MedicoPlexus
Contributing Authors:
Linus Kutup, Eric Hoffmeister, Benjamin Kersch, Niclas Samirae, Tobias Verdegem, Alexander Wolff, Lara Afaneh, Joana Strzlkowski, Nadine Fernandez, Katharina Weitzel
PART 1
1. Stages of child development. Physical characteristics of children.
Some introduction:
As children grow and develop, they undergo:
– changes in the appearance: weight, height, circumference of head and chest and arms etc, body proportions
– skeletal development: anterior fontanelle closes, ossification centres occur, primary and permanent teeth develop
– variations in: size and position of visceral organs, skin, muscles, nerve and lymphatic system
During the organ’s development, children face more risk factors, e.g.
- immature kidneys predispose children to electrolyte – and acid/base dysbalances!
- the narrow respiratory tract tends to be obstructed in children!!!
The intense grwoth of children requires unique demand for nutrients. It is difficult to meet the requirements due to the immature digestive and metabolic processes in a young child.
Also, the immature immune system puts children at an increased risk of infection.
Bare in mind, that children differ greatly in pathologic changes compared to adults:
a) Streptococcus pneumonia infection: causes bronchopneumonia in children while it causes lobar penumonia in adults
b) Vitamin D deficiency: causes rickets in children while it causes osteomalacia in adults
c) A neonate with severe infection is always weak in response, shows apathy, rejects feeding but does not show fever, or an increase in WBC or other obvious signs of infection!!
Characteristics like heart rate, blood presse, respiratory rate etc highly depend on the developmental stage of the child:
1) Pediatric respiratory rate:
- in infants ( up to 1 year): 30-60 breaths per minute
- in Toddlers (1-3y): 24-40 breaths pm
- in Preschoolers (3-6y): 22-34 breaths pm
- in school age: (6-12y): 18-30 breaths pm
- in adolescent (puberty-> 12-18y): 12-16 breaths pm
2) Pediatric Pulse rate:
– in infants ( up to 1 year): 100-160 beats per minute
– in Toddlers (1-3y): 90-150 bpm
– in Preschoolers (3-6y): 80- 140 bpm
– in school age: (6-12y): 70-120 bpm
– in adolescent (puberty-> 12-18y): 60-100 bpm
3) Systolic blood pressure:
– in infants ( up to 1 year): at least 60mmHg
– in Toddlers (1-3y): at least 70mmHg
– in Preschoolers (3-6y): at least 75mmHg
– in school age: (6-12y): at least 80mmHg
– in adolescent (puberty-> 12-18y): at least 90mmHg
Stages of child development and their physical characteristics:
– The different stages are:
Embryonic and fetal period, Perinatal period, Neonatal period, Infant period, Toddler age, Preschool age, School age and adolescence
– It is important to know these stages because the normal characteristics are different for each of these periods: functions of various organs, degree of immunity to diseae, response to effects of disease, drug doses and tolerance, mental and motor ability, pattern of emotional response
1) Intrauterine life: embryonic and fetal period
– embryonic period: first 8 weeks after fertilization
– fetal period: 9th week until birth ( ~ 40th week)
-> especially in the embryonic phase the growing organism is very sensitive to damage by teratogens!!!! Drugs, radiation etc
2) Perinatal period:
– from 28th week of gestation (weight is usually above 1kg) until 7th day after birth
– thus includes: 3rd trimester of pregnancy, delivery and early neonatal period
– Preterm birth, low birth weight intrauterine growth restriction predispose the fetus to asphyxia, severe congenital malformations and early-onset neonatal infections
– health care provision: promoting optimal medical practices before, during and after birth. Directly after birth: clear mouth and pharynx of fluid, take APGAR score, maintain body heat,…
3) Neonate
– from birth to 28 days (4 weeks) after birth
– the child begins ‘independent living’ -> the physiological regulation ability and the adaption to new circumstances are very poor -> morbidity and mortality are very high
– health care provision: enough nutrition, proper nursing care, prevention of diseases
4) Infant:
– from 28 days of age until 1 year
– Rapid growth occurs, it is the period of fastest brain growth!
– Nutrition and energy requirements are high while digestion and absorption are poor!
– The passive immunity of mother starts to drop and the acquired immunity starts to develop -> between 3 and 5 months of age, there is a period of very high susceptibility to infection because the passive immunity starts to decline while the acquired immunity just starts to develop and cannot compensate for the decline in passive immunity!!
– Health care provision: Enough nutrition, prevention of diseases, basic immunity (vaccinations!)
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