NURS 5333 Final Study Guide - all study guides Latest

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MOD 1: Study Guide Growth and Development and Immunizations:
Objectives:

Discuss major growth and development landmarks from birth to adolescence
 Growth & Development landmarks
Review health promotion principles across the various developmental stages
 Describe expected developmental progression for pediatric lifespan
 Discuss anticipatory guidance measures for pediatric patients at various developmental
stages
 Identify developmental warning signs or RED FLAGS
Know Tanner staging for boys and girls
Know nutrition requirements birth-adolescents
Know vitamin supplementation needed

Nutrition
Caloric requirements:
 Birth -6 months: 120kcal/kg/day
 7 months-1 year: 100kcal/kg/day
 2-10 years: 100 to 70 kcal/kg/day
 Adolescents: 45 kcal/kg/day
Breast feeding
 Perfect food; cannot be duplicated
 Decreases illness in infants
 Maternal antibodies are transferred to infants
 Decreased GI problems such as GERD
 Decreases allergies as it contains anti-inflammatory agents
 Breastfeeding during painful procedures provides analgesia
 The longer the mom breastfeeds, the less chance of the child to be overweight independent of
education and socioeconomic status
Exclusive breast feeding for six months
 Feed on demand
 Adequate nutrition confirmed by weight gain
o 30 g/day (1 oz/day) for the first 3 months
o Gain of 15-20 g/day during subsequent 3 months
 Vitamin Supplementation
o Vitamin D (400 IU per day at 2 months of age to adolescence
o Vitamin B12 for breastfeeding mothers who are strict vegetarians
 Iron
o For exclusively breast-fed infants: approximately 1 mg/kg/day of iron is recommended after 6
months of age
o Bottle feeding should contain iron supplementation
o Ideally iron should come from fortified cereals
o Elemental iron supplements can be given if iron intake from diet is not adequate
 Fluoride
o Supplements only when local water supply is less than 0.3 parts per million (ppm)
o Supplementation first 6 months of life
Weight gain progression
 Rapid accelerating growth followed by consistent growth

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o Initial 10% weight loss
o Regained within 7-14 days
o Doubles by 5-6 months of age
o Triples by 1 year of age
o Quadruples by 2 years of age
o 3-year-olds through school-age: gain 4-6 lb annually
o School-age children gain 5-7 lb annually

Growth and Development Milestones Table:

Gross Motor Months Fine Motor Months Language Months
Good head 2-3 Grasps and 2-3 Smiles and 2-3
control shakes rattle coos
Rolls back to 5-6 Reaches for 3-4 Laughs 4-5
front object
Sits alone 7 Hand-to-hand 5-6 Babbles 5-6
transfer
Pulls to stand 9-10 Raking grasp 6-7 “mama-Dada” 8-9
Stands alone 11-12 Finger grasp 7-9 Waves bye- 8-9
bye
Walks 12-14 Pincer grasp 8-10 Understands 9-10
no
Walks up and 22-24 Marks on 10-12 Points to body 15-18
down stairs paper parts
Jumps 24-28 Stacks 3 blocks 17-18 2-word 18-22
sentences
Stacks 6 to 7 22-24 30-50-word 22-24
blocks vocabulary

Milestones by age:
2-5 months
 Smiles and coos
 Watches a person’s face intently
 Follows people and object with eyes
 Laughs aloud
 Lifts head/chest when on stomach
 Holds head steady when pulled to sit
 Grasps rattle placed in hand
 Startles to loud noise
6-9 months
 Turns to sound
 Babbles and combines vowel/consonant sounds
 Responds to name
 Rolls over
 Sits independently
 Transfers objects
 Supports weight on feet
 Uses thumb and fingers to pick up objects
 Crawls

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10-12 months
 Takes simple action on request
 Purposefully says “mama” or “dada”
 Sits independently and plays
 Pulls to standing/cruise furniture
 Communicates by reaching and pointing
 Moves purposefully to get desired object
 Has increasing curiosity
 Recognizes people
 Uses both hands well
13-18 months
 Scribbles with large crayon
 Walks alone
 Feeds self with fingers and begins using a spoon
 4-10-word vocabulary
 Follows simple directions
 Coordinates use of both hands
 Responds to name
 Points to 2 pictures upon request
 Long jabbering sentences
 Throw ball overhead
19-24 months
 Walks up/down stairs
 Jumps with both feet
 Completes simple puzzles, circle shapes first
 Stacks 6-7 blocks
 Uses 2-word sentences
 30-50-word vocabulary

Well Child Checks
Stage appropriate screenings
 Specific tools of health screening
o Parent interview or history
o Physical exam
o Developmental monitoring
o Specific, stage-appropriate screenings (see lectures)
o Assessment of strengths/weaknesses
o Individualized and evidence-based interventions
 Subjective data
o Nutrition/appetite
o Elimination
o Sleep
o Development
o Parent concerns
o Health since last visit
 Objective data
o Physical exam
o Screening
 Denver-Developmental screening Test, second edition

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 Denver II or equivalent for children up to 6 year of age
o Laboratory
 Management
o Immunizations; initiation of primary series
o Illness management with medications
o Health promotion strategies with anticipatory guidance

Injury Prevention
 Car seats
 Poison control numbers
 Electrical exposure protection
 All poisons out of reach
 Gates to barricade unsafe areas
 Smoke/carbon monoxide detectors
 Pool safety
 Crib safety
 Hot water safety
 Sun safety
 Passive/secondary smoke
 Abuse/neglect potential
 Domestic violence
 Sexual abuse
 Firearms
Developmental Discussion
 How to perform simple tasks
 When to call a health care provider
 Expected responses to immunizations and procedures
 Time management
 Discipline