The Life Cycle

Question 1

premature birth

Answer 1

born in less than 37 weeks

Question 2

very premature birth

Answer 2

born in less than 32 weeks

Question 3

APGAR score

Answer 3

used to assess baby health. Appearance, pulse, grimace, activity, respiration. used to predict the likelihood of immediate survival

Question 4

postpartum reactions

Answer 4

oxytocin-dopamine interactions associated with maternal-infant bond. major depression can occur in up to 10% of new mothers within one month of childbirth. postpartum psychosis in 0.1% of mothers.

Question 5

spheres of development

Answer 5

motor, social, verbal/cognitive. occurs cephalad to caudad and central to peripheral.

Question 6

25% rule

Answer 6

by 1 year old, a stranger should understand 25% of a baby’s speech. 2 years, 50%, 3 years, 75% etc

Question 7

infancy to 18 months

Answer 7

humans need and seek the presence of others. attachment.

Question 8

when does social smile occur?

Answer 8

12 weeks

Question 9

when does stranger anxiety occur?

Answer 9

9 months

Question 10

characteristic of infant

Answer 10

reflexes and instincts that are necessary for survival. rooting reflex: touch cheek turn toward nupple. palmar grasp reflex: grip any object put in palm. moro reflex: limbs extend when child is startled. Babinski reflex: dorsiflexion of toes when the sole of the foot is stroked (gone at 1 year)

Question 11

toddler years: 18 months to 3 years

Answer 11

rapprochement: moves away but then quickly returns for comfort. parallel play: next to, not reciprocal. bowel and bladder function (4 and 5 years). gender identify by 3 years

Question 12

bad triads!

Answer 12

OCD, ticks, ADHD. fire setting, soiling pants, cruelty to animals

Question 13

preschool years (3-6)

Answer 13

sibling rivalry. regression seen if another child is brought into family. active fantasy life. cooperative play at 4 years. strong fear of bodily injury, curiosity about bodies

Question 14

milestones at 6 years

Answer 14

development of child’s conscience. a sense of morality. empathy. learns that lying is wrong. understand the finality of death.

Question 15

autism spectrum disorder

Answer 15

do not acquire verbal and social skills at the expected age. no reciprocity, restricted range of interests, clumsiness. seen before age 3. more common in boys, larger head circumference. genetic component. Tuberous sclerosis and fragile X syndrome

Question 16

rett’s disorder

Answer 16

4 years of normal functioning, hand wringing, breathing problems, intellectual impairment, ataxia motor and social declines, X linked.

Question 17

school age and adolescence

Answer 17

7-11 years. psychosexual issues are dormant. lifelong sense of competence. formal schooling starts, capacity for logical thought. concrete operations. learning problems identified here

Question 18

play and peer relationships at 7-11

Answer 18

relationships with adults who arent primary care giver. peer relationships. sexuality, morality (rule conscious). illness: deal better with hospitalization. by age 9 understand universality of death. acting out: defense mechanism

Question 19

early adolescence (11-14 years)

Answer 19

puberty is physical indicator of adolescence. usually more obedient, older teens are more likely to oppose adults

Question 20

middle adolescence

Answer 20

by 15: body image and popularity. prefers to spend time with friends not family. risk taking behavior. educate about obvious short term benefits. less likely to comply with medical advice

Question 21

late adolescence

Answer 21

identity crisis: define and refine place in the world. role confusion. some but not all develop abstraction.

Question 22

emotional and social factors that predispose to teen pregnancy

Answer 22

depression, poor school achievement, divorced parents

Question 23

problems affecting development in teen pregnancies

Answer 23

mental retardation, down’s syndrome, fragile X syndrome

Question 24

intellectual impairment in teen pregnancies

Answer 24

metabolic factors (infection, maternal substance abuse) is associated with autism, seizures, hearing and visual problems. normal IQ of 70.

Question 25

challenges of early and middle adulthood

Answer 25

transitional periods, reappraisal of desires, goals, and values. vulnerable to physical and emotional illness during periods of life change. regression (become more adolescent)

Question 26

assisted reproduction and adoption

Answer 26

fertility decreases with age. in vitro fertilization helps. adoption usualy has positive outcome. some people adopted after infancy are at risk for behavioral problem. tell child about adoption at earliest possible age

Question 27

early adulthood (20-40 years)

Answer 27

at age 30, ones role in society is defined, physical development at peak, individual is independent. Love and work/intimacy vs. isolation. women often change paths in middle 30s

Question 28

middle adulthood (40-65 years)

Answer 28

unique social responsibilities. responsibilities to older and younger relatives. climacterium: the physiological changes that occur in men and women during midlife. women: menopause, men: decrease in muscle strength and sex

Question 29

losses of aging

Answer 29

loss of social status, loss by death of spouses, family members, and friends. decline in overall health and strength. most adjust well. ego integrity vs. despair: did you waste your life or nah

Question 30

cognitive function in the elderly

Answer 30

dementia in less than 10% of elderly. some memory and learning problems. over the age of 85: half have some degree of cognitive impairment. alzheimer’s is the most common form of dementia

Question 31

physical and neurological changes of aging

Answer 31

neurological changes: decreased cerebral blood flow, decreased brain weight, amyloid plaques. intelligence remains the same. decreased neurotransmitter availability. more sensitive to side effects, increased depression

Question 32

psychosocial changes of aging

Answer 32

reduced bladder control, loss of strength, vision and hearing loss, abuse of cognitive or physically impaired elderly by caretakers

Question 33

stages of dying

Answer 33

denial, anger, bargaining, depression, acceptance. not necessarily in that order

Question 34

bereavement versus complicated bereavement

Answer 34

both normal grief and complicated bereavement have initial shock and denial. denial in abnormal grief can last over days or weeks. both include sadness, crying. anniversary reactions are common. abnormal grief has intense symptoms, involve suicidal thinking and hallucinations.

Question 35

role of physician in dying and death

Answer 35

make aware of diagnosis and prognosis. reassure that intense responses to news is expected. serve as resource to family. medically follow bereaved family members. resist emotional detachment