Pediatric Development

Question 1

Psychosocial Stage 1

Answer 1

Trust vs Mistrust
birth and one year of age
Child is dependent on caregiver
Children learn through sensation and motor action

Question 2

Psychosocial Stage 2

Answer 2

Autonomy vs Shame/Doubt
During early childhood
Focused on developing a greater sense of personal control
Toilet training, control over food choices, toy preferences, etc

Question 3

Psychosocial Stage 3

Answer 3

Initiative vs Guilt
During preschool years
Assert power and control over the world through directing play and other social interactions

Question 4

Psychosocial Stage 4

Answer 4

Industry vs Inferiority
early school years to age 5 to 11
Children begin to develop a sense of pride in their accomplishments and abilities

Question 5

2 month child well exam

Answer 5

Vitals: 130 avg P, and 23-48 R
FM: tracks to midline, hands to midline
GM: holds head steady briefly, raises head to 45 degrees
PS: coos and gurgles
Full PE and pulse oximetry for cardiac screening
Infant Reflexes

Question 6

4 month well child exam

Answer 6

lots of personal and social awareness
observed red flags: parent: minimal, disinterested
infant: uninterested in parents or surroundings, withdrawn, insistent on being held, difficult to console
Baby bottle tooth decay-sugar just sits on the teeth, don’t just leave your baby with a bottle

Question 7

6 month well child exam

Answer 7

Vital signs still the same
Begins to distinguish between friendly and angry voice patterns
Watch for safety precautions, start feeding them small amounts for semi solid foods

Question 8

9 months well child exam

Answer 8

Vital signs begin to decrease (90-160 P)
PS: may react to strangers, anxiety or fear may persist, formation of object permanence concept, seperation anxiety
toddler car seat when infant weights 20 lbs
Get more of their calories from solid foods but avoiding eggs, honey, peanuts, and acidic food
Regular sleep schedule established
Just keep redirecting child because they still can’t understand no
Screen: hemoglobin for anemia and looking at their transition from breast milk to food

Question 9

12 month well child exam

Answer 9

Vitals: R 22-31
fine motor skills
will start to develop autonomy
PE are challenging-do as much as you can in parent’s lap
Formal Developmental screen
can now have honey, tomatoes, and eggs
Can have only WHOLE milk-needed for brain development, using it for energy and height development

Question 10

15 and 18 well child exam

Answer 10

Vitals stay the same
Head starts to grow slowly until 10 yo
More independence, ego-centric 
should be able to say at least 3 words
regular routine for everything; 3 meals per day plus a snacks; avoid grazing

Question 11

2 year old well child exam

Answer 11

will try the same things many times to learn what happens (ie throwing cups down the stairs)
at least 20 words and 2 word sentences
tantrums-tell parents it will pass and to pick their battles
toilet training

Question 12

3 and 4 year old well child exam

Answer 12

P (73-137) and R (21-27) can start doing BP
speech really begins to develop
Formal developmental screen
problem behaviors in a child of this age usually reflective of other problems in the child or family and not true oppositional

Question 13

5 and 6 year old well child exam

Answer 13

Kindergarten readiness exam
Vitals decrease (100 P, 19-24 R)
personal and social is expanding
refer if persistent stuttering and embarrassment
car seat until 8 yo or 80 lbs or 4’9’’
kids are aware that they are going to get a shot

Question 14

middle childhood well child exam

Answer 14

Vitals are about the same as an adult
recognizes need for rule and fair play
try to interview child away from parent
safety and environment become very important
cholesterol screening