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ProvaENFRN > Growth, Development, and Stages of Life > Flashcards

Growth, Development, and Stages of Life Flashcards

1
Q

Well-Check Schedule

A 
Prenatal visit
Newborn visit
First week visit (3 to 5 days)
1, 2, 3, 4, 6, 9, 12, 15, 18 month visit
2, 2 1/2, 3 year visit
Annual visits from 4 to 18 years.
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2
Q

Recommended Childhood and Adolescent Immunizations

A
  • Birth: HepB
  • 1m: HepB
  • 2m: Polio (IPV), DTaP (diphtheria, tetanus, pertussis); Influenza B (Hib); Pneumococcal (PCV), Rotavirus (RV)
  • 4m: DTaP, Hib, IPV, PCV, RV
  • 6m: Dtap, Hib, HeptB, IPV, PCV, RV
  • 12-15m: Hib, PCV, MMR (measles, mumps, rubella), HepA, varicella.
  • 15-18m: DTaP
  • 18-33m: HepA
  • 4-6y: DTaP, IPV, MMR, varicela.
  • 11-12y: MMR (if not yet), Tdap, Meningo (MCV4) with booster at 16y. HPV (2 doses follow at 2 and 6m after first dose)
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3
Q

Hepatitis B Vaccine (HepB)

A
  • Intramuscular
  • Birth, 1-2m, 6-18m.
  • Contraind: Severe allergic reactions to previous dose or vaccine component (aluminum hydroxide, yeast protein).
  • Precautions: infant less than 2kg or moderate to severe acute illness with or without fever.
  • HBsAg positive mothers: infant should receive HepB and immunoglobulin (HBIG) within 12 hours of birth. Also, infants should be tested for HBsAg and antibody after completion of HepB series (9 to 18m).
  • Mothers whose HBsAg status is unknown: infant should receive the first dose of HepB within 12 hours of birth. Maternal blood should be drawn ASAP, if positive, infant should receive HBIG (no later than a week).
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4
Q

Rotavirus Vaccine (RV)

A
  • Is a cause of of serious gastroenteritis and is nosocomial. Most severe in children 3-24m. (younger than 3 has maternal antibodies).
  • Oral route (must replicate in infant’s gut)
  • Rotarix: 2 doses (2 and 4m).
  • RotaTeq: 3 doses (2, 4 and 6m).
  • Do not start the series on or after age 15 weeks.
  • The maximum age for the final dose is 8 months.
  • Vaccine may be withheld if infant is experiencing severe vomiting and diarrhea. Adm on recovery.
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5
Q

Diphtheria, tetanus, acellular pertussis* (DTaP)

*coqueluche

A
  • Intramuscular
  • 5 doses (2, 4, 6, 15-18m, 4-6y).
  • DTaP <7y. Should not be adm 5th dose if 4th was given with 4y or later.
  • Tdap >7y (adolescent preparation) is recommended at 11 to 12y for children who have completed the DTaP series but have not received a Td booster; children 13-18y who have not received Tdap should receive a dose.
  • Td is used as a booster every 10 years after Tdap is adm at 11-18y.
  • Encephalopathy is a complication.
  • Contraind: encephalopathy within 7 days of a previous dose or severe allergic reaction to a previous dose or component.
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6
Q

Haemophilus Influenzae type B (Hib)

A
  • Protects against numerous serious infections caused by H. influenzae type B, such as bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis.
  • Intramuscular
  • ActHIB, Hiberix, or Pentacel: 4-dose series at 2, 4, 6, 12–15 months
  • PedvaxHIB: 3-dose series at 2, 4, 12–15 months.
  • Contraind: Severe allergic reaction to previous dose or component.
  • Special recommendations to: HIV, chemotherapy or radiation, stem cell transplant, sickle cell disease, splenectomy, immunoglobulin deficience.
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7
Q

Influenza Vaccine

A
  • Recommended annually for children beginning at age 6y. (2 types: LAIV and IIV)
  • LAIV should not be used in persons with the following conditions or situations:
  • History of severe allergic reaction to a previous dose of any influenza vaccine or to any vaccine component (excluding egg, see details above)
  • Receiving aspirin or salicylate-containing medications
  • Age 2–4 years with history of asthma or wheezing
  • Immunocompromised due to any cause (including medications and HIV infection)
  • Anatomic or functional asplenia
  • Cochlear implant
  • Cerebrospinal fluid-oropharyngeal communication
  • Close contacts or caregivers of severely immunosuppressed persons who require a protected environment
  • Pregnancy
  • Received influenza antiviral medications within the previous 48 hours
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8
Q

Inactivated Poliovirus Vaccine (IPV)

A
  • Subcutaneous (may be given IM)
  • 4-dose series at ages 2, 4, 6–18 months, 4–6 years; administer the final dose at or after age 4 years and at least 6 months after the previous dose.
  • Contraind: Severe allergic reaction to previous dose or component (formalin, neomycin, streptomycin,or polymyxin)
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9
Q

Measles, Mumps, Rubella (MMR) vaccine

* Sarampo, caxumba e rubeola

A
  • Subcutaneous
  • 2-dose series at 12–15 months, 4–6 years. Dose 2 may be administered as early as 4 weeks after dose 1.
  • The maximum age for use of MMRV is 12 years.
  • Contraind: Severe allergic reaction to previous dose or component (gelatin, neomycin, eggs, pregnancy, known immunodeficiency.
  • If child received immunoglobulin, the MMR should be postponed for at least 3-6m.
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10
Q

Varicella Vaccine

A
  • Subcutaneous
  • 2-dose series at 12–15 months, 4–6 years. Dose 2 may be administered as early as 3 months after dose 1.
  • Children receiving vaccine should avoid aspirin products because of the risk of Reye’s syndrome.
  • Contraind: Severe allergic reaction to previous dose or component (gelatin, bovine albumin, neomycin), significant suppression of cellular immunity, pregnancy.
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11
Q

Pneumococcal Conjugate Vaccine (PCV)

A
  • Prevents infection with Streptococcus pneumoniae, which may cause meningitis, pneumonia, septicemia, sinusitis, and otitis media.
  • Intramuscular
  • 4-dose series at 2, 4, 6, 12–15 months.
  • Contraind: Severe allergic reaction to previous dose or component.
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12
Q

Hepatitis A vaccine (HepA)

A
  • Intramuscular
  • 2-dose series (minimum interval: 6 months) beginning at age 12 months.
  • Contraind: Severe allergic reaction to previous dose or component.
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13
Q

Meningococcal vaccine (MCV)

A
  • MCV4 is the preferred type and is IM.
  • 2-dose series at 11–12 years, 16 years.
  • adolescents at high school entry (15y) and all college freshmen living in dormitories should be vaccinated.
  • Contraindicated in children with history of Guillain-Barre syndrome.
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14
Q

Human papillomavirus vaccine (HPV)

A
  • Guards against type 6, 11, 16, 18 (depending on type).
  • most effective before exposure through sexual contact.
  • 3 injections over 6 months. Routinely recommended at age 11–12 years (can start at age 9 years).
  • second dose 2m after first, and third dose 6m after first dose.
  • Vaccine may cause pain, swelling, itching, and redness at the injection site, fever, nausea and dizziness.
  • Contraind: pregnant women and reaction to previous vaccine.
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15
Q

Reactions to vaccine

A

Local reactions:
- Tenderness, erythema, swelling.
- Low-grade fever.
- Behavioral changes, such as drowsiness, unusual crying, decreased appetite.
Minimizing local reactions:
- using appropriate needle and recommended site.
Anaphylactic reaction:
- Protect airway, restore adequate circulation, prevent further exposure.
- Mild reaction: SC injection of antihistamine.
- Moderate to severe: CPR, elevate head, adm epinephrine, fluids and vasopressors as prescribed. Monitor vital signs and urine output.

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16
Q

Development Characteristics: Infant

- Physical

A
  • Height increases 1 inch per month in the first 6 months, and by 1 year the length has increased 50%.
  • Weight is doubled at 5 to 6 months and tripled at 12m
  • At birth head circ. is 33-35 cm, aprox 2-3 cm more than chest circ.
  • Anterior fontanel is soft and flat, closes by 18m.
  • Posterior fontanel is soft and flat, closes by 4m.
  • First primary teeth to erupt are the lower central incisors at aprox. 6-10m.
17
Q

Development Characteristics: Infant

- Vital Signs

A

Newborn:

  • 36 to 37.2 C (96.8 to 99.0 F)
  • 120-160 bpm
  • 30-60 rpm
  • BP 80-90/40-50 mmHg

1 year old infant:

  • 36.1 to 37.2 C (97 to 99 F)
  • 90-130 bpm
  • 20-40 rpm
  • BP 90/56 mmHg
18
Q

Development Characteristics: Infant

- Skills

A

2 to 3 months
- smiles, turns head side to side, follows objects, holds head in midline.
4 to 5 months
- grasps objects, switches objects from hands, rolls over for the first time, enjoys social interaction, begins to show memory, aware of unfamiliar surroundings.
6 to 7 months
- creeps, sits with support, imitates, exhibits fear of strangers, holds arms out, frequent mood swings, waves bye bye.
8 to 9 months
- sits steadily unsupported, crawls, may stand while holding on, begins to stand without help.
10 to 11 months
- can change from prone to sitting, walks while holding to furniture, stands securely, entertains self for periods of time.
12 to 13 months
- walks with 1 hand held, can take a few steps without falling, can drink from a cup.
14 to 15 months
- walks alone, can crawl up stairs, show emotions such as anger and affection, will explore away from mother in familiar surroundings.

19
Q

Development Characteristics: Toddler

- Physical

A
  • Height and weight increases in phases.
  • Head circ. increases about 1 in (25.5 cm) between ages 1 and 2, thereafter increases 12.5 cm (1/2 in) per year until age 5.
  • Weight gain is slower, by 2y, the average is 22-27 pounds (10-12kg).
  • Normal height changes include about 3in (7.5cm) per year. Average height is 34in (86cm) ate age 2.
  • Lordosis (pot belly) is noted.
  • Dental care is essential, should never be allowed to fall asleep with bottle (unless with water).
20
Q

Development Characteristics: Toddler

- Vital Signs

A
  • 36.4 to 37 C (97.5 to 98.6 F)
  • 80-120 bpm
  • 20-30 rpm
  • BP 92/55 mmHg
21
Q

Development Characteristics: Toddler

- Skills

A
  • Runs by age 2 and walks backward.
  • Hops on one feet by age 3.
  • begins to master fine motor skills.
  • begins to use short sentences and vocabulary has about 300 words by age 2.
22
Q

Development Characteristics: Preschooler

- Physical

A
  • Grows 2.5 to 3 in per year (6.5 to 7.5).
  • Average height is 37 in (94cm) at age 3, 40.5in (103cm) at age 4, and 43in (110cm) at age 5.
  • Gains approx. 5 pounds (2.25kg) per year. Averange is 18ks (40 pounds) at age 5.
  • Requires about 12 hours of sleep per day.
23
Q

Development Characteristics: Preschooler

- Vital Signs

A
  • 36.4 to 37 C (97.5 to 98.6 F)
  • 70-110 bpm
  • 16-22 rpm
  • BP 95/57 mmHg
24
Q

Development Characteristics: Preschooler

- Skills

A
  • has good posture
  • develops fine motor coordination
  • can hop, skip, and run smoothly
  • athletic abilities begin to develop
  • increased skill in balancing
  • alternates feet when climbing stairs
  • can tie shoelaces by age 6
  • talk continuously and ask many why question. Vocabulary of about 900 words by age 3 and 2100 by age 5.
  • By age 3 talk in 3-4 word sentences. By age 4 speak in 5-6 word sentences and by age 5 speaks in longer sentences .
  • child can be understood and can understand clearly what others say.
  • By age 5, achieves bowel and bladder control, although accidents may occur.
25
Q

Development Characteristics: School-age child

- Physical

A
  • Girls usually grow faster.
  • growth is about 2in (5cm) per year between ages 6-12
  • height ranges from 45in (115cm) ate age 6 to 59in (150cm) ate age 12.
  • gain weight at a range of about 4.5-6.5 pounds (2-3kg) per year.
  • Average weight is 46 pounds (21kg) at age 6 and 88 pounds (40kg) at age 12.
  • The first permanent teeth erupt around age 6.
  • sleep requirements range from 10-12 hours.
26
Q

Development Characteristics: School-age child

- Vital signs

A
  • 36.4 to 37 C (97.5 to 98.6 F)
  • 60-100 bpm
  • 18-20 rpm
  • BP 107/64 mmHg
27
Q

Development Characteristics: School-age child

- Skills

A
  • refinement of fine motor skills
  • development of gross motor skills
  • strength and endurance increase
28
Q

Development Characteristics: Adolescent

- Physical

A
  • Puberty is the maturational, hormonal, and growth process that occurs.
  • Body mass increases in adult size
  • Sebaceous and sweat glands become active
  • body hair distribution occurs
  • increases in height, weight, breast development, and pelvic girth occur in girls.
  • Menstrual periods occur 2.5 years after onset of puberty.
  • in boys, increases in height, weight, muscle mass, and penis and testicle size occur. Voice deepens.
29
Q

Development Characteristics: Adolescent

- Vital Signs

A
  • 36.4 to 37 C (97.5 - 98.6 F)
  • 55-90 bpm
  • 12-20 rpm
  • BP 121/70 mmHg
30
Q

Development Characteristics: Early adulthood (late teens to mid 30s)

A
  • Completed physical growth by the age 20.
  • Tends to ignore symptoms and postpone seeking health care.
  • separates from family origin
  • gives much attention to occupation.
31
Q

Development Characteristics: Middle adulthood (mid 30 to mid 60)

A
  • Physical changes occur between 40 to 65y.

- Menopause occurs in women and climacteric occurs in men.

32
Q

Near-death physiological manifestations

A
  • Metabolism is reduced, body gradually slows down until all functions end.
  • Sensory: experiences blurred vision, decrease sense of taste and smell, decreased pain and touch perception, and loss of blink reflex and appears to stare ( hearing is believed to be the last sense lost).
  • Respirations: Rapid or slow, shallow and irregular. May be noisy and wet sounding (death rattle).
  • Circulation: HR slows and BP falls progressively. Skin is cool to the touch, and extremities become pale, mottled, and cyanotic. Skin is wax-like very near death.
  • Urinary output decreases, incontinence may occur.
  • GI motility and peristalsis diminish, leading to constipation, gas accumulation and distension.
  • Gradually loses ability to move, has difficulty speaking and swallowing, and loses the gag reflex.
33
Q

General postmortem procedures

A
  • close eyes
  • replace dentures
  • wash the body and change bed linens if needed
  • place pads under the perineum
  • remove tubes and dressings
  • straighten the body and place a pillow under the head in preparation for a family viewing

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