Exam 1- Health Promotion in the Toddler, Preschooler, School Aged Child, and Adolescent Flashcards

Question

Acetaminophen Poisoning

Answer 1

Most common accidental drug poisoning in children Toxic dose is 150mg/kg or greater in children Multiple formulation and concentrations make chronic acetaminophen toxicity a significant problem

Answer 2

Treatment: Antidote N-acetylcysteine (Mucomyst) can usually be given orally Dilute with fruit juice or soda Give loading dose, then 17 maintenance doses

Answer 3

Blood test done if infant is at risk at any time Universal Lead Serum Test is done at 1 year and 2 years

Answer 4

Children who are iron deficient absorb lead more readily than those with sufficient iron stores Lead interferes with the binding of iron onto the heme molecule

Answer 5

Developmental delays Lowered IQ (intelligence quotient) Reading skill deficits Visual-spatial problems Visual-motor problems Learning disabilities

Answer 6

Major Fears Loss of Control Separation

Answer 7

Minimize separation from parents Explain and maintain consistent limits Simple brief explanations Ask about home routines & rituals

Answer 8

Teach parents to explain their plans to the child (“I will be back after your nap.”) Provide sensory play (water play, finger painting) Trips to the playroom – mobility is very important to their development Expect regression

Answer 9

Heart Rate: 90 – 140 Respiratory Rate: 24 – 40 Systolic BP: 80 – 112 Diastolic BP: 50 – 80

Answer 10

A Powerhouse of gross motor activity. Play and fantasy are important. Has a fear of abandonment.

Answer 11

Growth still about the same as in the toddler period. 5 lb/yr (2.25kg) Weight Average wt. of 3 yr. old is 32 lb. ( 14 – 15 kg) 2 -3 inches Ht per year Teeth – now at age 3 has all 20 primary teeth May have achieved night time bowel and bladder control

Answer 12

Runs well A 3 year old can ride a tricycle Hops on one foot at about 4 yr Walks up and down stairs well 

Answer 13

Uses scissors at 4 years Ties shoelaces at 5 years Washes hands Scribbles and draws. Important for learning to read.

Answer 14

Starting to develop an ability to separate from parents for a while Preschoolers much more sociable and willing to please than toddlers

Answer 15

Preschoolers: Premoral (or Preconventional) before the age of 4yr – based on punishment or reward Have a concrete sense of justice and fairness

Answer 16

Uses 3 and 4 word sentences. (the age + 1 = # of words in sentence) 3yr old + 1 = 4 word sentences Vocabulary increases from 300 words at 2 yr of age to 2100 word at 5 yr Bilingual children reach language milestones at the same time as monolinguals By 4 yr should be counting and naming colors

Answer 17

Most critical period for speech development occurs between 2 and 4 years Stammer as they try to say a word they are already thinking of – developmental stuttering

Answer 18

Simple sentences Careful with what words you use Use play in explaining Starting to speak in full sentences

Answer 19

Imaginary playmates Play very important Aggressiveness at 4 years is replaced by more independence at 5 years.

Answer 20

Sexual curiosity Masturbation is normal Interested in anatomical differences Find out what children know and think Be honest, use correct names for anatomical parts

Answer 21

Gender identification – identify with same sex parent while developing strong attachments to opposite sex parent Gender identification occurs around 3 yr.

Answer 22

Provides an emotional outlet Pre-op teaching Help reduce fear

Answer 23

3 year old – Rides tricycle– needs helmet 4 year old – climbs and jumps and skips 5 year old – skips on alternate feet; ties shoes; beginning of cooperative play Imitative of adult patterns and roles. Offer playground materials, housekeeping toys, coloring books,

Answer 24

``` Coloring books Puzzles Cutting and Pasting Dolls Building blocks Clay Pretend medical equipment ```

Answer 25

Hgb done between 3 & 5 yr Normal: Hgb 11.5 – 14.5 g/dL Lead screening if not done at 1 & 2 yr. or at risk Urinalysis – once between 15 mo. & 5 yr Bedwetting – if have been dry at night, then start wetting bed again, usually due to UTI

Answer 26

Sexual curiosity, anatomic explorations, masturbation common and normal Sleep – 10 – 12 hours in 24 hour period Sleep problems common because of active imagination

Answer 27

Nightmares- Scarey dream followed by full waking Occurs in REM sleep in second half of night Crying and aware of presence of another person Professional counseling for recurrent nightmares Night Terrors- Partial arousal from very deep sleep Non-REM sleep in first few hours of sleep Screaming, not aware of another person’s presence Night terrors normal, and no intervention needed

Answer 28

counciling

Answer 29

No counciling

Answer 30

Extensive television viewing is associated with sleep problems in preschoolers

Answer 31

Vision screening begins at 3 years “Tumbling E” or Lea symbol chart Amblyopia needs to be detected and treated before the age of 4yr.

Answer 32

Balancing the child’s need to develop independence and initiative with the need to set limits Ignore bad behavior & reward good behavior Time Out – 1 minute per year of age

Answer 33

Water – Highest risk for drowning is in preschool period Fire – stop,drop,roll Sports Safety– helmets Car Seat – Keep your child rear-facing as long as possible. Should be rear-facing till wt. and ht. limit of car seat is reached. Booster seat when outgrows are seat

Answer 34

Teaching children normal, healthy boundaries of their bodies Tell someone

Answer 35

Milk 2% is still 2 – 3 cups/day Juice (100%) still limit 4 – 6 oz /day Calcium needs for children 1 – 3 yr is 500mg/day and for children 4 – 8 yr is 800 mg/day

Answer 36

First dental exam at 3 yr. Brush teeth 2 x day See dentist every 6 months Fluoride supplementation

Answer 37

Major fears Bodily injury and being abandoned. Fear of anything that he views as a hostile invasion of his body.

Answer 38

Follow home routines Parents close and involved Tell child that he did not cause the illness Accept regression and explain to parents

Answer 39

Heart Rate: 80 – 110 Respiratory Rate: 22 – 34 Systolic BP: 82 – 110 Diastolic BP: 50 – 78

Answer 40

6 – 12 year

Answer 41

Slow steady growth - -Wt. gain: 5 ½ lb/yr - --Ht. : 2 in/yr Growth spurt at 10 – 12 hr for girls at the onset of puberty Two years later for boys around 12 – 14yr

Answer 42

Enlarged tonsils and adenoids are common during these years and are not always an indication of illness. IgA & IgG levels are at adult levels at 10 yr.

Answer 43

Constant activity – Gross motor Musical instruments & Eye-hand coordination – Fine motor development

Answer 44

Eyes fully developed by 7 yr. Growth spurt in eyes leads to myopia Yearly visual screenings – Using Snellen chart

Answer 45

Industry vs. Inferiority Mastering useful skills and doing them well are important Competence

Answer 46

Egocentric thinking is replaced by social awareness of others Socialization with peers becomes important Parents still have a strong influence  Relative period of calm

Answer 47

1. Reversibility 2. Conservation - Milk glasses or 1 lb of rocks/feathers 3. Classification & Logic 4. Humor

Answer 48

Follows family’s religious practices Religious concepts must be presented in concrete terms God is viewed in human terms

Answer 49

Conventional Stage of Moral Development --Younger school age children obey authority --And follow rules --Views are black and white

Answer 50

Resistant to baths and showers, brushing teeth, everything Then showers all the time Sleep – Reduces from 12 hr at 6yr to 9 or 10 hr for a 12 year old

Answer 51

Give child household responsibilities Emphasize child’s strengths Do not do their homework or science project for them Allow children to make mistakes Consistency

Answer 52

Need a health care visit about every 2 years Scoliosis screening Nutrition -- There is increase in appetite What did you eat for breakfast, for lunch

Answer 53

Vitamin A Vitamin C Vitamin B6 Vitamin B12

Answer 54

Genetic, cultural, environmental, socioeconomic Unstructured meal, fast-food Lack of exercise Food as reward

Answer 55

Games had a greater impact on aggressive cognitions among younger children.

Answer 56

Loss of primary teeth and eruption of permanent teeth – will replace about 4 teeth per year until 12 years Fluoride toothpaste, flossing Dental sealants Mouth protectors Dangers of smokeless tobacco

Answer 57

``` Car Seats Firm limits and rules Helmets, knee pads, etc. Water safety Self care children Gun safety ```

Answer 58

Keep child in a booster seat until big enough to fit seatbelt. Seat belt fits properly when the lap belt lies snugly across the upper thighs, not the stomach. The shoulder belt should lie snug across the shoulder and chest and not cross the neck or face.

Answer 59

Avoid having firearms in the house Lock ammunition and firearm in separate cabinets Talk about firearms – what to do if you find a gun at school or at a friend’s house

Answer 60

1. Accidents – Most accidents occur between 3p & 6pm 2. Malignant neoplasms 3. Congenital anomalies 4. Assault/homicide 5. Suicide/self-harm

Answer 61

FEARS Loss of control Body injury Failure to live up to expectations Death 1. Provide choices 2. Provide concrete explanations 3. Contact with peers 4. Emphasize normal things the child

Answer 62

``` Board games Card games Hobbies, collections Puzzles Video games ```

Answer 63

Audiovisual aids work well Drawing Drawing is a very valuable form of communication Conversation Ask about school and friends Expanding vocabulary Pages 125 & 126

Answer 64

Cooperative play and sports Repair, building, mechanical activities Table games

Answer 65

Developing a sense of identity. Developing independence from family. Establishing meaningful relationships with peers

Answer 66

Rapid – Peak height velocity (PHV) Girls – 12 yr Boys – 14 yr Growth in ht for girls ceases about 2 – 2 ½ yr after menarche Girls – growth and sexual maturation occur about 2 years earlier than boys ------Increase fat deposits Boys –Muscle mass

Answer 67

May occur with normal achievement of male puberty and resolves within 1 year Can be caused by anabolic steroid use or endocrine disorders Testosterone supplementation may aggravate gynecomastia

Answer 68

11 – 14 years Characterized primarily by the changes in puberty Preoccupied with rapid body changes Decline in self-esteem Imaginary audience, Personal fable

Answer 69

15 – 17 years Conformity 46.7% sexual intercourse experience Peer orientation of peak importance, and acceptance by peers is total focus Abstract thinking – Idealistic, political & social concerns

Answer 70

18 – 21 yr Idealistic Emancipation Transition into adulthood

Answer 71

Beliefs become more abstract Kohlberg stage 4 and 5 Question family’s values and religion

Answer 72

New findings show that the greatest changes to the parts of the brain that are responsible for functions such as self-control, judgment, emotions, and organization occur between puberty and adulthood. Overproduction, then pruning of neurons in response to puberty.

Answer 73

1. Accidents – 40% of all teen deaths is the U.S. are the result of motor vehicle accidents 2. Homicide 3. Suicide 4. Malignant neoplasms 5. Heart diseases

Answer 74

Discipline – focus on encouraging teen to make decisions and understand consequences Save battles for important things

Answer 75

Ensure confidentiality and privacy Interview alone. And first. May interview parents afterwards. Adolescents will share more information when it is gathered during a casual conversation. Explain limits of confidentiality (abuse,suicide) Open ended questions -- Direct questions may illicit little information

Answer 76

In education, give details, include audiovisual material Never talk down to Able to comprehend adult concepts. When teaching adolescents, the focus on the here and now – “How will this affect me today?”

Answer 77

preoccupation with death and focused on morbid thoughts wants to give away cherished possessions loss of interest/energy changes in sleep recurrent stomach aches/ headaches reckless behavior anti social sudden cheerfulness after depression

Answer 78

Weight and fat deposition that is normal in puberty may lead to body image problems and eating disorders. Nutritional requirements are at their peak during adolescence Health promotion especially in adolescent girls should provide teaching about normal body changes

Answer 79

Benefits: Low-fat, high fiber Reduce risk of obesity, Type 2 Diabetes, Cardiovascular disease Economical Disadvantages: Vegan – low Vit. D, Vit. B12, Calcium, and omega-3 fatty acids, iron, and zinc Vegetarian – Vit. B12

Answer 80

Obesity Anorexia nervosa Bulimia

Answer 81

Studies of 15 and 16 year olds showed cognitive impairments in teen alcohol abusers, compared with non-abusing peers, even weeks after they stop drinking. This suggests that abuse of alcohol by teens may have long-term negative effects

Answer 82

Early, long term use linked with drop in IQ Synthetic marijuana responsible for increased incidence of kidney failure in adolescents

Answer 83

In 2013, 22.9% of high school students reported current use of a tobacco product, including 12.6% who reported current use of two or more tobacco products. More students using smokeless tobacco or cigars

Answer 84

Peer-led programs Emphasize social consequences rather than long-term health problems Use of multimedia images School and community settings Begin in elementary school and continue through high school

Answer 85

Major fears: Loss of control Altered body image Separation from peer group

Answer 86

Hospitalization of adolescents disrupts school and peer activities; they need to maintain contact with both. Alteration in body image can be devastating Teaching about procedures should include time without the parents present. When parents are present, direct questions to the adolescent , not the parents

Answer 87

Realize risk taking, rebelliousness,etc. is normal in adolescence Encourage socialization with peers Encourage increased responsibility for care and management of the disease or condition Emphasize good appearance, stylish clothes Encourage activities appropriate for age (driver’s license, etc.)

Answer 88

Privacy Encourage to wear street clothes Use scientific and medical terminology to prepare for procedures Encourage questions about appearance and future with illness Encourage peers to call and visit often

Answer 89

Infants: After 6 months, their cognitive development allows them to remember pain. Toddlers: They fear intrusive procedures Preschoolers: they fear body mutilation School-age children: They fear loss of control of their bodies Adolescents: Their major concern is change in body image.

Exam 1- Health Promotion in the Toddler, Preschooler, School Aged Child, and Adolescent Flashcards

(116 cards)