Care of the School-age Child and Adolescent Flashcards
Promoting optimal growth and development
-School age is 6-12 y
-Begins w/ shedding of 1st deciduous teeth and ends at puberty w/ acquisition of final permanent teeth
Biologic and psychosocial development
-Physically: decrease in head circumference in relation to standing height
-Biologic: height increases by 2 in per year, weight increases by 2-3 kg per year, males and females differ little in size
-Psychosocial: relationships center around same-sex peers, Freud described it as “latency” period of psychosexual development
Maturation of systems
-Bladder capacity increases
-GI –> fewer stomach upsets
-Heart smaller in relation to rest of body
-Immune system more effective
-Bones increase in ossification
-Physical maturity not necessarily correlated w/ emotional and social maturity
Prepubescence
-Defined as 2 years preceding puberty
-Typically occurs during preadolescence
-Varying ages from 9 to 12 (girls about 2 years earlier than boys)
-Average age of puberty is 12 in girls and 14 in boys
Erikson: industry
-Industry vs inferiority
-Eager to develop skills and
participate in meaningful and
socially useful work
-Acquire sense of personal and
interpersonal competence
-Growing sense of
independence
-Peer approval is strong
motivator
Erikson: inferiority
-Feelings may derive from self or social environment
-May occur if incapable or unprepared to assume the responsibilities
associated with developing a sense of accomplishment
-All children feel some degree of inferiority regarding skill(s) they cannot master
Piaget: cognitive development
-Concrete operations: Use thought processes to experience events and actions; Develop an understanding of relationships between things and ideas (Classification skills)
-Able to make judgments based on reason (conceptual thinking)
-Concept of conservation: Conservation is the understanding that something stays the same in quantity even though its
appearance changes.This can apply to aspects such as volume, number, area etc.
Social development
-Importance of the peer group: Identification with peers is a strong influence in a child gaining independence
from parents; Sex roles are strongly influenced by peer relationships
-Groups & clubs
-Bullying
-Gang Violence
Bullying
-Risk for long-term psychological
disturbances & psychiatric
symptoms
-Types –> cyber bullying, indirect or
direct
-Targeted individuals
-Bullies –> generally defiant
-Bullying prevention programs
Relationships w/ families
-Parents are the primary influence in shaping a child’s personality,
behavior, and value system: Family values usually take precedence over peer value systems
-Increasing independence from parents is the primary goal of middle
childhood
-Children are not ready to abandon parental control
Play
-Involves physical skills, intellectual ability, and fantasy
-Children form groups, cliques, clubs, secret societies
-Rules and rituals
-See need for rules in games they play
-Team play
-Quiet games and activities
-Ego mastery
Development: self-concept
-Definition: a conscious
awareness of a variety of self-
perceptions (abilities, values,
appearance, etc.)
-Importance of significant adults
in shaping child’s self-concept
-Positive self-concept leads to
feelings of self-respect, self-
confidence, and happiness
Development: body image
-Generally children like their physical
selves less as they grow older
-Body image is influenced by
significant others
-Increased awareness of “differences” may influence feelings of inferiority
Development: sexuality
-Normal curiosity of childhood
-Attitudes toward sex
-Use of terminology
Sex education
-Sex play as part of normal curiosity during preadolescence
-Middle childhood is ideal time for formal sex education: life span approach, information on sexual maturity and process of reproduction, effective communication w/ parents
Nurse’s role in sex education
-Treat sex as normal part of growth and development
-Questions and answers
-Differentiate between “sex” and “sexuality”
-Values, problem-solving skills
-Open for communication with parents
Stress and fear
-Stress from variety of sources
-Increasing violence in society –> impact on
children & family
-Increasing demands –> school environment & participation in activities
Stress response
-Stomach pains or headache
-Sleep problems
-Bedwetting
-Changes in eating habits
-Aggressive or stubborn behavior
-Withdrawal or reluctance to participate
-Regression to earlier behaviors (e.g., thumb sucking)
-Trouble concentrating or changes in academic
performance
Stress reduction
-Relaxation techniques
-Deep-breathing exercises
-Progressive relaxation of muscle groups
-Positive imagery
-Physical activity
-Develop a “toolkit” to help
Fear
-Dark
-Excessive worry about past behavior
-Self-consciousness
-Social withdrawal
-Excessive need for reassurance
-Being hurt
-Death
Fear reduction
-Support
-Consistent approach
Nutrition
-Importance of balanced diet to promote
growth
-Quality of diet related to family’s pattern of
eating
-Fast-food concerns
Sleep and rest
-Average 9½ hr/night during school-age (11½ hr for 5-year-olds and 9 hr for 11-year-olds) but highly individualized
-Ages 8 to 11 may resist going to bed
-12 years and older generally less resistant to
bedtime
Physical activity and exercise
-Exercise essential for development and function
-Importance of physical fitness for children
-Sports: Controversy regarding early participation in competitive sports; Concerns with physical and emotional maturity in
competitive environment
-Acquisition of skills
-Generally like competition
-Television, video games & the Internet –> exposure to violence
Dental health
-Permanent teeth eruption
-Good dental hygiene: Dental Problems, Prevention of dental caries, Periodontal disease, Malocclusion, Dental injury
School health
-Responsibilities of parents, schools, and
health departments
-Ongoing assessment, screening, and
referrals
-Routine services, emergency care, and
safety and infection control instruction
-Increase knowledge of health and health habits
Injury prevention
-Most common cause of severe injury and death in school-age children is motor vehicle crashes—pedestrian
and passenger
-Bicycle injuries—benefits of bike helmets
-Appropriate safety equipment for all
sports
Anticipatory guidance: care of families
-Guidance during school years: 6 y, 7-10 y, 11-12 y
-Parents adjust to child’s increasing independence
-Parents provide support as unobtrusively as possible
-Child moves from narrow family relationships to broader world of
relationships
