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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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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 • Toddlerhood autonomy vs shame and doubt • Preschooler initiative vs guilt • School-age industry vs inferiority
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
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
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…..
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