Ch 22. Child - Teen Flashcards
Prenatal: Infancy: Early Childhood: Middle Childhood: Adolescence:
Prenatal: conception to birth Infancy: birth to 12 to 18 months of age Early Childhood: 1 to 6 years of age Middle Childhood: 6 to 12 years of age Adolescence: 12 to 19 years of age
Intrauterine life
the entire time the fetus is in the womb (40wks, 9 months)
APGAR score
we give baby immediately after birth – lloks at baby’s ability to adjust. Colour, muscle tone, reflux, heart, resp
quickening
feeling of life “movement”
Neonatal
Neonatal period is the first 28 days of birth. Their physical functioning is mostly reflective. Internally they are stabilizing their major body organs. A neonate will smile spontaneously.
As nurses, we need to monitor and assess height, weight, head circumference, temperature, pulse, and respiration.
Early cognitive development examines behavior, reflexes, and sensory functions. Crying is a newborn’s only means to communicate. Each cry means something different: I am hungry, I am wet, etc.
A strong bond should develop. Infants rely on their family for feeding, hygiene, and comfort. If the family members (mother) are sick development may be delayed.
At this stage, we need to monitor for hyperbilirubinemia. Screening also occurs (inborn errors of metabolism, PKU).
Decisions are made regarding male circumcision.
Important, education regarding car seats and cribs must be reinforced.
Infant
Physical changes include a doubling of birth weight, increase in height, development of sight and hearing. Mothers will also see sleep and eating patterns emerge.
Cognitively, infants are continuing to learn through their environment. As they receive stimulation from others their senses of vision, hearing, and touch develop. They are also beginning to develop language, moving from cooing and crying to laughing, repeating sounds, and forming words.
Psychosocially infants begin to separate themselves from others and begin to form their own identify. At the 2- to 3-month stages, smiling is more purposeful than reflective.
It is important to incorporate play in care, as play helps to develop cognitive, social, and motor skills.
At this age injury prevention is of paramount importance. Injuries can occur due to accidents, aspiration, suffocation, falls, and poisoning. It will be important to assess for signs of child maltreatment and abuse. Box 12-2 presents warning signs of abuse.
Of course, at this age nutrition is important as well as considering vitamin supplements. Breast feeding will be supplemented with food choices.
Probably one of the scariest times for parents is when this age group needs immunizations. This can create religious and cultural ethical dilemmas.
Solid food after 6 months. At 6 cobo milk/food. At 1 yr can use solid food
No honey till 1 to prevent botulism
Vit D supplementation to prevent rickets
Toddler
Children begin to walk. Children begin to demonstrate their independence. Their mobility and cognitive abilities are developing. When they get frustrated, the dreaded “tantrum” may occur.
Physically these children will begin to feed, dress, and toilet themselves. They begin to develop fine motor skills as they scribble and draw. Mobility increases as they begin to run, jump, and want to ride a tricycle, climb, and further explore.
Cognitively, they are putting words together. They ask the favorite questions, “Who’s that?”, What’s that?” They also are into “that’s mine” and “me do it.” Linguistically, they have a vocabulary of about 300 words by the time they are 2 years old. At 3 years old, they will put sentences together.
However, toddlers still do not understand the concept of right or wrong.
Psychosocially they have a sense of autonomy (remember this is according to Erikson). Toddlers are still attached to their parents and fear separation. Kids don’t necessarily play with each other, but play alongside each other.
Health risks for this group are many. They want to put everything into their mouths as they continue to explore their environment. These kids need to have a well-balanced diet, with choices from the bread/grain, vegetables, fruit, dairy, and protein groups. It will be hard to introduce all of these groups: sometimes these children grown fond of certain food groups. Finger foods will let them feed themselves and explore food groups.
Preschooler
They refine mastery of their bodies. They begin formal education. Physical development occurs more slowly than cognitive and psychosocial development.
Physical changes can be seen in the development of large and fine muscle coordination. They can copy figures onto a paper. Children this age needs to learn and practice new physical skills.
Cognitively the brain continues to mature, especially in the frontal lobe, where personality develops. They begin to interact socially with others of their age. The fear for this group is bodily harm. They have fear of dark, big animals, thunderstorms, and medical personnel!
Morally, they begin to understand the difference between right and wrong.
Linguistically their vocabulary is expanding from 8,000 to 16,000 words.
Psychosocially preschoolers begin to leave family and explore with other children and other family units. They make new friends. Stress may cause this group to suck their thumb or bed wet.
These children will play together, play in groups, and pretend play.
TV, videos, games will help to support learning basic skills.
Health risks for this group still include falls and injury although their motor skills are getting better.
Nutritionally these children need 1800 calories a day and oftentimes they can be finicky eaters.
At this stage children can tell you what they want.
Parents are also more at ease with children at this stage.
School-Age Child
These are the middle years of childhood. The foundation is set for adult roles in work, recreation, and social interaction. Home and school influence growth and development. This age group is becoming more coordinated in sports and activities that require gross motor skills.
Physically this group will experience a growth spurt with height, weight, and fat distribution. Skeletal growth causes changes in posture and body appearance. Visual acuity sharpens. Fine motor development occurs.
Cognitively, this group has the ability to think in a logical manner. They use these skills to solve problems. Linguistically, they are developing rules for syntax, linking phrases, and sentences.
According to Erikson, psychosocially this group is experiencing the task of industry versus inferiority. They are learning skills necessary for them to be successful in adulthood.
Morally a need exists to acquire a moral and social code so they can make judgments. At this age you may see less predictable social and behavioral patterns.
Peer relationships, sexual identity, and stress are important obstacles to deal with. Figure 12-6 presents more information on peer relationships.
Health risks for this group are many. Parents worry about seat belt use, burns, drowning, substance abuse, poisoning, and body damage from sports/injury/accidents. Parents need to be careful to educate their children about stranger safety!
Health risks for this group include nutrition, oral hygiene, infections, substance abuse, and human sexuality. Table 12-3 presents information.
Adolescent
Transition from childhood to adulthood. Remember, the term adolescence refers to a stage of psychological maturation and the term puberty refers to the point at which reproduction becomes possible. Hormonal changes result in physical and cognitive changes. Adolescence is divided into three phases: Early (Pre) adolescence (11 to 14 years) Middle adolescence (15 to 17 years) Late adolescence (18 to 20 years).
Table 12-3 explains the challenges, opportunities, skills and pressures this group faces.
Physical changes are focused in four areas:
Growth of skeleton, muscle and viscera
2) Sex specific changes between males and females
3) Alterations in fat and muscle distribution
4) Development of reproductive system and secondary sex characteristics
Table 12-4 compares growth and development changes that occur during adolescence.
Cognitively this group develops the ability to think rationally. They can determine and rank possibilities, solve problems, and make decisions logically. They develop the ability to understand how the ideas or actions of an individual influence others. Linguistically, their primary focus becomes communication skills to use in situations. This groups needs to communicate their thoughts, feelings, and facts to peers, parents, teachers, and other authority figures.
Psychosocially they are searching for personal identity. Erikson explains that identity or role confusion occurs at this stage. This group needs to develop their own ethical system based on their personal values. They also need to think about their future job/professional aspirations, future education, and lifestyles. At this stage, this group struggles with sexual, group, family, vocational, moral, and health identity.
Health risks for this age group includes accidents, homicide, suicide, substance abuse, eating disorders, sexual experimentation, STDs, and pregnancy.
Box 12-4 presents a suicide risk assessment.
Box 12-5 presents health promotion interventions.
Three groups of adolescents need to be included in this discussion.
Rural adolescents have limited access to health care, limited health care insurance, limited privacy, lack of transportation to health care, poverty, and farming accidents.
Minority adolescents may live in high-risk environments. Limited access to health care services is common. Poverty is a factor that may impact all aspects of their lives.
Gay, lesbian, and bisexual adolescents have not been thoroughly researched. Even though some adolescents experiment with same sex relationships, they may not become homosexuals. This group does have an increased vulnerability to depression and suicide. Members of this groups who disclose their orientation are subject to violence, harassment, and family abuse.
Artificialism
everything on earth are created by people
Animism
attributes of animal to inanimate objects
Immanent justice
idea that if a built in law if violated a punishment will happen (child is sick because he lied to his mom)
