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113 Cards in this Set
- Front
- Back
Birth - 6 months growth
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Doubles birth weight, grows 1" per month (2.5cm/month)
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6-12months growth
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Birthweight triples by end of first year.
Height 0.5"/month |
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Toddlers Growth
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BW quadruples by age 2.5
Height is 50% of adult height by age 2 |
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Preschoolers Growth
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Yearly gain of 2-3 kg(4.5-5.5 lbs/year)
Height: 2-3"/year |
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School Age Children
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Weight 2-3kg/year
Height 2" (5cm)/year |
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Pubertal Growth Spurt
Females |
10-14 years
Mean weight gain of 38 1/4lbs Height 2-10"/4 years Approx 95% of adult height by onset of menarche (approx age 13) |
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Pubertal Growth Spurt
Males |
11-16 years
Weight: 15 1/4lbs Height: 4-12" 95% mature height by 15 years |
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Adrenarche
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appearance of pubic hair
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Gynecomastia
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breast enlargement and tenderness in males
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Menarche
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onset of menses in girls
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Physiologic Leukorrhea
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an increase in normal vaginal discharge occuring in early puberty
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Pubertal Growth Spurt
Females |
10-14 years
Mean weight gain of 38 1/4lbs Height 2-10"/4 years Approx 95% of adult height by onset of menarche (approx age 13) |
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Tanner staging- Females
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Stage I: No signs of breast changes or pubic hair
Stage II: Small breast buds with enlargement of the areola & dark, straight pubic hair Stage III: Increase of breast & areola areas; Coarse, curly pubic hair Stage IV: Secondary mound occurs in the breast at the areola; Pubic hair is adult like Stage V: Breast buds now mature; Pubic hair adult-like. |
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Pubertal Growth Spurt
Males |
11-16 years
Weight: 15 1/4lbs Height: 4-12" 95% mature height by 15 years |
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Tanner staging-Males
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Stage I: No pubic hair or changes in genitals
Stage II: Initial enlargement of the scrotum & testicles with reddening & textural change in scrotum; fine, straight hair at base of penis Stage III: Further enlargement of penis with continued changes in scrotum; Pubic hair darker & coarser & extends across pubis Stage IV: Penis continues to grow in diameter with development of glans larger & broader; Hair curly & more abundant; scrotum darker Stage V: Adult appearance |
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Adrenarche
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appearance of pubic hair
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Birth to 1 year Developmental
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Role of primary care givers significant
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Gynecomastia
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breast enlargement and tenderness in males
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Early childhood development
1-6 years Toddler 1-3 Preschool 3-6 |
Characterized by intense activity, curiosity and discovery.
*Acquire language and social skills Begin to develop self-concept *Increasing awareness of dependence & independence *Gaining self-control and mastery imp! |
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Menarche
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onset of menses in girls
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Physiologic Leukorrhea
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an increase in normal vaginal discharge occuring in early puberty
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Tanner staging- Females
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Stage I: No signs of breast changes or pubic hair
Stage II: Small breast buds with enlargement of the areola & dark, straight pubic hair Stage III: Increase of breast & areola areas; Coarse, curly pubic hair Stage IV: Secondary mound occurs in the breast at the areola; Pubic hair is adult like Stage V: Breast buds now mature; Pubic hair adult-like. |
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Tanner staging-Males
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Stage I: No pubic hair or changes in genitals
Stage II: Initial enlargement of the scrotum & testicles with reddening & textural change in scrotum; fine, straight hair at base of penis Stage III: Further enlargement of penis with continued changes in scrotum; Pubic hair darker & coarser & extends across pubis Stage IV: Penis continues to grow in diameter with development of glans larger & broader; Hair curly & more abundant; scrotum darker Stage V: Adult appearance |
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Birth to 1 year Developmental
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Role of primary care givers significant
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Early childhood development
1-6 years Toddler 1-3 Preschool 3-6 |
Characterized by intense activity, curiosity and discovery.
*Acquire language and social skills Begin to develop self-concept *Increasing awareness of dependence & independence *Gaining self-control and mastery imp! |
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Middle childhood 6-11 years
Developmental age periods |
Frequently referred to as “school age”
*Child is directed away from the family group towards activities with peers *Interested in developing skill competencies *Moral development begins to have relevance for later life stages |
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Later childhood 11-19 years
Pre-pubertal: 11 to 13 Adolescence: 13 to 18 |
Tumultuous transitional period of rapid changes
*Early years focus on group identity. *Later years focus on individual identity. In late adolescence, the young person begins to internalize all previously learned values |
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Trust vs Mistrust
Eriksons Theory of Psychosocial development |
Age: birth to 1 year
*Positive resolution: *Learns to trust others Achieved through consistency of care from the caregivers |
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Autonomy vs Shame and doubt
Eriksons Theory of Psychosocial development |
Age: 1 to 3 yrs.
*Positive resolution: *Learns self control without loss of self-esteem. The ability to cooperate. Shame develops when child’s attempts are unsuccessful or when he/she is forced to be dependent |
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Initiative vs Guilt
Eriksons Theory of Psychosocial development |
Age: 3 to 6 years
*Positive resolution: *Learns the degree to which assertiveness & purpose influence their environment. Learning to evaluate own behavior. Developing conscience. Discipline without shaming is important |
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Industry vs. Inferiority:School Age
Eriksons Theory of Psychosocial development |
Age: 6 to 12 yrs.
*Positive resolution: *Develops a sense of competence and perseverance. Focus of stage is achievement & accomplishment. Learns to compete, to cooperate, & to follow rules. Setting goals that are too high causes child to develop sense of inadequacy |
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Identity vs. Role Confusion: Adolescence
Eriksons Theory of Psychosocial development |
Age: 12 to 20 yrs.
*Positive resolution: *Develops coherent sense of self *Able to actualize one’s abilities. *Focus on appearance *Preoccupation with peer acceptance. Develop own values within their own culture. Late in stage become focused on choice of occupation. |
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Cognitive development:
Piaget |
Cognitive development:
Consists of age-related changes that occur in mental activities Piaget’s theory the most respected in this area |
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Piaget
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Basic concepts:
Intelligence is what enables an individual to adapt to their environment in ways that increase their chance of survival Through intelligent behavior, individuals establish & maintain equilibrium with their environment |
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Piaget's stages
* Sensorimotor: Birth to 2 yrs |
Progress from reflexive behavior & simple repetition of behaviors through imitation of behavior.
Develops a sense of cause & effect through trial and error. Rituals are important. Uses simple language efficiently at end. |
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Piaget's Stages
Pre-Operational: Pre-Conceptual Thought: 2 to 4 yrs |
Egocentrism: an inability to perceive the point of view of another. “It is ALL about me!”
Thinking is concrete. Cannot reason beyond the observable. Engage in fantasy and can have difficulty differentiating the fantasy from the real world |
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Piaget's Stages
Preoperational:Intuitive Thought Phase: 4 to 7 yrs |
Egocentrism diminishes
Includes others in the environment Thinks of one idea at a a time Words express thoughts well |
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Piaget's Stages
Concrete Operations:7 to 11 yrs |
Logic is beginning to emerge.
Can solve concrete problems. Able to classify & sort information Helps them problem solve Love to collect things… Less egocentric Can consider another’s point of view |
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Piaget's Stages
Formal Operations: 11 to 15 yrs. |
Can now think in abstract terms and resolve conflict
They can make hypotheses and test them Idealistic: “It’s not fair!” Difficult time with injustice |
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Kohlberg Theory of Moral Development
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*3 Stages:
Preconventional level Conventional level Postconventional level |
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Kohlberg Theory of Moral Development
Preconventional Level |
1 to 7 yrs
Determine goodness or badness of a behavior in terms of it’s consequences Avoidance of punishment is always the goal |
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Kohlberg Theory of Moral Development
Conventional Level |
7-11 years
Concerned with loyalty to family and peers. *“Good boy/good girl” orientation Behavior that meets with approval and pleases or helps others is considered to be good |
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Kohlberg Theory of Moral Development
Post Conventional |
11-15 years
Correct behavior now defined in terms of individual rights and societal standards “It’s not fair!” Interested in the possibility of changing standards Very idealistic |
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Infancy
Developmental Age Period: Infancy (Birth to 12 months) |
Erikson: Trust vs. mistrust
Piaget: Sensorimotor Kohlberg: No stage applies |
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Toddlers
Developmental Age Period: Early Childhood Toddler 1-3 yrs |
Erikson: Autonomy vs. shame & doubt
Piaget: Sensorimotor to Preoperational (preconceptual thought phase) Kohlberg: Preconventional |
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Preschool
Developmental Age Period: Early Childhood (Preschool 3-6 yrs.) |
Erikson: Initiative vs. guilt
Piaget: Preoperational thought continues (intuitive thought phase) Kohlberg: Pre-conventional |
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School Age
Developmental Age Period: Middle Childhood (6- app. 11 yrs.) |
Erikson: Industry vs. inferiority stage
Piaget: Concrete operations Kohlberg: Conventional |
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Adolescence
Developmental Age Period: Later Childhood Prepubertal: 11-13 Adolescence: 13-18 |
Erikson: Identity vs. role confusion
Piaget: Formal operations Kohlberg: Post-conventional |
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Nutrition
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The single greatest influence on growth & development!!
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Poverty
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A more powerful influence on child health & wellness than ethnicity or education!!!!!!
Remember the difference! |
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Heredity
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Intelligence determines your ability to learn
All 3 determine how the world interacts with you, as well as how you interact with the world “Beauty & the Geek”… how has the physical beauty, intelligence and/or personality of each of these individuals affected their individual development? Directs the pattern of physical growth Directs the behavior of others towards us: Role Identity Gender Identity |
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Socioeconomic Level
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At all ages, children from upper and middle class families are taller than comparative children of families in the lower socioeconomic strata
School achievement is consistently less for children falling under poverty guidelines |
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Interpersonal Relationships:
Emotional deprivation |
Old study on homeless infants in institution. Infants who did not receive consistent nurturing care :
Failed to gain weight even with an adequate diet Were pale listless, and immobile Were unresponsive to stimuli that usually would elicit a response such as smiling or cooing in normal infant |
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Types of Screening Tools
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Denver Developmental Screening Test (DDST-II)
Quick, easy, accurate & objective results when done by trained administrator of test. Parents Evaluation of Developmental Status (PEDS) A parental self report-> errors! Early Language Milestone Scale (ELMS) Batelle Developmental Inventory For full eval. Excellent, but requires hours to administer |
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Depression Medication: Response to meds varies in kids
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Many issues the same as adult anti-depression meds
SSRI’s: Fluoxetine (Prozac) the only drug FDA approved for depression in children, but many others used Sertraline (Zoloft) used Celexa, Lexapro used in adolescents NO PAXIL: (Increased Suicide risk) |
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Bipolar NOS
as well as genetics |
The diagnosis of Bipolar NOS has increased X 40 in the last 10 yrs.
If one parent has bipolar disorder, the risk to child is 15-30% If both parents have bipolar disorder, the risk is 50-75% In identical twins, if one has it, the other has a 70% likelihood of having it, too |
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Bipolar Disorder In Kids
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*Different from adults…
*Ongoing continuous mood disturbance that is a mix of mania and depression *Rapid and severe cycling between moods produces chronic irritability**** Extreme elevation of mood or extreme irritability Laughing uncontrollably at things no one else finds funny Mad over nothing Decreased ability to concentrate Racing speech & pressure to keep talking Risky activities & poor judgment |
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Bipolar DisorderMedication
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Lithium is the ONLY medication currently approved by the FDA for mania in adolescents (12 yrs and older)
Because lithium has a NARROW therapeutic index, blood level monitoring is required to avoid toxicity. Significant Adverse RXNS: Cardiac dysrhythmia, tremor, sedation, blurred vision |
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Suicide in children
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Prevalence in Children:
Children ages 10 to 14 — 0.9 per 100,000 Adolescents ages 15 to 19 — 6.9 per 100,000 Nearly five times as many males as females ages 15 to 19 died by suicide. |
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Suicide in Teens
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When there is a hand gun in the house, the teen is six times more likely to commit suicide
Substance overdose (83%), self-inflicted laceration, and hanging are the most common means used in teen suicide Tends to happen in “clusters” |
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Suicide in Teens: Risk factors
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Substance abuse
Child abuse Recent suicide in school Chronic conflict with parent Poor communication and coping skills Depression History of being bullied Social isolation Access to weapons |
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Suicide: What to do
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Talk with them about it.
Don’t be afraid to ask if they are contemplating suicide… People often think they will “plant the idea”…false If no one talks to them, it leaves the child locked into their dark world without others to discuss problems with. Bringing the thought out into the open can expose it for the “false fix” that it is. |
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Oppositional Defiant Disorder (ODD)
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DSM-IV: ODD is characterized by *two different sets of problems*:
Aggressiveness A tendency to purposefully bother and irritate others. |
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ODD DSM-IV Definition
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A pattern of negativistic, hostile, and defiant behavior lasting at least six months, during which at least 4 of the following are present:
OFTEN loses temper OFTEN argues with adults OFTEN actively defies to comply with rules OFTEN blames others OFTEN touchy OFTEN angry and resentful OFTEN spiteful and vindictive *Each concept is defined in concrete terms |
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ADHD
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Is inherited...several genes are implicated. Now viewed as a neuro-developmental disorder rather than a behavioral disorder. IT IS SO IMPORTANT TO BE THE CHILD’S INFORMED ADVOCATE IF THEY HAVE ADHD!
Teachers dislike them! Parents are afraid of the medications. Other kids isolate them! They can be helped! |
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Failure to thrive
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Organic vs. non-organic: important
Organic = there is a real physical reason within the child that makes the child unable to absorb calories for growth Non-organic = they are just not being fed enough… unable to obtain calories for growth |
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Failure to thrive - Factors
AND Tx |
Organic
Cerebral Palsy, GERD, metabolic disorder Non-Organic Maternal child attachment disorder Poverty Lack of knowledge Insufficient breast milk Tx? Find the cause!! |
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HOW MUCH IS ENOUGH??
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Newborn: Needs 24 oz/24 hrs.
This increases to 32 oz/24 hrs. by 4-6 months From 9-12 months, taking on more calories from table foods, but formula needs remain >24 oz/24 hr day |
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Downs Syndrome
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The most common chromosomal abnormality, occurring in 1/800-1000 live births
Attributed to an extra chromosome 21; called Trisomy 21 Usually diagnosed @ birth. |
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Downs Syndrome- serious chronic problems
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Congenital heart defects
Hypotonicity of muscles, including the chest muscles Increased resp. infections Narrower nose & airway passages Immune system dysfunction Hearing defects (75%) Congenital hypothyroidism Increased incidence of leukemia |
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Downs Syndrome- Characteristics
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Smaller stature
Slower mental development Delayed language & walking Flattening of the back of the head Almond shade eyes with one lid a little droopy Poor Vision Depressed nasal bridge Smaller ears, lower set Small mouth and jaw with large tongue Decreased muscle tone Loose ligaments Transverse palmar crease, curved little fingers Small hands and feet with gap between 1 and 2 toe |
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Working With Families With A Downs Child
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Emphasize the positive…Delightful affectionate children
Monitor respiratory status, development & growth closely Make appropriate referrals to spec |
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Autism & Autism Spectrum Disorders
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Autism is now viewed as a group of disorders that are linked by significant developmental delays.
It is now spoken of as “on the spectrum”, meaning there is a variety of disorders that fall into this category. Many research dollars are currently dedicated to research of ASD’s. Autism is now viewed as a group of disorders that are linked by significant developmental delays. It is now spoken of as “on the spectrum”, meaning there is a variety of disorders that fall into this category. Many research dollars are currently dedicated to research of ASD’s. |
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Autism Spectrum Disorders
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Autism
Aspergers Syndrome Rett’s Disorder Pervasive Developmental Disorder |
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Dx of Autism
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DSM-IV Criteria: At least 8 out of 16 identifying characteristics must be positively identified (See ATI)
**However, 3 general categories of impairment: Marked impairment in social interaction Restricted or repetitive behavior Delay in or total lack of verbal communication |
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S&S of Autism
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Lack of interest in touch or cuddling
Violent reactions to attempts of physical closeness Blank response and lack of expression to verbal stimulation No fear of separation from parents Severe tantrums Fascination in strange repetitive behaviors and rituals Self destructive acts such as hand biting and head banging Slow speech development Echolalia Retreats in own world |
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Nutritional Issues:
Autism |
More than half of children with struggle with problem eating behaviors, including
Selective or obsessive eating Insistence on specific nonfunctional mealtime routines Oral aversion |
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Sleep Issues
Autism |
Children with autism are more likely (prevalence between 44 and 83%) to have sleep disturbances, including:
Trouble with sleep latency (falling asleep) Sleep maintenance (staying asleep) |
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Dx and Tx
Autism |
Diagnosis
Complete neurological exam Developmental tests of speech, intelligence & behavior Treatment Therapy can help! Reassure parents by telling them that early intensive behavioral or developmental interventions are effective |
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Asperger Syndrome
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May be seen as children who are “normal, but different”
Frequently accompanied by tic disorders, attention problems, & mood disorders Core Symptoms Social deficits… can’t maintain friendships Just don’t understand the “rules” of social interaction, such as personal space, eye contact & initiating & terminating interactions Flat or inappropriate affect Lack empathy Peers find them to be overly rule governed |
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Asperger Syndrome: OCD
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Display rigid behavior & become distressed when a routine is interrupted
Becomes upset when mom drives home from school a different way |
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Distinguishing Features of AS
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*Restricted Interests: Fact based
EX: Excessive interest in dinosaurs, computers… *Language: Odd Patterns Vocabulary may be advanced but odd *Motor Abilities: Clumsy & poor coordination *Presentation: Friendship problems after 3 yrs. *Gender Ratio: Male:Female ratio is 15:1 *Prognosis: Educational outcomes better |
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Aspergers syndrome: Note about restricted interests
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One isolated & obsessive area of interest in which they are immersed; i.e. math, science, computers…
More rote than meaning Repetitive adherence to rules |
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Rett’s DisorderAnother one of the autism spectrum disorders
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Less common than autism or asperger
*Occurs almost exclusively in girls *Development starts off normally and then regresses Impairment in social skills & communication begins Non-purposeful hand movements begin to appear A gene on the X chromosome was recently discovered |
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Pervasive Developmental Disorder(NOS)
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Children with significant delay in ALL functions…
Language Fine Motor Gross Motor Personal/social Emotional Intellectual |
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Heart Rates
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Newborn: 100-160
Infant: 80-100 School age child: 70-115 Adolescent: 65-105 |
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Murmur: Intensity Grading
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Grade I… Barely audible
Grade II… Soft but easily heard Grade III… Moderately loud but no thrill Grade IV… Louder with a thrill Grade V… Audible with the stethoscope barely on the chest; thrill detectable Grade VI… Audible with the stethoscope off the chest; thrill detectable |
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Polio
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Before Immunizations:
50,000 cases of polio per year in US alone After Immunizations: NO POLIO IN WESTERN HEMISPHERE |
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Smallpox
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WHO declared it eradicated in 1980 after immunizations given.
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Haemophilus Influenzae Type b Meningitis
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Before Immunizations:
Most common cause of bact. men. in infants/children US Affected 1/200 children under age 5 Killed 1/600 HIB Meningitis... After Immunizations: Incidence has declined by 98%! 1994-1998, fewer than 10 fatal cases Few new pediatricians/ARNP’s have ever seen it |
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Current Immunizations: 2011Recommended by age 7
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5 doses of diptheria vaccine
5 doses of tetanus vaccine 5 doses of pertussis vaccine 4 doses of Hib vaccine 4 doses of pneumococcal vaccine 4 doses of injectible polio vaccine 2 doses of measles vaccine 2 doses of mumps vaccine 2 doses of rubella vaccine 3 doses of hep B vaccine 2 doses of hep A vaccine 2 dose of varicella (chicken pox vaccine) 3 doses of rotavirus vaccine (an oral vaccine) Yearly influenza vaccine after 6 mos of age… live nasal form now approved for kids as young as 2 yrs. |
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Current Immunizations:2011
Recommended 7-18 years |
1 TDaP vaccine
3 HPV4 vaccines New last year: Males now take the vaccine 1 meningococcal vaccine Yearly influenza |
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Diptheria…
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Skin lesions, Bull Neck, Airway Swelling
An acute infection of the upper respiratory tract caused by a toxin-producing bacteria Toxin is absorbed into the mucous membranes-forms a grayish color to tonsils, pharynx, or larynx. May result in injury to heart muscle, liver, kidneys Causes inflammatory response with…airway swelling!!!!! Schedule: 2 mos, 4 mos, 6 mos, 15-18 mos, 4-6 yrs Required for kindergarten entry in Ks. 1 booster @ 11-12 yrs (Tdap) |
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Tetanus
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Caused by a bacilli that produces a neurotoxin following contamination of a wound by soil with animal manure or animal bite
Toxin reaches the CNS & results in intense, often fatal, muscle contractions then paralysis. Pt. remain fully conscious & lucid as paralysis progresses… Schedule: Same as diptheria REQUIRED for kindergarten entry in KS. 1st booster @ 11-12 |
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Pertussis (Whooping cough)
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Highly contagious infection of the respiratory tract
Characterized by severe bronchitis and/or bronchiolitis with a “whoop” cough. Cough lingers 4-6 wks. Most severe in infancy as airway passages are so small Schedule: Same as diptheria & tetanus Required for kindergarten entry |
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Measles (Rubeola)
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Viral infection
Lasts 7-10 d. Contagious 5d after exposure to 5d after rash appears High fever (up to 105), hacky cough, conjunctivitis, lethargy, reddish brown maculopapular rash, photophobia, “Koplik’s Spots” Schedule: 1st dose @ 12-15 mos. 2nd dose @ 4-6 yrs. Required for kindergarten entry |
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Mumps
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Viral Infection
Primarily involves parotid salivary gland. Most common complication is nerve deafness… usually unilateral Schedule: Same as Measles 1st dose @ 12-15 mos. 2nd dose @ 4-6 yrs |
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Rubella aka German measles, 3 day measles
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Rubella
Caused by rubella virus Maculopapular rash beginning on face & rapidly spreading to entire body. Rash disappears by 4th day. Usually mild in children Dangerous in pregnant women: leads to serious and significant birth defects Schedule: Same as Measles & Mumps Again… 2 doses of vaccine… 12-15 months 4-6 yrs |
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Congenital Rubella Syndrome(when infants are born with rubella from mom)
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Common Triad of Symptoms:
Cataracts/congenital glaucoma, and/or retinopathy Congenital heart disease Loss of hearing. Purpura Splenomegaly Jaundice Microcephaly with, mental retardation, Meningoencephalitis, Bone disease- |
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MMR info
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A live vaccine
Should not be given to: Pregnant women Children who are moderately to severely ill Immune compromised Anyone who has had life threatening reaction to gelatin or the antibiotic neomycin |
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Poliomyelitis (polio)
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Caused by polio virus
Subclinical in 95% of cases S & S: Initially fever, myalgia, sore throat, and headache for 2-6 days Several symptom free days are then followed by return of fever & HA, stiff neck, spinal rigidity & nausea Mild cases resolve completely More severe cases result in asymmetric paralysis which affects swallowing, speech, and cardio-respiratory function Paralysis usually complete by the time temperature resolves Most improvement of muscle paralysis will take place within 6 months… after that, a permanent disability Now available as injectible only Used to be oral (OPV): was a live vaccine which caused disease in 1:1,000,000 cases. Paralysis in 1:10,000,000 children. Never used anymore. Injectible is a killed vaccine Schedule: Primary series of 4 shots: 2 mos, 4 mos, 6-18 mos., & 4-6 yrs. No booster required |
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Hib
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Name of a bacteria that causes different types of disease processes
Is NOT the name of a disease itself Most common cause of bacterial menningitis & epiglottitis before immunization. Can also cause cellulitis, septic arthritis, pneumonia, & bacteremia Schedule: 4 doses 2 mos, 4 mos, 6 mos, 12-18 mos The most dramatic impact on disease of any recent vaccine! Hib menningitis and epiglottitis are rarely seen today. |
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Hep B
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Hepatitis B in Children
Infant & children @ highest risk of developing lifelong infection. 25% of kids who become infected with hepatitis B virus are expected to die of related liver disease as adults 12,000 infants born to hepatitis B infected mothers were infected each year before vaccine Schedule: 3 shot series Ideally: Birth, 1-2 mos., & 6 mos. MUST be 24 wks before 1st dose and 3rd dose Can be given in 4 doses with combination vaccines |
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Hep A
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Fever, anorexia, vomiting, HA, abdominal pain
Jaundice follows these sx’s within 5-10 days Darkening of the urine & stools become light or clay colored Hepatomegaly Self-limiting, acute illness Death rare Schedule: 2 doses: 1st @ 1-2 yr 2nd 6 mos later |
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Chicken Pox
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highly contageous viral infection. varicella or herpes zoster virus. Incubation period 10-20 days. Virus lingers in latent form in sensory ganglia & can reappear at a later time as herpes zoster (shingles) in 10-15% of individuals
Schedule: Given @ 12 months Booster @ 4-6 years |
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Chicken pox s&s
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S & S:
Mild fever & mild malaise Crops of red macules that rapidly become tiny vessicles with surrounding erythema. Process occurs over 24 hrs. Vessicles then slowly crust over. New crops occur for about 5 days, then stops. Can occur in the anus, vagina and respiratory tract…”varicella pneumonia |
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Pneumococcal Infection:streptococcus pneumoniae
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The most common cause of bacterial respiratory disease, including otitis media and sinusitis.
More than 20 serotypes… PCV immunization protects against 7 common valents Some concern emerging that serotype replacement is going on since vaccine… emergence of different serotypes than previously knownPneumococcal disease begins as early as the 2nd month of life & becomes progressively more common as maternal antibodies decline |
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Pneumococcal Immunization: PCV & PPV
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PCV is a conjugated vaccine… better protection especially for younger children.
If PCV has not been given in infancy… then single dose PPV is recommended for high risk groups only.. .and only after age 2. PCV became known as the “ear infection vaccine”… not accurate Schedule: PPV Single Dose 2-6 yrs. High risk population if PCV missed Schedule PCV: 4 doses: 2 mos, 4 mos, 6 mos, & 12-15 mos |
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Meningococcal Vaccines:MPSV4 & MCV4
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2 vaccines available:
Meningococcal polysaccharide vaccine (MPSV4) Has been available since the 1970’s. Recommended for high risk groups under the age of 11. MPSV4 cannot be given under age 2 Meningococcal conjugate vaccine (MCV4) Recommended at 11-12 year exam Can be given @ high school entry or college entry if not previously vaccinated Congugated (MCV4) form can be given age 2-10 with certain hi-risk criteria Both vaccines work well… but the conjugated form (MCV4) is expected to give longer lasting protection |
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Rotovirus Vaccine
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An oral vaccine… not an injection
98% of kids who get vaccine are protected form severe diarrhea; 70% do not get the virus at all after vaccine Do not start the series later than 12 wks. Do not administer a dose later than 32 wks. Schedule : 3 doses (2, 4 & 6 mos.) |
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Influenza
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Infection of the respiratory tract caused by Influenza A or B
Especially dangerous in young children Characterized by high fever, difficult cough, malaise & extreme fatigue Often accompanied by respiratory distress… especially in young asthmaticsRecommended annually for: All Children > 6 mos. of age Anyone with close contacts for infants 0-5 months Children aged 6mos -9 yrs. receiving 1st dose: 0.25 ml. dose with 2nd dose 4 wks. later Children who have had before: 0.5 ml dose |
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HPV vaccine Gardacil
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HPV 4 (Quadrivalent)…
Protects against 4 serotypes, which together cause: 90% of genital warts 70% of cervical cancer (HPV 2 also available for girls but does not provide protection for genital warts) Available for young women & young men for the 1st time this year Immunization Schedule 1st dose: females 11-12 yrs 2nd dose: 1-2 mos after 1st dose 3rd dose: 6 mos after 1st dose Interesting note: CDC does not list this as recommended for males, just as available. Studies have shown the best way to prevent is by vaccinating females… |
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Common Side Effects of Most Immunizations
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Don’t Be Concerned: It’s ok!
Low grade fever Irritability for 24-48 hrs. Pain @ injection site Knot @ injection site Rash with varicella vaccine |