Growth & Development Flashcards
What is Regression?
The most common coping mechanism of all ages. Begins within hours of hospitalization.
How to treat regression?
Do not punish but focus on rewarding positive behavior.
Phases of separation anxiety
Protest
Despair
Denial aka detachment
Characteristics of protest
become aggressive physically - biting, clinging, scratching. considered proof of child-parent caring relationship
characteristics of despair
depression, withdrawn, loss of interest in play. parents might see this as child adjusting well.
characteristics of denial
detach from parents and form attachments to strangers.
Interventions for separation anxiety
parent education
same nurse assigned to child (if possible)
parents not sneak out when asleep, be honest when leaving
provide security objects and toys
give timeframe to look forward to when parents will return
Post hospital behaviors
7-10 days from discharge nightmares, anorexia fear anxiety immobility peer separation
3 types of failure to thrive
organic
non-organic
idiopathic
Interventions for failure to thrive
24 hour food diary
tests to determine issues (lead, anemia, zinc, stool parasite)
goal - provide sufficient calories for catchup growth
Positive plagiocephali
on back too long
assymetrical head, occipital flattens, transient bald spot
Reasons for failure to thrive
inability to suck swallow
spinal / neuro / reflex abnormalities
GI symptoms, metabolism, neglect / abuse, lack of maternal interaction, POVERTY
Types of cerebral palsy
Spastic - rigid, stiff limbs, poor head control, arched back, low muscle tone (hypotonia)
Ataxia - high stepping, scissoring of legs
Mixed - combination of 2 or more
Apatoid - jerking, twitching, abnormal involuntary mvoement
Phenobarbital
long half life, daily dose 10-40 therapeutic level
Depakote therapeutic range
50-125
Dilantin thera range
10-20 for children & adults
8-15 for neo-nates
Trust vs mistrust
birth to 1 year
Autonomy vs shame and doubt
1-3 years
Intiative vs Guilt
3-6 years
Industry vs inferiority
6-12 years
Identity vs Identity Diffusion
12-18 years
Stressors Birth to 1 year
4-6 months recognizes separate from mother
7 months stranger anxiety
Stressors 1-3 years
Separation anxiety
Change in routine
Loss of mobility
INABILITY TO COMMUNICATE
Stressors 3-6 years
Bodily injury
Unfamiliar environment
Fear of punishment
Stressors 6-12 years
Immobilization
Loss of control
Threats to modesty
Fear of death
Stressors 12-18 years
Threats to body image
Dependency on parents
Lack of privacy
Peer separation
