Ch 7 Human Development

Why must EMTs understand human development?

Humans develop throughout life, and physical and psychosocial changes at each life stage can alter the EMT’s approach to patient care.

What age range defines a neonate?

Birth to 1 month.

Where are neonates covered in the EMT textbook outline?

Chapter 33, “Obstetrics and Neonatal Care.”

What age range defines an infant?

1 month to 1 year.

How rapidly do infants develop?

Infants develop at a startling rate during the first year of life.

What is the usual birth weight of a neonate?

About 6 to 8 lb (3 to 3.5 kg).

How much of a neonate’s body weight is accounted for by the head?

About 25%.

How fast does an infant grow after the second week of life?

About 30 g per day.

When does an infant usually double and triple birth weight?

Doubles by 4 to 6 months and triples by the end of the first year.

What major cardiovascular transition occurs at birth?

The neonate changes from fetal circulation to independent circulation.

What is true of a neonate’s lungs before birth?

They have never been inflated.

What helps produce the neonate’s first breath?

Passage of the chest through the birth canal and the resulting increase in intrathoracic pressure help facilitate the first breath.

Why are infants younger than 6 months prone to nasal congestion?

Their small upper airways and dependence on nasal breathing make congestion especially significant.

Why is airway obstruction more common in infants?

They have proportionately larger tongues and shorter, narrower airways.

How does an infant’s rib cage differ from an adult’s?

It is less rigid, and the ribs lie more horizontally.

What ventilation danger must EMTs remember in infants?

Infant lungs are fragile, so forceful ventilation or overinflation can cause barotrauma.

What is barotrauma?

Pressure-induced injury caused by excessive ventilation pressure or overinflation.

Why can respiratory problems become life-threatening quickly in infants?

Their respiratory muscles are immature and their lungs contain fewer alveoli.

How developed is the nervous system at birth?

It continues to evolve after birth.

What reflexes are neonates born with?

Moro, palmar grasp, rooting, and sucking reflexes.

What is the Moro reflex?

When startled, the neonate opens the arms wide, spreads the fingers, and appears to grab at things.

What is the palmar grasp reflex?

The neonate grasps an object placed in the palm.

What is the rooting reflex?

Touching the neonate’s cheek causes the head to turn instinctively toward the touch.

What is the sucking reflex?

Stroking the neonate’s lips triggers sucking.

What are fontanelles?

Spaces between the skull bones that later fuse.

When does the posterior fontanelle usually fuse?

By about 3 months.

When does the anterior fontanelle usually fuse?

Between 9 and 18 months.

What may a depressed fontanelle indicate?

Dehydration.

What may a bulging fontanelle indicate?

Increased intracranial pressure.

What developmental abilities appear by about 2 months?

The infant can track objects with the eyes and recognize familiar faces.

What developmental abilities appear by about 6 months?

The infant can sit upright and begins making cooing and babbling sounds.

What developmental abilities appear by about 12 months?

The infant can walk with minimal assistance and knows his or her name.

How does maternal immunity help an infant?

The infant retains some of the mother’s immunity after birth.

How does breastfeeding support an infant’s immune system?

It provides maternal antibodies that further strengthen immunity.

What is the infant’s main method of communicating distress?

Crying.

How do psychosocial changes begin in infancy?

They begin at birth and develop as the infant interacts with and reacts to the environment.

What is bonding in infancy based on?

Secure attachment.

What is anxious-avoidant attachment?

An attachment pattern seen in infants who are repeatedly rejected.

How may a child with anxious-avoidant attachment behave?

The child shows little emotional response to parents or caregivers and treats them much like strangers.

When is separation anxiety common?

In older infants.

What is the trust-versus-mistrust stage?

From birth to about 18 months, the infant learns trust when parents or caregivers consistently meet the infant’s needs.

What age range defines a toddler?

1 to 3 years.

What age range defines a preschooler?

3 to 6 years.

How does the cardiovascular system of toddlers and preschoolers compare with an adult’s?

It is not dramatically different from an adult’s.

Why can toddlers and preschoolers not sustain deep or rapid breathing for long?

Their lung musculature is not well developed.

What happens to weight gain during the toddler and preschool years?

Weight gain begins to level off.

What is one of the most important physiologic changes in toddlers and preschoolers?

Loss of passive immunity.

What type of growth makes major progress in toddlers and preschoolers?

Neuromuscular growth.

Around what age is toilet training usually completed?

About 28 months.

What is the major psychosocial challenge of toddlers and preschoolers?

Autonomy versus shame and doubt.

By what age is basic language usually mastered?

About 36 months.

What social development begins in the toddler and preschool years?

Interaction and playing games with other children.

When does understanding of cause and effect begin?

Around 18 to 24 months.

How do young children learn to recognize gender differences?

By observing role models.

What age range defines a school-age child?

6 to 12 years.

What generally happens to physical traits and functions from ages 6 to 12?

They continue to mature at a rapid rate.

How quickly do school-age children grow each year?

About 4 lb (2 kg) and 2.5 inches (6 cm) per year.

What dental change occurs during the school-age years?

Permanent teeth erupt.

What happens to brain activity in school-age children?

Activity increases in both cerebral hemispheres.

What kinds of reasoning develop in school-age children?

Preconventional, conventional, and postconventional reasoning.

What is preconventional reasoning?

The child acts mainly to avoid punishment and obtain what he or she wants.

What is conventional reasoning?

The child seeks approval from peers and society.

What is postconventional reasoning?

The child makes decisions based on conscience.

What personal qualities begin developing during the school-age years?

Self-concept and self-esteem.

What age range defines adolescence?

12 to 18 years.

What happens to vital signs during adolescence?

They begin to level off within adult ranges.

What is the normal adolescent pulse range?

60 to 100 beats/min.

What is the normal adolescent respiratory rate?

12 to 20 breaths/min.

What is the typical adolescent systolic blood pressure range?

90 to 110 mm Hg.

How long does the adolescent growth spurt usually last?

About 2 to 3 years.

What occurs during the adolescent growth spurt?

Rapid increases in muscle and bone growth along with other body changes.

When do girls and boys generally finish their growth spurts?

Girls by about 16 years; boys by about 18 years.

What systems mature during adolescence?

The endocrine and reproductive systems.

What secondary sexual changes commonly occur during adolescence?

Pubic and axillary hair appear, voices change, and menstruation begins.

Why may adolescents conflict with their families?

They are trying to gain more control of their lives from their parents.

What personal issues become especially important during adolescence?

Privacy and increased self-consciousness.

What identity challenge occurs during adolescence?

Adolescents may struggle to create their own identity.

What gender-related concept may adolescents encounter?

Multiple options for gender exist.

Why may public image matter greatly to adolescents?

Many become highly focused on how others see them.

What contradiction is common in adolescent behavior?

They want to be treated like adults but still cared for like younger children.

When do antisocial behavior and peer pressure tend to peak?

Around ages 14 to 16 years.

What risk behaviors may arise during adolescence?

Smoking, illicit drug use, and unprotected sex.

Why may eating disorders arise during adolescence?

They may be an attempt to gain self-control through food intake.

How does a personal code of ethics develop in adolescence?

It is shaped by parents’ ethics and values, peers, and personal experiences.

What major mental-health risks are elevated in adolescence?

Depression and suicide.

What age range defines early adulthood?

19 to 40 years.

How do early-adult vital signs compare with the rest of adulthood?

They do not vary greatly from the vital signs seen throughout adulthood.

What is the average pulse and normal pulse range in early adults?

Average about 70 beats/min; range 60 to 100 beats/min.

What is the normal respiratory rate in early adults?

12 to 20 breaths/min.

What is the typical systolic blood pressure range in early adults?

90 to 120 mm Hg.

When does the body generally function at its optimal level?

From about age 19 to shortly after age 25.

What happens to lifelong habits during early adulthood?

They become solidified.

How does physical functioning change across early adulthood?

The body operates at peak efficiency early on, but aging effects gradually become apparent in the later years.

What does life commonly center on in early adulthood?

Work, family, and stress.

What major psychosocial goal is common in early adulthood?

Creating a place in the world and often settling down.

How stable is early adulthood despite stress and change?

It is one of the more stable periods of life.

What age range defines middle adulthood?

41 to 60 years.

What happens to vital signs in middle adulthood?

They generally remain the same as in earlier adulthood.

What sensory losses become more common in middle adulthood?

Vision and hearing loss.

What major body system becomes an increasing health concern in middle adulthood?

The cardiovascular system.