ATI Fundamentals: Lifespan Development, Health Assessment, and Vital Signs

Comprehensive practice flashcards covering growth and development from infancy through older adulthood, health assessment techniques, and vital signs monitoring based on ATI Fundamentals for Nursing.

How should a newborn infant be positioned and secured in a car seat prior to discharge from the hospital?

In a federally approved rear-facing car seat secured in the rear seat at a $45^{\circ}$ angle, with shoulder harnesses placed at or below the level of the infant's shoulders and the retainer clip positioned at the level of the armpits.

When should an infant who is discharged sooner than $48\text{ hours}$ after birth receive a follow-up examination by a provider?

Within $48\text{ hours}$ after discharge from the hospital.

What are the recommended guidelines for introducing solid foods to an infant?

Introduce solids around $6\text{ months}$ of age (starting with iron-fortified cereal), introduce one single-ingredient food every $3\text{ to }5\text{ days}$ to observe for allergy or intolerance, and continue breast milk or formula as the primary source of nutrition through the first year.

At what age does a toddler's anterior fontanel typically close?

By $18\text{ months}$ of age.

What are the expected annual weight and height gains for a toddler ($1\text{ to }3\text{ years}$)?

Toddlers gain approximately $1.8\text{ to }2.7\text{ kg}$ ($4\text{ to }6\text{ lb}$) per year and grow approximately $7.5\text{ cm}$ ($3\text{ in}$) per year.

What gross and fine motor skills are expected of a toddler at $15\text{ months}$ of age?

Gross motor: Walks without help, creeps up stairs, and assumes a standing position. Fine motor: Uses a cup well and builds a tower of two blocks.

What motor skills are typically achieved by an $18\text{-month-old}$ toddler?

Gross motor: Jumps in place with both feet. Fine motor: Manages a spoon without rotation and turns pages in a book two or three at a time.

What fine and gross motor skills are expected of a child at $2.5\text{ years}$ of age?

Gross motor: Jumps with both feet and stands momentarily on one foot. Fine motor: Draws circles and possesses good hand-finger coordination.

What is the primary psychosocial developmental stage for toddlers according to Erikson, and how does it manifest?

Autonomy vs. shame and doubt; toddlers develop independence by attempting to do everything for themselves, manifesting behaviors such as temper tantrums, saying 'no', and regressing during anxiety or separation.

What are the safe crib slat spacing and mattress requirements to prevent toddler suffocation?

The crib mattress must fit tightly and crib slats must be no further apart than $6\text{ cm}$ ($2.4\text{ in}$).

What are the typical annual physical growth parameters for preschool-age children ($3\text{ to }6\text{ years}$)?

Preschoolers gain about $2\text{ to }3\text{ kg}$ ($4.5\text{ to }6.5\text{ lb}$) per year and grow approximately $6.5\text{ to }9\text{ cm}$ ($2.5\text{ to }3.5\text{ in}$) per year.

In Piaget's preconceptual thought stage ($2\text{ to }4\text{ years}$), what are the definitions of artificialism, animism, and imminent justice?

Artificialism is the belief that everything is made by humans; animism is the belief that inanimate objects are alive; and imminent justice is the belief that a universal code exists determining law and order.

What type of play characterizes preschoolers, and how is it defined?

Associative play, which is play that is not highly organized and in which preschoolers do not cooperate during play.

What components make up the American Academy of Pediatrics' 5-2-1-0 framework for preschoolers?

$5$ servings of fruits and vegetables per day, $2\text{ hours}$ or less of screen time per day, $1\text{ hour}$ of physical activity per day, and $0$ servings of sugar-sweetened beverages.

Until what height or age should children continue using an approved car restraint system (booster seat)?

Until they reach a height of $145\text{ cm}$ ($4\text{ feet, }9\text{ in}$) or are $8\text{ to }12\text{ years}$ old.

What developmental milestones characterize Piaget's stage of concrete operations in school-age children ($6\text{ to }12\text{ years}$)?

Seeing weight and volume as unchanging, understanding simple analogies, classifying complex information, understanding time (days, seasons), becoming self-motivated, and solving problems by understanding cause and effect.

How does moral development shift from the early to the latter part of the school-age years?

Early school-age children operate under instrumental exchange ('I'll help you if you help me'), striving to make the best deal without considering loyalty or justice, whereas older school-age children transition into a law-and-order orientation that emphasizes justice.

What physical health screening is essential during the school-age period, especially for females?

Screening for idiopathic scoliosis (lateral curvature of the spine with no apparent cause).

What is the expected order of sexual maturation in adolescent females during puberty?

1. Appearance of breast buds; 2. Growth of pubic hair; 3. Axillary hair growth; 4. Onset of menstruation (menarche).

What is the expected order of sexual maturation in adolescent males during puberty?

1. Increase in the size of the testes and scrotum; 2. Appearance of pubic hair; 3. Penile enlargement; 4. Growth of axillary hair; 5. Facial hair growth; 6. Change in voice.

When do females and males typically stop growing physically?

Females typically stop growing $2\text{ to }2.5\text{ years}$ after the onset of menarche; males stop growing at around $18\text{ to }20\text{ years}$ of age.

What psychosocial conflict defines adolescence according to Erikson?

Identity vs. role confusion, during which adolescents try different roles and experiences to develop a personal identity and integrate with peer groups.

What behavioral warning signs indicate an adolescent may be at risk for self-harm or suicide?

Poor school performance, lack of interest in previously enjoyed activities, social isolation, disturbances in sleep or appetite, and direct expression of suicidal thoughts.

At what age range does muscle function peak in young adulthood?

Ages $25\text{ to }30\text{ years}$.

What is Erikson's developmental stage for young adults ($20\text{ to }35\text{ years}$)?

Intimacy vs. isolation.

What changes occur in cognitive intelligence during middle adulthood ($35\text{ to }65\text{ years}$)?

Crystallized intelligence (stored knowledge) remains intact, while fluid intelligence (the ability to learn and process new information) declines slightly.

What is Erikson's developmental crisis for middle adults, and what is its goal?

Generativity vs. stagnation, in which adults strive for generativity by contributing to future generations through parenting, community involvement, and creative or productive accomplishments.

Why is the middle adult stage frequently termed the 'sandwich generation'?

Because middle adults often provide assistance to their aging parents while simultaneously supporting their adult children and grandchildren.

What physiologic changes occur in the immune and endocrine systems of older adults ($65\text{ years and older}$)?

Immune: Decreased antibody production by B cells, decreased T-cell function, increased autoantibodies, decreased stress response, and lowered core body temperature. Endocrine: Decreased tissue cell sensitivity to insulin and decreased $T_3$ production.

How are delirium, dementia, and depression differentiated in older adults?

Delirium is acute and temporary (often secondary to infection, pain, or environmental change); dementia is chronic and progressive; depression can have an acute, gradual, or chronic onset and lasts at least $6\text{ weeks}$, frequently linked to loss or chronic disease.

What is the primary psychosocial task for older adults according to Erikson?

Integrity vs. despair, which involves adjusting to retirement, adapting to changes in living situation and family structure, dealing with multiple losses, and facing death.

What is the difference between subjective and objective data during client data collection?

Subjective data consists of information provided by the client during the health history (such as feelings and perceptions), whereas objective data is measurable information obtained through physical examination and diagnostic testing.

What is the standard sequence of physical examination skills for most body systems, and what is the exception?

The standard sequence is inspection, palpation, percussion, and auscultation. The exception is the abdomen, which is examined by inspection, auscultation, percussion, and palpation to avoid altering bowel sounds.

Which specific surfaces of the hands are used to assess temperature, vibration, and pulsations during palpation?

The dorsal surface assesses temperature; the palmar surface and base of the fingers assess vibration; and the fingertips assess pulsations, position, texture, turgor, size, and consistency.

When should a nurse use the diaphragm versus the bell of a stethoscope during auscultation?

Use the diaphragm pressed firmly on the body for high-pitched sounds (heart, lung, and bowel sounds); use the bell pressed lightly for low-pitched sounds (unexpected heart sounds, bruits).

What four basic parameters are evaluated as components of the general survey?

Physical appearance, body structure, mobility, and behavior (along with vital signs).

What are the four primary mechanisms of heat loss from the human body?

Conduction (direct transfer to another surface), convection (dispersion by air currents), evaporation (dispersion through water vapor/perspiration), and radiation (heat transfer between objects without direct contact).

What are the expected average body temperatures for a newborn and an older adult client?

Newborn: $35.5^{\circ}\text{ to }37.5^{\circ}\text{ C}$ ($95.9^{\circ}\text{ to }99.5^{\circ}\text{ F}$). Older adult: $35^{\circ}\text{ to }36.1^{\circ}\text{ C}$ ($95^{\circ}\text{ to }97^{\circ}\text{ F}$).

How far should a lubricated rectal thermometer probe be inserted into an adult client, and what are the contraindications for rectal measurements?

Insert $2.5\text{ to }3.5\text{ cm}$ ($1\text{ to }1.5\text{ in}$) into the anus toward the umbilicus. Contraindications include diarrhea, bleeding precautions (low platelet count), rectal disorders, and infants younger than $3\text{ months}$.

How should the pinna be manipulated when taking a tympanic temperature on an adult versus a child younger than $3\text{ years}$?

Pull the pinna up and back for an adult, and down and back for a child younger than $3\text{ years}$.

Why is aspirin contraindicated for managing fever in children and adolescents who have viral illnesses such as influenza or chickenpox?

Due to the increased risk of developing Reye syndrome.

How is peripheral pulse strength (volume) graded on a clinical rating scale?

$0$ = Absent, unable to palpate; $1+$ = Diminished, weaker than expected; $2+$ = Brisk, expected; $3+$ = Increased, strong; $4+$ = Full volume, bounding.