NURS 1400 Growth and Development Infancy through Adolescence Unit V

NURS 1400

Growth and Development

Infancy through Adolescence

Unit V

Physiological Development-Infant

• Weight and height

• Head growth

• Motor development

– Gross motor: ability to use large muscle groups to maintain balance for postural control and for locomotion

– Fine motor: ability to coordinate hand-to-eye movement in an orderly and progressive manner

Copyright 2007 Thomson Delmar

Learning, a division of Thomson

Learning Inc. All rights reserved.

8-2

Psychosexual Development



Cognitive development: Piaget’s sensorimotor stage has four substages

1.

2.

3.

4.

Reflexes

Primary circular reactions

Secondary circular reaction

Coordination of secondary schema




8-3

Psychosocial Development

• Erikson

• Trust versus mistrust




8-4

Health Promotion

• Health screening

– Phenylketonuria

– Iron-deficiency anemia

– Lead poisoning

– Hypothyroidism

• Immunizations

• Vision screening




(continues)

8-5

Health Promotion

• Hearing screening

• Dental care

• Nutrition

– Breast milk or formula

– Solid foods

– Weaning

– Use of pacifier




(continues)

8-6

Health Promotion

• Communication

– Receptive language

– Expressive language




(continues)

8-7

Health Promotion

• Temperament

– Activity

– Rhythmicity

– Approachwithdrawal

– Adaptability

– Intensity of response

– Threshold of responsiveness

– Mood

– Distractibility

– Attention span and persistence




(continues)

8-8

Health Promotion

• Colic

– Recurrent episodes of unexplained crying and inability to be consoled

• Sleep

– Sleep consolidation

– Diurnal cycle

– Sudden infant death syndrome (SIDS)




(continues)

8-9

Health Promotion

• Stranger and separation anxiety

• Alternative child care

– Center-based care

– Family child care

– In-home care




(continues)

8-10

Health Promotion

• Play

• Safety promotion and injury prevention: family teaching

– Safety checklist

– Hidden dangers




8-11

NURS 1400

Growth and Development of the Toddler Unit V

Physiological Development

• Neurological system

• Musculoskeletal system

• Gastrointestinal and genitourinary systems

– Decreased appetite: physiologic anorexia

• Cardiorespiratory system

• Sensory system




9-13


• Freud: anal stage

• Domestic mimicry: imitation of domestic roles and activity

• Family teaching




9-14


• Gaining self-control

• Developing autonomy

• Increasing independence

• Psychosocial milestones




9-15

Cognitive Development

• Milestones

• Communication with toddlers

• Piaget

– Sensorimotor phase

– Preconceptual phase

• Moral development




9-16

Health Promotion

• Negativism: “No!”

• Ritualism and regression

– Ritualism: need to maintain sameness

– Regression: return to earlier, safer, more familiar behavior




(continues)

9-17

Health Promotion

• Discipline

– Limit setting

– Appropriate discipline

– Corporal punishment

• Sibling rivalry




(continues)

9-18

Health Promotion

• Temper tantrums

• Toilet training

• Child care

• Play

• Nutrition

• Sleep

• Dental health




9-19

Safety Promotion and Injury

Prevention

• Developmentally specific prevention

• Auto safety

• Home and environmental safety

• Water safety

• Toy injuries

• Gun safety




9-20

Routine Health Screening

• Health monitoring

• Immunizations




9-21

NURS 1400

Growth and Development of the Preschooler Unit V


• Physical growth

– Slows

– Body systems mature

• Gross and fine motor development

– Increased eye-hand coordination

– Improved muscle coordination

– Development of fine motor skills




10-23


• Freud: Oedipal or phallic

• Sexual curiosity

• Caregiver’s role




10-24


• Cognitive ability

• Piaget’s preoperational stage

– Egocentrism

– Animism

– Transductive reasoning

– Idiosyncratic




(continues)

10-25


• Fear

• Language

– Increased vocabulary

– Telegraphic speech




10-26


• Erikson: initiative versus guilt

• Superego

• Caregiver’s role

• Socialization

• Family relations




10-27

Moral and Spiritual Development

• Preconventional or premoral stage

• Faith and religion




10-28

Health Promotion

• Nutrition

– Food pyramid

– Snacks

– Serving size

– Childhood obesity

• Sleep and rest

– Bedtime routines: family teaching

– Sleep disturbances

• Nightmares

• Sleep terrors




(continues)

10-29

Health Promotion

• Activity

– Physical games and sports

– Emphasis on physical fitness

– Play: appropriate toys

– Literacy: reading to child

– TV and other media




(continues)

10-30

Health Promotion

• Dental health

– Care of teeth

– Dentist visits

– Avoid sugary snacks

– Night grinding

• Safety and injury prevention

– Supervision

– Injury prevention guidelines




10-31

Health Screenings

• Yearly well-child checks

– Vision

– Hearing

– Blood pressure

• Immunizations




(continues)

10-32

Health Screenings

• Assess for:

– Hyperlipidemia risk

– High-dose lead exposure

– Tuberculosis

– Common illnesses

• Otitis media

• Colds

• Gastrointestinal disturbances




10-33

Preparation for School

• Benefits of early childhood programs

• Family teaching: preparation for first day of school

• Discipline

• Limit setting

• Time-outs

• Reverse attention

• Diverting aggressive behaviors




10-34

NURS 1400

Growth and Development of the School-Age Child Unit V


• Musculoskeletal

– Weight increases

– Height increases

– Basic gross motor skills

• Cardiorespiratory

– Increased efficiency

– Decrease in pulse rate

– Decrease in heart rate

– Tidal volume doubles




(continues)

11-36


• Dental

• Immune system

• Sexual development




11-37


• Freud: latency

• Sexual development

– Puberty

– Menarche




11-38


• Piaget: concrete operations

• Language and reading




11-39


• Peers

• Erikson: industry versus inferiority

• Self-concept and self-esteem




11-40

Moral Development

• Kohlberg stage: conventional level

• Conscience develops




11-41

Health Promotion

• Nutrition

– Dietary guidelines

– Family teaching: steps to avoid obesity

• Sleep

– Somnambulism

– Somniloquy




(continues)

11-42

Health Promotion

• Dental health

– Care of teeth

– Malocclusion

– Braces


– Contributing factors

– Safety rules for school-age children

• Health screening

• Immunizations




11-43

School

• Physical development

• Intellectual development

• Social development

• Homework

• Play

– Physical capabilities

– Concept of cooperation




(continues)

11-44

School

• Physical activity

– Overall health

• Sports

• Peers

• Body image

• Bullying

– Lack of social skills

– School nurse’s role




(continues)

11-45

School

• Stress: signs and symptoms

– Frequent fatigue

– Irritability

– Change in sleep or eating patterns

– Complaints of headache or stomachache

– Substance abuse

– Drop in academic performance




(continues)

11-46

School

• Latchkey children

– Tips for latchkey children

• Dishonesty

• Limit setting and discipline

• Sexuality




11-47

Nursing Role in Fostering

Healthy School-Age Children

• Role model for children, teachers, and caregivers

• Encourage caregivers to foster independence

• Promote acceptable limit setting

• Education for nutrition, exercise, rest, sexuality, and safety




11-48

NURS 1400

Growth and Development of the Adolescent Unit V


• Puberty

– State of physical development when secondary sex characteristics begin to appear, sexual organs mature, reproduction first becomes possible, and the adolescent growth spurt starts




(continues)

12-50


• Adolescence

– The time of life that begins with puberty and ends when the individual is physically and psychologically mature and able to assume adult responsibilities




(continues)

12-51


• Musculoskeletal system

– Adolescent growth spurt

– Female peak height velocity (PHV): 11 years old or 6–12 months before menarche

– Male peak height velocity: about 13 years old

– Weight increases follow the same growth curve as height




(continues)

12-52


• Genitourinary system

– Follicle-stimulating hormone (FSH)

– Luteinizing hormone (LH)

– Tanner stages

• Females: describes breast and pubic hair development

• Males: describes testes, penis, scrotum, and pubic hair development




(continues)

12-53


• Cardiorespiratory system

– Heart

– Lungs

• Neurological systems

– Brain growth

• Gastrointestinal system

– Teeth

– Gastric acidity and capacity




12-54


• Freud’s psychosexual theory

• Body image




12-55


• Cognitive socialization

– Lev Vygotsky’s theory: zone of proximal development (ZPD)

• Social perspective taking

– Selman’s theory: social perspective taking ability

• Moral development

• Religiosity




12-56

Adolescent Egocentrism

• Elkind: capacity to consider others’ thoughts is crux of adolescent egocentrism

• Imaginary audience: adolescents’ beliefs of always being on stage

• Personal fable: adolescents’ exaggerated notion of their own uniqueness




12-57

Psychosocial Development:

Psychosocial Identity

• Identity

• Identity statuses

• Gender identity

– Cognitive reasoning and personal identity

• Intimacy




12-58

Adolescents in Context

• Families

– Caregiver socialization: caregiver responsiveness and expectations

– Attachment and autonomy

– Caregiver-adolescent conflict

– Divorce and remarriage

– Sibling relationships




(continues)

12-59

Adolescents in Context

• Peers

– Peer influence

– Caregivers and peers

• Dating

• Schools

• Work and career development




12-60

Health Promotion:

General Nursing Considerations

• Caring environment

• Treat adolescents with dignity

• Assessment with purpose of improving health, describing health-promoting behaviors, and increasing understanding

• Family relationships




12-61

Health Promotion

• Immunizations

• Nutrition

• Dental health

• Sleep, rest, and activity


• Risky behaviors

• Violence




(continues)

12-62

Health Promotion

• Sexual activity

• Homosexuality

• Television

• Suicide




12-63

NURS 1400

Infectious Diseases Unit V

Anatomy and Physiology

• Immature immune system

• Pathogens

• Transmission

– Infectious agent

– Reservoir

– Mode of transmission

– Portal of entry to host

– Susceptible host




15-65

Factors Supporting Development of

Disease

• Ability of pathogen to survive

• Asymptomatic or carrier state

• Dose of infection




15-66

Family Teaching: Spread of Infection

• Home

• Day care or school

• Community




15-67

Developmental Stages and Risk of

Infection

• Infants

– Vertical transmission

– Mobility

– Hand-to-mouth behaviors

• Toddlers and preschoolers

– Toilet training

– Day care

– Objects in mouth

– Small animals




(continues)

15-68

Developmental Stages and Risk of

Infection

• School-age children

– Lack of hygienic practices

– Sharing with friends

• Adolescents

– Immunizations

– Sexual contact

– Risk of drug use increases




15-69

Infectious Diseases in Day Care and

School Settings

• Factors increasing infection

• Family teaching




15-70

Immunizations

• Schedule of immunizations

• Combination vaccines

• Cultural considerations

• Vaccine handling and storage

• The National Childhood Vaccine Injury Act

• Precautions and contraindications




15-71

Nursing Management

• Clinical manifestation

• Etiology

• Incidence

• Incubation period

• Therapeutic management




(continues)

15-72

Nursing Management

• Resources

• Care of children

• Sexually transmitted diseases

• Reporting to Centers for Disease Control and

Prevention




15-73

Future Directions

• New vaccines

• Drug resistance




15-74

NURS 1400

Child Abuse and Neglect Unit V

Child Maltreatment: Intentional Injury of a Child

• Child neglect: harmful, malicious, or ignorant withholding of physical, nutritional, or health care or emotional and educational necessities

• Child abuse: range of intentional behaviors by parent or caregiver that can involve neglect, physical, emotional, and/or sexual abuse




(continues)

36-76

Child Maltreatment: Intentional Injury of a Child

• Physical abuse: bodily injury to a child that appears to have been inflicted by other than accidental means

• Psychological abuse: results from habitual lack of attention to a child’s needs




36-77

Theoretical Approaches to Child Abuse and Neglect

• Sociological model

• Social-interactional systemic perspective model

• Attachment model




36-78

Physical Abuse: Clinical Manifestations

• Unexplained bruises, scars, welts in various stages of healing

• Unexplained swollen extremity

• Bite marks

• Bruises shaped like recognizable objects




(continues)

36-79

Physical Abuse: Clinical Manifestations

• Burns

– “Stocking” or “glove” type burns

– Splash burns

– Flexion burns

– Contact burns

• Shaken baby syndrome




36-80

Physical Abuse: Psychological

Manifestations

• Withdrawal

• Depression

• Sad mood

• Anger

• Hostility

• Frightened when approached

• May harm siblings, peer, pets, neighborhood animals




36-81

Physical Abuse

• Diagnosis

• Treatment

• Nursing assessment

– Physical assessment categories

– Psychological assessment categories

– Interpersonal assessment: caregiver

– Interviewing the child

– Interviewing the caregiver




36-82

Munchausen Syndrome/Munchausen Syndrome by

Proxy

• Warning signs

• Nursing management

– Establishing trusting relationship

– Assessing family dynamics

– Patterns of illness

– Quality of relationships: careful documentation

– Corroborating histories with appropriate professionals

– Review with multidisciplinary teams




36-83

Child Abandonment and Neglect

• Abandonment

• Physical neglect

• Medical neglect

• Custody-related neglect

• Emotional neglect

• Educational neglect

• Nursing management of child abandonment and neglect




36-84

Psychological Abuse

• Omission

• Commission

• Indicators of psychological abuse

• Assessment scales identify children and caregivers at risk

• Nursing management




36-85

Sexual Abuse

• Sexual abuse

• Assault

• Date or acquaintance rape

• Incest

• Exploitation

• Exhibitionism

• Pedophilia

• Child molestation




(continues)

36-86

Sexual Abuse

• Factors describing the experience of sexually abused children

– Traumatic sexualization

– Stigmatization

– Betrayal and powerlessness

• Assessment of sexual abuse

• Family teaching




36-87

Child Abuse and Neglect

• Strategies to prevent child abuse and neglect

– Preventing maladaptive behaviors

– High-risk communities

– Child’s ability to recognize and resist assault

• Legal issues related to child abuse and neglect

• Reporting child abuse




36-88

NURS 1400 Growth and Development Infancy through Adolescence Unit V

Safety Promotion and Injury

Prevention

Nursing Role in Fostering

Healthy School-Age Children

Psychosocial Development:

Psychosocial Identity

Health Promotion:

General Nursing Considerations

Factors Supporting Development of

Disease

Family Teaching: Spread of Infection

Developmental Stages and Risk of

Infection

Developmental Stages and Risk of

Infection

Infectious Diseases in Day Care and

School Settings

NURS 1400

Child Maltreatment: Intentional Injury of a Child

Child Maltreatment: Intentional Injury of a Child

Theoretical Approaches to Child Abuse and Neglect

Physical Abuse: Clinical Manifestations

Physical Abuse: Clinical Manifestations

Physical Abuse: Psychological

Manifestations

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NURS 1400 Growth and Development Infancy through Adolescence Unit V

Safety Promotion and Injury

Prevention

Nursing Role in Fostering

Healthy School-Age Children

Psychosocial Development:

Psychosocial Identity

Health Promotion:

General Nursing Considerations

Factors Supporting Development of

Disease

Family Teaching: Spread of Infection

Developmental Stages and Risk of

Infection

Developmental Stages and Risk of

Infection

Infectious Diseases in Day Care and

School Settings

NURS 1400

Child Maltreatment: Intentional Injury of a Child

Child Maltreatment: Intentional Injury of a Child

Theoretical Approaches to Child Abuse and Neglect

Physical Abuse: Clinical Manifestations

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Physical Abuse: Psychological

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