Week 1 - Growth and Development Flashcards
define maturation
- total way a person grows/ develops
- gene growth
- can depend on physical/ psychological environments
define growth
increase in physical size measured in quantitative numbers
what are the main things we assess for growth ?
- height
- weight
- head circumference
- body proportion
- teeth
define developement
- function of the body
- all pieces over the progress of time
- words/ self expression improves
- ask questions
social group expansion
do toddlers play together?
no for the most part they parallel play
do preschoolers play together?
yes
when kids are developing what happens with their emotions?
- have lots but not able to regulate or organize them
- very concrete thinkers/ learners
- self orient over time
what are nursing goals for development?
- notice obvious delays
- understand how to communicate effectively
- provide safe care
what is the first pattern of growth?
cephalocaudal pattern
where does the cephalocaudal pattern occur? Why?
- head area (eyes/ brain)
- grow faster than the lower parts
what constitutes the majority of the body during prenatal development and early infancy?
head
what does tummy time help with?
- strengthening
- being able to list their head up
what is proximodistal?
growth occurring from centre of body out
once proximodistal growth starts what should you except? answer in the order it occurs
- grasping/ pushing arms and legs
- gross motor skills
- fine motor skills
development refers to what?
physiological, psychosocial, and cognitive changes occurring over one’s life span due to growth, maturation, and learning
development assumes what?
orderly/ specific situations lead to new activities and behaviour patterns
at 3 months old what is a major developmental milestone ?
- raising head
- controlling head movements
at 6 months old what is a major developmental milestone ?
sitting/ starting to roll
at 8 months old what is a major developmental milestone ?
crawling
at 12 months old what is a major developmental milestone ?
walking
at what age do we get concerned when kids aren’t walking yet?
18 months
paediatric growth charts are based on what
- age
- sex
for the paediatric growth percentiles, what is the average for any given age?
50th percentile
for the paediatric growth percentiles what are most children between?
5-95%
where on the paediatric growth percentile do we start to become concerned?
25% and 85%
where on the paediatric growth percentile are we concerned?
under 5% and over 95%
if a child Is 5% and under on the paediatric growth percentile, what are we looking at?
- malnourishment
- are they growing properly - if they are nourished
- absorption
- chronic illness
if a child Is 95% and above on the paediatric growth percentile, what are we looking at?
- are the parents large
- genetic issues
- are they being overfeed?
- obesity
if a child is in the 95th percentile what does this mean in regards to population?
only 5% of the worlds population is bigger than them
name all the developmental stages in order from youngest to oldest
- neonatal
- infant
- toddler
- preschool
- school age
- adolescent
- adult
what is the age range for the neonatal developmental stage?
birth - 28 days
what is the age range for the infant developmental stage?
first year
what is the age range for the toddler developmental stage?
1-3 years
what is the age range for the preschool developmental stage?
3-5 years
what is the age range for the school age developmental stage?
6-12 years
what is the age range for the adolescent developmental stage?
13 - 16 or 18 years
what is the age range for the adult developmental stage?
18 years and older
some research to indicate that adolescence should be considered up to what as a result of incomplete brain development?
25 years
what are the 3 developmental theories?
- erikson
- piaget
- kohlberg
in regards to the different developmental theories what is Erikson’s based on?
psychosocial
in regards to the different developmental theories what is Piaget’s based on?
cognitive
in regards to the different developmental theories what is Kohlberg’s based on?
morals
what are some other factors that can influence the development of a child?
- genetics
- resiliency
- temperament
- environment
- having siblings
- culture/ religion
- income
- SDOH
- gender/ sex
- illness
- special needs
- developmental disabilities
what makes up a child’s environment?
- house they live in
- people in home
- rural or urban setting
- community building
what are things that could potentially be in a child’s home?
- air pollution
- childproofed
- mold
- water source
- food
- second/ third hand smoke
what is anticipatory guidance?
- car safety
- fall prevention
- injury prevention
- preventable health care
- accident prevention
in regard to anticipatory guidance, what’s included in car safety?
- car seats rear facing until 1 year
- only in back seats
in regard to anticipatory guidance, what’s included in car fall prevention?
- never leave unattended on flat surface
- can fall
- baby walkers banned in canada
in regard to anticipatory guidance, what’s included in injury prevention?
- burns
- traffic
- falls
- choking
- poisoning
- drowning
- electric shock
- animal bites
- safety
in regard to anticipatory guidance, what’s included in preventable health care?
- 18 month enhanced well-baby visit
- developmental screening tool
- screen parents
- promote early literacy activity
- information about community resources
in regard to anticipatory guidance, what’s included in accident prevention?
- automobiles
- burns
- poisoning
- stranger danger
what are the 2 categories used for injury?
- unintentional
- intentional
what is included in the unintentional injury category?
- road traffic
- falls
- fire/ burns
- drowning
what is included in the intentional injury category?
- homicide
- abuse/ neglect
- self-harm/ suicide
what are the leading causes of death in Canada for children 1-14 years old? List from most to least
- accidents
- malignant neoplasms
- congenital malformations/ deformations
- suicide
- influenza/ pneumonia
- assault (homicide)
- COVID-19
where does anticipatory guidance occur?
- schools
- online
- maternity unit
- public health
who is at an increased risk of injury for kids?
- males
- age 5-9
- lower economic status
- rural or northern population
- any minority
- chronic illness
- developmental delays
- immune function
what does the nursing role consist of during hospitalization ?
- admission
- fall assessment
- isolation
- care plan
- clinical pathway
in regards to the nursing role during hospitalization, what’s included in admission?
- meet emotional needs
- informed consent from parent/ guardian
- ID
- safety measures
- procedures
- transporting/ holding
in regards to the nursing role during hospitalization, what’s included in fall assessment?
- Humpty Dumpty fall scale
- 12+ = high risk
in regards to the nursing role during hospitalization, what’s included in care plans?
- focus on the child not the condition
- assess caregiver
in regards to the nursing role during hospitalization, what’s included in clinical pathway?
- broad view of the entire team
- goals/ outcomes
in regards to being admitted to the paediatric unit, what could be included in safety measures?
- crib
- ID bracelet
- bubble top
- no sockets
- meds out of reach
- no sharp toys
- weight in KG
- fire extinguishers
in regards to the nursing role during hospitalization, what’s included in procedures?
- simple explanation
- keep parents close by
in regards to the nursing role during hospitalization, what’s included in transporting/ holding?
- cradle position
- football position
- upright position
- colic carry
what are the developmental stages in infants?
- trust/ mistrust
- movements
- try to control body
- reach for things
- learning to put things in their mouth
- mobility
what are the major safety risks for infants?
- falls
- choking
- poisoning
- illnesses
- cord strangulation
- hot things
what is the nursing role specifically when caring for infants?
- nutritional requirements
- promoting nutrition
- teaching newborn care
- promoting healthy sleep/ rest
- promoting healthy teeth/ gums
- promoting appropriate discipline
- addressing childcare needs
- addressing common developmental concerns
what is the number one energy source for an infant? What’s it important for?
- fat
- brain development
what is included in teeth/ gum care for infants?
- rub gums
- when first tooth comes out brush it
- don’t put baby to bed with bottle
- 12 months go see dentist
what is an appropriate form of discipline?
saying no and redirection with repetition
what are the developmental Stages for toddlers?
- autonomy vs. discipline
- no
- talking
- walking
- dancing
- start to interact with people
- see others emotions
- follow simple demands
what are the major safety risks for toddlers?
- poisoning
- falls
- choking
- candy/ colourful things
- cannot be left unsupervised
what is the nursing role when caring for toddlers?
- anticipatory guidance
- safety promotion
- sleep/ rest
- dental health
- nutritional health
- discussing appropriate methods of discipline
- support/ encouragement
- education
What is the leading causes of death and hospitalization for paediatric patients?
unintentional accidents/ injuries
What is the second leading causes of death and hospitalization for teenage patients?
self harm/ suicide
for toddlers is separation anxiety High? What should you use?
- yes
- use transitional object (blanket/ toy)
for toddlers what does continuous reappearance of the parent do to the child?
-stress them out
to prevent a toddler from experiencing separation anxiety from the parents what should the nurse do with the parents?
- reassure
- maintain trust
- allow toddler to work through experiences
with toddlers who’s parents aren’t present what behaviour is expected?
regression
treatments in what room should be avoided?
playroom
why do we need to be careful with soothers for toddlers?
b/c of teeth growth
what does a tantrum look like in a toddler?
- looks like they are really sad/ angry/ frustrated
when should parents start to include physical discipline
not until at least 18 months old
what are the developmental stages for preschoolers?
- initiative vs. guilt
- making friends
- learning
- sight words
- color
- shapes
- tons of emotions they don’t know what to do with them
what is the best way to work with preschoolers in the hospital?
using play
what are the major safety risks for preschoolers?
- big risk for falls
- more adventurous
- play grounds
- street games
- riding bikes
- animal curiosity
at the preschooler age what do we want to instruct to parents?
- create independence
- do not be a helicopter parent
what is included in the nursing role when caring for a preschooler?
- anticipatory guidance
- emotions
- appropriate play
- reading/ numbers
- proper nutrition
- sleep
- gender/ sex curiosity
- discipline
when caring for a preschooler what do you always need to ensure you do around communication with them?
- tell the truth about timing
- realistic expectations
- children understand things literally be careful with wording
- provide compassion/ tell them they aren’t in trouble, they’re safe and going to get help
what types of discipline work for preschoolers?
- time outs
- redirection
- body questions
what are the developmental stages for a school age child?
- abstract thinker
- deeper understanding of relationships/ other people
what type of explanation works well for school age kids?
simple explanations
what is included in the nursing role of school age kids?
- anticipatory guidance
- emotions
- play
- school/ education
- proper nutrition
- sleep
- sex education
- discipline
at what age can we see the impact of secure attachment?
school-age
secure children will be able to tolerate what?
time away from parents
when making decisions about care, how should the nurse ask questions to the school-aged child?
give simple choices
how should the nurse attempt to organize assessments/ diagnostics for a school-aged child?
around a set school schedule
how does socialization change with school-age children?
- social issues with friends
- figuring out relationships/ connections
how is nutrition impacted with school-age children?
- increase in picky eating
- eating disorders
- obesity
how is discipline affected in school-age children?
understand consequences a bit more
what are the developmental stages for adolescents?
- identify vs. role confusion
- who are you in the world
- gaining independence
what are the major safety risks for adolescents?
- depression
- suicide
- car accidents
- sex
- alcohol
- teen pregnancy
- mental health issues
- sports accidents
what is included in care specifically for the nursing role in adolescents?
- anticipatory guidance
- sex education
- emotions
- interest/ life planning
- school/ education
- proper nutrition
- sleep
- parenting
what are adolescents aged 11-14 concerned about?
- height
- weight
- sexual development
what are adolescents aged 15-17 concerned about?
- self image
- acceptance
- group behaviour
what are adolescents aged 18-2o concerned about?
- education
- career
- community
- lifestyle
- dating partner
- counsellors when future impacts career, education, long term goals
what is the best way to provide anticipatory guidance to an adolescent in the hospital?
- provide privacy
- have parent step out of the room
- have conversations with patients as we do will adults
when asking a parent to leave a room so you can have a private conversation with an adolescent, what should you say to the parent?
- ask the parents to step out of the room so you can do an assessment it will only take 10-15 minutes
- inform them this is a routine thing you do with all children this age
if your patient is an adolescent, what does this mean regarding consent?
can refuse medication as long as they can explain their reasoning
why are indicators of child health important to understand?
- provides baseline measures of population health
- identify children/ family’s at risk for illness/ injury
what are common child health indicators?
- infant mortality
- low birth weight
- pre-term birth
- injury mortality
- injury hospitalization
in what percentiles do we notice common child health indicators?
under 5th percentile or over 95th percentile
illness/ hospitalization is stressful for the child, how do they normally respond?
- fear
- anxiety
- behavioural distress
- developmental regression
illness/ hospitalization is stressful for the child, how do the parent/ family normally respond?
- fear
- anxiety
illness/ hospitalization is stressful for the child, how do the siblings normally respond?
- fears
- behavioural disruptions
what are the warning signs that a child is stressed?
- crying
- can’t control emotion
- regression
- isolating themselves
- clinging to parent
- not eating/ eating less
- not sleeping
- can’t concentrate or concentrate for shorter amount of time
- stuttering
- grinding teeth
in regards to warning signs that a child is stressed what are examples of regression?
- potty training
- thumb sucking
- wanting soother
what are the fears for an infant 0-12 months?
- loss of support
- loud noises
- bright lights
- sudden movements
- as they get older > strangers, separation anxiety, animals
how should a nurse try to gain trust for an infant when they are 6-8 months old?
- learn who their people are and gain trust
what are some coping strategies that can be done for infants?
- make calm/ stable environment
- get parents to bounce baby
- make whooshing sounds
- soother/ bottle if parents ok with this
- give them their blanket or stuffy
- put on their favourite music/ song
how do you make a stable/ calm environment for an infant?
- low lights
- make it warm
- parents near by
- calm/ soothing voice
- swaddling
what fears do toddlers/ pre-schoolers have?
- separation from parents
- the dark
- loud/ sudden noises
- injury
- strangers
- certain people/ situations
- supernatural beings (clowns)
- animals
- large objects/ machines
- change in environment
when toddlers/ pre-school children are in the hospital how can we best prevent them from having fears due to a change in their environment?
- encourage parents to do as many home routines as possible in hospital
what are some comfort measures we can provide for toddlers in the hospital?
- use nightlight if they have one at home
- provide favourite blanket/ toy
- explain things to them in a way they can understand prior to completing
- have parents at bedside when completing tasks
what are some comfort measures we can provide for pre-schoolers in the hospital?
- provide more options
- be creative
- help parents name that emotion and validate it/ try to figure out whats going on
- redirection/ distraction
for a pre-schooler, provide an example of a creative comfort measure
this medication is going to give you super powers
for a pre-schooler, provide an example of more options for comfort measure
do you want meds by yourself or with your parents here
pre-schoolers do not have a good sense of what? How should you go about this ?
- time
- say you’ll be back when their shows done or when the timer goes off
instead of saying shot or bee sting what should you say?
medicine
instead of saying organ what should you say?
special place in body
instead of saying stretcher what should you say?
rolling bed
instead of saying pain what should you say?
hurt or owie
instead of saying deaden what should you say?
numb
instead of saying put to sleep what should you say?
special sleep
instead of saying specimen what should you say?
sample
instead of saying take (as in temp) what should you say?
see how warm
instead of saying electrodes what should you say?
stickers
instead of saying incision what should you say?
special opening
what are fears that a school age child may have?
- supernatural being
- injury
- storms
- the dark
- staying alone
- seperation from parents
- TV/ movies
- death
- tests
- failure
why do schoolbag children have a better understanding of death, injury, illness?
have better understanding of time
at what age is it legally ok to have children stay at home alone?
10 years old
provide examples of comfort measures for school age children
- use things they like to connect with them
- if they say no as them to explain why
- if they are in a failure to thrive state remind them they didn’t do anything wrong/ just getting help
what are fears adolescents experience?
- inept social performance
- social isolation
- sexuality
- drugs
- divorce
- crowds
- gossip
- public speaking
- plane/ car crash
- pain
provide examples of comfort measures for adolescents
- if not comfortable talking infront of parents ask them to leave
- talk about anxieties/ fears and strategies they have in place
- if friends on approved list have them visit
- give patient back their autonomy
what are some strategies that can be used to enhance communication with children?
- recognize cognitive/ emotional developmental stage
- use age-appropriate vocab
- communicate through eye level position
- quiet, unhurried/ confident voice
- be honet
- give choices only when one exists
remember with children who are developmentally delayed, it’s a good idea to ask what? provide example
what their development age is
ex. child is 12 yrs old but developmentally is 7 yrs old
what are some positives about a physical survey/ assessment?
- prevent heat loss
- minimal touch
- colour
- RR
- ## focus
what’s included in a basic data collection?
casual observation without touching and asking parent
what’s included in a history survery?
ask about:
- safe environments
- coping patterns
- family values
what’s included in a physical survey?
- head to toe
- ear exam
what are some strategies you can use to build rapor with a child?
- introduce
- welcome
- explain
- teach
- provide privacy
- involve child
- honesty
- language
how should you complete an assessment on a child?
- list
- observe
- question
- start with visual assessment
- do least invasive thing first prior to touching child
what are some approaches you can use to facilitate interactions with families?
- introduce everyone
- be nonjudgmental
- good communication skills
- respect family diversity
- avoid assumptions about family beliefs/ values
nurse role in family- entered care is to enter into what?
relationship or partnership with family to achieve goals of health for members
family centered care includes what?
- collaborative partnership
- health/ function of family influencing health of client/ other members
- family empowerment
- security
- cultural safety
what re some key elements for family centred care?
- interpersonal sensitivity
- general health info
- valuable resource
- communication
- respect