School age Flashcards

(36 cards)

1
Q

School age

A

6-12 years

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2
Q

Freuds School age stage

A

latency stage
ages 6-12years
-marked by repression of sexual urges as children play mostly with peers of the same sex

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3
Q

Jean Piaget school age

A

concrete stage
age 7-11years
-children become more organized and rational in thinking
-quantity remains constant even if its appearance changes

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4
Q

Erik Erickson school age

A

age 6-12
industry vs. inferiority
-desire to please adults
-complex tasks

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5
Q

WCC

A

school age annually

-2nd dose of MMR vaccine ages b/t age 4 and 6: prior to school entry
-ages 11 and 12 get Tdap, HPV, Varicella, and Meningococcal conjugate vaccine

-Dental assessment and cleaning every 6months

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6
Q

Average wt increase

A

5-7lbs per year

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7
Q

Average ht increase

A

2-3inches per year

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8
Q

Female peak height velocity (PHV)

A

ages 11 and 12
prior to menarche

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9
Q

Obesity in school age?

A

-indicated by BMI over the 95th percentile

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10
Q

Visual Acuity

A

20/20

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11
Q

eruption of permanent teeth

A

age 6

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12
Q

Precocious Puberty

A

uses Tanner Stage
females younger 8years of age
males younger than 9years of age

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13
Q

PPD

A

test for tuberculosis
-given annually with any risk factors:
-low socioeconomic status, residence in area where TB is prevalent, exposure to TB, or immigrant status

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14
Q

scoliosis test

A

Adam forward bend test or scoliometer

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15
Q

hematocrit done annually

A

assess for anemia before child becomes symptomatic

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16
Q

hand dominence begins?

A

appears by age 5

17
Q

screen time limited to what?

A

less than 2 hours a day

18
Q

dental health for school age

A

-floss
-encouraged to brush teeth after meals and before bed
-dental cleaning every 6months
-sealant should be placed on the Childs premolars and molars as soon as the come in

19
Q

Injury Preventions

A

communicate risks
-tobacco
-drugs
-alcohol abuse
-use of safety devices, helmets and seatbelts

20
Q

Sleep for School age

A

8-10 hours per night
-night terrors resolve by age 12

21
Q

Obesity of School age

A

determines by BMI
-overweight if BMI is above 85th percentile
-Obese if BMI is above 95th percentile

obesity is a combination of genetic, physiologic, and environmental factors

-obesity can sometimes be caused by genetic disorders such as Prader-Willi syndrome and Trisomy 21

-medications like antipsychotics produce obesity

NP should take patients Hx, eating patterns, activity Hx, Medications Hx, Psychological Hx

-review for comorbidities like DM type 2, sleep apnea, PCOS, Vitamin D deficiency

-safest way to lose wt is healthy eating and active lifestyle, no diets!

22
Q

Child Abuse

A

acts of omission or commission, including emotional, physical, and sexual acts, that pose a clear risk to the development and health of the child.

-many abusers are parents
-child abusers have traits “a breakdown of impulse control”
-abusers are usually former victims themselves

23
Q

most common type of child abuse

24
Q

injuries that indicate abuse

A

soft tissue markings with any outline of any object, weapon, cigarette burn, or hand
-delay in seeking care is suspicious of abuse and may result in bruises and fractures in various stages of healing

-Differential:
-homeopathic or cultural practices
cupping/ coining
-NP consider coagulation disorder

25
Lab test for abuse
coagulation profile CBC, platelet, PT, PTT, serum calcium, alkaline phosphates, and phosphorous levels may be measured if bone disease is suspected -Skeletal Survey: picks up old fractures -NP r/o other conditions like Osteogenesis Imperfecta (brittle bone disease)
26
Suspected child abuse
NPs are required to report suspected child abuse
27
ADHD
chronic neurodevelopcenttal disorder -usually onset before age 7 -more common in boys -Overactive and unable to focus or control their behavior -inattention, distractibility, impulsive, and hyperactivity
28
Risk Factors for ADHD
-prenatal exposure of tobacco, alcohol, or cocaine -perinatal factors include prematurity, prolonged labor, perinatal asphyxia, and signs of fetal distress -post natal factors: cerebral palsy, epilepsy, CNS trauma or infection -possible LEAD -Psychosocial: child abuse, disorganized or chaotic environments, family Hx of alcoholism, hysterical or sociopathic behaviors, developmental learning disorders, Hx family ADHD
29
ADHD has 2 categories
-inattention -hyperactivity and impulsivity diagnosis: at least 6 symptoms form either category or combination of both and be present at least 6months and in at least 2 different settings 6+6=12 before age 7 dx and as late as age 12
30
ADHD standardized test
-Conners Parent and Teacher Rating Scale -Achenbach Child Behavior Checklist -Vanderbilt Assessment Tool
31
ADHD management
medication and behavioral therapy stimulants most common -increase avail or neurotransmitters to strengthen focus and attention Stimulants: -methylphenidate and amphetamines -methylphenidate: Ritalin, Metadate, Focalin -amphetamines: lisdexanfetamine (Vyvanse), dextroamphetamine (Dexedrine), Adderall -Prescribe low and go slow -0.3mg/kg-0.7mg/kg starting in morning 5-10mg -increase 2.5-5mg per week -change in behavior identifies w/in 30-90min of ingestion -short-acting for children younger than 6 years of age -long acting last 10-12hours used with children who require duration of action longer than 4 hours. -avoid evening dose to minimize insomnia
32
Contraindications for ADHD medication
-heart disease -HTN -Glaucoma Psychiatric: -marked anxiety and increased risk for suicide
33
Drug holidays
implemented around school breaks or summer vacations
34
ADHD nonpharm measures
behavioral treatment parent education support
35
ADHD medication side effects
-stomach aches -headaches -anorexia -weight loss -tachycardia -tics (usually remain despite long term use) -sleep disturbances
36
ADHD legal
-need to sign control substance abuse form -Perform drug testing to make sure they are taking med and not selling