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Pediatric Growth and Development Flashcards

(61 cards)

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1
Q

Pediatric Health Promotion and Prevention

A

best approach is through education and anticipatory guidance!!

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2
Q

Leading Causes of Morbidity and Mortality (Infants)

A

birth defects

preterm birth and LBW

pregnancy complications

SUIDS/SIDS

injuries

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3
Q

Leading Causes of Morbidity and Mortality (Ages 1-4)

A

accidents

congenital/chromosomal abnormalities

assault (homicide)

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4
Q

Leading Causes of Morbidity and Mortality (Ages 5-14)

A

accidents

cancer

self harm/suicide

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5
Q

Growth

A

increase in size

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6
Q

Development

A

increased capabilities and ability to adapt

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7
Q

Growth and Development

A

3 ways!!

cephalocaudal: head to tail

proximodistal: near to far/midline to periphery

gross motor to fine motor: touchpoints (dynamic variation of family system from birth to 3 yrs)

focus on caregivers ability to demonstrate behaviors and provide tools necessary for rapid changes

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8
Q

Stages of Pediatric Client

A

infant: birth to 1 yr

toddler: 1-3 yrs

preschool: 3-5/6 yrs

school age: 6-12 yrs

adolescent: 12-18 yrs

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9
Q

Ericksons Theory of Psychosocial Development

A

8 stages; explores how social interactions shape an individual’s ability to deal with developmental “crisis” of each lvl

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10
Q

Trust vs Mistrust (Infancy)

A

basic needs must be met and trust must be learned

“hold me, feed me, take care of me”

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11
Q

Autonomy vs Shame (Toddler)

A

controlling body excretions, “no”, balance independence and self sufficiency

“watch me do this myself”

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12
Q

Initiative vs Guilt (Preschool)

A

exploring world, creating, resourcefulness to achieve and learn new things

“i want to help you; i can do it too”

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13
Q

Industry vs Inferiority (School Age)

A

new activities, sports, school, sense of confidence

“i want to fit in”, “what are the rules?”

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14
Q

Identity vs Role Confusion (Adolescent)

A

new sense of identity and sense of self

“i just want my friends” “who cares, so what”

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15
Q

Piagets Theory of Cognitive Development

A

focused on cognitive/intellectual maturation of 4 stages

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16
Q

Sensorimotor (Infancy-2 Yrs)

A

learns from sensory input, language skills

5 senses

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17
Q

Preoperational (2-6 Years)

A

increasing verbal, limitations in thought, development of motor skills

using words and images to represent things; pretend play

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18
Q

Concrete Operational (7-11 Yrs)

A

organize thought in logical order, manipulates objects

grasping concrete analogies; math

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19
Q

Formal Operational (12-Adulthood)

A

mature, abstract thought and reasoning to handle difficult concepts

moral reasoning

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20
Q

The Importance of Play

A

all stages!!

physical: reflexes and neurological development, motor skills

cognitive: communication and language development

psychosocial: personality and temperament, moral development

nursing role to facilitate play!

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21
Q

General Physical Changes (Infancy)

A

body organs not fully mature; includes nervous system and ability to control bodies

growth measured month to month

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22
Q

Newborn (Birth-1 Month)

A

no head control
flexed position
hands closed but strong grasp

communicates by cooing, babbling and crying

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23
Q

3-6 Months

A

birth weight doubled at 6 months

holds head more erect and sits supported at 6 months
rolls over
can move objects from hand to hand
discovers self (plays with hands, feet, mouth)

begins to support self in tripod position

communicates by cooing, babbling and crying

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24
Q

9-12 Months

A

birth weight tripled by 12 months

head and chest circumference are same by 12 months
creeps, pulls self up on object, teetering (begins to take first steps without assistance)

uses pincer grasp
begins to hold and throw objects
waves bye-bye
can understand “no”, “mama”, “dada”
stranger anxiety!

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25
Infant Development
discriminates visually images, sounds and tastes solitary play reflexive manner-grasps objects
26
Multisensory Stimulation Play for Infants
music and noise making objects rocking, cuddling visual patterns, mirrors, and mobiles black and white patterns hearing spoken language
27
Fine/Gross Motor Activities for Infants
soft toys, rattles-objects to grasp teething toys large blocks (9-12 months) peek-a-boo pincer grasp “cheerios”
28
Toddler General Physical Changes
gains about 1.4 kg-2.3 kg a year height increases about 3 in a year walks, climbs, runs and jumps holds objects such as utensils, draws, begins to undress self
29
Toddler Cognitive and Sensory Function
temper tantrums and “NO” enjoys pictures, reading aloud and naming objects age 1: uses 1 word commands, can follow 1 step direction age 2 uses 2/2, etc…
30
Toddler Psychosocial Development
parallel play; imitative behaviors occasionally trade toys and words
31
Fine/Gross Motor Play for Toddlers
building blocks scribbling with crayons push and pull toys up and down stairs
32
Preschooler General Physical Changes
gains about 1.5-2.5 kg a yr height increases about 4-6 cm (1.5-2.5 in) a yr walks, climbs, run and jumps easier tie shoes, fasten buttons draws stick figures can use scissors
33
Preschooler Cognitive and Sensory Function
visual acuity sharpens (can focus on letters and #) concrete thinking “why”, enjoys rhymes, vocabulary of 1500-2000 words
34
Preschooler Psychosocial Development
learns rules begins to pick up gender differences associative play
35
Fine/Gross Motor Play for Preschoolers
dramatic play; puppets (very effective in hospital for teaching) reading together (learning letters) crafts, can use scissors large motor activities bicycle, climbing, swimming
36
School Age General Physical Changes
gains about 4-6 lbs a yr height increases about 2 in. a yr walks, climbs, runs and jumps with precise coordination; additional activities like swimming and dancing fine dexterity improves-writing, instruments, crafting
37
School Age Cognitive and Sensory Function
thinking becomes more logical, solving problems “why” goes to “how” visual acuity reaches 20/20 (?) vocab 8000 to 15000 words
38
School Age Psychosocial Development
increased peer influence gender identity; same sex friends cooperative play (bargaining, negotiating)
39
Fine/Gross Motor Play for School Age
sports!! (*can concentrate longer, able to jump rope and ride two wheeler, decrease in active play d/t technology*) puzzles, readings and games cooperative play (*goal oriented; winning/losing*)
40
Adolescent General Physical Changes
girls gain about 15-55 lbs; boys 15-66 lbs girls increase about 2-8 in. in height; boys 4-12 in secondary sex characteristics develop endurance and coordination start to peak fine dexterity sharpens allowing for effortless manipulation of objects
41
Adolescent Cognitive and Sensory Function
can think in abstract terms, hypothesize can use future time perspectively vocab of 50,000 words
42
Adolescent Psychosocial Development
mainly guided by peer influence push pull dynamic with parental/caregiver units continues cooperative play (bargaining, negotiating)
43
Fine/Gross Motor Play for Adolescents
sports and school activities (peer group is focus!!) games, reading, music movies and video games dance
44
General Pediatric Health History
nutrition PMH including birth history play/activity/sleeping patterns family history social/psychosocial history immunizations, UTD? developmental milestones
45
Pediatric Physical Exam
always begin with least invasive to most distressful..steps may not always be in order VS measurements
46
Infant Physical Assessment Approaches
start with non-invasive procedures save HEENT for last separation anxiety! examine in parents lap for as much as possible neurologic portion of exam will have more reflex measurements
47
Toddler Physical Assessment Approaches
allow child to remain in parents lap let child get comfortable and used to being in room before starting don’t ask for permission to perform exam give choices when possible use distractions when needed
48
Preschool Physical Assessment Approaches
more cooperative sense of body image fear of mutilation use simple explanations have child participate use games
49
School-Age Physical Assessment Approaches
child should sit up on the table explain what you’re doing take opportunity to teach about body
50
Adolescent Physical Assessment Approaches
do exam alone; teen may request parent presence talk with teen throughout exam good opportunity to provide teaching about maturing body and physical changes be non-judgmental confidentiality cover sensitive topics when parents are out of room
51
Length
measure supine until around 2 yrs; hips and knees extended flat use paper on table if no board stadiometer shoes off shoulder and heels touch wall
52
Weight/BMI
infant scale until age 2; remove all clothes and diaper older children on standing scale height ALWAYS IN CM AND WEIGHT ALWAYS IN KG
53
Growth Charts
plot on growth charts until 18 separate charts; boys and girls and by age
54
Head Circumference
plot for first 2 yrs supine or sitting position place tape over occipital, parietal and frontal prominences deviations can signify problems ALWAYS IN CM
55
VS
HR and RR higher the younger pt is BP is lower the younger pt is no change in temp. O2 is lower in immediate newborn period
56
Hospitalized Families: Caregivers
anxiety/fear disrupts routines role changes financial strain discharge/caring at home
57
Hospitalized Families: Siblings
little attention from parents perception of illness (lack of understanding and guilt) nightmares, behavioral problems
58
Hospitalized Families: Patient
separation anxiety/stranger anxiety immobilization sensory overload loss of control painful procedures fear of dark loss of privacy/bodily functions fear of death fear of altered body image **regression, repression, rationalization, fantasy**
59
On Unit
tour of areas and orientation to environment maintain routines as much as possible early discharge planning exchange communication standards encourage social activities as appropriate talk about unit flow
60
Procedural Support
education (**age-appropriate, allow Q’s and expressions of fear**) appropriate environment (*treatment rooms, positioning*) comfort (**caregivers at bedside, pain management, bottle feed**) play therapy (**role playing, role modeling, dolls, toys, distraction, child life specialist**) rewards and prizes
61
Pediatric Care Equipment
isolette infant crib regular size crib toddler bed regular bed output (*weighing of diapers*) dietary needs (*breast feeding/formula*) med admin ADLs restraints (**no-no’s, papoose, IV site covers**) abductions (*code pink*)

WCF (6 decks)

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