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WVSOM - CS1
Growth and Pain Objectives
| Question | Answer |
|---|---|
| IGF-1 | Growth hormone produced by the liver |
| Hypothalmus | secretes somatostatin and GNRH whihc both act on pituitary gland |
| GMRH | stimulates the pituitary to release GH |
| Somatostatin | inhibits the release of GH |
| GH | works to create protein synthesis in cells, and works with the IGF-1 to cause muscle and skeletal growth. |
| Dwarfism | GH deficiency |
| Gigantism | excess GH in children; excessive linear growth |
| Acromegaly | Excess GH in adults; enlarged hands, feet and facial features |
| Gynocomastia | caused by marijuana; abnormally large breasts in men |
| Relevant growth history in infants | bright wieght/length/height; pregnancy/birth complications; milestones/development patterns; disease or illness |
| Relevant growth history in children | Age of menarche; growth velocity; sports and peer involvement; sexual maturity rating |
| Pregnant women relevant grwoth history | Last menstrual cycle; wieght and weight gain; eating disorders (PICA); nausea/vomitting |
| Relevant growth history in older adults | difficulty in obtaining or preparing meals; trouble eating/chewing/swallowing; trouble feeding themselves |
| Measuring weight | no shoes or heaving clothing; ideally only in a gown |
| Measuring infant weight | special scale in grams. Naked, no diaper |
| Hip Measurement | Widest part of gluteal region |
| Waist Measurement | Midpoint between illiac crest and costal margin |
| Waist/Hip Ratio | Divide waist by hip. Should be less than 1 in men and less than .85 in women |
| High waist/hip ratio | Apple shape. Associated with a lot of medical conditions |
| Height Measurement | remove shoes. measure this in recumbent position until 2 years of age |
| Head circumference | every visit until 3 years of age, measure largest circumference |
| Macrocephaly | two or more standard deviations above normal distribution mean (rule out hydrocephally) |
| Microcephaly | two or more standard deviations below normal distribution (causes mental retardation) |
| Arm span Measurement | longest distance between fingers with arms abducted at a 90 degree angle from the body |
| Ballard Gestational Assessment Tool | used within 36 hours of birth; looks at 6 physical and 6 neuromuscular findings; EGA < 37 preterm; EGA 37-41 term; EGA > 41 Postterm |
| Sexual Maturity rating | in adolescents to dexcribe teh relationship to normal and abnormal pubertal development |
| Thelarche | Breast bud, first sign of puberty |
| Menarch | Development of menses; usually at SMP 3 or 4 |
| Premature Menarche | before age 6 in African Americans and 7 in Caucasians |
| Adrenarche | development of pubic hair |
| Precocious puberty | premature menarche and adrenache |
| Males: first sign of puberty | enlargement of scrotum |
| Early puberty for males | before 9 y/o |
| Cushing Syndrome | excessive cortisol production by the adrenal complex. Characterized by weakness, weight gain, hyperpigmentation, oligomennorhea and decreased testosterone |
| Achondroplasia | genetic disorder resulting in decreased growth in cartilage in the epiphysis. Results in premature ossification |
| Pain Assessment | JCAHO requrires on every patient |
| interpretation of pain | unequal. Different for every person; note non-verbal communication |
| Perception of pain | age, emotion, culture, sleep, development |
| Pain Scales | 1-10 |
Created by:
tjamrose
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