Test #1 - Newborn and Pediatric: Growth and Development Flashcards
What is considered non-traditional family?
Single Parent
Blended
Adoptive
Multigenerational
Same-Sex parents
Communal
What are some family considerations?
Structure:
Who makes up the family?
Developmental Needs
Cultural Influences:
Behaviors
Roles within the family:
Caregiver/Nurturer
Parenting Styles:
Authoritarian
Authoritative
Permissive
What are some cultural aspects and communication we need to keep in mind?
Nurse should be aware of own feelings
Language Barrier:
Interpreter - Must use one that is NOT family
Cultural Beliefs:
May cause conflict in care, discussion, or treatment of a disease
Non-Verbal Communication:
Body Language, Eye Contact, Touch, Use of Space
Verbal Communication:
Tone of voice, expression of emotion
What things do we need to keep in mind when communicating with children?
Consider developmental stage and effect of illness on their development
Environment:
Healthcare setting, is it familiar? Is it going to be scary?
Health Status of the child
Do they have fears at their developmental stage?
Phrasing of communication is important
What do we know about a 3 month old?
Follows objects with eyes
Hand to mouth
Hold objects placed in their hands
(IF CAN’T THEN FURTHER ASSESS!!!!!!)
What are some safety issues for 4-5 month olds?
Pillows
Rolling off tables, couches
What are some safety issues for 6-7 months?
Choking:
Food, toys, anything that can fit in their mouth
What ages are Newborns?
Birth to 1 month
What is the ages of infancy?
1 month to 12 months
What are the ages of toddlers?
12 months to 3 years
What are the ages of Preschooler?
3 to 6 years
What are the ages of School Age children?
6 to 12 years
What are the ages of adolescence?
12-18 years
What is a group with common ancestor OR “group living in a household sharing common attachments such as mutual caring, emotional bonds, regular interactions, and common goals including the health of the individual?
Family
What are some things that you want to consider with family?
The structure (who makes up the family)
Developmental Needs
Roles within the family (Parenting style - Dictatorial, Permissive, Authoritative)
Who is the caregiver and nurturer?
What are some cultural considerations when it comes to communication with the families?
Nurse should be aware of their own feelings
May be a language barrier and require an interpreter who is NOT a family member
Cultural beliefs may cause conflict in care or discussion of disease
Non-Verbal and verbal communication (Non=Eye contact, touch, use of space - Verbal=Tone of voice, expression of emotion)
What are some cultural aspects to consider with care?
Religion/Spirituality/Death rituals
Pain
Nutrition
Communication
Family patterns and gender roles
Repatterning may need to be encouraged
What are some things to remember when dealing with children?
Development stage and effect of illness on their development
Health care setting (Is it familiar? They might be scared)
Health status of the child
Do they have any fears at their developmental stage
Phrasing of communication is important
There are 4 stages of cognitive development, what ages are in the stages?
Stage 1 (1st month)
Stage 2 (1-4 months)
Stage 3 (4-8 months)
Stage 4 (8-12 months)
What happens during the 1st stage (1st month) of cognitive development?
Use of reflexes (Cry, root, suck, grasp, learn that behaviors get a sequential response)
Cry>Root>Nipple>Suck>HAPPY :)
What happens during the 2nd stage (1-4 months) of cognitive development?
Reactions (Now not only associates nipple with gratification but that the mother’s voice is associated with the nipple which makes baby HAPPY :)
What happens during the 3rd stage (4-8 months) of cognitive development?
Secondary circular reactions
Puts 2&2 together (Throws toy on the floor bc you will pick it up)
What happens during the 4th stage (8-12 months) of cognitive development?
Coordinate and Apply (Bottle in mouth=feed)
If an object is in their way they will attempt to go over it or move it whereas before they would have given up
During Play (Perform act over an over again once they?ve mastered it)
Their affect (Begin to develop sense of object permanence which is where they realize that objects that leave the visual field still exist. 9-10 months they lift up that hand that is hiding the block and the block is there.)
Separation (Learn to separate themselves from other objects in the environment)
How does an infant learn trust?
Achieved by caregivers ability to recognize cues by the infant and tend to their needs in a timely manner
how is mistrust developed?
When their basic needs are not met such as food, cleanliness, touch, comfort and warmth
What happens to an infants weight from birth to 12 months?
It triples
If it hasn’t reassess
What are some physical tasks for a toddler 12 m months - 3 years (THE SAFETY AGE)?
Rate of growth slows
Birth weigh has quadrupled by 2 1/2 years
Potbellied appearance
Builds tower of four blocks
Walks alone by 12-13 months
Runs, walks up and down stairs, push/pull toys
Jump, kick and throws overhand
Learns to dress self
What are some psychosocial assessments for toddlers?
Autonomy vs Shame/Doubt
Characterized by: Negativism (Persistent negative response to request “NO!” is a fav word)
Ritualism (Need to maintain sameness)
Without rituals autonomy is hindered and they feel insecure
What are some cognitive assessments for toddlers 12-24 months?
Actively experimenting to achieve goals that were not able to be reached previously
Begin rational judgment & intellectual reasoning
Aware of one event causing another (light switch=light on and off
Tries every lifht switch around. Cannot apply one light switch to the next.)
Appearance of an object=it’s function (Ex: They have their toys in a large tub, laundry in a tub, trash can looks like a tub… If they dump one of the toys they will dump them all)
Learns by trial and error
Beginning ability to wait
Symbolic Play
Preoperational Thinker
Toddlers have spatial relationships with size and shapes, what does that look like?
Will try nesting objects
Put round objects in round hole
Stretch to reach things
Object Permanence has been mastered (Locked cabinets and high places can be the ONLY safe places)
Toddlers between 19-24 nonths have Domestic Mimicry and Sex Role behavior, what is it?
Domestic Mimicry (Following mom ex: helping vacuum), Following Dad (Carry Tools)
Sex Role Behavior (Identification with the same sex parent)
The first phas of the pre-operational period for toddlers is referred to as pre-conceptual is known as what?
Egocentric
It’s all about them
They can only see things from their perspective
Vocabulary grows but logic is not well developed (May say bad words)
What 4 types of play do toddler’s engage in and what are they?
Parallel
Like to be around other children playing with the same toys but NOT necessarily with each other
May exchange toys and words but not together
Initiative
Play kictche, toy phone, grocery carts (Domestic mimicry)
Gross Motor
Like sandboxes, tricycles, soft ball and bat, finger paints, play dough
Fine Motor
Large pencil and paper, wooden puzzles or cloth books.
What are some fears of toddlers?
Separation Anxiety
Separation from parents is a major stressor
Loud noises: Horns, Fireworks, loud trucks, loud tractors
What are some safety issues for toddlers?
Falls (Can now climb up and stand up)
Poisoning (Can work latches, climb on counters, open doors, open lids on bottles)
Burns (Can reach stove top, reach fireplace
Teach parent to turn pot handles)
Motor Vhicle (Can undo seat bellt and may resist car seat) - Aspiration (Food, large pieces of meat)
DROWNING ( Age 1-4 rank 2nd and 3rd in case of accidental deaths because of increase locomotion)
What are some ways to communicate with toddlers and early childhood?
• Egocentric
Messages directed at them mean more
They could care less about how your child felt after a tonsillectomy
• Concrete
Do not understand the abstract
“Coughing your head off” is taken literally
• Songs
Use of songs to learn new skills
Use song playing to lime brushing teeth orwashing hands
• Fears
Separation, loud noises, change in environment
What are some things to remember when a toddler is hospitalized?
Coping Behaviors (Regression and Aggression)
Routines are important
A painless procedure may cause a reaction as severe as a painful procedure
They have a weak sense of body boundaries, a procedure that Is minimally invasive such as looking in the ears may cause as much anxiety as a highly invasive procedure.
What are some communication techniques for toddler hospitalization?
Distraction techniques (Toys, bubnles, holding them)
Transitional Objects (Minimize feelings of fear and loneliness. Parent’s need to be honest about leaving and returning)
What are some physical items of a 3-5 year old?
Long Bones lengthen, Appearance is more long and slender
Run, hold bat, throw ball, can write a few letters and buttion clothes
Gains 2.3kg or 5 lbs per year
Physical growth rate can be influenced by genetics
What stage of psychosocial behavior is a preschooler (3-5 yrs) in?
Initiative Vs. Guilt (May start crying because they did something bad)
Tries new activities
If constantly criticized then will develop feelings of guilt and lack of purpose
What are some cognitive assessments for a preschooler?
Pre-Operational Sub Stage
MAGICAL THINKERS (Believ that their thoughts are “all powerful”. They believe that 3events occur because of their thoughts or wishing)
Moral=Punishment and obedience orientation (Being sick might be a punishment, hospital might be a punishment, Anything parent does kid thinks they are being punished)
What is Pediculosis Capitis?
Head Lice
What are some health promotion teachings for Pediculosis Capitis?
Nits hatch in 7-10 days
Do not jump or fly
Female louse lives 1 month
Can live for 48 hours without a host
Trat environment with Pediculocides and check frequently!!
Bag toys for 2 weeks, vacuum, wash sheets, bag pillows that cannot be washed, burshes in hot H2O)
What are some Toddler Language?
• Most can verbally communicate by age 2
» Predominate words include ‘me’, I, ‘mine’
- Receptive language develops earlier and more quickly than speech
- 300 or more words by age 2
- 60-70% of speech is understood by age 2
- Hearing issues can delay language
- Reading helps enhance speech and development
What are some preschooler psychosocial behaviors?
- Learning appropriate communication and social skills
- Sense of initiative
- Encourage imagination and creativity
- Associative play
- Imaginary friends are common near age3
- Sexual identity and body image are developing
- Compare their bodies to others
- Sense of rivalry with same-gender parents
•Identifies and imitates the same-gender parent
■Right from wrong
■Concept of God is concrete
What is some preschooler health promotion?
Fears-this age group has the largest number of fears, and the biggest variety of fears
- Real fears
- Darkness, being along, separation, animals
- Imagined fears
- Monsters, ghosts, boogeyman
- Safety isthe same as the toddler
- Add bikes toward the end of this stage
Pediculosis Capitis
What are some Physical assessments in School Age Children?
- Slow and steady/Gradual and subtle
- Average 2.5 kg per year/2 inches per year
■ Boys approx. 1 in taller and 2 lbs heavier until…
- 10 or 11 years of age, then girls catch up
- By 12 years of age, girls usually 1 in taller and 2 lbs heavier
- Brain size complete by 10 years
- Onset of puberty, between ages 12 and 14
- Growth spurt
- 2 years later in boys than in girls
What are some motor skills for school Age Children?
•More graceful and coordinated
•Active play:
Tag, jump rope, hide and seek
Team sports, soccer, baseball
Balance
Hand-Eye Coordination:
Playing musical instruments, model building, drawing
What are some cognitive/sensory items for School Age children?
Moving into logical thinking from intuitive thought (6-7 years)
Concrete Operations:
7-8 years
Alphabet
Read
Reversibility
Conservation
Classification and Logic
Humor
Vision
Hearing
What are some Language assesments for school age children?
- Continues at a rapid pace
- 8,000 to 14,000 words by age 8
May begin to experiment with profanity and ‘dirty’jokes
You wanna hear a dirtyjoke?? A boy fell in a mud puddle…
What are some assessments for communication in school age children?
Fear
• Injury or death of themselves or family
- Dark, being along, failing, loss of self control
- Hospital protocol may be interpreted as direct attack on their independence/identity
- Boredom is a major problem
- May respond with hostility, depression, or frustration
- Be able to communicate their pain by descriptive words ■ Have developed coping mechanisms to pain
- Modesty is a consideration
- Responds well to rules, explanations, praise, and socialization
What scale do you use for Pain for School Age children?
oucher pain scale
Adolescent and Pediatric Pain Tool APPT
what are some psychosocial assessments of school age children
- Industry vs. Inferiority
- Tries new things
- Has goals and tries to attain them
Peer group becomes a major social influence
•Concept of friendship
Sensitive to the norms and values of the peer group
•Formal and informal clubs
Spiritual and moral development
Knows the rules but not the reason behind them
- Antisocial behaviors may occur ■ Fear of obeying or punishment
- Punishment from God ifthingsare bad
What is some health promotion for school age children?
■ Play
- Has rules
- Team play
- Quiet play
- Collections, board games
- Fears
- Dark, being hurt, kidnapped, surgery, death is a BIG fear at this age
Deal with stress by regressing, becoming aggressive, sleep disturbance
- Safety
- Most common cause of severe injury and death is motor vehicle accidents either as a passenger or pedestrian
- Bikes, skateboards, ATVs, scooters
- Education
- Best prevention
- Child and parents
What are some physical assessments for adolescents?
- Primary and secondary sex characteristics
- Sexual maturation occurs
- Adolescent growth spurt - earlier in girls
- 20-25% °f height is achieved in this age
- Boys
- Can gain 15-65 pounds and 4-12 inches in height
- Girls
- Can gain 15-55 pounds and 2-8 inches in height
What are some motor skils for adolescents?
»Well coordinated
- Dance
- Sports
- Generally cannot run as fast or as long as young adults
What are some cognitive and sensory assessments for adolescents?
- From concrete toabstractthinking
- Inductive and deductive reasoning
- Ability to connect separate events
- Ability to understand later consequences
- Able to differentiate others’ perception from their own
- Vision and hearing fully developed
What are some Language assessments for adolescents?
■ Process and express complex thoughts
- Social development
- Symbolic language of their own
- Using technology
What are some communication assessments for adolescents?
good luck!
- Patience
- Be open to their ideas
- Be wiliingto negotiate
- Be an advocate
- Do not take sides ageinst i
Maintain confidentiality
- Desire independence and identity
- React to hospitalization with anger, self-assertion, frustration, withdrawal, rejection, and may be uncooperative
- Pain intensity or presence is often hidden
repore with hospital staff can determine effectiveness of treatment
• Do not respond well to unsolicited advice (lecturing) . Be flexible
■ Use sense of humor, listen, encourage communication, be honest, give as much control as you can
What are some psychosocial assessments for adolescents?
- Desire independence and identity
- React to hospitalization with anger, self-assertion, frustration, withdrawal, rejection, and may be uncooperative
- Pain intensity or presence is often hidden
repore with hospital staff can determine effectiveness of treatment
• Do not respond well to unsolicited advice (lecturing) . Be flexible
■ Use sense of humor, listen, encourage communication, be honest, give as much control as you can
What is some health promotion for adolescents?
- Play
- Sports popular in this age
- Be aware of physical and emotional limitations
- Encourage them accordingly
- Peak physical, psychomotor, and sensory function
- May give them the feeling that they are indestructible
- Risk taking behaviors begin
- Fears
- Fearless, indestructible for the most part
- Do fear mutilation or altered appearance
Safety
MVAs, firearms, drowning, fires
Suicide is high, accidents are #1 injury and death related
■ Acne:
Need to eat a balanced diet,
Rest, exercise moderately,
Reduce emotional stress,
May receive medications to assist in reduction of acne (Antibiotics/hormones)
What are some cognitive/sensory assessments for preschoolers?
- Age 3, brain reaches 2/3 of adult size
- Retain mental images
- Symbolic play
- Transductive reasoning
- Difficulty focusing on the important aspects of a situation
- Everything is important
- Likes routine
- Directions one at a time
- Irreversibility
- Magical and egocentric thinker
What are some language assessments for Preschoolers?
- Dramatic increase in language skills during this period
- More than 2100 words by age 5
- Start talking incessantly and tend to boast and exaggerate
- ‘Bad’ language should be ignored
- By ages speak in sentences of adult length use all parts of speech
- Mix fantasy with reality and perceived by adults as ‘lying’
- Recite the days of the week and can name seasons
Reading to the child helps build vocabulary and build love of reading
•’How’ and ‘Why’ are common
What is some communication with preschoolers?
■ Fear bodily injury • Mutilation
- Terms are taken literally
- dye = die
- Cough head off = head off the body
- Pain
- Respond better to preparation than toddlers but may still overact
- FACES (Wong-Baker) scale is appropriate as early as 3 years of age
- Answer questions simply and concretely
- Be sure you know what the real question is
