Chapter 14
A parent tells the nurse, "I am worried about my 13-year-old son. He hasn't started puberty, and my daughter did when she was 11 years of age." The most appropriate explanation by the nurse is "This is unusual and requires further evaluation of your son." "This is unusual because the onset of pubescence is usually the same in siblings." "This is normal because the onset of pubescence is usually earlier in girls than it is in boys." "This is abnormal because the onset of pubescence is usually earlier in boys than it is in girls."
"This is normal because the onset of pubescence is usually earlier in girls than it is in boys." Girls begin puberty on average approximately 2 years before boys. Puberty usually begins no earlier than age 12 years in boys, with an average age of onset of 14 years; therefore, no further evaluation is necessary at this time. The age of pubescence is gender related, with the average age of puberty onset being 12 years for girls and 14 years for boys. Puberty usually begins no earlier than age 12 years in boys, with an average age of onset of 14 years; therefore, her son is not having an abnormal onset of puberty.
dental health
-Eruption of permanent teeth -Good dental hygiene -Prevention of dental caries -Periodontal disease -Malocclusion -Dental injury -Dental avulsion: replacement/reattachment- Knocked out tooth—place in cold milk or under child's tongue (or parent's) until it can be replaced.
WHat happens at development of a 8-9year old ?
-Height grows 2 inches per year -More graceful -Can count backward -Reads for pleasure -Uses common tools, chores -Dramatizes -Social groups -Dresses self, modesty
What are causes of stress on the child ?
-Identify with peers -Domestic violence-50% likely to be abused -Academic competition -Athletic competition -Over-programmed with activities -High divorce rates •50% divorce rate -Bullying
WHat happens at development of a 7 year old ?
-Learns time -Brushes teeth and hair with minimal help -May steal but developing a conscience -Group play, team play Prefers to play with own gender
What happens at the development of a 6 year old?
-Loses first tooth -Constant activity -Vision reaches maturity -Knows rt and lt -Reads from memory, -Will cheat to win as they learn rules -Occasional tantrums
What to teach about emergency prepardness?
-Smoke detecters -Poison control -Matches -Guns locked -Don't open door -Fire department number Kids : address and phone number
nurse's role in sex education
-treat as normal part of growth and development -*encourage use of correct terms* -differentiate sex vs. *sexuality - orientation and having emotions for another person* -questions and answers -values, problem solving skills -open for communication with parents
average age of puberty
12 in girls 14 in boys
prepubescence
2 year period the precedes puberty, typically occurs in preadolescence
height increases by ___ inches per year, and weight increases by ___ kg per year
2inches, 2-3 kg
Which action would indicate a priority for the nurse in terms of health promotion safety? 8-year-old child uses helmet protection while riding a bicycle. 4-year-old child wears protective equipment while on a skateboard. School-age child uses car seat restraint system. Protective equipment is used while the 9-year-old child is riding a scooter.
4-year-old child wears protective equipment while on a skateboard. Skateboard use is not recommended for children aged 5 and younger regardless if they are wearing protective equipment. All of the other options indicate that attention has been placed on safety concerns and that the children are developmentally appropriate to handle the physical skill activity.
When is dishonest behavior common ?
5-6 y/o
What is the difference in sports between ages 5-8 and 8-10?
5-8: not focussed on winning 8-10: like competition, encourage a variety of sports to try, prone to injuries bc of competition
School age is generally defined as age _____
6-12 years
What is considered school-age ?
6-12 years
At which age, is a strong preference exhibited for members of the same sex to engage in play activities rather than play with mixed groups? 7 6 8 9
7 At age 7, boys prefer to play with boys and girls prefer to play with girls. At age 6, play is considered to be more independent but showing some degree of socialization. Between the ages of 8 and 9, there is more interest in body-girl relationships and beginning to mix group play.
what ages may resist going to bed?
8-11 years
prepubescence age
9-12; typically 2 years before boys for girls
the average amount of sleep a night is ___ hours in school aged children, but it is highly individualized
9.5
WHat signs do you teach parents about psychosomatic complaints of bullying?
A Healthy kid c/o HA, stomach ache, problems sleeping, anxiety, low self esteem
An 8-year-old girl tells the nurse that she has cancer because God is punishing her for being bad. What should the nurse interpret this as?
A common belief at this age
A parent asks about whether a 7-year-old child is able to care for a dog. Based on the childs age, what does the nurse suggest
A dog can help the child develop confidence and emotional health.
Which statement is not accurate regarding the roles and responsibilities of a school nurse? They are responsible for development and implementation of plans of care for all children within the designated school. All school nurses are registered nurses. They are responsible for medical needs of the children within the designated school. They evaluate implementation of care delivered to children within the designated school setting.
All school nurses are registered nurses. Not all schools have a school nurse but may have unlicensed assistive personnel that work within the school setting that have received training to provide routine standardized care under the supervision of a school nurse. The other options are all within the roles and responsibilities of a school nurse.
What should you teach regarding bullying?
Assess for signs Discussion groups Training to teachers, school nurse
The nurse is developing a teaching pamphlet for parents of school-age children. What anticipatory guidelines should the nurse include in the pamphlet?
At age 12 years, parents should be certain that the childs sex education is adequate with accurate information.
7 to 12 years old
At what age can children identify their own physiologic responses to stress
8 -11 years old
At what ages do school-age kids resist going to bed?
What is the average age of puberty in boys and girls?
Average age of puberty is 12 in girls and 14 in boys (prepubescence is about 2 years prior)
57 inches tall
Booster seats should be used until the child is_________
What accurately describes physical development during the school-age years?
Boys and girls double strength and physical capabilities.
Which of the following statements best describes the relationship school-age children have with their families? A) children desire to spend equal time with family and peers B) children are prepared to reject parental controls C) children need and want restrictions placed on their behavior by the family D) the peer group replaces the family as the primary influence in setting standards of behavior and rules
C
When teaching injury prevention during the school-age years, what should the nurse include?
Caution children against engaging in competitive sports.
A 10-year-old child is riding a bicycle on the grounds of the school. Which finding if observed by the school nurse would require intervention? Child is seen walking the bicycle through the crosswalk. Child is riding close to the curb. Child's shoes are ill fitting. Child is riding single file.
Child's shoes are ill fitting. Shoes that are ill fitting can result in potential injury as they can get caught up in gears and affect the ability of the child to navigate. All of the other observed behaviors are consistent with safe practice.
Which is descriptive of the social development of school-age children? Identification with peers is minimal Children frequently have "best friends" Boys and girls play equally with each other Peer approval is not yet an influence toward conformity
Children frequently have "best friends" Same-sex peers form relationships that encourage sharing of secrets and jokes and coming to each other's aid. Identification with the peer group is an important milestone for the school-age child to move toward independence from families. During the school-age years, same-sex peer groups are more prevalent; therefore, there is less interaction between boys and girls. Conforming to the rules is an essential part of group membership and, therefore, an important skill for the school-age child to learn in terms of peer relationships.
How is spiritual development for a school age child?
Children think in very concrete terms Children expect punishment for misbehavior May view illness or injury as punishment for a real or imagined misdeed
What should the nurse include when giving parents guidelines about helping their children in school? Help children as much as possible with their homework. Punish children who fail to perform adequately. Communicate with teachers if there appears to be a problem. Accept responsibility for children's successes and failures.
Communicate with teachers if there appears to be a problem. Parents should communicate with teachers if there is a problem and not wait for a scheduled conference. Parent involvement is one factor in children's success in school. Children need to do their own homework. This cultivates responsibility. Discipline should be used to help children control behaviors that might be affecting school performance, but failure to perform adequately should not be punished itself. Communicating with the child is a better solution to getting to the "root" of the school performance problem. School-age children need to develop responsibility. Keeping promises and meeting deadlines lays a successful foundation for adulthood and adult responsibilities.
At what Piaget stage is the school age child in?
Concrete operations -They use thought processes to experience events and actions -they can develop understanding of relationships between things and ideas -Able to make judgments based on reason ("conceptual thinking") -Conservation—physical matter does not appear and disappear by magic
Piaget Cognitive Development
Concrete operations * Use thought processes to experience events and actions * Develop an understanding of relationships between things and ideas * Able to make judgments based on reason (conceptual thinking)
A middle age child understands that with regards to a mathematical equation that 7 can be composed of 4+3 as well as 2+5. Based on this finding, the nurse documents that the development level of the child reflects? Concrete operations Verification of latency period Conservation Accomplished industry versus inferiority
Conservation Piaget's cognitive theory development describes conservation as the ability of the child to understand that the same concept may exist as identified by a different method. Numerical relationships are understood before substance conservation. Concrete operations is the term Piaget applies to the entire stage whereby children are able to use thought processes to experience events and actions. The latency period is described by Freud as the ability of the child to go from peer relationships to heterosexual relationships. Industry versus inferiority refers to Erikson's overview of this time frame whereby children if successful master the challenges between industry and inferiority.
kohlberg: moral development
Development of conscience and moral standards in a child age 6 to 7 years, reward and punishment guide choices older school-age child is able to judge an act by the intentions that prompted it rules and judgments become more founded on the needs and desires of others
At what age would orthodontic treatment be considered to have the most potential for successful outcome? When the adolescent growth period has stopped. Early referral if malocclusion presents regardless of age. Treatment differs based on gender due to difference in growth and development. When all primary teeth are present.
Early referral if malocclusion presents regardless of age. If malocclusion is present, best practice would be to have early referral for evaluation and treatment. Orthodontic treatment should be started prior to the growth period stopping. Orthodontic treatment is based on individual presentation and not gender based variables. Orthodontic treatment is typically not started when all primary teeth are still present.
The school nurse is discussing dental health with some children in first grade. Which should be included? Teach how to floss teeth properly. Recommend a toothbrush with hard nylon bristles to get in between the teeth. Emphasize the importance of brushing before bedtime. Recommend nonfluoridated toothpaste.
Emphasize the importance of brushing before bedtime. Children should be taught to brush their teeth after meals and snacks and before bedtime to prevent dental caries. Parents should help with flossing until children develop the dexterity required, when they are in about the third grade. A toothbrush with soft nylon bristles is recommended to prevent damage to the gums. The American Dental Association recommends fluoridated toothpaste for this age-group.
Which action would improve dental health in the school-age child? Limiting brushing of teeth to three times a day following meals. Encouraging the child to floss. Have the parent brush the child's teeth in order to make sure it is done properly. Have the child consume fruit juice rather than soda.
Encouraging the child to floss. Flossing is a critical activity that has been shown to improve dental health. Brushing teeth following meals as well as following snacks has also been shown to improve dental health. At this age, the child should be able to brush their own teeth. Whereas soda should be avoided, the use of fruit juice may contribute to dental caries as it is considered to be a sugar source and example of a fermentable carbohydrate. Water as a drink should be promoted to improve dental health.
Industry vs. Inferiority
Erickson's stage of development from 6 to 12 YEARS
What may cause a child to lie?
Escape punishment Meet other expectations Cant separate fact and fantasy No property rights
Which is characteristic of the psychosocial development of school-age children? A developing sense of initiative is important. Peer approval is not yet a motivating factor. Motivation comes from extrinsic rather than intrinsic sources. Feelings of inferiority or lack of worth can be derived from children themselves or from the environment.
Feelings of inferiority or lack of worth can be derived from children themselves or from the environment. The school-age child is eager to develop skills and participate in activities. All children are not able to do all tasks well, and the child must be prepared to accept some feelings of inferiority, as highlighted in Erikson's stage for this age-group of industry versus inferiority. Initiative versus guilt is the stage characteristic of preschoolers. Peer group formation is one of the major characteristics of school-age children. School-age children gain satisfaction from independent behaviors that are internally driven and accomplished.
How are the children developing their relationships?
Friends and sustaining relationships important Ability to form complex relationships Communication, share feelings Increasing independence from parents necessary
What is an important consideration for the school nurse who is planning a class on bicycle safety?
Head injuries are the major causes of bicycle-related fatalities. Helmets, helmets, helmets
Who is at more risk of child abuse ?
Homes with domestic violence are 50% llikely to abuse children
2 inches
How much does a school- aged child's height increase in a year?
2-3 kg (4.4 -6.6 lbs)
How much does a school- aged child's weight increase in a year?
7 years old
If a child has a strong family history of high cholesterol, at what age should they be screened?
What is the problems if parents discourage self sexual exploration?
If parents avoid this curiosity the information will come from they will do their own self sexual exploration with inaccurate info
Which behavior is most characteristic of the concrete operations stage of cognitive development? Progression from reflex activity to imitative behavior Inability to put oneself in another's place Increasingly logical and coherent thought processes Ability to think in abstract terms and draw logical conclusions
Increasingly logical and coherent thought processes Increasingly logical and coherent thought processes are characteristic of concrete operations. Children in this stage are able to classify objects. Progression from reflex activity to imitative behavior is characteristic of the sensorimotor stage, which occurs from birth to 2 years of age. Inability to put oneself in another's place is characteristic of the preoperational stage, ages 2 to 7 years. Adolescents, in the formal operations stage, have the ability to think in abstract terms and draw logical conclusions.
What is important to note about play?
Involves physical skill, intellectual ability, and fantasy Children form groups, cliques, clubs, secret societies Rules and rituals See need for rules in games they play
How should the nurse interact with a school age child?
Involving them in the care because they are -Eager to develop skills and participate in meaningful and socially useful work -Acquire sense of personal and interpersonal competence -Growing sense of independence -they want to be approved by peers -they feel inferior when they mess up or cannot accomplish something so provide activities they can accomplish
The parents of 9-year-old twin children tell the nurse, They have filled up their bedroom with collections of rocks, shells, stamps, and bird nests. The nurse should recognize that this is which?
It is a characteristic of cognitive development at this age
60 minutes
It is recommended that school-aged children should participate in a minimum of _______________ of moderate to vigorous physical activity daily
What are latchkey children?
Kids home w/o parents and have the key to home and can go in without adult supervision teach not to answer door
The school nurse is teaching a class on safety. Which activities require protective athletic gear? Select all that apply. Lacrosse Football Swimming Gymnastics Skateboarding
Lacrosse Football Skateboarding Any sport that involves body contact such as lacrosse, football, and skateboarding requires a child to wear protective equipment. Swimming does not involve body contact and requires no protective equipment. Gymnastics does not require protective equipment.
What is being used to develop school lunches?
MY Plate
Examination of a child's mouth reveals that teeth do not line up properly upon attempts to have the child bite down. This finding is noted as? Malocclusion Gingivitis Evidence of dental caries Dental injury
Malocclusion Malocclusion occurs when upper and lower teeth do not approximate when a child bites down. Gingivitis refers to inflammation of the gums. Evidence of dental caries would refer to the presence of a cavity. Dental injury refers to evidence of chipping or dislocation as a result of trauma.
How are they to help develop their personality?
Manage parental expectations Help the child be successful Enhance positive developmental outcomes Anticipate high-risk situations Allow children to succeed in ways appropriate to their unique temperaments Where do I "fit" in with family, school environment and relationships with peers
What other activities may they take part in?
Need time for play longer intention span Ability to read Musical instruments Collecting and organizing Media
Which benchmark serves as the ending period for the middle year period of development? Beginning school Onset of puberty Wisdom teeth appearing Loss of deciduous teeth
Onset of puberty The onset of puberty signals the end of the middle year period. Beginning school and loss of deciduous teeth are associated with the beginning of the middle year period. Appearance of wisdom teeth occurs later on in life.
anticipatory guidance: care of families
Parents adjust to child's increasing independence Parents provide support as unobtrusively as possible Child moves from narrow family relationships to broader world of relationships
What does it mean by theFamily becoming the "sounding board"?
Parents are encouraging their kids to be more independent and reducing their micromanagement roles parents are listening and consulting with their kids more
Childs relationship with family
Parents are primary influence in shaping child's personality, behavior, and value system Increasing independence from parents is primary goal of middle childhood Children not ready to abandon parental control
What are the goals of organized athletics for preadolescent children?
Physical fitness Basic motor skills A positive self-image
A child has sustained an injury and lost a primary tooth. Which priority action should be taken by the nurse at this time? Provide comfort measures and assess for bleeding. Referral to the dentist for immediate consultation. Recover the tooth and prepare for reimplantation. If the tooth is dirty, rinse it off and cover in gauze until needed for reimplantation.
Provide comfort measures and assess for bleeding. Avulsed primary teeth are usually not reimplanted. Therefore the nurse should focus on assessment of the site and comfort measures. All of the other options would be indicated if an avulsed tooth were to be reimplanted.
WHat are stress reduction techniques for children?
Relaxation techniques Deep-breathing exercises Progressive relaxation of muscle groups Positive imagery Physical activity
school health
Responsibilities of parents, schools, and health departments ongoing assessment, screening, and referrals, routine services, emergency care, safety and infection control instruction increase knowledge of health and health habits
What may cause a child to cheat?
Revenge Supplement income Attention or love Poor role models Don't know any better
What to teach about car safety?
Seatbelts Booster seats till 12
What should you teach the child about sexuality?
Sex educations in schools Open lines of communication Terminology Normal curiosity of childhood
The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize?
Sexuality is presented as a normal part of growth and development
What is an important consideration related to childhood stress? Children should be protected from stress. Children do not have coping strategies. Parents cannot prepare children for stress. Some children are more vulnerable to stress than others.
Some children are more vulnerable to stress than others. Children's age, temperament, life situation, and state of health affect their vulnerability, reactions, and ability to handle stress. It is not feasible to protect children from all stress. Children can be taught coping strategies. Supportive interpersonal relationships are essential to the psychological well-being of children. Adults need to recognize signs of stress before they become overwhelming. Providing children with interpersonal security helps them develop coping strategies for dealing with stress.
Why is it that a 9 year old can have menses but still is not emotionally or psychosocially mature?
Some younger children are advanced in their tanner stages, but still at their normal emotional developmental level Physical maturity not necessarily correlated with emotional and social maturity
The school nurse is discussing after-school sports participation with parents of children age 10 years. The nurses presentation includes which important consideration
Sports participation is encouraged if the type of sport is appropriate to the childs abilities.
What are red flags of stress?
Stomach pains or headaches Sleep problems Bed-wetting Changes in eating habits Aggressive behaviors Reluctance to participate Regression to earlier behaviors (thumb sucking)
When teaching injury prevention during the school-age years, what should the nurse include?
Teach basic rules of water safety.
The nurse is teaching parents about safety for their latchkey children. What should the nurse include in the teaching session?
Teach the child weather-related safety Emphasize fire safety rules and conduct practice fire drills
What characterizes moral development in the older school-age child?
The child is able to judge an act by the intentions that prompted it rather than just by the consequences.
6 years old
The first permanent (secondary) teeth erupt at what age?
Parents of a 10-year-old child are concerned that their child has been recently showing signs of low self-esteem. Which should the nurse consider when discussing this issue with the parents? Changing self-esteem is difficult after about age 5 years. Self-esteem is the objective judgment of one's worthiness. Transitory periods of lowered self-esteem are expected developmentally. High self-esteem develops when parents show adequate love for the child.
Transitory periods of lowered self-esteem are expected developmentally. Self-esteem changes with development. Transient declines are expected and, with positive encouragement and support, are only temporary. Self-esteem is influenced throughout adolescence. One aspect of self-esteem is a subjective judgment of one's worthiness. Self-esteem is based on several factors, including competence, sense of control, moral worth, and worthiness of love and acceptance.
The school nurse is presenting sexual information to a group of school-age girls. What approach should the nurse take when presenting the information?
Treat sex as a normal part of growth and development.
true
True/False: before puberty, there is no essential size or strength difference between girls and boys
true
True/False: school- age children's larger, stronger muscles and increased stamina means they can they can engage in more physical activity but they still may not be ready for strenuous competitive athletics
The school nurse is teaching bicycle safety to a group of school-age children. What should the nurse include in the session?
Watch for and yield to pedestrians Ride bicycles with traffic away from parked cars. Keep both hands on the handlebars except when signaling.
car restraint systems door-lock mechanisms appropriate passenger seating locations
What are three automobile safety measures proven to reduce motor vehicle injury in children?
influenza, meningococcal, Tdap, HPV
What immunizations are needed at ages 11-12 years old?
reasoning
What is an effective disciplinary technique for school aged children?
6 -12 years old
What is the age range for a school-age child?
9 1/2 hours
What is the average amount of sleep a school- age child gets at night?
honestly, matter of fact, at their level of understanding tell them what they need to know and what will happen to them as they become sexually mature
What is the best way to answer a school-aged child's questions about sex?
motor vehicle accidents
What is the most common cause of severe injury in school-aged children?
replant tooth and have child bite down on gauze then transport to dentist OR can place tooth in cold milk for transport
When a tooth is knocked out (avulsed) what can be should be done with the tooth?
after meals, after snack, at bedtime
When should teeth be brushed?
rear seat
Where is the safest vehicle seat for a child under 13?
WHat happens at development of a 9-12 year old ?
Writes brief stories Reads for enjoyment, care of pets Cooks Leaves home for short periods "best friend" Consider death irreversible Gain independence within family
What are the components of a health visit?
Yearly health visits: -Blood pressure screening -Vision and hearing screening -Assessment for height, weight, and body mass indices that would signify childhood obesity -Scoliosis screening -Assessment of developmental milestones -Permanent teeth eruption
A female school-age child asks the school nurse, How many pounds should I expect to gain in a year? The nurse should give which response?
You will gain about 4.4 to 6.6 lb per year.
A male school-age student asks the school nurse, How much with my height increase in a year? The nurse should give which response?
Your height will increase on average 2 inches a year.
self concept
a conscience awareness of self-perception, such as one's physical characteristics, abilities, values, self-ideals, and expectancy and the idea of self in relation to others
self concept
a conscious awareness of a variety of self perceptions (ex- abilities, values, appearances) importance of significant adults in shaping this
how is moral developed in the older school age?
able to judge an act by the intentions that prompted it
The children should know..
address and parent phone number
What to teach about cellphone safety?
address and phone number fire department
What to teach about water safety?
avoid drowning by teaching children to swim gated pool Encourage parents to have 1 adult life guarding
nocturnal enuresis
bed wetting; more likely in males; can last up to 15 years old
children of 12 years and older are general less resistant to
bedtimes
puberty
beginning of development of secondary sex characteristics
preadolescence
begins toward the end of middle childhood and ends at 13th birthday
The nurse is teaching a community health promotion class to parents and school-age children related to bicycle safety. Issues to cover in the sessions include bicycle helmets need to be worn only if the child is planning to ride in traffic. reflectors should be installed only on bicycles that are to be ridden at night. bicycles should be ridden against the traffic so that the rider can see the cars. bicycles should be walked through busy intersections.
bicycles should be walked through busy intersections. Bicycles should be walked through busy intersections to allow the child to have full view of the traffic and be able to react accordingly, with safety the number one priority. Bicycle helmets should be worn at all times to prevent head injuries. Reflectors should be installed on all bicycles, whether they are ridden during the daytime or at night only. Bicycles should always be ridden with the traffic, not against the traffic. This will assist in preventing accidents.
maturation of systems
bladder capacity increases; heart smaller in relation to the rest of the body; immune system increasingly effective; bones increase in ossification; physical maturity not necessarily correlated with emotional and social maturity
The school nurse is asked to speak with the parents of a 10-year-old boy who has been bullying other children. The nurse's response should be based on knowledge that bullying at this age is considered normal. children who bully others usually join gangs. bullying is a short-term problem that is generally outgrown by the end of the school-age years. bullying often manifests itself in children who are different or have poor academic or social skills.
bullying often manifests itself in children who are different or have poor academic or social skills. Poor relationships with peers and a lack of group identification, such as looking different or having poor academic or social skills, contribute to bullying behavior. Bullying is a maladaptive response to poor relationships with peers and lack of group identification; therefore, it is not considered normal behavior. Children who chronically bully tend to be impulsive, easily frustrated, and at increased risk for dropping out of school, but there is no direct correlation between bullies and joining gangs. Children who bully may be at risk for long-term psychological disturbances and psychiatric symptoms. Future problems for bullies may include violence, substance abuse, and criminal convictions, which often occur in adulthood.
spiritual development
children think in concrete terms expect punishment for misbehavior may view illness or injury as punishment for a real of imagined misdeed
The parents of 9-year-old twins tell the nurse, "They have filled up their bedroom with collections of rocks, shells, stamps, and cars." The nurse should recognize that this behavior is characteristic of giftedness. typical "twin" behavior. cognitive development at this age. psychosocial development at this age.
cognitive development at this age. Classification skills are developed during the school-age years. This age-group enjoys sorting objects according to shared characteristics. Giftedness is not measured simply by a school-age child's ability to classify objects, which is an expected cognitive skill for this age-group. Giftedness signs include specific academic aptitudes, advanced memory skills, creative thinking, ability in the visual or performing arts, and psychomotor ability, either individually or in combination. The development of classification skills is characteristic of the school-age child and is not related to the behavior of twins. Psychosocial development of the school-age child is focused on accomplishment or industry, not the cognitive skills of classification that are described.
sports
controversy regarding early participation in competitive sports concerns with physical and emotional maturity in competitive environment acquisition of skills general like competition
Prepubescence
defined as the two years preceding puberty; typically occurs during preadolescence
boys are more likely to bully using the ___ method
direct (physical)
2 types of bullying
direct and indirect
eriksons stage meaning
eager to develop skills and participate in meaningful and socially useful work; acquires a sense of personal and interpersonal competence; growing sense of independence; peer approval is a strong motivator
Nursing interventions to promote health during middle childhood should include stressing the need for increased calorie intake to meet the increased demands on the body. instructing parents to defer questions about sex until the child reaches adolescence. educating the child and parents about the need for effective dental hygiene because these are the years in which permanent teeth erupt. advising parents that the child will need decreasing amounts of rest toward the end of this period.
educating the child and parents about the need for effective dental hygiene because these are the years in which permanent teeth erupt. Because the permanent teeth are present, it is important for the child to learn how to care for these teeth. Caloric needs are diminished in relation to body size during the middle years; however, a balanced diet is important to prepare for the adolescent growth spurt. Parents should approach sex education with a life span approach and answer questions appropriate to the child's age. School-age children often need to be reminded to go to sleep.
Erikson: Inferiority
feelings may derive from self or social environment; may occur if incapable or unprepared to assume the responsibilities associated with developing a sense of accomplishment; all children feel some degree of inferiority regarding skills they cannot master
growth and development at this stage is, and they will have progress with physical and emotional maturity
gradual
nutrition
importance of balanced diet to promote growth quality of the diet related to the family's pattern of eating quality of dietary choices in the school caf fast food concerns
social development
importance of the peer group identification with peers is a strong influence in a child gaining independence from parents sex roles are strongly influenced by peer relationships
Bones ______ in ossification
increase
Immune system ______ effectiveness
increases
How much is the bladder capacity at this age?
increases to about 300 cc
what is the primary goal of middle childhood?
increasing independence from parents
girls are more likely to bully ___
indirectly (gossip)
Erikson stage
industry v. inferiority (6-12)
What is the erickson stage for school aged children?
industry vs inferiority
increased awareness of differences may influence feelings of:
inferiority
What makes a child a target for bullying :( ?
lack esteem, insecurities
freud stage
latency period of psychosexual period
Childrens who played were ______ likely to commit violence as adults
least
generally, children like their physical selves ___ as they grow older
less
What are dishonest behaviors child face?
lying, stealing, cheating
what is the ideal time for formal sex education?
middle childhood Lifespan approach; info on sexual maturity and the process of reproduction; effective communication with parents
What is malocclusion?
misalignment of teeth and people get braces
What is Kohlberg's theory?
moral development Development of conscience and moral standards Rules and judgments become more founded on needs and desires of others
An important consideration in preventing injuries during middle childhood is that peer pressure is not strong enough to affect risk-taking behavior. most injuries occur in or near school or home. injuries from burns are the highest at this age because of fascination with fire. lack of muscular coordination and control results in an increased incidence of injuries.
most injuries occur in or near school or home. Most children in the middle years spend the majority of their time in and around school or home; therefore, the risk for injuries is increased in and around these areas. Peer pressure as an impetus for risk-taking behavior begins in the school-age years but is more significant in adolescence. Burn injuries are higher in the toddler years, when children are curious and mobile. They may expose themselves to objects capable of burning them (e.g., hot pots of water in the kitchen). Automobile accidents, either as a pedestrian or passenger, account for the majority of severe accidents in the middle years. School-age children have more refined muscle development, which results in an overall decrease in the number of accidents. Lack of muscular coordination and control leading to injuries occurs in younger children.
the most common cause of severe injury and death in school aged children is:
motor vehicle crashes, pedestrian and passenger bike injuries
are children ready to abandon parental control?
no
In reviewing information about a school-age child, the nurse notes that the child goes to after school activities each day as the parents do not get home until considerably later in the day. Based on this description, the nurse would document concern for the growth and development due to lack of parental influence. no further action is needed. referral to a social worker for evaluation of the family unit. notation of being a latchkey child.
no further action is needed. Many children have working parents and do not exhibit any adverse outcomes if they attend after school activities each day following release from school. There is no need for referral to a social worker. A latchkey child by definition is one that has no parental or supervision contact following the school day and are responsible for their own care until the parent comes home.
who is the primary influence in shaping a child's personality, behavior, and value system?
parents
play in school age children involves
physical skill, intellectual ability, fantasy form groups, cliques, clubs, secret societies rules and rituals see the need for rules in the game team play quiet games and activities ego mastery
What should you teach parents with sports?
pick sports matching their physica ldevelopment
10 in girls and 12 in boys
puberty begins at ____________ in girls and ___________ in boys
When does school-age end?
puberty with acquisition of final permanent teeth
psychosocial development
relationships center around same sex peers
Signs and symptoms that are associated with stress in a school-age child that require intervention are Select all that apply. child not wanted to go to sleep occasionally at the usual bedtime. reverting to a previous behavioral pattern exhibited several years ago. bedwetting. doesn't want to eat a certain food although the child has ate it before. doesn't want to go outside and prefers to remain in his bedroom each day after school but previously had been extremely sociable.
reverting to a previous behavioral pattern exhibited several years ago. bedwetting. doesn't want to go outside and prefers to remain in his bedroom each day after school but previously had been extremely sociable. Reverting to a previous behavior indicative of regression, evidence of bedwetting and change in socialization pattern as signs and symptoms of stress should be investigated as they are signal areas of concern. Occasional reluctance to go to sleep at the regularly scheduled bedtime may be an isolated event which is self-limiting. Refusal to eat a food even if the child ate the food before is not by itself indicative of a significant stress event.
how is moral developed in the age of 6-7?
reward and punishment guide choices
what is second to the family as a socializing agent?
school experience
positive self concept leads to feelings of:
self respect, self confidence, happiness
what is a normal curiosity during preadolescence?
sex play
When does school-age begin?
shedding of first deciduous teeth
the dental health stage begins with the
shedding of the first deciduous teeth
What did a study show about video games?
show pathologic play poor grades cannot solve conflicts peacefully violent
body image ins influenced by
significant others
Heart ________ in relation to the rest of bod
smaller
The parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. Based on the nurse's knowledge of this age-group, the most appropriate recommendation is organized sports, such as soccer, are not appropriate at this age. competition is detrimental to the establishment of a positive self-image. sports participation is encouraged if the sport is appropriate to the child's abilities. girls should compete only against girls because at this age boys are larger and have more muscle mass.
sports participation is encouraged if the sport is appropriate to the child's abilities. The parents should help the child select a sport that is suitable to her capabilities and interests. Team sports contribute to the school-age child's social, intellectual, and skill growth. Organized sports for school-age children can provide safe, appropriate activities with supportive parents and coaches. The desire to participate in competitive team sports develops out of a need for peer interaction for the school-age child. A sport should be selected that meets the child's capabilities and interests. The physical changes in boys described take place during puberty, later in the school-age years; therefore, there is no reason for boys and girls to compete separately at age 8 years.
How to promote nutrition in school-age children ?
taking family centered approach cooking together
concerns related to normal growth and development
teachers, parents, latch key children, limit setting ans discipline, dishonest behavior, stress and fear
2
there is approximately a _______ year difference between girls and boys in the onset of prepubescence
Why can school-age children become obese?
they have more food choices and can opt to vending machines
A parent is concerned as her 6-year-old child "cheats" when playing games with other children. The parent is concerned that this behavior will affect future behaviors as the child gets older. The nurse understands the parent's anxiety about the described behavior and provides the following assurance this type of behavior occurs around this age period and is due to the child not being able to understand what it means to lose. this is a prompted behavior that occurs intermittently at this age. you are right to be concerned about this type of behavior. it is best to ignore the behavior as it will stop eventually.
this type of behavior occurs around this age period and is due to the child not being able to understand what it means to lose. Cheating as a behavior occurs primarily between the ages of 5 and 6. It is almost at times displayed as an automatic behavior as the child does not understand about winning and losing. The behavior typically goes away as the child matures. Ignoring the behavior without some direction is not advised as it is best to address the situation and help the child to begin understanding of the concept.
How to promote exercise?
through sports
An example of indirect bullying would be if telling an individual that you don't like them because you were hurt by their actions. raising one's hand to prevent another person from hitting you. taking a toy away from someone because you want it to see it. using social media to make offensive comments about an individual.
using social media to make offensive comments about an individual. Indirect bullying are actions that are taken that are meant to cause harm to an individual or group. The use of social media to make offensive comments about an individual is not the place for professing feelings. One must take into account that offensive comments by definition are offensive. Telling an individual that you don't like them as a result of their exhibited behavior is an example of direct communication. Taking a toy away from someone because you want to see it may not be the best approach but it does involve direct action.
the school experience helps with the transmission of ___ of the society, and peer relationships become increasingly important
values
A finding that is consistent with prepubescence is variation in physical appearance between boys and girls. age of onset of physical signs is the same for both boys and girls. does not occur during the preadolescence period. appearance of secondary sex characteristics is the same for both boys and girls.
variation in physical appearance between boys and girls. During the period of prepubescence there is a variation in physical appearance between boys and girls. The age of onset of these appearances also varies with girls exhibiting changes earlier than their male counterparts. The changes occur during the preadolescence period. Secondary sex characteristics also present at different times for boys and girls.
injury prevention
wear helmets when riding bikes, appropriate safety equipment for all sports
What to teach about sun safety?
wear sunscreen
will males and females differ in size during the school age period?
yes