NURS 5220 Test 1 Exam Latest Updated 2023 With (Detailed Solution).

NURS 5220 Test 1 Exam Latest Updated 2023 With (Detailed Solution). NURS 5220 Test 1 Exam Growth and Development • Two hypothalamic hormones control growth hormone synthesis and secretion in the anterior pituitary gland Growth hormone–releasing hormone (GHRH) stimulates the pituitary to release growth hormone Somatostatin inhibits the secretion of both GHRH and thyroid-stimulating hormone • Brain: peak fetus, early infancy • Skeleton: peak fetus, infancy, adolescence • Muscle: peak fetus, adolescence • Adipose: peak infancy, adolescence • Lymphoid: peak age 10 to 12 years • Neural: peak age 4 to 14 years • Genital: peak adolescence • Fetus Head growth predominates • Infant Trunk growth predominates Weight gain at rapid but decelerating rate • Child Legs are fastest growing Weight gained at steady rate • Adolescence Trunk and legs elongate. 50% of ideal weight is gained. Of adults who are obese 30% become obese during childhood 70% become obese during adolescence Skeletal mass and organ systems double in size. • Pregnant Women Progressive weight gain, fetus 6-8lbs is expected, rest of weigh is from maternal tissue and fluids, weight gain is slow in 1st trimester, rapid in 2nd and slows in the 3rd • Older adult Stature declines beginning at 50 (thinning of discs, kyphosis) Increase in overweight and obese older adults Decrease in weight for height and BMI among those over 60 A loss of 5% of body weight over several years occurs accompanied with an increase in body fat as skeletal muscle declines (due to decreased exercise and reduced anabolic steroid secretion) Reduction in the size and weight of organs (liver, lungs, kidneys) Related History NURS 5220 Test 1 Exam • History of present illness Weight loss and weight gain • Undesired weight loss, anorexia, vomiting or diarrhea, difficulty swallowing, excessive thirst, frequent urination, change in lifestyle, activity and stress levels • Medications: chemotherapy, diuretics, insulin, fluoxetine, diet pills, laxatives, steroids, oral contraceptives Changes in body proportions • Coarsening facial features, enlarging hands/feet, moon facies • Change in fat distribution • Medication: steroids • Past medical history Chronic illness • Gastrointestinal • Renal • Pulmonary • Cardiac • Cancer • Human immunodeficiency virus or other infections • Allergies Previous weight loss or gain efforts • Weight at 21 • Maximum body weight • Family history Obesity • Constitutionally short or tall stature • Precocious or delayed puberty Genetic or metabolic disorder • Cystic fibrosis • Dwarfism • Personal and social history Usual weight and height Activity and exercise pattern Use of alcohol Use of illicit drugs • Infants Estimated gestational age, birth weight, length, head circumference Following an established percentile growth curve Development: achieving milestones at appropriate ages Congenital anomaly or chronic illness • • Children and Adolescents NURS 5220 Test 1 Exam Sexual maturation of girls: early (before 7 years) or delayed (beyond 13 years); signs of breast development and pubic hair, age at menarche Sexual maturation of boys: early (before 9 years) or delayed (beyond 14 years); signs of genital development and pubic hair Short or tall stature Medications: steroids, growth hormones • Pregnant Women Pregnancy weight, dietary intake Age at menarche Date of last menstrual period, weight gain pattern, following established weight gain curve for gestational course Eating disorders History of pica (eating laundry starch, ice, clay, raw rice) Nausea and vomiting • Older adults Chronic debilitating illness • Problems with meal preparation • Difficulty feeding self, chewing, swallowing, poorly fitting dentures • Ability to follow prescribed diet • Difficulty with digestion Examination and Findings Equipment • Standing platform scale with height attachment • Skinfold thickness calipers • Measuring tape • Infant scale • Recumbent measuring device (for infants) • Stature-measuring device (for children) Weight and standing height • Weight Weight variations occur during the day and from day to day with changes in body fluid and intestinal contents When monitoring a patient’s weight daily or weekly, weigh the patient at the same time each day using the same scale • Height Make the reading at the nearest centimeter or 1/2 inch • Frame size Determined to assess the appropriateness of a person’s weight for age, height, and gender when using weight tables NURS 5220 Test 1 Exam • BMI The most common method used to assess nutritional status and total body fat For adult men and women, the following are classifications of weight for height by BMI values (kg/m2 ): • Undernutrition―under 18.5 • Appropriate weight for height―18.5 to 24.9 • Overweight―25 to 29.9 • Obese―30 to 39.9 • Extreme obesity―40 and higher Calculating BMI • The formula to calculate the BMI using pounds (be sure to convert ounces to a decimal) and inches: • [weight in pounds ÷ (height in inches)2 ] × 703 • The formula to calculate the BMI using kilograms and centimeters: weight in kg ÷ [height in meters]2 Infants • Recumbent length • Weight • Head circumference • Chest circumference • Gestational age o Classification ▪ Appropriate for gestational age (AGA) ▪ Small for gestational age (SGA) ▪ Large for gestational age (LGA) o Weight percentiles ▪ 10th to 90th ▪ Less than 10th ▪ Greater than 90th • Small for gestational age infants who are full term have an increased risk for: o Respiratory distress o Hypoglycemia o Other health problems • Large for gestational age infants are at higher risk for: o Birth injuries such as shoulder dystocia o Respiratory distress syndrome o Intraventricular hemorrhage o Bronchopulmonary dysplasia • Measurement of chest- tape at the level of the nipple line • Measurement of head- around the largest circumference of the infant’s head, across the occiput and the forehead NURS 5220 Test 1 Exam Children • Stature and weight BMI is now standardized for use in children and adolescents, and it is calculated the same way as for adults • Underweight―BMI for age under the 5th percentile • At risk of overweight―BMI for age greater than the 85th percentile • Overweight―BMI for age greater than the 95th percentile • Upper/lower segment ratio A higher upper-lower body segment ratio than expected may be associated with dwarfism or bone disorders • Arm span Arm span that exceeds height is associated with Marfan syndrome • Sexual maturation Assessment of children and adolescents involves evaluation of secondary sexual characteristic development. In girls, breast and pubic hair development is evaluated. In boys, genital and pubic hair development is evaluated. Girls • Most girls start puberty between 9 and 12 years of age with breast enlargement. • A girl’s breasts often develop at different rates and appear asymmetric. Boys • Most boys start puberty between 10 and 13 years of age with testicular enlargement. • Pubic hair development, enlargement of the penis, and the growth spurt follow. • Pregnant women Weight gain • Weight gain during pregnancy should be calculated from the woman’s prepregnancy weight. • To provide guidance in weight gain during pregnancy, first determine the prepregnancy BMI. • Monitor the woman’s weight throughout pregnancy using the BMI weight gain curve guidelines on the prenatal weight gain chart • Older adults Measurement procedures for the older adult are the same as those used for the general population. Calculate the BMI Abnormalities • Acromegaly NURS 5220 Test 1 Exam A rare disease of excessive growth and distorted proportions caused by hypersecretion of growth hormone and insulin-like growth factor after closure of the epiphyses • Cushing Syndrome A disorder associated with a prolonged and excessively high exposure to glucocorticoids • Turner Syndrome A genetic disorder in which there is partial or complete absence of a second X chromosome • Hydrocephalus An excess volume of cerebrospinal fluid (CSF) in the brain leading to an enlarged head circumference .