Special populations - Ch 27-28 kids and elderly

Question 1

what is the Denver Developmental Screening Test II (DDST-II)

Answer 1

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.

Question 2

How much exercise is recommended for young people

Answer 2

at least 3 days/week for at least 20 minutes

Question 3

what are the Tanner stages

Answer 3

defines 5 different levels of sexual maturity, based on the development of primary (genitalia) and secondary sex (pubic hair and breasts) characteristics.

Question 4

at what age do you begin routine BP measurements w/ a cuff and sphygomomanometer?

Answer 4

3 years old

Question 5

for children, choose a BP cuff that covers ____ of the child’s upper arm

Answer 5

80%

Question 6

Why do we measure the head circumference in children?

Answer 6

• 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.

Question 7

Lymph nodes are frequently palpable in children but they should be

Answer 7

small, cylindrical, movable, and nontender

Question 8

The lymphatic system grows exponentially between _____ and ____ years and reaches adult size around _____years

Answer 8

6 and 12, 12 years of age

Question 9

esotropia

Answer 9

cross-eyed

Question 10

exotropia

Answer 10

eye misalignment, eyes turn outward

Question 11

normal vision finding for a toddler

Answer 11

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).

Question 12

In children, ear deformities are often connected to _____ deformities.
Why?

Answer 12

kidney problems.

Why? Bc organogenesis for both ears and kidneys occurs about the same time in utero

Question 13

Ear exams in children

Answer 13

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

Question 14

eustachian tube in a child is

Answer 14

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!

Question 15

what is the most common infectious disease in childhood?

Answer 15

dental caries

Question 16

Lower airway diameters in children are

Answer 16

approximately half that of adults, which contributes to increased wheezing and pneumonia

Question 17

Coarctation (congenital narrowing of a short section of the aorta) can present with

Answer 17

unequal pulses between the upper and lower extremities

Question 18

innocent murmurs are associated with

Answer 18

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.

Question 19

Early onset of puberty at what age in children is worrisome

Answer 19

onset of puberty before 8 yrs in girls and 9 yrs in boys may need further investigation

Question 20

Wilms tumor

Answer 20

malignant kidney tumor common in children, occur in toddlers and early school-age children

Question 21

Hypospadias

Answer 21

congenital condition in males where urethra is located on the underside of the penis

Question 22

when are head and chest circumferences measured in children?

Answer 22

from birth to 3 years of age

Question 23

older adults heal more slowly because of

Answer 23

slower growth of new cells

Question 24

geriatric syndromes include

Answer 24

nutritional changes, mobility impairment, falls, polypharmacy, and skin breakdown

Question 25

how is the skin of an older adult different?

Answer 25

it has increased wrinkling and is thinner, less elastic, and drier

Question 26

Senile ptosis

Answer 26

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

Question 27

UNEXPECTED findings in the mouth of an older adult include

Answer 27

pallor, malodorous breath, poor dentition, and candidiasis

Question 28

respiratory changes in an older adult

Answer 28

The older adult has a less elastic chest wall, decreased respiratory muscle strength, loss of alveolar recoil, and increased residual volume

Question 29

Circulatory changes in an older adult

Answer 29

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

Question 30

Gastrointestinal changes (in older adults) include

Answer 30

slowed peristalsis, reduced hepatic flow, and decreased metabolism of drugs on the first pass.

Question 31

Large nodules (hard, nontender bony swellings) in the distal interphalangeal joints

Answer 31

Heberden nodes (found in the older adult, commonly found in assoc with arthritis)

Question 32

Hard, nontender enlargements of the proximal interphalangeal joints

Answer 32

Bouchard nodes (found in the older adult, commonly found in assoc with arthritis)

Question 33

Kidney changes that happen with age

Answer 33

• Kidney function decreases with age, causing a decreased glomerular filtration rate, decreased creatinine clearance, and inability to conserve sodium

Question 34

What is the best time to assess the respiratory rate of a young child?

Answer 34

While the child is quietly sitting on the parent’s lap

Question 35

During assessment of a child’s visual acuity, which finding may indicate myopia (nearsightedness)?

Answer 35

Holding a book close to the face

Question 36

What is an easy way to determine whether a child has strabismus

Answer 36

Shine the light in his or her eyes

Question 37

symptoms of lead poisoning in a child may include

Answer 37

irritability, headaches, abdominal pain

Question 38

When should you start to measure a child’s height with them standing?

Answer 38

starting between 2 and 3 years of age

Growth charts for children 0 to 3 years are recumbent heights.

Question 39

when should you stop charting the child’s head circumference?

Answer 39

at 36 months

Question 40

At about what age should you begin to question the child, rather than the parent, regarding presenting symptoms

Answer 40

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.

Question 41

Changes in the inner ear of an older adult can have what impact?

Answer 41

it can interfere with sound discrimination (making it hard to hear voices when around a lot of background noise)

Question 42

What is a “geriatric syndrome”

Answer 42

the interaction of multiple diagnoses that contribute to problems in the older adult