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Peds Exam 1
Child Development and Health Promotion Adolescence
| Question | Answer |
|---|---|
| Middle childhood school age | 6-11 or 12 years |
| Physical Growth Middle Childhood is influenced by | genetics and environment |
| during school age physical growth: teeth | deciduous teeth shed Permanent teeth appear (6 years) |
| during school age physical growth: organ systems | Organ systems nearing adult capacities HR and RR slow down, BP increases stronger immune system |
| at what age is the airway more adult like | 7 years |
| during school age, muscular strength and size is | increasing, children remain at risk for overuse injuries so they're encourage to try alternate sports girls grow more than boys |
| Prepubescence occurs | in preadolescents (middle childhood- 13th birthday) |
| Prepubescence is the | 2 years preceding puberty |
| Prepubescence is when | gender differences emerge, can be difficult for kids a 9 yr old may develop but a 12 yr old has not |
| growth spurts and Prepubescence | girls especially have their growth spurts, boys have theirs 2yrs later |
| puberty ages | 9-12, as early as 8 and girls as late as 13 |
| Gross & Fine Motor Development Middle Childhood | Increasing coordination and strength, can climb |
| gross motor skills middle childhood | Bicycling, jumping rope, skating May become awkward- growth spurts and still adapting |
| fine motor skills middle childhood | Crafts, card games, board games, play instrument |
| Cognitive Development stage for middle childhood | Piaget- Concrete Operational Stage (7-11yrs) |
| during this cognitive stage, | they are developing perceptual thinking and problem solving based on reason |
| middle childhood children develop an understanding of | complex relations Classification into simultaneous categories - can sort Conservation, reversibility - mass doesn't change despite appearance |
| middle childhood children are able to | tell time, but are not thinking about the future |
| Communication and Language in middle childhood children | Learning to read Use of plurals and pronouns Enjoy jokes and riddles Metalinguistic awareness Understand metaphors Profanity and dirty jokes |
| Metalinguistic awareness | Understand double meanings and play on words |
| if middle childhood children are bilingual, | they'll speak english at school and native language at home |
| body image in school age development | Acutely aware of bodies and deviation Physical impairment- great importance Risk feeling inferior, less desirable |
| sexuality in school age development | Curiosity Sex education - encourage parents to talk to child, dispel myths, ANTICIPATORY EDU |
| at what age should sex ed be | end of school age, 10-12 yrs |
| Social Interaction Middle Childhood | Peer support becomes important Strong sense of belonging, desire to be liked and accepted Best friendships, frequently changing Often segregate by gender Bullying emerges |
| bullying emerges in middle childhood | teach parents to look for the signs and symptoms |
| Psychosocial Development: Middle Childhood Erikson 6-12 | Industry vs Inferiority children are eager to help and learn |
| industry | Mastery of social, physical, and academic skills Focus on peers and society the children need to see themselves as successful |
| inferiority | Doesn’t measure up to expectations of self, peers, and adults if taught that they don't live up to expectations |
| Moral Development- Kohlberg 6-7 year olds | Know expected rules and behaviors Don’t understand reasoning of the rules Behavior guided by rewards and punishment May interpret accidents/illness as punishment for bad behavior |
| Moral Development- Kohlberg 8-12 year olds | Judge act by intention, rather than only consequences How it would make others feel |
| middle childhood its normal to | lie and cheat |
| Cultural Influences on school age | School age children thrive on culture Music, language, tradition, holidays, games, values |
| biggest fear of school age | death of a loved one, things that are real |
| Play during Middle Childhood | Cooperative and competitive play Group activities, rules and standards Importance of both solitary and participatory activities |
| cooperative play is when | the kids are working towards a common goal |
| solitary (quiet) time is important because | school age can be bossy in beginning stages |
| activities for 6-9 year olds | board and number games, hopscotch, jump rope, collect things, ride bikes, build models, organized sports |
| activities for 9-12 year olds | crafts, build models, collect things, hobbies, jigsaw puzzles, board or card games, organized sports, musical instrument |
| Middle Childhood Anticipatory Guidance | School issues (achievement, bullying, positive peer relationships) Teach parents signs to look for in bullying |
| Healthy lifestyle behaviors in school age | nutrition & exercise - don't use food as reward tobacco, alcohol, street drugs - model good lifestyle |
| Sports and injury prevention/Accident prevention in school age | Helmets, car seat/seatbelt use Motor vehicle crash- most common cause of death >4 years |
| latch key kids | growing up coming home to empty house kids shouldn't be home alone until 10 have contingency plan |
| contingency plan | no phone, doorbell, don't say parents aren't home |
| School-Age Fears shift from | imaginary to real life |
| School-Age Fears | Natural disasters, being hurt, death of loved one Being kidnapped, having surgery May continue to fear dark |
| what to do for school age fears | acknowledge fear but don't give into it, overcome!! |
| Healthy People 2030 screen time | Increase the proportion of parents who follow AAP recommendations on limiting screen time for children aged 6 to 17 years 8-10 years less than 10hrs/day teens less than 11hrs/day |
| Adolescent Development age | 13 to around 18 years |
| Biological Development Adolescence | a time of change growth sequence body composition brain and rest |
| a time of change in adolescence | Adolescent growth spurt lasts about 4–5 years girls 10-15 and stops 2-2.5 years after period boys 11-16 and stops 18-20 |
| growth sequence in adolescence | Weight first, then height Girls (pre-pubertal) before boys (end of Mid-puberty) |
| body composition in adolescence | Full bone length, muscle mass & strength |
| brain and rest in adolescence | Neurohormonal releasing factors Increased need for sleep gonadotropins put kids into puberty |
| 2030 for brain and rest in adolescence | change school times |
| Sexual Development Adolescence: girls | Tanner: breast development, pubic hair Menarche ~2 years after breast development |
| what does breast development start with | bump under nipple, asymmetric and tender starts at 8-13 |
| Sexual Development Adolescence: boys | Tanner: pubic hair, penis, testes, scrotum changes Ejaculation ~1 year after penis lengthens Gynecomastia – early to mid puberty |
| first sign of Sexual Development Adolescence in boys | testicle enlargement, the penile hair starts around 9 and btwn 9-14 |
| Gynecomastia | breast development can be normal and goes away in 2 years unless overweight |
| Sexual Development Adolescence: both | Tanner staging: 5 stages, pre-adolescence to adult Precocious puberty Delayed puberty |
| Precocious puberty | starts puberty too soon girl before 8 and boy before 9 |
| Delayed puberty | delayed puberty girl after 13, boy after 14 |
| Cognitive Development Adolescence | Piaget- Formal operational stage (11-15 yrs.) |
| Piaget- Formal operational stage (11-15 yrs.) | Systematic and abstract thought - beginning to think about the future Appreciation of the hypothetical Future projection/orientation Pre-frontal cortex- last to develop (20 Yrs.) decision making |
| Adolescents think | they're invincible until their prefrontal cortex develops, fit in with others so they'll do dangerous things |
| Psychosocial Development: Adolescence Erikson 12-18 | Indentity vs role confusion |
| Identity | Coming to know self Establishing personal ideology |
| Role confusion | Unable to acquire a sense of self |
| 12-18 are obsessed with | fitting in which is where ED's come in |
| shaping identity | Group identity — peer influence: positive or risk-taking Individual identity Sex-role identity - finding a partner |
| group identity is the | 1st stage of adolescence getting individualize identity |
| Cultural influences | Differing views- permissive or conservative Rites of passage ceremonies |
| Health Promotion Adolescence | Nutrition Monitor for depression, self harm, substance abuse Teach monthly TSE and BSE Abstinence/ safe sexual practices Reinforce motor vehicle safety Piercings and Tattoos |
| Nutrition Adolescence | Obesity trend Eating disorders- anorexia and bulimia |
| Piercings and Tattoos | sterile |
| Healthy People 2030 | Reduce the proportion of students in grades 9-12 who report sunburn Increase proportion of high school students who get enough sleep Increase proportion of secondary schools with start time of 8:30am or later |
| Vaccine Hesitancy: The Trend | Vaccine hesitancy is rising Conflicting information |
| Vaccine hesitancy is rising | Loss of herd immunity Reemergence of measles and other vaccine-preventable diseases |
| Conflicting information | vaccines do not cause autism!! Government mandate, August 2026 - decrease # of vaccines for all children 11-18, Hep A&B, meningococcal, RSV Current CDC guidelines - decision parents make with PCP, 1 vax/visit, MMR into 3 shots and 3 appts |
| Childhood Vaccines: Evidence Based Benefit | Prevents serious disease, disability, and death Herd immunity protects infants and the immunocompromised Far lower risk than the disease it prevents Some diseases nearly eliminated in the U.S. |
| Childhood Vaccines: Evidence Based RIsk | Common: soreness, low-grade fever, fussiness Rare: severe allergic reaction (anaphylaxis) - epi available IM Contraindications must be screened Not linked to autism — extensively studied |
| bottom line in childhood vaccines | the risk of vaccine-preventable disease outweighs the risk of the vaccine. Screen, counsel, document. |
| documented risks of vaccines | Anaphylaxis/allergic reaction – agent vs. suspension medium Compromised immune function History of Intussusception or Severe Combined Immunodeficiency (SCID) History of seizures Moderate or severe illness |
| communications with hesitant parents | Provide accurate and user-friendly information - based on science Acknowledge parental concerns - ASK Avoid judgmental or threatening language Provide vaccine information statement (VIS) before vaccination Respect parents’ ultimate wishes |
| Immunizations | Pain management Administration Documentation Family teaching - side effects |
| Vaccines to protect baby: pregnant moms | Pertussis / whooping cough — Tdap each pregnancy (27th–36th week) - mother RSV (Abrysvo) — 32–36 weeks during pregnancy Flu |
| Vaccines to protect baby: caregivers and close contacts | Should be up to date on vaccines q 10 Tdap and Flu Timing — 2 weeks before meeting baby |
| Scheduling Takeaways Infancy — Hepatitis B | Given at birth or as soon as possible Most other vaccines start at 2 months |
| Scheduling Takeaways MMR & Varicella — live | Compromised immune system is a contraindication MMR is combined only; no single vaccines exist |
| Age limits to remember | Rotavirus: maximum age for 1st dose: 14 weeks 6 days MMR / Varicella: minimum age 12 months HPV: minimum age 9 years |
Created by:
leh195