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PNCB CPNP-PC > School-age Health > Flashcards

School-age Health Flashcards

1
Q 
School-age Health
Focii
Physical: -1-
Cognitive: -2-
Psychosocial: -3- stage; desire to -4-
A
  1. Latency period
  2. Concrete
  3. Industry
  4. please adult figures
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2
Q

School-age Health
Subjective:
-1- (-2-, enuresis/-3-)
Risk factors/behaviors (-4-, especially caffeine for older children)

A
  1. Elimination
  2. constipation
  3. Bed-wetting
  4. alcohol, tobacco, other drugs
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3
Q 
School-age Health
Subjective Screening:
-1-
-2-
-3-
-4-
A
  1. Lead, inf. disease
  2. sleep
  3. safety
  4. dental health
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4
Q 
School-age Health
PE
-1- (from 2 yo up)
-2-
-3- (precocious puberty)
Depression screening (-4-); annual screening begins at age -5-
A
  1. BMI
  2. Scoliosis
  3. Tanner staging
  4. PHQ-9
  5. 12
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5
Q

School-age Health
TB testing risk factors from patient history:
> Residence in areas where TB is prevalent: -1-, -2-
> -3-, w/ special attention to -4-

A
  1. nursing home
  2. prison
  3. immigration status
  4. refugees
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6
Q

School-age Health
Labs
Hct -1- according to -2-
Cholesterol for -3- between -4-; screening earlier, but no later than 10 years of age if FMH of dyslpidemia or premature cardiac disease (cardiac event <55 yo)

A
  1. annually
  2. risk factors
  3. all children
  4. 9-11 years of age
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7
Q

School-age Health
Mgmt plan
Immunizations (-1- for school entry, -2-)
-3- with medication
Health promo strategies w/ AG, mainly -4-
-5- and cleanings every 6 months

A
  1. 2nd vaccine against MMR
  2. varicella, Tdap
  3. Illness mgmt
  4. self-care
  5. dental assessment
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8
Q

School-age Health
Interview
Fears: -1-, -2-, and -3-
-4- and -5- when appropriate

A
  1. pain
  2. loss of control
  3. death
  4. Encourage child to be involved
  5. answer questions
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9
Q

School-age Health
Rapid growth levels off (latent period)
Avg -1- male is -2- in weight and -3- tall.

A
  1. 10 yo
  2. 78 lb (~35kg)
  3. 54.75 in (~140 cm)
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10
Q

School-age Health
Rapid growth levels off (latent period)
Avg -1- female is -2- in weight and -3- tall.
Avg growth (both sexes): wt: -4-; ht: -5-

A
  1. 10 yo
  2. 80 lb (~36 kg)
  3. 54.5 in (~140 cm)
  4. 4-7 lb/year (2-3 kg/yr)
  5. 2.5 in/yr (6-7 cm/yr)
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11
Q

School-age Health
Rapid growth levels off (latent period)
>Girls reach -1- at -2- (prior to -3-)

A
  1. Peak height velocity (PHV)
  2. age 11-12
  3. menarche
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12
Q 
School-age Health
Rapid growth levels off (latent period)
Ht, wt, BMI
>BMI b/t the -1- is defined as -2-
> A BMI -3- indicates -4-
A
  1. 85th and 95th %iles
  2. overweight
  3. > 95th %ile
  4. obesity
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13
Q 
School-age Health
VS each visit
Pulse: -1-
Respiration: -2- per minute
BP: -3-: 95/60 to 110/73
-4-: 100/65 to 119/76
A
  1. 60-95 bpm
  2. 14-22 breaths
  3. 6-9 yo
  4. 10-11 yo
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14
Q 
School-age Health
PE proceeds from -1-
Visual -2-
-3-
-4- in girls
A
  1. head to foot (ask about preference)
  2. acuity approaches 20/20
  3. permanent teeth erupt
  4. breast development begins
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15
Q 
School-age Health
Dev Monitoring
Motor Skills
>are -1-, around -2-
> -3-
A
  1. well developed
  2. 6 or 7 yo
  3. hand dominance emerges
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16
Q 
School-age Health
Cog Dev
Piaget's -1-
Cognitive -2- at this age are -3-
Acquiring -4- and sense of -5-
A
  1. concerete operational thinking stage
  2. tasks
  3. varied
  4. new knowledge
  5. industry
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17
Q 
School-age Health
Cog Dev
Language becomes -1-
>Can grasp the -2-
>Can use concepts of -3-
>Masters -4-
Understands concept of -5-
A
  1. fluid & descriptive
  2. concept of conservation
  3. time & money
  4. cause & effect
  5. space (Minecraft)
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18
Q

School-age Health
Psychosocial Dev
Dev of -1-
> Believes they’re -2-

A
  1. self-esteem

2. worthy of love

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19
Q 
School-age Health
Socialization
> Plays with others, -1-
> Intereseted in -2-, -3-
> Capable of behaving in a -4-
> Toward late school age, -5-
A
  1. organized sports
  2. peer groups
  3. clubs
  4. peer environment
  5. peers become extremely important
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20
Q

School-age Health
Responsibility
> Can -1- and -2-

A
  1. fulfill household

2. school responsibilities

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21
Q

School-age Health
AG - Discipline
Teach difference b/t -1-
-2- must -3- (-4-, both)

A
  1. right & wrong
  2. adults
  3. role model
  4. parents & providers
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22
Q 
School-age Health
AG
Reinforce -1-
Respect the need for -2-
Expect lying: confront the child in a positive way, as -3- often -4-
Encourage -5-, and -6-
A
  1. honesty
  2. privacy
  3. need to please
  4. leads to deception
  5. competence, independence
  6. self-responsibility
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23
Q 
School-age Health
AG - Nutrition
Instutution of the current USDA food guidelines: -1-
-2- food.
May appear to have -3- stabilizes
A
  1. My Plate
  2. Minimize “junk”
  3. increased weight as linear growth
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24
Q

School-age Health
AG - Dental Health
-1- with fluoridated toothpaste for 2 minutes
Dental cleaning -2-

A
  1. Brush teeth twice daily

2. every 6 mo.

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25
Q

School-age Health
AG - Injury Prevention
> Communication about -1-, -2-, and -3- abuse
> -4- (e.g. -5-)

A
  1. cigarettes
  2. drugs
  3. alcohol
  4. Safety
  5. Biking (helmets in general), community oriented
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26
Q 
School-age Health
AG - Gun Safety
Store the guns unloaded with bullets in a -1-
Keep guns and bullets -2-
-3-
Parents should make sure guns are -4-
A
  1. separate place (inaccessible to children if possible)
  2. locked up
  3. Hide the keys
  4. properly stored at houses the child is visiting
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27
Q 
School-age Health
AG - Sex
Increased -1- of sex
Prepare girls for -2-, males for -3-/-4-
Give -5- about sexual intercourse; reinforcement over time is vital
A
  1. curiosity
  2. menstruation
  3. hormonal
  4. body changes
  5. accurate information
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28
Q

School-age Health
AG - Sleep
Sleep -1- hours per night
-2-

A
  1. 8-10

2. Nightmares decrease (terrors should be gone by 12)

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29
Q

School-age Health
AG - Screen Time
1. Develop a Family -1- (-2-)

A
  1. Media Use Plan

2. Family Screen Basket at Dinner, for instance

30
Q 
School-age Health
AG - Dev Warning Signs
Younger
Poor -1-
Not -2-
Lack -3- or presence -4-
A
  1. adjustment to school
  2. performing to ability
  3. of social interaction
  4. of peer problems
31
Q 
School-age Health
AG - Dev Warning Signs
Older
Revert to dependent, shy, -1-
-2- responsibilities
-3- in any -4-
-5- to express self
A
  1. passive roles
  2. Using illness to avoid
  3. Disinterest
  4. Extra-academic activity
  5. Destructive behavior
32
Q 
School-age Issues & Disorders
Obesity
Causes/Incidence
Usually a combo of -1-, -2-, & -3-
Diet  high in -4-
Relative -5-
A
  1. physiologic
  2. genetic
  3. environmental causes
  4. fats & simple carbs
  5. inactivity
33
Q

School-age Issues & Disorders
Obesity
Causes/Incidence
Use of -1- or as a control mechanism
physical or -2- of decreased energy expenditure
-3- have higher rates of overweight and obesity than -4-

A
  1. food for emotional comfort
  2. genetic disorders
  3. AFAM, hispanic, & native children
  4. non-hispanic whites
34
Q 
School-age Issues & Disorders
Obesity
DDx
-1-
-2- such as -3-
-4- (-5-)
A
  1. Endocrine disease
  2. Genetic conditions
  3. Prader-Willi syndrome
  4. Medication-induced obesity
  5. antipsychotics
35
Q

School-age Issues & Disorders
Obesity
Dx Studies
As indicated to rule out…

A

…physical causes

36
Q

School-age Issues & Disorders
Obesity
Mgmt
Goal for the younger child is to -1-; -2- will compensate
> -3-
> -4-
-5- referral if -6- seem(s) a likely cause

A
  1. stabilize weight
  2. linear growth
  3. Nutritional planning
  4. increase activity
  5. Counseling
  6. psychosocial issues
37
Q

School-age Issues & Disorders
Child Abuse/Neglect
Definition: a collective term used to descrbie acts of -1-, including -2-, that -3-; all states have requried reporting standards for mandated professionals (incl. DNPs)

A
  1. commission and/or omission
  2. physical, sexual, and emotional acts
  3. endanger the health and development of the child
38
Q 
School-age Issues & Disorders
Child Abuse/Neglect
Causes/Incidence
-1- is the -2- of child abuse
-3- of -4-
A
  1. Neglect
  2. most common form
  3. 80%
  4. abusers are parents
39
Q 
School-age Issues & Disorders
Child Abuse/Neglect
S/S
-1- is vague and -2-
-3- can lead to fractures and bruises in various stages of healing
-4-
A
  1. PMH
  2. not compatible with the injury
  3. delay in seeking care
  4. dev delays
40
Q 
School-age Issues & Disorders
Child Abuse/Neglect
DDx
-1-
underlying disease (e.g. -2-, -3-)
-4- such as -5-
A
  1. accidents
  2. coagulopathies
  3. osteogenesis imperfecta
  4. homeopathic or cultural practices
  5. cupping, coining
41
Q 
School-age Issues & Disorders
Child Abuse/Neglect
Dx
-1-
-2-
A
  1. Thorough PE

2. Home Ax

42
Q 
School-age Issues & Disorders
Child Abuse/Neglect
Labs
Blood -1- in children with -2- or -3-
-4- levels may be useful if bone disease is suspected
A
  1. coagulation studies (e.g. platelet count, bleeding times, PT, PTT)
  2. bruises
  3. PMH of “easy bruising”
  4. CA, P, & AlkPhos
43
Q

School-age Issues & Disorders
Child Abuse/Neglect
X-ray
-1-: for any child with soft tissue findings who is nonverbal or unable to give a clear history an dmore than 4-5 years of age or for infants ussupected fo FTT
-2-: on a -3- basis, depending on clinical findings
-4- is useful if -5- is suspected

A
  1. Skeletal survey (in the ER, to assess for old fractures)
  2. CT/Bone Scan/MRI
  3. case-by-case
  4. Ultrasound
  5. Visceral injury
44
Q 
School-age Issues & Disorders
Child Abuse/Neglect
Mgmt
-1- & -2-
-3- mothers/-4- and -5-
A
  1. Education
  2. Prevention
  3. ID high-risk
  4. parents
  5. refer
45
Q

School-age Issues & Disorders
Child Abuse/Neglect
Mgmt
-1- according to state statute; need -2-, not -3-
> In situations with doubt as to the -4-, -5- should be offered prior to a CPS report

A
  1. Mandatory reporting
  2. cause for concern
  3. proof
  4. parental health/wellness literacy (i.e., smoking around an asthmatic child, but otherwise good care is being taken)
  5. education and support
46
Q

School-age Issues & Disorders
ADHD
Definition: a disorder in which -1- have trouble paying -2-, controlling -3- behaviors, or who are -4-

A
  1. children
  2. attention
  3. impulsive
  4. overly active
47
Q

School-age Issues & Disorders
ADHD
Epidemiology
-1- are affected at a rate -2- than -3-

A
  1. Boys
  2. 3-5 times higher
  3. girls
48
Q

School-age Issues & Disorders
ADHD
Biological influences
-1-: frequency among -2- has been noted
Prenatal factors include -3- during pregnancy
Perinatal factors include -4-, prolonged -5-
Postnatal factors include -6- trauma/infections

A
  1. Genetics
  2. family members
  3. maternal smoking
  4. prematurity, fetal distress
  5. labor, & perinatal asphyxia
  6. CP, epilepsy, & CNS
49
Q

School-age Issues & Disorders
ADHD
Environmental influences
-1- which can also lead to -2-

A
  1. environmental lead

2. dev delay

50
Q 
School-age Issues & Disorders
ADHD
Psychosocial Influences
-1-
Child -2-
Family history of -3-
-4-
A
  1. Disorganized or chaotic environments
  2. abuse or neglect
  3. alcohol use disorder
  4. developmental learning disorders
51
Q 
School-age Issues & Disorders
ADHD
S/S
Findings -1- to a(n) -2-
In addition, there must also be at least -3- or -4-
A
  1. cannot be attributable
  2. underlying psychiatric disease
  3. 6 findings of inattention
  4. 6 findings of hyperactivity/impulsivity
52
Q 
School-age Issues & Disorders
ADHD
S/S/Dx
Findings usually -1- years, but can be -2-
Findings must persist -3-
A
  1. present before age 7
  2. as late as age 12
  3. 6 months or more
53
Q

School-age Issues & Disorders
ADHD
S/S/Dx
Findings -1- in at least -2-: -3-, -4-, -5-

A
  1. interfere with functioning
  2. two of the following settings
  3. home
  4. school
  5. play
54
Q 
School-age Issues & Disorders
ADHD
CMs
Inattention: Fails to -1-; is -2-
Impulsivity: -3- others
Hyperactivity: -4-, difficulty -5-
A
  1. pay attention to detail
  2. easily distracted
  3. interrupts or intrudes on
  4. fidgetiness
  5. remaining seated (why are you up?)
55
Q 
School-age Issues & Disorders
ADHD
Subtypes
Predominantly -1-
Predominantly -2-
-3- (-4- with -5- of ADHD)
A
  1. inattentive type
  2. hyperactive-impulsive type
  3. Combined type
  4. most children are diagnosed
  5. this type
56
Q 
School-age Issues & Disorders
ADHD
Comorbidity
> -1- (at least -2-)
> Psych disorders
-> Anxiety (-3-)
-> Depression (-4-)
-> ODD or Conduct Disorder (-5-)
A
  1. Learning disabilities
  2. 50%
  3. 25%
  4. 30%
  5. 60%
57
Q 
School-age Issues & Disorders
ADHD
DDx
-1- such as -2-
-3- disorder
Situational -4-
A
  1. Sensory disorders
  2. Avoidant Personality Disorder (AvPD)
  3. psychiatric
  4. anxiety
58
Q 
School-age Issues & Disorders
ADHD
Dx Studies
-1- history
Standardized tests/questionnaires
> -2- Scales
> -3- Child Behavior Checklist
> -4- Tool
-5- settings
A
  1. Perinatal
  2. Connor’s Rating
  3. Achenbach
  4. Vanderbilt Assessment
  5. Direct observation in multiple
59
Q 
School-age Issues & Disorders
ADHD
Mgmt
-1- mgmt (required)
> -2- environment
> Consider -3-
A
  1. Multi-modal
  2. Structured
  3. mental health referral
60
Q 
School-age Issues & Disorders
ADHD
Mgmt - Pharm
CNS -1-: highly effective (70-90%)
> -2- (e.g., -3-, -4-, Metadate, -5-)
A
  1. Stimulants
  2. Methylphenidates
  3. Ritalin
  4. Concerta
  5. Focalin
61
Q 
School-age Issues & Disorders
ADHD
Mgmt - Pharm
CNS -1-
> -2- (e.g., -3-, -3- XR, Dexedrine, -4-)
A
  1. Stimulants
  2. Amphetamines
  3. Adderall
  4. Vyvanse
62
Q

ADHD - Mgmt - Pharm

Stimulants MOA: -1- of -2- to increase -3- and -4-

A
  1. increase availability
  2. neurotransmitters
  3. focus
  4. attention
63
Q 
School-age Issues & Disorders
ADHD
Mgmt - Pharm
Rx Principles
-1- and go -2-, titrate -3- intervals, and -4- from -5- to assess effectiveness
A
  1. Start low
  2. slow
  3. up at weekly
  4. get feedback
  5. parents and teachers
64
Q

School-age Issues & Disorders
ADHD
Mgmt - Pharm
Rx Principles
> Behavior changes may be identified w/in -1- of ingestion
> -2- generally last -3- (no chewing) and often need -4- preparations generally last -5-

A
  1. 30-90 minutes
  2. Short-acting preparations
  3. 4 hours
  4. redosing; long-acting
  5. 8-12 hours
65
Q 
School-age Issues & Disorders
ADHD
Mgmt - Pharm
Rx Principles
If a child does not respond to higher doses of one stimulant, or if side-effects are unacceptable, -1- before considering other medications or -2-. Even if -3- are discovered, such as -4-.
A
  1. switch stimulants
  2. types of therapy
  3. comorbidities
  4. depression
66
Q 
School-age Issues & Disorders
ADHD
Mgmt - Pharm
Cautions with CNS stimulants
> Moderate -1-
> Marked -2-
> Hx of -3-
> -4- risk
A
  1. HTN
  2. anxiety
  3. drug abuse
  4. MDD/suicide
67
Q 
School-age Issues & Disorders
ADHD
Mgmt - Pharm
Side effects of CNS Stimulants
> -1-
> -2-
> Temporarily -3- and development
> -4- (methylphenidate and mixed amphetamine salts)
> -5-
A
  1. Insomnia
  2. Weight loss
  3. decreased growth rate
  4. Tics
  5. Head-/stomach aches
68
Q

School-age Issues & Disorders
ADHD
Mgmt - Pharm
-1- tend to -2- (except -3- from -4-, which indicates a need for -5-)

A
  1. Side effects
  2. level out
  3. tics
  4. Adderall
  5. change in prescription
69
Q

School-age Issues & Disorders
ADHD
Mgmt - non-pharm
May benefit from cognitive, social skills, or -1-
-2- may be considered on an individual basis, in order to:
> -3- the -4- for medication
> -5- to medication

A
  1. parenting therapy
  2. Drug holidays (structured treatment interruption)
  3. Demonstrate
  4. clinical need
  5. Temporarily remove side effects (sleep delay, appetite suppression, perceived/real tolerance to Tx)
70
Q

Abusers are -1- with psychiatric, cognitive, and emotional impairment. While it is true that -2- have -3- of incidence of abuse, this is not the case for -4-. -5-, however, are the other demographic with a high incidence of child abuse.

A
  1. often former victims
  2. African Americans
  3. 2x national average
  4. Asian Americans
  5. Native Americans
71
Q

-6- is the most common form of child abuse, and about -7- are parents.

A
  1. Neglect

7. 80% of abusers

PNCB CPNP-PC (19 decks)

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