School-Age Health Flashcards
What is the definition of school age?
6 through 12 years
What is the average height and weight of a 10 year old?
rapid physical growth/development tends to level off
avg height for 10 yr old is 52-56 inches and avg weight is 70 lbs
How much height and weight do school age children gain per year?
5-7 lbs per year
2-3 inches per year
When do girls reach peak height velocity?
11 to 12 years old prior to menarche
When does scoliosis screening begin?
age 9
BMI between 85th-95th percentile?
BMI above 95th percentile?
at risk for becoming overweight
>95% indicates obesity
What are developmental warning signs in younger school-age children?
poor adjustment to school
not working to ability
frequent illnesses and need to stay home from school
lack of social interaction and peer problems
bullying??
Developmental warning signs in older-school age children?
personality change revert to dependent, shy, passive roles using illness to avoid responsibilities cannot make or keep friends poor school performance disinterest in academic activity destructive behavior to express self gang activity?
What is the most common type of child abuse?
neglect
Who is most commonly the abusers in child abuse?
80% are parents
When should a skeletal survey be ordered for children with suspected abuse?
for any child with soft tissue findings who are nonverbal or unable to give a clear history or for infants suspected of failure to thrive
What are the 3 subtypes of ADHD?
predominantly inattentive type predominantly hyperactive-impulsive type combined type (most diagnosed with this)
What criteria must be present to make the diagnosis of ADHD?
symptoms must be present before age 7
symptoms must persist for 6 months
symptoms must be more frequent and more severe than those observed in other children at the same developmental level
symptoms must interfere with functioning in at least 2 settings: home, school, and play
What population does ADHD most commonly affect?
boy at a rate of 6 times higher than girls
What are the predisposing factors of ADHD?
biologic influences: genetics, prenatal smoking, perinatal (prematurity, fetal distress, long labor, perinatal asphyxia) and postnatal factors (cerebral palsy, epilepsy, CNS trauma)
environmental: lead, dietary
psychosocial: chaotic environments, child abuse, family history of substance abuse, developmental learning disorders
To diagnose ADHD there must be ___symptoms of ____OR _____ symptoms of ______.
6 symptoms of inattention
6 symptoms of hyperactivity/impulsivity
What medications are used to treat ADHD?
CNS stimulants:
Methylphenidates- ritalin, concerta, focalin
Amphetamines- adderall, vyvanse
How do stimulants help with ADHD?
stimulants increase availability of neurotransmitters to increase focus and attention
What is the main prescribing principle of ADHD medications?
start low and go slow–titrate up at weekly intervals based on feedback from parents and teachers
**if a child does not respond well to higher doses of 1 stimulants, or if side effects are unacceptable, switch to another stimulant before considering other medications
What is the starting doses typically of ADHD medications?
usual dose is 0.3 to 0.7 mg/kg starting with 5 to 10 mg in the morning
If not effective, increase dose increments of 2.5 to 5 mg per week until effect level is reached
How soon do the ADHD medications show changes and how long do both short/long acting preparations last?
Behavior changes can be identified within 30-90 minutes of injection
Short acting prep- last 4 hours and often need reducing
Long acting prep- last 10-12 hours
*avoid evening dosage changes to prevent insomnia
What are contraindications of ADHD medications?
symptomatic cardiovascular disease hypertension anxiety glaucoma history of drug abuse depression suicide risk
What are the side effects of ADHD medications?
insomnia anorexia weight loss tachycardia temporary decrease in rate of growth and development tics headaches stomachaches tolerance to medication
