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PNCB CPNP-PC > School-age Health > Flashcards

School-age Health Flashcards

1
Q 
School-age Health
Focii
Physical: -1-
Cognitive: -2-
Psychosocial: -3- stage; desire to -4-
A
  1. Latency period
  2. Concrete
  3. Industry
  4. please adult figures
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2
Q

School-age Health
Subjective:
-1- (-2-, enuresis/-3-)
Risk factors/behaviors (-4-, especially caffeine for older children)

A
  1. Elimination
  2. constipation
  3. Bed-wetting
  4. alcohol, tobacco, other drugs
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3
Q 
School-age Health
Subjective Screening:
-1-
-2-
-3-
-4-
A
  1. Lead, inf. disease
  2. sleep
  3. safety
  4. dental health
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4
Q 
School-age Health
PE
-1- (from 2 yo up)
-2-
-3- (precocious puberty)
Depression screening (-4-); annual screening begins at age -5-
A
  1. BMI
  2. Scoliosis
  3. Tanner staging
  4. PHQ-9
  5. 12
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5
Q

School-age Health
TB testing risk factors from patient history:
> Residence in areas where TB is prevalent: -1-, -2-
> -3-, w/ special attention to -4-

A
  1. nursing home
  2. prison
  3. immigration status
  4. refugees
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6
Q

School-age Health
Labs
Hct -1- according to -2-
Cholesterol for -3- between -4-; screening earlier, but no later than 10 years of age if FMH of dyslpidemia or premature cardiac disease (cardiac event <55 yo)

A
  1. annually
  2. risk factors
  3. all children
  4. 9-11 years of age
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7
Q

School-age Health
Mgmt plan
Immunizations (-1- for school entry, -2-)
-3- with medication
Health promo strategies w/ AG, mainly -4-
-5- and cleanings every 6 months

A
  1. 2nd vaccine against MMR
  2. varicella, Tdap
  3. Illness mgmt
  4. self-care
  5. dental assessment
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8
Q

School-age Health
Interview
Fears: -1-, -2-, and -3-
-4- and -5- when appropriate

A
  1. pain
  2. loss of control
  3. death
  4. Encourage child to be involved
  5. answer questions
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9
Q

School-age Health
Rapid growth levels off (latent period)
Avg -1- male is -2- in weight and -3- tall.

A
  1. 10 yo
  2. 78 lb (~35kg)
  3. 54.75 in (~140 cm)
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10
Q

School-age Health
Rapid growth levels off (latent period)
Avg -1- female is -2- in weight and -3- tall.
Avg growth (both sexes): wt: -4-; ht: -5-

A
  1. 10 yo
  2. 80 lb (~36 kg)
  3. 54.5 in (~140 cm)
  4. 4-7 lb/year (2-3 kg/yr)
  5. 2.5 in/yr (6-7 cm/yr)
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11
Q

School-age Health
Rapid growth levels off (latent period)
>Girls reach -1- at -2- (prior to -3-)

A
  1. Peak height velocity (PHV)
  2. age 11-12
  3. menarche
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12
Q 
School-age Health
Rapid growth levels off (latent period)
Ht, wt, BMI
>BMI b/t the -1- is defined as -2-
> A BMI -3- indicates -4-
A
  1. 85th and 95th %iles
  2. overweight
  3. > 95th %ile
  4. obesity
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13
Q 
School-age Health
VS each visit
Pulse: -1-
Respiration: -2- per minute
BP: -3-: 95/60 to 110/73
-4-: 100/65 to 119/76
A
  1. 60-95 bpm
  2. 14-22 breaths
  3. 6-9 yo
  4. 10-11 yo
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14
Q 
School-age Health
PE proceeds from -1-
Visual -2-
-3-
-4- in girls
A
  1. head to foot (ask about preference)
  2. acuity approaches 20/20
  3. permanent teeth erupt
  4. breast development begins
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15
Q 
School-age Health
Dev Monitoring
Motor Skills
>are -1-, around -2-
> -3-
A
  1. well developed
  2. 6 or 7 yo
  3. hand dominance emerges
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16
Q 
School-age Health
Cog Dev
Piaget's -1-
Cognitive -2- at this age are -3-
Acquiring -4- and sense of -5-
A
  1. concerete operational thinking stage
  2. tasks
  3. varied
  4. new knowledge
  5. industry
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17
Q 
School-age Health
Cog Dev
Language becomes -1-
>Can grasp the -2-
>Can use concepts of -3-
>Masters -4-
Understands concept of -5-
A
  1. fluid & descriptive
  2. concept of conservation
  3. time & money
  4. cause & effect
  5. space (Minecraft)
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18
Q

School-age Health
Psychosocial Dev
Dev of -1-
> Believes they’re -2-

A
  1. self-esteem

2. worthy of love

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19
Q 
School-age Health
Socialization
> Plays with others, -1-
> Intereseted in -2-, -3-
> Capable of behaving in a -4-
> Toward late school age, -5-
A
  1. organized sports
  2. peer groups
  3. clubs
  4. peer environment
  5. peers become extremely important
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20
Q

School-age Health
Responsibility
> Can -1- and -2-

A
  1. fulfill household

2. school responsibilities

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21
Q

School-age Health
AG - Discipline
Teach difference b/t -1-
-2- must -3- (-4-, both)

A
  1. right & wrong
  2. adults
  3. role model
  4. parents & providers
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22
Q 
School-age Health
AG
Reinforce -1-
Respect the need for -2-
Expect lying: confront the child in a positive way, as -3- often -4-
Encourage -5-, and -6-
A
  1. honesty
  2. privacy
  3. need to please
  4. leads to deception
  5. competence, independence
  6. self-responsibility
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23
Q 
School-age Health
AG - Nutrition
Instutution of the current USDA food guidelines: -1-
-2- food.
May appear to have -3- stabilizes
A
  1. My Plate
  2. Minimize “junk”
  3. increased weight as linear growth
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24
Q

School-age Health
AG - Dental Health
-1- with fluoridated toothpaste for 2 minutes
Dental cleaning -2-

A
  1. Brush teeth twice daily

2. every 6 mo.

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25
School-age Health AG - Injury Prevention > Communication about -1-, -2-, and -3- abuse > -4- (e.g. -5-)
1. cigarettes 2. drugs 3. alcohol 4. Safety 5. Biking (helmets in general), community oriented
26
``` School-age Health AG - Gun Safety Store the guns unloaded with bullets in a -1- Keep guns and bullets -2- -3- Parents should make sure guns are -4- ```
1. separate place (inaccessible to children if possible) 2. locked up 3. Hide the keys 4. properly stored at houses the child is visiting
27
``` School-age Health AG - Sex Increased -1- of sex Prepare girls for -2-, males for -3-/-4- Give -5- about sexual intercourse; reinforcement over time is vital ```
1. curiosity 2. menstruation 3. hormonal 4. body changes 5. accurate information
28
School-age Health AG - Sleep Sleep -1- hours per night -2-
1. 8-10 | 2. Nightmares decrease (terrors should be gone by 12)
29
School-age Health AG - Screen Time 1. Develop a Family -1- (-2-)
1. Media Use Plan | 2. Family Screen Basket at Dinner, for instance
30
``` School-age Health AG - Dev Warning Signs Younger Poor -1- Not -2- Lack -3- or presence -4- ```
1. adjustment to school 2. performing to ability 3. of social interaction 4. of peer problems
31
``` School-age Health AG - Dev Warning Signs Older Revert to dependent, shy, -1- -2- responsibilities -3- in any -4- -5- to express self ```
1. passive roles 2. Using illness to avoid 3. Disinterest 4. Extra-academic activity 5. Destructive behavior
32
``` School-age Issues & Disorders Obesity Causes/Incidence Usually a combo of -1-, -2-, & -3- Diet high in -4- Relative -5- ```
1. physiologic 2. genetic 3. environmental causes 4. fats & simple carbs 5. inactivity
33
School-age Issues & Disorders Obesity Causes/Incidence Use of -1- or as a control mechanism physical or -2- of decreased energy expenditure -3- have higher rates of overweight and obesity than -4-
1. food for emotional comfort 2. genetic disorders 3. AFAM, hispanic, & native children 4. non-hispanic whites
34
``` School-age Issues & Disorders Obesity DDx -1- -2- such as -3- -4- (-5-) ```
1. Endocrine disease 2. Genetic conditions 3. Prader-Willi syndrome 4. Medication-induced obesity 5. antipsychotics
35
School-age Issues & Disorders Obesity Dx Studies As indicated to rule out...
...physical causes
36
School-age Issues & Disorders Obesity Mgmt Goal for the younger child is to -1-; -2- will compensate > -3- > -4- -5- referral if -6- seem(s) a likely cause
1. stabilize weight 2. linear growth 3. Nutritional planning 4. increase activity 5. Counseling 6. psychosocial issues
37
School-age Issues & Disorders Child Abuse/Neglect Definition: a collective term used to descrbie acts of -1-, including -2-, that -3-; all states have requried reporting standards for mandated professionals (incl. DNPs)
1. commission and/or omission 2. physical, sexual, and emotional acts 3. endanger the health and development of the child
38
``` School-age Issues & Disorders Child Abuse/Neglect Causes/Incidence -1- is the -2- of child abuse -3- of -4- ```
1. Neglect 2. most common form 3. 80% 4. abusers are parents
39
``` School-age Issues & Disorders Child Abuse/Neglect S/S -1- is vague and -2- -3- can lead to fractures and bruises in various stages of healing -4- ```
1. PMH 2. not compatible with the injury 3. delay in seeking care 4. dev delays
40
``` School-age Issues & Disorders Child Abuse/Neglect DDx -1- underlying disease (e.g. -2-, -3-) -4- such as -5- ```
1. accidents 2. coagulopathies 3. osteogenesis imperfecta 4. homeopathic or cultural practices 5. cupping, coining
41
``` School-age Issues & Disorders Child Abuse/Neglect Dx -1- -2- ```
1. Thorough PE | 2. Home Ax
42
``` School-age Issues & Disorders Child Abuse/Neglect Labs Blood -1- in children with -2- or -3- -4- levels may be useful if bone disease is suspected ```
1. coagulation studies (e.g. platelet count, bleeding times, PT, PTT) 2. bruises 3. PMH of "easy bruising" 3. CA, P, & AlkPhos
43
School-age Issues & Disorders Child Abuse/Neglect X-ray -1-: for any child with soft tissue findings who is nonverbal or unable to give a clear history an dmore than 4-5 years of age or for infants ussupected fo FTT -2-: on a -3- basis, depending on clinical findings -4- is useful if -5- is suspected
1. Skeletal survey (in the ER, to assess for old fractures) 2. CT/Bone Scan/MRI 3. case-by-case 4. Ultrasound 5. Visceral injury
44
``` School-age Issues & Disorders Child Abuse/Neglect Mgmt -1- & -2- -3- mothers/-4- and -5- ```
1. Education 2. Prevention 3. ID high-risk 4. parents 5. refer
45
School-age Issues & Disorders Child Abuse/Neglect Mgmt -1- according to state statute; need -2-, not -3- > In situations with doubt as to the -4-, -5- should be offered prior to a CPS report
1. Mandatory reporting 2. cause for concern 3. proof 4. parental health/wellness literacy (i.e., smoking around an asthmatic child, but otherwise good care is being taken) 5. education and support
46
School-age Issues & Disorders ADHD Definition: a disorder in which -1- have trouble paying -2-, controlling -3- behaviors, or who are -4-
1. children 2. attention 3. impulsive 4. overly active
47
School-age Issues & Disorders ADHD Epidemiology -1- are affected at a rate -2- than -3-
1. Boys 2. 3-5 times higher 3. girls
48
School-age Issues & Disorders ADHD Biological influences -1-: frequency among -2- has been noted Prenatal factors include -3- during pregnancy Perinatal factors include -4-, prolonged -5- Postnatal factors include -6- trauma/infections
1. Genetics 2. family members 3. maternal smoking 4. prematurity, fetal distress 5. labor, & perinatal asphyxia 6. CP, epilepsy, & CNS
49
School-age Issues & Disorders ADHD Environmental influences -1- which can also lead to -2-
1. environmental lead | 2. dev delay
50
``` School-age Issues & Disorders ADHD Psychosocial Influences -1- Child -2- Family history of -3- -4- ```
1. Disorganized or chaotic environments 2. abuse or neglect 3. alcohol use disorder 4. developmental learning disorders
51
``` School-age Issues & Disorders ADHD S/S Findings -1- to a(n) -2- In addition, there must also be at least -3- or -4- ```
1. cannot be attributable 2. underlying psychiatric disease 3. 6 findings of inattention 4. 6 findings of hyperactivity/impulsivity
52
``` School-age Issues & Disorders ADHD S/S/Dx Findings usually -1- years, but can be -2- Findings must persist -3- ```
1. present before age 7 2. as late as age 12 3. 6 months or more
53
School-age Issues & Disorders ADHD S/S/Dx Findings -1- in at least -2-: -3-, -4-, -5-
1. interfere with functioning 2. two of the following settings 3. home 4. school 5. play
54
``` School-age Issues & Disorders ADHD CMs Inattention: Fails to -1-; is -2- Impulsivity: -3- others Hyperactivity: -4-, difficulty -5- ```
1. pay attention to detail 2. easily distracted 3. interrupts or intrudes on 4. fidgetiness 5. remaining seated (why are you up?)
55
``` School-age Issues & Disorders ADHD Subtypes Predominantly -1- Predominantly -2- -3- (-4- with -5- of ADHD) ```
1. inattentive type 2. hyperactive-impulsive type 3. Combined type 4. most children are diagnosed 5. this type
56
``` School-age Issues & Disorders ADHD Comorbidity > -1- (at least -2-) > Psych disorders -> Anxiety (-3-) -> Depression (-4-) -> ODD or Conduct Disorder (-5-) ```
1. Learning disabilities 2. 50% 3. 25% 4. 30% 5. 60%
57
``` School-age Issues & Disorders ADHD DDx -1- such as -2- -3- disorder Situational -4- ```
1. Sensory disorders 2. Avoidant Personality Disorder (AvPD) 3. psychiatric 4. anxiety
58
``` School-age Issues & Disorders ADHD Dx Studies -1- history Standardized tests/questionnaires > -2- Scales > -3- Child Behavior Checklist > -4- Tool -5- settings ```
1. Perinatal 2. Connor's Rating 3. Achenbach 4. Vanderbilt Assessment 5. Direct observation in multiple
59
``` School-age Issues & Disorders ADHD Mgmt -1- mgmt (required) > -2- environment > Consider -3- ```
1. Multi-modal 2. Structured 3. mental health referral
60
``` School-age Issues & Disorders ADHD Mgmt - Pharm CNS -1-: highly effective (70-90%) > -2- (e.g., -3-, -4-, Metadate, -5-) ```
1. Stimulants 2. Methylphenidates 3. Ritalin 4. Concerta 5. Focalin
61
``` School-age Issues & Disorders ADHD Mgmt - Pharm CNS -1- > -2- (e.g., -3-, -3- XR, Dexedrine, -4-) ```
1. Stimulants 2. Amphetamines 3. Adderall 4. Vyvanse
62
ADHD - Mgmt - Pharm | Stimulants MOA: -1- of -2- to increase -3- and -4-
1. increase availability 2. neurotransmitters 3. focus 4. attention
63
``` School-age Issues & Disorders ADHD Mgmt - Pharm Rx Principles -1- and go -2-, titrate -3- intervals, and -4- from -5- to assess effectiveness ```
1. Start low 2. slow 3. up at weekly 4. get feedback 5. parents and teachers
64
School-age Issues & Disorders ADHD Mgmt - Pharm Rx Principles > Behavior changes may be identified w/in -1- of ingestion > -2- generally last -3- (no chewing) and often need -4- preparations generally last -5-
1. 30-90 minutes 2. Short-acting preparations 3. 4 hours 4. redosing; long-acting 5. 8-12 hours
65
``` School-age Issues & Disorders ADHD Mgmt - Pharm Rx Principles If a child does not respond to higher doses of one stimulant, or if side-effects are unacceptable, -1- before considering other medications or -2-. Even if -3- are discovered, such as -4-. ```
1. switch *stimulants* 2. types of therapy 3. comorbidities 4. depression
66
``` School-age Issues & Disorders ADHD Mgmt - Pharm Cautions with CNS stimulants > Moderate -1- > Marked -2- > Hx of -3- > -4- risk ```
1. HTN 2. anxiety 3. drug abuse 4. MDD/suicide
67
``` School-age Issues & Disorders ADHD Mgmt - Pharm Side effects of CNS Stimulants > -1- > -2- > Temporarily -3- and development > -4- (methylphenidate and mixed amphetamine salts) > -5- ```
1. Insomnia 2. Weight loss 3. decreased growth rate 4. Tics 5. Head-/stomach aches
68
School-age Issues & Disorders ADHD Mgmt - Pharm -1- tend to -2- (except -3- from -4-, which indicates a need for -5-)
1. Side effects 2. level out 3. tics 4. Adderall 5. change in prescription
69
School-age Issues & Disorders ADHD Mgmt - non-pharm May benefit from cognitive, social skills, or -1- -2- may be considered on an individual basis, in order to: > -3- the -4- for medication > -5- to medication
1. parenting therapy 2. Drug holidays (structured treatment interruption) 3. Demonstrate 4. clinical need 5. Temporarily remove side effects (sleep delay, appetite suppression, perceived/real tolerance to Tx)
70
Abusers are -1- with psychiatric, cognitive, and emotional impairment. While it is true that -2- have -3- of incidence of abuse, this is not the case for -4-. -5-, however, are the other demographic with a high incidence of child abuse.
1. often former victims 2. African Americans 3. 2x national average 4. Asian Americans 5. Native Americans
71
-6- is the most common form of child abuse, and about -7- are parents.
6. Neglect | 7. 80% of abusers

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