and Bones

A

Alveoli increase until 7 years old

Eustachian tubes remain short and straight

20 teeth

Bones increase in length and muscles strengthen however musculoskeletal still not mature and susceptible to injury

147
Q

Preschooler Developmental Theories (Erikson)

A

Erikson: (Psychosocial) Initiative versus Guilt (3 to 6 years):

feels pride in accomplishments leading to initiative, however when they extend themselves passed what capable of leads to guilt.

148
Q

Preschooler Developmental Theories (Piaget)

A

Piaget: (Cognitive) Preoperational sub-stages:

149
Q

Preschooler Developmental Theories (Piaget) What are the Preoperational sub-stages?

A

Preconceptual (2 to 4 years):

Intuitive phases (4 to 7 years): classify and relate objects, knows if something is right or wrong but doesn’t‘ understand why

150
Q

Preschooler Developmental Theories (Piaget)

Preoperational sub-stages: Preconceptual (2 to 4 years)- What is it?

A

Preconceptual (2 to 4 years): egocentric, active imagination, learns through observing and imitating

151
Q

Preschooler Developmental Theories (Piaget)

Preoperational sub-stages:

Intuitive phases (4 to 7 years): What is it?

A

classify and relate objects, knows if something is right or wrong but doesn’t‘ understand why

152
Q

Preschooler Developmental Theories: Kohlberg

A

Kohlberg: punishment–obedience orientation (2 to 7 years): determine good vs bad dependent upon associated punishment

153
Q

Preschooler Developmental Theories: Freud

A

Freud: phallic stage (3 to 7 years): jealousy and rivalry toward same-sex parent with love of opposite sex parent

154
Q

Preschoolermoral and spiritual development

A

Child’s moral standards are those of their parents or other adults who influence them, not necessarily their own.

Knowing a family’s religious beliefs can be helpful especially when hospitalized.

155
Q

Slide 45: Expected motor skills development for Preschoolers

A

Read it cause idk

156
Q

Preschoolercommunication and language development: 3 years

A

Speaks in complete sentences

Follows instructions with two or three steps

Can name most familiar things

Vocab of 200 words

157
Q

Preschoolercommunication and language development: 5 years

A

Can explain how to use something

Talks about past, present, future and imaginary events

Can answer questions that use why and when

Vocab of 2100 words

158
Q

Preschooleremotional and social development

A

Cooperation
Sharing (of things and feelings)
Kindness
Generosity
Affection display
Conversation
Expression of feelings
Helping others
Making friends

159
Q

Preschooleremotional and social development: Friendships

A

Preschoolers learn how to make and keep a friend

160
Q

Preschooleremotional and social development: Temperament

A

Influenced by parent’s expectation of child’s behavior

Determines child’s task orientation, social flexibility, and reactivity

161
Q

Preschooleremotional and social development: Fears

A

Preschoolers exhibit variety of fears
Parents should acknowledge child’s fears
Nightmares versus “night terrors”

162
Q

Preschoolerpromoting healthy growth and development

A

Building self-esteem

Maintaining routine and rituals
Setting limits and remaining consistent with them

Early recognition of signs of developmental delay

Supporting development of self-care activities (e.g., dressing, toileting)

Developing social skills within both the family and the larger society

163
Q

Preschoolernursing concerns

A

Delayed growth and development

Imbalanced nutrition, less than body requirements

Interrupted family processes

Risk for injury (or falls, poisoning, trauma)

Risk for caregiver role strain

Risk for delayed development

Risk for disproportionate growth

Disturbed sleep patterns

164
Q

Preschooler signs of developmental delay (3 years)

A

Falls down often or had trouble with stairs

Drools or unclear speech

Can’t work simple toys

Doesn’t make eye contact

165
Q

Preschooler signs of developmental delay (5 years)

A

Doesn’t show a variety of emotions

Extremes of behavior (fear, anger, aggression)

Unusually withdrawn or inactive

Cannot complete self-care activities (toileting, dressing, teeth, brushing)

166
Q

Preschoolerpromoting healthy growth and development

A

Promoting growth through play
Promoting early learning
Promoting language development
Promoting social skills for preschool/kindergarten
Promoting safety
Promoting nutrition
Promoting healthy sleep and rest
Promoting appropriate discipline

167
Q

Preschoolerpromoting nutrition. (Calcium, Iron, Fiber amounts?) and how should they eat?

A

500 to 800 mg calcium
10 mg iron
19 mg fiber

Regular meals with healthy snacks in between

Diet high in nutrient-rich foods

168
Q

Preschoolerpromoting nutrition: Amount of fats preschoolers should have

A

Fat intake no less than 20% and no more than 30% daily calories

Saturated fats less than 10%

169
Q

Preschoolerspromoting healthy eating habits

A

Small portions on smaller sized plates and bowls with appropriately sized utensils

Encourage child to serve self

Allow child to decide when to stop eating (don’t force food)

Snacks should be high quality (lean proteins, whole grain, fruits, veggies, dairy)

Family meal times allow parents to model appropriate behaviors at meals and facilitate communication

170
Q

Preschoolers preventing overweight and obesity- What is overweight defined as?

A

Overweight is defined as BMI at or above the 85th percentile and below the 95th percentile for age and sex

171
Q

Preschoolers preventing overweight and obesity- What is obesity defined as?

A

Obesity is defined as BMI greater than the 95th percentile for age and sex

172
Q

Consequences of childhood obesity include:

A

Hypertension

Hyperlipidemia

Insulin resistance

173
Q

Preschoolersdevelopmental issues

A

Lying
Sex education
Masturbation

174
Q

Preschoolersfocus on health care visits

A

Expected growth and development

Anticipatory guidance

Preparation for school entry

Planning for safety in the child’s environment

175
Q

School-age childphysiologic growth- How much height and weight gained per year

A

Grows an average of 2.5 inches per year.
Increases weight by average of 7 pounds per year.

176
Q

School-age childphysiologic growth- How do girls and boys compare?

A

Early on, boys and girls are similar in height and weight.

Later, girls may develop faster than boys in height and weight; boys will “catch-up” later.

177
Q

In school aged children, expectations of behavior should be consistent with what?

A

Expectations of behavior should be consistent with age, not appearances.

178
Q

What begins to appear in school aged children?

A

Secondary sexual characteristics begin to appear.

179
Q

School-age childorgan system maturation: Neurologic System

A

brain and skull grow very slowly; cognitive processes mature

180
Q

School-age childorgan system maturation: Respiratory System

A

respiratory rates decrease;

respirations are diaphragmatic in nature

181
Q

School-age childorgan system maturation: Cardiovascular System

A

blood pressure increases and pulse rate decreases.

182
Q

School-age childorgan system maturation: Immune System

A

matures to adult level around 10 years old; fewer infections experienced

183
Q

School-age childorgan system maturation: GI System

A

deciduous teeth replaced by permanent teeth;

fewer gastrointestinal upsets;

stomach capacity increases;

caloric needs are lower but appetite may increase.

184
Q

School-age childorgan system maturation: Genitourinary System

A

bladder capacity increases (age in years + 2 ounces); prepubescence occurs.

185
Q

School-age childorgan system maturation: Musculoskeletal System

A

greater coordination and strength; muscle still immature and can easily be injured.

186
Q

School-age childmotor skill development: Gross motor skills

A

Coordination, balance, rhythm improve.

Ride bike, jump rope, dance, sports, skating, swimming

187
Q

School-age childmotor skill development: Fine motor skills

A

Hand usage improves.

Eye–hand coordination and balance improve.

Can write, print words, sew, or build models.

Takes pride in activities requiring dexterity and fine motor skills, such as playing musical instruments.

188
Q

School-age childvision problems: Amblyopia

A

also called “lazy eye”) is the term to describe the condition when one eye can focus better than the other.

189
Q

Causes of Amblyopia

A

Uncorrected refractive errors or other eye defects in one eye (near-sighted, far-sighted or astigmatism)

Malalignment of the eye muscles (strabismus)

Deprivation due to cataract formation in one eye (rare)

190
Q

Symptoms of Amblyopia

A

Symptoms: Eye rubbing, squinting, avoiding reading, headaches, problems with depth perception or hand-eye coordination

191
Q

School-age childdevelopmental theories- Erikson

A

is psychosocial

Industry vs inferiority

192
Q

School-age childdevelopmental theories- Piaget

A

Cognition

Concrete operational thinking

193
Q

School-age childdevelopmental theories- Kohlberg

A

Conventional

194
Q

School-age childdevelopmental theories- Freud

A

Latency

195
Q

School-age childcommunication and language development

A

Vocabulary expands to 8,000 to 14,000 words.

Culturally specific words are used.

Reading efficiency improves language skills.

More complex grammatical forms are used.

Development of metalinguistic awareness occurs (ability to think about language and comment on its properties)

Metaphors are beginning to be understood.

196
Q

School-age childemotional and social development

A

Temperament

Self-esteem development

Body image

School-age fears

Peer relationships

Teacher and school influences

Family influences

197
Q

School-age childpromoting healthy growth and development

A

Cardiovascular fitness
Weight control
Emotional tension release
Development of leadership and social skills

198
Q

School-age childpromoting safety

A

Car safety
Pedestrian safety
Bicycle and sport safety
Fire safety
Water safety
Abuse in children

199
Q

School-age childpromoting nutrition- how to check for nutrition history

A

Nutrition history including a 24-hour recall of what was consumed.

200
Q

School-age childpromoting nutrition

A

Check height and weight compared to previous measurements; assess BMI for age.

Inquire about family meals and the social aspects of eating including who prepares the meals.

Solicit from both parent and child.

Identify any knowledge gaps relating to nutrition.

201
Q

School-age childpromoting nutrition- How much water per day? Protein? Calcium?

A

1,800 to 2,100 mL of water per day (limit sugary beverages and juices)

28 g protein

800–1,000 mg calcium for 4 to 8 year olds, increases to 1,300 mg for 9 to 13 year olds

*skipped slide 70

202
Q

School-age childdevelopmental concerns

A

Television and video games (setting limits on both the content and amount of time)

School refusal (school phobia)

Latchkey children and safety

Stealing, lying, cheating, bullying (whether as the perpetrator or the victim)

Fitting in with peer groups

Tobacco and alcohol education

203
Q

School-age childpromoting sleep and rest: How much sleep is required?

A

12 hours of sleep required.

204
Q

School-age childpromoting sleep and rest: how?

A

Should have predictable bedtime expectations and wake-up times.

Children may need help in winding down to promote sleep.

205
Q

School-age childpromoting sleep and rest: what may occur? how long?

A

Night terrors and sleepwalking may occur but should resolve by age 8 to 10 years.

206
Q

Adolescentgrowth and development- how does growth occur?

A

Rapid physical growth in body size and proportions second only to growth in infancy

Sexual characteristics and reproductive maturity occur

207
Q

Adolescentgrowth and development- when does puberty occur?

A

Puberty begins in girls around 9 to 10
years old and

in boys around 10 to 11 years old

208
Q

Adolescentgrowth and development – physiologic changes - hormone secretion in girls and boys

A

Secretion of estrogen in girls and

testosterone in boys stimulates physical sexual changes

209
Q

Adolescentgrowth and development – physiologic changes - peak height velocity in girls and boys

A

Peak height velocity occurs at about 12 years of age in girls and 14 years of age in boys

210
Q

Adolescentgrowth and development – physiologic changes - what increases in girls and boys?

A

Muscle mass increase in boys and fat deposits increase in girls

211
Q

Adolescentgrowth and development – physiologic changes common in boys and girls?

A

Voice deepens (most dramatic in males)

Limbs elongate disproportionately (may look “leggy”)

Growth plates at the end of long bones begin to close

Apocrine glands (sweat glands) activate in axilla and genital areas

Skin changes related to increased sebaceous gland secretions may lead to skin eruptions (acne)

Increase in body hair

212
Q

Adolescentgrowth and development – physiologic changes differing in boys and girls?

A

Hips widen in females, shoulders widen in males

213
Q

Adolescentorgan system maturation: Neurologic system

A

Neurologic system: growth of myelin sheath enables faster neural processing; cognitive growth increases

214
Q

Adolescentorgan system maturation: Respiratory system

A

Increase in diameter and length of the lungs; respiratory volume and vital capacity increase

215
Q

Adolescentorgan system maturation: Cardiovascular system

A

size and strength of heart increases; systolic blood pressure increases and heart rate decreases

216
Q

Adolescentorgan system maturation: GI system

A

full set of permanent teeth; liver, spleen, kidneys, and digestive tract enlarge

217
Q

Adolescentorgan system maturation: Musculoskeletal system

A

linear growth is not complete until late adolescence in boys and occurs earlier in girls; growth plates (which promote linear growth) begin to close at puberty. Adult height is attained when growth plates have closed in late adolescence

218
Q

Adolescentorgan system maturation: Integumentary system

A

skin is thick and tough; sebaceous glands are more active; sweat glands function at adult level

219
Q

Adolescentdevelopmental theories Erikson

A

Psychosocial

Identity v role confusion or diffusion

220
Q

Adolescentdevelopmental theories Piaget

A

Cognition

Formal operation

221
Q

Adolescentdevelopmental theories Kohlberg

A

Moral development

Postconventional level III

222
Q

Adolescentimprove communication

A

Allow sufficient time for conversation
Speak respectfully as you would to a colleague
Talk face to face; be aware of body language (yours and the teen’s)
Ask open-ended questions to clarify and promote understanding
Reflect back what you think you heard so that he or she feels heard
Choose words carefully so that message and intent are clear
Be honest; don’t be afraid to say you don’t know
Be liberal with praise; acknowledge effort
Solicit the teen’s input in decision making as often as possible
Clearly state expectations and set limits fairly

223
Q

Adolescentinfluence of peers- what kind of role do peers play?

A

Play essential role in identity of the adolescent

Provide opportunities to learn negotiation of differences

Provide recreation, companionship, and someone to share problems with

Create stability in times of stress or transition

Serve as credible sources of information and social reinforcement (behaviors, roles)

Can have positive or negative influences

224
Q

Adolescentsafety concerns

A

Unintentional injuries
Internet safety
Motor vehicle safety (as a driver and as a passenger)
Avoiding substance abuse
Firearm safety
Water safety

225
Q

Adolescentnutrition- what influences food choices?

A

Peer pressure; growing wish for independence from family in food choices
Low cost/convenience/easy access of fast foods
Family culture relating to food and meal time rituals
Lack of time/opportunities for family meals (busy schedules)
Growing wish for independence in food choices
Others?

Peds (15 decks)

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