Pediatric milestone and common infections. Exam 3 final

Fine motor: transfer objects from hand to hand

2 years old

turn the page of a book and build a tower of six blocks

3 year old

Copy a circle and a cross- build using a small block

15 months

·         Walk alone

·         Creep upstairs

·         Assume standing position without falling

·         Hold a cup with all fingers grasped around it.

18 months

·         Hold cups with both hands

·         Transfer objects hand-to- hand at will

24 months (2-year-old)

·         Go up and down stairs alone with two feet on each step.

·         Hold a cup with one hand

·         Drink well from a small glass held in one hand

·         Remove most of own clothes

30 months (2yr & 6 months)

·         Jump with both feet

·         Jump from chair or step

·         Walk up and downstairs, one foot on a step

·         Drink without assistance

2 years

toddler uses his senses and motor development (grasping, crawling, walking, reaching) to different self from objects.

·         Over time, through sensory exploration and movement, they learn that they are separated from objects around them.

¨       EX. A toddler shakes a rattle not just for fun, but to understand the sound it makes and how their action causes it.

¨       If a toy is out of reach, the toddler learns they cannot get it unless they move toward it.

2-3 years

  : pre-conceptual phase of cognitive development - where he is still egocentric and cannot take the point of view of other people.

·         cannot easily imagine what someone else is feeling or thinking.

·         Using a stick as a sword or a spoon as a microphone.

·         they may believe the moon follows them

·         If a friend is sad, the toddler may not understand why—they only see their own feelings.

Toddler 1-3 yrs old

Very social but still egocentric

 Imitates parents

 Notice sex differences and know own sex

 Erikson

·         Development of autonomy – I CAN DO IT MYSELF

·         Centered around toddlers, increasing abilities to control their bodies, themselves and their environment

3 yr old

copy a circle and a cross- building small blocks 

4 yr old

use scissors

color with the borders

5 yr old

write some letters and draw a person with body parts

Preschool 3-6 yr old

§  Buttoning clothing

§  Holding a pencil

§  Building with small blocks

§  Using scissors

§  Playing a board game

§  Have a child draw picture of himself

Preschool 3-6 yr old

§  Begins to be able to give reasons for his belief and actions, but not true cause-effect relationship.

·         Ex. A child says, “It rained because I wore my red shirt,” or “The flowers wilted because they are sad.”

·         Still egocentric but less- begin to consider other’s ideas but still struggle to understand other’s perspective.

¨       Ex. A preschooler might share a toy if asked, but still assume everyone wants exactly what they want.

Preschool 3-6 yr old

§  Fears the dark

§  Impatient and selfish

§  Expresses aggression through physical and verbal behaviours

§  Show signs of jealousy of siblings

Preschool 3-6 yr old

§  Egocentric

§  Tolerates short separation

§  Less dependent on parents

§  May have dreams & nightmares

§  Attachment to opposite sex parent

§  More cooperative in play

§  Erikson Theory

·         Develop sense of initiative

¨       Where he wants to learn what to do for himself

¨       Learn about the world and other people

SChool age 6-12

§  Refined and with more focus

§  Building: models- logos

§  Sewing

§  Musical instrument

§  Painting

§  Typing skills

§  Technology: computers

§  6-8 years old

·         Rides a bicycle

·         Runs, jumps, climbs, hops

·         Has improved eye- hand coordination

·         Prints and learn cursive writing

·         Can brush and comb hair

8-10 yr old

·         Throws balls skillfully.

·         Used to participate in organized sports.

·         Use both hands independently.

·         Handles eating utensils (spoon, fork, knife) skillfully.

§  10-12 years old

·         Enjoy all physical activities

·         Continues to improve his motor coordination.

8-10 yr old

Gross Motor: Team sports

10 yr old

·         Match sport to the physical and emotional development

7-8 yr old

·         concrete operational stage of cognitive development

¨       able to function on a higher level in his mental ability

Greater ability to concentrate and participate in self-initiating quiet activities that challenge cognitive skills, such as reading, playing computer and board games

School age 6-12

§  Continues to be egocentric

§  Wants other children to play with him.

§  Insists on being first in every thing

§  Becomes peer oriented.

§  Improves relationship with siblings.

§  Has greater self–control, confident, sincere.

§  Respects parents and their role.

§  Joints group (formal and informal).

§  Engage in tasks in the real world.

Adolescents

§  Start: physical changes that show puberty has started, but are not directly involved in reproduction.

·         Examples:

·         Girls: breast development, pubic hair

·         Boys: facial hair, voice deepening, increased muscle mass

§  End: person is fully grown physically (somatic growth) & Is psychologically mature – meaning they can think more like an adult, make decisions, and take responsibility.

Ø  Begin to challenge values as teenager gain independence

Ø  Relies on peer relationships

Ø  Critical of adult authority

Ø  Mood swings esp in eatly adolescence

Adolescent

§  Cognitive: Formal operational thinking - can deal with problems

§  Emotional: Mood swings, alternating disturbed behavior with quiet periods- may become hostile or ready to fight, complain or resist everything

§  Social: Develops sense of identity, shows interest in opposite sex, seeks close friendships

·         He needs to know “who he is” in relation to family and society

weeks

 People have Epstein-Barr Virus (Mononucleosis) can transmit for ________.

Epstein-Barr Virus (Mononucleosis)

healthy people can carry this in salvia and transmitted the virus for lifetime.

Erythema Toxicum (fifth Disease)

§  BEFORE RASH (SEVERAL DAYS): Fever, runny nose, headache RASH (7 DAYS TO SEVERAL WEEKS)

§  Red rash on face (slapped cheek) which appears from day 1 to 4

§  Maculopapular red spots symmetrically distributed on upper and lower extremities progressing proximal to distal surfaces through 1 week

§  Secondary itchy rash that can appear on rest of body, especially on the soles of the feet

 Onset of manifestations before rash appears

When Erythema Toxicum (fifth Disease) is contagious 

Droplet/blood

how Erythema Toxicum (fifth Disease) spread?

  Measles (Rubeola)

Ø  3-4 days prior to rash

§  Mild to moderate fever

§  Conjunctivitis

§  Fatigue

§  Cough, runny nose, red eyes, sore throat- RASH

§  Koplik spots (tiny white spots) appear in mouth 2 days before rash

§  Red or reddish- brown rash beginning on the face spreading downward

§  Spike in fever with rash

Contact precaution

Measles (Rubeola) contact precaution

4 days before the to 5 days after rash appears

A period during which individuals with measles (Rubeola) are contagious.

Direct Contact/ Droplet

Mumps precaution

immediately before and after begins

A period which individuals with Mumps are contagious

Mumps

§  Painful, swollen parotid glands

§  Fever and muscle aches

§  Headache

§  Earache made worse by chewing

§  Fatigue and loss of appetite

§  Orchitis – inflammation of testes

§  Encephalitis – brain inflammation

§  Meningitis- meninges inflammation (protective membrane around the brain & spinal cord

§  Oophoritis – Ovaries inflammation

§  Mastitis – breast tissue inflammation – common in breastfeeding women

§  Deafness- partial/complete

§  Myocarditis – heart muscle inflammation (myocardium)

§  Arthritis- inflammation of the joints, causing pain, swelling, stiffness.

§  Hepatitis – Liver inflammation

Mumps Complications

Rubella

§  Low-grade fever and sore throat

§  Headache

§  Malaise

§  Cough

§  Lymphadenopathy – swollen lymph nodes

§  Red rash that starts on the face and spreads to the rest of the body, lasting 2 to 3 days

Ø  : 7 days before to 5 days after the rash appears

is the contagious period for Rubella.

§  Birth defects in fetus of women infected during pregnancy

·         Deafness

·         Heart defects

·         Mental, liver, and spleen damage

v  Pertusis

Rubella Complications

Pertusis

§  Common cold manifestations: runny nose/congestion, sneezing, mild fever, mild cough

§  Severe coughing starts in 1 to 2 weeks

§  Coughing fits

§  Violent and rapid coughing

§  Loud “whooping” sound upon inspiration

Ø  : greatest during catarrhal stage (1-2 wks) before onset of paroxysmal stage (2-6wks)

is the period when the infection is most contagious in whooping cough/ pertusis

Direct COntact/ Droplet

Pertusis precaution

1 day before lesions appear until 6 days after the lesions have formed crusts

The period of contagion for Varicella (Chickenpox) or Varicella- Zoster Virus

Varicella (Chickenpox) or Varicella- Zoster Virus

§  Manifestation 1-2 days prior to rash

·         Fever, fatigue, loss of appetite, headache

§  Rash

·         Macules start in center of trunk, spreading to the face and proximal extremities

·         Progress from macules, to papules, to vesicles, and crust formation follows

·         Scabs appear in approximately 1 week

Direct Contact

Conjunctivitis Precaution

Conjunctivits

Pink/red sclera, swelling of conjunctiva, excessive tearing, yellow-green purulent discharge, crusty eyelids in the morning.

§  Viral: Clears in 7-14 days

§  Bacterial: Spreads eye-to-eye, clears with antibiotics

§  Allergic: Occurs in people with other allergies

Types of Conjunctivitis