Peds Growth and Development Flashcards
(112 cards)
1
Q
what is more important than a child’s actual size?
A
the rate of growth of a child
2
Q
what measurements of growth are the best indicators of general health in children?
A
serial measurements
3
Q
what helps to identify children at risk in terms of growth and development? if any measurement is off the curve, what do you do?
A
failure to conform to expected patterns of growth
RECHECK
4
Q
when do children get their well child checks?
A
(1) a 2 weeks and/or 1 month
(2) 2, 4, 6 month (shots)
(3) 9 months
(4) 12, 15 months (shots)
(5) 18 months
(6) 2 y/o (shots)
(7) annually after 2 y/o
(8) 4 y/o (shots)
5
Q
is it easy to deflect a normal child from their own target growth curve?
A
NO!! - it’s very difficult!!
6
Q
what should be measured at ALL office visits for children?
A
weight
height
head circumference (FOC - frontal-occipital circumference) for children < 2/yo
7
Q
what is the best index of nutrition and growth for children?
A
weight
8
Q
how much weight loss can you expect a child to lose during the first 3-4 days of life? why?
A
10% weight loss
b/c they poop out meconium (green poop) - can be dispelled inside the motor if baby is stressed
9
Q
at what day of life should infants regain their birth weight?
A
day of life (DOL) 14
10
Q
how should infants be weighed?
A
wearing only a dry diaper
11
Q
how should older children be weighed?
A
without shoes and stuff in their pockets
12
Q
at age 0-3 months, what should be their monthly weight gain (kg and lb)?
A
1 kg (2 lb)
13
Q
at age 3-6 months, what should be their monthly weight gain (kg and lb)?
A
0.6 kg (1.25 lb)
14
Q
at age 6-9 months, what should be their monthly weight gain (kg and lb)?
A
0.5 kg (1 lb)
15
Q
at age 9-12 months, what should be their monthly weight gain (kg and oz)?
A
0.4 kg (12 oz)
16
Q
at age 1-3 years, what should their monthly weight gain (kg and oz)?
A
0.25 kg (8 oz)
17
Q
how should children’s height be measured?
A
without shoes
18
Q
if a height measurement doesn’t plot appropriately, what should you do?
A
remeasure
19
Q
what is a reliable indicator of brain growth up to 2 y/o?
A
head circumference (FOC)
20
Q
head circumference (FOC) is a reliable indicator of what?
A
brain growth up to 2 y/o
21
Q
at what age do most cranial sutures close by?
A
6 months of age
22
Q
at what age does the anterior fontanel close by?
A
9-18 months of age
23
Q
if an FOC doesn’t plot appropriately, then do what?
A
remeasure
24
Q
if the skull doesn’t grow, what can happen to the brain?
A
the brain will herniate thru the foramen magnum (uncle herniation)
25
what is the purpose of the BMI for children?
to provide a measure/predictor for obesity and its associated health risks
26
what BMI is a significant risk factor for obesity?
>95%
27
what are the 5 important routine screening tests for children?
(1) Lead
(2) Iron Deficiency
(3) Cholesterol
(4) Tb
(5) STD
28
when do you do the routine screening tests?
during a well child check
29
at what ages is the Lead screening test required?
at 9 and 12 months, and again at ages 2 and 3
30
at what ages is the Iron Deficiency screening test required?
Hgb or Act at 12 months and again at 2, 3, 4, 5 and 6 y/o
31
what is the best formula for iron deficiency children?
breast milk (if possible)
32
what can be an early sign of lead poisoning in children?
iron deficiency
33
development definition
the acquisition of skills or "milestones" considered appropriate for a given age, based on population standards
34
at what age do children start to change from concrete thinking to abstract thinking?
15 y/o
35
what is the importance of developmental screening?
(1) identify delays and their etiologies
(2) maximize potential of a child with appropriate interventions when available (MOST IMPORTANT)
(3) provide support and reassurance to the family
36
what are the 4 part of development?
(1) Gross motor
(2) Fine motor
(3) Language
(4) Social
37
good screens make a correction decision how often?
70% of the time
38
when do children have their greatest progress of gross motor and fine motor skills?
during the first 3 years of life
39
at what age do children have rapid acquisition of gross and fine motor skills?
first year
40
what early gross motor milestone occurs at 4-10 months of age?
rolls back to stomach
41
what early gross motor milestone occurs at 6-9 months?
sits steadily
42
what early gross motor milestone occurs at 7-12 months?
pulls to standing
43
what early gross motor milestone occurs at 9-16 months?
stands alone
44
what complex gross motor skill occurs at 13 months?
walks well
45
what complex gross motor skill occurs at 15 months?
stoops and recovers
46
what complex gross motor skill occurs at 2 years?
kicks ball forward
47
what complex gross motor skill occurs at 3 years?
throws ball overhand
48
what complex motor skill occurs at 4 years?
balances on 1 foot, 2 sec, hops
49
what complex motor skill occurs at 5 years?
catches a ball
50
what fine motor skill occurs at 5-7 months?
rake
51
what fine motor skill occurs at 8-10 months?
radial-digital grasp b/w thumb and side of index finger (lobster claw)
52
what fine motor skill occurs at 10-12 months?
perfection of pincer grasp b/w fingertips of fingernails of thumb and index finger
53
what is a sign of Gowers Musc. Dystrophy?
walks hands up on legs after stooping
54
what fine motor task occurs at 15 months?
scribbles
55
what fine motor task occurs at 24 months?
imitates vertical or circular strokes, tower of 6 cubes
56
what are the 2 universal screening tests for hearing?
Auditory Brainstem Response (ABR)
Otoacoustic Emissions (OAE)
57
what is the Auditory Brainstem Response (ABR)?
Hearing screening test
used in newborns and infants
sounds are played to the baby's ears and test measures the brain responding to sounds
58
what is the Otoacoustic Emissions (OAE)?
Hearing screening test
used in newborns and infants to assess cochlear fracture
sounds are played into the ear and cochlear response is measured
-if baby hears normally, an echo is reflected back to the microphone
59
at 0-3 months, what is the assessment of hearing?
does your baby startle to loud noises?
60
at 4-6 months, what is the assessment of hearing?
does your baby turn his eye or head at the sound of your voice?
61
at 7-9 months, what is the assessment of hearing?
does baby make string of sounds like "ba ba ba, da, da, da"?
62
what is the #1 cause of speech delay in children/
hearing loss
63
when should a child be referred for a professional speech and/or language assessment? (5 criteria)
(1) not talking by 2 y/o
(2) unintelligible speech by 3 y/o
(3) no sentences by 3 y/o
(4) child is embarrassed by his/her speech at any age
(5) other known d/o is present like hearing loss, mental retardation, autism, dysarthria, stuttering
64
at what age is stuttering normal?
b/w 2 1/2 - 4 y/o
65
what is the most important finding on assessment of vision for an infant?
presence of red reflex
66
what's an indication of retinoblastoma?
white reflex on fundoscopic exam
67
what exams are involved in assessment of vision for children?
red reflex (infants)
corneal light reflex
cover/uncover test
68
what does the corneal light reflex assess for?
to help assess for misalignment
69
what does the cover/uncover test, assess for?
tests tracking in younger children and checks for strabismus
70
how can you fix a lazy eye if caught early?
with patching - patch non-lazy eye
71
what does a full-term newborn focus on and track in terms of vision?
focuses one ace and briefly tracks objects
72
at 2 months, what is the vision assessment like?
tracks across midline, responsive smile, follows movement 6 feet away
73
at 4-5 months, what is the vision assessment like?
reaches for object 12 inches away, notices raisin 1 foot away, familiar smile
74
what is the personal-social skill at 2 months?
social smile
75
what is the personal-social skill at 6 months?
reaches for objects
76
what is the personal-social skill at 9 months?
feeds self, passes object hand to hand
77
what is the personal-social skill at 12 months?
plays appropriately with toy
78
what is the personal-social skill at 18 months?
drinks from cup (without spilling)
79
what is the personal-social skill at 2 years?
uses spoon
80
what is the personal-social skill at 4 years?
puts on T-shirt
81
what is the ONE VOICE mnemonic?
mnemonic device on communicating with children
82
what does O stand for in ONE VOICE?
one voice should be heard during procedure
83
what does N stand for in ONE VOICE?
need parental involvement
84
what does E stand for in ONE VOICE?
educate patient before the procedure about what is going to happen
85
what does V stand for in ONE VOICE?
validate child with words
86
what does the second O stand for in ONE VOICE?
offer the most comfortable, non-threatening position
87
what does the I stand for in ONE VOICE?
individualize your game plan
88
what does the C stand for in ONE VOICE?
choose appropriate distraction to be used
89
what does the second E stand for in ONE VOICE?
eliminate unnecessary people not actively involved with the procedure
90
what is it important to account for in a premature infant when assessing their growth and development?
their degree of prematurity
91
a premature infant may only have what skills?
those skills appropriate to his/her adjusted gestational age
92
infants that have a complicated neonatal course (like ventilator support, infection), may have more ___
delays as a result
93
what's the age of an early adolescence?
10-13 y/o
94
what changes are seen in early adolescence?
- rapid physical change
- concerned if different than peers
- concerte thinking (vague, unrealistic goals)
95
what's the age of a middle adolescence?
14-16 y/o
96
what changes are seen in middle adolescence?
- more comfortable with bodies (or NOT!) - see eating d/o's at this age
- concerte thinking changes to abstract thinking
- sense of omnipotence (sex, drugs, and rock-n-roll)
97
at what age do you want to talk to adolescence w/out parents in the room? what if parents won't leave the room?
14-16 y/o (middle adolescence)
-if parents won't leave room, then that's a red flag
98
wha's the age of a late adolescence?
17 years and older
99
what changes are seen in late adolescence?
- less self-centered
| - realistic future plans
100
what are the 3 leading causes of death in adolescence?
(1) unintentional (accidents) - #1 cause of death at this age (no seat belts, helmets)
(2) suicide
(3) homicide
101
what are the 4 suicide triage questions?
(1) in the past few weeks, have you wished you were dead?
(2) in the past few weeks, have you felt that you or your family would be better off if you were dead?
(3) in the past week, have you been having thoughts about killing yourself?
(4) have you ever tried to kill yourself?
102
what should occur if teen answers YES to 2 of the 4 suicide triage questions?
section 12 -> commit them/consult
103
if teen is at risk for suicide, what can you do?
- follow-up
- formal counseling
- family and/or community partnership
- section 12/OPC hospital admission
104
what are adolescents smoking now, cigarettes or e-cigs?
e-cigs
105
what are the Preventive Service Guidelines for adolescents?
(1) Deter behaviors that jeopardize health
(2) Detect physical, emotional, and behavioral problems early
(3) Discourage unhealthy behaviors
106
what are the 3 mandatory reporting?
(1) self-imposed danger
(2) danger to others
(3) abuse victim
107
what is the Mass mature minor rule?
minors can consent to medical tx (except for abortion) if the doctor believes the minor can give informed consent to the tx and it is in the minor's best interest not to notify their parents
108
what is the tanner staging? how many stages?
breast development, pubic hair development, and genitalia development
5 stages
109
what stage of tanner staging is breast budding?
stage 2
110
at what stage of tanner staging do areola and papilla form secondary mound?
stage 4
111
at what stage of tanner staging do mature female breasts form?
stage 5
112
at first sign of breast buds, when does menarche develop?
usually comes w/in a year
