EMS CH 7

BP rates tend to

increase w/ age

younger the person, the

faster pulse + respiratory rates should be

newborn age

0-1 month

newborn pulse rate

100-205

newborn respiratory rate

30-60 breaths/min

newborn systolic BP

67-84 mmHg

newborn, infant, toddler, preschool, school temperature

97-100 F or 36-38 C

infant age

1 M - 1 year

infant pulse rate

100-180 bpm

infant respiratory rate

30-53 breaths / min

infant systolic BP

72-104 mmHg

toddler age

1-3 years

toddler pulse rate

98-140 bpm

toddler respiratory rate

22-27

toddler systolic BP

86-106 mmHg

preschool age

3-6 years

preschool age pulse rate

97-118 bpm

preschool age respiratory rate

20-28 breaths / min

preschool age systolic blood pressure

89-112 mmHg

school age

6-12 YO

school age pulse rate

75-118 bpm

school age respiratory rate

18-25

school age systolic blood pressure

97-115

adolescent age

12-18 YO

adolescent + adult pulse rate

60-100 bpm

adolescent + adult respiratory rate

12-20 breaths / min

adolescent systolic BP

110 - <120

adolescent + adult normal temperature

98.6

adult age

18+

adult systolic BP

90-120 mmHg

pulse rates of children may be slightly lower when

children are sleeping

birth weight

typically 6-8 lbs

first week weight

decreases 5-10% bc fluid loss

second week weight

increases @ a rate of 1 oz / day

4-6 month weight

weight doubles

12 month weight

weight triples

fetal blood is circulated through the

umbilical cord + placenta

what helps newborns transition fr fetal circulation → extrauterine circulation

hormones + changes in pressure

barotrauma

injury caused by pressure to enclosed body surfaces

• too much pressure in the lungs

infants under 6 months are susceptible to

nasal congestion + respiratory infections bc they’re nose breathers

airway obstruction is more common in

infants

• toungue = larger than oral cavity

• airway = shorter + narrower

moro reflex

infant caught off guard + opens their arms wide, spreads their fingers + grabs things

palmar grasp reflex

something placed in the infant’s palm + they grab it

rooting reflex

something touches an infant’s cheek + they turn their head toward touch

sucking reflex

infant starts sucking when their lips are stroked

fontanelles

areas where the newborn/infant’s skull hasn’t fused together to help during birth

• disappear @ 18 months of age

depressed fontanelle indicates

dehydration

bulging fontanelle is a sign of

intracranial pressure

infants can track objects + recognize familar faces @

2 months

infants can sit upright, make cooing + babbling sounds + follow a bright light / toy w/ their eyes or turn their head toward a sound of a familiar voice @

6 months

walking, talking, pointing happens by what age

12 months

infants carry passive immunity from

the mother’s antibodies

• can be strengthened through breastmilk

bringing objects to mouth + smiling / frowning happens by

3 months

reaching arms out to people + drooling happens around

4 months

sleeping through the night + distinguishing family members from strangers happens around

5 months

teething, upright sitting, speaking one syllable words happens @

6 months

afraid of strangers + mood swings happens around

7 months

responds to ‘no’, can sit alone, plays peek a boo happens @

8 months

pulls self up to stand, explores objects by placing them in the mouth happens

@ 9 months

responds to name, crawls efficiently happens @

10 months

begins to walk w/o assistance; becomes frustrated by restrictions happens

@ 11 months

identifies w/ name + walks happens @

12 months

trust V mistrust

stage of development fr birth - 18 months

• infants gain trust in parents / caregivers if their world is planned, organized, routine

if all needs of an infant have been addressed, the infant may be

ill

• 2 months or younger

2-6 month indications of infant illness

• lack of eye contact

  • depressed mental status or delay in development

• persistent crying + irritability

assessing newborns + infants

1. observe fr a distance

2. provide sensory comfort

   1. warm hands + end of stethoscope

   2. offer pacifier

   3. allow guardian to hold infant

3. perform painful procedures @ the end

• explain steps to guardian between / before

musculature of toddlers + preschoolers prevents them from

sustaining deep or rapid respirations for an extended period

• cardiovascular + pulmonary systems

toddlers no longer possess

passive immunity → more susceptible to infection

viral infections in toddlers + preschoolers manifest with

gastrointestinal distress or upper respiratory systems

acquired immunity

result of contracting an illness + keeping the antibodies

toddlers + preschoolers transition fr __ to __

gross motor activity , fine motor activity

toddlers lack __ → inc risk of choking

molars

toddlers begin to walk + explore their environment @ ___ + →

12-18 months + increase in injuries

separation anxiety peaks around

12-18 months

transition fr simple phrases → communicating wants → creatively happens @

18-36 months

social interactiveness + cause + effect are learned @

18-36 months

learning fr other children happens @

18-36 months

rapid increase in language skills happen @

3-6 years

assessing toddlers

1. allow toddler to hold any special object

2. perform an assessment on their special object first

3. use visual cues + Wong Baker FACES pain rating scale

4. distract them while you assess vital signs

5. if no life threats begin assessment @ feet / far fr location of pain

• involve guardian in assessment → comfort + extra help

assessing preschoolers

• can understand directions, describe sensations, identify painful areas

1. tell child your actions

2. maintain honesty while reassuring + incorporate games

3. start w/ feet + move towards head

physical changes in school age children

• gain weight + grow taller

• grow permanent teeth

• increase in brain activity

school age psychological changes

• preconventional reasoning

• conventional reasoning

• postconventional reasoning

preconventional reasoning

child acts to avoid punishment or get what they want

conventional reasoning

looks for approval fr peers + society

postconventional reasoning

child bases decisions on their own conscience

assessing school age children

• talk to the child + caregiver

1. begin w/ head + continue down

2. give appropriate choices to provide patient w/ some control

3. encourage cooperation + modesty

physical changes in adolescents

• growth spurt in muscle + bone density

• maturation of endocrine + reproductive systems

psychosocial changes in adolescents

• desire privacy + personal space

• spend more time w/ friends

• increase in self consciousness

• rebellious behavior + drug use + unsafe driving + unprotected sex peak around 14-16 YO

adolescent assessment considerations

• discuss the situation + allow the adolescent to be involved

• respect their privacy + use same gender if possible

• ask if there’s any risk of pregnancy

• explain procedures in advance

early adult age

18-40 years

effects of aging in latter years of adulthood

• muscle strength decreases

• reflexes slow

• metabolism decreases

• fatty tissue decreases

psychosocial changes in early adults

• stress

• family

• career

middle adult age

40-65 YO

physical changes in middle adults

• vision + hearing loss

• increased cholesterol levels

• decreased cardiac efficiency

• difficulties with weight control

• increased incidence of cancer

• menopause

psychosocial changes in middle adults

• pressure to accomplish career + relationship goals

• adjusting after children leave home

• worries about financial means to retire

• caring for parents

geriatrics

assessment + treatment of disease in someone 65+

older adult age

65+

chronic conditions, multiple medications, physiology of aging impact

presentations of injuries + illness in geriatric patients

atherosclerosis

plaque accumulates inside BVs causing blood flow to become restricted or blocked

• inc risk of heart attack

• stroke

• vascular illness

cardiovascular effects of aging

• inc bradycardia + abnormal heart rhythms

• inc risk for hypertension

• diminished ability to inc cardiac output to meet body’s demands

• diminished ability to dilate + contract BVs → inc diastolic BP

• heart less able to cope w/ disease or exercise

  • can lead to heart failure