Normal growth and development
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Normal Growth and Development. Why do Nurses need to Understand Child Development?. Freud- Psychosexual Development. Oral stage Anal stage Phallic stage Latency stage. Theories of Child Development. Erikson - The Four Ages of Childhood Infancy trust vs mistrust

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Normal Growth and Development

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Normal Growth and Development


Why do Nurses need to Understand Child Development?


Freud-Psychosexual Development

  • Oral stage

  • Anal stage

  • Phallic stage

  • Latency stage


Theories of Child Development

Erikson -The Four Ages of Childhood

  • Infancytrust vs mistrust

  • Toddlerhoodautonomy vs shame and doubt

  • Preschoolerinitiative vs guilt

  • School-ageindustry vs inferiority


Autonomy VS. Doubt & Shame???


Theories of Child Development

Piaget- Theory of Intellectual Development

  • Sensoriomotor Thought0-2 yrs

  • Preoperational Thought2-7 yrs

    (Egocentrism, Transductive reasoning,

    Centration, Animism, Magical Thinking)

  • Concrete Operations7-11 yrs

  • Formal Operations>11 yrs


Basic Principles of Child Development

#1 Children are competent

#2 Children resemble one another

#3 Each child is unique


Body midline

#4

Development is Directional

Cephalocaudal

Which body systems grow most rapidly during early childhood?

Proxiimodistal


#5 Development is Timely

There are recognized critical (sensitive) periods of development


Factors Influencing G&D

ENVIRONMENT

  • Socioeconomic level

  • Parent-child relationship

  • Family position

  • Health/Genetics

  • Nutrition

  • Genetics

  • Temperament


INFANT 1 –12 monthsTrust vs Mistrust

  • Double birth weight at 6 months

  • Triple at 12 months

  • Rolls over 4 months

  • Holds head steady at 6 months

  • Sitting 6-8 months

  • Walking 12 months

  • Pincer grasp 10 months

  • 2 words by 12 months

  • Solid food @ 6 months

  • Object permanence

  • Separation anxiety

  • Risk for aspiration

6 Months

8 Months


Eruption of Teeth-lower incisor are 1st teeth @ 6-10 months


Separation Anxiety ~ 8 months


First Steps

~ 12 Months


Nursing Management-Infancy

  • Discuss age-appropriate recommendations

  • Teach nutrition

  • Sleep patterns

  • Foster attachment

  • Explore family support systems

  • Safety


Nutrition in Infancy

  • Breast milk a/o formula 1st year

  • Solids @ 4-6 months-iron fortified rice cereal 1st

  • Next veggies, fruit, then meat 8-10months


Toddler 1 – 3 years

NO!

  • 2 word sentences by age 2

  • Screening for lead poisoning

  • Decreased appetite

    (physiologic anorexia)

  • Temper tantrums

  • Toilet training

  • Negativism


Sibling Rivalry (expect regressive behavior with arrival of new baby)

Parallel play (won’t share!)

Toddler Years include…..


Transitional objects

Temper Tantrums

Toddler years include…..


Toddler Years include…. Parallel Play


Nursing Management-Toddler

  • Discuss age-appropriate recommendations

  • Growth & Development

  • Toilet Training

  • Negativism

  • Encourage gross motor skills

  • Sibling Rivalry

  • Regression

  • Sleep patterns

  • Safety


Physiologic anorexia

Food jags

Serving amounts?

If on a food jag may only eat yogurt for days!

Provide for self feeding: finger foods/spoon

Nutrition – Toddler years


Toddlers are at high risk for injuries r/t their increasing cognitive and motor skills curiosity. What measures could prevent injury from the following hazards?

  • Falls

  • Poisoning

  • Burns

  • Motor Vehicle Crashes

  • Drowning


Preschooler 3-5 years

  • Body contour changes

  • Social/language skills ^

  • Appetite is diminished

  • Fear of dark, mutilation, and abandonment

  • Self-centered

  • Magical Thinking “If I am mad at Mommy & she gets sick, I caused it!”

  • Bedtime issues


Associative Play with strong imaginative & dramatic themes …like to assume adult roles in play

Preschool years include….Associative Play


Nursing Management-Pre School

  • Discuss age-appropriate recommendations

  • Teach nutrition

  • Sleep patterns

  • Discuss G&D

  • Family

  • Fears

  • Safety


School-age 6-12 years

  • Slimmer, stronger, ^ fine motor skills

  • Growth spurt/prepubescent period

    girls ~10yrs, boys ~13 yrs

  • Permanent teeth erupt

  • Latch-key children

  • Concrete thought

  • Cooperative Play/Rules/Routine

  • Obesity risk begins

  • Peer group bigger influence

  • Sexuality/Inappropriate touch


Nursing Management-School Age

  • Discuss age-appropriate recommendations

  • Teach nutrition

  • Sleep patterns

  • Discuss G&D

  • Family

  • Promote skill development in school, sports and play

  • Safety

Kids want to know: Why do I wake up at night with leg cramps?


Infant: consistent contact/feeding, crib rails @ all times

Toddler: allow transitional objects, prepare for “NO!”; remember can’t “conserve” when giving liquid meds, FULL CRIB RAILS

Preschooler: “dramatic play” to explain care-”you listen to Daddy’s heart 1st, apply concept of animism!

School Age: can give more detailed explanations, same age roommate

**Involve parents (rooming in) for all age groups

**Select age appropriate play activities

Nursing Interventions: Health Care Setting


Safety in Childhood

Prevent aspiration-especially 1st year

Prevent falls-from birth

Prevent Poisonings-especially after walking & during toddlers years

Prevent Burns-especially after walking and thru school age

Prevent injury from firearms especially school-age

Prevent drowning- especially after walking

Implement Car Safety-from birth


Safety: 1st year of life


Promoting Safety Throughout Childhood


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