Exam 2 Blueprint section rev 6 01

Exam 2 blueprint Use this Blueprint to guide your studying. The tables are expandable. I have filled in a few key concepts to start you off. Build on my entries. As you read, fill in the columns. I added a medication table as well. Care of the Preschooler 5 Care of the School-Age Child 5 Math - ANC calculations, fluid volume requirement calculations (no formulas) 5 Alterations in Neurological and Sensory Function 6 Alterations in Musculoskeletal Function 6 Alterations in Neuromuscular Function 6 Alterations in Endocrine Function 6 Oncological Disorders 6 Alterations in Hematological Function 5 Pre-School School Age 6-12 yo Developmental Level Psychosocial – Erickson: Initiative vs guilt, asserts self-more and wants to please parents, plans and initiates activities. Cognitive: Preoperational stage until 4 years of age, Remains egocentric and focuses only on one aspect, transudative reasoning: connecting unrelated events, Intuitive thinking after 4, develops logical thought based on perception, irreversibility: unable to reverse sequence of events, Magical thinking: fantasy and vivid imaginations. Industry vs inferiority Cognitive – Logical thinking, friends (Same sex) and peers become more important, self-confidence, Participation in clubs and sports Psychosocial Learns productivity and perseverance Develops confidence and competence Likes how things work Realistic achievable goals Cognitive Concrete operational stage Can put items in sequential order Concepts of reversibility and time Learns about objects through manipulation Understands cause and effect Learns principle of conservation. Physical Growth Height: 2.5 to 3” per year, Average 4y/o is 40” (3.3 ft) Weight: Gain 5lb per year from ages 3 to 6, Average 4y/o is 40lbs Head circumference: Brain growth slows , Only 1.9 to 2.4in increase from 3 – 18 y/o Document all physical growth data points on growth charts to assess trends and averages. Height Grow 2.5 to 3 in (6.3 to 7.3 cm) per year Intermittent growth spurts Girls are taller than boys at 12 y/o Weight Gains 6.5 to 7.5lbs (2.9 to 3.4 kg) year Weight varies based on diet, physical activity levels and home environment Begin plotting body mass index to determine risk for obesity BMI = 95th obesity, BMI 85 – 95th overweight, 5th - 85th normal Assessment Involve Child in health history Sitting on table or parents’ lap Play with safe medical equipment Invasive parts last Visual acuity at age 4 Hearing with optoacoustic emissions test Assess pinna of ear at age 3, pull up and back More formal assessments and screenings Play games to illicit cooperation Use radial for heart rate assessment 20/20 (4-5) Thoracic breathing at 5 Stool holding during toilet training Day time bladder control around 3 Body is more slim and abdominal muscles are stronger. Knock knees early preschool Point to location of pain Unable to describe quality Faces scale Observation and caregiver report for accuracy. Sexual maturation characteristics Direct question to child Request child to sit on exam table Head to toe manner Explain in concrete terms Parents remain in room Use Snellen eye chart 20/20 vision from K+ Hyperlipidemia at 11 yo Frontal sinuses are developed at 7 Tonsil’s hypertrophy Head elongated Oriented x 4 Fully developed Respiratory system Maximum impulse moves to 5th intercostal space Bowel movements affected by diet and activity Acne may develop Legs and arms grow faster than the rest of the body Puberty Secondary develop between 9-14 Testicular enlargement Growth spurt in males later in puberty Females Secondary characteristics 8 – 13 Breast bud development (thelarche) 1st sign Growth spurt earlier in puberty Menarche 2 yrs after breast bud development Tanner Maturity rating Table 18.1 Pain – faces for under 7 Number scale for older than 7 Nonpharmacological pain method works well Describe pain well Cultural consideration for pain assessment 1 st & 2nd year molar introduction Gross Motor Safety big issue, Steps, tricycle, kick ball, balance, independence Muscle coordination rhythm and balance improve Ride bike by 7 – 8 Growth spurts may decrease coordination Organized sports, dance, and gymnastics are popular Fine Motor Scribble age 3, better at 4, better at 5 Improved hand eye coordination and finger dexterity Play instrument, building, braiding Frustrated as skills develop Speech/Communication/L anguage Proliferative, concrete language, talk to kids, have conversations, Red flag - delayed, autism, cognitive, emotional delays, socioeconomic status or neglect, underlying neuro disorder Colors, name, address, Think about language and how it is used Increase of jokes and humor Reading skills increase Think and talk through thoughts and feelings Social/Emotional Cope with emotions, use imaginary play, elaborate stories, cooperation more common, learn to share and take turns, basic sexuality by 5-6 concerns of fear from imagination. Separate from parents and develop peer relationships Positive or negative self esteem through interaction with others Best friend by 7 Want to be accepted by peers Peer pressure subjected Negative self esteem more likely to give in Same sex peer groups Older different gender identity Ages 9 to 10 Short or long term Support children Assist families in adjusting Remain nonjudgmental Watch for bullying depression anxiety and low self esteem Health Promotion Bike, water, household safety, teach home address and phone Bike, water, household safety