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DRT PEDS > School age > Flashcards

School age Flashcards

1
Q

School age

A

6-12 years

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2
Q

Freuds School age stage

A

latency stage
ages 6-12years
-marked by repression of sexual urges as children play mostly with peers of the same sex

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3
Q

Jean Piaget school age

A

concrete stage
age 7-11years
-children become more organized and rational in thinking
-quantity remains constant even if its appearance changes

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4
Q

Erik Erickson school age

A

age 6-12
industry vs. inferiority
-desire to please adults
-complex tasks

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5
Q

WCC

A

school age annually

-2nd dose of MMR vaccine ages b/t age 4 and 6: prior to school entry
-ages 11 and 12 get Tdap, HPV, Varicella, and Meningococcal conjugate vaccine

-Dental assessment and cleaning every 6months

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6
Q

Average wt increase

A

5-7lbs per year

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7
Q

Average ht increase

A

2-3inches per year

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8
Q

Female peak height velocity (PHV)

A

ages 11 and 12
prior to menarche

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9
Q

Obesity in school age?

A

-indicated by BMI over the 95th percentile

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10
Q

Visual Acuity

A

20/20

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11
Q

eruption of permanent teeth

A

age 6

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12
Q

Precocious Puberty

A

uses Tanner Stage
females younger 8years of age
males younger than 9years of age

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13
Q

PPD

A

test for tuberculosis
-given annually with any risk factors:
-low socioeconomic status, residence in area where TB is prevalent, exposure to TB, or immigrant status

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14
Q

scoliosis test

A

Adam forward bend test or scoliometer

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15
Q

hematocrit done annually

A

assess for anemia before child becomes symptomatic

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16
Q

hand dominence begins?

A

appears by age 5

17
Q

screen time limited to what?

A

less than 2 hours a day

18
Q

dental health for school age

A

-floss
-encouraged to brush teeth after meals and before bed
-dental cleaning every 6months
-sealant should be placed on the Childs premolars and molars as soon as the come in

19
Q

Injury Preventions

A

communicate risks
-tobacco
-drugs
-alcohol abuse
-use of safety devices, helmets and seatbelts

20
Q

Sleep for School age

A

8-10 hours per night
-night terrors resolve by age 12

21
Q

Obesity of School age

A

determines by BMI
-overweight if BMI is above 85th percentile
-Obese if BMI is above 95th percentile

obesity is a combination of genetic, physiologic, and environmental factors

-obesity can sometimes be caused by genetic disorders such as Prader-Willi syndrome and Trisomy 21

-medications like antipsychotics produce obesity

NP should take patients Hx, eating patterns, activity Hx, Medications Hx, Psychological Hx

-review for comorbidities like DM type 2, sleep apnea, PCOS, Vitamin D deficiency

-safest way to lose wt is healthy eating and active lifestyle, no diets!

22
Q

Child Abuse

A

acts of omission or commission, including emotional, physical, and sexual acts, that pose a clear risk to the development and health of the child.

-many abusers are parents
-child abusers have traits “a breakdown of impulse control”
-abusers are usually former victims themselves

23
Q

most common type of child abuse

A

neglect

24
Q

injuries that indicate abuse

A

soft tissue markings with any outline of any object, weapon, cigarette burn, or hand
-delay in seeking care is suspicious of abuse and may result in bruises and fractures in various stages of healing

-Differential:
-homeopathic or cultural practices
cupping/ coining
-NP consider coagulation disorder

25
Q

Lab test for abuse

A

coagulation profile
CBC, platelet, PT, PTT, serum calcium, alkaline phosphates, and phosphorous levels may be measured if bone disease is suspected

-Skeletal Survey: picks up old fractures
-NP r/o other conditions like Osteogenesis Imperfecta (brittle bone disease)

26
Q

Suspected child abuse

A

NPs are required to report suspected child abuse

27
Q

ADHD

A

chronic neurodevelopcenttal disorder
-usually onset before age 7
-more common in boys

-Overactive and unable to focus or control their behavior
-inattention, distractibility, impulsive, and hyperactivity

28
Q

Risk Factors for ADHD

A

-prenatal exposure of tobacco, alcohol, or cocaine
-perinatal factors include prematurity, prolonged labor, perinatal asphyxia, and signs of fetal distress
-post natal factors: cerebral palsy, epilepsy, CNS trauma or infection

-possible LEAD

-Psychosocial: child abuse, disorganized or chaotic environments, family Hx of alcoholism, hysterical or sociopathic behaviors, developmental learning disorders, Hx family ADHD

29
Q

ADHD has 2 categories

A

-inattention
-hyperactivity and impulsivity

diagnosis: at least 6 symptoms form either category or combination of both and be present at least 6months and in at least 2 different settings

6+6=12
before age 7 dx
and as late as age 12

30
Q

ADHD standardized test

A

-Conners Parent and Teacher Rating Scale
-Achenbach Child Behavior Checklist
-Vanderbilt Assessment Tool

31
Q

ADHD management

A

medication and behavioral therapy
stimulants most common
-increase avail or neurotransmitters to strengthen focus and attention

Stimulants:
-methylphenidate and amphetamines

-methylphenidate:
Ritalin, Metadate, Focalin
-amphetamines:
lisdexanfetamine (Vyvanse), dextroamphetamine (Dexedrine), Adderall

-Prescribe low and go slow
-0.3mg/kg-0.7mg/kg
starting in morning 5-10mg
-increase 2.5-5mg per week

-change in behavior identifies w/in 30-90min of ingestion

-short-acting for children younger than 6 years of age

-long acting last 10-12hours used with children who require duration of action longer than 4 hours.

-avoid evening dose to minimize insomnia

32
Q

Contraindications for ADHD medication

A

-heart disease
-HTN
-Glaucoma

Psychiatric:
-marked anxiety and increased risk for suicide

33
Q

Drug holidays

A

implemented around school breaks or summer vacations

34
Q

ADHD nonpharm measures

A

behavioral treatment
parent education
support

35
Q

ADHD medication side effects

A

-stomach aches
-headaches
-anorexia
-weight loss
-tachycardia
-tics (usually remain despite long term use)
-sleep disturbances

36
Q

ADHD legal

A

-need to sign control substance abuse form
-Perform drug testing to make sure they are taking med and not selling

DRT PEDS (11 decks)

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