Peds Ch notes Essay Example

Initiative versus Guilt (3 to 6 years): The child experiences more people, activities and ideas. The child learns to assume new responsibilities. Constant criticism leads to feelings of guilt and a lack of purpose. (Some children may have initiative to start projects, but not finish them)  Industry versus Inferiority (6 to 12 years): Development of new interests and focus on intellectual pursuits.

Child takes confidence in his/her ability to be successful. If the child cannot achieve what is desired, a sense of inferiority may result. Must be balanced, since the child must learn to be realistic. Identity versus Role Confusion (12 to 18 years): A new sense of identity or self is established. The adolescence tries out new roles and examines what fits best for self. The self, family, peers, and community are all examined and redefined. The adolescence who is unable to establish a meaningful definition of self and may experience confusion. A certain amount of role confusion is desirable because it allows self-examination. These stages are important in family planning and parental education. Parents benefit from learning the appropriate stages of development, and these discussions ay highlight parental concerns.

Hospitalizing interrupts these stages, and it is important to know how to plan interventions around these interventions. Piglet's Theory of Cognitive Development A theory based on cognitive, or intellectual, development. The child incorporates new experiences via assimilation and changes to deal with these changes by the process of accommodation. The child's mind unfolds so that processes used to understand reality at different ages are unlike those at earlier changes Piglet's Stages: *TEST* 1 . Seniority (Birth to 2 years): Infants learn about the . Use

of Reflexes (birth to 1 month): Begins life with reflexes such as sucking, rooting and grasping.

Reflexes pave the path for 1st learning experiences. B. Primary Circular Reactions (1 to 4 months): Once the infant responds reflexively, the pleasure from the behavior causes repetition of the behavior. C. Secondary Circular Reactions (4 to 8 months): Awareness of environment as the infant learns about cause-and-effect. D. Coordination of secondary schemes (8 to 12 months): Exhibit intentional behavior, using learned behavior to obtain objects, create sounds, or engage in pleasurable behavior.

Object permanence occurs here. E. Tertiary Circular Reactions (12 to 18 months): Curiosity, experimentation, and exploration are present as the toddler tries out actions to learn results. F. Mental Combinations (18 to 24 months): Language provides a new tool for understanding the world. Enables thought before and after events/objects occur. Operational (2 to 7 years): The child thinks using words as symbols, but logic is not well developed. A. Preconception substrate (2 to 4 years): vocabulary and comprehension increase greatly, but the child shows egocentrics. . Intuitive substrate (4 to 7 years): the child relies on transduction reasoning.

Often improper (child disobeys parents and breaks arm, thinks it's because he disobeyed) Magical thinking, concentration and animism. (see terms below). 3. Concrete Operational (7 to 11 years): more accurate understanding of cause and effect. The child can reason well with concrete objects used in teaching. The concept of conservation is also learned. *TEST* 4. Formal Operational (11 to adulthood): Fully mature intellectual thought has not been attained. Abstract thinking occurs, as well as considering different alternatives r outcomes. Idealism occurs at this stage, too. They deserve to know what

is going on with them. *TEST* The nurse must understand the child's thought processes in order to design activities and meaningful, appropriate teaching plans.

Presence of the parent is important. Teaching a 6-year-old versus a 16-year-old about newly diagnosed diabetes would be very different. -Object permanence (seniority period): ability to understand that when something is out of sight, it still exists. Happens at 10 months. Egocentrics: ability to see things from one's own point of view. Transduction reasoning: connecting two events in a cause-and-effect relationship together.

-Concentration: Focusing only on one particular aspect of a situation. -Animism: Giving lifelike qualities to nonliving things. -Magical thinking: Knowledge that events occur because of one's thought or actions -Conservation: Knowledge that matter is not changed when its form is altered. (Same amount of water in different containers. ) Kohlrabies Theory of Moral development: Decisions are based on the development concerns with moral decisions. Presentational stage (4 to 7 years): decisions are based on the desire to please there and to avoid punishment. Conventional stage (7 to 11 years): conscience or an internal set of standards become important, but they are learned from others (parents). Rules become important. Observational (12 years and older): The individual has internalized ethical standards on which to base decisions. Social responsibility is recognized.

Social Learning Theory: Children learn attitudes, beliefs, customs, etc. From their social contact with adults and other children. Children imitate behavior they see. People can also choose how to act. The external environment and the child's internal processes are the two important factors here. -Self-efficacy: of the expectation that someone can produce a desired outcome. Behaviorism: Focuses on the idea of stimuli for behaviors.

In other words, children (animals in Watson case) will learn behaviors that are elicited by positive or negative behavior in certain ways. " Ecologic Theory: Emphasizes the presence of mutual interactions between the child and all of life's setting. Nature and nurture are considered of equal importance.

Each child brings in a unique set of genes that they use to interact with the environment. There are ultimate different levels of this theory, including Microsystems, Microsystems, ecosystem, Microsystems, and chronometers. (See below for relationship of systems) Temperament: Recognize innate qualities of personality that each individual beings to the events of daily life. Infants generally display clusters of responses.

A "good fit" for temperament is when the environment matched the child's capabilities and characteristics. The nine parameters of personality are activity level, rhythmic, approach or withdrawal, adaptability, threshold of responsiveness, intensity of action, quality of mood, destructibility, and attention span. These can be explained on pig. 141) "Easy' child: is generally moderate in activity, shows regular eating, sleeping, elimination patterns, and is usually in a positive mood. Adapts to situations and is able to accept rules and work well with others. "Difficult" child: irregular schedules, adapts slowly to new persons and stimuli, and displays a predominant negative mood. Intense reactions to environment are common. "slow-to-warm-up" child: reactions of mild intensity and slow adaptability to new stimulation.

Initial withdrawal with gradual, quiet and slow interactions with the environment. Ways to improve goodness of fit: -Extremely active: plan active play several times a day. Have restful periods before bedtime. -Shy: Allow time to adapt at own pace. -Easily stimulated: Have a quiet room for sleeping as an infant. Have a quiet

room for studying as a child. -Short attention span: Provide projects that can be completed in a shortened amount of time. Gradually increase periods of time. Resilience is the ability to function with healthy responses, even with stress and adversity.

Families and individuals have protective factors that provide strength and assistance in dealing with a crisis, and risk factors that promote or contribute to their challenge. Nursing strategies can target risk factors in developing a care plan. This is important since hospitalizing is a common crisis in a family (or individual) setting. Age Groups: Prenatal- time from conception to birth Newborn- from birth to one month of life Infancy- from 1 to 12 months; high level of care in Addles Toddlers- from 1 to 3 years of age; increased motor ability and independent behavior

Preschool- from 3 to 6 years; refines gross and fine motor ability and language skills. School age- from 6 to 12 years; growing intellectual skills, physical ability Adolescence- from 12 to 18 years; mature cognitive thought, formation of identity & influence of peers The Newborn Stage (birth to 1 month) Prenatal care comes into a large play in this stage of life. Early prenatal care can provide the opportunity to evaluate the health of the mother as well as intervene to eliminate fetal risks. Teaching focuses on eliminating unhealthy practices and encouraging healthy ones. Good nutrition is particularly important during pregnancy.

Among a newborn's physical characteristics, its reflexes help it receive input, nourishment, and comfort. Cognitive Development: the importance of reflexes in determining the newborn's cognitive development. They are the tools that help the child transition to the outside world. Psychosocial

Development -Newborn is particularly attuned to people in the environment, especially its parents.

-Attachment is a strong emotional bond between people, and it can begin at the -Newborns are often alert at birth and watch the mother carefully. This first interaction is important and is often extended to the father and siblings. The newborn learns in the first few months that they can trust that their basic needs are taken care of by their caregivers. -En face position, where the parent and the newborn's faces are in the same plane, facing each other. By 2-3 months, the baby should be en face and responsive.

Liver and kidney functions are increased, Maturation of nervous system takes place. Infants can generally master walking (anywhere from 12 to 18 months) Cognitive Development: maturation of cells (no so much an increase in number). Newborn's eyes widen with sound, while a I-year old turns to the sound and coziness its significance. I-year old says a few words and can reach for toys.