Life Span & Special Populations Flashcards
Adolescent
A child 12 to 18 years of age.
Decompensatory Respiratory Distress
Increased respiratory effort caused by impaired respiratory function.
Compensated Respiratory Distress
When the respiratory compensatory mechanisms have begun to
fail and respiration becomes inadequate
Fontanelle
The “soft spot” on the top of an infant’s head where the bony plates of the skull have not yet fused together
Infant
A child from birth to 1 year; during the first month, referred to as a neonate.
Neonate
A child from birth to 1 month of age.
Neglect
Insufficient attention or provision of respect to someone who has
a claim to that attention.
Abuse
Improper or excessive action taken that injures or causes harm.
Preschooler
A child 3 to 6 years of age.
School-aged child
A child 6 to 12 years of age.
Sudden Infant Death Syndrome (SIDS)
The sudden and unexpected death of an infant or young child in which an autopsy fails to identify the cause of death; typically occurs while the neonate/infant is asleep
- Experts report an increased risk factor in premature infants, babies that sleep on their back and/or on a soft surface, and babies exposed to secondhand smoke
Toddler
A child 1 to 3 years of age.
Normal range of vitals for Neonate/Infant
- HR: 140- 160 per min
- Respiratory volume: 7-8 mL/kg at birth increasing to 10-15 mL/kg at 1 year
- RR: 40-60 at birth, 30-40 soon after birth
- Systolic BP: 70 mmHg at birth, 90 mmHg at 1 yr
Special considerations for infants
- Head is 25% of weight at birth
- Newborns weight drops by 10% at first, then increases at 5-6 oz per week after 2nd week
- Shorter, narrower, softer airway/trachea
- Lung tissue is fragile
- Infections and stress cause an increase in respiration –> infants more susceptible to dehydration and loss of body heat
- More diaphragmatic breathing
- Increased pressure in the heart as connections to mother’s bloodstream close slowly, heart tissue is weaker
- Infants gain antibodies (& therefore immune system) from mother –> “Passive immunity”
- Fontanelle is sensitive and depresses with dehydration and bulges with head injury & crying
- At first sleep 16 to 18 hours per day, decreases to 14 to 16 hours per day
- 25% of infant weight is muscle
- Only bones in fingers are hard, the rest are soft (mostly cartilage)
- Infants bond with people who meet their needs
- Communicate by crying
Passive immunity
The amount of antibodies infants received from their mother while in the uterus.
Epiphysis
Rounded end of a long bone, where these bones grow
Babinski reflex
Stroking the sole of the infant’s foot should produce the following: toes spread outward and upward
- This reflex usually goes away after the first several months
Babkin reflex
With the infant lying supine, press on his/her palms. The infant’s mouth should open and the eyes close.
- This reflex eventually goes away.
Moro reflex
While near the infant, make a loud noise. Infants should stretch their arms and legs, spread their fingers, and then hug themselves.
- This reflex usually goes away after the first several months of life
Palmar grasp reflex
Place an object in the palm of the infant’s hand. The fingers should curl around the object.
- This reflex usually goes away after the first several months of life.
Rooting reflex
Touch the infant’s cheek or near the lips. The infant should turn toward the stimulation (side you are touching) and pucker the mouth.
Stepping reflex
Hold the infant upright at the waist with the infant’s feet touching a solid surface. The infant should make stepping motions, as if walking.
Sucking reflex
Touch the infant’s mouth with a nipple. The infant’s lips should begin to pucker and start sucking.
Tonic neck reflex
If you place the infant in the supine position, the infant turns his or her head and extends the arms and legs on the side of the body toward which the head is turned.
Activities associated with 2 months of age
- Tracks objects with eyes
- Focuses on objects 8 to 12 inches away
- Recognizes familiar faces
- Displays primary emotions and facial expressions (such as smiling occasionally)
- Hears and recognizes familiar sounds and voices
- Moves in response to stimuli
Activities associated with 6 months of age
- Sits upright in a highchair
- Makes one-syllable sounds
- Raises the head when placed on the stomach
- Grasps and shakes hand toys
- Pushes the legs and feet down when held on a firm surface
- Follows moving objects with the eyes
- Recognizes familiar objects at a distance
- Babbles and attempts to imitate familiar sounds
Activities associated with Twelve months of age
- Walks with assistance
- Knows his/her name
- Sits upright without assistance
- Crawls on hands and feet
- Puts objects into containers
- Pokes objects with fingers
- Responds to simple requests and “no”
- Says “mama” and “dada”
- Imitates words and facial expressions
- Begins to use objects such as combs and cups correctly
- Finger feeds himself/herself
Toddler development characteristics
- By 18 months, exhibit separation anxiety. They might tend to be more attached to a caregiver and might have a difficult time separating from this person
- By 2, Start developing unique personality traits and moods. They know what they like and dislike.
- By 2, should be able to say simple words and phrases.
- By 2, start following directions
- By 2, nervous system is almost completely developed
- By 2, muscle mass and bone density increase, so most toddlers walk very well.
- By 2, renal system is well developed, giving toddlers the ability to control their bladder and bowel functions
- Most toddlers might be physiologically capable of toilet training by 12 to 15 months, but most are not psychologically ready until they reach 18 to 30 months (average age, 28 months)
- Basic language is usually acquired around three years of age
- Start recognizing the difference between male and female, and start modeling themselves after adults of their own sex
- Increase production of growth hormones, insulin, and corticosteroids. On average, the toddler gains approximately 6.5 pounds per year
Preschooler development
- Preschoolers can recite their first and last name, and their speech is understandable to strangers.
- Preschoolers can complete short sentences and questions, and love to hear stories and tell stories.
- Separation anxiety is typically gone by preschool age (although some preschoolers have a difficult time separating from their caregivers).
- The cardiovascular system continues to develop.
- The capillary beds become more prominent, which assists in the body’s thermoregulation.
- Hemoglobin also increases to near adult levels.
- Within the pulmonary system, the terminal airways continue to branch and alveoli continue to increase.
- Passive immunity is no longer present and the preschooler is susceptible to infections and common pathogens.
- Preschoolers begin to develop their own immunity (known as “active immunity”).
- The weight of a preschooler’s brain is about 90% that of an adult.
- Like toddlers, a preschooler gains an average of 6.5 pounds per year.
Developmental characteristics of child at age 3
- Walks alone and begins to run
- Pulls or carries several toys when walking
- Climbs up or down furniture or stairs with minimal support
- Scribbles and plays with toys
- Recognizes names, faces, voices, objects, and body parts
- Finds hidden objects
- Sorts objects by shape and color
Developmental characteristics of child at age 5
- Stands on one foot for more than 10 seconds
- Hops, jumps, swings, climbs, and does somersaults
- Dresses and undresses without assistance
- Uses forks, spoons, and sometimes knives appropriately
- Counts 10 or more objects
- Traces and draws pictures
Nocturnal Enuresis
Involuntary bed-wetting at night
Musculoskeletal, Nervous, Renal, and Reproductive development for School- Aged children
Musculoskeletal system:
- The musculoskeletal system continues to grow, with the bones becoming larger and stronger.
- In some children, this might cause some discomfort (“growing pains”).
- Baby teeth are replaced by permanent teeth.
Nervous system:
- About 95% of skull growth is completed by age 10.
- Brain function increases in both hemispheres.
- Children are normally able to read and write.
Renal System:
- Although the renal system is completely developed and school-age children are far past potty training, some might still have an accident at night, even after the age 10.
Reproductive system
- The reproductive system becomes active as the child reaches puberty.
- Sex hormone levels increase before any external signs appear (such as underarm hair in males and breast development in females).
- Females typically start puberty before males (anywhere from 8–13 years, with males starting from 13–15 years).
Challenging issues facing adolescents
- Depression and suicide are common in this age group.
- Adolescents compare themselves with others and are very conscious about how they look.
- In some, this level of self-consciousness might lead to disorders such as anorexia and bulimia.
- Some might take herbs and other over-the-counter (or illegal) drugs to lose weight.
- These stimulants can cause problems such as tachycardia, among others.
Physical growth in adolescents
- Organs such as the liver, spleen, kidneys, and heart increase in size.
- Growth of bone and muscle mass is nearly completed during the 2-to 3-year growth spurt.
- The adolescent’s growth spurt begins distally, with enlargement of the feet and hands, and progresses along the extremities.
- The final stage is enlargement of the torso.
- Typically, females finish growing by the age of 16 and males by the age of 18.
Puberty in females
- A change in breast tissue begins with what is known as a “breast bud.”
- Months later, pubic hair and underarm hair begin to grow, and the breasts enlarge.
- Approximately two years after breast budding, menarche usually occurs.
- The endocrine system changes and begins to release gonadotropin, luteinizing hormone, and follicle-stimulating hormone.
- These hormones produce estrogen and progesterone.
- Progesterone increases breast development and the start of the menstrual cycle.
- Estrogen causes development of secondary sex characteristics such as underarm and pubic hair, widened hips and buttocks, and smaller waist.
Puberty in males
- Gonadotropin promotes the production of testosterone, a hormone produced by the testes.
- Changes in the scrotum occur, and there is an increase in size of the testes and penis.
- The male’s voice starts to deepen
- Facial hair, pubic hair, and axillary hair begins to develop.
- The penis has erections, and ejaculation occurs from stimulation and during sleep.
- Body muscles become stronger, and shoulders broaden.
- In both sexes, the appearance of secondary sex characteristics marks the last period of rapid growth.
Early adulthood characteristics
- Early adulthood (young adults) is the period between 20 and 40 years of age.
- At the early onset of adulthood (19–26 years), individuals are at their physical peak. They are usually involved in high-risk activities, with accidents the leading cause of death.
- It is at this time that young adults develop lifelong habits and routines that directly affect their quality of life.
- After they reach their physical peak, metabolisms start to slow down. Fat is stored, weight is gained, and muscle tone increases.
- Psychosocially, this age group has developed the ability to love. New bonds and families increase stress.
- Young adults typically gain independence and leave home to begin a life of their own.
- Childbirth is very common in this age group.
- In addition, young adults typically experience the highest levels of stress in the workplace
Middle adulthood characteristics
- Middle adulthood is the age group from 41 to 60 years of age.
- Physiological changes can occur from different disease processes (such as cardiovascular disease).
- Choices in early adulthood might become apparent, such as smoking, drinking alcohol, or gaining excessive weight from eating unhealthy foods.
- Certain high-risk activities such as contact sports might start taking their toll on the body.
- Cancer is also common in this age group.
- Menopause occurs in women.
- Vision and hearing changes occur.
- During this time, parents might experience the “empty nest syndrome” as children begin leaving home.
- Finances might also be tight because of extra expenses (such as college tuition) and retirement plans (and other life-long goals).
- Additional stressors might also be placed on adults at this age—from taking care of elderly parents to providing care for a grandchild.
- However, people in middle adulthood also experience great joy during this time period, for some of the same reasons (grandchildren, time alone with spouse, and so on).
Late adulthood characteristics
- Body systems begin to deteriorate.
- Hair color changes (typically to gray)
- Hearing decreases
- Taste and smell are diminished
- Joints become stiff
- Bones become brittle
- Tissue elasticity is lost (which causes skin to wrinkle and sag
- Height decreases (in some, as much as three inches).
Vital signs for toddlers
Heart rate: 80 to 130 BPM
Respiratory rate: 20 to 30 BPM
Systolic blood pressure: 70 to 100 mmHg
Vital signs for preschoolers
Heart rate: 80 to 120 BPM
Respiratory rate: 20 to 30 BPM
Systolic blood pressure: 80 to 110 mmHg
Vital signs for school-aged children
Heart rate: 70 to 110 BPM
Respiratory rate: 20 to 30 BPM
Systolic blood pressure: 80 to 120 mmHg
Vital signs for adolescents
Heart rate: 55-105 BPM
Respiratory rate: 12-20 BPM
Systolic blood pressure: 100 to 120 mmHg
