The pediatric Patient Flashcards
(24 cards)
1
Q
Parental influence on the peds patient
A
- conception
- health awareness: nutition, wellness checks, lifestyle etc
2
Q
Normal growth and development
stages
A
- infancy: 0-12 months
- early childhood: 1-4 years
- middle childhood 5-10
- adolescence: 11-20
3
Q
Infancy
A
- 0-12 months
- most rapid physical development
- exploration
- cognitive, language
- self and family: attachment and trust
- concerns: delays in mapping sensoimotor cortex
4
Q
Early childhood 1-4 years
A
- physical development slows to 1/2 rate of infancy
- gross motor skills and fine motor skills
- language
- cognitive-preoperational; lacks logic
- seeking independence
- developing personal boundaries: being shy
- becoming more self-sufficient in basic activities
- concerns: human interaction, pscyhosocial milestones, reading, language
5
Q
Middle childhood
A
- 5-10 years
- physical growth slower
- concrete operational: goal directed exploration; rec activities
- environmental influence-self efficacy, self esteem, social independence, right/wrong
- concerns: self-esteem, physical challenges increase fo those with illness of disabilities may influence learning and development
6
Q
Adolescence
A
- 11-20 years
- endocrine-mediated changes
- formal operrational: thinking, logic, abstact reasoning, future implications of actions
- socially and emotionally challenging period
- family an deeper influence development of self and independence
- concerns: identity, independence and intimacy
- social emotional maturity by 20 for most
7
Q
bone health
A
- total lifetime bone mass estabilished during puberty (12.5 females, 14 males)
- calcium - most important dietary nutrient
- decreased activity, caffeine, dietary restriction, soft drinks, excessive thinness with late menarche or amenorrhea can impact and intensify bone loss of aging
8
Q
Pediatric physical therapy: congential, genetic and acquired pediatic conditions table
A
- achondroplasia (dwarfism)
- cerebal palsy
- cycstic fibrosis
- down syndrome
- hemophilia
- juvenile rheumatoid arthitis
- neural tube defect
- osteogeneiss imperrfecta
- praderwili syndrome
- sickle cell disease
- spinal muscle atrophy
9
Q
puberty
A
- females: 10 (8-13)
- males 11 (9.5-14)
- growth spurts
- sexual characteristics
- precocious puberty: early onset (before 8 females and before 9 in males)
- possible underlying disorders require endocrine screening, radiogaphs of growth plates
- CNS disease, trauma, tumors, McCune-Albright Syndrome, pimary hypothryroidims
- Growth plate images if not w/i normal percentiles
10
Q
A
11
Q
Female athlete triad
A
- energy availability
- menstural function
- bone mineral density
- dysmenorrhea: delay or irregular cycles, referrral to gyno/endocrinologist
- concern around age 16
12
Q
male milestones
A
- normal development
- first orgasm (organsmarche)
- first ejaculation (oigarche)
- and first wet dream (nocturnal emissions)
- occur between 12.2 and 16.2 years
13
Q
MSK system
A
- vertebral column: axial skeletal growth plates - epiphyses activates between 7-9 and close between 14-24
- Susceptible to spinal pathology (tumors) and growth distrubances scoliosis and scheurmann’s
- 50% will complain of back pain
14
Q
DDX for MSK and back pain
A
- trauma 25%
- sickle cells crisis 13%
- idiopathic cause 13%
- UTI 5
- viral 4
15
Q
common MSK disease
in peds
A
- osteochondrosis AVN
- legg-calve-perthes diseases
- freiberg’s disease: osteochonrosis of metatarsal heads
- UE osteochonrosis: shoulder and elbow
- epiphyseal disorders
- scoliosis
- osteochondritis dissecnas (typically in knees and talus)
- neoplastic disorders
16
Q
Cardiovascular disease
A
- incubation period 0-adolescence
- latent period: adolescentce - early adulthood
- clinical manifestation
- 75%-90% CVS related to dyslipidemia, HTN, DM, tobacco use, lack of physical activity, obseity, poor nutrition
17
Q
Integumentary system
changes during puberty
A
- endocrine system: changes in hair, sebaceous and sweat glands
- thermoregulation changes
- acne = dietary causes, polycystic ovarian syndrome adrenal hyperandrogenism
18
Q
Thermoregulation in children
A
- greater Sa to body mass ratio
- produce more metabolic heat per mass than adults
- sweating capacity decreased/decreased evaporation
19
Q
Heat stress disorder
Heat illness: clinical features
A
- weight loss by sweat = < 5%
- thirst
- chills
- clammy skin
- cramps
- nausea
- muscle twtiches
- weakness
- fatigue
20
Q
Heat stress disorder
heat illness: treatment
A
- drink 1/2 cup water every 15-20 minutes during breaks rest in shade
- remove extra clothes
21
Q
Heat stress disorder
Heat exhaustion clinical features
A
- weight loss via sweat 5-10%
- reduced sweating
- dizziness
- HA
- SOB
- lack of saliva
- extreme fatigue
- weak nad rapid pulse
- lack of coordination
- thirst
22
Q
Heat stress disorder
Heat exhaustion treatmetn
A
- stop activity
- move to cool place
- drink 2 cups water for every pound lost
- remove clothes
- sit in chair in cold shower
23
Q
Heat stress disorder
heat strok: clinical features
A
- weight loss more than 10%
- lack of sweat
- dry
- hot skin
- lack of urine
- hallucinations
- swollen tongue
- deafness
- agression
- ataxia
- high temp
- seizures
- vomiting
- rapid HR
- diarrhea
24
Q
Heat stress disorder
heat stroke treatment
A
- medical emergency
- stop activity and move to cool place, place ice bag on head nad back
- do not give water (risk choking)
