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HUNT243 > Lecture 11 > Flashcards

Lecture 11 Flashcards

Infancy and Toddlers

1
Q

how does muscle control and coordination develop in children

A

top down and centrally to peripherally

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2
Q

Critical or sensitive time periods or windows of development occur where

A

certain skills must be learned in order for subsequent learning to occur

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3
Q

all infants progress on …

A

their own timeline of development

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4
Q

the world health organisation recommends that infants should sit alone by what age

A

7 months

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5
Q

the world health organisation recommends that infants should stand holding furniture by what age

A

9 months

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6
Q

the world health organisation recommends that infants should stand alone by what age

A

14 months

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7
Q

the world health organisation recommends that infants should walk alone by what age

A

15 months

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8
Q

child growth assessment is important to determine whether a child is

A

growing “normally” or has a trend towards a growth concern that should be addressed

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9
Q

in child growth assessment weight is a good indicator of what

A

of acute changes in dietary intake

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10
Q

in child growth assessment height reflects

A

long term nutrition (better nutrition they will grow better standing height)

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11
Q

in child growth assessment head circumference reflects

A

brain growth

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12
Q

in child growth assessment BMI screens for

A

overnutrition or growth faltering

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13
Q

what are the two components of child growth assessment

A
  1. measure = weight, length / height, head circumference and BMI
  2. plot measurements of a childs body size on growth charts
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14
Q

clinical electronic scales are calibrated how often

A

every 6 months

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15
Q

what must be done when measuring children’s weight up to 2 years

A

remove clothing and nappy

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16
Q

what are the guidelines of measuring weight for children 2 years and above

A

minimal clothing, remove shoes, empty bladder and before a meal

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17
Q

weight in children is recorded to the nearest what

A

nearest 10g

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18
Q

what is an alternate method of measuring a childs weight when they are younger than 2 years

A

weigh mother and infant together and subtract the weight of the mother

-This methods is a little less accurate

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19
Q

what is used to measure length in children

A

a calibrated length board with fixed headpiece and moveable footpiece which is perpendicular to the surface of the table

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20
Q

how many people are needed to get an accurate length measurement of a child

A

two people

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21
Q

when measuring an infants length what must they be wearing

A

without shoes, and wearing light underclothing or diaper

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22
Q

how should an infant be positioned to have their length measured

A
  • should be placed on their back in the centre of the board, lying flat against the surface.
  • eyes should be looking up
  • both legs should be fully extended and toes should be pointing upwards with feet flat against the foot piece
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23
Q

length in infants should be measured to the nearest (it is good practice to take how many measurements)

A

nearest 0.1cm

good practice to take 3 measurements

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24
Q

what is the change in terms of measuring a childs height at 2 years

A

at 2 years we measure their height standing up rather than their length

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25
Q

when should weight and length be measured in children

A
  • in the first weeks of lide
  • at routine cheeks
  • when there is a concern about weight gain, growth or general health
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26
Q

who is measuring the weight and length

A

Often by LMC/GP/Well child provider

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27
Q

how often should we measure weight and height in infants and why should we not doo this too often

A
  • measuring too often can be misleading
  • should be measured > 2 weeks apart after 6 months of age
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28
Q

how to measure head circumference

A

position the tape just above the eyebrow, above the ears and around the biggest part on the back of the head

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29
Q

what should be used to measure head circumference

A

use a flexible, non stretchable tape

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30
Q

head circumference should be measured to the nearest

A

0.1cm

31
Q

head circumference is measured up until what age

A

1 year of age

32
Q

what is a growth reference

A

describes how certain children grew in a particular time and place

33
Q

what is a growth standard

A

describes how healthy children should grow under optimal environmental and health conditions

34
Q

why are we unable to use growth standards after the age of 5 years

A

after 5 years we are unable to control for the same factors that could when younger so we use references not standards

35
Q

what was the criteria used for the WHO multi centre growth reference study

A
  • mothers willing to exclusively breastfeed for at least 4 months
  • introduction of complementary feeding by the age of 6 months and continued partial breastfeeding up to at least 2 months
  • no maternal smoking before and after delivery
36
Q

how many home visits were included in the WHO multi centre growth reference study (and how often were these)

A

20 home visits

  • once fortnightly until 2 months old
  • once monthly until 13 months old
  • thereafter every 2 months until second birthday
37
Q

what was recorded in the WHO multi centre growth reference study

A

anthropometrics (from birth) and developmental milestone age (from 4 months of age)

38
Q

what was found about the variance in the WHO multi centre growth reference study

A

variance in growth was due to differences among individuals and only minimally to difference among site (country)

39
Q

what is the growth reference data for children aged 5-19 WHO

A
  • weight for age (5-10 years)
  • height for age (5-19 years)
  • BMI for age (5-19 years)
40
Q

what is the growth reference data for children aged 2-20 years CDC

A
  • stature for age (2-20 years)
  • weight for age (2-20 years)
  • BMI for age (2-20 years)
41
Q

how to calculate z-scores

A
  1. mean (find the avereages)
  2. standard deviation (calculate how spread out the values are from the mean)
  3. z score
42
Q

what does a z score tell you

A

tells you how many standard deviations away a specific value is from the mean

43
Q

if the z score is 0 it means

A

the value is exactly the average

44
Q

if the z score is positive it indicates

A

the value is above the average

45
Q

if the z score is negative it indicates

A

the value is below the average

46
Q

the higher the z score ( in the positive or negative direction), the …

A

the more unusual or less typical the value is compared to the average

47
Q

what is the z score equal to

A

measured value - average in the reference population / standard deviation of the reference population

48
Q

why plot on a growth chart ?

A
  • to compare a childs weight, height or head circumference against other healthy children of their age
  • to track how a child grows over time
  • normal growth is an important indicator of health
49
Q

what are the New Zealand Growth Charts for children aged 0-5 years

A

New Zealand - World Health Organisation Growth Charts (0-5 years)

50
Q

what are the New Zealand Growth Charts for children aged 5-18 years

A

either WHO reference 2007 or the Centres for Disease Control (CDC) Growth Charts

51
Q

on a growth chart, if a child is growing normally growth will

A

‘track’ parallel to one of the centile lines on the growth chart

52
Q

if a childs growth on a growth chart starts to track up or down significantly, further investigation is necessary (how many centiles for weight and height would this be a concern)

A

there is a consistent change in centile position by two or more intercentile spaces for weight

or by one or more inter-centile spaces for height

53
Q

if there is a difference of …….. or more inter-centile spaces between the weight and height values of a child this also requires investigation

A

a difference of two or more inter-centile spaces

54
Q

what does each percentile (centile line) mark

A

the weight or height below which the percent of children of that age and gender fall

55
Q

how many centiles are there on growth charts and where do they extend from

A

9 centiles that extend from 0.4th to the 99.6th

56
Q

what does the 50th centile represent

A

the mean

57
Q

a child is described as being …. or …. on a growth chart

A

on a centile or between two centiles

58
Q

a centile describes

A

the number of children expected to below that line ( e.g 50% below the 50th centile)

59
Q

50th centile is de-emphasized

Why?

A

Wasnt that appropriate because mothers were concerned if their child was not In the 50th centile then they wernt growing correctly but no matter where they are they should grow along the centile

60
Q

head circumferences taken within the first 24hrs of life are

A

unreliable because the head may be subjected to molding

61
Q

babies often lose weight in the first 3-5 days, what % regain by 2 weeks

A

80%

62
Q

is weight loss in babies after birth normal

A

yes

63
Q

baby weight loss is expressed as a

A

percentage of birthweight

64
Q

a baby weight loss greater than …. may indicate a feeding problem or illness

A

> 10%

65
Q

why do the centiles shift slightly when length is changed to height measure at 2 years of age

A

because when a child is standing up their spine is compressed / squashed slightly compared to lying down

66
Q

head circumference usually tracks within

A

a range of one centile space

67
Q

rapid head growth can be a sign of

A

hydrocephalus

68
Q

slowing head growth may be a sign of

A

underlying problems of brain or skull growth and development

69
Q

why is head growth no longer useful after 2 years of age

A

because it is slow

70
Q

BMI reflects

A

how heavy a child is relative to their height

71
Q

BMI is for …. not

A

BMI for screening tool not a diagnostic tool

72
Q

how often should infants and toddlers be measured

A
  • in the first week of life
  • at 1, 2, 4, 6, 9, 12, 18 and 24 months
  • between 4 - 6 years
  • older children and adolescents should be measured once each year
73
Q

what are the NZ recommendations of measuring weight and height and head circumference up until what age

A

weight and height = up to 5 years

head circumference = up to 1 year

HUNT243 (16 decks)

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