Week 2: Principles of Growth and Development Flashcards
normal growth parameters for the infant at 3 months
lift head (no head lags), clasp hands, coo
What are normal growth parameters for early childhood (1-4 yrs old) development
15 mo: walk
2 yrs: run
4 yrs: tricycle and jump
sensorimotor learning (touching/looking)
impulsive, poor self regulation
preoperational: no sustained logical thought process
What are normal growth parameters for the middle child (5-10 yrs)?
Concrete operational: capable of limited logic and more complex learning
Limited logic, complex learning
School, family, environment influence
Self efficacy
More independent
Guilt, self-esteem
Wrong vs right
What are normal growth parameters for the adolescent (11-20yrs)?
formal operational thinking: abstract thinking, manipulating ideas in head
Reason logically, abstractly
From family dominated influences to more autonomy and peer influence
Brain development til 20’s
Struggle for identity, independence, intimacy = stress, health related problems, high risk behaviors
In considering abnormal growth, which children should be prioritized for evaluation?
Variations b/t 2 standard deviations for age or Kids above 95% or below 5%
Drop in height % on growth curve
Drop > 2 quartiles in 6 months (goes from 25% - 50% - 75%), each 25%, so if drops more than that!
Weight for length < 5% (Use height if < 2 yo; if over 2 yrs, use BMI)
Head circumference above 95% or < 5%
What are the five domains of infant/child development?
Gross motor
Fine motor
cognitive development (problem solving)
Communication
Personal/social domains of development
For babies born prematurely, how do you adjust expected developmental milestones for the gestational age? And up to what age do we do this?
Correct prematurity til 24 months. if don’t adjust, we will have abnormal findings on developmental screening if expected milestones are not adjusted.
if premature 32 weeks, it’s 8 weeks/2 months early. If baby comes in at 12 month visit, we expect them to attain milestones appropriate for a 10 months old. (subtract how early he/she is by the month visit)
if premature 28 weeks, 28-40= 12 weeks/3 months. if comes in at 9 month check up, 9 - 3 months, expect the baby to be 6 months
What are the various cognitive stages that children progress through?
Sensorimotor stage 0-2
Child interacts with environment
touching/looking to symbolic thinking, solving simple problems, remembering songs , engaging in imitative plays
Preoperational stage 2-7
Represent events
Uses symbols, gestures
Concrete operational 5-10 yrs
Limited logic and more complex learning
Formal operational stage 11 yrs
Systematic and reasonable
Reason with tangible objects and events
Abstract thinking
What is the difference between active and passive immunity?
active immunity: protection that is made by person’s own immune system
Lasts yrs to lifetime
Vaccines, or being exposed to disease
passive immunity: protection by products produced by an animal or human and transferred to another human, usually by injection
Immunity wanes
Mother to infant
Blood products (IVIg, antitoxin)
What are the two types of vaccines and how do they work?
Live attenuated vaccines
Made by modified disease producing virus (“wild) or bacterium in lab
Can replicate/grow but DOESN’T cause illness
If does cause “disease”, its milder than natural disease and known as adverse reaction
Small % of ppl don’t respond to 1st dose (ie MMR or varicella) and need 2nd dose
MMR, vaccinia, varicella, zoster, yellow fever, rotavirus, influenza
NO immunocompromised pt’s (Uncontrolled replication (growth) of vaccine virus , Pregnant pts, < 1 years old)
Inactivated vaccines
Can’t replicate
Less effective than live
Need multiple doses
1st dose = “primes” immune system
Need booster
Antibody titers diminish with time
What special consideration should you make about the interval between most live virus vaccines?
Can give injection/intranasal live vaccines SAME visit or else have to wait at least 4 weeks in between each one
What are the various types of adverse vaccine reactions?
any medical event that occurs after vaccination
Local reaction (80% of vaccine doses; w/in few hrs; Mild, self limited; Pain, welling, redness at injection site)
Systemic (Generalized, Fever, malaise, h/a, LOA)
Allergic (d/t vaccine or component)
What are the only contraindications to receiving a vaccine?
Severe allergic reaction to a vaccine component or following a prior dose
Encephalopathy NOT due to another identifiable cause happening w/in 7 days of pertussis vaccination
Severe combined immunodeficiency (rota virus)
History of intussusception (rotavirus vaccine)
Pregnant (No live vaccines, MMRV, HPV vaccine)
Immunosuppressed
Moderate or severe illness
Delay BOTH live and dead vaccine til recovered
Contraindications in pregnancy
- no live vaccines
- inactivated vaccines administered if indicated
- HPV vaccine should be deferred during pregnancy
- MMRV
Diptheria
pathogen:
sx:
complications:
vaccine schedule:
Bacteria
Sx’s: Mucous membranes, Insidious onset pharyngitis, within 2-3 days, membrane forms = respiratory obstruction
Complications:
Myocarditis
Neuritis
Paralysis of soft palate
Eyes & limbs
Death (5-10%, 40% if <5 yo and >40)
Vaccine:
5 childhood doses, 1 adolescent dose then every 10 years
DTAP - children 6 wks - 6 yrs
2, 4, 6, 15-18 months, 4-6 years, 11-12 yrs (TDAP)
Every 10 yrs with TD or TDAP