growth and development - adolescent Flashcards
School-age years
6 through 12 years
* Begins with entry into school
* Growing intellectual skills
* Physical ability
* Independence
* Impact on development and relationships
School-age years - Use feedback from
- Adults
- Peers
- Their own self-evaluation
- To judge their competencies
Sensory Ability
Can Read
* Concentrate for longer periods
* By filtering out surrounding sounds
Language Development -Communication
- Efficient language skills
- Important linguistic accomplishments
- Correct syntax, improved grammar, word usage * Metalinguistic awareness
ID, Ego, Superego
is your ego realistic?
ID - basic sexual energy
* Ego: realistic part of the
person
* Superego: moral ethical system
ego
Ego diverts impulses and protects itself – using defense mechanisms
* Regression- an unconscious defense mechanism, which causes the temporary or long-term reversion of the ego to an earlier stage of development
* Repression
* Rationalization
* Fantasy
Freud’s Theory of Psychosexual Development- when is the latency period?
- 6-12 years
- “latency” period of
- Sexual energy at rest
- Relationships – same sex peers
Buddies
Having good relationships
*
* Are less lonely
* Less depressed
* Miss fewer days of school
* Enjoy school more
Social Development
- Importance of the peer group
- Identification with peers is a strong influence in child gaining
independence from parents - Sex roles strongly influenced by peer relationships * Self-confidence
Characteristics
- Sensitive about being compared to peers
- Prefers same gender playmates; gender identification is strong
Relationships with Peers
- Formation of formalized groups or clubs * Code of rigid rules
- Exclusiveness – privilege to join
- Uniform – special words
- Password
- Modes of dress
Erikson’s Theory of Psychosocial Development - Theoretical Framework
- Identified a crisis
- A challenge at that stage
- Leads to - Healthy personality development
Sense of industry
- Erikson
- Successful completion of 1st 3 stages requires
- Loving environment
- Stable family unit
- Prepares child to engage in experiences and relationships beyond the family
Erikson:
Developing a
Sense of
Industry - characteristics of what stage? it’s in the name
- Eager to develop skills and participate in meaningful and socially useful work
- Gives them a sense of self worth
Sense of industry
(the industry is valuable)
- Learn the value of doing things with others
- Volunteer
Erikson’s – 6-12 years
(sex inferiority)
INDUSTRY Vs INFERIORITY
* New interest
* Involvement in
activities
* Pride in accomplishments
* Sense of achievement
Sense of industry - works well w/ or w/out ppl?
(motivated by the industry)
Motivated to complete tasks * Working alone
* Working with others
School-Age
Child (2 of 6)
(2 equals 3 Cs)
*Conservation
* Cognitive development
* Concrete operations
School-age years
- Thinking is concrete
- Thinking and reasoning is more logical
- Organized
- Example
- Classify objects in different ways
- Baseball cards by teams, playing position, league, etc.
Piaget 7-11 years
Characteristics of stage
Understand cause and effect
Concept of conservation
* Capable of mature thought
* When allowed to manipulate objects
Nursing Applications
* Use concrete objects in teaching * Give clear instructions about
details of treatment
* Show the child equipment
kohlberg - moral development - what is the basic concept?
(lump of kohl)
reward and punishment
= reward and punishment, older school age = able to judge and act by the intentions that prompted it. rules and judgements become more founded on needs and desires of others
Sexuality
- Help them develop healthy self-image * Interested in sexual issues
- Schools & families provide information * Safe touch
- Information on trusted adults
Nurses Role in Sex Education
- Treat sex as normal part of growth and development
- Questions and answers
- Differentiate betweensexandsexuality
- Values, problem-solving skills
- Open for communication with parents
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 with parents
School-Age Child )
- Mature understanding of language
- Sexuality
- Application to nursing care
Spiritual development- school age
- Family beliefs
- God as human
- Punishment fits the crime
- View illness or injury as punishment
- Comforted by prayer
Stress
- Peer pressure
- Parent pressure
- Over programmed with activities
- Stomach pains or headache
- Sleep problems
- Bed-wetting
- Changes in eating habits
- Aggressive or stubborn behavior
- Reluctance to participate
- Regression to earlier behaviors ( thumb sucking)
Stress Reduction for Children
- Relaxation techniques
- Deep-breathing exercises
- Progressive relaxation of muscle groups * Positive imagery
- Physical activity
- Promote good sleeping habits
Healthy Lifestyle
- Good Nutrition
- Appropriate calories, fats, proteins * Reduced sugars
- Good Oral Health
- Adequate Physical Activity
- Healthy Relationships * Family and peers
Nutrition
- Independence
- Formation of habits
- Independent food choices
- Discuss weight changes
- Discuss usual meal routines and favorite foods
Physical activity
- Family activities * Take walks
- Bike rides
- Run races
- Jump rope * Play games * Swimming
- HAVE FUN!!!
Injury Prevention
- Most common cause of severe injury and death in school-age children is motor vehicle crashes—pedestrian and passenger
- Bicycle injuries/skateboarding—benefits of bike helmets * Appropriate safety equipment for all sports
Anticipatory Guidance— Care of Families
- Parents adjust to childs increasing independence
- Parents provide support as unobtrusively as possible
- Child moves from narrow family relationships to broader world of relationships
Adolescence
- Psychosocial development * Independence
- Identity
- Peers
- Language use
- Exploration and rebellion * Need for privacy
- Sexuality
Adolescent
- 12-18 years
- Begins with entry into
teen years - Mature cognitive thought
- Formation of identity
- Influence of peers
Adolescents
- As teenagers gain independence they begin to challenge values * Critical of adult authority
- Relies on peer relationship
- Mood swings especially in early adolescents
12–18 years
- Sports—ball games, gymnastics, water and snow skiing/boarding, swimming, school sports
- School activities—drama, yearbook, class office, club participation
- Quiet activities—reading, schoolwork, television, computer, video games, music
12–18 years - communication
Increasing communication and time with peer group— movies, dances, driving, eating out, attending sports events
* Applying abstract thought and analysis in conversations at home and school
Activities
- Sports- ball games, water & snow skiing/boarding, school sports * School activities- drama, yearbook, class office, clubs
- Quiet activities- reading, school work, computer, video games
- Driving
- Hanging out * Peer group
Communication
- Understands all parts of speech * Slang
- Study a foreign language
- Establish close ties with peers
- Wants to be different * Try new roles
Physical Development
- Most teens enter puberty by age 15.
- Girls rapid growth right before their first menstrual period
- By age 15, girls are near their adult height.
- Boys usually continue to grow taller and gain weight through their teen years.
Fine Motor Ability
Skills are well developed * Art
* Music
* Polishing nails
* Applying make-up
Gross Motor Ability
- New sports activities
- Muscle development continues
- Some lack of coordination common during growth spurt * Increased appetite
Sensory & Motor Ability
- Fully developed
- May be a little awkward or clumsy.
- Their brains need time to adjust to longer limbs and bigger bodies.
- Getting regular moderate exercise can improve coordination and help your child build healthy habits.
adolescent - Cognitive Development - what do they think about their ideas?
- Understand abstract ideas such as morality. * Understand other people better.
- Begin to have empathy
- Others have different ideas,
- Strongly believe that their own ideas are the most true.
- Emergence of formal operational thought * Think about possibilities
- Future work, college
Psychosocial Development During
adolescence
AGE: 12-18 years
- Activities
- Communication
Freud’s Theory of Psychosexual Development - what ages?
- 12 years to adult
- Mature sexuality achieved
- Physical growth is completed * Relationships
Nursing applications - Adolescent
Freud: Genital stage
Focus on genital function and relationships
* Ensure access to gynecologic care for females * Testicular exams for males
* Ensure privacy during health care
* Provide information on sexuality
* Have brochures and videos available for teaching
Erikson’s Theory of Psychosocial Development
- Identified a crisis
- A challenge
- Healthy personality development
Erikson: 12-18 years
- IDENTITY VS ROLE CONFUSION
- New sense of identity
- Examines and redefines self
Erikson -
Adolescent
Search for self-identity
Adolescent
* Leads to independence from parents * Reliance on peers
Nursing Applications - Adolescent
- Provide privacy
- Interview and examine adolescent without parents present, if
possible - Encourage adolescent participation in treatment and decision making
- Encourage visitation of peers
- Provide separate recreation room
- Introduce teen to other teens with same health problem
- Provide written & verbal explanations
Sexuality
Maturation of body & increased secretion of hormones
* Achieves sexual maturity
* Interest in sexuality, romantic relationships, sexual relationships * Focus on family an d society
* Identity formation
Emotional and Social Development
- Finding their place in the world
- “Who am I?”
- “HowdoIfitin?”
- So it is normal for their emotions to change from day to day.
Heath Promotion & Maintenance
- Basically healthy * Minor illness
- Immunizations
- Sports exam
- Birth control * Injury
Our Policy On Confidentiality
- Our discussions with you are private. We hope that you feel free to talk openly with us about yourself and your health. Information is not shared with other people unless we are concerned that someone is in danger.
HEEADSSSS
- H–Home
- E – Education/Employment * E – Exercise/Eating
- A – Activities
- D – Drugs
- S – Suicidality/Depression
- S – Sexuality
- S – Safety
- S – Spirituality
Nutrition
- Well balanced diet to support growth * Usually don’t eat well
- Follow peers
- Identify youth with eating disorder
- Try - Vegetarian, vegan, no carbohydrate
Physical Activity
- Inadequate physical activity
- Recommend 60 minutes of moderate or vigorous activity * Athletes – nutritional supplements
Signs of Depression & Substance Abuse
Depression
* Changes in appetite & weight
* Changes in sleep pattern
* Changes in school performance
* Physical complaints
* Substance abuse
* Changes in school performance, sleep, & appetite
* Unusual behavior, such as getting in trouble in school
* Lack of responsibility for actions
* Increased mood changes
Immunizations
- Tdap – Tetanus, diphtheria, pertussis * HPV – Human papillomavirus
- Meningococcal
- Flu - influenza
Injury Prevention Strategies
- Injury – greatest health hazard * Automobile crashes
- Boats, jet skis, tools
- Drowning
- Sun
- Firearms * Sports
- Abuse
Piaget: Cognitive Development - Formal Operational 11- adulthood
- Fully mature intellectual attained
- Thinks abstractly about objects & concepts
- Different alternatives or outcomes
Piaget: Formal Operational Stage 12-18 years
Characteristics of stage
* Capable of mature, abstract thought
Nursing Applications
* Clear information about care & treatments
* Written & verbal instructions
* Provide information about their disease
Kohlberg: Moral Development
- Development of conscience and moral standards
- Older school age—able to judge an act by the intentions that
prompted it - Rules and judgments become more founded on needs and desires of others
Planning Assessments
- The nurse must assess a child according to developmental age.
- Make comparisons between actual and expected age based on physical,
cognitive, and psychosocial changes at each stage. - Make referrals for disparity between actual and expected age.
Planning Assessments - School-age
School-age
* Plan assessments based on:
* Growing interest in peer group and extracurricular activities.
* Growth spurt occurring earlier in girls than boys.
* Ability to think about solutions and determine the best among several
alternatives.
* Understanding of the concept of conservation.
Planning Assessments - Adolescence
Adolescence
* Plan assessments based on:
* Child undergoing identity formation.
* Sexual maturity nearing completion.
* Formal operational thought processes becoming possible.
erikson - sense of industry - Nursing Application
Nursing Application
* Encourage child to continue school work while hospitalized
* Bring favorite pastimes to hospital
* Help adjust to limitations on favorite activities
conservation - what age? and what is it?
age 2-6. Conservation is the realization that quantity or amount does not change when nothing has been added or taken away from an object or a collection of objects
girls - physical growth during growth spurt
gain between 15-55 lbs, and grow 2.5 - 20 cm
boys - physical growth during growth spurt
gain 15-65 lbs and grokw 11-30 cm
kohlberg - when is development of conscience?
development of conscience, age 6- 7
