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MaternalChild > Growth/Development/Newbros > Flashcards

Growth/Development/Newbros Flashcards

1
Q

Increase in physical size.
Sequential process by which infants and children gain various skills and functions.
Educating parents about normal growth and development.

A

Growth
Development
Anticipatory guidance

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2
Q

What are the two growth patterns?

A

Cephalocaudal: head to toe
Proximodistal: trunk to extremities

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3
Q

What are four theories of development and their developers? (Each measures a different component of development)

A

Personality: Erickson
Cognition (Piaget)
Psychosexuality (Freud)
Morality (Kohlberg)

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4
Q

What are some methods of developmental screening?

A

Parental report, demonstration during the exam, utilizing a screening tool.
Early detection means early treatment, so that growth is maximized and development is optimized. Any child who loses a developmental milestone needs an immediate full evaluation.

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5
Q

What are the five stages of growth and development?

A 
Infant: birth up to 1 year
Toddler: 1-3 years 
Preschooler: 3-6 years
School-age: 6-13 years
Adolescent: 13-18 years
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6
Q

What is the average newborn weight and length? How much do they increase by in 1 year? When does the posterior fontanel close?

A

Weight: 7.5lbs. Doubles by 4-6 months, triples by 1 year.
Length: 20”. Increases by 50% by 1 year
Posterior fontanel closes birth-2 months

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7
Q

How does the neurologic system begin to mature during infancy?

A

Involuntary movements to voluntary. Immature vocalizations and crying to beginning language. Reflexive behavior to purposeful movements.

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8
Q

Psychosocial and cognitive development in infancy?

A

Erickson: Trust vs mistrust
Piaget: Sensorimotor. Object permanence. Cause and effect.
Freud: Oral stage (sucking and feeding)

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9
Q

Gross motor skill development of infants?

A 
2 months: raises head
4 months: rolls
5 months: no head lag
6 months: sits with help
9 months: crawls
10 months: pulls to stand, cruises
12 months: walks
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10
Q

Fine motor skill development in infants?

A 
1 month: involuntary hand movements
4 months: bats at object
5 months: grasps rattle purposely 
7 months: transfers object from one hand to the other
8 months: pincer grasp 
9 months: bangs objects together
12 months: feeds self, pokes with finger
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11
Q

Sight and hearing sensory development in infants?

A

Sight is nearsighted. 6 weeks to 4 months is binocularity. & months is color vision and tracking.
Heating is intact at birth and acute.

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12
Q

Communication and language for the infant?

A 
Communicates by crying
2 months: coos (vowels)
4 months: laughs, “raspberries” 
6-7 months: babbles (consonants)
9 months: “mama”, “dada”
12 months: single words with meaning
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13
Q

Social and emotional development for the infant?

A

2 months: smiles
3-4 months: engaging interactions
6-8 months: stranger anxiety begins
8-12 months: separation anxiety begins

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14
Q

Height, weight, and anterior fontanel closure for toddlers?

A

Half of adult height by age 2. Weight gain of 3-5lbs per year. Anterior fontanel closes by 18 months.

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15
Q

Organ maturity and changes for toddlers?

A

Maturity by 24 months. Progressive brain myelinization and improved coordination. Increased colon and bladder size. Pot-bellied appearance.

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16
Q

Psychosocial and cognitive development in the toddler?

A

Erickson: Autonomy vs shame and doubt. Negativism. “Parallel play.”
Piaget: Sensorimotor and pre-operational. Imitation and make-believe. Sense of ownership. Sorts shapes and colors. Animism.
Freud: anal stage (potty-training)

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17
Q

Gross and fine motor skill development in the toddler?

A

Gross: Toddler gait, strengthened large muscle groups, kicks and throws a ball
Fine: Points, removes article of clothing, scribbles, stacks 4-10 objects

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18
Q

Sensory development of the toddler?

A

Explores the world through the senses, including mouthing.

Incomplete taste discrimination. Risk for accidental ingestion.

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19
Q

Communication and language development in the toddler?

A

Receptive language is greater than the expressive language. Echolalia, telegraphic speech, stuttering.
By 2 years: 40-50 words, 2 word sentences, points to pictures or body parts

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20
Q

Emotional and social development in the toddler?

A

Egocentrism: ritualism, individualism, negativism.
Aggressive/impulsive behaviors. Separation anxiety. Temper tantrums. Regression.
Fears: loss of parents, strangers, large animals, loud noises, the dark

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21
Q

How does one promote healthy growth and development in the toddler?

A

Routines and limits. Early learning. Promote safety: at the home (poison control), car seat and helmets, water. Promote nutrition: weaning and self-feeding, choking prevention, food jags, obesity.

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22
Q

Physical development of the preschooler?

A

Steady and slow growth. More slender with loss of baby fat. More agile and stronger. Maturity of most organ systems. 20 teeth. Bladder and bowel control

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23
Q

Psychosocial and cognitive development of the preschooler?

A

Erikson: Initiative vs guilt. Cooperative play, development of conscience.
Piaget: Pre-operational stage. Magical thinking. Active imagination. Opposites.
Freud: Phallic stage (opedipal)

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24
Q

Motor skills in the preschooler?

A

Gross: agile, constant motion, hops, runs
Fine: gripping in adult fashion, copy shapes and letters, cut, ties shoes

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25
Q

Communication and development in the reschooler?

A

Developing fluency. Complete sentences, 1500-2100 words. Concrete and literal communication

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26
Q

Emotional and social development in the preschooler?

A

Interactive communication, active imagination and fears, curiosity as far as sexuality, poor sense of the body, friendships and developing social skills.

27
Q

What should be promoted in the preschooler?

A

Language development or literacy. Early learning and preschool.
Safety: hand guns, bike riding. Car seat/booster at 4 years. Water, learn to swim.
Reducing fears: loud noises, imaginary monsters, strangers, the dark, body mutilation, painful procedures

28
Q

Physical growth of the school-age child?

A

Erikson: Industry vs inferiority. Sense of self-worth. Increased activities outside the home.
Piaget: Concrete operational. Classfies objects; starts collections. Principle of conversation. Concept of time.
Freud: Latency period. Social relationships with same-sex trends. Clubs.

29
Q

Motor skill development of the school-age child?

A

Gross: coordination, balance, rhythm improves. Participation in sports.
Fine: Improved hand-eye coordination and balance. Dexterity allows playing a musical instrument.

30
Q

Emotional and social development of the school-age child?

A

Metalinguistic awareness. Self-esteem and body image form. Peer approval and peer group identification. Fears: death, disability, and being kidnapped. Teachers/school important influences

31
Q

Physical development of the adolescent?

A

Rapid growth and dramatic changes. Girls reach physical maturity before boys. Sebaceous glands more active on face, back, and genitals leading to acne.
Sweat glands overproduce in response to hormones

32
Q

Puberty in teens?

A

Age 9-15 years (Tanner staging)
Thelarche in girls. Testicular enlargement in boys. Menarche usually at Tanner 3. Ossification of the skeletal system – Tanner 5

33
Q

Psychosocial and cognitive development of teens?

A

Erikson: Identity vs role confusion. Conformity to peer group. Interested in the opposite sex. Conflict with authority figures.
Piaget: Formal operations. Abstract though process developing. Egocentric thinking: invincibility. Risk-taking behaviors.

34
Q

Motor skill development of teens?

A

Gross: Increased endurance, speed, and assurance
Fine: Computer skills, refined dexterity, improved hand writing

35
Q

Emotional and social development in teens?

A

Relationship with parents: Increased independence and less parental influence.
Self-concept, body image, importance of peers, colloquial speech, sexuality, dating

36
Q

Developmental concerns in teens?

A

Violence: Homicide/gangs. Suicide, dating violence. Substance use.

37
Q

From the 28th week of gestation until the 7th day after birth.
From birth through the first 28 days of life.

A

Perinatal period

Neonatal period

38
Q

This hole shunts blood from the pulmonary artery to the aorta.
Shunts blood from the right to left atrium.
Bypasses hepatic system to the vena cava.

A

Ductus arteriosus
Foramen ovale
Ductus venosus

39
Q

Explain the HR in the newborn? Blood volume? Blood components?

A

110-160 bpm. “functional” murmurs are normal in neonatal period.
Average 80-85 mL/kg in term newborns. Delayed cord clamping increases volume by 25-40%
Fetal RBCs live 80-100 days. Physiologic anemia of infancy. Leukocytosis

40
Q

Fluid removal due to thorax compression during vaginal delivery. Pressure changes, light, chilling, low O2.

A

Initiation of respiration. Lipoprotein is a surfactant. Coats the lung tissue, prevents alveolar collapse.

41
Q

Explain respiration in the newborn?

A

Respirations are shallow and irregular, 30-60 per min. Periodic breathing: short periods of newborn respiratory pauses <10 secs, totally normal,.

42
Q

Maintaining balance between heat loss and production. Newborn unable to tolerate fluctuations.

A

Thermoregulation.
Heat loss occurs because thin skin, large body surface area, lack of brown fat and fat, lack go shivering, limited muscle activity, limited stores of energy sources. Conduction, convection, evaporation, radiation.

43
Q

Maintenance of body temp without energy use. Eliminate cold stress and prevent overheating.

A

Neutral thermal environment (NTE).

Optimal body temp is 97.7-99.5

44
Q

Transfer of heat from one object to another through touch.

A

Conduction.
From baby to cold exam table or crib blanket. Warm blankets and basinets in the labor room.
Warm hands and stethoscope

45
Q

Giving off heat to a cooler solid object in the vicinity but not touching.

A

Radiation
If warm baby is laying in crib near cool window, baby will give off heat to the window surface. Keep cribs away from windows and outside walls. Use radiant warmer when examining or transporting baby. Place hat on infant

46
Q

Air currents, such as breezes by open windows and fans.

A

Convection.

Keep infant away from open windows and fans.

47
Q

When a liquid is converted to a vapor, water on skin begins to evaporate immediately.

A

Evaporation.

Dry babies immediately after birth. Don’t allow newborns to lay in wet diapers or blankets.

48
Q

What are major functions of the liver?

A

Blood coagulation, conjugation of bilirubin, storage of fat soluble vitamins (A,D,E,K). Carb metabolism. Iron storage, detoxification

49
Q

Explain blood coagulation in the newborn?

A

During intrauterine life, fetus receives vitamin K from mother; no liver stores. After birth, decrease in vitamin K leads to being at risk for delayed clotting leading to severe bleeding

50
Q

This is synthesized in the intestinal flora, absent in the neonate because it takes a week to develop intestinal bacteria.

A

Vitamin K. Given prophylactically within 1 hour after birth. IM: vastus lateralis. Protect from light.
Side: pain, redness, bruising at the site

51
Q

Bile pigment from the destruction of RBCs.

Mucosal barrier development into newborn?

A

Bilirubin conjugation. Conjugated by the liver for excretion. Risk for jaundice.
Mucus: Absence of intestinal bacteria (sterile gut). Colonization within 24 hours.

52
Q

Explain carb metabolism and iron storage in the newborn.

A

Carb: increased energy needs after birth. Liver releases glycogen stores when feeding is intermittent or poor.
Iron: fetal stores dependent on the mother’s intake. Lasts about 6 months, then supplemented via the diet.

53
Q

Explain the stomach and digestion in a newborn

A

Stomach capacity is 30-90mL, only 10-20mL in the first 24 hours. Immature GE sphincter, decreased stomach motility. Stomach is rigid and non-elastic in the first 48 hours.

54
Q

Bowel elimination in newborns?

A

Meconium: greenish-black, tarry for the first 24 hours.
Transitional stool: greenish-brown/yellow, seedy
Milk stool: yellow

55
Q

These have a lower tolerance to fluid imbalance. Increased fluid turnover rate.

A

Immature newborn kidneys. Body mass=75% water.
Normal urine output is 15-60 mL/kg/day (0.6-2.5mL per hour). May contain pink uric acid crystals in first voids. Decreased GFR and specific gravity.

56
Q

What makes up natural immunity in the newborn? Explain the skin?

A

Skin, mucous membranes, gastric acids, enzymes.
Skin provides barrier to pathogens, limits loss of water, assists with thermoregulation, protects from physical trauma. Fragile with high risk for breaks. May look dry and peel after birth.

57
Q

What are the two types of acquired immunity?

A

Active, which is absent until exposed to a foreign organism. Passive, maternal transfer of antibodies.

58
Q

Explain acquired immunity in newborns?

A

IgG is the most abundant, crosses the placenta at birth.
Lack of IgA and IgM at birth. Doesn’t cross the placenta. Major source of IgA is MBM. IgM is the first to respond to infection.

59
Q

Explain the five senses in a newborn?

A

Myelin develops early in sensory impulse transmitters. Hearing: well developed at birth, turns to sound
Taste: Distinguishes sweet & sour at 72 hours old
Smell: Distinguishes mother’s breast milk
Touch: Sensitive to pain, responds to tactile stimuli
Vision: Incomplete at birth, focuses at 8-10 inches

60
Q

Important indicators of neurological function in the newborn.

A

Reflexes.
Absence, persistence, or reappearance means a pathology of some sort.
Early identification means early intervention and less complications.

61
Q

How long does the first period of reactivity in the newborn last?

A

0.5-2 hours.

Alert and moving, HR/RR increase. Good time for eye contact with parents and initiating breastfeeding.

62
Q

How long is the decreased period of responsiveness in the newborn?

A

1-2 hours. Sleepy, decreased activity, decreased responsiveness. Difficult to arouse the newborn, no interest in sucking.

63
Q

How long does the second period of reactivity last in the newborn?
When is stability?

A

2-8 hours. Awake, interested in surroundings, HR/RR increase. Bonding is encouraged, teaching may begin.
Stability occurs after 24 hours.

64
Q

Predictable periods triggered by external stimuli. Expected behaviors?

A

Behavioral responses. Orientation – alert, responds to stimuli
Habituation – responds to and then blocks out stimuli
Motor maturity – controls and coordinates movement
Self-quieting ability – “consolability”
Social behaviors – “cuddling” and positive responses

MaternalChild (15 decks)

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