20:45v13/12/2023 PediatricvATIvRNvNotes
PediatricvATI
Chapterv1
Parentingvstyles
• Dictatorialvorvauthoritarianv vnotvreallyvgoodvparents
• Democraticvorvauthoritativev vveryvgoodvparents
• Passive
Chapterv2
Physicalvassessmentvfindings
• EverythingvisvgoingvtovbevhighervexceptvforvBP
• InfantvHR:v80-180vRR:v30-35vBP:v65-80/40-50
• Fontanelsv–vflatvandvsoft
o Posteriorvclosesvbetweenv6v&v8vweeks
o Anteriorvclosesvbetweenv12v&v18vmonths
• Teethv–v6vtov8vteethvbyv1vyear
o 20vbabyvteethvandv32vpermanentvteeth
• Reflexesv**vchartvonvpg.v10
o Moro
o Tonicvneckvreflex
o Babinski
• Cranialvnervesv**vchartvonvpg.v11
o Olfactory
o Optic
o Oculomotor
o Trochlear
o Trigeminal
o Abducens
o Facial
o Acoustic
o Glossopharyngeal
o Vagus
o Spinalvaccessory
o Hypoglossal
Chapterv3
Infants
• Baby’svbirthvweightvwillvdoublevbyv6mvandvtriplevbyv12m
• Infantsvwillvgrowv1vinchvpervmonthv(2.5vcm)vforvthevfirstv6mvofvlifevandvatv12mvtheirvbirthvlengthvhasvincreasedvbyv50%
• Firstvteethveruptvbetweenv6vandv10m
• Grossvandvfinevmotorvskills
o Byv3mvavbabyvshouldvonlyvhavevslightvheadvlag
o 4mvshouldvbevablevtovrollvfromvbackvtovside
o 5mvrollvfromvfrontvtovback
o 6mvrollvfromvbackvtovfrontvandvholdvavbottle
o 7mvmovevobjectvfromvhandvtovhand
o 8mvsitvunsupported
o 9mvcrudevpincervgrasp
o 10mvpronevtovsittingvpositionvandvgraspvavrattlevbyvhandle
o 11mvputvobjectsvintovavcontainervandvhavevavneatervpincervgrasp
o 12mvtryvtovbuildvav2-blockvtowervandvwon’tvsucceed
• Piagetv cognitivev developmental v stage
s
o Sensorimotorv (birthv tov 24m)
▪ Separation
▪ Objectvpermanencev–varoundv9m
▪ Mentalv representation
• 3-5vwordsvbyv1yr
• Conceptvofvno
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• Erikson’s:vTrustvvs.vmistrustvbirthv–v1yr.
o Caretakervmeetingvthevneedsvofvthevinfant
• Separationvanxietyvbeginsvtovoccurvaroundv4-8mvofvage
• Strangervfearv6-8mvofvage
• Rattles,vBlocks,vBrightlyvcoloredvtoys,vMirrors,vPattyvcake
• Immunizations
o Birthv–hepvB
o 2mv–vhepvB,vIPV,vRV,vPCVv+vdtapv&vHIB
o 4mv–vallvofvthev2mv–vthevhepvB
o 6mv–vhepvBv+vallvthevprevious
o Fluvshotsv6m-1vyr.
• Nutrition
o Breastvmilkvfirstv6m
o Solidsv4-6mv&vfirstvsolidvisvusuallyvironvfortifiedvricevcereal
o Novjuicevorvwatervisvnotvneededvforvfirstvyear
o Foodsvintroducedvonevatvavtimevovervav4-7vdayvperiodvtovmonitorvforvallergies
• Choking/aspiratingv–vgrapes,vcoins,vcandy
• Burnsv–vsunscreen,vhandlesvturnedvawayvonvstove,velectricalvoutletsvarevcovered
• Drowning
• Rearvfacingvcarvseatvuntilv2yrs.
• Cribvslatsvarevnovmorevthanv6cmvapart,vnovpillows,vandvsleepvonvback
Chapterv4
Toddlers
• 4xvtheirvbirthvweightvbyv30m
• 3vinchesvpervyearv(7.5vcm)
• Headvandvchestvcircumferencevarevaboutvequalv–
vcomparedvtovwhenvtheyvarevborn,vandvtheirvheadvisvwidervthanvtheirvchest
• Grossvandvfinevmotorvskills
o 15mvexpectvwalkingvwithoutvhelpv+vshouldvbevablevtovbuildv2vblockvtower
o 18mvcanvthrowvavballvovervhand
o 2vyr.vcanvwalkvupvandvdownvstairsvbyvplacingvfeetvonveachvstepv+v6/7vblockvtower
o 2.5vyrs.vCanvjumpvwithvbothvfeetv+vdrawvcircles
• Language
o 1vyr.v=v1vwordvsentencesv v“hollowvphrases”
o 2vyr.v=v2-3-wordvsentences
• Erikson’svstagesv–vautonomyvvsvshamevandvdoubt
o Independence
o Beginvtovexpressvselvesvbyvsayingvnovavlot
o Thrivevonvritualsv–vmaintainvroutines
• Agevappropriatevactivitiesv–vblocks,vpushvpull,vthickvcrayons,vpuzzle
• Toiletvtrainingvbeginvwhenvtheyvhavevrecognizedvthevsensationvthatvtheyvneedvtovgovpotty
• Immunizations
o 12-15mv–vIPV,vPCVv+vMMRv&vvaricellav+vHIB
o 12-23mv–vHepvAv2vdoses/6mvapart
o 15-18mv–vdtapv+vannualvfluvvaccine
• Nutrition
o Breastvmilkvorvformulavthroughv1vyear
o 1-2vyearvwholevmilk
o Afterv2vcanvtransitionvtovlowvfat
o Limitvjuicevconsumptionv–v4-6ozvpervday
o Preventv chokingv v nuts,v grapes,v hotv dogs,v peanutv butter,v rawv carrots,v toughv meatv andv popcorn
• Burns,vdrowning,vfalls,vaspirationvprevention
Chapterv5
Preschoolers
• 4.5-6.5vpoundsvpervyear
• 2.5-3.5vinchesvpervyearv(6-9vcm)
• Grossvmotorvskills
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o 3yr.vcanvridevtricyclev+vjumpvoffvbottomvstepvonvstairs
o 4yr.vcanvskipvandvhopvonvqvfootv+vthrowvballvovervhead
o 5vcanvjumpvrope
• Cognitivev development
o Piaget:vpreoperational vphasev4-
7vyrs.v vMovingvfromvthevpreconceptualvphasevtovthevphasevofvintuitivevthought
▪ Magicalvthinking
▪ Animism
▪ Centration
▪ Time
• Psychosocial v developmentv –v Erikson’s
o Initiativevvsvguilt
• Anothervbabyvinvthevfamilyvcanvcausevthevpreschoolervtovregressvtovbedvwettingvorvthumbvsuckingv–vtovbevexpected
• Playingvball.vPuzzles,vtricycles,vdressvup,vrolevplaying
• Immunizations
o 4-6vyearsv–vdtap,vMMR,vIPVv+vannualvflu
• 12vhoursvofvsleep,vbedtimevroutine
• Eruptionvofvprimaryvteethvisvfinalizedvbyvthevbeginningvofvthevpreschoolvyears
• Protectivevgearvwithvtricycles
Chapterv6
School-agevchildren
• 4-6-poundvweightvgainvpervyearv&vgrowv2vinchesv(5vcm)vpervyear
• Permanentvteethvstartvtovcomevin
• Piagetsvcogvdevelopmentv–vconcretevoperations
o Perceptualvtovconceptualvthinking
o Learnsvtovtellvtime,vseevothervperspectives,vsolvevproblems
• Erikson’s:vindustryvvsvinferiority
o Tryingvtovmakevmeaningvcontributionsvtovsocietyv&vcooperativevandvcompetevwithvothers
• Peervgroupsvimportantv–vcompetitivevandvcooperativevplay
• Boardvgames,vhopvscotch,vbikes,vjumpvropev&vorganizedvsports
• Immunizations
o 11-12yrv–vdtapv+vHPVvvaccinev(seriesvofv3vshots)
• 9vhoursvofvsleepvrecommendedv@v12vyrs.
• Safetyv–vhelmets
Chapterv7
Adolescentsv(12-20)
• Girlsvstopvgrowingv2-2.5vyearsvaftervtheirvperiodvstarts
• Boysvstopvgrowingvaroundv18-20
• Sexualvmaturationvinvgirls:
o Breastv development
o Pubicvhairvgrowth
o Underarmvhair
o Period
• Sexualvmaturationvinvboys:
o Testicularv enlargement
o Pubicvhair
o Penilevenlargement
o Underarmvhairvgrowth
o Facialvhair
o Vocalvchanges
• Piagetsvcogvdevelopmentv–vformalvoperations
• Erikson’s:videntityvvsvrolevconfusion
• Videovgames,vmusic,vsports,vpets,vreading
• Immunizations
o Flu
o 16-18v–vmeningitisv(beforevcollege)
• Injuryvpreventionv–vhelmetvuse,vseatvbelts,vdriving,vsubstancevabuse
about:blank 3/19
PediatricvATI
Chapterv1
Parentingvstyles
• Dictatorialvorvauthoritarianv vnotvreallyvgoodvparents
• Democraticvorvauthoritativev vveryvgoodvparents
• Passive
Chapterv2
Physicalvassessmentvfindings
• EverythingvisvgoingvtovbevhighervexceptvforvBP
• InfantvHR:v80-180vRR:v30-35vBP:v65-80/40-50
• Fontanelsv–vflatvandvsoft
o Posteriorvclosesvbetweenv6v&v8vweeks
o Anteriorvclosesvbetweenv12v&v18vmonths
• Teethv–v6vtov8vteethvbyv1vyear
o 20vbabyvteethvandv32vpermanentvteeth
• Reflexesv**vchartvonvpg.v10
o Moro
o Tonicvneckvreflex
o Babinski
• Cranialvnervesv**vchartvonvpg.v11
o Olfactory
o Optic
o Oculomotor
o Trochlear
o Trigeminal
o Abducens
o Facial
o Acoustic
o Glossopharyngeal
o Vagus
o Spinalvaccessory
o Hypoglossal
Chapterv3
Infants
• Baby’svbirthvweightvwillvdoublevbyv6mvandvtriplevbyv12m
• Infantsvwillvgrowv1vinchvpervmonthv(2.5vcm)vforvthevfirstv6mvofvlifevandvatv12mvtheirvbirthvlengthvhasvincreasedvbyv50%
• Firstvteethveruptvbetweenv6vandv10m
• Grossvandvfinevmotorvskills
o Byv3mvavbabyvshouldvonlyvhavevslightvheadvlag
o 4mvshouldvbevablevtovrollvfromvbackvtovside
o 5mvrollvfromvfrontvtovback
o 6mvrollvfromvbackvtovfrontvandvholdvavbottle
o 7mvmovevobjectvfromvhandvtovhand
o 8mvsitvunsupported
o 9mvcrudevpincervgrasp
o 10mvpronevtovsittingvpositionvandvgraspvavrattlevbyvhandle
o 11mvputvobjectsvintovavcontainervandvhavevavneatervpincervgrasp
o 12mvtryvtovbuildvav2-blockvtowervandvwon’tvsucceed
• Piagetv cognitivev developmental v stage
s
o Sensorimotorv (birthv tov 24m)
▪ Separation
▪ Objectvpermanencev–varoundv9m
▪ Mentalv representation
• 3-5vwordsvbyv1yr
• Conceptvofvno
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,20:45v13/12/2023 PediatricvATIvRNvNotes
• Erikson’s:vTrustvvs.vmistrustvbirthv–v1yr.
o Caretakervmeetingvthevneedsvofvthevinfant
• Separationvanxietyvbeginsvtovoccurvaroundv4-8mvofvage
• Strangervfearv6-8mvofvage
• Rattles,vBlocks,vBrightlyvcoloredvtoys,vMirrors,vPattyvcake
• Immunizations
o Birthv–hepvB
o 2mv–vhepvB,vIPV,vRV,vPCVv+vdtapv&vHIB
o 4mv–vallvofvthev2mv–vthevhepvB
o 6mv–vhepvBv+vallvthevprevious
o Fluvshotsv6m-1vyr.
• Nutrition
o Breastvmilkvfirstv6m
o Solidsv4-6mv&vfirstvsolidvisvusuallyvironvfortifiedvricevcereal
o Novjuicevorvwatervisvnotvneededvforvfirstvyear
o Foodsvintroducedvonevatvavtimevovervav4-7vdayvperiodvtovmonitorvforvallergies
• Choking/aspiratingv–vgrapes,vcoins,vcandy
• Burnsv–vsunscreen,vhandlesvturnedvawayvonvstove,velectricalvoutletsvarevcovered
• Drowning
• Rearvfacingvcarvseatvuntilv2yrs.
• Cribvslatsvarevnovmorevthanv6cmvapart,vnovpillows,vandvsleepvonvback
Chapterv4
Toddlers
• 4xvtheirvbirthvweightvbyv30m
• 3vinchesvpervyearv(7.5vcm)
• Headvandvchestvcircumferencevarevaboutvequalv–
vcomparedvtovwhenvtheyvarevborn,vandvtheirvheadvisvwidervthanvtheirvchest
• Grossvandvfinevmotorvskills
o 15mvexpectvwalkingvwithoutvhelpv+vshouldvbevablevtovbuildv2vblockvtower
o 18mvcanvthrowvavballvovervhand
o 2vyr.vcanvwalkvupvandvdownvstairsvbyvplacingvfeetvonveachvstepv+v6/7vblockvtower
o 2.5vyrs.vCanvjumpvwithvbothvfeetv+vdrawvcircles
• Language
o 1vyr.v=v1vwordvsentencesv v“hollowvphrases”
o 2vyr.v=v2-3-wordvsentences
• Erikson’svstagesv–vautonomyvvsvshamevandvdoubt
o Independence
o Beginvtovexpressvselvesvbyvsayingvnovavlot
o Thrivevonvritualsv–vmaintainvroutines
• Agevappropriatevactivitiesv–vblocks,vpushvpull,vthickvcrayons,vpuzzle
• Toiletvtrainingvbeginvwhenvtheyvhavevrecognizedvthevsensationvthatvtheyvneedvtovgovpotty
• Immunizations
o 12-15mv–vIPV,vPCVv+vMMRv&vvaricellav+vHIB
o 12-23mv–vHepvAv2vdoses/6mvapart
o 15-18mv–vdtapv+vannualvfluvvaccine
• Nutrition
o Breastvmilkvorvformulavthroughv1vyear
o 1-2vyearvwholevmilk
o Afterv2vcanvtransitionvtovlowvfat
o Limitvjuicevconsumptionv–v4-6ozvpervday
o Preventv chokingv v nuts,v grapes,v hotv dogs,v peanutv butter,v rawv carrots,v toughv meatv andv popcorn
• Burns,vdrowning,vfalls,vaspirationvprevention
Chapterv5
Preschoolers
• 4.5-6.5vpoundsvpervyear
• 2.5-3.5vinchesvpervyearv(6-9vcm)
• Grossvmotorvskills
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o 3yr.vcanvridevtricyclev+vjumpvoffvbottomvstepvonvstairs
o 4yr.vcanvskipvandvhopvonvqvfootv+vthrowvballvovervhead
o 5vcanvjumpvrope
• Cognitivev development
o Piaget:vpreoperational vphasev4-
7vyrs.v vMovingvfromvthevpreconceptualvphasevtovthevphasevofvintuitivevthought
▪ Magicalvthinking
▪ Animism
▪ Centration
▪ Time
• Psychosocial v developmentv –v Erikson’s
o Initiativevvsvguilt
• Anothervbabyvinvthevfamilyvcanvcausevthevpreschoolervtovregressvtovbedvwettingvorvthumbvsuckingv–vtovbevexpected
• Playingvball.vPuzzles,vtricycles,vdressvup,vrolevplaying
• Immunizations
o 4-6vyearsv–vdtap,vMMR,vIPVv+vannualvflu
• 12vhoursvofvsleep,vbedtimevroutine
• Eruptionvofvprimaryvteethvisvfinalizedvbyvthevbeginningvofvthevpreschoolvyears
• Protectivevgearvwithvtricycles
Chapterv6
School-agevchildren
• 4-6-poundvweightvgainvpervyearv&vgrowv2vinchesv(5vcm)vpervyear
• Permanentvteethvstartvtovcomevin
• Piagetsvcogvdevelopmentv–vconcretevoperations
o Perceptualvtovconceptualvthinking
o Learnsvtovtellvtime,vseevothervperspectives,vsolvevproblems
• Erikson’s:vindustryvvsvinferiority
o Tryingvtovmakevmeaningvcontributionsvtovsocietyv&vcooperativevandvcompetevwithvothers
• Peervgroupsvimportantv–vcompetitivevandvcooperativevplay
• Boardvgames,vhopvscotch,vbikes,vjumpvropev&vorganizedvsports
• Immunizations
o 11-12yrv–vdtapv+vHPVvvaccinev(seriesvofv3vshots)
• 9vhoursvofvsleepvrecommendedv@v12vyrs.
• Safetyv–vhelmets
Chapterv7
Adolescentsv(12-20)
• Girlsvstopvgrowingv2-2.5vyearsvaftervtheirvperiodvstarts
• Boysvstopvgrowingvaroundv18-20
• Sexualvmaturationvinvgirls:
o Breastv development
o Pubicvhairvgrowth
o Underarmvhair
o Period
• Sexualvmaturationvinvboys:
o Testicularv enlargement
o Pubicvhair
o Penilevenlargement
o Underarmvhairvgrowth
o Facialvhair
o Vocalvchanges
• Piagetsvcogvdevelopmentv–vformalvoperations
• Erikson’s:videntityvvsvrolevconfusion
• Videovgames,vmusic,vsports,vpets,vreading
• Immunizations
o Flu
o 16-18v–vmeningitisv(beforevcollege)
• Injuryvpreventionv–vhelmetvuse,vseatvbelts,vdriving,vsubstancevabuse
about:blank 3/19
