Pediatric Nursing – HESI – Growth & Development – Flashcards
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What are the theories of growth & development?
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-Erikson's 8 stages of psychosocial development -Piaget's 4 Stages of Cognitive Development -Kohlberg's Moral Development -Tanner's Stages of Secondary Sex Characteristics
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What are the stages of Erikson's Psychosocial Development?
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-Infancy: Birth to 1 y.o. -- Trust vs. Mistrust -Toddlerhood: 1 y.o. to 3 y.o. -- Autonomy vs. Shame and doubt -Preschool: 3 to 6 y.o. -- Initiative vs. Guilt -School Age: 6 to 12 y.o. -- Industry vs. Inferiority -Adolescent: 12 to 18+ y.o. -- Identity vs. Role Confusion
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What are Piaget's Cognitive Theories?
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-Sensorimotor: Birth - 2 y.o. -Preoperational: 2-7 y.o. -Concrete Operational: 7-11 y.o. -Formal Operational: 11-15 y.o., adulthood
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Describe Piaget's Sensorimotor stage.
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Birth - 2 y.o. -object permanence (object exists even though it is not longer visible) -governed by sensations in which simple learning takes place -- imitative behavior, cause & effect, problem solving by trial & error.
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Describe Piaget's Preoperational Stage.
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2-7 y.o. -Egocentrism -intuitive (e.g. reasoning = stars have to go to bed just as they do); -transducive (because two events occur together, they cause each other—e.g. all women w/ big bellies have babies).
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Describe Piaget's Concrete Operational Stage:
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7-11 y.o. -Conservation (realize that physical factors such as volume, weight, & number remain the same even though outward appearances are changed); -Inductive (based on evidence, conclusion is probably true).
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Describe Piaget's Formal Operational Stage:
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11 - 15 y.o., adulthood -Adaptability & flexibility. -Abstract thinking.
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Describe Erikson's Trust vs. Mistrust stage
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Birth to 1 y.o. -Basic trust; exists only in relation to something or someone, therefore consistent loving care is essential. *faith & optimism
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Describe Erikson's Autonomy vs. Shame/Doubt
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1 to 3 y.o. (Toddlerhood) -Childs ability to control their bodies, themselves, and their environment. -Learning through imitation -Children are made to feel small and self conscious when their choices are disastrous or they're forced to be dependent. *Self-control & willpower.
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Describe Erikson's Initiative vs. Guilt
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3 to 6 y.o. (preschool) -Magical Thinking!! -Belief that thoughts are all powerful (if sister gets sick, they will feel its their fault for "wishing" it) -Develop conscience *Direction & Purpose
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Describe Erikson's Industry vs. Inferiority
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6 to 12 y.o. (School Age) -Ready to be workers & producers -They learn the rules -Decisive period in social relationships -May feel inadequate if they cannot measure up to standards. *Competence
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Describe Erikson's Identity vs. Role Confusion
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12 to 18 y.o.+ (Adolescence) -Rapid & marked physical changes -Preoccupied by perception of others -inability to solve core conflict results in role confusion *Devotion & fidelity
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When does birth weight double?
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6 months
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When does birth weight triple?
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12 months (1 year)
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When does birth length increase by 50%?
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12 months (1 year)
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When do the posterior fontanels close?
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8 weeks
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When do the anterior fontanels close?
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12-18 months
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When does a child smile and make "cooing" sounds
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2 months
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When does the head turn to locate sounds?
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3 months
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What are all of the newborn reflexes?
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Moro Babinski Plantar Palmar Stepping Rooting
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What is the rooting reflex and when does it disappear?
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Baby turns toward stimulus when cheek or corner of lip touched -disappears around 4 months
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What is the Moro reflex & when does it disappear?
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When startled, baby symmetrically extends & abducts all extremities; forefingers form a C shape -disappears around 4 months
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What is the Tonic Neck reflex and when does it disappear?
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When neck is turned to side, baby assumes fencing posture -disappears around 4 months
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What is the Babinski reflex and when does it disappear?
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When sole of foot is strokd from heel to ball, toes hyperextend & fan apart from big toe -disappears around 12-18 months
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What is the Palmar Grasp and when does it disappear?
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When hand placed in infant's palm, newborn will curl his/her fingers around examiner's finger. -Disappears around 3-4 months
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What is the plantar reflex and when does it disappear?
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a finger at base of toes causes them to curl downward -disappears at 8 months
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What is the Stepping reflex and when does it disappear?
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When infant is held in upright position with feet touching a hard surface, walking motions are made -disappears around 3-4 months
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When is steady head control achieved?
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4 months
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When can an infant roll from stomach to back & back to stomach?
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5-6 months
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When does an infant play peek-a-boo?
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after 6 months
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When does an infant develop stranger anxiety?
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7-9 months
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When can an infant sit unsupported?
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8 months sit up straight = 8
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When can an infant crawl?
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10 months
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When does the fine pincer grasp appear?
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10-12 months
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When can a baby wave "bye-bye"?
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10 months
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When can a baby walk with assistance?
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10-12 months
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When does a baby say a few words in addition to "mama" and "da-da"?
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12 months
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When does the birth length double?
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by 4 y.o.
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When does a child achieve 50% of adult height?
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2 years old
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When does a child throw a ball overhand?
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18 months
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When does a child speak 2-3 word sentences?
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2 years
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When does a child use scissors?
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4 years
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Whend oes a child tie his/her shoes?
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5 years
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what is the difference between a girls and guys growth spurt?
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girls begins earlier than a boys -as early as 10 y.o.
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What behavior would indicate that thyroid hormone therapy for a 4-month-old is effective?
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think about milestones..what happens at 4 months? -head control if baby has head control, the therapy is appropriate for adequate growth
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What are toys for hospitalized infants?
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mobiles rattles squeaking toys picture books balls colored blocks activity boxes
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When does a child appear to be bowlegged and potbellied?
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1-3 years
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How many primary teeth are there and when are they present?
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20 -- present by 1-3 years
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When does a child kick a ball?
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2 years
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When can a child feed him/herself with a spoon and cup
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2 years
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when are 3-4 word sentences spoken
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3 years
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Are temper tantrums common? How should they be controlled?
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temper tantrums are common in the toddler years -the behavior should be ignored.
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How would you describe to a toddler he/she is getting a procedure?
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-give simple, brief explanations before procedures
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What are the nursing implications of taking care of a hospitalized toddler?
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-enforced separation from parents is greatest THREAT to toddlers psychological & emotional integrity -Security objects or favorite toys from home should be provided -Teach parents to explain their plans to the child in detail ("I will be back after your nap) -Expect regression (bed-wetting) -provide guided choices when appropriate to support autonomy
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What are some appropriate toys for the hospitalized toddler?
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board and mallet push-pull toys toy telephones stuffed animals storybooks with pictures *mobility very important -> take them to playroom!
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When does visual acuity reach 20/20?
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Around preschool age - 3-6 y.o.
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What are the nursing implications for taking care of a preschool age child?
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3-6 y.o. -understand egocentricity. Explain that he/she did not cause the illness & that painful procedures are not punishment for misdeeds. -use simple words that will be understood by the child. -Therapeutic or medical play are helpful -Fear of mutiliation from procedures is common (use a Band-Aid)
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What are some appropriate toys for the hospitalized preschooler?
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coloring books puzzles cutting & pasting dolls building blocks clay toy that allow preschooler to work out hospitalization experiences
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How should procedures be explained to preschoolers?
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preschooler needs prep for procedure -he/she should understand what is & what is not going to be "fixed" -simple explanations & basic pictures are helpful -let the child handle equipment or models of equipment
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What task could a 5 y.o. boy with diabetes expect to accomplish by himself?
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-think about growth and development... -let him choose the injection site! this gives the child a sense of control (autonomy)
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When does a child typically lose his/her teeth?
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loss of teeth and eruption of permanent teeth occur between 6-12 y.o.
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When does a child learn to tell time?
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between 6-12 y.o.
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When is a child able to write script?
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8 y.o.
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What are the nursing implications for a hospitalized school age child?
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-need more support from parents than child wishes to admit. -Maintaining contact with peers & school activities is important -explanation of all procedures are important & should be respected during hospitalization (close curtains during procedures; allow privacy during baths) -participation in care with staff fosters a sense of involvement & accomplishment
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What are some appropriate toys for the school-age child during hospitalization?
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board games card games hobbies (stamp collecting, puzzles, video games)
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When can a child begin to remember pain?
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after 6 months
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What about pain do toddlers fear? Preschoolers? School-age children? Adolescents?
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toddlers: fear intrusive procedures preschoolers: fear body mutilation school-age: fear loss of control of their bodies adolescents: major concern is change in body image
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When do girls finish growth? Boys?
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girls finish growth around 15 y.o. boys finish growth around 17 y.o.
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what are the nursing implications of a hospitalized adolescent?
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-disrupts school & peer activities; they need to maintain contact with both -they should share a room with other adolescents -illnesses, treatments, & procedures that alter the adolescents body image can be viewed as devastating -teaching about procedures should include time without parents being present. it is important to direct questions to the adolescent when the parents are present. -for prolonged hospitalizations, adolescents need to maintain identity (have their own clothing, posters, & visitors) Take them to the teen room! -adolescents parents should be discouraged to room-in.
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What is the age of assent for making medical decisions in adolescents?
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ranges from 7-14 y.o. -parents consent is also needed for treatment
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What should be focused on when teaching adolescents?
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the here and now "how will this affect me today?"
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When can an infant transfer objects from 1 hand to the other?
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7 months
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When can a child walk with out assistance?
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typically 15 months
