Special populations - Ch 27-28 kids and elderly Flashcards
what is the Denver Developmental Screening Test II (DDST-II)
considered the standard criterion for the developmental evaluation of children aged 1 month to 6 years.
It evaluates four developmental areas of interest: personal/social, language, fine motor/adaptive, and gross motor.
How much exercise is recommended for young people
at least 3 days/week for at least 20 minutes
what are the Tanner stages
defines 5 different levels of sexual maturity, based on the development of primary (genitalia) and secondary sex (pubic hair and breasts) characteristics.
at what age do you begin routine BP measurements w/ a cuff and sphygomomanometer?
3 years old
for children, choose a BP cuff that covers ____ of the child’s upper arm
80%
Why do we measure the head circumference in children?
• Measuring head circumference, especially during the first 3 years, may identify neurological abnormalities as well as malnutrition. It can lead to early diagnosis of preventable conditions.
Lymph nodes are frequently palpable in children but they should be
small, cylindrical, movable, and nontender
The lymphatic system grows exponentially between _____ and ____ years and reaches adult size around _____years
6 and 12, 12 years of age
esotropia
cross-eyed
exotropia
eye misalignment, eyes turn outward
normal vision finding for a toddler
Normal visual acuity in preschoolers is 20/40, improving to 20/30 or better by 4 years old. By 5–6 years old, normal visual acuity should approximate that of adults (20/20 in both eyes).
In children, ear deformities are often connected to _____ deformities.
Why?
kidney problems.
Why? Bc organogenesis for both ears and kidneys occurs about the same time in utero
Ear exams in children
In the child younger than 1 year, pull the pinna down and toward the face to straighten out the ear canal and promote visualization of the tympanic membrane.
If 1–2 years of age, pull straight back on the pinna to straighten the ear canal for visualization of the tympanic membrane.
If 2–3 years of age, pull up and back on the top of the pinna to visualize the tympanic membrane
eustachian tube in a child is
more horizontal than adults, making them more prone to otitis media (inflammation of the ear).
This is why you should never put your child to sleep with a bottle!
what is the most common infectious disease in childhood?
dental caries
Lower airway diameters in children are
approximately half that of adults, which contributes to increased wheezing and pneumonia
Coarctation (congenital narrowing of a short section of the aorta) can present with
unequal pulses between the upper and lower extremities
innocent murmurs are associated with
normal 1st and 2nd heart sounds (S1 & S2)
They occur in systole, are brief and well localized, and are usually heard near the left sternal border.
Early onset of puberty at what age in children is worrisome
onset of puberty before 8 yrs in girls and 9 yrs in boys may need further investigation
Wilms tumor
malignant kidney tumor common in children, occur in toddlers and early school-age children
Hypospadias
congenital condition in males where urethra is located on the underside of the penis
when are head and chest circumferences measured in children?
from birth to 3 years of age
older adults heal more slowly because of
slower growth of new cells
geriatric syndromes include
nutritional changes, mobility impairment, falls, polypharmacy, and skin breakdown
how is the skin of an older adult different?
it has increased wrinkling and is thinner, less elastic, and drier
Senile ptosis
the long-term effects of gravity and aging cause stretching of a wide, tendon-like tissue that helps the levator muscle lift the eyelid. Although both eyes usually are affected, drooping may be worse in one eye
UNEXPECTED findings in the mouth of an older adult include
pallor, malodorous breath, poor dentition, and candidiasis
respiratory changes in an older adult
The older adult has a less elastic chest wall, decreased respiratory muscle strength, loss of alveolar recoil, and increased residual volume
Circulatory changes in an older adult
Arterial walls are less elastic and stiffer, causing increased systolic blood pressure, increased ventricular wall hypertrophy, decreased coronary blood flow, reduced cardiac output, and increased circulating catecholamines
Gastrointestinal changes (in older adults) include
slowed peristalsis, reduced hepatic flow, and decreased metabolism of drugs on the first pass.
Large nodules (hard, nontender bony swellings) in the distal interphalangeal joints
Heberden nodes (found in the older adult, commonly found in assoc with arthritis)
Hard, nontender enlargements of the proximal interphalangeal joints
Bouchard nodes (found in the older adult, commonly found in assoc with arthritis)
Kidney changes that happen with age
• Kidney function decreases with age, causing a decreased glomerular filtration rate, decreased creatinine clearance, and inability to conserve sodium
What is the best time to assess the respiratory rate of a young child?
While the child is quietly sitting on the parent’s lap
During assessment of a child’s visual acuity, which finding may indicate myopia (nearsightedness)?
Holding a book close to the face
What is an easy way to determine whether a child has strabismus
Shine the light in his or her eyes
symptoms of lead poisoning in a child may include
irritability, headaches, abdominal pain
When should you start to measure a child’s height with them standing?
starting between 2 and 3 years of age
Growth charts for children 0 to 3 years are recumbent heights.
when should you stop charting the child’s head circumference?
at 36 months
At about what age should you begin to question the child, rather than the parent, regarding presenting symptoms
The nurse should begin to ask the child direct questions early to encourage self-care and to assist in establishing RAPPORT beginning at age 5.
Changes in the inner ear of an older adult can have what impact?
it can interfere with sound discrimination (making it hard to hear voices when around a lot of background noise)
What is a “geriatric syndrome”
the interaction of multiple diagnoses that contribute to problems in the older adult
