Peds Exam 2 Flashcards
what area of the body has a higher likelihood of injury by the age 6-12?
increased muscle tissue puts the risk of injury higher.
the 2-year period that precedes puberty
what is the average age for boys?
girls?
prepubescence
10 for girls and 12 for boys
Piaget’s concrete development is between which age range?
The ability to understand and apply reasoning to ______ concepts.
They work to classify and order the environment. What are three key concepts for this period?
7-11
concrete (still within their environment and unable to understand more abstract and broader issues)
1. math, symbols
2. less egocentric
3. reading
As to God, during the ages of 6-12, what do they think about Him?
they just want to know who this God everyone is talking about.
younger school age children behave according to what?
what do older children abide by?
they use consequences as a guide for moral behavior.
Older children can judge an act based on intentions, they utilize the golden rule.
How about Erikson’s stage from ages 6-12?
the boy scout age. They want to be independent, to try out tasks, feel accomplished–they want to show how useful they are. This is the sense of industry; we need to promote a growth mindset rather than a fixed one.
what’s a better time to teach sex education?
middle childhood–treat it as a normal part of growing up.
how is the relationship with families around 6-12?
family values take precedence over peer value systems.
Due to spending a lot of time with peers, they can begin to question or criticize parents.
They need and want restrictions and boundaries to provide them with security.
Ego mastery
Play is more physical activity that uses larger muscles which helps them acquire the feeling of mastery over themselves, their environment, and others–this is also a great way to relieve frustrations.
discipline at 6-12 years old
you start to teach them why things are wrong and point out a more acceptable form of behavior for future situations. Start to stimulate the child’s ability to empathize with the victim of a misdeed.
physically aggressive disciplines are linked to:
poor internalizing behaviors, depression, anxiety, hopelessness, aggression, violence.
bedtime resistance is common until what age?
12
in between ages 5-11 the average hours of sleep goes down from _____ to ______
11.5 hours to 9 hours.
child uses a booster until what height?
backseat until when?
57 inches tall or 4 ft 9 inches.
over 13 years old
chronic enuresis is called so if it is occurring for at least 3 months by the age of ____ and _____ for encopresis.
5 and 4.
primary enuresis or encopresis
never been accident-free for extended periods (or never been potty trained)
secondary encopresis or enuresis
the onset of accidents after a period of established continence
what is one unlikely cause of enuresis
chronic renal failure, a disorder that impairs the concentrating ability of the kidneys.
DDAVP (Desmopressin)
used to stop the frequent urination of enuresis by controlling sodium levels.
is considered second-line management
what three deficiencies (2 low, and 1 high) are possible causes of encopresis
hypothyroidism, hypokalemia, hypercalcemia.
low and slow, and then too much calcium also never lets anything move well.
The people of Flint, MI have this problem in their young…
constipation–encopresis
muscular dystrophy
a cause of encopresis
ADD and oppositional disorder can be a cause of what?
encopresis
Vanderbilt assessment tool
for ADHD, used by parents and teachers.
ADHD treatment (in those >5 years old)
methylphenidate (LA or IR)
lisdexamfetamine; start low and slow (based on symptoms rather than weight)
NEVER use with children with tic-like behaviors or hx of Tourette’s.
Adjunct therapy: tricyclic antidepressants, clonidine.
side effects of ADHD treatment (significant for child, but maybe not for adult)
abdominal pain, anorexia, headaches, sleep disturbances.
these are common side effects, so we will have to be more flexible with feeding schedules because of them.
what treatment is most effective for ADHD
multimodal treatment
3 stages of PTSD response
1) initial response minutes to hours of fight or flight
2) approximately 2 weeks when defense mechanisms are mobilized.
3) 2 to 3 months of coping, inquiry, may appear to be getting worse, flashbacks.
fluoxetine is the first choice for which age group?
> 8 years old.
SSRIs have a black box warning btw.
adrenal cortex is responsible for what?
the small amount of sex hormones released before puberty.
androgens increase rapidly around (___-___ years in boys) continuing for about ____ years
7-9 years, 15 years.
Thelarche ( ____ to_____ years):
Adrenarche (____to_____years):
Menarche: about _____ years after thelarche, menstruation begins.
8-13, breast buds.
8-13, pubic hair growth
2 years
puberty delay is classified if?
no thelarche by age 13
male maturation (9.5-14 years)
stage 1:
stage 3:
stage 5:
testicular enlargement and sparse pubic hair.
penile enlargement, voice changes, early facial hair.
gynecomastia occurs in 1/3 of midpuberty boys.
penile growth, first ejaculation, axillary, groin, and facial hair, final voice changes.
pubertal delay if:
no enlargement of testes or scrotal changes by 14 years old.
Erikson’s >12 identity development
group identity vs alienation
individual identity vs role diffusion/confusion: who they think they should be.
same-sex or opposite-sex friendships, and now romantic relationships.
The shift from concrete to formal operations in Piaget >11 years old.
abstract thinking
beyond the present
foresee a sequence of events
influenced by principles beyond their own thoughts and experiences.
–way past egocentrism.
Moral development by adolescence (highest step)
moral standards are considered subjective, and subject to disagreement. Justice, caring, and quality of life take precedence over established social norms.
“what’s the fairest most compassionate thing to do?–even if it contradicts laws or norms”
spiritual development by adolescence
During this period, there’s a shift towards introspection and personal belief systems rather than just following external rituals or practices. Teens often start to reexamine the beliefs and values they grew up with, questioning and sometimes reshaping them to fit their evolving identity and worldview.
What’s fascinating is that higher levels of religiosity and spirituality in adolescents are often linked to positive health behaviors. This can mean a greater sense of purpose, community, and support, leading to healthier lifestyle choices and a buffer against stress and adversity.
universal screening for hyperlipidemia is when?
first at ages 9-11 and then again at 17-21
adolescent vaccinations
tdap, meningococcal, HPV
if not complete: HepB, varicella.
enlarged testicular veins, resulting in pain or growth arrest of affected testicle may impair fertility; requires surgery or embolization.
varicocele
unilateral scrotal pain, redness, swelling, if sexually active, may be r/t STI
guess the treatment
often confused with what?
epididymitis (the key is that it is only affecting one area)
because it’s an infection, it can be related to a STI, and it needs antibiotic therapy.
often confused with testicular torsion.
surgical emergency; swollen and painful scrotum.
testicular torsion
what unlikely condition is r/t varicocele
gynecomastia. You will need plastic surgery for moobs
retin A, topical or systemic antibiotics can be used for what?
acne vulgaris
anorexia, bulimia, and female athlete triad need this for therapeutic management
nutrition, behavioral, pharmaco, psychotherapy.
hypothalamic disorder is linked to what in the female reproductive system?
secondary amenorrhea
