Chapter 7 - Life Span Development

Neonate (birth–1 month): normal pulse, resp, systolic BP, temp?

Pulse 100–180;

Resp 30–60;

Systolic BP 50–70;

Temp 98–100°F (37–38°C)

Infant (1 month–1 year): normal vitals?

Pulse 100–160;

Resp 25–50;

Systolic BP 70–95;

Temp 96.8–99.6°F (36–37.5°C)

Toddler (1–3 years): normal vitals?

Pulse 90–150;

Resp 20–30;

Systolic BP 80–100;

Temp 96.8–99.6°F

Preschool (3–6 years): normal vitals?

Pulse 80–140;

Resp 20–25;

Systolic BP 80–100;

Temp 98.6°F (37°C)

School age (6–12 years): normal vitals?

Pulse 70–120;

Resp 15–20;

Systolic BP 80–110;

Temp 98.6°F

Adolescent (12–18 years): normal vitals?

Pulse 60–100;

Resp 12–20;

Systolic BP 90–110;

Temp 98.6°F

Early adult (19–40) and middle adult (41–60): normal vitals?

Pulse 60–100;

Resp 12–20;

Systolic BP 90–130;

Temp 98.6°F

Older adult (61+): normal vitals?

Same table ranges as adults: pulse 60–100, resp 12–20, systolic 90–130. Actual values depend on health and medications.

Trend rule: how do pulse, respirations, and BP change with age?

Younger = faster pulse and respirations. Blood pressure goes UP with age.

Why do infants obstruct their airway easily?

Large tongue; shorter, narrower, flexible airway; oversized occiput; can't reposition themselves.

Hyperextending or hyperflexing an infant's head and neck?

Can easily cause airway obstruction. Preserve airway with proper positioning.

Neonates and infants under 6 months: nose?

Primarily nose breathers; prone to nasal congestion. Make sure nasal passages are clear of mucus.

How to count an infant's respirations?

Count abdominal rise (belly breathing), not chest rise alone.

Infant bag-mask ventilation precaution?

Fragile lungs: forceful ventilation or overinflation can cause barotrauma.

Why can a struggling infant deteriorate fast?

Limited ability to compensate: tires quickly, overheats, dehydrates. Respiratory problems become life threatening quickly.

Depressed fontanelle?

Possible dehydration.

Bulging fontanelle?

Possible increased intracranial pressure.

When do fontanelles close?

Posterior by month 3; anterior 9–18 months.

Why head and spine injury concern in infant falls?

Head is about 25% of body weight; infants can't extend arms to break a fall; they land headfirst.

Leading cause of death in neonates/infants (chapter)?

Congenital abnormalities (birth defects).

Neonatal weight pattern?

Loses 5–10% in week 1; regains by week 2; about 1 oz (30 g)/day; doubles at 4–6 months; triples at 1 year.

Four neonatal reflexes?

Moro (startle: arms wide, fingers spread);

palmar grasp (object in palm, hand closes);

rooting (cheek touch, head turns);

sucking (lips stroked, latches).

Trust vs. mistrust?

Birth to about 18 months. Consistent care builds trust; inconsistent or rejecting care builds mistrust.

Secure vs. anxious-avoidant attachment?

Secure: caregiver responds, infant explores. Anxious-avoidant: from recurring rejection; little response to caregivers, treats them like strangers.

Separation anxiety: when and how to approach?

Peaks 10–18 months; clingy, fears unfamiliar people. Keep family and familiar items nearby; preserve routine.

Toddler/preschooler psychosocial challenge?

Autonomy vs. shame and doubt.

Toddler physiology that raises infection and fatigue?

Passive immunity lost, frequent viral infections; lungs can't sustain deep or rapid breathing for long.

Seriously ill child, panicked parent?

Parent may be a secondary patient; their distress makes treating the child harder.

Moral reasoning levels?

Preconventional: punishment/reward. Conventional: peer and societal approval. Postconventional: internal conscience.

Interviewing an adolescent?

They may withhold or lie in front of family. Ask sensitive questions privately.

High-risk behaviors peak at what age?

About 14–16 (smoking, drugs, unprotected sex, antisocial behavior, peer pressure).

Adolescent growth spurt order?

Hands and feet, then long bones of extremities, then torso.

Middle adults may have what unrecognized conditions?

Diabetes and hypertension (hypertension is the silent killer).

Why older adults may lack classic signs?

Pain may be diminished, fever may be absent, heart rate may not rise (weaker heart or medications).

Older adult airway protection?

Weaker cough and gag, fewer cilia: higher risk of aspiration and obstruction.

Older adult respiratory reserve?

Vital capacity about 50% of a young adult by age 75; rigid, fragile chest; little reserve, shows only when severely ill.

Why is blood loss dangerous for older adults?

Marrow replaced by fat, so they replace lost blood cells poorly.

Why head injury hides bleeding in older adults?

Brain shrinkage leaves space; bridging veins tear; bleeding may go unnoticed.

Why more falls and trauma in older adults?

Slower reflexes and reaction time, diminished sensation, less muscle mass and balance, osteoporosis.

Confused older adult?

Dementia or new and sudden confusion; find out how to get history and what is baseline (supplemental: ask family/caregivers).

Older adult senses?

Hearing loss about 4x more common than vision loss, but many have good hearing and vision; don't assume.

Where do most older adults live?

95% at home; most are relatively healthy, active, independent.