1. Health Promotion for the Infant Flashcards
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A continuous, orderly series of conditions that leads to activities, new motives for activities, and patterns of behavior
An increase in function and complexity through GROWTH, MATURATION & LEARNING
> i.e. language acquisition
Development
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An increase in the physical size of a whole or any of its parts or an increase in number and size of cells
Can be measured easily and accurately by determining changes in weight & length
Growth
Stages of Growth & Development
Newborn : Birth to 1 month
Infancy : 1 month-1 year
Toddlerhood : 1-3 years
Preschool : 3-6 years
School age : 6-11 or 12 years
Growth & Development - Parameters of Growth
> Weight, length, and height are used to monitor growth
> Head circumference indicates brain growth
> Eruption of teeth also follows a sequential pattern
> Slow, steady weight gain during childhood is followed by GROWTH SPURTS in adolescence
Principles of Growth & Development - Patterns of growth and development
> From head to lower extremities (cephalocaudal)
* At birth head is large when compared to rest of the body
* As child matures body proportions gradually
> From proximal to distal (proximodistal)
* Progression from center outward
> Wide variations within normal limits occur
* General to specific (e.g. whole body response to pain as opposed to guarding in older child)
* Simple to complex (e.g. language - one word to full sentences)
Factors Influencing Growth & Development
* Genetics
* Environment
> Prenatal exposure to maternal smoking, alcohol intake, chemical exposures, and infectious diseases
> After birth socioeconomic status, air, and water pollution
* Culture
* Nutrition
> Obesity - prevalence US 18.5% with boys higher than girls
* Health status
* Family structure
* Parental attitudes
* Child-rearing philosophies
Theories of Growth and Development
* Theories are an attempt to explain human behavior
> Piaget’s theory of cognitive development
* Understanding how thinking during childhood progresses and differs from adult thinking
___ period (birth-2 yr)
* Reflexive behavior used to adapt to environment - involves whole body
___ view of the world
Development of ___ ___ - awareness that objects continue to exist even when they disappear from sight
Sensorimotor
Egocentric
object permanence
___ thought (2-7 yr)
* Language becomes useful
* Situations perceived by their view only - egocentric thinking
* Magical thinking - believe that events occur due to wishes
Preoperational
___ operations (7-11 yr)
* Systematic and logical thinking
* Concrete objects and activities needed
* ___ operations
Concrete
___ operations (11yr-Adulthood)
* New ideas created
* Analysis of situations
* Abstract/futuristic thinking
* Understands logical consequences of behavior
Formal
Used by nurses when developing teaching plans of care for children
Learning geared towards child’s level of understanding. Active participants in the learning process.
Freud’s theory of psychosexual development
* Certain parts of the body assume psychological significance as foci of sexual energy
* Areas shift from one part of the body to another as the child moves through the different stages of development
* Used to determine normal sexual development and sex education
Oral stage (___)
Anal stage (___)
Phalic or oedipal electra stage (___ age)
Latency stage (___ age)
Puberty or genital stage (___)
Infancy
Toddlerhood
Preschool
School
Adolescence
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* Lifelong series of conflicts affected by social and cultural factors
> Unsuccessful resolution of conflicts leads to emotionally disabled individuals
> Used in nursing to determine regression behaviors especially when hospitalized
Erikson’s psychosocial theory
___ vs ___ & ___ (Toddlerhood)
> Control over self and body functions
Autonomy vs Shame & Doubt
___ vs ___ (Infancy)
> Trust developed with sense of good care, warm, and nurturing caregiver
> Mistrust can lead to restlessness, crying, clinging, physical dysfunctions such as vomiting and diarrhea
Trust vs Mistrust
___ vs ___ (Preschool age)
> Development of a can-do attitude about the self
> Behavior is goal-directed, competitive, imaginative
> Initiation into gender role
> Characterized by purpose
Initiative vs Guilt
___ vs ___ (Adolescence)
> Begins development of sense of “I”
> Peers become important
> Gains independence from parents
> Characterized by faith in self
Identity vs Role confusion
___ vs ___ (School age)
> Mastering of skills and tools of the culture
> Learning how to play and work with others
> Characterized by competence
Industry vs Inferiority
___ vs ___
> Characterized by care
Generativity vs Stagnation
___ vs ___
> Characterized by love
Intimacy vs Isolation
___ ___ vs ___
> Characterized by wisdom
Ego integrity vs Despair
Kohlberg’s theory of moral development
> Acceptance of values and rules of society as they shape behavior
> Although knowing what behaviors are right and wrong is important, BUT more importantly is understanding and appreciating why the behaviors should or should not be exhibited
> Used by nurses to provide anticipatory guidance to parents on expectations and discipline
Premorality or preconventional morality. Stage ___ (0-2 yr): Naivete & Egocentrism
> Based on what pleases the child
Stage 0
Premorality or preconventional morality. Stage ___ (2-3 yr): Punishment-Obedience Orientation
> Right or wrong are determined by physical consequences, so if they don’t get caught, they must be right
Stage 1
Premorality or preconventional morality. Stage ___ (4-7 yr): Instrumental Hedonism and Concrete Reciprocity
> Rules are followed out of self interest; behavior is guided by an “eye for eye” orientation
Stage 2
Premorality or preconventional morality. Stage ___ (7-10 yr): Good boy or good girl orientation
> Morality based on avoiding disapproval or disturbing conscience - socially sensitive
Stage 3
Morality of Conventional Role Conformity. Stage ___ (10-12 yr): Law and Order Orientation
> Respect for authority, obeys orders for own sake
Stage 4
Morality of Self-accepted Moral Principles. Stage ___: (Adolescence) Social Contract Orientation
> Laws for mutual good
Stage 5
Physical Growth: Infancy to 1 year
> Growth is an excellent indicator of health during infancy
> Birth weight doubles by 4-6 months, triples by 1 year
> Head’s circumference growth rate during the first year is approximately 5/10 in (1-2 cm) per month
> __ __ closes by 2 to 3 months of age
> (Larger) __ __ may remain open until 18 months
> Organ systems grow and mature more rapidly in the infant
> Organs remain very different from those of older children and adults
Posterior fontanelle
(Larger) anterior fontanelle
Physical Growth : 1-2 months
> Fast growth
> Weight 1.5 lb/month and height 1 in/month for 1st 6 months
> Primitive reflexes present
> Strong suck and gag reflex
> Posterior fontanel closes by 2-3 months
Physical Growth : 4-5 months
> Growth rate declines
> Drooling begins in preparation for teething
> Morrow, tonic neck, and rooting reflexes disappear
Physical Growth : 6-7 months
> Weight gain slows to 1 lb/month and length gain of 1/2 inch/month
> Birth weight doubles
> Tooth eruption begins along with chewing and biting
> Maternal iron stores are depleted
Physical Assessment
General Approaches to Physical Assessment
> Quiet, private, safe, warm environment
> In infants - complete quiet tasks first like pulses and respirations (best to do when infant is not crying)
> In ages 6-12 mos may distract by giving infant a toy
> Comfortable position (parent’s lap) while feeding or sleeping
> Alter exams to developmental stage or needs
CDC Immunization Schedule (Birth to 15 Months)
* Hepatitis B
* Rotavirus
* Diphtheria, tetanus, and acellular pertussis
* Pneumococcal conjugate
* Inactivated poliovirus
* Influenza (IIV) or Influenza (LAIV4)
* Measles, mumps, rubella
* Varicella
Feeding and Nutrition
* Finger foods : 8-10 months
> Bite-size pieces and soft, not round
* Snacks
> Introduced when child has three full meals/day
* Food allergies
> Most common allergens cow’s milk, egg, soy products, fish, peanuts, chocolate, corn, and wheat
