Module 6,7,8
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| What is growth? | physiologic increase in size
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| What is development? | Psychological, physiological, cognitive changes during life span
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| Biologic infant milestone (0-3mos) | Sleeps a lot, improved head lag, head support in prone position
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| Biologic infant milestone (3-6mos) | Improved head control, Posterior fontanel closes (2mos), Grasping, Sitting w/out support, rolls abd-back, 2x BIRTH WEIGHT (6mos), Teething, Social smile (2-5mos)
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| Biologic infant milestone (6-9mos) | Sits without support, rolls back-abd, scoots, pull up to walk, pincer grasp, Object Permanence
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| Biologic infant milestone (9-12mos) | crawls, stands, may walk, 3x BIRTH WEIGHT, imitates expressions, first words
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| Biologic Toddler milestone (1-3yrs) | Growth slows, anterior fontanel closes (15-18mos), head proportional, fine motor skills improve, bones lengthen/straighten, walk (15mos), climbs (18mos)
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| Biologic Preschooler milestone (3-5yrs) | slow growth, body systems control, hop/skip/jump, tricycle, improved fine motor, dresses self
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| Biologic School-age milestone (6-12yrs) | Steady, physical growth, inc. skeletal growth, Inc/strengthening muscles, improving motor skills
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| Biologic Adolescent milestone (13-18+yrs) | Puberty, growth spurt
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| Key to Erikson's Psychosocial development | Inter-relationship between emotional/ physical variables, conflict resolution stages
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| Key to Piaget's Cognitive development | Shaped by actions/consequences, follows orderly progression
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| Psychosocial developement - Infancy (birth - 1 1/2yrs) | TRUST VS MISTRUST - basic needs met, Stranger/ Separation Anxiety (6mos - 3yrs)
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| Psychosocial developement - Toddler (1 1/2 - 3yrs) | AUTONOMY VS SHAME/DOUBT - sense of control, "no", ritualism, parallel play
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| Psychosocial developement - Preschooler (3 - 6yrs) | INITIATIVE VS GUILT - behavior goal-directed and imaginative, criticism = guilt
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| Psychosocial developement - School-Age (6 - 12yrs) | INDUSTRY VS INFERIORITY - mastery of skills (fosters self esteem), rules important, predictability
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| Psychosocial developement - Adolescent(12 - 21yrs) | IDENTITIY VS ROLE CONFUSION - egocentric, peers important, independence from parents
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| Piaget's Cognitive development Period 1 (birth - 2yrs) | SENSORIMOTOR PERIOD - reflexive-intentional behavior, egocentric, Object Permanence
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| Piaget's Cognitive development Period 2 (3-7yrs) | PRE-OPERATIONAL - magical thinking, animism, NO reversibility, thoughts cause actions
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| Piaget's Cognitive development Period 3 (7-11yrs) | CONCRETE OPERATIONS - systematic/logical, fact from fantasy, sense of time, transductive reasoning (cause/effect), reversibility
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| Piaget's Cognitive development Period 4 (11yrs-adult) | FORMAL OPERATIONS - abstract thinking, analytical, new ideas
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| What hinders advancing to Piaget's Formal operations stage? | poor comprehension, lack of education, learning disabilities, substance abuse
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| Different screenings throughout childhood | Apgar, newborn, lead, vision/hearing, scoliosis
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| What do well child check-ups check for? | Height, weight, head circumference
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| How long do infants need breastmilk or Fe-fortified formula? | 12mos
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| When should infants start to eat solids? Progression? | 4-6mos; rice cereal--> veggies--> fruits--> meats
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| When can infants start finger foods? Restrictions? | 8+mos; nuts, raisins, hot dogs, peanut butter, raw honey
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| When do Toddlers need whole milk? | 1-2yrs
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| What should the daily intake of milk be for toddler? why? | 16-24oz; so they can eat other food as well
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| Key to nutrition for pre-schooler? | Establish good eating habits/schedule
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| Keys to nutrition for school age children? | Inc. appetite, busy schedule = rush eating to play, independent food choices
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| Keys to nutrition for adolescents? | Growth--> inc. protein, Fe, Ca needs (especially for athletes), appearance and peer acceptance
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| What concepts contribute to childhood obesity? | Genetic influence AND environmental exposure
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| Cardio affects of obesity? | HTN, CAD, Lt ventricle hypertrophy, dyslipidemia, MI, stroke
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| Respiratory affects of obesity? | Asthma, PE, enlarged tonsils/adenoids, sleep apnea
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| Endocrine affects of obesity? | IDDM, insulin resistance, Polycystic Ovarian syndrome
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| GI affects of obesity? | Steatohepatitis (fatty liver), cirrhosis, gall bladder disease (cholecystitis)
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| Acanthosis nigricans | Hyperpigmentation d/t insulin resistance in axilla or back of neck
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| AAP prevention of childhood obesity 5-2-1-0 | 5 servings fruit/vegs, <2hrs screen time, 1+hrs phys activity, 0 sugared bevs
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| Psychosocial affects of obesity? | Depression, social isolation, anxiety, poor self-esteem, bullying, suicidal, eating d/o, discrimination
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| Why are childhood immunizations given? | Primary prevention of many communicable diseases
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| what are live, attenuated vaccines? examples? | Weakened form of disease; MMR, Varicella, Nasal flu vaccine
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| what are inactivated vaccines? examples? | killed/synthetic bacteria/virus; DTaP, Polio (IPV), HepB
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| How long to attenuated vaccines last? | 20+ years for single dose
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| Disadvantage of inactivated vaccine? | Need frequent boosters
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| Disadvantage of attenuated vaccines? | Can't give to immunocompromised (can give inactivated vacc)
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| When is HepB vaccine given (hint: 3stages) | birth--> 1-2mos--> 6-18mos
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| What is RV vaccine? When given? | Rotavirus vaccine against severe diarrhea; given @ 2,4,6mos
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| what is DTaP vaccine? When given? | Diptheria (resp dz that causes paralysis, heart failure, death), Tetanus (lockjaw; causes muscle spasms & death), Pertussis (whooping cough); given @ 2,4,6, 15-18mos, and 4-6yrs
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| what is Hib vaccine? When given? | Haemophilus influenzae type B (can cause illnesses that affect brain, lungs, and bones or joints); given @ 2,4,6, & 12-15mos
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| Difference between DTaP and Tdap? | DTaP for <7yrs old; Tdap for 8+yrs old
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| what is PCV vaccine? When given? | Pneumococcal Conjugate Vaccine (against bacteria that causes PNA); given @ 2,4,6, 12-15mos
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| what is IPV vaccine? When given? | Inactivated Polio Vaccine (against Poliomyelitis virus that causes inflammation of spinal cord that leads to paralysis/death); given @ 2,4,6-18mos, 4-6yrs
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| what is MMR vaccine? When given? | Measles, Mumps, Rubella attenuated vaccine given @ 12-15mos & 4-6yrs
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| what is Varicella vaccine? When given? | Chicken Pox attenuated vaccine given @ 12-15mos & 4-6yrs
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| When is HepA vaccine given? | Given in 2 doses between 12-24mos
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| When is flu shot given? Key thing to know? | Yearly starting at 6mos; if 1st time between 6mos-8yrs, given in 2 doses, 4 wks apart; if only 1 dose given, next season, give 2 doses
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| What if vaccine is missed? | Provider will catch up with next vaccination with first dose
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| Contraindications for vaccinations? | Immunocompromised (oncology pts, chronic steroid meds), allergies, illness, pregnancy
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| What immunizations can be given at 2mos? | HepB, RV, DTaP, Hib, PCV, IPV
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| What immunizations can be given at 4mos? | RV, DTaP, Hib, PCV, IPV
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| What immunizations can be given at 6mos? | HepB, RV, DTaP, Hib, PCV, IPV, flu shot
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| What immunizations can be given at 12mos? | HepB, Hib, PCV, IPV, flu shot, MMR, Varicella, HepA
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| What immunizations can be given at 4-6yrs? | DTaP, IPV, flu shot, MMR, Varicella
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| What allergies can contraindicate vaccine to be given? | allergy to eggs, poultry, latex, gelatin, neomycin
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| Vaccine site for infants/children? | Vastus lateralis
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| When to call healthcare provider after vaccine? | High fever over night (>100.5F), Bx changes, severe adverse reaction
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| #1 injury for infants? | Scalding burns
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| How to prevent scalding burns in bath tubs? | Adjust thermostat on water heater
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| Leading causes of injuries for toddlers? | Drownings and burns
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| When should 1st dental exam be done? | 3yrs old
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| What to know about water? | need fluoride supplements if drinking water <0.7ppm
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| Leading cause of death for School age children? | Accidents
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| Leading cause of injury for adolescents? | MVA, firearm accidents, sports
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| When is deceased diagnosed as SIDS? | autopsy is inconclusive
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| When does SIDS usually occur? what time of year? to who? | 95% before 6mos; peak at 2-4mos; more in winter; preemies/low birth wt babies
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| #1 intervention for SIDS? | Supine sleeping; "back to bed"
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| Where is Pb absorbed? | Thru GI, accumulates in bones, teeth, brain, kidneys
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| Acceptable Pb level? when needed to treat? | <10mcg/dl; must treat >20mcg/dl
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| What does Pb poisoning lead to? | Pb absorbed into bones instead of Ca and breaks down RBCs, = Anemia (dec H&H)
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| How is Pb poisoning treated? | EDTA chelating agent given IV that absorbs Pb out of bones back into blood and excreted thru kidneys
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| When possible poisoning, first questions? | 1. What was it? 2. When did it happen?
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| If bolus is ordered for unknown poisoning, what fluid used? why? | NS, because other fluids can alter labs and may cause reaction
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| How does activated charcoal help in poisoning? | absorbs agent and expels thru GI
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| When/What age do you usually see Separation Anxiety? 3 phases? | Infancy to pre-school age (6mos - 4yrs); Protest, Despair, Detachment
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| Child concept of death by age? | Infant= none; Preschool= temporary separation; School-age= sad,irreversible; Adolescent= inevitable, irreversible, distant
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| Most common type of child abuse? | Neglect (then physical, sexual [usually not reported], psycho, medical, other)
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| Most common trigger for Shaken Baby Syndrome? What's it lead to? | Crying; leads to whiplash induced intracranial/retinal bleed
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| What are pregnant teens at an increased risk for? | Pre-eclampsia, CPD, preterm labor/birth, low birthweight, depression
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| Lack of growth and development leads to what? | Failure to Thrive - decline on growth curve in ht/wt
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| Organic, physical factors of Failure to thrive? | GI d/o, cardiac, chronic infxns, endocrine d/o, metab d/o
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| Inorganic, psychosocial factors of Failure to thrive? | Poverty, poor social support, family stress, inadeq nutrition, diff bonding, maternal depression
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| Failure to thrive interventions? | treat cause, multidisciplinary, observe, MONITOR HT/WT,I&O, teach, referrals
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| What is neonatal sepsis? | Viral or bacterial infection of the blood in newborn
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| #1 cause of Neonatal Sepsis? | Group beta streptococcus
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| Labs/Diagnostic tests for Neonatal sepsis? | Urine, CSF, and Blood test
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| Blood tests in Neonatal sepsis? | CBC w/ diff, CRP, ESR, Bands
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| What is CSF panel looking for in neonatal sepsis? | Elev. WBC, low glucose
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| Common problems w/ Downs Syndrome? | Cardiac problems, pyloric stenosis, hypothyroid, compromised immunity, sensitive skin, audio/visual impairment
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| Clinical manifestations of Down's syndrome? | Low set ears, protruding tongue, hypotonia, simian crease, inner epicanthial folds, short,broad neck, wide, flat nasal bridge
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| Otitis Media? How treated? | Inflammation of MIDDLE ear; oral antibiotics
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| How is child's eustachian tube different from adults which leads to more Otitis media infections? | child's is more horizontal and shorter
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| S/S of Otitis media? | DIFFICULTY FEEDING/SUCKING, pain, pulling at ears, fever, irritability, ear drainage
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| What is OME? | Otitis media w/ effusion; middle ear inflammation w/ fluid behind tympanic membrane
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| What can chronic otitis media lead to? Usually at what age? | can lead to hearing loss and delayed speech; older than 3mos
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| What is myringotomy w/ PE? | Inserting pressure equalizing tubes to treat frequent otitis media infections
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| what may be needed for chronic OM? | audiologist referral
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| Treatment for varicella? | Acyclovir IV, fever mgmt, skin care, comfort measures
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| When can kid w/ chicken pox go back to school? | After all vesicles are crusted over
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| What is Roseola? | Virus that causes fever, then rosy pink macular rash to trunk that lasts a week in 6-18mos old
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| 3 stages of pertussis? Complication? | Catarrhal (URI symptoms), Paroxysmal (cyanosis; whopping cough), Convalescent (less coughs); PNA
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| What is impetigo? Complication? | Superficial bacterial infection; cellulitis
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| 3 Cs of Rubeola? | Coriza (runny nose), Cough, Conjunctivitis
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