Growth And Development Flashcards

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1
Q

When does wt double by and triple by?

A

Doubles by 6 month

Triples by 1 year

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2
Q

When anterior and posterior fontanelsclose?

A

Posterior - 2 months (6-8 weeks)

Anterior- 12-18 months

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3
Q

If a parent is unable to stay with the toddler when ill, encourage him or her to

A

designate another family member, such as a grandparent.

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4
Q

At birth, infants are dominated by biological needs and drives. The reliability and quality of their relationship with caregivers will influence the extent to which they develop a sense of trust (or mistrust) in others, themselves, and the world in general. The virtue of hope is associated with this stage.

A

Trust Versus Mistrust (Infancy) 0- 18 months

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5
Q

Social demands for self-control and bodily regulation (toilet training) influence feelings of self-efficacy versus self-doubt. The quality of will, the willful self-discipline to do what is expected and expectable, emerges at stage two.

A

Stage 2: Autonomy Versus Doubt and Shame (Early Childhood) 18 months-3 years?

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6
Q

Here children begin actively exploring their environment. Will they sense guilt about these self-initiated activities, or will they feel justified in planning and asserting control over their activities? The virtue of purpose—the courage to pursue personally valued goals in spite of risks and possible failure—now ascends.

A

Stage 3: Initiative Versus Guilt (Preschool Age) 3-6?

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7
Q

The societal context in which the first three psychosocial conflicts are negotiated is predominantly the home and immediate family. In stage four, however, children begin formal instruction of some sort. Mastery of tasks and skills valued by one’s teachers and the larger society becomes focal. The quality of competence is said to develop. (if they don’t complete tasks, they may feel inferior.)

A

Stage 4: Industry Versus Inferiority (School Age) 6-12?

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8
Q

Stage 5: Identity and Diffusion (Adolescence) 12-20
3/…?
This is the linchpin in Erikson’s scheme, a time when adolescents actively attempt to synthesize their experiences in an effort to formulate a stable sense of identity. Although this process is psychosocial in nature—a social fit or “solidarity with group ideals” must occur—Erikson emphasizes reality testing and the acquisition of credible self-knowledge. Youths come to view themselves as products of their previous experiences, and a unified sense of temporal self-continuity is experienced. Positive resolutions of prior crises—being trusting, autonomous, willful, and industrious—facilitate identity formation; previous failures may lead to identity diffusion. Fidelity, the the ability to maintain commitments in spite of contradictory value systems, is the virtue that emerges during adolescence.

A

Stage 5: Identity and Diffusion (Adolescence) 12-20

3/…?

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9
Q

Discipline

A

What to say”—Tips for effective discipline During effective discipline, allow for negotiation and flexibility, which can help build the child’s social skills. Also, allow the child to experience the consequences of behavior.
• Speak to the child as you would want to be spoken to if someone were reprimanding you.
• Neve Rationalizing
4 / 39
○ Remember to be CONSISTENT! For example: do not tell a child that they can’t go to the football game because they forgot to do a chore; but then proceed to tell them their sibling wants to go and then allow them to go when they shouldn’t be able to.
r resort to name-calling, yelling, or disrespect
.• Be clear about what you mean
.• Be firm and specific. Whenever possible, the consequences must be delivered immediately, relate to the rule broken, be short enough in duration, and emphasize the positives. In addition, the consequences must be fair and appropriate to the situation and the child’s age.
: helps to educate and promote safety
● Time-outs/grounding
● Corporal punishments
● Withholding
Rationalize
Remember to be CONSISTENT! For example: do not tell a child that they can’t go to the football game because they forgot to do a chore; but then proceed to tell them their sibling wants to go and then allow them to go when they shouldn’t be able to.

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10
Q

Toddler Nutrition and Eating habits ?

A

Nutrition: Family meals; allow toddler to self-feed and use a cup at mealtimes;
allow child to make food choices;
provide finger foods;
provide two to three healthy snacks per day;
do not force eating

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11
Q

Instruct the family on good hygienic practices: infants

A
  • Wash hands after changing diapers and using the toilet.
  • Wash hands before food preparation and eating.
  • Carefully dispose of soiled diapers.
  • Wash linen or clothing contaminated with stool separately in hot water.
  • Clean contaminated household surfaces with bleach and water (1/4 cup of bleach to 1 gallon of water).
  • Teach families about the importance of the HAV and HBV vaccinations.
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12
Q

Children; grow from head to tail, middle to distal, simple to complex, grow at the same steps but not the same rates.

A

Yes

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13
Q
Babbling at 4 months 
• Roll front to back 5 months 
• Back to tummy at 6 months 
• Pick things up like food (handful) 4-6 months 
• Sitting by 8 months 
• Pick things up with Pincher 8-9 months 
• Object permanence by 9-10 months 
• Walk at 12 months
A

Yes

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14
Q

the infant knows that an object still exists even if covered up or removed from sight (9-10 month)

A

object permanence

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15
Q

concept of death

• Infant;

A

undefined due to level of cognition.

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16
Q

Toddler concept of death

A

• Toddlers; unable to distinguish fact from fantasy inhibits true perception of death (death may mean separation from parents; respond with fear and sadness).

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17
Q

Preschooler concept of death

A

Preschoolers: can understand that something is wrong. Fear of death as early as 3 years. Magical thinkers; don’t say death is like going to sleep (fear of sleeping).

18
Q

School-age child: concept of death 8-9

A

realistic understanding of death but is not precise until they understand the concept of time (ages 8-9).

19
Q

Adolescents: concept of death

A

can understand death, but difficulty in accepting it as reality. Thinks death can be defied. Emotional ability to face death is absent.

20
Q

Growth during infancy (1 to 12 months)

Reflexes and growth

A

Weight: doubles birth weight in 6 months; triples birth weight in 1 year NCLEX ®
2. Height: increases 50% by 1 year
3. Head growth is rapid; brain increases in weight 2.5 times by 1 year a. Head circumference exceeds chest circumference b Posterior fontanel closes at 2 to 3 months NCLEX ® c. Anterior fontanel closes by 12 to 18 months
4. Reflexes present at birth NCLEX ® a.
Moro: startle reflex elicited by loud noise or sudden change in position
b. Tonic neck: elicted when infant lies supine and head is turned to one side; infant will assume a “fencing position”
c. Gag, cough, blink, pupillary: protective reflexes
d. Grasp: infant’s hands and feet will grasp

Rooting: elicited when side of mouth is touched, causing infant to turn to that side
f. Babinski: fanning of toes when sole of foot is stroked upward
5. Reflexes that appear during infancy
a. Parachute: involves extension of arms when suspended in prone position and lowered suddenly b. Landau: when infant is suspended horizontally, head is raised
c. Labyrinth righting: provides orientation of head in space
d. Body righting: when caregiver turns hips to the side, the body follows
6. Gross motor development: developmental maturation in posture, head balance, sitting, creeping, standing, and walking NCLEX ®
a. Gains head control by 4 months
b. Rolls from back to side by 4 months
c. Rolls from abdomen to back by 5 months
d. Rolls from back to abdomen by 6 months
Sits alone without support by 8 months
f. Stands holding furniture by 9 months
g. Crawls (may go backward initially) by 10 months
h. Creeps with abdomen off floor by 11 months i. Cruises (walking upright while holding furniture) by 10 to 12 months
30 / 39
j. Can sit down from upright position by 10 to 12 months
k. Walks well with one hand held by 12 months
7. Fine motor development: use of hands and fingers to grasp objects NCLEX ®
a. Hand predominantly closed at 1 month
b. Desires to grasp at 3 months
Two-handed, voluntary grasp at 5 months
d. Holds bottle, grasps feet at 6 months
e. Transfers from hand to hand by 7 months
f. Pincer grasp established by 10 months
g. Neat pincer grasp (e.g., picks up raisin) with thumb and finger by 12 months
8. Sensory development
a. Hearing and touch well developed at birth
b. Sight not fully developed until 6 years; differentiates light and dark at birth; prefers human face; smiles at 2 months
c. Usually searches and turns head to locate sounds by 2 months
d. Has taste preferences by 6 months
Responds to own name by 7 months
f. Able to follow moving objects; visual acuity 20/50 or better; amblyopia (“lazy eye”) may develop by 12 months
g. Can vocalize four words by 1 year

21
Q

Nutrition 0-1 year

A

Nutrition
a. Human breast milk is easily digested and most complete
b. Iron-fortified commercial formulas used for bottle-feeding closely resemble nutritional content of human milk; recommended for first 12 months
c Solids are introduced no sooner than 6 months to avoid exposure to allergens NCLEX ®
d. Iron-fortified rice cereal is introduced first because of its low allergenic potential e. Deciduous “baby” teeth erupt by 5 to 6 months; lateral incisors erupt first; increase in drooling and saliva; may be accompanied by slight elevated temperature
f. Gradual weaning from breast to bottle to cup during second 6 months of infancy
Juices may be introduced, diluted 1:1 at 6 months; preferably given by a cup
h. Introduction of fruits, vegetables, and meats (one food each week is recommended to identify any allergy)
i. Junior foods or chopped table foods introduced by 12 months
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j. Limit intake of formula to no more than 32 oz per 24 hours to avoid iron-deficiency anemia

22
Q

Safety 0-1 year

A

a. Infants up to 20 lb (9 kg) and age 1 year should be restrained by law in a rear-facing car seat in back seat of car; the American Academy of Pediatrics recommends keeping toddlers in a rear-facing direction until they reach 2 years or the maximum height and weight allowed by car seat manufacturer
b. Keep side-rails of crib up
c. Never leave infant unattended on table, bed, or in bathtub
d. Check temperature of bath water, formula, and foods
e. Avoid giving bottles at naps or bedtime (may cause dental caries)
f. Parents should learn injury prevention, including aspiration of foreign objects (buttons, toys, peanuts, hotdogs), suffocation (plastic bags, strangulation), falls, poisonings, and burns (electric cords, wall outlets, radiators, pots and pans on stoves)

23
Q

Play 0-1 year

A

Provide black/white contrasts for premature and newborn infants

b. Hang mobile 8 to 10 inches from infant’s face
c. Provide sensory stimuli (bath water) and tactile stimuli (feel of various shapes of objects), large toys, balls
d. Expose to environmental sounds: rattles, musical toys e. Use variety of primary-colored objects during infancy
f. Place unbreakable mirror in crib for infants to focus on own face
g. Provide toys that let infants practice skills to grasp and manipulate objects h. Vocalization provides pleasure in relationships with people (smiling, cooing, laughing)

24
Q

TODDLER GROWTH AND DEVELOPMENT

Period from 1 to 3 years of age

A

B. Weight: growth rate slows considerably; weight is 4 times the birth weight by 2½ years
C. Height: at 2 years, height is 50% of future adult height
D. Head circumference: 19½ to 20 in. (49 to 50 cm) by 2 years; increases only 3 cm in second year; achieves 90% of adult-sized brain by 2 years
E. Anterior fontanel closes by 18 months NCLEX ®
F. Gross motor development: still clumsy at this age NCLEX
® 1. Walks without help (usually by 15 months)
2. Jumps in place by 18 months
Goes up stairs (with 2 feet on each step) by 24 months
4. Runs fairly well (wide stance) by 24 months
G. Fine motor development NCLEX ®
1. Uses cup well by 15 months
2. Builds a tower of two cubes by 15 months
3. Holds crayon with fingers by 24 to 30 months
4. Good hand–finger coordination by 30 months
5. Copies a circle by 3 years
H. Sensory development
1. Binocular vision well developed by 15 months
2. Knows own name by 12 months; refers to self
3. Identifies geometric forms by 18 months
4. Uses short sentences by 18 months to 2 years
5. Follows simple directions by 2 years
6. Able to speak 300 words by 2 years
7. Remembers and repeats 3 numbers by 3 years
I. Object permanence is knowledge that an object or person continues to exist when not seen, heard, or felt
J. Ritualistic behavior is exhibited during toddler period; ritualism is toddler’s need to maintain sameness and reliability; provides sense of comfort
5. Follows simple directions by 2 years
6. Able to speak 300 words by 2 years
7. Remembers and repeats 3 numbers by 3 years
I. Object permanence is knowledge that an object or person continues to exist when not seen, heard, or felt
4. Good hand–finger coordination by 30 months
5. Copies a circle by 3 years
H. Sensory development
1. Binocular vision well developed by 15 months
2. Knows own name by 12 months; refers to self

25
Q

Nutrition toddlers

A

Growth slows at age 12 to 18 months; thus appetite and need for intake decrease

  1. Toddlers are picky, ritualistic eaters
  2. Avoid more than 32 oz formula or milk/day to prevent iron-deficiency anemia
  3. Avoid large pieces of food such as hot dogs, grapes, cherries, peanuts
  4. Able to feed self completely by 3 years
  5. Deciduous teeth (approx. 20) are present by 2½ to 3 years
  6. Teach good dental practices (brushing, fluoride)
26
Q

Toddler safety

A

Continue to use car seat properly; the American Academy of Pediatrics recommends placing toddlers in a rear-facing car seat in the back seat of car until they reach age two or they exceed car seat manufacturer height and weight limits for rear-facing seat; children over the age of 1 and over

20 lb may be placed in forward-facing car seats with harness straps at or above shoulders per current law

  1. Supervise indoor play and outdoor activities
  2. Teach that use of ipecac for accidental ingestions is no longer recommended
  3. Teach injury prevention
    a. Childproof home environment: stairways, cupboards, medicine cabinet, outlets
    b. Suffocation: plastic bags, pacifier, toys, unused refrigerators
    c. Burns: ovens, heaters, sunburns; check water and food temperature

d. Falls: stairs, windows, balconies, walkers
e. Aspiration/poisonings: medications, cleaners, chemicals; store harmful substances out of reach M.

27
Q

Toddler play

A

Play (parallel) NCLEX ®

  1. Begins as imaginative and make-believe play; may imitate adult in play
  2. Provide blocks, wheel toys, push toys, puzzles, crayons to develop motor and coordination abilities
  3. Toddlers enjoy repetitive stories and short songs with rhythm
28
Q

PRESCHOOL GROWTH AND DEVELOPMENT

A. Period from 3 to 5 years of age;

A

tricycle by 3 years
B. Weight: growth is slow and steady; gains 4 to 5 lb/year
C. Height: increases 2 to 3 in/year D. Motor
1. Rides tricycle by 3 years
2. Skips and hops on one foot by 4 years
3. Throws and catches ball well by 5 years
4. Balances on alternate feet by 5 years
5. Knows 2100 words by 5 years
6. Increased strength and refinement of fine and gross motor abilities NCLEX ®

29
Q

Preschool nutrition

A

Similar to toddlers’ eating patterns

  1. Demonstrates food preferences: likes and dislikes
  2. Influenced by others’ eating habits
  3. Caloric requirement: 90 kcal/kg/day
  4. Reinforce good dental hygiene: regular exams, brushing, fluoride, less concentrated sugar
30
Q

Preschool safety

A

Use belt-positioning booster seat with car’s lap and shoulder belt when child exceeds manufacturer’s height and weight limits on forward-facing car seat; all children younger than 13 years should sit in back seat of vehicle

  1. Able to learn safety habits
  2. Teach injury prevention such as traffic safety, risks with strangers, fire prevention/safety, water safety/drowning
31
Q

Preschool play

A

G. Play (associative) NCLEX ®

  1. Enjoys imitative and dramatic play (imitates same sex role in play)
  2. Provide toys to develop motor and coordination skills (tricycle, clay, paints, swings, sliding board)
  3. Parental supervision of television
  4. Enjoys sing-along songs with rhythm
32
Q

SCHOOL AGE GROWTH AND DEVELOPMENT

Period from 6 to 12 years of age

A

B. Weight: steady, slow growth; gains approximately 5 lb/yr
C. Height: increases 1 to 2 in/year; boys and girls differ little at first, but by end of period girls gain more weight and height compared to boys
D. Motor/sensory develop
1. Bones grow faster than muscles and ligaments develop
2. Susceptible to greenstick fractures
3. Movements become more limber, graceful, and coordinated
4. Have greater stamina and energy
5. Vision 20/20 by 6 to 7 years; myopia may appear by 8 years

33
Q

School age nutrition

A

Risk of obesity in this age group

  1. Identify those above 95th and below 5th percentiles in weight and height on plotted growth charts NCLEX ®
  2. Requirement of 85 kcal/kg/day
  3. Tendency to eat “junk” foods, empty calories
  4. Secondary sex characteristics begin at 10 years in girls; 12 years in boys
  5. Loses first deciduous teeth at age 6; by age 12 has all permanent teeth, except final molars
34
Q

School age safety

A

F. Safety NCLEX ®
1. Incidence of accidents/injuries less likely
35 / 39
2. Teach proper use of sports equipment
3. Discourage risk-taking behaviors (smoking, alcohol, drugs, sex)
4. Introduce sex education
5. Teach injury prevention: bicycle safety, firearms, smoking education, hobbies/handicrafts

35
Q

School age play

A

Comprehends rules and rituals of games

  1. Enjoys team play, which helps instill values and develop sense of accomplishment
  2. Enjoys athletic activities such as swimming, soccer, hiking, bicycling, basketball, baseball, football
  3. Provide construction toys: puzzles, erector sets, small interlocking blocks
  4. Good eye–hand coordination: interested in video and computer games (needs monitoring and time limits)
  5. Enjoys music, adventure stories, competitive activities
36
Q

Adolescent growth and development

Period from 13 to 18 years of age

A

ADOLESCENT GROWTH AND DEVELOPMENT

B. Weight: rapid period of growth causes anxiety; girls gain 15 to 55 lb (7 to 25 kg); boys gain 15 to 65 lb (7 to 29 kg)
C. Height: attain final 20% of mature height; girls: height increases 3 in/year, slows at menarche, stops at 16 years; boys: height increases 4 in/year, growth spurt approximately at 13 years, slows in late teens
D. Puberty NCLEX ®
1. Related to hormonal changes
2. Apocrine glands become active; adolescent may develop body odor
Appearance of acne on face, back, trunk
4. Development of secondary sex characteristics: girls experience breast development, menarche (average age 12½ yrs), pubic hair; boys experience enlargement of testes (13 years), increase in scrotum and penis size, nocturnal emission, pubic hair, vocal changes, possibly gynecomastia

37
Q

Period from 13 to 18 years of age

Nutrition

A
  1. Growth spurt: brief period of rapid increase in growth
  2. “Hollow leg stage”: appetite increases
  3. Nutrition requirements: 60 to 80 kcal/kg/day (approximately 1500 to 3000 kcal/day at 11 to 14 yrs and 2100 to 3900 kcal/day at 15 to 18 years)
  4. At risk for fad diets; food choices influenced by peers
  5. Require increased calcium for skeletal growth
    36 / 39
  6. Continue emphasis on prevention of caries and good dental hygiene
    Final molars erupt at end of adolescence; orthodontia common dental need
38
Q

Adolescence safety

A

Safety NCLEX ®
. Accidents: leading cause of death (motor vehicle accidents, sports, firearms)
2. Provide drug and alcohol education
3. Provide sex education
4. Discourage risk-taking activities
5. Adolescents may display lack of impulse control, reckless behaviors, sense of invulnerability
6. Reinforce health promotion: breast self-exam (BSE), testicular self-exam (TSE)
7. Teach injury prevention
a. Proper use of sports equipment (protective gear)
b. Diving, drowning
c. Provide driver’s education
d. Use of seat belts
e. Violence prevention
f. Crisis intervention (stress, depression, eating disorders
Provide information about the risks of body piercing
8. Reinforce rules when necessary

39
Q

Adolescence play

A

G. Play/activities NCLEX ®

  1. Enjoy sports, school and peer group activities (movies, dances, eating out, music, videos, computers)
  2. Interest in heterosexual relationships common
40
Q

In toddlers] **Too much calcium= Anemia because “calcium impedes iron absorption”

  • Adolescents (puberty)- surge of growth. Muscle mass.
  • Anorexia - Not eating; Control issues, body dysmorphia.
  • Bulimia - Binge and purge; Body dysmorphia.
  • Infant- breast feed up to 1 year, no milk prior
  • Solid foods - around 6 mo., slowly new food every 3-4 days
  • Toddlers - picky eaters, physiological anorexia, grazers; no food fads are detrimental unless purposely not eating.
  • Growth problems if not receiving proper amount of proteins: Ask what they like (if don’t like milk
A

find another option for calcium)
**Too much milk can cause anemia [Ca impedes iron absorption]
Safety and education with positive reinforcement; to make good choices, aggressiveness with toddlers because they don’t remember:
-Withholding, time out, rationalizing, distractions
Time out [without isolation], redirection, distraction, positive reinforcement, modeling preferred /desired behavior, removal of privileges, natural consequences of actions.
*Manage as you would an adult.
-Pain scales- Faces and FLACC are preferred. *For children 10-12 years old can use the numerical pain scale.
-Believe the child’s report.