Growth and Development

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Author:
servinggod247
ID:
292627
Filename:
Growth and Development
Updated:
2015-01-22 08:29:00
Tags:
pediatrics
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pediatrics
Description:
pediatrics
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  1. Growth=
    size
  2. development=
    activites and behavior
  3. Chronological age does not equal
    developmental age
  4. Cephalocaudal
    Occurs first

    Development from head down.

    control their head, then the trunk, then the legs, then the feet.
  5. Development occurs in ________ and ________ sequence
    sequential and orderly
  6. Proximodistal
    occurs second

    leading to more fine motor
  7. Differentiation
    Happens third

    simple to complex
  8. Neonatal period
    birth to 1 month
  9. neonatal wt
    6-8 lbs

    gains 5-7 ozs/week x 6 months
  10. neonatal ht
    20 in

    grows 1 in/mo x 6 months
  11. neonatal proportions
    head is 1/4 of body length

    top heavy with shorter extremities
  12. neonatal head circumferance
    33-35 cm

    greater than chest circumfrance
  13. Infancy period
    1-12 months
  14. infancy wt
    doubles birth wt in 5-6 months

    triples in 1 yr
  15. infancy ht
    increases by 50% by age 1
  16. infancy head growth
    RAPID!

    frontanels(soft spots) inspected and palpated for size, tenseness and pulsation 

    normal: soft, flat and ant pulsatile with sitting position
  17. POsterior fontanel closes by
    2-3 months
  18. Anterior fontanel closes by
    12-18 months

    Bigger

    Pulses

    • If it closes early- bad
    • if it closes after 18 months, bad, referred for eval
  19. Moro reflex
    • startle reflex
    • arms go out and flex
    • clap behind them to check for both hearing and moro reflex 
    • diminished by 4-6 months
  20. Tonic neck reflex
    When baby laying flat, if you turn their head left, right arm goes out straight and visa versa 

    diminished by 3-6 months
  21. Grasp reflex
    diminishes by 3 months
  22. Rooting reflex
    if you brush their cheek, they will turn head and open mouth 

    diminished by 4 months
  23. Babinski reflex
    If you press on bottom of foot, toes fan 

    • diminishes between 1-2 years
    • completely gone after walking
  24. head control around
    4 months 

    "head lag"
  25. rolling around
    4 months

    RISK FOR FALLS
  26. roll abdomen to back
    5 months
  27. Rolls back to abdomen
    6 months
  28. Sits alone without support
    8 months
  29. Stands holding furniture
    9 months
  30. Crawls with abdomen on floor
    10 months
  31. creeps with abdomen off floor
    11 months
  32. Cruises holding furniture
    10-12 months
  33. Walks well with one hand held
    12 months
  34. Iron fortified formulas used for bottle-feeding recommended for
    first 12 months if not breastfed
  35. NO solids before _____ to avoid
    6 months

    allergen exposure
  36. Solid number 1
    iron-fortified rice cereal at 4-6 months

    New foods added one at a time with at least 3 days between another
  37. Solid 2
    vegetables and fruits between 6-8 months
  38. after 6 months, 100% fruit juice limited to
    4-6 oz/day
  39. Citrus fruits, meat and eggs not untill after
    6 months
  40. Cooked chopped table food by
    9 months
  41. Crib safety: mattresses down and rails up with slats no more than
    2 3/8 in apart
  42. Falls safety
    watch after 3-4 months!

    Once they can roll they cannot be left on high surfaces without supervision
  43. Walker safety
    keep away from stairs
  44. Toddler
    1-3 years
  45. toddler wt
    at 30 months, 4 x birth wt
  46. toddler ht
    3 in/yr
  47. toddler head circ
    equals chest cir by 1-2 yo
  48. Object permanenc
    knowledge that an object or person continues to exist when not seen, heard or felt

    toddler age
  49. Ritualism
    • needed to maintain sameness and reliability 
    • provides sense of comfort

    toddler age
  50. approx 20 deciduous teeth by
    2.5-3 yrs
  51. No bottle to bed by
    toddler
  52. Growth and appetite slow in
    toddlers
  53. Toddlers are what type of eaters
    • picky
    • ritualistic
  54. Limit milk to what during toddler age
    less than 32 oz/day to prevent iron-deficiency
  55. feeds self completely by
    3 yo
  56. Toddler: childproof home environment
    stairways, cupboards, medicine cabinet, outlets
  57. Toddlers: aspiration/poisonings
    medications, store garage items out of reach
  58. No longer recommended to have _______ in home as anitidote for poisoning
    ipecac
  59. Infants play is
    solitary
  60. Toddler play
    • parallel 
    • Imitate adult in play 
    • Appropriate activities: blocks, wheel toys, push toys, puzzles, crayons
    • Enjoy repetitive stories and short songs with rhythm
  61. Piaget
    cognitive guide
  62. Sensorimotor
    • birth to 2 years
    • Learns through senses and motor activity 
    • Develops sense of "cause and effect"
    • Language helps to better understand world
    • Curiousity, experimentation, exploration results in learning
    • Object permanence fully developed
  63. Erikson
    psychosocial development
  64. TRUST VS MISTRUST (Erikson)
    • birth to 1 year
    • Task of first year is to establish trust in people providing care
    • Mistrust develops if basic needs are inconsistently or inadequately met
  65. AUTONOMY VS. SHAME AND DOUBT (Erikson)
    1-3 years

    • Increased ability to control self and environment
    • New physical skills lead to autonomy
    • Symbolizes independence by controlling body secretions (toilet training, urge to use bathroom)
    • Say "no" when asked to do something
    • Self-confidene and willpower if successful
    • Sense of shame and doubt result from criticism or being unsuccessful
    • Discipline should be consistent with well-defined boundaries
  66. Unpredictable routine causes
    distrust
  67. Seperation anxiety
    • between 6-30 months
    • peaks around 15 months
  68. Stages of seperation anxiety
    • protest: appears sad, agitated, angry, inconsolable, watches desperately for parents to return 
    • despair: appears sad, hopeless, withdrawn, acts ambivalent when parents return
    • detachment: appears happy, interested in environment. Becomes attached to caregivers, may ignore parents
  69. Seperation anxiety interventions
    • preserve trust
    • reassure that parents will return
    • "rooming in" (parents stay 24/7)
    • personal articles, picture, favorite toy
    • maintain usual routine
    • allow choices WHEN POSSIBLE
  70. Responses to pain:
    • Infants will increases BP and HR and decrease in O2 sat
    • Harsh, tense, loud crying
    • Facial grimacing, flinching, thrashing extremities
    • Toddlers verbalize with generalized restlessness, uncooperative, clings to family member
    • Regression: use behavior that is more appropriate to earlier stage of development; used to cope with anxiety or stress
  71. Regression
    use behavior that is more appropriate to earlier stage of development; used to cope with anxiety or stress

    result is lack of control, toddler may become frustrated, returns to bottle, temper tantrums, incontinence

    Help parents understand and avoid punishment
  72. If a baby is getting frequent heel sticks, how can they be consoled?
    sucrose pacifier

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