H&P Final Exam- Children & Adolescents Flashcards
What to assess at well visit? (10)
1- VS *vision & hearing
2- Health habits
3-Development
4-SHx
5-FHx
6- P/E
7-Assessment
8- Anticipatory guidance
9- Immunizations
10-Plan for F/u
Motor/Physical
4y
- hops & stands on 1 foot (2sec)
- catches/bounces a ball
- pours
- cuts w/scissors
Motor/Physical
5y
- stands on 1 foot (>10sec)
- hops & skips
- uses fork/ spoon well
- toilet trained
- swings & climbs
Language
4y
“he” & “she”
songs/poems from memory
tells stories
1st & last name
Language
5y
Speaks clearly
tells simple story using full sentences
uses future tense
names & addresses
Social/Emotional
4y
Plays “mom” & “dad”
make believe play
cooperates w/other kids
-rather play with others
cant tell real from make believe
Social/Emotional
5y
Can tell real from make believe
wants to please friends
aware of gender
independence
Cognitive
4y
colors & numbers
understands counting
understands same & different
copying some capital letters
board games
Cognitive
5y
Counts 10+
person w/ 6 body parts
print some letter & numbers
copies triangle
Development
5-7y
- School begins
- increased sensorimotor coord
- fine motor pen & paper
- cognitively preoperational (focus on 1 variable at a time)
- recognize numbers, letters, words, start to write
- MAGICAL THINKING
Development
7-11
- latency years (school & peers)
- achievement in school
- acceptance by peers
- sports & inc. coord w/organized teams
Sleep Req 3-5y
10-14hrs/night naps disappear
Sleep Req 5-7y (school aged)
10-14hrs/night
Sleep Req Adolescents
9-9.5 hrs/night
Nightmare v Night terror (5 points)
Appearance/Behavior
NT- screaming, thrashing, crying, appears not awake
NM- bad dream-awakens scared
Age?
NT- 4-5y
NM-toddlers & up
Timing
NT-w/in 2 hrs of going to bed
NM- 2nd part of night dur intense dreamig
Return to Sleep
NT- Back to sleep quickly
NM- May have trouble
Memory of Experience
NT- no memory
NM- may remember & talk about it next day
Toilet training usually completed by
4-5y
How often should kids be stooling?
up to Q3D NL
Constipation: 3 ways to help
Have a low threshold to start on.______.
1- Diet (fiber, bran, whole what, fruits & veggies, H2O)
2-Behavior (toilet after meals-gastrocolic reflex)
3-Medications
- Miralax!
what is it called when you hold your stool for inappropriately long times to the pt that the rectum strectches out
Encopresis
what is bed wetting called? what type of dizorder?
when should it completely resolve by?
Nocturnal Enuresis
Maturational Disorder
resolves by 15y
Adolescent Immunizations (3)
TDaP
Menigococcal
HPV
2 Brain systems that continue to develop through adolescence
Pre-frontal cortex (decisions, planning, inhibitive behavior, self-awareness, social interactions
Limbic System (emotional processor, ‘reward center’, hyper-sensitive!!!!)
Puberty hormones - Males
GnRH- LH & FSH
- LH stimulates testosterone
- FSH stimulates sperm maturation
Puberty hormones- Females
GnRH- LH, FSH
- FSH stimulates secretion of estrogen from ovaries
How many Tanner Stages?
What do they assess
5
Male GU
Female GU
Female Breast
Tanner Stage 1
prepubertal
(all)
Tanner stage 2
Male-testis enlarge, scrotal reddens, straight hair
female breast- bud, elevation of breast and papilla
female GU- sparse, lightly pigmented, straight
Tanner Stage 3
Male- penis grows length, hair coarse, curly, dark
female breast- further enlargement, no separation of contour
female gu- darkening, curl, inc pubic hair to symphysis
Tanner Stage 4
male- penis grows width, darker scrotum, hair full but LIMITED
Female breast- secondary mound above breast
Female GU- coarse, curly hair, abundant
Tanner Stage 5
Male- mature adult, hair to medial thighs
Female Breast- Mature stage, projection of papilla only
Female GU- mature adult, hair to median thighs
Precocious puberty
before 8 in girls, 9 in boys
Delayed puberty
after 13 in girls, no menarche 16 in girls
after 14 in boys