Developmental Considerations for Children (giving medications)

Question 1

0-3 Month Stage
3-6 Month Stage
6-12 Month Stage

Answer 1

Trust vs. Mistrust

Sensorimotor Period

Question 2

0-3 Month Considerations = Implications (for medication delivery)

Answer 2

Enjoy sucking = admin. liquid through nipple
Suck/rooting reflex = stroke cheek to initiate nipple grasp
Tongue thrust = place medication to side of tongue
Comfort/security being held = cuddle after injections
Short straight Eustachian tube allows liquid to enter middle ear = hold infant, head up when admin oral meds

Question 3

3-6 Month Considerations = Implications (for medication delivery)

Answer 3

Enjoys biting = use oral syringe

Increased drooling = retrieve/re-feed meds on chin

Question 4

6-12 Month Considerations = Implications (for medication delivery)

Answer 4

Stranger anxiety = hold/cuddle prior to med admin OR allow parent to administer under RN supervision
Taste discrimination = mix in food/drink
Increased fine/gross motor skills (may grab cup/syringe) = more firm restraint needed.

Question 5

1-3 Years Stage

Answer 5

Autonomy vs. Shame/Doubt
Sensorimotor (0-2 years)
Preoperational (2-7 years)

Question 6

1-3 Year Considerations = Implications (for medication delivery)

Answer 6

Increased negativity = approach firm but gentle manner/
sit toddler on lap/tell don’t ask (its time to take your med)
Seeks independence = wants to hold cup/syringe; allow choice of drink to follow
Incorporates past experience(remembers taste/needle) = explain briefly “will only hurt for a minute”
Depends on Mom during stress = cuddle following admin
Concrete reasoning = child assistance w/Band-Aid (insides fall out after needle)
Concerned w/rituals = maintain control (child cannot reason)/consistent w/medication delivery

Question 7

3-6 Years Stage

Answer 7

Initiative vs. Guilt

Pre-Operational (2-7)

Question 8

3-6 Year Considerations = Implications (for medication delivery)

Answer 8

Afraid of intrusive procedures = provide short simple truth about procedure
Wants to cooperate but unable = explain you will help them hold still
Experience guilt when they don't cooperate = needles hurt, its okay to cry/praise the cooperation they provided
Begin to make decisions = which medicine first
Learning to express feelings = Say "ouch", hold hand, count to five
Experience in relation to self = explain how it feels, how long it will take (right before procedure)
Show parental preference = allow parent to be present
Learns about environment through play = encourage play through dolls (bandages/Dr. kits)
MAGICAL THINKING (needles as punishment) = Can hold medicine cup/take pills out
Improved motor development = may prefer swallowing pills over liquid

Question 9

6-11 Years Stage

Answer 9

Industry vs. Inferiority

Concrete Operations

Question 10

6-11 Year Considerations = Implications

Answer 10

Concerned w/how things are made/work & what they do = honesty about meds, allow collection of cup/liq. syringe
Fear death/disability = draw affects of med on body
Eager to learn/assume responsibility = allow choices (where/when)
Developing concept of time = timelines set/reinforced, reward cooperative behavior
Peers become important = group same age kids
Concern for privacy = provide privacy while giving certain meds (wounds)

Question 11

12-18 Years Stage

Answer 11

Identity vs. Role Confusion

Formal Operations

Question 12

12-18 Year Considerations = Implications

Answer 12

Concerned w/growing independence/self-control = involve teaching of meds, plan schedule (timing)
Problem solving ability = encourage self admin when possible
Body image concerns = educate on potential side effects
Increased importance of peers = be non-judgmental, allow for privacy, provide emotional support, support group of peers w/similar needs