Week 7 Flashcards
Growth
increase in physical size
development
Sequential process by which infants and children gain various skills and functions
Maturation
Increase in functionality of various body systems or developmental skills
Assessing growth and development of a premature infant
Use infant’s adjusted age to determine expected outcomes
Subtract number of weeks infant was premature from infant’s chronologic age
Plot growth parameters and assess developmental milestones based on adjusted age
ways to assess achievement of milestones
Ask parent if skill is present and, if so, when attained
Infant may demonstrate skill during interview
Screening Tools for developmental delay
rourke baby record
denver II developmental
ages and stages questionnaire
Looksee (Nipissing region)
growth of toddler
Height and weight increase in spurts
Height increases 10-12 cm (4-5 in) per year
Generally reaching half of adult height by age 2
Weight increases 1.36-2.27 kg (3-5 lb) per year
Fontanels close by 18 months
Head size more proportional to body by age 3
growth of preschooler
Average growth of 6.5 to 7.8 cm (2.5 to 3 in) per year
Average weight gain of 2.3 kg (4 to 5 lb) per year
Loss of baby fat and growth of muscle
Length of skull increases slightly; lower jaw more pronounced; upper jaw widens
growth of school aged child
Grow an average of 5 to 7 cm (2.5 in) per year
Total increase in height of 30 to 60 cm (1 to 2 ft)
Increase in weight of 3 to 3.5 kg (4 to 6 lb) per year
Secondary sexual characteristics begin to appear
growth of adolescents
Rapid growth with dramatic changes in body size and proportions, second only to growth in infancy
Sexual characteristics and reproductive maturity occur
onset of puberty (ages)
Girls: 9 to 10 years old
Boys: 10 to 11 years old
what is puberty
Triggered by secretion of hormones
Girls: estrogen
Boys: testosterone
phys development, hormonal changes, sexual maturation
peak height velocity
Girls: 12 years of age
Boys: 14 years of age
infant neurological system
Newborn states of consciousness
Newborn primitive reflexes
toddler neurological system
Brain and spinal cord reach full size by age 2
preschoolder neurological system
Spinal cord myelination: bowel, bladder control
school aged child neuro system
Brain and skull grow very slowly
Shape of head is longer
Growth of facial bones changes facial proportions
Adolescents neuro system
Growth of myelin sheath enables faster neural processing
infant resp system
Narrower nasal passages
More compliant trachea and chest wall
Shorter and narrower bronchi and bronchioles
More funnel-shaped larynx
Larger tongue
Significantly fewer alveoli
toddler resp system
Alveoli increase in number until age 7
Trachea and airways continue to grow but are still small compared with those of an adult
preschooler resp system
Respiratory structures continue to grow in size; number of alveoli increase
Eustachian tubes remain short and straight
school aged child resp system
Continues to mature with development of lungs and alveoli
Respiratory rates decrease
Respirations diaphragmatic in nature
adolescent resp system
Increase in diameter and length of the lungs; respiratory volume and vital capacity increase
infant cardio system
Heart: doubles in size
Average pulse rate: decreases from range of 120 to 140 in newborn to about 100 in 12-month-old
Blood pressure: steadily increases from 60/40 in newborn to 100/50 in 12-month-old
Peripheral capillaries: closer to skin surface in newborn and young infant, increasing heat loss
Thermoregulation: becomes more effective
toddler cardio system
Heart rate decreases
Blood pressure increases
preschoolder cardio system
Heart rate decreases; blood pressure increases slightly; innocent heart murmur may be heard
school aged child cardio system
Blood pressure increases
Pulse rate decreases
adolescents cardio system
Size and strength of heart increases
Systolic blood pressure increases
Heart rate decreases
infant GI system
Eruption of teeth
Increase in capacity of stomach and intestines
Increased production of digestive enzymes
Liver begins to conjugate bilirubin and secrete bile
Consistency and frequency of stools change
Toddler GI system
Stomach increases in size
Small intestine grows in length
Stool passage decreases in frequency to 1-2 a day
Preschoolder GI system
20 deciduous teeth should be present
Small intestine grows in length
school aged child GI system
Deciduous teeth replaced by permanent teeth
Fewer GI upsets
Stomach capacity increases
Caloric needs are lower
adolescents GI system
Full set of permanent teeth
Liver, spleen, kidneys, and digestive tract enlarge
Infant Genitourinary System
Greater % of body weight in extracellular fluid (35%)
Greater susceptibility to dehydration
Greater frequency of urination
Relatively lower specific gravity of urine
Immature renal structures
Reduced glomerular filtration rate, tubular secretion and reabsorption and renal perfusion
Toddler Genitourinary system
Kidneys reach adult function by 24 months of age
Bladder capacity increases , allowing longer retention
preschooler genitourinary system
Urethra remains short, susceptible to UTIs
school aged child genitourinary system
Bladder capacity increases
Prepubescent occurs
toddler musculo system
Bones increase in length; pot-bellied appearance due to weak abdominal muscles until 3 years old
preschooler musculo system
Bones lengthen, muscles strengthen and mature
school aged child musculo system
Greater Coordination and strength
Muscles still immature and can easily be injured
Bones continue to ossify
Mineralization not complete until maturity
adolescents nusculo system
Ossification occurs earlier in girls, in late adolescents in boys
Shoulder, chest, and hip breadth increase in middle adolescence
infants integumentary system
Vernix caseosa (white, greasy substance)
Covers fetus in utero, preterm newborn
Found in folds of skin, axilla, groin of term newborn
Lanugo (fine, downy hair)
Covers body of many neonates; lost over time
Milia (tiny white bumps on nose, cheeks, or chin)
Baby acne (bright red raised bumps on face, torso)
Acrocyanosis (blueness of hands and feet)
Mottling (pink-and-white marbled appearance)
adolescents integumentary system
Skin becomes thick and tough;
Sebaceous glands are more active;
Sweat glands function at adult level
infant immune system
Immunoglobulin G (IgG)
Delivered through placenta to fetus from mother
Confers immunity during first 3 to 6 months of life for antigens mother was previously exposed to
Then, synthesized by infant, reaching 40% of adult levels by age 12 months
IgM
Produced abundantly after birth, reaching adult levels by 9 months of age
IgA, IgD, and IgE
Gradual increase in production until early childhood
School aged child immune system
Matures to adult level around 10 years old; fewer infections experienced
infant gross motor skills
Phenomenal increases in first 12 months of life
Movements using large muscles (head control, rolling, sitting walking)
Develop in a cephalocaudal (head-to-tail) fashion
infant fine motor skills
Movements using small muscles of hands and fingers (grasping, self-feeding, self-dressing)
Develop in a proximodistal (centre-to-periphery) fashion
toddler gross motor skills
Running, climbing, jumping, pushing or pulling a toy, throwing a ball, pedaling a tricycle
toddler fine motor skills
Reaching, grasping, releasing, stacking, turning pages, removing socks and shoes, building block towers, holding utensils and crayons
school aged children gross motor skills
Coordination, balance, and rhythm improve
Bicycling, jumping rope, dancing, skating, swimming
school aged children fine motor skills
Refined due to myelination of central nervous system
Hand-eye coordination and balance improve
Writing, printing words, sewing, building models
adolescents gross motor skills
Endurance increases
Middle adolescence: increased speed, accuracy, coordination
adolescents fine motor skills
Greatly increased due to use of computers
Early adolescence: increased ability to manipulate objects; improved finger dexterity, handwriting
Middle adolescence: refining of dexterity skills
Late adolescence: precise hand-eye coordination
Sensory Development Warning Signs
Young infant does not: Respond or startle to loud noises
Follow a moving object by 2 to 3 months
Focus on a near object
Start to make sounds or babble by 4 months
Turn to locate sound at age 4 months
Infant has persistent crossing or wandering of eyes at any age
toddler sensory development
Use of all senses to explore the world
Vision progresses
Depth perception matures
Hearing at adult level
Sense of smell matures
Taste discrimination not completely developed
school aged children sensory development
All senses are mature
Typical child has 20/20 vision acuity
Vision problems frequently identified in school-age children
Amblyopia (lazy eye: reduced vision in an eye not adequately used during early development)
Language Development Warning Signs
Infant does not: Make sounds at 4 months of age
Laugh or squeal by 6 months of age
Babble by 8 months of age
Point to desired objects at 12 months of age
Use two to three single words with meaning at 12 months of age (mama, dada)
toddler language development
Receptive language development
The ability to understand what is being said or asked
Typically far more advanced than expressive language development
Echolalia: repetition of words and phrases without understanding
Telegraphic speech: speech that contains only the essential words to get the point across
preschooler language development
Not capable of abstract thought (e.g., death)
Acquisition of language allows expression of thoughts and creativity
Transition from telegraphic speech at age 3 years to sentences adult-like in structure at age 5 years
Increased fluency
school aged children language development
Vocabulary expands
Culturally specific words are used
Reading efficiency improves language skills
More complex grammatical forms are used
Development of metalinguistic awareness occurs
Metaphors are beginning to be understood
adolescents language development
Improved communication skills, using correct grammar and parts of speech
Increased vocabulary
Use of slang, making communication with people other than peers more challenging
By late adolescence, language skills comparable to those of adults
infant social and emotional development
Stranger anxiety
Indicates infant recognizes self as separate from others
Separation anxiety
Infant becomes distressed when parent leaves
Temperament
Ranges from: Less or moderately active, regular, and predictable
To highly active, more intense, and less adaptable
Cultural differences
toddler social and emotional development
Separation
Seeing oneself as separate from the parent
Individuation
Forming a sense of self and independence
Exerting control over one’s environment
Leads to emotional lability (temper tantrums)
Egocentrism
Focus on self
typical behaviours of the toddler
May rely on a security item
Becomes aware of gender differences
May display aggressive behaviours
Becomes more self-aware, but does not have clear body boundaries
May express separation anxiety again
Expresses temperament (easygoing, difficult, slow-to-warm-up)
May show fear of loss of parents and of strangers
social and emotional development of preschooler
Cooperation
Sharing (of things and feelings)
Kindness
Generosity
Affection display
Conversation
Expression of feelings
social and emotional development of school aged child
temperament
self esteem
body image
peer relationships
family and cultural influences
habits, beliefs, values
social and emotional development of adolescents
Relationship with parents and siblings
Changes and conflict, requiring adjustments and understanding of adolescent development
Pursuit of self-identity and independence
More time spent with peers
Self-esteem linked to body size and shape, sexual characteristics, meeting societal standards
Peers’ essential role in forming identity of adolescent
infant nutrition
Infant Nutritional Requirements
Essential for growth and development
Breastfeeding and bottle - feeding of infant formula both acceptable
Cultural factors
Needs related to the tremendous growth
breastfeeding
Breast milk composition
Maternal-infant bonding
Breast milk supply and demand
Breastfeeding techniques
Assess new mothers for pain on breastfeeding
Exceptions to recommended breastfeeding
bottle feeding
Feeding patterns
Types of formulas and bottles
Special formulas
Proper preparation
Proper storage of formula
Care of bottles
Importance of fortification with iron
nutritional plan for first year of life
Progressing to solid foods (typically after 6 months)
Assessing infant readiness
Disappearance of tongue extrusion reflex
Ability to swallow
Production of sufficient amounts of enzymes
Choosing appropriate solid foods
Iron-fortified rice cereal mixed with breast milk or formula
Introduction of one new food every 3 to 5 days
Promoting healthy eating habit
toddler nutrition
Forming healthy eating habits early in life
Diet high in nutrient-rich foods
Weaning
Timing depends on cultural and ethnic beliefs, mother’s work schedule, desired child spacing
Inform mother of benefits of extended breastfeeding
Weaning of bottle-feeding by 12 to 15 months
Teaching about nutritional needs
Advancing to solid foods
promoting self feeding in toddlers
Use a child -sized spoon and fork with dull tines
Seat the toddler in a high chair or at a comfortable height in a secure chair
Never leave the toddler unattended while eating
Minimize distractions during mealtime
Promoting healthy eating habits
Preventing overweight and obesity
nutrition for school aged children
Calorie needs vary based on age, gender, and activity level
Boys and girls 4 to 8 years old, moderately active 1,200 to 1,400 calories/day
Boys 9 to 13 years old, moderately active 1,800 calories/day
Girls 9 to 13 years old, moderately active 1,600 calories/day
Promoting healthy eating habits and preventing overweight and obesity
nutrition for adolescents
Nutritional assessments to help guide food choices at home and in restaurants
Evaluation of foods from different food groups eaten each day
Number of times fast foods, snacks, other junk food eaten per week
Calorie intake
sleep and rest
Hours of sleep needed per night: 6 to 8 years old: 12 hours 8 to 10 years old: 10 hours 10 to 12 years old: 9 to 10 hours
Should have bedtime expectations and wake-up times
Night terrors and sleepwalking may occur but should resolve by age 8 to 10 years
