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Normal Growth and Development

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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  1. Normal Growth and Development

  2. Why do Nurses need to Understand Child Development?

  3. Freud-Psychosexual Development • Oral stage • Anal stage • Phallic stage • Latency stage

  4. Theories of Child Development Erikson -The Four Ages of Childhood • Infancy trust vs mistrust • Toddlerhood autonomy vs shame and doubt • Preschooler initiative vs guilt • School-age industry vs inferiority

  5. Autonomy VS. Doubt & Shame???

  6. Theories of Child Development Piaget- Theory of Intellectual Development • Sensoriomotor Thought 0-2 yrs • Preoperational Thought 2-7 yrs (Egocentrism, Transductive reasoning, Centration, Animism, Magical Thinking) • Concrete Operations 7-11 yrs • Formal Operations >11 yrs

  7. Basic Principles of Child Development #1 Children are competent #2 Children resemble one another #3 Each child is unique

  8. Body midline #4 Development is Directional Cephalocaudal Which body systems grow most rapidly during early childhood? Proxiimodistal

  9. #5 Development is Timely There are recognized critical (sensitive) periods of development

  10. Factors Influencing G&D ENVIRONMENT • Socioeconomic level • Parent-child relationship • Family position • Health/Genetics • Nutrition • Genetics • Temperament

  11. 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

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

  13. Separation Anxiety ~ 8 months

  14. First Steps ~ 12 Months

  15. Nursing Management-Infancy • Discuss age-appropriate recommendations • Teach nutrition • Sleep patterns • Foster attachment • Explore family support systems • Safety

  16. 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

  17. Toddler 1 – 3 years NO! • 2 word sentences by age 2 • Screening for lead poisoning • Decreased appetite (physiologic anorexia) • Temper tantrums • Toilet training • Negativism

  18. Sibling Rivalry (expect regressive behavior with arrival of new baby) Parallel play (won’t share!) Toddler Years include…..

  19. Transitional objects Temper Tantrums Toddler years include…..

  20. Toddler Years include…. Parallel Play

  21. Nursing Management-Toddler • Discuss age-appropriate recommendations • Growth & Development • Toilet Training • Negativism • Encourage gross motor skills • Sibling Rivalry • Regression • Sleep patterns • Safety

  22. 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

  23. 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

  24. 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

  25. Associative Play with strong imaginative & dramatic themes …like to assume adult roles in play Preschool years include….Associative Play

  26. Nursing Management-Pre School • Discuss age-appropriate recommendations • Teach nutrition • Sleep patterns • Discuss G&D • Family • Fears • Safety

  27. 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

  28. 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?

  29. 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

  30. 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

  31. Safety: 1st year of life

  32. Promoting Safety Throughout Childhood

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