Contemporary Pediatrics Flashcards
Challenges of peds nursing (
- Everything is fragile and sensitive
- Variety of reasoning strategies are necessary for interventions
- Two levels and directions of discussion (kids and parents)
- Kids see nurses as a threat
- Kids crash quicker
- Increased pressure to have things go right
- Ethical dilemmas
- Difficult for caretakes to care for children emotionally
Cephalocaudal direction
Growth development from head to toe, moving in 3 mon increments and after 2 years in 6 mon increments, then in increments of 12 mon in the next 2 years
3 month development milestones
Maintain head upright (head)
6 month development milestones
Sitting upright (trunk)
9 month development milestones
crawling (legs)
12 month milestones (feet)
Walking/Standing 2-3 steps
18 month milestones
run “run away from home”
2 year development milestones
Jump “two feet leave the ground”
3 year development milestones
tricycle “tri = 3”
4 year development milestones
Hop on one foot
- A 5-year-old boy has always been one of the shortest children in class. His
mother tells the school nurse that her husband is 6’ tall and she is 5/7”. What should the nurse tell the child’s mother?
1. He is expected to grow about 2 inches every year from ages 6 to 9 years
2. He is expected to grow about 3 inches every year from age 6 to 9
3. He should be seen by an endocrinologist for growth-hormone injections
4. His growth should be re-evaluated when he is 7 years old
- He is expected to grow about 2 inches every year from ages 6 to 9 years
- Which statements would indicate to the nurse that a school age child is not
developmentally on track for age? Select all that apply
1. The child is able to follow a four-to-five step command
2. The child started wetting the bed on admission to the hospital
3. The child has an imaginary friend named Kelly
4. The child enjoys playing board games with her sister
5. The child is not able to follow rules
- The child has an imaginary friend named Kelly (this is more often in children 3
and 4 years old) - The child is not able to follow rules
Theorists and their developmental theories
- Sigmund FREUD’s theory of psychosexual development
- Jean PIAGET’s theory of cognitive development
- Erik ERIKSON’s psychosocial theory
- Lawrence KOHLBERG’s theory of moral development
Erickson’s stages of development
- Infancy (trust vs. mistrust)
- early childhood (autonomy vs. shame)
- preschool (initiative vs. guilt)
- school age (industry vs. inferiority)
- Adolescence (identity vs. role confusion)
- Young adult (intimacy vs. isolation)
- Middle adulthood (generatively vs. stagnation)
- Maturity (ego integrity vs. despair)
Ericksons psychosocial development definition
- Occurs through a life-long series of crises affected by social and cultural factors
- Each psychosocial crisis needs to be resolved for the child or adult to progress emotionally. Unsuccessful resolution can leave the person emotionally disabled.
Kohlberg moral development definition
- Moral development is sequential
*Stages or levels of moral development cannot be
skipped
Kohlberg stages
- Pre conventional level (no internalization of right/wrong)
Stage 1: Avoiding punishment
Stage 2: Aiming at a reward - Conventional level (Intermediate internalization of right/wrong)
Stage 3: Good boy & good girl
Stage 4: Loyalty to law and order
*Post conventional level
Stage 5: Justice and the spirit of the law
Stage 6: Universal principles of ethics
- A nurse instructor is preparing to conduct a seminar about Piaget’s Theory of Cognitive
Development. The current topic is the concrete operational stage. Which of the following
milestones during this stage should be included in the discussion, except?
A. Ability to think logic about objects and events.
B. Ability to understand that an object does not affect its number, length, volume, or mass when it changes appearance or shape.
C. Increased classification skills.
D. Ability to exhibit propositional thought.
E. Ability to perform mathematical problems in both addition and subtraction
D. Ability to exhibit propositional thought.
- A maternity nurse is providing instruction to a new mother regarding the psychosocial development of the newborn infant. Using Erikson’s psychosocial development theory, the nurse would instruct the mother to:
A. Allow the newborn infant to signal a need.
B. Anticipate all of the needs of the newborn infant.
C. Avoid the newborn infant during the first 10 minutes of crying.
D. Allow the infant to cry, once lessen, then attend to the infant.
A. Allow the newborn infant to signal a need.
Stages of separation anxiety
Stage 1: Protest
Stage 2: Despair
Stage 3: Denial or detachment
Stage 1 of separation anxiety behaviors
*loud inconsolable crying
*Clinging
*Attempts to force parents to stay
*Lasts variable lengths of time
Stage 2 of separation anxiety behaviors
*Physical (wt loss, prone to minor illnesses, insomnia)
*other behaviors (inactivity, disinterest, may appear sad, may wail not cry, regression to earlier behaviors)
