Growth and Development Basics Lecture 1 The Basics Growth quantitative change increase in physical size Single best indicator of a child s health Sequential Family and nutrition related Tracked on growth curves ex height and weight compared to other children CDC growth charts Measure length laying down until age 2 and then measure height when they can stand Weight Head circumference until age 3 BMI over age 2 Development qualitative increase in capability or function Differentiation of function Learning skills Cephalocaudal vs proximodistal development Cephalocaudal gain control of head Head to toe Head grows more than body at first Child gains head control first then they gain control of the rest of the body downwards Proximodistal spinal cord to peripheral body Move arm before fingers Gross skills precede fine motor skills More skills then growth Anticipatory guidance pediatric word of the day what you as a care provider would give to the parents your teaching about the child what you would expect next Anticipate growth and development of the child and tell parents Nature vs nurture Influenced by hereditary and environment Environment social cultural and family group What is it that the child becomes Personality Growth and development varies from child to child Both are interrelated there are critical periods Parent infant bonding and language development period VERY important should not be interrupted Developmental Theories Freud psychosexual stages of development Psychotherapy believed in predetermined sequence of development Ego superego id Oral stage birth 1yr Sucking pleasure breast feeding Bad oral habits as adult smoking drinking nail biting Anal stage 1 3 yrs Potty training years Feces control As an adult anal retentive perfectionists must have things clean Phallic stage 3 6yrs Pleasure in genitals common Aware of their bodies notice gender differences Boys have unconscious desire for their mothers Problems in this stage confused sexual identities Latency stage 6 12yrs Repressed sexual urges Play with peers of the same sex not involved with opposite sex Do things with parent of the same sex Genital stage 12yrs adulthood Puberty marks the beginning Child becomes pleasure seeking Piaget cognitive development their perception and use of the world around them Focus educating children Cyclical process Sensorimotor stage 0 2yrs 5 senses to explore the world egocentric child Preoperational stage 2 7yrs Age of magical thinking Developing motor skills Egocentrism decreases a lot by age 7 understands there are other people Not able to logically think Can still trick this age group don t get puppets etc Concrete operational stage 7 11yrs Child becomes very logical Can problem solve sort things Formal operational stage 11yrs adulthood Kids are able to abstract reason Can come up with hypothesis and conclusions Cause and effect Erikson psychosocial theory of human development Identity crisis basis Every stage has a conflict and have to resolve to move forward Trust vs mistrust birth 1yr Hope stage reliable care giver Autonomy vs shame doubt 1 3yrs They realize that they can say no They need to explore the world Smothering parents child problems no autonomy Initiative vs guilt 3 6yrs Know that they have a purpose I can do it myself Industry vs inferiority 6 12yrs Childs teacher is the primary person to make them feel this Are they competent Compare themselves to others Are things fair teacher Teacher is main person Identity vs role confusion 12 18yrs Ties into fidelity Who am I where do I fit where am I going in life Intimacy vs isolation young adulthood Relationship building Do I fit in with others Will I find that special person Girls looking for marriage and dreaming of babies Generativity vs stagnation middle adulthood Sense of purpose good path do you feel good about where youre going Ego integrity vs despair older adulthood Look back with sense of accomplishment Feel proud about where they are Need to know this for boards Developmental Stages anticipatory guidance Infancy birth 12months Toddlerhood 1 2yrs Preschool 3 5yrs School Age 6 12yrs Adolescence 13 18yrs Infancy Toddlerhood Preschool want to experiment looking for differences asking how School Age Adolescence measured cognitively by what they are doing in school This course looks at the nursing care of children at all developmental levels Advance growth and development while they are sick in the hospital Chronic conditions do not mean a stop in development Pediatric Assessment READ CH 35 Not just small adults Head proportionally larger head injuries Rapid brain growth first 2 years of life breast milk or formula then whole milk Until puberty bones are weaker fractures Until school age larger proportion of body wt is water dehydrate fast Abd provides poor protection trauma Short narrow trachea foreign body can get caught Anterior fontanelle open 18 months close and posterior fontanelle 2 3 Respiratory Rate o Newborn 30 55 min o HR Beats min Blood pressure Physical Exam o Age appropriate explanations o Avoid questions Can I o Hold and examine equipment o Game o Distraction o Flexible sequence o Parents lap o Vocabulary Effects of Hospitalizations Infants o Separation anxiety parents present o Stranger anxiety home routine o Painful invasive procedures topical anesthetics o Immobilization o Sleep deprivation o Overload o Feeding routine disrupted o Irritability Toddler o Separation anxiety o Loss of self control o Painful invasive procedures o Bodily injury or mutilation o Fear of dark o Scared to lie supine o Pain punishment o Why doesn t parent rescue o Take to treatment room for blood work etc so that bed remains a safe place
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