STUDY GUIDE EXAM 2

Because the permanent teeth erupt during the school-age years what is important?

Dental hygiene and regular attention to dental caries are important parts of health supervision during this period. Potential dental problems include caries, periodontal disease, malocclusion, and dental injury.

What is acute epiglottis?

Or acute supraglottitis, is a serious obstructive inflammatory process that occurs predominantly in children 2 to 5 years of age, but can occur from infancy to adulthood.

The highest incidences of RSV are observed during what season?

Winter months of November through March; however, the virus may be transmitted anytime during the year.

how many word does a child a child say at 1 year? how many at 2 years?

about four at 1 year of age to approximately 300 at age 2 years— the ability to comprehend and understand speech is much greater than the number of words the child can say.

According to Erikson, the major developmental task of toddlerhood is

acquiring a sense of autonomy while overcoming a sense of doubt and shame. Several characteristics, especially negativism and ritualism, are typical of toddlers in their quest for autonomy.

How much bigger are adults than children at age of 2

adult height is about twice the child's height at 2 years of age.

According to Jean Piaget, adolescent cognitive development is represented by the stage of formal operational thought that includes which of the following? Select all that apply. a. Believing that thoughts are all-powerful b. Thinking in abstract terms c. Thinking about hypotheses d. Using a future time perspective e. Thinking in the here and now

B,C,D

Which of the following immunization booster vaccines should be considered for a 12-year-old adolescent who has completed all recommended routine childhood vaccinations? Select all that apply. a. DTaP vaccine b. Tdap vaccine c. Meningococcal vaccine d. Pneumococcal vaccine e. Hepatitis B vaccine

B,C

When does adolescence begin?

· the gradual appearance of secondary sex characteristics at about 11 or 12 years of age and to end with cessation of body growth at 18 to 20 years.

The incidence and severity of respiratory tract infections are influenced by

· the infectious agents involved, the child's age, and the child's natural defenses.

specific tasks in toddler psychological development include

differentiating self from others tolerating separation from parent coping with delayed gratification controlling bodily function acquiring socially acceptable behavior communicating verbally and interacting with others in a less egocentric manner. Achievement of toilet training is a major developmental milestone for the toddler.

Screening adolescents for hypertension should occur when? Additional annual screenings include

every year height, weight, and BMI.

Parental concerns during the toddler years include

toilet training, coping with sibling rivalry, limit setting and discipline, dealing with temper tantrums, negativism, and regression

. Most upper respiratory tract infections in otherwise healthy children are caused by

viruses

parallel play

· The solitary play of infancy progresses to parallel play the toddler plays alongside, not with, other children.

At what age do toddlers walk alone? When are they able to jump using both feet and climb stairs?

· . By 12 to 13 months of age, toddlers walk alone. They are able to jump using both feet and climb stairs by age 2 to 2½ years.

What physiological system are not completely developed by the end of toddlerhood?

· Although most of the physiologic systems are mature by the end of toddlerhood, development of certain areas of the brain is still occurring, allowing for greater intellectual capacity. By the end of the first year, all the brain cells are present but continue to increase in size.

What do preschoolers learn about body image?

· The preschool years play a significant role in the development of body image. With increasing comprehension of language, preschoolers recognize that individuals have undesirable and desirable appearances. They recognize differences in skin color and racial identity and are vulnerable to learning prejudices and biases.

Accurate measurement of height and weight during the toddler years should reveal what?

· a steady growth curve that is steplike rather than linear (straight), which is characteristic of the growth spurts during the early childhood years.

Adolescents and motor vehicle accidents

· are the primary cause of death from injury in the adolescent years. Motor vehicle injuries often involve alcohol use, unrestrained passenger or driver, excess speeds, and distraction by such things as cellular telephones (especially "texting"). · The increasing use of motorcycles, all-terrain vehicles, jet skis, and snowmobiles has caused an increase in injuries among young people who are below the legal age for driving automobiles.

Preoperational thought is characterized by

· by egocentrism, centration, global organization of thought processes, animism, and irreversibility.

Adolescents Spiritual Development

· characterized by the questioning of family values and ideals, a move to more philosophic thinking, and emphasis on personal religion.

According to Erikson, the major developmental crisis of adolescence is what?

· establishing a sense of identity. The adolescent's identity is defined according to the peer group, self, and sex role. Identification with a peer group supersedes parental relationships in the quest for identity.

Adolescents' health-related interests and concerns include

· include stress and anxiety, relationships with adults and peers, weight, acne, and feelings of sadness or depression. Health concerns are often consistent with the immediate developmental tasks that teenagers face. Adolescents define health in much the same way as adults: health means being able to live up to one's potential; being able to function physically, mentally, and socially; and experiencing positive emotional states.

By 36 months age 3 age 4 age 5

· preschoolers are walking, running, climbing, and jumping well. Refinement in eye-hand and muscle coordination is evident in several areas. At age 3, the preschooler rides a tricycle, walks on tiptoe, balances on one foot for a few seconds, and broad jumps. By age 4, the child skips and hops proficiently on one foot and catches a ball reliably. By age 5, the child skips on alternate feet, jumps rope, and begins to skate and swim.

The two phases of differentiation of self from significant others are

· separation and individuation. "The separation-individuation phase takes place at about four or five months, as the child begins to develop a sense of self, separate from the mother." (toddlers)

Transitional objects

· such as a favorite blanket or toy, provide security for toddlers, especially when they are separated from parents, dealing with a new stress, or just fatigued.

When does Middle Childhood occur?

"The school years" - Extends from 6 - 12 years of age This period begins with entrance into the school environment, which has a significant impact on development and relationships.

School aged children;

- More graceful than they were as preschoolers, steadier on their feet. - Their bodies take on a slimmer look with longer legs, varying body proportions, and a lower center of gravity. - Posture improves over that of the preschool period to facilitate locomotion and efficiency in using the arms and trunk.

Biologic development during puberty is characterized by

- increased activity of the pituitary gland, which results in sexual maturity and the appearance of secondary sex characteristics.

How many words in vocabulary at age 5?

2100

Universal screening for hyperlipidemia should optimally occur at what age? how to screen for hyperlipidemia ?

9-11 years years and again at ages 17 to 21 years. · . A non-fasting blood sample is adequate for screening.

3. Which statement by an 8-year-old child with asthma indicates that she understands the use of a peak expiratory flow meter? a. "My peak flow meter can tell me if an asthma attack is coming, even when I still feel OK." b. "My peak flow meter works best if I do three breaths without pausing in between breaths." c. "I breathe in as deeply as possible, and record that number." d. "If I use my peak flow meter every day, I will not have an asthma attack."

A

A hallmark of cognitive development in the school-age child is in what Piaget describes as concrete operations. In this stage the child: a. Uses thought processes to experience events and actions b. Is unable to see things from another's point of view c. Has a limited perspective of how others' interpretations of a given event differ d. Makes judgments based on what he or she sees

A

School-age children are prone to accidental injury primarily because of: a. Peer pressure and risk-taking behaviors b. Physical awkwardness and clumsiness c. Parents' lack of supervision d. Attempts to impress members of the opposite sex

A

What is the most common source of unintentional injury and death in young people? a. Motor vehicle crashes b. Drowning c. Poisoning d. Chronic illnesses

A

Self-concept refers to;

A conscious awareness of a variety of self-perceptions, such as one's physical characteristics, abilities, values, and self-ideals, and one's idea of self in relation to others. Closely associated with developing a sense of industry is developing a concept of one's value and worth. With the emphasis on skill building and broadened social relationships, children are continually occupied in the process of self-evaluation

Puberty involves;

A predictable sequence of hormonal and physical changes that occur universally over a defined period. It encompasses both sexual maturation and physical growth.

1. A 5-year-old is recovering from a tonsillectomy and adenoidectomy and is being discharged home with his mother. Home care instructions should include which of the following? Select all that apply. A. Report fever greater than 100.4 degrees Farenheit to physican. B. Encourage the child to take sips of cool, clear liquids. C. Observe the child for restlessness or difficulty breathing. D. Introduce solid foods as soon as possible to prevent weight loss. E. Administer an oral analgesic as ordered for pain.

A,B,C,E

At an appointment at the pediatrician's office, a patient's mother states, "My son gets rough with some of the neighborhood kids. I am worried that he is becoming a bully." Which statements by the mother need more teaching? Select all that apply. a. When my son becomes aggressive, I feel he needs to be punished. b. I think it is good for him to bond with his dad, so they often watch TV together. c. I am trying to get him to learn to say what he is upset about in words. d. Boys will be boys, so I think this can be considered a normal stage in development. e. I am thinking that a time-out would be a better strategy than spanking when my son shows this behavior.

A,B,D

. A school nurse in middle school (grades 6, 7, and 8) is preparing an outline for a sex education class. Which of these statements represent important concepts to be covered in discussing this topic with this age group? Select all that apply. a. Consider separating the boys and girls into same-sex groups with a leader of the same sex. b. Answer questions in a matter-of-fact manner and honestly and appropriate to the children's level of understanding. c. Use vernacular or slang terms to describe human physiologic functions. d. Avoid discussing sexually transmitted diseases in this age group. e. Discuss common myths and misconceptions associated with sex and the reproductive process. f. Avoid controversial topics such as birth control.

A,B,E

The nurse caring for a preschool child understands which of the following developmental concepts? Select all that apply a. Preschoolers have egocentric thought and believe that everyone thinks as they do. b. Play can be therapeutic and enlightening into a child's level of understanding. c. Explanations are helpful when using detail to allay the preschooler's stress. d. Preschoolers understand inferences and can relate to others' feelings with empathy. e. Preschoolers have magical thinking and believe their thoughts have power.

A,B,E

At the clinic appointment, a 4-year-old's mother wants to discuss several concerns. Which statements require more teaching by the nurse? Select all that apply. a. My husband feels that TV is okay as long as it is educational. b. I think it is okay for my son to play dress-up along with the girls. c. I told my son that his imaginary playmate moved away because it did not seem normal. d. My mother-in-law thinks I should be working around the house all the time, but I believe playing with my son is very important. e. My neighbor gave me some flash cards with letters and numbers for my son to use, but I said, "What's the rush? He's only 4."

A,C,E

In terms of social development, the school-age child does which of the following? Select all that apply. a. Begins to explore the environment beyond the family b. Has an increased interest in persons of the opposite sex (gender) c. May actively participate in same-sex groups or clubs d. Strives to be different from those in the peer group e. Begins to form strong relationships with persons of the same sex (gender)

A,C,E

What does the term operations imply?

An action that is performed on an object or set of objects; thus a mental operation is an alteration or transformation that an individual carries out in thought rather than in action.

What is bronchiolitis?

An acute viral infection with maximum effect at the bronchiolar level

______________is the leading cause of chronic illness in children

ASTHMA - Asthma is classified into four categories— Intermittent, mild, moderate, and severe—based on the symptom indicators of disease severity.

Three clinical observations that are predictive of epiglottitis are?

Absence of spontaneous cough, presence of drooling, and agitation. Emergency airway equipment and trained health care providers should always be readily available for treatment of the child with acute epiglottitis. Visualization of the child's throat should be delayed until such equipment and personnel are available.

· the chief psychosocial task of the preschooler: Erickson

According to Erikson, acquiring a sense of initiative Development of the superego occurs during this period, and conscience begins to emerge.

How are pneumonias classified?

According to site (lobar, bronchial, or interstitial) or by etiologic agent (viral, bacterial, mycoplasmal), or are associated with aspiration of foreign material.

what is the most common cause of illness in infancy and childhood.

Acute infection of the respiratory tract

Therapeutic management of TB disease in children consists of?

Adequate nutrition, pharmacotherapy, general supportive measures, prevention of unnecessary exposure to other infections that further compromise the body's defenses, prevention of reinfection, and sometimes surgical procedures.

Adolescents- parents v. peer group

Adolescent relationships with parents may be strained, whereas the influence of the peer group increases and intimate relationships assume importance. Adolescents want to grow up and to be free of parental restraints, but they are fearful as they try to comprehend the responsibilities that are linked with independence

What is recommended for adolescents to prevent cardiovascular disease, obesity, and diabetes?

Adolescents are encouraged to engage in 60 minutes of moderate to vigorous physical activity daily to prevent cardiovascular disease, obesity, and diabetes

When is the live attenuated influenza vaccine (LAIV) given?

An acceptable alternative to the intramuscular trivalent vaccine in specific age groups. Either TIV or LAIV may be given to healthy, nonpregnant persons ages 7 to 18 years.

What is Infectious Mononucleosis? what are the symptoms? What is the principal cause of infectious mononucleosis How is it transmitted?

An acute, self-limiting infectious disease that is common among young people under 25 years of age. · The disease is characterized by an increase in the mononuclear elements of the blood and by symptoms of an infectious process. The characteristics of the disease are malaise, sore throat, and fever with generalized lymphadenopathy, hepatosplenomegaly, and an increase in atypical lymphocytes that may persist for several months. The herpes-like Epstein-Barr virus is the principal cause of infectious mononucleosis. It is believed to be transmitted by direct contact with oral secretions, via blood transfusion, or by transplantation. No specific treatment exists for infectious mononucleosis.

What age is the influenza vaccine recommended?

Annually for children 6 months to 18 years (completed).

Immunization updates and adolescents

Appropriate adolescent immunizations include Tdap, meningococcal vaccine, human papillomavirus vaccine, MMR booster, yearly influenza, and TB screening if exposed or traveling to countries where endemic TB rates are high. Verify that the recommended childhood vaccines have been received according to the recommended schedule for hepatitis A and B, varicella, and poliovirus.

General therapeutic management of asthma includes?

Assessment of asthma severity, allergen control, drug therapy, symptom management, and sometimes hyposensitization.

4. A child with cystic fibrosis is hospitalized for a respiratory infection. Which finding would indicate the need for counseling regarding nutrition and gastrointestinal complications? a. Weight unchanged from yesterday b. Frothy, foul-smelling stools c. Weight changed from yesterday d. Eats three snacks every day

B

5. Which intervention would be the highest priority for a child with cystic fibrosis admitted to the hospital for a respiratory infection? a. Maintaining strict intake and output b. Administering intravenous antibiotics c. Recording vital signs every four hours d. Arranging for sweat chloride testing

B

Characteristics of bullying include: a. Unintentional harm inflicted upon another person that is part of the socialization process in childhood b. The infliction of repetitive physical, verbal, or emotional abuse upon another person with intent to harm c. An attempt to gain acceptance and be liked by same-sex peers d. An early sign of a severely disturbed personality disorder that escalates in adulthood

B

One of the concerns of the preschool period is adequate nutrition. What can the nurse say to give anticipatory guidance to parents? a. Preschoolers are growing during this period and need to increase their caloric intake to 110 kcal/kg, for an average daily intake of 2200 calories. b. There is some evidence that children self-regulate their caloric intake. If they eat less at one meal, they compensate at another meal or snack. c. To monitor fat intake, dairy and meat should be limited to twice a day. d. For children who do not like milk, consumption of fruit juices is a healthy alternative.

B

When her preschool son is in the hospital, the parent tells the nurse, "I think there is something wrong with him because he is so skinny." The most appropriate answer by the nurse is: a. Most preschoolers weigh between 10 and 14 kilograms. b. The legs of a preschooler, rather than the trunk, increase in length, which may make him look slimmer. c. Preschoolers usually keep that pot-bellied appearance until about 4 years old. d. Most preschoolers gain 2 to 3 pounds per year.

B

As a nurse caring for children, an understanding of childhood depression is essential. Some important information about depression includes which of the following statements? Select all that apply. a. Authorities agree that childhood depression exists, and the manifestations are often similar to adult depression. b. Identification of the depressed child requires a careful history taking (e.g., health, growth and development, social and family health); interviews with the child; and observations by the nurse, parents, and teachers. c. If antidepressants are prescribed, the child and family need to know that antidepressants must be at a therapeutic level for 4 to 6 weeks to achieve a beneficial effect. d. Depressed children often exhibit a distinctive style of thinking characterized by low self-esteem, hopelessness, poor social engagement with peers, and a tendency to explain negative events in terms of personal shortcomings. e. Nurses should be aware that depression is a problem that can be easily overlooked in the school-age child and one that can interrupt normal growth and development.

B,D,E

What are common infections of the lower airways?

Bronchitis, respiratory syncytial virus (RSV) and bronchiolitis, and pneumonia.

Why will infants and small children have more fifficulty breathing with respiratory tract infection?

Because of the size of their airway, difficulty handling mucus, and, especially in infants, predominant nose breathing.

When does the Preadolescence period begin and end?

Begins toward the end of middle childhood and ends with the thirteenth birthday.

By one year how have braincells developed? While they change from now on?

By the end of the first year, all the brain cells are present but continue to increase in size.

2. An 18-month-old child is admitted with a diagnosis of pneumonia. Following the initial workup, the baby is still short of breath but is rubbing his eyes as if he is sleepy. The mother wants to lay the baby down for his nap, but the infant refuses to lie down. Which suggestion would the nurse give the mother to best help the child? a. Rocking the baby until he is asleep and then lay him down b. The mother gently hold the baby supine until asleep c. The mother allow the baby to sleep in an upright position d. A sleeping pill to help the baby rest

C

The school aged child develops a______

CONSCIENCE and is able to understand and adhere to rules and standards set by others. - Older school-age children are able to judge an act by the intentions that prompted it rather than just by the consequences. - Rules and judgments become less absolute and authoritarian and begin to be founded more on the needs and desires of others. ·- Children at this age think in concrete terms but are avid learners.

What develops in the concrete operational stage?

Children develop an understanding of relationships between things and ideas. They progress from making judgments based on what they see (perceptual thinking) to making judgments based on what they reason (conceptual thinking).

What predisposes children to more respiratory tract infections than adults

Close contact with other children, frequent hand-to-mouth activity, lack of hygiene awareness, and decreased resistance to certain viruses and bacteria predispose children to more respiratory tract infections than adults

the most important social interactions for school-age children are?

Daily relationships with age mates - For the first time, children are able to join in group activities with unrestrained enthusiasm and steady participation. Previously, interactions were limited to short periods under considerable adult supervision. They be kinda freeer now.

Bacteria resistance and acute Otitis media what bacteria? protocol

Concerns about drug-resistant Streptococcus pneumoniae and other drug resistances have led infectious disease authorities to recommend careful and judicious use of antibiotics for treatment of this illness. Current literature indicates that waiting up to 72 hours for spontaneous resolution is safe and appropriate management of AOM in healthy infants over 6 months and children.

__________is the most common inherited disease in children

Cystic fibrosis The primary factor, and the one that is responsible for many of the clinical manifestations of the disease, is mechanical obstruction caused by the increased viscosity of mucous gland secretions in the lungs and gastrointestinal tract (including pancreas). Effects on the gastrointestinal system include vitamin and nutrient malabsorption, growth failure, and cystic fibrosis-related diabetes (CFRD).

What factors should the nurse consider when interviewing an adolescent patient? a. Begin with sensitive issues then proceed with less sensitive topics b. Assume you understand the adolescent by including your own experiences c. Interview the adolescent with the parents to ensure accuracy d. Ask open-ended questions

D

How is influenza spread from one individual to another?

Direct contact (large-droplet infection) or by particles recently contaminated by nasopharyngeal secretions

The nursing care management of children (and their families) with respiratory infections includes

Easing respiratory effort, promoting comfort, preventing the spread of infection, reducing body temperature, promoting hydration and nutrition, observing for deterioration, and providing family support and home care.

Complications of pneumonia include?

Empyema, pyopneumothorax, or tension pneumothorax.

What are important features of social development during the school years?

Entertaining different points of view, becoming sensitive to social norms, and forming peer friendships

Clinical manifestations of pulmonary TB FACTS

Extremely variable in children. - The disease may be asymptomatic or produce a broad range of symptoms, including general responses such as fever, malaise, anorexia, and weight loss or more specific symptoms related to the site of infection (e.g., lungs, bone, brain, kidneys). Lung disease may or may not include cough (which progresses slowly over weeks to months), aching pain and tightness in the chest, and (rarely) hemoptysis.

Common respiratory tract infections of childhood include;

Include nasopharyngitis and acute infectious pharyngitis (including tonsillitis).

In tuberculosis (TB), susceptibility to bacillus can be influenced by

Heredity, age, stress, poor nutrition, and intercurrent infection such as human immunodeficiency virus. The source of infection in children is usually an infected member of the household or any frequent visitor to the household, such as a sitter or domestic worker.

What is an intervention to teach parents whose child has RSV?

How to suction the infant's nose and mouth to remove excess mucus

What are essential to a childs socialization?

Identification and association with the peer group are essential to a childs socialization - Cooperative play, team activities, and the acquisition of skills are prime elements of play during the school years, and rules and rituals assume greater importance.

Who is more at risk for difficulty breathing with a respiratory tract infection?

Infants and small children may have more difficulty breathing with respiratory tract infections than older children .

What does a positive tuberculin skin test (TST) indicate?

Infection and sensitivity to the tubercle bacillus.

According to Piaget, the preschool age is characterized by

Intuitive thinking a move toward logical thought processes through advanced, complex learning, language, and understanding of causality.

what is the major cognitive achievement in childhood ?

Language

Language in a preschooler

Language becomes more sophisticated and complex during the preschool years. Both cognitive ability and environment, particularly consistent role models, influence vocabulary, speech, and comprehension.

What are the overall goals of asthma management

Maintain normal activity levels, maintain normal pulmonary function, prevent chronic symptoms and recurrent exacerbations, provide optimum drug therapy with minimal or no adverse effects, and assist the child in living as normal and happy a life as possible. Support for the family of the child with asthma includes education about the disease and its therapy and facilitation of self-management.

When should the trivalent inactivated influenza vaccine (TIV)

May be given to any healthy children 6 months old and older via IM injection.

Antisocial behavior is seen during;

Middle childhood - Previously well-behaved children may engage in lying, stealing, and cheating. Such behaviors are disturbing and challenging to parents.

What is one of the most prevalent diseases of early childhood?

Otitis media is one of the most prevalent diseases of early childhood. - Its incidence is highest in the winter months. Many cases of bacterial otitis media are preceded by a viral respiratory tract infection.

This is the only product available in the USA for prevention of RSV

Palivizumab (Synagis), a monoclonal antibody, which is given monthly in an intramuscular injection to preterm infants and those with medical conditions that place them at greater risk for mortality as a result of RSV.

rational judgement, an understanding of causal relationships and discovery of objects as objects is in which one of Piagets stages

Piaget's sensorimotor and preoperational phases of development

magical thinking

Preschoolers' thinking is often described as magical thinking. Because of their egocentrism they believe that thoughts are all powerful. Such thinking places them in the vulnerable position of feeling guilty and responsible for bad thoughts that may coincide with the occurrence of a wished event.

Management of pulmonary problems caused by cystic fibrosis is directed toward?

Prevention and treatment of pulmonary infection by improving ventilation, removing mucopurulent secretions, and administering antimicrobial agents.

How is viral pneumonia treated?

Primarily symptomatic

Most cases of bronchiolitis are caused by?

RSV, which is the most frequent cause of hospitalization in children less than 1 year old.

What signals the beginning of adolescence?

The pubescent growth spurt that begins around age 10 in girls and age 12 in boys signals the - The term teenage years is used synonymously with adolescence to describe ages 13 through 19.

What is the princnipal treatment for pancreatic insufficiency?

Replacement of pancreatic enzymes, which are administered with meals and snacks to ensure that digestive enzymes are mixed with food in the duodenum. Water-miscible forms of vitamins A, D, E, and K are given, along with multivitamins. Children with CF require a well-balanced, high-protein, high-caloric diet, with unrestricted fat (because of the impaired intestinal absorption). Improved nutrition in children with CF has been associated positively with improved lung function.

How is bacterial pneumonia treated?

Requires aggressive management with antibiotics and supplemental oxygen.

According to Erikson, a major task during the middle school years is developing a sense of_________

SENSE OF INDUSTRY , or accomplishments School-age children are eager to develop skills and participate in meaningful and socially useful work. Children gain a great deal of satisfaction from independent behavior in exploring and manipulating their environment and from interaction with peers.

Treatment of influenza includes?

Symptomatic management of fever, cough, and dry throat, as well as ensuring adequate hydration. - Zanamivir (Relenza) and oseltamivir (Tamiflu) may be used for treatment but must be initiated within 48 hours of appearance of symptoms.

How is RSV treated?

Symptomatically with cool humidified oxygen, adequate fluid intake, airway maintenance, and medications

What is prepubescence?

The 2 year period that precedes puberty, typically occurs during preadolescence

What should be explained to school aged children and their families? physical characteristics? physical maturity vs social and emotional

The associated characteristics of height and weight relationships, rapid or slow growth, and other important features of development should be explained to children and their families. - Physical maturity is not necessarily correlated with emotional and social maturity. Seven-year-old children who look like 10-year-old children will think and act like 7-year-olds.

What does puberty signal?

The beginning of the development of secondary sex characteristics

What is the most common reasons for antibiotic use in the ambulatory setting?

Treatment for acute otitis media (AOM) - All cases of AOM in infants younger than 6 months of age should be treated with antibiotics because of the infant's immature immune system and the potential for infection with bacteria other than the three most common organisms found in older infants and children with AOM. Supportive care or symptomatic treatment of AOM includes treating the fever and pain. - Concerns about drug-resistant Streptococcus pneumoniae and other drug resistances have led infectious disease authorities to recommend careful and judicious use of antibiotics for treatment of this illness. Current literature indicates that waiting up to 72 hours for spontaneous resolution is safe and appropriate management of AOM in healthy infants over 6 months and children.

How are preschoolers aware of acceptable behavior?

are aware of appropriate behavior primarily through punishment or reward and rely almost completely on parental principles for developing their own moral judgment.

What are Primary sex characteristics ?

are the external and internal organs that carry out the reproductive functions (e.g., the ovaries, uterus, breasts, and penis).

When is gender identity formed?

by age 3

Biologic development during the toddler years is characterized by what?

characterized by the acquisition of fine and gross motor skills that allow children to master a wide variety of activities

Piaget's sensorimotor and preoperational phases of development

experiments by incorporating the old learning of secondary circular reactions with new skills and applies this knowledge to new situation There is the beginning of rational judgment, an understanding of causal relationships, and discovery of objects as objects.

What is the toddler stage?

extending from 12 to 36 months, is a period of intense exploration of the environment.

the events of puberty are triggered by ________ and controlled by ________

hormonal influences and are controlled by the anterior pituitary gland in response to a stimulus from the hypothalamus.

Two primary reasons for hospitalization with RSV include?

inability to maintain adequate oxygen saturation without supplemental oxygen, and inadequate hydration.

Cognitive development in adolescence includes

includes abstract thought, thinking beyond the present, logical reasoning, and a sense of idealism. Adolescents can imagine a sequence of events that might occur, such as college and occupational possibilities; how things might change in the future, such as relationships with parents; and the consequences of their actions. At this time, their thoughts can be influenced by logical principles rather than by just their own perceptions and experiences. They become increasingly capable of scientific reasoning and formal logic.

Sexual orientation

is defined as a pattern of sexual arousal or romantic attraction toward persons of the opposite gender (heterosexual), of the same gender or of both genders. Sexual orientation encompasses several dimensions, including attraction, fantasy, actual sexual behavior, and self-labeling or group affiliation. In individuals, the direction and intensity of each dimension are not necessarily consistent with any of the others.

What is negativism? what is it a necessary assertion of?

is not an expression of being stubborn or insolent, but a necessary assertion of self-control.

What is locomotion?

is the major gross motor skill acquired during toddlerhood, followed by increased eye-hand coordination.

body image occurs with what? what does this mean toddlers recognize?

occurs with increasing motor ability, at which point toddlers recognize the importance and capacity of body parts

Likes and dislikes established at an early age continue in middle childhood although;

preferences for single foods subside, and children develop a taste for a variety of foods. - The availability of junk foods, irregular family meals, and schedules of working parents often hamper optimal nutrition.

when does the super ego occur ?

preschool

is verbal enforcement more effective with toddlers or preschoolers?

preschoolers

preschool and the separation-individuation process

process is complete Preschoolers have overcome much of their anxiety associated with strangers and the fear of separation of earlier years. They relate to unfamiliar people easily and tolerate brief separations from parents with little or no protest. However, they still need parental security, reassurance, guidance, and approval, especially when entering preschool or elementary school

Temper tantrums

tantrums are nearly universal during toddlerhood as independence is established and more complex tasks are attempted that may overwhelm the child emotionally. Toddlers may assert their independence by violently objecting to discipline.

What are secondary sex characteristics?

the changes that occur throughout the body as a result of hormonal changes (e.g., voice alterations, development of facial and pubertal hair, and fat deposits), but that play no direct part in reproduction. The Tanner stages are used to classify development of stages of secondary sex characteristics and genital development in females and males

One of the outstanding characteristics of middle childhood is

the formation of formalized groups or clubs. Initially, children in the early middle years merely hang around the periphery of the formalized group, watching, learning, practicing various skills, and participating in group activities whenever the members of the group allow them to do so. As they age, children eventually take their places as full-fledged participating group members

Piaget's period of concrete operations refers to;

the school-age period, when children are able to use their thought processes to experience events and actions and make judgments based on what they reason.

The process of evolving a personal identity in adolescents

time consuming and fraught with periods of confusion, depression, and discouragement. Experts emphasize that adolescents still need monitoring and input from parents during their search for identify; total abandonment during this phase is undesirable and may leave the adolescent feeling fragmented, alone, and adrift, resulting in the development of psychopathology

moral development in preschool

· these children are in the stage of naive instrumental orientation, in which they are concerned with satisfying their own needs and, less frequently, the needs of others. · Children generally learn about faith and religion from significant others in their environment, usually from parents and their religious beliefs and practices. However, young children's understanding of spirituality is influenced by their cognitive level.

Body image- school age children

· what children think about their bodies. School-age children are knowledgeable about the human body, and social development during this period focuses to a large extent on the body and its capabilities.

Adolescents and Kohlberg's theory of moral development

·adolescents begin to question existing moral values and learn to make choices. Adolescents search for a moral code that preserves their personal integrity and guides their behavior, especially in the face of strong pressure to violate the old beliefs.