Lecture 1: intro to family nursing Flashcards
what are ACEs
adverse childhood experiences
can include: abuse, neglect, household challenges
what is classified as a neonate
birth-27 or 28 days
what is classified as infancy
0-12 months
what is classified as a toddler
1-3 yrs
what is classified as preschool
3-6 years
what is classified as school age/childhood
6-11 years
what is classified as adolescence
12-18 yrs
what are the 2 directional patterns for growth considerations
- cephalocaudal development
- proximodistal
Kids can lift up their head, before they sit up, etc
Metabolic rate is higher in children than adult, so infants need more nutrients than an adult because they need it for growth, oxygen consumption, and energy
what are 5 developmental considerations
- ht
- length
- wt
- body proportions
- metabolic rate
what are growth standards and how do we know what is normal for this child and their age
- ht, wt, head circumference
- compare to standard to assess progress
- growth charts
- children in good health tend to follow a consistent pattern of growth
- individual differences are normal
- % levels show extend to which a child’s measurement deviates from 15th percentile
what are growth charts specific too
- gender
- age
Birth-24 months
2-19 years of age
what skills does the Nippissing District Developmental Screen assess
vision
hearing
speech and language
communication
gross motor and fine motor
cognitive
social/emotional
self help
what ages does the nipissing district developmental screen assess
during the first 6 yrs at 13 different stages
Important to identify a problem, to intervene as quick as possible
Intervene: understanding the “why” to figure out what is going on and to incorporate more healthcare professionals
Want to maximize their development
what are 9 factors influencing growth and development
socioeconomic status
housing insecurity
environment
social environment
culture
hereditary traits
gender
family
health inequities
what is normal development in infancy
- nuturance-meeting basic needs
- sense of trust-dependability, security
- oral phase-importance of sucking
- environment-strangers, safety are big concerns
- major stressor-seperation
what is normal growth in infancy
- length increase by 50%
- wt double by 6 months and triple by 1 yr
- anterior and posterior fontanelles
- eruption of teeth around 8 months
interventions for normal development/growth in infancy
have parents present
familiar objects
cuddling
rocking
music
sucking
soft slow voice
interventions for normal growth and development for toddler
familiar objects
parents present
allow for appropriate choices
use simple terms - child’s language
normal development for toddler
- motor skills develop faster than intellectual
- sense of autonomy
- must have mastery of self and environment
- seperation from mother
- anal stage - seeking control, ritualistic, tantrums
- major stressors - separation, fear of bodily harm, and alteration in routine
normal growth for toddler
- growth rate slows 2nd yr of life (mostly in legs)
- limited food intake
- growth spurts - steplike on growth curve
- by age 2: half of adult ht
- head circumference = chest circumference
- birth wt quadrupled (avg wt: 27lbs)
- by 33 months: all deciduous teeth: child has about 20 teeth in total
- LOVE to say no
- Separation from parents is very difficult for them
- Use simple terms, talk through everything you are doing so they can gain the vocabulary
Might not eat as well
normal growth and development interventions for preschool
- simple explanations
- allow for appropriate choices
- familiar objects
- parental presence
- be patient
- focus on present not the future
normal development preschool
- increasing independence - imaginative, curious, energetic learning
- sense of initiative-developing self image (male/female)
- learning through imitation
- socializes w peers
- major stressors: fear of bodily harm, loss of control, heightened imagination leads to increased anxiety
- Help them see what you are doing
- Do NOT ask YES/NO questions
- Make them feel like they have some control
- Starting to develop self image
- Brain growth up till the age of 5 - how much kids learn in before 6 years is impressive due to brain growth
- Stuffies are very important
Have very large imagination
normal growth preschool
- slow and steady (long bones of arms and legs)
- gain 3-5lbs per yr
- grow about 2.5 to 3 in per yr
- deciduous teeth development
- complete
- 6 yrs start to lose teeth and get secondary teeth
normal interventions for growth/development in childhood
- explain procedures
- honesty
- privacy
- include in decision making
- parental presence
normal development in childhood
- development of logical thinking
- interest outside of family
- sense of industry - challenges, achievement
- major stressors - loss of control, bodily injury, pain, separation
- Puberty happening around 9ish in women, slightly later in males
- Be honest about what is happening
- Maintain privacy
Threat to independence, include them in the decision making (which can be hard)
normal growth in childhood
- slow and smooth (girls faster)
- 2 in per yr in ht
- 6 lbs per yr in wt
- by 7 yrs brain nearly completed its growth
- development of small muscle and eye-hand coordination increases
- pubertal growth
- loss of teeth
normal growth/development interventions for adolescence
- explain procedures
- involve in decision-making
- privacy
- avoid authoritarian approach when possible
- great time for health teaching
- promote positive attitudes
- need feedback that they are normal and healthy
normal development for adolescent
independence
physical and sexual maturity
major stressors - loss of control, threats to independence
normal growth for adolescents
- wt doubles and ht increase 15-20%
- major organs double in size (except lymphoid tissue, which decreases)
- boys gain strength and muscle mass
- pituitary glands stimulated at puberty to produce androgen steroids responsible for secondary sex characteristics
what is major developmental milestones for 4-6 wk
1) motor skill
2) language
3) adaptive behaviour
1) head lifted from prone position and turned from side to side
2) cries
3) smiles
what is major developmental milestones for 4 months
1) motor skill
2) language
3) adaptive behaviour
1) no head lag when pulled to sitting from supine position. tries to grasp large objects.
2) sounds of pleasure
3) smiles, laughs aloud, and shows pleasure to familiar objects or persons
what is major developmental milestones for 5 mo
1) motor skill
2) language
3) adaptive behaviour
1) voluntary grasp with both hands. plays both toes.
2) primitive sounds: “ah goo”
3) smiles at self in mirror
what is major developmental milestones for 8mo
1) motor skill
2) language
3) adaptive behaviour
1) sits w/o support, transfers objects from hand to hand, rolls supine to prone
2) combines syllables” “baba, dada, mama”
3) responds to “no”
what is major developmental milestones for 10 mo
1) motor skill
2) language
3) adaptive behaviour
1) sits well, creeping, standings holding, finger-thumb opposition in picking up small objects
3) waves “bye bye,” plays “patty-cake” and “peek-a-boo”
what is major developmental milestones for 12 mo
1) motor skill
2) language
3) adaptive behaviour
1) stands holding, walks with support
2) says 2 or 3 words w meaning
3) understands names of objects, shows interest in pictures
what is major developmental milestones for 15 mo
1) motor skill
2) language
3) adaptive behaviour
1) walks alone
2) several intelligible words
3) requests by pointing, imitates
what is major developmental milestones for 18 mo
1) motor skill
2) language
3) adaptive behaviour
1) walks up and down stairs holding, removes clothes
2) many intelligible words
3) carries out simple instructions
what is major developmental milestones for 2 yr
1) motor skill
2) language
3) adaptive behaviour
1) walks up and down stairs by self, runs, scribbles with crayons, jumps
2) 2-3 word phrases
3) organized play, points to some parts of body
what is major developmental milestones for 30 mo
1) motor skill
2) language
3) adaptive behaviour
1) kicks a ball with either foot, rolling a ball
2) use more than 350 words, use action words (ex: run, spill, fall)
3) show concern when another child is hurt or sad
what is major developmental milestones for 3 yr
1) motor skill
2) language
3) adaptive behaviour
1) engage in multi-step pretend play, catches large ball, rides a tricycle
2) understand “who”, “what”, “why” questions. create long sentences using 5+ words
3) show affection for favourite playmates, takes turns
what is major developmental milestones for 4 yr
1) motor skill
2) language
3) adaptive behaviour
1) begins somersaults, climbing on jungle gym and ladders
2) tell stories with a clear beginning, middle, end, able to generate simple rhymes
3) talk to try and solve problems w adults and other children. demonstrate increasingly complex imaginative play
what is major developmental milestones for 5 yr
1) motor skill
2) language
3) adaptive behaviour
1) jump rope, begins to skate and swim
2) describe past, present, and future events in detail. know all letters of the alphabet
3) seek to please their friends. show increasing independence in friendships. toilet training mostly complete
what to look for for non-verbal communication
- posture and gait
- facial expression
- eye contact
- gestures
- sounds
- territoriality and personal space
what is developmentally appropriate communication for infants
non-verbal
crying as communication
types of cries
comment and pay attention to the child
what is developmentally appropriate communication for early childhood
- focus on CHILD in communication
- explain what, how, and why
- use words they will recognize
- be consistent: don’t smile when doing painful things
what is developmentally appropriate communication for adolescent
- be honest with them
- aware of privacy needs
- think about developmental regression
- importance of peers
what is play and why is it important for kids
- children’s “work”
- child’s “developmental workshop”
- therapeutic intervention
- stress reliever
- pain reliever/distractor
- barometer of illness
good online educational resources for family
- about kids health
- children’s mental health ontario
- KFL&A
