Test 2 Flashcards
Infant Proportional changes
Weight gain per week…
5-7 oz
Birth weight compared to one year..
.x3
Height increase per month as an infant…
1 inch for 6 months
Double the birth weight by what age
age 6 months
Length compared to birth at a 4 years old…
Double the length by age 4 years
Fine motor
Grasps objects at… (grasping at random)
2-3 months
Palmar at…(should be able to pick things up)
6 months
Transfer objects between hands at…
7 months
Pincer at (should be able to use fingers, pick up something small)
…10 months
Remove objects from container at…
11 months
Build tower of two blocks at…
12 months
Gross Motor Development
Head lag
in first 2 months
Head control at
4 months
Rolling over (from abdomen to back) at
5 to 6 months
*baby need to have “tummy time” need to learn to roll over
Sit alone by
7 months
Move from prone to sitting position by
10 months
Locomotion
Increased coordination of extremities at
4 months
Crawling at
6 to 7 months (usually backward) - with abdomen on the flood and pulling pushing with arm
Creeping at
9 months - uses hands and knees
When can the infant start walking with assistance and when will they be able to walk alone.
assistance 11 months
alone 12 months
Social Development
Attachment, social smile
Reactive attachment disorder (RAD)
Stems from inadequate attachment to parent
Separation anxiety appears during what age
And
Stranger anxiety happens between what months
4-6 mo, aware of parent’s absence
Stranger anxietyNormal beginning at 6-8 months and disappears after 1 year
Language Development for infant, what is the first basic communication of infants
CRYING
Crying is the first verbal communication
Vocalizations by
6 weeks
Coo, gurgle, laugh aloud at
3 to 4 months
Imitate sounds and add consonants at
8 months
B, d, m are early sounds baby able to make
Comprehend “No”; follow commands at
9 to 10 months
may not be actual meaning of words but still correlates to something
Ascribe meaning to a word at
10 to 11 months
Three to five words with meaning by
age 1 year -
Nutrition: Breast milk only is the best choice for the first __ months of life
6 MONTHS
NO need for additional fluids in the first __ months
Replaces calories, can lead to low Na levels seizures
4 MONTHS
NO honey in the first year of life WHY?
botulism spores
Introduction of solid foods after
age 6 months
Introduce foods at intervals of _ to _ days to allow for identification of food allergies
4 to 7 days
Soft finger foods at
9 months
Weaning from breast or bottle to cup by
1 year
lean towards whole milk
What is the normal infant sleep pattern and total amount of hour they sleep
Nocturnal pattern of 9 to 11 hours by 3 to 4 months
Total daily sleep: 15 hours
Dental health for infants
Dental Health
Avoidance of early childhood caries
Cleaning begins when primary teeth erupt
First dental visit at 6 months (eruption of first teeth)
Water is preferred to toothpaste until after
age 2 years
Consider need for fluoride supplements
Contraindications for vaccine administration
Severe febrile illness
Immunocompromised child or household member
Recently acquired passive immunity (blood transfusion, immunoglobulin, or maternal)
Known allergic response
Parental fears, misinformation, and questions
Religious beliefs - there are no more personal exemption
Common Injuries in Infancy
Aspiration of foreign objects Suffocation Motor vehicle injuries Falls Poisoning Burns Drowning
Toddler Age Range
Age 12 to 36 months
Characteristic of toddlers
Intense period of exploration
Temper tantrums and obstinacy occur frequently
Successful mastery of developmental skills depends on the trust and guidance of parents
Weight gain slows to __ to __ pounds per year as a toddler
4 to 6
Birth weight should be quadrupled by
2½ years
Height increases about __ inches per year (in toddlers)
3 inches per year
How do the growth vary as toddler
Growth is steplike rather than linear
Anterior fontanel closes by __ months
12 months
Anterior fontanel closes between 12 and 18 months of age
True or False, Toddlers have enhanced taste and is okay to have 20/40 vision
Visual acuity of 20/40 is acceptable
Development of hearing, smell, taste, and touch increases
Taste to food may change due to taste enhancement
Uses all senses to explore the environment
Voluntary control of elimination
Sphincter control at age __ to __ months
18 to 24 months
True or False, Most physiologic systems are relatively mature by the end of toddlerhood
Inner ear structures are short and straight, tonsils are large and, therefore, upper respiratory tract infections, otitis media, and tonsillitis are common
True.
Walks by __ months; runs by __ months
Climbs stairs by age __ years
Walks by 12 months; runs by 18 months
Climbs stairs by age 2 years
Has improved coordination between __ and __years
Fine motor development
Has improved coordination between 2 and 3 years
Fine motor development
Has improved manual dexterity at__ to __months
Has improved manual dexterity at 12 to 15 months
Throws a ball by __ months
Throws a ball by 18 months
Draws circles by age __ years
3 years
Psychosocial Development of Toddlers
Begins development of independence and self-control
Erikson: Autonomy versus shame and doubt
Wants to things for themselves, even things they are not physically able to do
Negativism
Ritualization provides a sense of comfort
Cognitive Development of toddlers
Piaget Sensorimotor phases Imitation and domestic mimicry Awareness of causal relationships between two events (problem solving and operations) Learns spatial relationships
Development of Body Image of toddlers
Body image closely parallels cognitive development and self-awareness
Refers to body parts by name
Avoid negative labels about physical appearance
Recognizes gender differences by age 2 years
Development of Sexuality
Exploration of genitalia is common
Gender roles are understood by a toddler
Gender identity is established by age 3 years
Playing “house”
Social Development
of toddlers
Differentiation of self from mother and from significant others is a major task Separation Individuation Increased understanding and awareness of object permanence and ability to tolerate frustration diminished stranger fear Transitional objects provide security Language Increasing level of comprehension Increasing ability to understand
Comprehension of 300 words by age __ years
2 years
At age __ years, can use two- or three-word phrases
At age __ years, can use simple sentences and acquires five to six new words a day
At age 2 years, can use two- or three-word phrases
At age 3 years, can use simple sentences and acquires five to six new words a day
Gestures precede each language milestone up to 30 months of age
Individuals with language delays are taguht to use sign languages
Personal Social Behavior of toddlers
Toddlers develop skills of independence
Sudden mood swings are common
Skills of independence may result in tyrannical, strong-willed, volatile behaviors
Skills include feeding, playing, dressing, and undressing self
Play in a toddler
Parallel play
Imitation
Little emphasis on gender-stereotyped toys
Increased locomotor skills
Educational toys and books
Tactile play - like to touch things, play dough, sand, finger painting
Appropriate safety in relation to size, shape, risk for toxins, and sturdiness of toys
Coping with Concerns Related to Normal Growth and Development of toddlers
Sibling rivalry – preparation of a toddler
Temper tantrums – nearly universal, ignore unless injurious
Negativism – don’t ask yes/no questions
Don’t give choices if there isn’t a choice
Do you want this medication in a cup or a syringe, do you want to wear your purple shirt or your greens shirt, don’t give choices they can’t say no to
Regressive behavior – common during stress
Assessing Readiness for Toilet Training
Voluntary sphincter control
Ability to stay dry for 2 hours
Fine motor skills to remove clothing
Willingness to please parents
Curiosity about adult’s or sibling’s toilet habits
Impatience with wet or soiled diapers
Promoting Optimum Health during Toddlerhood
Nutrition
Phenomenon of physiologic anorexia
Picky, inconsistent eaters
Ritualism – same dish or cup
Drinks an average of 24 to 30 oz of milk/day
May need iron supplementation
Serving size = 1T/year or ¼ - 1/3 an adult portion
Sleep and activity
Sleeps for 11 to 12 hours per day
Has an adult sleep pattern by age 3 years
How old are preschoolers
3-5 years
What is the most significant lifestyle change for preschoolers group…
Going to school
In regards to growth and development what happens to separation, attention span and memory…in preschoolers
Tolerate brief and prolonged separations, attention span and memory increase
Biologic development
What happens to physical growth for preschoolers…
Slows and stabilizes
What is the average weight gain per year for preschoolers…
5 lbs
What is the average height increase in inches per year for preschoolers…
2.5-3 in
Body systems mature and stabilize; can adjust to moderate stress and change (good to know)
What gross motor skills should be well established by this time period…for preschoolers
Walking, running, climbing, jumping (NOT skipping)
What fine motor skills should be well established…for preschoolers
Drawing, dressing, artwork, skillful manipulation
Cognitive development
What age do children enter school and what is the reason for this specific age group to go into school..
.5-6 years-readiness for school, scholastic learning, and achievement of cognitive goals
Explain this age groups concept of time…
Incompletely understood
Development of body image of preschoolers
Explain this age groups understanding of appearance…I
ncreasing comprehension of “desirable appearances”, racial identity, and biases
Explain of preschoolers groups understanding of injury and body boundaries (like the skin)…
Poorly defined-if skin is “broken”, one’s “insides” can leak out
Development of sexuality of preschoolers
Explain the attachment with parental figures…
Forms strong attachment to the opposite-sex parent while identifying with the same-sex parent
Sexual exploration is more pronounced as well as questions about sexual reproduction (good to know)
Social Development of preschoolers
Explain individuation, This age groups feelings on anxiety and separation…
Separation process is completed, stranger anxiety and fear of separation from parents is overcome
Speech Problems
for preschoolers
Most critical period for speech development is age 2-4y
Vocabulary is growing faster than words can be formed
Stuttering
Stammering
Dyslalia (articulation problems)
Promoting Optimum Health during the Preschool Years
Nutrition
what are caloric requirements cal/kg
Caloric requirements are approximately 90 kcal/kg
Fluid requirements are approximately 100 mL/kg, depending on activity and climate
Food fads and strong tastes are common
Important to emphasize limiting milk and juice (should only have one cup) intake
Sleep and Activity for preschoolers
Sleeps for 12 hours per night; infrequent naps
Free play is encouraged
Emphasis is on fun and safety
The preschool period lasts from age __ to __ years
The preschool period lasts from age 3 to 5 years
Preschoolers’s developmental stage
Preparation for the most significant lifestyle change: going to school
Tolerates brief and prolonged separations
Uses language for mental symbolization
Has an increased attention span and memory
Biologic Development of preschoolers
Physical growth slows and stabilizes
Average weight gain remains about 5 pounds per year
Average height increases 2½ to 3 inches per year
Body systems mature and stabilize; can adjust to moderate stress and change
Preschoolers Uses magical thinking frequently, define magical thinking
Uses magical thinking frequently
Vulnerable to feeling guilt due to “wished thoughts” coming true. Egocentricity leads them to believe they are all powerful.
Development of Body Image of preschoolers
Increasing comprehension of “desirable” appearances
Aware of racial identity, differences in appearances, and biases
Poorly defined body boundaries
Fear that if the skin is “broken,” all one’s blood and “insides” can leak out
Frightened by intrusive experiences
Development of Sexuality of preschoolers
Forms a strong attachment to the opposite-sex parent while identifying with the same-sex parent
Becomes concerned with modesty
Sex role limitation; “dressing up like Mommy or Daddy”
Sexual exploration is more pronounced
Questions arise about sexual reproduction
Social Development of preschooler
Individuation–separation process is completed
Overcomes stranger anxiety and fear of separation from the parents
Responds well to preparation for separation.
Still needs parental security and guidance
Security from familiar objects
Play therapy is beneficial for working through fears, anxieties, and fantasies
For a preschooler Vocabulary increases dramatically between age __ and __ years
For a preschooler Complexity of language use increases between age___ and __ years
For a preschooler Vocabulary increases dramatically between age 2 and 5 years
For a preschooler Complexity of language use increases between age 2 and 5 years
Personal and Social Behavior of preschooler
Minimal help with toileting, eating, or dressing
Is willing to please
Has internalized values and standards of family and culture
May begin to challenge parental values
Play of preschoolers
Associative play
Imitative play
Imaginative play and imaginary playmates
Dramatic play
preschoolers’ fears
Dark, Being left alone, Animals (e.g., snakes, large dogs), Ghosts, Objects or persons associated with pain, Technique of desensitization to overcome fears
Aggression of preschoolers
Behavior that attempts to hurt another person or destroy property
May be influenced by biological, sociocultural, and familial variables
Factors that increase aggressive behavior include gender, frustration, modeling, and reinforcement
Speech Problems of preschoolers
Most critical period for speech development is age ___ to ___ years old
Most critical period for speech development is age 2-4y
Vocabulary is growing faster than words can be formed
Stuttering
Stammering
Dyslalia (articulation problems)
Nutrition of preschoolers
Caloric requirements are approximately ___kcal/kg
Fluid requirements are approximately 100 mL/kg, depending on activity and climate
Food fads and strong tastes are common
Important to emphasize limiting milk and juice (should only have one cup) intake
Caloric requirements are approximately 90 kcal/kg
Fluid requirements are approximately 100 mL/kg, depending on activity and climate
Food fads and strong tastes are common
Important to emphasize limiting milk and juice (should only have one cup) intake
Sleep and Activity of preschoolers
Sleeps for 12 hours per night; infrequent naps
Free play is encouraged
Emphasis is on fun and safety
Sleep Problems for preschoolers
Prime age for sleep disturbances, Thorough assessment of sleep problems, Nightmares, Sleep terrors, Nighttime fears, Encourage consistent bedtime routine
Dental Health for preschoolers
Eruption of deciduous teeth is complete
Still requires parental supervision and assistance in brushing
Professional care and prophylaxis
Fluoride supplements
Injury Prevention for preschoolers
Safety education
Reckless behavior – running into the street
Parents must set a good example
Development of long-term safety behaviors
Bike helmets
School age is generally defined as age __ to __ years
School age is generally defined as age 6 to 12 years
Biologic Development of school age child (6-12)
Height increases by__ inches per year
Height increases by 2 inches per year
Weight increases by __ to __ kgs (___– ___ lbs) per year
Weight increases by 2 to 3 kgs (4.5 – 6.5 lbs) per year
True or false
Girls surpass boys at the end of this period (school age 6-12)
true
Maturation of Systems of school age children (6-12)
Bladder capacity increases
Heart is smaller in relation to the rest of the body
Immune system is increasingly effective
Bones increase in ossification
Physical maturity is not necessarily correlated with emotional and social maturity
When does puberty start?
Varying ages from 9 to 12 years (in girls, it occurs about 2 years earlier than in boys)
Average age of puberty is 12 years in girls and 14 years in boys
Psychosocial Development of school age children (6-12)
Relationships center around same-sex peers
Freud described it as the latency period of psychosexual development
Erikson: Developing a Sense of Industry
Eager to develop skills and participate in meaningful and socially useful work
Acquires a sense of personal and interpersonal competence
Growing sense of independence
Peer approval is a strong motivator
Erikson: Inferiority
Feelings may derive from self or the social environment
May occur if incapable or unprepared to assume the responsibilities associated with developing a sense of accomplishment
All children feel some degree of inferiority regarding skill(s) they cannot master
Piaget: Cognitive Development
Concrete operations
Use thought processes to experience events and actions
Develop an understanding of relationships between things and ideas
Able to make judgments based on reason (conceptual thinking)
Conservation and classification skills
Kohlberg: Moral Development
Development of conscience and moral standards
In a child age 6 to 7 years, reward and punishment guide choices
Older school-age child is able to judge an act by the intentions that prompted it
Rules and judgments become more founded on the needs and desires of others
Spiritual Development of school age children
Children think in concrete terms
Children expect punishment for misbehavior
May view illness or injury as punishment for a real or imagined misdeed
Social Development of school age children
Importance of the peer group
Identification with peers is a strong influence in a child gaining independence from parents
Sex roles are strongly influenced by peer relationships, become more separate
Relationships with Families - school age children
Parents are the primary influence in shaping a child’s personality, behavior, and value system
Increasing independence from parents is the primary goal of middle childhood
Children are not ready to abandon parental control
Play - school age children
Involves physical skill, intellectual ability, and fantasy
Form groups, cliques, clubs, secret societies
Strong need for conformity
Rules and rituals - school age children
See the need for rules in games they play
Team play – teaches need to modify behavior for the good of the team, learns camplex rules and strategies
Quiet games and activities; collections; reading
Ego mastery – can feel big and powerful
Developing a Self-Concept
Definition: A conscious awareness of a variety of self-perceptions (e.g., abilities, values, appearances)
Importance of significant adults in shaping a child’s self-concept
Positive self-concept leads to feelings of self-respect, self-confidence, and happiness
Developing a Body Image for school age children
Generally, children like their physical selves less as they grow older
Body image is influenced by significant others
Increased awareness of “differences” may influence feelings of inferiority
Coping with Concerns Related to Normal Growth and Development of school age children
School experience
Second only to the family as a socializing agent
Transmission of values of the society
Peer relationships become increasingly important
Coping with Concerns Related to Normal Growth and Development
Teachers – take on some parental roles
Parents – share responsibility of teaching
Latch-key children
Limit setting and discipline - reasoning
Dishonest behavior – lying, stealing, cheating
Stress and fear- increasing violence
Promoting Optimum Health during the School Years
Nutrition of school age children
Importance of balanced diet to promote growth
Quality of the diet related to family’s pattern of eating
Quality of dietary choices in the school cafeteria
“Fast food” concerns
the caloric intake is less than the need for preschool, and even lesser than the adolescent.
Sleep and Rest of school age children
The average amount of sleep a night is___
The average amount of sleep a night is 9½ hours in school-age children, but this is highly individualized
May resist going to bed at age 8 to 11 years
Children of 12 years and older are generally less resistant to bedtimes
Exercise and Activity of school age children
Sports
Controversy regarding early participation in competitive sports
Concerns with physical and emotional maturity in competitive environment
Acquisition of skills
Generally like competition
Dental Health of school age children
Stage begins with the shedding of the first deciduous teeth
Eruption of permanent teeth
Good dental hygiene
Prevention of dental caries
Malocclusion
Dental injury
Dental avulsion (replacement or reattachment)
Injury Prevention of school age children
Most common cause of severe injury and death in school-age children is motor vehicle crashes, pedestrian and passenger
Bicycle injuries; benefits of bike helmets remind parents to act as role models
Appropriate safety equipment for all sports
Weight of an infant is doubled at __ months of age, tripled at ___ and quadrupled at __ years of age.
It is doubled at 6 months of age , tripled at 1 year old and quadrupled at 2 years of age.
Bowel training should come before bladder training, why?
Bowel training is usually accomplished before bladder training because of its greater regularity and predictability. The sensation to defecate is stronger than that of urination. The completion of bowel training will give the toddler a sense of accomplishment that can be carried onto bladder training. Nighttime bladder control normally takes several months to years after daytime training; therefore, this should not be the initial focus of toilet training with a toddler. There is no universal right age to begin toilet training or an absolute deadline to complete training. One of the nurse’s most important responsibilities is to help parents identify the readiness signs in their child.
True or false By 2 years of age, children are able to walk up and down stairs without falling. Grasping small objects without being able to release them is a task of infancy. Interaction with the environment is essential for mastery of both fine and gross motor skills at this age and beyond.
True
The nurse notices that a toddler is more cooperative taking medicine from a small cup than from a large cup. This is an example of which characteristic of preoperational thought?
Irreversibility
What is bottle-mouth caries ?
Giving a bottle of milk or juice at nap time or bedtime predisposes the child to this syndrome.
Sweet liquids, or the sugars in milk and even breast milk, pooling in a toddler’s mouth during sleep increase the incidence of dental caries. Changes in the positioning of the teeth may result from pacifier use or thumb sucking and are not related to bottle-mouth caries. Frequent breastfeeding before sleep can cause bottle-mouth caries, since breast milk does contain lactose, which is present in higher concentrations than in cow’s milk–based formula. Juice, which contains varying concentrations of sugar, in bottles before sleep contributes to bottle-mouth caries.
At what age would children be able to get off of car seats?
A car seat should be used until the child weighs 18 kilograms (40 pounds) and is approximately 4 years old.
The concept of gender identity begins at about __ years of age, at which children are able to label their own as well as other’s genders. It is not inherent at birth or by 1 year of age.
2 years of age (24 months), at which children are able to label their own as well as other’s genders. It is not inherent at birth or by 1 year of age.
What is Rapprochement and at what age does it show?
Rapprochement occurs when the child returns to the mother for reassurance following exploration of the environment.
Toddler
What to expect for attitude for preschoolers
The end of preschool and the beginning of school age is a more tranquil period. Preparing the parent for increased aggression is anticipatory guidance for 4-year-old children. Encouraging the parent to offer the child choices is anticipatory guidance for 3-year-old children. Advising the parent that this is the age when stuttering may develop is anticipatory guidance for 3-year-old children.
What is the difference between nightmares and sleep terrors
Nightmares are associated with difficulty returning to sleep as opposed to sleep terrors where the individual easily goes back to sleep. With the advent of a nightmare, the child has a memory of the dream like state, is comforted by traditional methods of contact and thrashing type behaviors cease upon awakening. In sleep terrors, the child has no memory of the event, continues thrashing behaviors when awaken, and is not comforted by traditional methods of contact.
Malocclusion
Malocclusion occurs when upper and lower teeth do not approximate when a child bites down.
