The Life Cycle Flashcards
premature birth
born in less than 37 weeks
very premature birth
born in less than 32 weeks
APGAR score
used to assess baby health. Appearance, pulse, grimace, activity, respiration. used to predict the likelihood of immediate survival
postpartum reactions
oxytocin-dopamine interactions associated with maternal-infant bond. major depression can occur in up to 10% of new mothers within one month of childbirth. postpartum psychosis in 0.1% of mothers.
spheres of development
motor, social, verbal/cognitive. occurs cephalad to caudad and central to peripheral.
25% rule
by 1 year old, a stranger should understand 25% of a baby’s speech. 2 years, 50%, 3 years, 75% etc
infancy to 18 months
humans need and seek the presence of others. attachment.
when does social smile occur?
12 weeks
when does stranger anxiety occur?
9 months
characteristic of infant
reflexes and instincts that are necessary for survival. rooting reflex: touch cheek turn toward nupple. palmar grasp reflex: grip any object put in palm. moro reflex: limbs extend when child is startled. Babinski reflex: dorsiflexion of toes when the sole of the foot is stroked (gone at 1 year)
toddler years: 18 months to 3 years
rapprochement: moves away but then quickly returns for comfort. parallel play: next to, not reciprocal. bowel and bladder function (4 and 5 years). gender identify by 3 years
bad triads!
OCD, ticks, ADHD. fire setting, soiling pants, cruelty to animals
preschool years (3-6)
sibling rivalry. regression seen if another child is brought into family. active fantasy life. cooperative play at 4 years. strong fear of bodily injury, curiosity about bodies
milestones at 6 years
development of child’s conscience. a sense of morality. empathy. learns that lying is wrong. understand the finality of death.
autism spectrum disorder
do not acquire verbal and social skills at the expected age. no reciprocity, restricted range of interests, clumsiness. seen before age 3. more common in boys, larger head circumference. genetic component. Tuberous sclerosis and fragile X syndrome
rett’s disorder
4 years of normal functioning, hand wringing, breathing problems, intellectual impairment, ataxia motor and social declines, X linked.
school age and adolescence
7-11 years. psychosexual issues are dormant. lifelong sense of competence. formal schooling starts, capacity for logical thought. concrete operations. learning problems identified here
play and peer relationships at 7-11
relationships with adults who arent primary care giver. peer relationships. sexuality, morality (rule conscious). illness: deal better with hospitalization. by age 9 understand universality of death. acting out: defense mechanism
early adolescence (11-14 years)
puberty is physical indicator of adolescence. usually more obedient, older teens are more likely to oppose adults
middle adolescence
by 15: body image and popularity. prefers to spend time with friends not family. risk taking behavior. educate about obvious short term benefits. less likely to comply with medical advice
late adolescence
identity crisis: define and refine place in the world. role confusion. some but not all develop abstraction.
emotional and social factors that predispose to teen pregnancy
depression, poor school achievement, divorced parents
problems affecting development in teen pregnancies
mental retardation, down’s syndrome, fragile X syndrome
intellectual impairment in teen pregnancies
metabolic factors (infection, maternal substance abuse) is associated with autism, seizures, hearing and visual problems. normal IQ of 70.
challenges of early and middle adulthood
transitional periods, reappraisal of desires, goals, and values. vulnerable to physical and emotional illness during periods of life change. regression (become more adolescent)
assisted reproduction and adoption
fertility decreases with age. in vitro fertilization helps. adoption usualy has positive outcome. some people adopted after infancy are at risk for behavioral problem. tell child about adoption at earliest possible age
early adulthood (20-40 years)
at age 30, ones role in society is defined, physical development at peak, individual is independent. Love and work/intimacy vs. isolation. women often change paths in middle 30s
middle adulthood (40-65 years)
unique social responsibilities. responsibilities to older and younger relatives. climacterium: the physiological changes that occur in men and women during midlife. women: menopause, men: decrease in muscle strength and sex
losses of aging
loss of social status, loss by death of spouses, family members, and friends. decline in overall health and strength. most adjust well. ego integrity vs. despair: did you waste your life or nah
cognitive function in the elderly
dementia in less than 10% of elderly. some memory and learning problems. over the age of 85: half have some degree of cognitive impairment. alzheimer’s is the most common form of dementia
physical and neurological changes of aging
neurological changes: decreased cerebral blood flow, decreased brain weight, amyloid plaques. intelligence remains the same. decreased neurotransmitter availability. more sensitive to side effects, increased depression
psychosocial changes of aging
reduced bladder control, loss of strength, vision and hearing loss, abuse of cognitive or physically impaired elderly by caretakers
stages of dying
denial, anger, bargaining, depression, acceptance. not necessarily in that order
bereavement versus complicated bereavement
both normal grief and complicated bereavement have initial shock and denial. denial in abnormal grief can last over days or weeks. both include sadness, crying. anniversary reactions are common. abnormal grief has intense symptoms, involve suicidal thinking and hallucinations.
role of physician in dying and death
make aware of diagnosis and prognosis. reassure that intense responses to news is expected. serve as resource to family. medically follow bereaved family members. resist emotional detachment
