Chapter 7/8
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166 Terms
1 Q: What are the major life-span age groups?
A: Newborn: birth–1 month; Infant: 1 month–1 year; Toddler: 1–3 years; Preschooler: 3–6 years; School-age: 6–12 years; Adolescent: 12–18 years; Early adult: 18–40 years; Middle adult: 40– 65 years; Older adult: 65+.
Card
65+
adult
18→75 years → kidneys lose ~50% of neph
How do pulse and respiratory rates generally
change with age?
The younger the person, the faster the normal
pulse and respiratory rates.
How does blood pressure generally change
with age?
It tends to increase with age.
What is the normal pulse rate for a newborn?
90–180 beats/min.
What is the normal pulse rate for an infant?
100–160 beats/min.
What is the normal pulse rate for a toddler?
90–150 beats/min.
What is the normal pulse rate for a
preschooler?
80–140 beats/min.
What is the adolescent pulse rate?
60–100 beats/min.
What is the adolescent respiratory rate?
12–20 breaths/min.
What is the adolescent systolic BP range?
90–110 mm
How much does a newborn normally weigh?
6–8 lb (3–3.5 kg).
What percentage of a newborn's body weight
is the head?
About 25%.
After week 2, how rapidly does an infant gain
weight?
About 1 oz (30 g) per day.
When does an infant usually double birth
weight?
4–6 months.
When does an infant usually triple birth
weight?
By the end of the first year.
Why are infants especially susceptible to
airway obstruction?
They have proportionately larger tongues and
shorter, narrower airways.
Why is nasal congestion especially important
in infants younger than 6 months?
They are particularly prone to nasal
congestion.
What is different about an infant's rib cage?
It is less rigid, and the ribs sit horizontally.
What must you remember when bag-mask
ventilating an infant?
The lungs are fragile.
What can forceful ventilation or overinflation
cause in an infant?
Barotrauma—pressure-induced lung trauma.
Why can respiratory problems become life-
threatening rapidly in infants?
Respiratory muscles are immature and they
have relatively few alveoli.
What is the Moro reflex?
When startled, the newborn opens the arms
wide, spreads the fingers, and appears to grab.
What is the palmar grasp?
The newborn grasps when an object is placed
in the palm.
What is the rooting reflex?
The newborn turns the head toward
something touching the cheek.
What is the sucking reflex?
Sucking occurs when the newborn's lips are
stroked.
What are fontanelles?
Gaps between the newborn's cranial bones
connected by flexible fibrous tissue.
When does the posterior fontanelle close?
By about 3 months.
When does the anterior fontanelle close?
9–18 months.
What can a depressed fontanelle indicate?
Dehydration.
What can a bulging fontanelle indicate?
Increased intracranial pressure.
What can infants typically do by 2 months?
Track objects with their eyes and recognize
familiar faces.
What developmental changes occur around 6
months?
Sit upright and begin cooing/babbling.
What can infants usually do by 12 months?
Begin to walk, point, and talk.
What is an infant's primary method of
communicating distress?
Crying.
What may an inconsolable infant indicate
after obvious needs have been addressed?
Significant illness.
How do infants commonly explore their
environment?
By picking objects up and putting them in
their mouths.
What is bonding based on?
Secure attachment.
What is anxious-avoidant attachment?
Attachment seen in infants who are
repeatedly rejected.
How may a child with anxious-avoidant
attachment behave?
Show little emotional response to caregivers
and treat them like strangers.
What is separation anxiety?
Distress associated with separation from a
parent/caregiver; common in older infants.
What is trust versus mistrust?
Developmental stage from birth to about 18
months involving whether the infant's needs are
met.
How should an EMT begin assessing an
infant?
Observe from a distance, preferably while the
infant is in the caregiver's arms.
Why should you warm your hands and
stethoscope?
To provide sensory comfort and avoid
unnecessarily upsetting the infant.
When should painful procedures be
performed on an infant?
At the end of the assessment.
Should the caregiver remain close during
assessment?
Yes, whenever possible.
What ages are toddlers?
1–3 years.
What ages are preschoolers?
3–6 years.
Why can respiratory problems become
serious in toddlers and preschoolers?
Their lung musculature isn't well developed,
so they cannot sustain deep or rapid respirations
for long.
What happens to weight gain during the
toddler/preschool period?
It should level off.
What happens to passive immunity between 6
months and 1 year?
It is lost.
How does acquired immunity develop?
Exposure to viruses and bacteria initiates
antibody development.
Around what age is toilet training usually
completed?
28 months.
Why are toddlers at increased risk for
choking?
Lack of molars may prevent them from fully
chewing food before swallowing.
What is the major psychosocial challenge of
toddlers/preschoolers?
Autonomy versus shame and doubt.
At what age is basic language generally
mastered?
36 months.
When does understanding of cause and effect
begin?
Around 18–24 months.
Why may toddlers resist EMTs?
They may fear strangers and separation from
caregivers.
What should a toddler be allowed to hold
during assessment?
A favorite comfort object.
How can you demonstrate an assessment
before touching a toddler?
Demonstrate it on a doll or stuffed animal.
Why is pain assessment difficult in toddlers?
They have difficulty precisely describing or
localizing pain.
What pain scale can help with toddlers?
Wong-Baker FACES.
If there are no life threats, where should a
toddler assessment begin?
At the feet or away from the painful area.
How should you communicate with
preschoolers?
Simply and directly.
When should you tell a preschooler what
you're about to do?
Immediately before doing it.
How can preschoolers be distracted?
Counting games, toys, or conversation.
Why should you never lie to a pediatric
patient?
Once trust is lost, it can be difficult to regain.
In what direction should a preschool
assessment proceed?
Feet → head.
What privacy consideration develops during
preschool age?
Modesty, so keep the child covered when
possible.
What ages are school-age children?
6–12 years.
How much weight does a school-age child
gain annually?
About 4 lb (2 kg).
How much height does a school-age child
gain annually?
About 2.5 inches (6 cm).
What happens to the teeth?
Permanent teeth come in.
Reasoning — HIGH YIELD
What is preconventional reasoning?
Acting primarily to avoid punishment and get
what you want.
What is conventional reasoning?
Looking for approval from peers and society.
What is postconventional reasoning?
Making decisions guided by one's conscience.
What is self-concept?
How we perceive ourselves.
What is self-esteem?
How we feel about ourselves.
Assessment
How does the assessment of a school-age
child compare with an adult?
It becomes much more like an adult
assessment.
Who should you speak to during the history?
Talk directly to the child, not just the caregiver.
In what direction should a school-age
assessment proceed?
Head → feet.
Should school-age children be given choices?
Yes—simple appropriate choices such as
whether they want to sit or lie down.
What must EMTs respect during examination?
The child's modesty.
What ages are adolescents?
12–18 years.
How long is the typical adolescent growth
spurt?
2–3 years.
When do girls generally finish their growth
spurt?
Around 16 years.