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PNP: Physical Assessment > Session 2: Development > Flashcards

Session 2: Development Flashcards

1
Q

Freud Developmental Phase: Oral (3)

A

Brith-18 months

  1. Mouth is primary body zone
  2. Major conflict of weaning
  3. Interpersonal focus on self with little differentiation from others
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2
Q

Freud Developmental Phase: Anal (4)

A

18 months-3 years

  1. Anus is primary body zone
  2. Major conflict: toileting
  3. Major activities: toilet training
  4. Interpersonal focus is rebellion vs. compliance with parent wishes
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3
Q

Freud Developmental Phase: Phalic (4)

A

3-6 years

  1. Genital area is primary body zone
  2. Genital exploration and fantasy are major activities
  3. Major conflict: oedipal complex
  4. Attraction to opposite sex parent with identification with same sex parents as major interpersonal focus
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4
Q

Freud Developmental Phase: Latency (4)

A

6-11 years

  1. No primary body zone
  2. Social relationships are very important
  3. No major conflict
  4. Identification with same sex peers and powerful heroes
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5
Q

Freud Developmental Phase: Genital (4)

A

Puberty- Adult

  1. Primary body zone: genital
  2. Sexual maturity and expression are major activities
  3. Separation from family is the major conflict
  4. Successful extrafamilial relationships
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6
Q

Erikson’s Stages: Infancy (3)

A

Trust vs. Mistrust (Birth-18 months)

  1. Develops when needs are met by a consistent person
  2. Mistrust develops when needs are not consistently met
  3. Sense of hope and optimism is outcome
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7
Q

Erikson’s Stages: Toddler (3)

A

Autonomy vs. Shame and Doubt (18 months-3 years)

  1. Child gains control over environment
  2. Shame and doubt appear when child is forced to be dependent when the child can actually master control
  3. Sense of self control and will-power
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8
Q

Erikson’s Stages: 3-5 years old (4)

A

Initiative vs. Guilt (3-5 years)

  1. Uses senses and power to control the body and want
  2. Conscience is acquired as child starts to listen to an inner voice
  3. Guilt arises when child does something in conflict with goals of other
  4. Positive outcome is direction and purpose
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9
Q

Erikson’s Stages: School age (4)

A

Industry vs. Inferiority (6-10 years old)

  1. Child starts to complete activities
  2. Becomes a rule learner and works cooperatively and competitively with others
  3. Inferiority comes when more is expected than the child can achieve
  4. Sense of competence is the positive outcome
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10
Q

Erikson’s Stages: Adolescence (3)

A

Identity vs. Role Confusion

  1. Preoccupied with physical appearance
  2. Unable to solve conflicts between concept of self and society
  3. Positive outcome is a sense of fidelity to values and other people
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11
Q

Stella Chess’ Temperament (4)

A
  1. Easy (40%): regular routines, cheerful
  2. Difficult (10%): Irregular, slow to accept change, negative responder, unsatisfied
    * Set schedules to help establish regular routine
  3. Slow to warm (15%): Inactive, mild low key, slow adjustment
  4. Mixed (35%)
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12
Q

Noam (3)

A
  1. Feels early adolescence is more concerned about group cohesion and less concerned about identity
  2. Younger adolescents are more susceptible to peer pressure (ex: 7th and 8th grade)
  3. Development is not linear
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13
Q

Easy Temperament (8)

A
  1. Regularity
  2. Positive approach
  3. High adaptability
  4. Mildly to moderately intense mood
  5. Parent needs to spend separate time with child since he may be forgotten because he’s easier
  6. May do what other’s want even though it’s not in best interest
  7. Child is trusting
  8. Teach child how to develop own rules
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14
Q

Difficult Temperament (8)

A
  1. Irregularity of biological functioning
  2. Negative withdrawal in response to new stimuli, non adaptability
  3. Slow adaptability
  4. Intense mood

Parent needs to be:

  1. Firm and CONSISTENT
  2. Gradual repeated reinforcement of positive and negative for expected
  3. Give minimum number of rules for any one time
  4. Provide venue to extra emotions and energy
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15
Q

Slow-to-warm Temperament (6)

A
  1. Negative mood of mild intensity
  2. Slow adaptability to new situations

Parent needs to be:

  1. Maintain calm as anger accelerates for child’s reaction
  2. Do not compete with this child
  3. Repetition is needed
  4. Maintain consistent rules
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16
Q

Goodness of fit

A

Central is understanding how child’s temperament affects the family
*Impact of temperament on child’s adaptive functioning

Good fit: child’s temperament fits with parental goals, standards and values that affects the nature of the parent’s responses to the child

Poor fit: difference between parental expectation and the child’s temperament

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17
Q

Piaget’s Sensorimotor Stage

A

Birth-2 years

*No thinking structures

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18
Q

Piaget’s PreOperational Stage

A

2-7 years old

Develop language skills, cognitive structures - prelogical

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19
Q

Piaget’s Concrete Operational Stage (4)

A

7 years old - Adolescence

  1. Begins to question life
  2. Solves problems but haphazardly
  3. Mass, number, linear time
  4. Deductive reasoning
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20
Q

Piaget’s Formal Operational Stage

A

Adolescence and onward

  1. Capable of sophisticated logical thought
  2. Can think both abstract and hypothetically
  3. Solves problems using the logic of combinations
21
Q

Medical/Biological Neonatal Risk Category for Developmental Delay (7)

A
  1. Birth weight less than 1501 grams
  2. Gestational age less than 35 weeks
  3. Central nervous system insult or abnormality (including neonatal seizures intracranial hemorrhage, need for
    ventilator support for more than 48 hours, birth trauma)
  4. Congenital malformations
  5. Asphyxia (Apgar score of three or less at five minutes)
  6. Abnormalities in muscle tone, such as hyper- or hypotonicity
  7. Hyperbilirubinemia (> 20 mg/dl)
22
Q

MEDICAL/BIOLOGICAL NEONATAL RISK CRITERIA FOR DEVELOPMENTAL DELAY 2 (5)

A
  1. Hypoglycemia (serum glucose under 20
    mg/dl)
  2. Growth deficiency/nutritional problems (e.g., small for gestational age; significant feeding problem)
  3. Presence of Inborn Metabolic Disorder (IMD)
  4. Perinatally- or Congenitally transmitted infection (e.g., HIV, hepatitis B, syphilis)
  5. 10 or more days hospitalization in a Neonatal Intensive Care Unit (NICU)
23
Q

MEDICAL/BIOLOGICAL NEONATAL RISK CRITERIA FOR DEVELOPMENTAL DELAY 3 (6)

A
  1. Maternal prenatal alcohol abuse
  2. Maternal prenatal abuse of illicit substances
  3. Prenatal exposure to therapeutic drugs with known potential development implications (e.g., psychotropic medications, anticonvulsant, antineoplastic)
  4. Maternal PKU
  5. Suspected hearing impairment (e.g., familial history of hearing impairment or loss; suspicion based on gross screening measures)
  6. Suspected vision impairment (suspicion based on gross screening measures)
24
Q

MEDICAL/BIOLOGICAL NEONATAL RISK CRITERIA FOR DEVELOPMENTAL DELAY 4 (6)

A
  1. Parental or caregiver concern about developmental status
  2. Suspect score on standardized developmental or sensory screening test
  3. Serious illness or traumatic injury with implications
    for central nervous system development and requiring hospitalization in a pediatric intensive care unit for ten or more days
  4. Elevated venous blood lead levels (above 19 mcg/dl)
  5. Growth deficiency/nutritional problems (e.g., significant organic or inorganic failure-to-thrive, significant iron-deficiency anemia)
  6. Chronicity of serous otitis media (continuous for a minimum of three months)
25
Q

Kohlberg: birth-18 months

A

Amoral

Moral reasoning cannot begin until the child reaches a certain level of cognitive development

26
Q

Kohlberg: 18 months-9 years

A

Preconventional: Obedience and Punishment Orient

  1. Behavioral decision made on fear of punishment
  2. Good and bad defined in terms of physical consequences
27
Q

Kohlberg: Preconventional Instrumental Relativist Orientation

A

3-6 years old

Behavioral decisions made based on concern of self and egocentric satisfaction, although may occasionally do something to please another if there are advantages for self

28
Q

Kohlberg: Conventional Interpersonal Concordance Orient

A

6-11 years old

Behavioral decisions based on desire to gain approval from others, judgments made based on intentions

29
Q

Kohlberg: Conventional Law and Order Orientation

A

6-11 years old

Behavioral decisions based on laws and respect for authority, laws take precedence over personal wishes

30
Q

Kohlberg: Postconventional Social Contract Legalist

A

11-18 years

Morality based on personal values, people must work to change laws that are not moral or just

31
Q

Kohlberg: Postconventional Universal Ethical Principle

A

11-18 years

Morality based on internalized ideals and conscience rather than social rules

32
Q

Key Principles about Development (10)

A
  1. Growth and development are orderly and sequential
  2. Each child sets their own pace
  3. Growth is cephalocaudal first then proximodistal
  4. Behaviors become increasingly integrated
  5. Environmental, social, genetics, nutrition play a role
  6. Responses to stimuli go from generalized reflexes involving the entire body to discrete voluntary actions
  7. Language delays are the most common
  8. Growth milestones are predictable
  9. Receptive and expressive language are different
  10. Skills are built on each other and are rarely skipped
33
Q

Developmental Surveillance (7)

A
  1. Monitoring a child’s development over time; an ongoing process of accessing a child’s developmental status at each well child visit
    (Does the child look developmentally on target? Use visual assessments, etc.; not a screening tool)
  2. Take a thorough history
  3. Review developmental milestones
  4. Make skilled observations of child during each visit
  5. Elicit parental concerns
  6. Observe child’s rate of development, temperament style, emotional adjustment
  7. Access a child’s current developmental function compared with a standardized sample of children of same age
34
Q

Developmental Screening Tools (3)

A
  1. Minnesota Child Development Inventories
  2. Ages and Stages Questionnaire (formerly infant monitoring system)
  3. Parent’s Evaluations of Developmental Status (PEDS)
35
Q

Moro Reflex

A

Eliciting the reflex involves sudden drop of the head when the infant is supine. The full response involves extension of the arms, “fanning” of the fingers, and then upper extremity flexion followed by a cry

Emergence: 37 weeks gestation (present at birth)

Age of disappearance: 4 months

36
Q

Tonic Neck Reflex

A

If the head is directed to one side, either by passive turning or inducing the baby to follow an object to that side, tone in the extensor muscles increases on that side in the flexor muscles on the opposite side

Emergence: 35 weeks gestation, peaks at 4-6 weeks of life

Disappears: 4-6 months

37
Q

Palmar Grasp

A

Age of emergence: 28 weeks gestation

Disappearance: 3-6 months

38
Q

Placing, Stepping Reflex

A

Age of emergence: 37 weeks gestation

Disappearance: 6-8 weeks

39
Q

Ankle clonus, up to 5-10 beats reflex

A

When you flex the ankle upwards, there are little reflexive beats; up to 5-10 beats is normal in first month of life but abnormal afterwards (would be a sign of hypertonicity)

Age of emergence: 33-35 weeks gestation

Age of disappearance: 1 month

40
Q

Pupillary Response

A

Age of emergence: 32 weeks gestation

Never disappears!

41
Q

Babinski reflex

A

Run the thumb down the medial surface of the tibia and the big toe fans and extends

Age of disappearance: positive until starting to walk

42
Q

Physical length growth in first year of life?

A

9-11 inches

43
Q

Head circumference growth (3)

A
  1. Birth-3 months: 2cm/month
  2. 4-6 months: 1cm/month
  3. 6-12 months: 0.5cm/month
44
Q

When does posterior fontanel close?

A

2 months

45
Q

When does anterior fontanel close?

A

18 months-2 years

46
Q

Weight growth

A
  1. Birth-6 months: one ounce per day
  2. 6 months-12 months: 1/2 ounce per day
  3. Birth weight is quadrupled by end of the 2nd year
  4. From 2-9 years old: gain 5 lbs per year
    * Toddlers lose appetite because they don’t have to gain weight
47
Q

Length growth

A
  1. 5 inches in 2nd year
  2. 3-4 inches in 3rd year
  3. 2-3 inches per year post this
48
Q

How many teeth by 2.5 years old?

A

20 teeth

PNP: Physical Assessment (21 decks)

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