Peds: Growth & Development

Question 1

Nutritional Requirements for Pediatric Patients

Answer 1

Small patients have higher metabolic rates requiring higher caloric needs:
newborn - 6 mos:  120 kcal/kg/day;
7 mos - 1 yr:  100 kcal/kg/day;
2 yrs - 10 yrs :  100 to 70 kcal/kg/day;
adolescents:   45 kcal/kg/day;
adults:  30 to 32 kcal/kg/day

Question 2

Benefits of Breast Fed Infants

Answer 2

• Exclusive breastfeeding recommended up to 6 mos (AAP).

- BF decreases risk of allergies, illnesses, GI upset/GERD,. pain (prostaglandin effect), and obesity (prolonged BF).

Question 3

Nutritional Supplementation for Breast Fed Infants:

(Vitamin D, B12, and Iron)

Answer 3

Vitamin D: 400 IU/day (2mos - adolescents);
Vitamin B12: (if BF mother is vegan, prevents neuro abs);
Iron: 1mg/kg/day (exclusively BF infants after 6 mos)

Question 4

Nutritional Supplementation for Children: (fluoride)

Answer 4

• if water supply < 0.6 parts per mil after 6 mos of age:
  6 mos - 3 yrs: 0.25 mg/day;
  3 yrs - 6 yrs: 0.5 mg/day;
  6 yrs- 16 yrs: 1mg/day

Question 5

Order of Tooth Eruption for Children

Answer 5

-Presentation follows mandibular then maxillary as:
incisors (central and lateral), cuspids, and molars (1st & 2nd)
-“Come Little Children Munch Meat”

Question 6

Ages for Tooth Eruption for Children

Answer 6

“Come Little Children Munch Meat”

• central incisors (primary): 6 - 7.5 mos; (perm.): 6 - 8 yrs;
• lateral incisors (prim.): 7-9 mos; (perm.): 7 - 9 yrs;
• cuspids (prim.): 16 - 18 mos; (perm.): 9 - 12 yrs;
• 1st molars (prim.): 12 - 14 mos; (perm.): 6 - 7 yrs;
• 1st & 2nd bicuspid (perm*.): 10 - 12 yrs;
• 2nd molars (prim.): 20 -24 mos; (perm.): 11 -13 yrs

Question 7

Cognitive Domain of Growth & Development: Primary Theorist- Jean Piaget

Answer 7

sensorimotor stage: birth to 2 yrs
(object permanence- looks for hidden objects 8-9 mos, reflexes adapt to environ., simple problem solving, trial/error learning);
preoperational/preconceptual stage: 2 to 4 yrs
(no cause/effect reasoning, ego-centrism, magical thinking/develops intuitive thought, focus on single aspect of problem);
intuitive/preoperational thinking: 4 to 7 yrs
(beginning of causation- cause/effect);
concrete thinking: 7 to 11 yrs
(logical though/logical operations- math skills);
formal operational thought: 11 to 15 yrs
(abstract thinking- complex problems solving, logical conclusions, reality-based)

Question 8

Psychosocial Domain of Growth & Development: Primary Theorist- Erik Erikson

Answer 8

-characterized by a progression of tasks/stages across lifespan
-successful psychosocial development requires resolution of developmental tasks;
infancy (birth to 1 yr): trust vs mistrust (Sanaa);
toddler (1 to 3 yrs): autonomy vs shame & doubt (Judah);
preschool (3 to 6 yrs): initiative vs guilt (Halle);
school age (6 to 12 yrs): industry vs inferiority (Sissy);
adolescence (12 to 18 yrs): identity vs role confusion (Boys)

Question 9

Psychosocial Domain of Growth & Development: Psychosexual Theorist- Sigmund Freud:
3 components/personalities of psychosexual stages

Answer 9

3 components/personalities are/not developed by experiences in particular stages of development:

• Id (pleasure principle);
• Ego (principle of reality/self-interest);
• Super Ego (principle of morality & conscience)

Question 10

Psychosocial Domain of Growth & Development: Psychosexual Theorist- Sigmund Freud:
5 psychosexual stages

Answer 10

INFANCY (oral stage):
- birth to 6 mos (orally passive, develops ID, pleasure principle)
- 7 mos to 18 mos (orally aggressive, teething, mother meets needs of oral satisfaction which decreases tension);
TODDLER (1.5 to 3 yrs- anal stage);
PRESCHOOL (3 to 6 yrs- phallic stage; identifies with parents of opp. sex called Oedipal complex, develops ego as becomes interested in self);
SCHOOL AGE ( 6 to 12 yrs- latency stage; not much occurring, socializing, develops super ego as noted by moral conscience);
ADOLESCENCE (12 to 18 yrs- genital stage; super ego)

Question 11

Growth & Development Landmarks

Answer 11

• assessment of landmarks: determined by using corrected age for premies (ex. Denver Development Screening Test);
• corrected gestational age (CGA)- adjustment of developmental expectations for premies done for up to 2 yrs (allowed 2 yrs to catch up)

Question 12

Measurement Tools for Growth & Development Landmarks

Answer 12

• Growth Parameters: assessed with growth charts, measurements of ht, wt, and head circum, BMI (kg/ht2 for pts over age 2), bone age (tarsals/carpals determine extent of ossification);
• Cognitive Development: standardized IQ tests (2 separate tests for assessment), use toys/language-based assessment based on mental age (chronological);
• Denver II: general assessment tool, used birth - 6 yrs age, measures gross/fine motor development, language, & personal-social development (not an IQ test)