Volume 1 Chapter 11 Paramedic Care

What is the age range for infancy?

Birth to 12 Months

What is the age range for toddlers?

12 to 36 months

What is the age range for preschool age?

3 to 5 years

What is the age range for school age?

6 to 12 years

What is the age range for adolescence?

13 to 18 years

What is the age range for early adulthood?

19 - 40

What is the age range for middle adulthood?

41 - 60

What is the age range for late adulthood?

61+

Why does an infants weight generally drop in the first week of life? What percentage can the weight of an infant drop by?

Excretion of extracellular fluid can cause a drop of 5 to 10 percent in infant weight.

At what age should infants have doubled their birth weight by? When should it be tripled?

4 to 6 months for double

9 - 12 months for triple

What is the foramen ovale?

This is a passageway through the interatrial septum that allows blood to bypass the pulmonary circuit while a child is still inside the womb.

How long does closure of the foramen ovale take? What is marked depression that takes the place of the foramen ovale known as?

Sometimes it can take 30 days up to a year.

The depression is known as the fossa ovalis

What is the average pulse, respiration rate, and blood pressure for a toddler?

HR: 80 - 110

RR: 24 - 40

BP: 95 - 105 systolic

What is the average pulse, respiration rate, and blood pressure for a preschool age child?

HR: 70 - 110

RR: 22 - 34

BP: 95 - 110 systolic

What is the average pulse, respiration rate, and blood pressure for a school-age child?

HR: 65 - 110

RR: 18 - 30

BP: 97 - 112 systolic

What is the average pulse, respiration rate, and blood pressure for an adolescent?

HR: 60 - 90

RR: 12 - 26

BP: 112 - 128 systolic

When are infants primarily nose breathers?

From birth to 4 weeks.

What is important to know about infant airway obstructions?

That an infant's airway is shorter, narrower, less stable, and more easily obstructed than at any other stage in life.

What is a special consideration to keep in mind when ventilating an infant?

An infant's lungs are fragile and prone to barotrauma. This is due to fewer alveoli.

What is specific gravity?

This is the weight of a substance compared to an equal amount of water.

What is the moro reflex? What does an asymmetric moro reflex indicate?

Referred to as the startle reflex this is when a baby is startled, he throws his arms wide, spreading his fingers and then grabbing with the arms and fingers.

Possible paralysis or weakness on one side of the body.

What is the rooting reflex?

This is an infant's reflex of turning his or her head to the left or right when something touches his or her cheek. This is used for breast feeding.

What is the primary purpose for fontanelles? Two purposes are mentioned.

To allow for compression of the head during childbirth and for rapid growth of the brain during early life.

What is a fontanelle?

These are diamond shaped soft spots of fibrous tissue at the top of an infant's skull where three or four bones will eventually fuse together.

When do the anterior and posterior fontanelles close respectively?

Posterior - 2 or 3 months

Anterior - 9 and 18 months

What can clinically be derived from the fontanelle of a toddler?

An infants hydration level. If he is dehydrated the fontanelle will be sunken.

What is reciprocal socilization?

This is the the interactions babies have with their families and how they help them to grow and change and help the families do the same.

What causes an anxious resistant attachment? What will a child act like using this form of attachment?

This is caused when an infant is uncertain about whether or not his caregivers will be responsive or helpful when needed.

A child with this form of attachment is prone to separation anxiety, causing him to be clinging and anxious about exploring the world.

What is a secure attachment?

This is when an infant senses that his needs will be met by his caregivers.

What causes an anxious avoidant attachment? What will a child act like using this form of attachment?

This occurs when an infant has no confidence that he will be responded to helpfully when he seeks care.

This can lead to variety of personality disorders, from compulsive self-sufficiency to persistent delinquency.

What stage of life does a person go through from the age of 0 to 1 and a half?

Trust vs. Mistrust

What is scaffolding?

This is when someone builds on what they already know, this is particularly prevalent in children.

What are the three types of temperaments in children?

Easy

Difficult

Slow to Warm up

What are the three stages of the parental separation reaction in order?

(1) Protest

(2) Despair

(3) Detachment or Withdrawal

What changes happen in the renal system from being a newborn to a toddler?

The kidneys are much more well developed and the urine in these children will almost be as concentrated as an adults.

What is the normal age for a child to be toilet trained? When are they physically capable?

The average age is around 28 months although children are physically capable around 12 - 15 months, but they are not psychologically capable until 18 - 30 months.

When do children start to understand cause and effect?

Around the ages of 18 - 24 months.

What are the characteristics of an authoritarian parent?

These parents are demanding and desire instant obedience from their children. No consideration is given to the child's view, and no attempt is made to explain why.

What is the result of authoritarian parenting?

Often the child will have low self esteem and low competence. Boys are often hostile and girls are often shy.

What are the characteristics of an authoritative parent?

These parents will respond to the need and wishes of their children. They believe in parental control, but they attempt to explain their reasons to the child.

What is the result of authoritative parenting?

Often the child will be self-assertive, independent, friendly, and cooperative.

What are the characteristics of a permissive parent?

These parents take a tolerant, accepting view of their children's behavior, including aggressive behavior and sexual behavior. They rarely punish or make demands of their children.

What is the result of permissive parenting?

Often the child will be impulsive, aggressive, have low self-reliance, low self-control, and low maturity, and lack responsible behavior.

What two effects does television violence have on toddlers and preschoolers?

It increases levels of aggression, and passive acceptance of use of aggression by others.

What is preconvential reasoning? What is stage one and two?

Stage one: Children obey rules but only to avoid punishment

Stage two: Children obey the rules, but only for pure self-interest. They are aware of fairness to others, but only as it pertains to their own satisfaction.

What is conventional reasoning? What is stage three and four?

Stage Three: Children in this stage are concerned with interpersonal norms, seeking the approval of others and developing the "good boy" or "good girl" mentality.

Stage Four: Children develop the social system's morality, becoming concerned with authority and maintaining the social order. They realize that correct behavior is "doing one's duty".

What is postconventional reasoning? What is stage five and six?

Stage five: Is concerned with community rights as opposed to individual rights. Children at this level believe that the best values are those supported by the law.

Stage Six: Is concerned with universal ethical principles, such as that an informed conscience defines what is right, or people act not because of fear, approval, or law, but from their own standards of what is right and wrong.

When are males and females generally done growing respectively?

Males are generally done by age 18

Women are generally done by age 16

When percentage of body fat do females require in order for menarche?

18 - 20 percent

What is the greatest determinant of how fast an adolescent progresses through the stages of identity development?

How well they handle crises.

At what age do people generally begin to make their own personal "code of ethics"?

Adolescence

When does peak physical condition occur?

Between the ages of 19 - 26

What is the maximum life span for human beings?

120 years.

What organ system is effected the least by aging?

The gastrointestinal system

What is the ratio of people over 60 who have diverticula?

One in three

What is something to think about when administering opiates to a geriatric patient?

They may have an increase in opiate receptors whcih may lead to significant constipation when narcotics are ingested.

What is hearing loss for pure tones known as?

Presbycusis

What is the terminal-drop hypothesis?

This asserts that there is a decrease in cognitive functioning over a five year period prior to death.

What percentage of single women above the age of 60 live under the poverty level?

More than 50%

Who is the poorest group in the united state's society?

Older women

With cognitive growth, moral reasoning appears, and the control of the child's behavior shifts from external sources to what?

Internal self-control

Awareness that the time in which they can accomplish their life's goals is becoming shorter is a major concern in what age group?

Middle adulthood

What is a description of a 6 to 12 year olds relationship with his parents?

Protective and proud; likes parents attention; peers are important but needs home support.

What is a common physiological change, pertaining to the vessels of the body that is associated with aging?

Blood vessel walls thicken, reducing blood flow to end organs and causing blood pressure to rise.

When does a child's hearing reach maturity?

3 to 4 years.

Conventional reasoning is characterized by an orientation towards what?

Concern with interpersonal norms.

What age group takes time out to experiment with a variety of identities?

Adolescents

What hormone in adolescents promotes estrogen and testosterone production?

Gonadotropin

How much does a typical newborn sleep in a 24 hour period?

16 - 18 hours

At what age is the airway shorter, narrower, less stable, and more easily obstructed than at any other stage in life?

infant

At what stage does exploratory behavior accelerate playing simple games, following basic rules, and displaying early sign of competitiveness appear?

Preschool Age

When palpating the head of a 12 month old infant, it would be normal to feel which fontanelle?

Anterior fontanelle

Psychological Readiness

Children

Authoritarian

12 to 15 months

Extreme Privacy

Demands and desires infants obediance

What age does magical thinking begin?

24 - 36 months

At what rate is the ventilation too fast to sustain adequate tidal volume in an infant?

Above 60

What is a decrease in cognitive functioning over a five year period prior to death termed?

Terminal drop

At what age should an infant typically be able to sit up in a high chair and make one syllable sounds?

6 Months

In which stage of development do the trachea and large airways increase in diameter?

Late adulthood

What is the normal birth weight of a full-term newborn infant?

3.0 - 3.5kg