objective 9 (2) Flashcards
– Trust versus mistrust
– Meeting basic needs is paramount
– Separation anxiety begins as early as 6 months
4 weeks to 1 year
what is the main goal of infant developmental level?
– Assist with parent-infant bonding and promote
sensorimotor stimulation
– May abandon some milestones
– Should not be expected to develop new habits during
hospitalization
what are the needs of a hospitalized infant?
*Can be frustrating for the infant
*Used to getting what they want when they want it
*May miss continuous affection of their parents
*Daily schedules are disrupted
*Can be frustrating for the infant
*Used to getting what they want when they want it
*May miss continuous affection of their parents
*Daily schedules are disrupted
- Developmental Tasks: Autonomy vs. shame and doubt
- Object permanence continues to develop
- Fears of instruments e.g. needles
1-3 years
what is the social development of 1-3 years?
– Parallel Play at 16-18 months
– Sharing
– Often says no
– Increased independence
– Egocentric, everything is “mine”
what is the fine motor development of a 1-3 year old?
- At 12-16 months, toddler can drink from a cup
- At 24 months, toddler can turn the page of a book; undress self
- 36 months, holds cup by handle and spoon with 2 fingers; copies
a circle
what is the gross motor development of a 1-3 year old?
- At 12-16 months, toddler begins to walk
- At 16-18 months, toddler walks alone and walk backward
- At 24 months, toddler climbs steps; runs; throws ball; jumps with
both feet; imitates oral hygiene
can follow simple commands; object
permanence developing
12-16 months L&C
ses symbolic language (bye-bye); able
to point to familiar objects; begins to realize cause and
effect
16-18 months L&C
uses plural words, words to tell story, names
familiar objects. Develops likes and dislikes
24 months L&C
can say full name; curious as to why? How?
Understands one concept at a time, knows two colors
and imitates parental roles
36 months L&C
how do we prepare toddlers for treatment/procedure?
– Involve parents
– Offer simple explanations
– Give permission to express discomfort
– Offer one direction at a time
– Allow for choices, if possible
– Use distraction
– Hug after treatment or procedure
- Developmental task: initiative vs. guilt
- Cannot understand abstract concepts
- Can understand time relationships
- Slowing of physical growth
- Mastering and refining of motor, social, and
cognitive abilities
2-5 years
have difficulty seeing any point of view
other than their own
egocentric
what are the major tasks of preschool age child?
- Preparation to enter school
- Development of a cooperative-type play
- Control of body functions
- Acceptance of separation
- Increase in communication skills, memory &
attention span
what are the needs of hospitalized preschooler?
- Explanations must be
made in realistic terms;
they also need to be
clear, understandable,
and truthful
– Afraid of bodily harm
– Engage in magical
thinking and fantasy - Understand Time in relation to
activities - Teach parents that upon
discharge, the child may be
demanding and irritable - May believe they are sick
because of something they did
- Developmental Tasks: industry vs Independence
- More engrossed in fact than fantasy
- Develop first close peer relationships outside the
family group and first affiliation with adults outside
the family
6-12 years
what are the needs of hospitalized school aged children?
- Separation anxiety continues with a “brave”
approach
– Observe body language - Forced dependency- loss of control &security
- Like to feel “grown up”- simple choices can help
foster independence
how do we prepare school aged children for treatment/procedure?
- All of the previously mentioned
strategies for younger age groups, plus
– Let them examine equipment
– Encourage child to verbalize fears
– Offer small reward after treatment or
procedure, for example, a sticker
- Developmental Tasks: Identity vs Role Confusion
- Divided into early, middle, and late because of the changes
that occur between 13 and 20 years of age - learns to understand self in relation to others’ perceptions
and expectations. - main concerns are self-definition and self-esteem.
- experiences an identity crisis brought on by physical
(including sexual) changes and conflict about future choices
and expectations of others.
1-20
what are the major tasks of adolescence?
Establishing an
identity
– Separating from family
– Initiating intimacy
– Developing career
choices for economic
independence
what are the major challenges of adolescence?
– Adjusting to rapid physical
and physiological changes
– Maintaining privacy
– Coping with social stresses
and pressures
– Maintaining open
communications
– Developing positive health
care practices and lifestyle
choices
threat to body image
11-14
ability to appeal to opposite sex
15-17
school,career
18-20
what are the needs of the hospitalized adolescent?
- Experiences feelings of
loss of control during
hospitalization - May cause adolescent
to withdraw, be
noncompliant, or
display anger - May be concerned
with how the illness will
affect appearance - Incorporating choice,
privacy, and the
opportunity for peer
visitors is important
how do we prepare adolscence for treatment/procedure?
- Provide privacy
- Involve teen in treatment or
procedure - Explain treatment or procedure and
equipment - Suggest coping techniques
what do we DO with hospitalized child?
Keep crib sides up and locked in place at all times when
the child is unattended in bed
– Identify a child by ID bracelet and NOT by room or bed
number
– Use a bubble-top or plastic-top crib for infants and
children capable of climbing over the crib rails
– Place cribs so that children cannot reach sockets and
appliances
– Provide age appropriate supervision
– Inspect toys for sharp edges and removable parts
– Keep medications and solutions out of reach of the child
– Prevent cross-infection; Diapers, toys, and materials that
belong in one patient’s unit should not be borrowed for
another patient’s use.
– Remain with child who uses tub or shower
– Take proper precautions whenever oxygen is in use.
– Locate fire exits and extinguishers , become familiar with
hospital’s fire procedure
what do we NOT DO with hospitalized child?
allow ambulatory patients to use wheelchairs or stretchers
as toys
– leave an active child in a baby swing, feeding table, or
high chair unattended
– leave a small child unattended when out of the crib
– leave medications at the bedside
– prop nursing bottles or force-feed small children—risk of
choking
what is crib safety?
The mattress must fit securely into the crib
– Blankets should NOT be tucked in
– Soft or contour pillows should not be placed in cribs
– The distance between crib rails should be no more than
6cm (2 3/8 inches)
– Decorative extensions on the corners of cribs can
become caught on clothing and strangle a child
– A bubble top or extension should be in place if the child
is capable of climbing over the side of the crib
