Pediatric Growth, Development, Health Promotion, and Clinical Nursing Flashcards

Comprehensive set of 100 practice flashcards covering infant through adolescent growth and development, fine/gross motor milestones, sensory changes, nutrition, minor consent, screening tools, contraception, and sexually transmitted infections.

What does the term "cephalocaudal" mean in the context of growth and development?

Growth progressing from the head downward.

What does the term "proximodistal" mean in pediatric growth and development?

Growth progressing from the central trunk toward the distal extremities.

How is "prehension" defined in pediatric motor development?

Grasping an object.

At what age does the posterior fontanel typically fuse?

6-8 weeks.

By what age does an infant's average birth weight double?

6 months.

What is the average monthly rate of length increase during the first 6 months of life?

$1\,\text{inch per month}$.

By what age does an infant's average birth weight triple?

12 months.

What is the average monthly rate of length increase from 6 to 12 months of age?

$0.5\,\text{inches per month}$.

How much do head size and brain weight increase by 12 months of age?

Head size increases by $33\%$ and brain weight increases by $2.5\times$.

At what age range does the anterior fontanel close?

12-18 months.

What visual capabilities are present at birth in a newborn?

Blink reflexes (doll eyes) and the ability to fixate on an object $8\text{--}10\,\text{inches}$ away.

What visual tracking capability does a 1-month-old infant demonstrate?

Can follow in a range of $90^\circ$ (not past midline).

What visual and physiological changes occur at 1 month of age regarding interaction and tears?

Watches parent as they speak, and tear glands begin to function.

What range of peripheral vision is present at 1.5-3 months of age?

Peripheral vision is $180^\circ$ (can follow past midline by 3 months).

What happens to the doll's eye reflex around 1.5-3 months of age?

The doll's eye reflex begins to disappear.

At what age does binocular vision begin to develop, and what ability does it enable?

Begins to develop at 6 weeks; the infant starts to focus on smaller objects.

What visual milestone occurs at 3 months of age regarding object interaction?

The infant focuses on a visual object and reaches toward it.

What visual developmental milestones occur at 3-5 months of age?

Recognizes a feeding bottle and looks at hand while sitting or lying on back.

What visual developmental milestones occur at 5-7 months of age?

Adjusts posture to see an object, retrieves a dropped toy, and hand-eye coordination starts to develop.

What is the expected hearing response in a newborn from birth to 1 month?

Startled reflex (responds to loud noises).

How does a 2-3 month old infant respond to sound?

Turns head to the side when sound is at ear level.

How does a 3-4 month old infant locate sound?

Locates sound by turning head to the side and looking in that direction.

How does a 4-6 month old infant locate sound?

Locates sound by turning head to look.

How does a 6-8 month old infant respond to sound and name recognition?

Turns head in a curving arc and responds to name.

What hearing capability develops in infants between 9 and 13 months of age?

Learns to control and adjust responses to sounds.

Describe the progression of the palmar grasp during early infancy.

Occurs as a reflex in the first 2-3 months and becomes voluntary.

What fine motor milestone is observed at 3-4 months of age?

Will hold objects placed in hands.

At what age does grasp become voluntary?

5 months.

What fine motor ability is expected at 6 months of age?

Can grasp feet.

At what age can an infant transfer objects from one hand to another?

7 months.

At what age range does an infant start to use the pincer grasp?

8-9 months.

By what age is the pincer grasp typically fully developed?

11 months.

What fine motor skill emerges at 10 months of age?

Can intentionally throw or let go of an object.

What fine motor capability is present at 11-12 months of age?

Can manipulate objects.

What degree of head lag is present when an infant is pulled to sit at 1 month of age?

Complete head lag.

What degree of head lag is present when pulled to sit at 2 months of age?

Partial head lag.

At what age is there almost no head lag when pulled to sit?

4 months.

What prone head control is expected at 1 month of age?

Momentarily lifts head.

What prone head control is demonstrated at 4 months of age?

Lifts head and chest $90^\circ$ and bears weight on forearms.

What prone head control capability is present at 6 months of age?

Lifts head, chest, upper abdomen, and can bear weight on hands.

Describe an infant's sitting posture at 1 month of age.

Back rounded, no ability to sit upright.

What sitting milestone is attempted at 2 months of age?

Can try to pull up with some head control.

Describe an infant's sitting position and head control at 4 months of age.

Only lumbar is rounded, able to sit erect with good head control.

What sitting milestone is achieved at 7 months of age?

Can sit alone, leaning on hands for support.

At what age can an infant sit without support?

8 months.

What weight-bearing milestone occurs in locomotion at 7 months of age?

Bears full weight on feet.

What locomotion milestones are achieved at 9 months of age?

Stands holding onto furniture, crawls with abdomen on floor and pulls self forward, and creeps on hands and knees.

What standing/locomotion capability is present at 10 months of age?

Deliberate steps while standing.

What are the primary nutrition characteristics and benefits of breast milk for an infant aged 0-4 months?

Easily digestible micronutrients, low fat content, and immune globulins.

What supplement should be given to exclusively breastfed infants, and at what daily dosage?

Give $400\,\text{IU}$ Vitamin D daily (QD).

Under what maternal condition is breastfeeding contraindicated?

HIV positive (HIV+).

What is an acceptable alternative to breast milk for infants aged 0-4 months?

Iron-fortified formula.

What is the guideline for introducing solid foods between 4-6 months of age?

Introduced for taste and experience of chewing, introduced every 5-7 days.

Why should honey be avoided in children under 1 year of age?

Risk of infant botulism.

What reflexes related to feeding are present in infants aged 4-6 months?

Extrusion and sucking reflex present.

Are additional fluids required for an infant during the first 4-6 months of life?

No, infants do not require additional fluids for the first 4-6 months.

What is the recommendation for fluoridated water in infants under 6 months of age?

Fluoridated water is not recommended for $< 6\,\text{months}$.

What are the primary nutrition sources for infants aged 6-12 months?

Breastmilk and iron-fortified formula.

What happens to the extrusion reflex during the 6-12 month period?

The extrusion reflex is gone.

What is the recommendation regarding whole milk for infants under 12 months of age?

Whole milk is not recommended for $< 12\,\text{months}$.

What is the core psychosocial developmental focus for an infant according to the notes?

Learning to love and be loved, and developing a mutually satisfying relationship.

How is trust or mistrust established during infancy?

Based on how well physical and emotional needs are met via the quality of relationship and care received.

What scenario leads to the development of mistrust in an infant?

Inconsistent or inadequate basic and emotional needs, such as an immature parent who does not know behavior cues, leading to excessive child frustration.

What parameters are measured on CDC growth charts for preschoolers (3-5 years) and school-age children?

Weight, height, and BMI.

What is the recommended sleep duration for a 5-year-old child?

$11.5\,\text{hours}$.

What is the recommended sleep duration for an 11-year-old child?

$9\,\text{hours}$.

What maturity factors are necessary for school-age children participating in competitive sports?

Physical and emotional maturity, along with acquisition of skills.

What is the most common cause of injury in school-age children?

Motor vehicle collisions (MVC), whether as a pedestrian or passenger.

What physical growth changes occur during the pubertal growth spurt in adolescents?

Final $20\text{--}25\%$ linear growth, up to $50\%$ of ideal body weight, and changes in BMR.

Describe the hormonal feedback loop controlling pubertal development as illustrated in the endocrine diagram.

The Hypothalamus secretes GnRH to stimulate the Anterior Pituitary, which releases LH/FSH to stimulate the Gonads; the Gonads produce Estrogen/Testosterone/Progesterone, which feed back to the Hypothalamus and Pituitary.

What physiological changes occur in the cardiovascular system during adolescence?

Heart size, blood volume, and systolic blood pressure (SBP) increase in size and strength, while heart rate (HR) decreases.

What change occurs in respiratory function during adolescence?

Respiratory vital capacity increases.

What age range corresponds to the development of Formal Operational Thinking?

Ages 11-14 years.

What key cognitive abilities characterize Formal Operational Thinking?

Reasoning with abstract terms, possibilities, and hypotheses, along with enhanced decision-making capabilities and concepts of spirituality and trust.

What limitation in adolescent cognitive thought and decision making is noted?

Adolescents may not use formal operational thought and reasoned decision making all the time when making "choices".

Describe Tanner Stage 1 pubic hair development and age.

No hair; age $< 10\,\text{years}$.

Describe Tanner Stage 2 pubic hair development and age.

Small amount, downy hair; age 10-11 years.

Describe Tanner Stage 3 pubic hair development and age.

Hair is coarse and curly; age 11-13 years.

Describe Tanner Stage 4 pubic hair development and age.

Hair is adult-like but not on thigh; age 13-14 years.

Describe Tanner Stage 5 pubic hair development and age.

Hair extends to medial thigh; age $> 14\,\text{years}$.

What is the primary psychosocial goal for adolescents according to the notes?

Experiencing and developing a sense of identity and social roles, using peer groups to build identity.

What causes Role Confusion in adolescents and what are its potential consequences?

Caused by lack of goals, direction, identity, and society's restrictions around choices; results in being unprepared for adulthood, insecurity, and self-doubt.

What is the average recommended sleep duration for adolescents per night?

Average $8\text{--}10\,\text{hours per night}$.

What is the leading cause of death among adolescents?

Unintended injury.

For what reproductive health services can minors consent at any age under Consent-Based Notification?

Birth control, pregnancy, and abortion.

Under what minor consent condition is sexual assault care placed for any age?

Parent notification required.

For adolescents aged 12 and older, which health services fall under Consent-Based Notification?

STIs, contagious & reportable diseases, HIV testing, and federally assisted treatment program alcohol/drug counseling.

Which alcohol/drug counseling programs require parent notification for adolescents aged 12 and older?

Non-federally assisted treatment program alcohol/drug counseling.

What care requires parent notification for adolescents aged 12 and older regarding mental health?

Outpatient mental health treatment.

What domains are assessed in the HEADSSS adolescent health screening tool?

Home, Education, Activities, Drug use, Sexual activity, Self-harm/suicide, Safety.

What is the purpose and target age range of the CRAFFT screening tool?

Designed to identify substance use and substance-related risk among youth ages 12-21.

What do the letters in the CRAFFT screening tool mnemonic represent?

Car, Relax, Alone, Forget, Friends, Trouble.

What is the PHQ9 screening tool used for and what is its approved age range?

Assesses depression-related items and is approved for ages $12+$.

What scope of practice does California AB 2348 (2020) grant to registered nurses regarding contraception?

Allows RNs to dispense pill, patch, ring, and administer Depo-Provera shot.

What clinical assessments are required prior to dispensing Combined Hormonal Contraception (CHC)?

BP measurement (with follow-up every 3 months) and verification of a negative pregnancy test or being reasonably certain the patient is not pregnant.

What is the dosing schedule for oral contraceptive pills and what nursing intervention improves adherence?

Take 1 pill daily (QD); setting an alarm increases consistent use.

What is the regimen and skin reaction rate for the contraceptive patch?

Use 1 patch/week for 3 weeks, then no patch for 1 week for withdrawal bleeding; $20\%$ skin reaction rate, $2\%$ discontinue due to reaction; cannot be used continuously.

What are the key instructions for using the vaginal ring contraceptive?

Leave in 3 weeks, take out 1 week for period; can be removed for $< 3\,\text{hours}$ for sex; maintains stable blood hormone concentrations for 5 weeks; reinsertion delayed up to 10 days since LMP.

How often is Depo-Provera administered, and what are its notable side effects and long-term profile?

Administered every 3 months; causes bleeding irregularities and bone mineral density changes; no evidence of increased cancer risk among long-term users.

What are the signs/symptoms, treatment, and pregnancy outcomes of Gonorrhea?

S/Sx: mostly asymptomatic, pelvic/ABD pain, green-yellow purulent discharge, menstrual irregularities, rectal itching/pain/blood; Tx: $1\,\text{g}$ azithromycin + $250\,\text{mg}$ ceftriaxone IM; Preg Outcomes: PID, salpingitis, increased risk for ectopic pregnancy, infertility, HIV, and half of infants born develop conjunctivitis or pneumonia.