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What are developmental concerns for infants in regards to the head, face, neck?
Molding of head occurs during vaginal delivery, fontanels allow for growth, posterior fontanel closures by 2 mo. and anterior fontanel closes by 18 mo.
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What are developmental concerns for older adults in regard to head, neck, face?
loss of connective tissue elasticity causes changes in facial structures
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What are developmental concerns for pregnant women in regard to integumentary assessment?
Thyroid can be palpated on some clients due to increased activity, chloasma occurs in face
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What are developmental concerns for infants in regard to eyes?
permanent eye color is established by 9 mo. able to fixate and follow object with both eyes at 3-4 mo. visual acuity 20/200
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What are developmental concerns for older adults in regard to eyes?
lens can be opaque and yellowed, central and peripheral vision decreases, arcus senilis around iris, ptosis of eyelids, night vision and depth perception less accurate
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What are developmental concerns for children in regard to eyes?
Strabismus is not corrected by 4-6 years it can result in blindness, preschoolers and other who cannot read HOTV chart can have acuity tested using LEA symbols, preschooler visual acuity 20/30 or 20/40, check for color blindness
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What are developmental considerations for infants in regards to ears?
low set ears can indicate a genetic abnormality, more prone to ear infections
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What are developmental concerns for adolescents in regard to ears?
Noise induced hearing loss
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What are developmental concerns for older adults in regard to ears?
ears elongate, high frequency sounds may not be heard, hearing loss due to cerumen, balance and equilibrium can be affected by degeneration and atrophy of inner ear structures
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What are developmental concerns for infants in regard to the mouth?
narrow, flate palate or high arched palate can cause feeding and speech problems
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What are developmental condsierations for children in regard to the mouth?
have 20 deciduous teeth
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What are developmental concerns for older adults in regard to the mouth?
sense of smell and taste decrease, salivation decreases
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What are developmental concerns of infants in regard to the neck?
lymph tissue small compared to body size as infant, neck short with skin folds
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What are developmental concerns for children in regard to the neck?
lymph tissue twice the size of adult tissue
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What are developmental concerns for older adults in regard to the neck?
basal metabolic rate can decrease due to increased thyroid function
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What are cultural considerations in regard to head, face & neck?
- Africans develop pseudofolliculitis
- Chinese have very little facial hair
- Irish are at increased risk for skin cancer
- Filipinos have almond shaped eyes, mildly flared nostrils, and a low flat nose bridge
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What are cultural considerations for the eyes?
- Asians-palpebral fissure is upward, often have epicanthal eyefolds
- Caucasians-8-10% of males have color vision deficit, .1-1% of females are affected
- sunny climates have an increased rateof cataracts
- dark skinned clients may have small black dots in sclera or muddy in appearance
- african americans 4-5% of males have color vision deficit
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What are cultural considerations for ears?
- asians & native americans have dr, lt gray & flakey cerumen
- caucasians & african americans have moist, brown, & sticky cerumen
- people who live in industrial communities have increased risk for hearing loss
- Native americans, hispanics and alaskan infants have increased rates and severity of otitis media
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What are cultural considerations for nose & throat?
dark skinned clients can have patchy coloration of the gums, lighter skinned clients usually have smooth, pink coloration of the gums, bridge of the nose is sometimes flat in asians & african americans
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What do you do during the physical assessment of head, neck ears?
Approach (anterior to posterior) inspect, palpate, percuss, auscultate. Use penlight, tongue blades, gauze, stethoscope, cup of water, gloves
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What is some pathophysiology associated with the head, neck, ears
perforated tympanic membrane, otitis medina, hydrocephalus, down's syndrome, swollen lymph nodes
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