Human Growth & Development/ Communication Flashcards
Growth and development occurs in a
cephalocaudal sequence
Motor skills progress in a
Proximal distal sequence
Erickson’s Trust v. Mistrust (Birth to 1 year)
Child develops a sense of self from the development of a trusting relationship with a consistent primary caregiver
Freud’s Oral Stage (Birth to 18 months)
sucking, swallowing, chewing and biting are not only pleasurable but crucial for survival
Birth weight ______ in 4-6 months
Doubles
Sphincter control begins around age
2yrs
Birth weight _____ in 1 year
Triples
Posterior fontanel closes by
2-3 months
Height increases by ___% in the first year
50%
Toys at 3 months
Music box
Mobile
Mirror
A toddler continues solitary play but engages in
Parallel play (Several toddlers play in the same proximity but don’t interact with each other)
Erickson’s Initiative v Guilt (3-6yrs)
A child develops a sense of self esteem thru task accomplishment. Guilt occurs if caregiver’s responses are too harsh
Psychosocial at 3 months
Social smile
Responds to stimuli with whole body
Knows primary caregiver
Motor at 3 months
Lifts head and chest in prone position
Follows objects with eyes
Moves arms and legs simultaneously
Psychosocial at 6 months
Apprehensive of strangers
Babbles and coos
Observes environment
Motor at 6 months
Rolls from side to side
Sits with assistance
Transfers objects from hand to hand
Toys at 6 months
Rattle
Soft toys
Bright colors
Psychosocial at 9 months
Waves bye-bye
Mama, Dada indiscriminately
Stranger anxiety
Exhibits object permanence
Motor at 9 months
Sits well w/o assistance
Uses pincer grasp
Crawls
Stands w/ assistance
Toys at 9 months
Rattle
Soft toys
Bright colors
Psychosocial at 12 months
Imitates behaviors
Cooperates with dressing
Shows jealousy
Motor at 12 months
Walks with assistance
Turns pages in a book
Stands w/o assistance
Attempts to stack blocks
Toys at 12 months
Push and pull
Cloth books
Surprise toys
Ball
Infant play is characterized by
Onlooker and solitary play (the infant actively watches others)
Erikson’s Autonomy v Shame and Doubt (1-3yrs)
The toddler develops a sense of independence thru exploration and encouragement. Learns to tolerate frustration thru socialization and toilet training
Frued’s Anal Stage (18months-3yrs)
Toilet training. Activity is centered around the anus and buttocks
Piaget’s Sensorimotor Stage (Birth-2yrs)
The infant is learning thru all the senses and motor activities. The infant is egocentric. Everything is perceived in relation to self
Kohlberg Egocentric Orientation Stage
The stage that which is good is what one likes and wants
Piaget Preoperational Stage (2-7yrs)
Child begins ability to use symbols in language and play and continues egocentrism.
“Animism”
Birth weight _____ by 2 year
Quadrupels
Anterior fontanel closes by
18 months
Psychosocial at 15 months
uses 4-6 words
knows one body part
Motor at 15 months
Walks w/o assistance
Builds tower of 2 blocks
Toys at 15 months
Push and pull
Blocks
Psychosocial at 24 months
Understand possession
Temper tantrum
Parallel play
Separation anxiety
Motor at 24 months
Walks up and down stairs Climbs Removes clothes Turns door knob Sphincter control
Toys at 24 months
Push and pull
Riding toys
Jack in the box
Finger paints
Psychosocial at 36 months
Agreeable behavior Shares well Nightmares Fear of monsters Knows first and last name Knows sex differences
Motor at 36 months
Runs well
Dresses and undresses
Jumps from a step
Walks on tip toe
Toys at 36 months
Tricycle Crayons Puzzles Books Videos
Growth slows at age _____ months
12-18 months. Toddlers are picky eaters
Freud’s Phallic stage (3-5yrs)
focuses on gender differences
Oedipal/Electra complez
Kholberg’s Punishment-Obedience Stage
Child is good b/c a parents says so. Avoids punishment and obeys w/o question those who have authority
Height for a 3-6 year old increases
2-3 inches/year
All deciduous teeth are present by age
3-6 years old
Toys at 3-6 years old
Coloring books Play house Story time Ball Puppets Clay
The preschooler interacts with others in _____ play
Associative
Erikson’s Industry v Inferiority (6-11yrs)
Self concept development, peer group activities encourage cooperation and competitiveness
Freud’s Latent stage (6-12yrs)
There is a resolution of sexual conflict and investment in other interest
Piaget’s Concrete Operational (7-11yrs)
Begin logic ability to order and relate experiences to an organized whole. They understand the relationship between numbers, letters, words, and time. Problem solving capabilities
Reaches one half of adult height by age
6
Deciduous teeth are replaced by
Permanent teeth
Play for children ages 6-12 is primarily
Group, same sex oriented
Erikson Identity v Role Confusion (Puberty)
Focuses on independence from the family, peer acceptance is extremely important. Fantasizes and daydreams. Experiences feelings of invulnerability
Freud’s Genital Stage (12-19yrs)
Masturbation, sexual intercourse and feelings for others
Kholbergs Social Contract Orientation
Follows societal law but recognizes the possibility of changing the law to improve society. What society should value rather than what society would value
Kholberg’s Higher law conscience
Judgments are made on the basis of benefiting society and leading to cooperation
Kholbergs Universal Ethical Principle
Judgments are made on the bases of consequence in accord with ethical principles such as justice, integrity, equality, and respect for dignity of human rights
Hereditary factors that influence growth and development
Physical impairments
Mental illness
Trauma is not a factor
Environmental factors that influence G & D
Nutrition
Pollution
Freuds components of human personality
Id: most primitive, basic instincts
Ego: helps judge reality, regulates impulses
Superego: regulate, restrain, and prohibits actions (conscience)
Normal reflexes for a newborn
Blinking in response to bright light Startling in response to loud noise Palmar/plantar grasp Swalllowing Babinski +
The communication process
Sender
Message
Receiver
Response/Feedback
Nonverbal communication
Body language
Personal appearance
Posture/gait
Gestures
Do not use email for
Urgent information
High confidentiality info
Abnormal lab data
Factors influencing communication process
Development and gender Sociocultural characteristics Values and perceptions Personal space Environment Congruence Attitudes
What is congruence
When verbal and nonverbal aspects match
Barriers to communication
Stereotyping Being defensive Challenging Probing/Testing Rejecting/Judging Changing topics Unwarranted reassurance Giving common advice
Therapeutic Communication
Interactive process b/w nurse and client. Helps client overcome temporary stress. Established with purpose of helping client.
Blocks to attentive listening
Rehearsing Assuming Judging Identifying Getting off track Filtering
Common mistakes of therapeutic communication
Giving advice Discounting feelings Deflecting Interrogating Sparring
Therapeutic relationship phases
Preinteraction
Introductory
Wroking (Stage 1 & 2)
Termination
Pre-interaction phase
The nurse reviews available data
Talk to other caregivers who have info on pt
Plan enough time for the initial interaction
Introductory Phase
Set the tone for the relationship Nurse and client observe each other Assess pt health status Prioritize problems Clarify problem
Working Phase Stage 1
Exploring and understanding thoughts and feelings Respect Reflecting, Paraphrasing Clarifying Confronting
Working phase Stage 2
Facilitate and take action Collaborate Make decisions Provide support Offer options
Termination phase
Summarizing
Allow time for adjustment to independence
Evaluate goal achievement
Achieve smooth transition
Purposes of patient records
Communication Planning care Research Education Legal documentation Health care analysis
Different documentation systems
Source oriented Problem oriented Problem, intervention, evaluation (PIE) Focus charting Charting by exception
Components of Source Oriented records
Narrative charting Admission Sheet Nurse/progress notes Diagnostic reports Physician order sheet Referral summary Initial nursing assessment Flow sheet Medical H&P Consultation records Discharge plan
Problem oriented record
Arranged according to client problems
Components of problem oriented records
Database
Problem list
Plan of care
Progress notes (SOAP)
Problem, Intervention, Evaluation (PIE) components
Flow sheet
Ongoing care plan
Assessment establishes
Focus charting components
3 columns (Data,Action, Response) Focus on condition, NANDA, behavior and S/S
Charting by exception
Flow sheets
Bedside access
Elimination of lengthy notes
One of the most potent forms of communication is
Touch
Clarifying
To check whether understanding is accurate, restate an unclear, ambiguous message to clarify the sender’s meaning
Focusing
Centers on key elements or concepts of a message
Paraphrasing
Restating another’s message in your own words briefly
Summarizing
Concise review of key aspects of an interaction
Self-disclosure
Subjectively true personal experiences about the self that are intentionally revealed to another person
Consultation
One caregiver gives advice about the care of a pt to another caregiver. One time opinion.
Referral
An arrangement for services by another care provider
Types of narrative documentation
Focus charting
PIE
SOAP
Kardex
method for organizing, recording. Portable “flip over” file kept at nurses station. Eliminates the need for repeated information
The major purpose of the hand-off report is to
Maintain continuity of care
Hand-off reports include
Name, Gender, Dx of pt
Recent changes in health problems
Info on family members as it relates to pt’s problems
Review ongoing d/c plan (pt prep level to go home)
New meds, Significant changes in ways therapies are to be given
Evaluate results of nursing measures
Be clear about priorities
APGAR score measures what
Heart rate Muscle tone Skin color Respiration Reflexes
Pre-embryonic
First 14 days after fertilization
Embryonic stage
Day 15-week 8
The development of the placenta begins in
The 3rd week of the embryonic stage
APGAR is conducted at what times after birth
1 min and 5 min after birth
Fetal stage
End of the 8th week until birth
Height increases by _____ the first 6 months and then ____ each month until 12 months
1 inch, then 1/2 inch
The average toddler grows ____ inches in height and gains about _____ lbs a year
2.5inches
5-7lbs
Preschool children gain about ___lbs a year and grow about ____ inches
5lbs
2.5-3 inches
The greatest fear of preschoolers is
bodily harm
Warning signs of suicide
Withdrawal Loss of initiative Loneliness, sadness, crying Appetite and sleep disturbances Verbalization of suicidal thought
Social factors that influence G & D
support system violence resources parental influences cultural expectations
Intimacy v Isolation (Young adult)
Search for meaningful friendships and an intimate relationship with another person
Transference
Patients feelings to nurse
Counter transference
Nurse feelings to patient
What are the three levels of Kholbergs moral development?
Level 1: preconventional
Level 2: conventional
Level 3: post conventional
Level 1 preconventional stage
Primarily egocentric, thinking is based on likes and pleasure. This stage progresses toward having punishment guide behavior
Level 2 conventional reasoning
Moves from “what’s in it for me?” To “how will this affect my relationship with others”. Emphasis now on social rules
Level 3 post conventional reasoning
A person finds a balance between basic human rights and obligations and societal rules and regulations. What an ideal society would be like
Which stage in intrauterine life is most vulnerable?
Embryonic. All body organs are formed by week 8
The placenta functions as the fetal
Lungs
Kidneys
GI tract
Endocrine organ
