School- Age Health Flashcards
This is a group between the age of 6 to 12 years of age?
School age
The physical focus of school age is ____ period
Latency
Cognitive focus of school age is ______
concrete
Psychosocial focus is ____ stage and desire to please adult figures
industry stage
Subjective data:
Elimination with well-child checks think what?
Elimination (constipation, enuresis)
Subjective data:
Developmental with well-child checks think what?
School, activities, exercise, friends, behavior, family relationships
Objective data from well-child includes:
a) Physical examination should include:
1) ______
2) Scoliois
3) Tanner staging (preconcious puberty)
BMI
Laboratory test for well-child check include:
a) ____ _____ ____ test for tuberculosis once before school entry at 4 to 6 years fo age; annually if any of the following risk factors are present:
a) Low socioeconomic status
b) Residence in areas where tuberculosis is prevalent
c) Exposure to tuberculosis
d) Immigrant status
Purified protein derivative (PPD)
Lab test: ________ at age 8 years; additional as needed
Hematocrit
________ if family history dylipidemia or premature cardiac disease (biological parents and / or granparents with caridac event
Cholesterol
The management plan of school-age kid:
a) Immunization [ ____ vaccine against measles, mumps and rubella (MMR) of r school evtry]
b) Illness management with mediation
c) Health promotion strategies with anticipatory guidance
d) Dental assessment and cleaning every 6 months
2nd
Maximize the Interview:
a) May use diagrams
b) Industry vs _______
c) The child wants to be brave
d) Older school-age children become more modest
e) Fears pain, loss of control, death
inferiority
Average 10 year old is ___ lbs
70 lbs
The average height of 10 years old is?
52 to 56 inches tall
Average growth weight is ____ pounds per year
5 to 7 pounds per year
Average height is ___ inches per year
2 to 3 inches per year
Girls reach peak height velocity (PHV) at age _____ (prior to menarche)
11 to 12 years
If the BMI is between 85th and 95th percentile the patient is at risk for becoming __________?
overweight
A BMI above ____ percentile indicated obesity?
95%
Physical examination for school-age include?
a) ____ ____ (pulse and respiration rate decrease; blood pressure increases)
Vital Sign
What is Visual acuity ____ in school-age?
20/20
Permanent teeth ____ in school-age students
erupt
________ screening begins age what?
9 years
School-age child:
a) _____ skills are well-developed
b) Muscle strength increases
c) Hand dominance emerges
Motor
What are the stages of Erikson’s industry vs inferiority:
a) Child is active
b) __________
c) curious
energetic
____ _____ concrete operational thinking stage
a) The cognitive task at this age are varied
b) Acquiring new knowledge and sense of industry
c) Language becomes fluid and descriptive
Jean Piaget’s
Language becomes _______ and ___________
a) Thought processes expand: Capable of reversibility
b) Can grasp the concept of conservation
c) Cand classify thing based upon one characteristic
d) Can use concepts of time and money
e) Master a cause and effect
f) Understands the concept of space
g) Capable of deductive reasoning
fluid and descriptive
Cognitive Development of School-age: Psychosocial development 1) Marked expansion to include the outside world 2) Can grasp the concept of conservation 3) Can classify things based upon one characteristic 4) Can use concepts of time and money 5) Masters \_\_\_ and \_\_\_\_\_\_\_ 6) Understands the concept of space 7) Capable of deductive reasoning
cause and effect
Psychological development of school-age:
1) Marked expansion to include the outside world
2) Development of ____ -____
3) Socialization
4) Responsibility
2) Self- esteem
Development of ____-______
a) Feels competent in abilities: Learning, decision-making, etc
Development of self- esteem
_________
a) Plays with other organized sports
b) Interested in peer groups, clubs
c) Capable of enhancing in a peer environment
d) Toward late school-age, peers become extremely important
Socialization
____________
a) Will be proactive to meet needs
b) Can fulfill household and school responsibilities
c) Will often seek moneymaking opportunities with limited responsibility (such as babysitting, dog-walking, etc.)
Responsibility
______ guidance is unique to the age group (School age)
Anticipatory
_______: School-age
a) consistency is critical
b) Adults must role model
c) Should emphasize natural and logical consequences
d) Should be assigned regular duties/chores
e) As a child develops language skills, encourage parents to listen to respond
Discipline
________ ________/ Guidance: School age
a) Discipline
b) reinforce honesty
c) Respect need for privacy
d) Be aware of television programming and internet activity (should be less than 2 hours/day)
e) Expect lying, Confront child in a positive way.
Developmental Discussion/Guidance
_____/______: Shcool age
a) Institution of the current food guidelines- my plate
b) Minimize “junk” good
c) May appear to have increased weight as liner growth stabilizers
Nutrition/ Feeding
_____ _______: School-age
a) Brushing after meals and before bed
b) A dental cleaning every six months
c) Placement of sealants
d) Learn how to floss
Dental Health
___ _____: Shcool age
a) Communication about cigarettes, drugs and alcohol abuse
Injury Prevention
__________: School-age
a) Increased curiosity for sex
b) Established communication about sexually transmitted infestations, human immunodeficiency virus/acquired immune deficiency syndrome
c) Prepare girl for menstruation, males for hormonal/body changes
d) Give accurate information about sexual intercourse, reinforcement over time is vital
Sexuality
________: School age
a) Sleep 8 to 10 hours per night
b) Nightmare decrease
Sleep
In _______ school-age children
a) poor adjustment to shool
b) not working to ability
c) frequent illness/ need to stay home from school
d) Lack of social interaction/ peer problems
younger
In _______ school-age children
a) Revert to the dependent, shy, passive role
b) Using illness to avoid responsibilities
c) cannot make or keep friends
d) poor school performance (feeling “left behind”)
e) disinterest in any extra academic activity
f) destructive behavior to express self
older
_______ a term generally used to describe a condition in which the body fat to lean mass ratio is too great as a result of high caloric intake and/or low energy use
Obesity
This form of _______ may be defined as mild, moderate or morbid
obesity
Cause of _________
a) is caused by a combination of physiologic, genetic, and environmental causes
b) diet high in fats and simple carbohydrates
c) relative inactivity
d) use of food for emotional comfort or as a control mechanism
e) Physical or genetic disorders of decreased energy expenditure
obesity
Differential Diagnosis for Obesity is?
a) Endocrine disease
b) Genetic conditions such as Prader- Willi syndrome
c) medication-induced obesity (antipsychotics)
Diagnostic Study Obesity:
a) As indicated to rule out physical causes
b) As indicated to assess for ______ sequelae
c) Determination of obesity:
1) BMI is greater than 95th percentile for age/gender
physiologic
_________ of obesity includes:
a) Prevention through anticipatory guidance
b) treat underlying physical cause if appropriate
c) The goal for the younger child is to stabilize weight; linear growth with compensating
1) Nutritional planning
2) increased activity
d) Counseling referral if psychosocial issues seem a likely cause
Management
____ ____ and ______
a) A collective term used to describe acts of commission and or omission, including physical, sexual, and emotional acts that endanger the health and development of the child
1) All states have required reporting standards for suspected abuse/neglect by mandated professionals
Child Abuse and Neglect
Cause of incidence and abuse
1) abusers are often former _____ with psychiatric, cognitive, and emotional impairment
2) Neglect is the most common form of child abuse
3) African American and Native American have twice the national average of reported incidence
4) Eighty percent of abusers are parents
victims
Signs and symptoms of abuse include:
a) History is vague and not compatible with the injury
b) delay in seeking care can lead to _____ and bruising in various stages of healing
c) Soft tissue marking with an outline of a hand, object, weapons, or cigarettes burn
d) Physical needs not met
e) Development delays
f) Child/ parent interaction si unusual
fractures
The differential diagnosis for abuse is?
a) accident
b) underlying disease (coagulopathies)
c) Homeopathic or cultural practices
Diagnostic Studies for abuse include:
a) _____ _______
b) As indicated to rule out the underlying cause of symptoms (coagulations and/or osteogenesis imperfecta)
c) Home assessment
d) Diagnostic assessments: Lab and radiographic
Physical examination
_____ _______
a) Blood coagulation studies (platelet count, bleeding time, prothrombin time, and partial thromboplastin time) in children with bruises or a history of “easy bruising”
b) Serum calcium, phosphorus, and alkaline phosphatease level may be useful if bone disease is suspected
Laboratory tests
_____ ________:
a) Local radiological evaluation in children with limited range of motion or bony tenderness on examination
b) Skeletal survey: For any children with soft tissue findings who are nonverbal or unable to give a clear history ( more than 4 to 5 years of age) or for infants suspected of failure to thrive
c) CT scans/bone scans/MRI: On a case by case basis, depending on clinical findings
d) Ultrasonography is useful if the visceral injury is suspected
Radiographic studies
Management of school-age health:
a) Education and prevention
b) Identify ____ risk mothers/parents and refer
c) Anticipatory guidance
d) Mandatory reporting according to state statute
high
_____ is the most commonly diagnosed behavioral problem in childhood and is now regarded as a chronic illness.
The essential impairment is a deficit behavioral inhibition which disrupts the developmental process of learning how to self -regulate behaviors. Instead, behaviors such as inattention, distractibility, impulsivity, and hyperactivity, which are appropriate behaviors in young children, persist into school- age and adolescence, making internal regulation of behaviors difficult at best
ADHD
According to the 4th edition of the diagnostic and statistical manual of mental disorders the are 3 diagnostic subtypes of ADHD:
a) Predominantly ______ type
b) Predominantly hyperactive-impulsive type
c) Combined type (most children are diagnosed with this time of ADHD
inattentive
Symptoms must be present before the age of ____ with ADHD?
7 years
Symptoms of ADHD must persist for at least ____ months?
6 months
Symptoms must b more frequent and more severe than those observed in other children at the ____ level of development (ADHD).
same
Symptoms interfere with functioning in at least ___ settings:
a) Home
b) School
c) Play
two
Boys are affected at a rate of ___ times greater than girls (ADHD).
6
Biological influence: ADHD
_____: Frequency among family members has been noted.
Genetics
Biological influence: ADHD
Prenatal factors include maternal ____ during pregnancy
smoking
Biological influence: ADHD
________ factors include prematurity, the sign of fetal distress, prolonged labor, and perinatal asphyxia
Perinatal
Biological influence: ADHD
________ factors include cerebral palsy, epilepsy, and central nervous system (CNS) trauma or infections
Postnatal
Environmental: ADHD
Environmental ______
lead
Environmental: ADHD
Dietary factors, including ____ ___, additives, and sugar
food dyes
Psychosocial influences: ADHD
_________ or chaotic environmental
Disorganized
Psychosocial influences: ADHD
______ abuse or neglect
Child
Psychosocial influences: ADHD
Family history of ________, hysterical, or sociopathic behavior
alcoholism
Psychosocial influences: ADHD
_________ learning disorders
Developmental
ADHD:
1) Symptoms cannot be attributable to underlying psychiatric disease.
2) In addition to these, there must be at least ___ symptoms of inattention or ____ symptoms of hyperactivity/impulsivity
6
ADHD is a combination of three components?
Inattention
impulsivity
Hyperactivity
____________:
a) Makes careless mistakes
b) Fails to pay attention to detail
c) Easily distracted
d) difficulty concentrating long enough to complete task
e) Difficulties following instructions
f) Difficulties organizing tasks and activities
Inattention
_________:
a) Difficulties awaiting one’s tun
b) frequently blurts out answers
c) Interrupts or intrudes on others
Impulsivity
______:
a) Fidgetiness
b) difficulty remaining seated
c) difficulty playing quietly
d) subjective feeling fo restlessness in adolescents
e) subjective feeling of restlessness in adulescents
f) Difficulties with social relationships
g) low frustration tolerance
hyperactivity
Learning disabilities with ADHD is seen as how often?
35%
Anxiety is seen as how often in ADHD?
25%
Depression is seen as how often with ADHD?
25%
Oppositional defiant disorder or conduct disorder is seen in ADHD what %?
50%
Differntial Diagnosis of ADHD is?
a) Sensory ________
b) Psychiatric disorder
c) Age appropriate activities
d) Situational anxiety
a) Sensory impairment
A variety of standardized test/questionnaires are used to assess symptoms of ADHD:
a) ________ Rating Scales
b) Achenbach Child Behavior Checklist
c) Vanderbilt assessment tool
Connor’s
Management of requires multi- modal management for ADHD?
a) __________ environment
b) Operant conditioning techniques
c) Consider mental health referral
d) Pharmacologic Management
Structured
CNS stimulants are highly effective ____ to ____ % effective
70 to 90%
Another name for ADHD methylphenidates?
a) Ritalin
b) Concerta
c) Metadate
d) Focalin
Another name for ADHD Amphetamines?
a) Adderall
b) Adderall XR
c) Dexedrine
d) Vyvanse
How do stimulants help with ADHD?
Stimulants increase the availability of neurotransmitter to increase focus and attention
Start ____ and go slow; titrate up at weekly intervals; get feedback from patients and teachers to assess the effectiveness
low
Dosing principles for ADHD:
Usual dose _____ to ____ mg/kg, starting with 5 to 10 mg in the morning.
If not effective, increase the dose in increments of 2.5 to 5.0 mg per week unit effect level is reached
0.3 to 0.7 mg/kg
With ADHD medication behavior changes can be identified within ____ to ____ minutes of ingestion
30 to 90 minutes
ADHD: Short-acting preparations generally last ___ hours (no chewing), and often need re-dosing; long-acting preparations generally last 10 to 12 hours
4
ADHD: Avoid evening dosage changes in minimizing _________
insomnia
ADHD: If a child does not respond to higher doses of ____ stimulant, or if side effects are unacceptable, switch to another stimulant before considering other medications.
1
ADHD cautions/contraindications:
a) Symptomatic ________ disease
b) Moderate hypertension
c) marked anxiety
d) glaucoma
e) History of drug abuse
f) depression
g) depression/ suicide risk
cardiovascular
Side effects of a stimulant with ADHD include:
a) ______
b) anorexia
c) weight loss
d) tachycardia
e) temporary decrease in rate of growth and development
f) tolerance to the medication
g) Tics
h) Headaches
i) Stomach aches
insomnia
Non- pharmacological management of ADHD:
a) May benefit from ______, social skills or parenting therapy
b) No drug Holidays= practice guideline
cognitive
