Growth/ development/ play

Adolescent psychosocial development

Adolescent psychosocial development -Identity formation is the major developmental task -Others include formation of a sexual and vocational identity and ability to emancipate oneself in the family or become independent -Energy focused with himself and the younger adolescence described as egocentric or self absorbed -Frustrated parents often described teenagers during this phase as self-centered lazy or irresponsible -They need time to think concentrate on themselves and determine who are they going to be -Ericsson describes conflict of this phase of psychosocial development as identity formation versus role confusion in this phase corresponds to Fred's general stage of psychosocial development -Tried you laws an experiment with the environment until they find a rule that fits -Phase of experimentation has been termed the moratorium meaning if you create a delayed granted to someone not yet ready to make more than a tentative commitment -Adolescence changing interest from year to year illustrate lack of commitment -Parents invest in expensive sports going to find out in abandoned it after a short time -They take their cues on appearance social behavior and language from PEer group -Peer group serves as a safe haven as adolescence emotionally move away from the family and struggling to determine who they are -Peer group validates acceptable behavior and teenagers feel secure and trying on new rules with peer group approval -Teens spend all day with friends and school and all evening rehashing The days events over the phone or through postings on chat and social media - early and middle adolescence our audience conscious And feel that they are the focus of everyone's attention -A bad hair day or a blemish me through the adolescent into despair The adolescent and Erickson -Identity formation and establishment of autonomy -Acquisition of abstract reasoning leading to an analytical thinking, Problem solving and planning for the future - Britain states that race and ethnicity identification may complicate identity formation For these adolescence -Interactions with multiple aspects of the physical and social environment are critical for development of positive or negative identity -Negative environment attitudes such as prejudice or discrimination or risk factors for negative identity formation -Early and middle adolescents are. It's when teams are prone to gang formation and activities -Pier modeling and pure acceptance being of the upmost importance lead some adolescents to form games that provide a collective identity and give them a sense of belonging -Peer pressure companionship protection or most frequently reported reasons for joining gangs -Early and late adolescence bitch I have unique reactions to a developmental task which are influenced by adolescent cognitive thinking -Paget is adolescent condition characterized by a transition from concrete operational far too formal operational thought the ability to think logically and use deductive and abstract reasoning -Acquisition of formal operational thinking allows adolescent to recall past experience and to apply knowledge to the future by drawing logical consequences from a set of observations -Capable of using abstract symbols such as those to ride from higher order mathematics -Problem-solving and decision-making skills become more highly developed although I may still be conflicted about idealism versus reality Early adolescence> -11 to 14 years have intense feelings about body image and many physical changes taking place -Less confident with members of opposite sex early adolescence tent a group together and have best friends of same-sex -One has only to visit local mall movie theater to see groups of young teens in the same sex observing that Riley speaking to groups of opposite sex -Quite egocentric and move from obedience to rebellion regarding parental authority parents are often shocked I said internal events and I hurt by teams rejection -Providing parents with anticipatory guidance regarding each pacific development changes as a primary nursing function -Happy go lucky 11-year-old me turn into Chi self absorbed 12-year-old who seems comfortable only in the prescence of friends -Young teens who develop egocentric how to differentiate between how others see them in their own mental preoccupations thanking everyone is as obsessed with them as they are with themselves -Elkind Reaction to imaginary audience -The believe in imaginary audience is probably why young teens are self-conscious they believe everyone is critical of them and teens are quite critical of one another -Subconscious behavior may be the result of physical and emotional transition to middle adolescence -Early adolescence is losing the familiar rule of Tryon but does not yet feel comfortable with the role of the adult -Ambivalence toward independence is common in teen who feels too grown-up for a good night kiss from parents still falls asleep with the favorite teddy bear -elkind Believe that young things are so audience conscious they see themselves as unique and tell them selves a personal fable and that supports feelings of invulnerability, They believe bad things will happen to others but not to them Middle adolescents> -15 to 17 years parents describe this is the most frustrating Phaseadolescent development -Real audience replaces imaginary audience teens become even more introspective and narcissistic -Conformity to peer group norms becomes more important and conflicts become teenagers and parents often escalate -Testing of limits soaking with drawl over to rebellion a car over conflicts regarding curfews friends activities appearance cars and money -May feel more secure by associating with her becoming a member of a gang -Use of color who are gang members go through transition between early in the middle adolescents we're optimism and hope about achieving future goals evolve into despair when faced with the reality of consequences of gang membership -Gang members begin to except the fact that they want for themselves and their families may not be achievable with the engagement in illegal activities -Adolescents who have been exposed to more victims of gang violence exhibit mental health issues such as anxiety or PTSD secondary to fear's for their safety -When working with gang members it's particularly important and nurses consider risk for suicide -Consistent discipline and structure make adolescence feel more secure in the assists with decision making -With parental guidance they are able to make decisions that will result in desirable outcomes -Adults must keep in mind that middle adolescents are impulsive and impatient -Parenteau concern may be seen as interference rather than guidance and maybe met with resistance and resentment -Feelings about self image and social relationships are intense -Middle adolescence is generally a time of transition from seeing sex friendships to an extreme interest in the opposite sex -A time when adolescence make knowledge is homosexual feelings -Teens who are sexually experienced and sexually active has the clients as has a team birth rate -Sexual activity is often related to peer pressure and self-esteem issues -Those with low self-esteem or more vulnerable and are more apt to engage in negative wrist taking activities associated with sexuality -Decisions about sexual activity are often impulsive and made with little regard to later consequences or previous preparation -Another concern is participation in oral sex -Questions about oral sex activity is not currently induced in the YRBSS -They intend to have oral sex for various reasons but primarily because they believe it is more socially acceptable then vaginal intercourse and does not carry the same risk -Many adolescents me know that various STDs can be contracted from engaging in oral sex so they don't consider oral sex to be as risky as vaginal sex -Questions of an adolescent if there is sexually active is no longer sufficient questions should be directed toward assessing participation in various specific types of sexual activity as well as method of barrier protection used -Parents need encouragement to maintain open communication guy teenagers in sexual decision making -Providing parental guidance about sexual behavior is not easy during middle adolescence ring privacy is of extreme importance in communication with parents tend to decrease -Some parents find sexual behavior difficult topic to discuss not in the avoid talking with teens about it Vocational exploration> -Likely to experience role confusion and have unrealistic expectations of themselves -Sam identify a role that holds their interest whereas others experiment with many rules moving quickly from one to another -Over identification with grammar rest rolls take precedence over reality and is in Riched by daydreams and fantasy -A 15-year-old girl may spend time with their friends describing her future is a popular video star well failing to fall the laundry or do dishes -Middle adolescents some acquire part time jobs and identify various skills and interests part-time jobs are often a source of income for material possessions and activities not provided by parents such experiences help adolescence set realistic expectations about work become more independent and develop self-esteem -Those who are successful in the working world demonstrate a sense of responsibility intend to have more positive social interactions -May allow work to interfere with education activity and have difficulty setting priorities *Nurses working with middle school or's need to be approachable maintain objectivity encourage confidence support parental authority be a child advocate well not coming between adolescents and their parents encourage the family to work as a mutually respectful unit -Late adolescence 18 to 21 years> -Ability to think abstractly conceptualize verbally and express thoughts and feelings about various aspects of life -Turn to be idealistic about love social issues ethics lifestyles until their experiences modify their believes -Conformity becomes less important as teens progress through late adolescence -With development of unique identity self-esteem increases and adolescents are able to resist group pressure if it is not in their best interest -Interactions with parents are less turbulent -Leaving home is a major issue and prepare themselves to meet this task through education or vocational training -Identifying realistic career goals is important but many are not yet ready to make lifelong commitments -Changing career goals is not uncommon but nurse should be cautious for those who have not sat career goals or who demonstrate empathy about future and hope you're committed only to the present -Apathy and boredom are symptoms of depression -Relationships more mature -Friendships develop and may last a lifetime expectations of friends and loved ones become more realistic and less self serving -Ability to consider others' needs increases and recognition of suicidal needs is more parent as the adolescent moves from adolescence to adulthood -Failure to achieve identity formation believe adolescents in role confusion and NPD successful mastery of the task of young adult hood -Positive ego identity depends on adolescents ability to except the past learn from experience and become engaged in the future -Most move through the identity versus role confusion stage of development within minimal difficulty

Safety in adolescence

Safety in adolescence -Injuries clean more lives during adolescence than all other causes of death combined -Predominance of injuries during adolescence results from combination of factors growth cycle motor function physical coordination energy impulsivity peer pressure and experience -Feelings of invulnerability it can't happen to me resist a little thought maybe give into negative consequences of certain behaviors -Alcohol and drugs in parent Jon Schmidt and contribute to fatal injuries

Signs of developmental delays

Signs of developmental delays -Lack of eye muscle control after 4 to 6 months suggest a vision impairment and the need for further evaluation -Lack of a social smile by 8 to 12 weeks requires for the evaluation and close follow up

Cognitive Development

-Infants sensory capabilities, neuromuscular control, perceptual skills all affect how their cognitive processes unfold infancy and throughout life -Variables such as the quality and quantity of parental interaction and environmental stimulation contribute to cognitive development -Cognitive development during the first two years of life begin with egocentrism -Egocentrism is a child's complete self absorption in the in ability to view the world from anyone else's vantage point (Padgett) -Invanz cognitive Capacities expand, become increasingly aware of the outside world and there separateness from it -With maturation and experience they become capable Of differentiating themselves from others and their surroundings -According to Padgett's theory cognitive development occurs in stages of periods as described in the following discussion -Infancy is included in the sensorimotor stage from birth to two years, During which infants experience the world through their senses and their attempts to control the environment -Learning activities progress from simple reflex behavior to trial and error Experiments -During the first month of life infants are in the first substage, reflex activity, of the sensory motor period. Behavior such as grasping, sucking, licking is dominated by reflexes. Paget Believe that infants organize their activity survive and adapt to the world by the use of reflexes -Primary circular reactions dominate the second substage occurring from age 1 to 4 months -Reflexes become more organized and new schemata are AcquiredUsually entering on the infants body -Sensual activities such as sucking and kicking become less reflexive and more controlled and I repeat it because of stimulation they provide. Also begins to recognize objects especially those that bring pleasure such as breast or bottle -Third substage or stage of secondary circular reaction's, perform actions that are more oriented toward the world outside their own bodies -4-8 month old Infant in this stage begins to play with objects in the external environment such as a rattle or stuffed toy -Actions are labeled secondary because they are intentional (Repeated because of the response that is elicited) -Example, a baby in this upstage intentionally shakes a rattle to hear the sound -8 to 12 months infants in the fourth substage (Coordination of secondary schemata) Begin to related objects as if they realize that the object exist even when they are out of sight -This awareness referred to as object permanence illustrated by a nine month old infant seeking a toy after it's hidden under a pillow -Six months can follow the path of the toy that is dropped in front of them but will not look for the job toy or protestants disappearance until they are older and have developed the concept of object permanence -Fourth stage, solves problems differently from how they solve problems in earlier so stages -They choose actions that were successful in the past -They remember and can perform some mental processing -Seem to be able to identify simple casual relationships and they show definite intentionality -One 811 month old child sees a toy that is beyond reach the child uses a blanket that is resting on to pull it closer -Cognitive development in the infant parallels motor development -More activity is necessary for cognitive development in cognitive development is based on interaction with the environment -Infant cognitive development lays the foundation for later cognitive function -Nurses promote infants cognitive development by encouraging parents to interact with their infants into your provide them with normal interesting simuli -Parents should maintain familiar routine experiences through them which their infants can develop a sense of security about the world -Infants will thrive and learn

Physical growth and development in school age child

Physical growth and development in school age child -Characterized by a slow and steady growth -Physical changes are gradual and Subtle -Average weight gain 5.5 pounds a year and height 2 inches per year -Boys are 1 inch taller and 2 pounds heavier than girls -At 10 to 11 years girls begin to catch up in size as the undergo pre-adolescent growth spurt -By 12 girls are 1 inch taller than boys and 2 pounds heavier -Growth spurt signals onset of puberty and usually occurs between 12 and 14 in occurs two years later in boys than in girls Body systems -Appear thinner and more graceful -Muscle skeletal growth leads to greater coordination and strength -Muscles are so mature and those can be injured from overuse -Growth of the facial bones changes facial proportions -As facial bones grow the Eustachian Tube assumes in more down word and in word position resulting in few were infections -In Fattic tissues grow till nine years -IGA and I GG reach adult levels at 10 years -Enlarged tonsils and adenoids Common and not always an indication of illness - Frontal sinuses develop at seven years -Brain growth complete at 10 years -Respiratory system continues to mature -Lungs and Alviola develop fully and fewer respiratory infections occuR Dentition> -Oh 20 deciduous teeth are lost and replaced by 28 of the 32 permanent teeth -All permanent teeth except the third molars irrupt during this phase -First teeth to be lost or the lower central incisors at around six years -First graders are characterized by a snaggletooth appearance Sexual development> -Purity occurs 89 years and girls -Black girls begin puberty one year earlier than white girls -The reason for earlier development among black girls is not known -Purity begins 1.5 to 2 years later than boys -Menarche Occurs at 12 -Females who are overweight have earlier onset of puberty and menarche -10 and 11-year-old girls have already had menarche -Common cause of embarrassment because town is not to want to appear different from peers -Children how much are either early or late my struggle with feelings of self consciousness and inferiority -Sex education programs introduced in elementary school -Children question about sexuality and related issues should be answered honestly and in a matter of fact way -If sex education is presented within context of learning about the human body with it wanders in mysteries children are less likely to feel embarrassed and anxious -Regardless of whether sex education is a part of formal school curriculum children need accurate information -Basic anatomy and physiology and expected changes of purity should be introduced to children before onset of puberty -Older squeeze children need information about menstruation nocturnal omissions and reproduction Motor development> Development of gross motor skills> -Coordination improves - Developed sense of balance and rhythm allows children to ride to World bicycle dance skip jump rope participate in various sports -As puberty approaches in late school-age. Children become more awkward and their bodies grow faster than their ability to compensate Importance of active play> -Spend much of their time in active play practicing and refining motor skills -They seem to be constantly in motion -Children of this age enjoy active sports and games as well as crafts and fine motor activities -Activities requiring balance and strength such as bicycle riding tree climbing and skating or exciting and fun -Muscle coordination improves as a child is given opportunity to practice -Children learn physical fitness skills -Tag jump rope hide and seek provide a release of emotional tension and enhance development of leader and follower skills -Soccer and baseball provide opportunities not only for exercise and refinement of motor skills but also for development of Sportsmanship and teamwork -time spent watching tv watching movies or playing computer games often diminish a child's interest. In active play outside -encourage limit screen for 2 hrs Or less per day and to encourage them to engage in more active play -Parents need to provide adequate space for children to run jump and scuffle -Children should have enough free time to exercise and play Preventing fatigue and dehydration> -Six-year-olds will not stop and activity to rest -Parents learn to recognize signs of 50 ordered ability and enforce rest periods before the child becomes exhausted -Charles metabolic rate is higher than adults and sweating ability is limited extremes in temperature while exercising can be dangerous -Dehydration and overheating compose threats to the child health -Frequent rest periods in adequate hydration are essential for the child during physical exercise Development of fine motor skills> -Increased mylenizAtion Of central nervous system is shown by a refinement of find motor skills -Balance in hand I coordination improve with maturity and practice -Take pride in activities that require decks trading in fine motor skills such as model building or playing a musical instrument

Stages of growth and development

Stages of growth and development -

Cognitive and sensory development in the toddler and preschooler

Cognitive and sensory development in the toddler and preschooler -Toddler> -Consumed with curiosity -Boundless energy provide them with resources for the tremendous cognitive growth that occurs during this phase -12 and 18 months are in Paige's sensory-motor Phase -Spend their day experimenting to see what will happen as They dump feel empty and explore every accessible area of their environment -19-24 months the child enters a final stage of sensory-motor Phase -Object permanence established by this age -Has the ability to use symbols in words when referring to absent people or objects in science to solve problems mentally rather than by repeating in action over and over -I've been seeing imitating the parent of the same sex performing household task termed domestic Mimi cry -Play in this stage child displays deferred imitation which is imitating the parent putting on make up or shaving after the parent has left for work -18 month old can wait as evidence by appropriate response of the taller to a parent who says just a minute -Connors think in terms of predictable routines of their daily schedule -When talking with the toddler the nurse should use time orientation in relation too familiar activities -Toddler understands your mother will be here after your nap better than your mother will be here at 2 o'clock -Enjoy opening drawers and doors and exploring the contents of cabinets and closets and generally wreck havoc throughout the house as well as exposing themselves to potential danger -Piaget, Preoperational stage of cognitive development characterizes second half of early childhood -Stage is divided into two phases the preconceptual phase 2 for years long and intuitive phase 4 to 7 years long -During preconceptual Fais child begins to use symbolic thought which is the ability to allow a mental image to represent objects or ideas -Mental symbols allow try to remember the pass and explain events that happened in the past -24 months they enter the preconceptual phase which ends at four years and during this phase they begin to think and reason at a primitive level -Two years old have a beginning ability to retain mental images -Allows them to internalize what they see and experience -Symbols in form of war can be used to represent ideas -Increasing amounts of playtime or spent pretending -A box may become a spaceship or a hat or pebbles maybe money or popcorn -Turn on properly grows vocabulary Symbolic play -Begin to think about alternative solutions to a problem and can't even consider the consequences of an action without caring it out such as touching a hot stove or running too fast on a slippery sidewalk -They're thinking is immature and limited and it's logic -Egocentrism animism irreversibility magical thinking and centration characterize preoperational thought of the toddler Preschooler> -By age 3 maturation of central nervous system contributes to the child's increasing cognitive abilities -Can retain a mental image of a loved one and can periodically think about that person -A picture can help children cool with separation by bridging the gap between the physical and mental image -Preschoolers ability to remember their parents and recognize their needs can be met even though your parents are not present enhances their ability to tolerate separation -Preschooler still engaged in animism And often endow innominate objects with life my qualities during play -A door may become a crying baby or a teddy bear may become a friend who listens x-Symbolic play important for emotional development because it allows the child to work through distressing feelings -Allowing your child to play with medical equipment after a painful procedure can be therapeutic -Orioles who have received injections may be found working out their feelings by giving their dolls lots of shots -During pre-conceptual face reality may be distorted by transductive reasoning -Preschool child reasons for in particular to particular rather than from particular to General and vice versa -Child can't understand that relationships exist and cannot be in the hole with respect to its parts -Preschool child has difficulty in focusing on the important aspects of a situation -Field dependency, Where a child thinks everything is important and inter-dependent -The preschooler may have difficulty falling asleep at night because the parent did not follow through usual bedtime routine -Objects routine and sameness are important for the preschool child -Second phase of Piaget's Preoperational stage the intuitive Phase, The tendency to center or focus on one part of the situation and ignore the other parts -The second phase of PIagets Preoperational stage the intuitive phase is characterized by Centration and like Of reversibility -Centration is a tendency to center or focus on one part of a situation and ignore the other parts -The child cannot understand logical relationships and is unable to focus on more than one aspect of a situation at a time -Child may not be able to follow in sequence of directions but will perform well if the directions are given one at a time -45-year-old shows irreversibility In thought -Cannot reverse a process or the order of event -Able to take a complex puzzle The part but have difficulty putting it back together -45-year-old also likes reversibility for mathematical processes -Can add three and one and get IV but reversing The problem would be too difficult -Period of rapid learning -Curious and wants to know how things work -Thinking is so magical and egocentric which focused on the self -Understand events only as these events affect them believing that everyone else has had the same experience -See my mom and distress may bring her a doll or assuming that it would come for the mother as it does the child -Believe that their thoughts are powerful enough to cause things to happen -Frighten them selves with some other ideas believing that they may become what they imagine they will be -Feel overwhelmed by cute when I sibling is hospitalized because they believe that their hostile feelings cause the siblings illness -Child might say I got sick because I was bad

Cognitive development

Cognitive development -Transitions to logical thinking from intuitive thinking of preschool years -Develops more efficient problem-solving ability and greater flexibility of thinking -Six and seven-year-olds remain in the intuitive thought stage (Piaget )Characteristic of older preschool children -IH8 years child moves into the stage of concrete operations followed by stage of formal operations at 12 years (Piaget) Intuitive thought stage> -6-7 years, thinking is based on immediate perceptions of the environment in the child's own viewpoint -Thanking still characterized by egocentrism, animism, In centration -Children cannot understand another's viewpoint form hypotheses or deal with abstract concepts -Child in the intuitive thought stage has difficulty forming categories and often solves problems by random guessing Concrete operational stage> -7-8 years enter stage of concrete operations -Learn that their point of you is not the only one and begin to differentiate their own viewpoints from those of peers and adults (Piaget) -Enables children to think more flexibly and to learn about the environment more accurately - Problem-solving becomes more efficient and reliable as a child learns how to form hypotheses -The symbolism becomes more sophisticated and children can manipulate symbols for things in the way They once manipulated things -Learns the alphabet and how to read -Attention span increases as they grow older facilitating classroom learning Reversibility> -In concrete operations -Can mentally retrace a process a skill needed for understanding math problems -Can take a toy apart and put it back together or walk to school and find a way back home without getting lost -Valuable tool for problem-solving -Can understand use of Clock time at eight years Conservation> -Learns that certain properties of objects do not change simply because their order form or appearance has changed -Example the child who has mastered conservation of mass recognizes that a lump of clay that has been pounded flight is still same amount of clay as when it is rolled into a ball -Can understand conservation of weight by answering the question which weighs more a pound of feathers or a pound of rocks -Simpler conservations like number in a mass or understood first -9 to 10 years understand weight -11 to 12 years understand volume Classification and logic> -Classify objects according to characteristics they share, to place things in a logical order, and to recall similarities and differences -Ability is reflected in school a child's interest in collections -They love to collect and classify stamps stickers cards -Your stand relationship of larger and smaller lighter and darker -Comprehend class inclusion the concept that objects belong to or than one classification for example a man can be your brother a father and his son at the same time -Move away from magical thinking they are skeptic and no longer believing in Santa Claus or the Easter bunny -Humor> -Increase mastery of language and beginning of logic enable children to appreciate a play on words -They laugh at incongruities and love silly jokes riddles and puns -Riddle and joke books make ideal gifts for young children - They use it as a positive coping mechanism for stress associated with painful procedures and life events

Discipline

Discipline -When it is used in a positive manner the child internalizes controls established by parental limits and begin to develop a conscience -Toddlers need and want discipline to feel secure -Have a little control over their behavior I need limits to learn how to behave and how to follow rules -Toddlers negativism intense emotions and curiosity put them at risk for injury -Usually unaware of consequences of their actions -Frightened by a lack of limits and will deliberately test their parents until they are showing how far they can go -From discipline promotes the development of Autonomy by giving a child a feeling of freedom within bounds -Toddlers repeat parental provisions to themselves while engaging in a forbidden activity -A toddler may walk over to an electrical outlet knowing that it is out of bounds and mumble no no hurt -Effective discipline techniques for children of this age include allowing natural and logical consequences, positive reinforcement for acceptable behavior and Diversion and time out -Teaching parents how to discipline their child helps avoid problems related to incorrect use of discipline -Parents must be consistent -Physical punishment such as spanking as one of the least effective discipline techniques and is discouraged -Preschoolers struggle to gain control over their strong inner impulses -To achieve this control they need limits set on their behavior -When limits are set child feels more secure and can explore the environment and try new rules in an atmosphere of freedom and safety -Limit setting helps child learn self confidence self control and in moral values -Child must be consistent discipline -Limits must be clearly defined in consistently enforced to be effective -To prevent confusion and anxiety the consequences of miss behaviors should be spelled out in advance and carried out immediately after miss behavior occurs -When a child is disciplined for misbehavior a simple truth full explanation of why the behavior was unacceptable should be given -Focus of the explanation should be on the behavior rather than on the child for example throwing toys could hurt someone is a better response than I don't want to be around you when you act like that or you're a bad girl for doing that -Time out, time in such as the mother periodically strokes the child's hair or rubbed his back when he is quietly playing on the floor near her while she talks on the telephone. The child who receive this type of reinforcement is likely to continue what he's doing and much less likely to interrupt the mother, Offer restricted choices he made drink your juice in the kitchen or you may go into the living room without your juice, diversion you must stop marking on the wall with crayons here mark on -this paper instead -Consistent positive reinforcement for desired behavior is a powerful tool -As a parent does not care or is too busy to enforce rules child will not internalize rules and will not feel guilty about breaking them

Ericksons psychosocial theory

Erikson's Psychosocial Theory Erik H. Erikson (1902-1994), inspired by the work of Sigmund Freud, proposed a popular theory about child development. He viewed development as a lifelong series of conflicts affected by social and cultural factors. Each conflict must be resolved for the child and adult to progress emotionally. How individuals address the conflicts varies widely. However, according to Erikson, unsuccessful resolution leaves the individual emotionally disabled (Erikson, 1963). Each of eight stages of development has a specific central conflict or developmental task. These eight tasks are described in terms of a positive or negative resolution. The actual resolution of a specific conflict lies somewhere along a continuum between a perfect positive and a perfect negative. Erikson (1963) describes the first developmental task as the establishment of trust. The basic quality of trust provides a foundation for the personality. If an infant's physical and emotional needs are met in a timely manner through warm and nurturing interactions with a consistent caregiver, the infant begins to sense that the world is trustworthy. The infant begins to develop trust in others and a sense of being worthy of love. Through successful achievement of a sense of trust, the infant can move on to subsequent developmental stages. Erikson suggests that the unsuccessful resolution of this first developmental task results in a sense of mistrust. If needs are consistently unmet, acute tension begins to appear in children. During infancy, signs of unmet needs include restlessness, fretfulness, whining, crying, clinging, physical tenseness, and physical dysfunctions such as vomiting, diarrhea, and sleep disturbances. All children exhibit these signs at times. However, if these behaviors become personality characteristics, the unsuccessful resolution of this stage is suspected. The toddler's developmental task is to acquire a sense of autonomy rather than a sense of shame and doubt. A positive resolution of this task is accomplished by the ability to control the body and body functions, especially elimination. Success at this stage does not mean that the toddler, even as an adult, will exhibit autonomous behavior in all life situations. In certain circumstances, feelings of shame and self-doubt are normal and may be adaptive. Erikson's theory describes each developmental stage, with crises related to individual stages emerging at specific times and in a particular order. Likewise, each stage is built on the resolution of previous developmental tasks. However, during each conflict, the child spends some energy and time resolving earlier conflicts (Erikson, 1963). Nursing Implications of Erikson's Theory In stressful situations, such as hospitalization, children, even those with healthy personalities, evoke defense mechanisms that protect them against undue anxiety. Regression, a behavior used frequently by children, is a reactivation of behavior more appropriate to an earlier stage of development. This defense mechanism is illustrated by a 6-year-old boy who reverts to sucking his thumb and wetting his pants under increased stress, such as illness or the birth of a sibling. Nurses can educate parents about regression and encourage them to offer their children support, not ridicule. They can provide constructive suggestions for stress management and reassure parents that regression normally subsides as anxiety decreases. Erikson's main contribution to the study of human development lies in his outline of a universal sequence of phases of psychosocial development. His work is especially relevant to nursing because it provides a theoretic basis for much of the emotional care that is given to children. The stages are further discussed in the chapters on each age-group.

Growth and development of school age child

Growth and development of school age child -Middle school child develop a sense of industry according to Erickson In learns the basic skills required to function in society -Child develops in appreciation of rules and a conscience -Child grows from egocentrism of early childhood to a more mature thinking -Ability to solve problems and independent judgments based on reason characterizes this new maturity - Is invested in the task of middle childhood learning to do things and do them well -Competence in self-esteem increase with each academic social and athletic achievement -The relative stability and security of middle childhood. Prepare the child to enter the emotional and physical changes of adolescents

Guidelines for disciplining a toddler

Guidelines for disciplining a toddler

Motor development

Motor development -During first few months after birth muscle growth and weight gain allow for increased control reflexes in more purposeful movement -One month movement occurs in a random fashion with the first tightly clenched -The neck muscle is weak and then head is large infants can lift their hands briefly -2 to 3 months and Vince can lift in at 90° From a prone position and can hold it steadily erect while in sitting position -Active grass been gradually replaces Reflexive grasping and increases in frequency as I hand coordination improves -Moral tonic neck and rooting reflex is disappear at 3 to 4 months -Primitive reflexes which are controlled by the midbrain disappear because they are suppressed by growing Cortical layers -Head control increases during third month -Fourth month head remains in a straight line with the body when the infant is pulled to a sitting position -Invented play with her feet by 4 to 5 months drawing them up to suck on their toes -Parents need anticipatory guidance about ways to prevent unintentional injury by baby proofing their homes before each motor development milestones reached -The nurse might explain infants grow and mature and very rapidly now is the time to baby proof the home before Marie turns over begins crawling in reaching for objects are doing this now you can prevent later injuries and worries -Put in six months motor development accelerates rapidly -Events of this age readily reach for and grasp objects -They can bear weight when held in a standing position in can turn from abdomen to back -By five months some infants rock back-and-forth as a precursor to crawling -6 months can sit alone leaning forward on their hands a.k.a. tripod sitting , this ability provides them with a wider view of the world and creates new ways to play - Infants of this age can roll from back to abdomen and can raise their hands from the table when supine -6 to 7 months transfer objects from one hand to the other and can grab small objects with the whole hand and insert them into their mouth with lightning speed -6 to 9 months infants begin to explore the world by crawling -Nine months most infants have enough muscle strength and coordination to pull themselves up and cruise around furniture these methods of mobility enable the infant to follow a parent or caregiver around the house -6 to 7 months infants become increasingly adept at pointing to make their demands known -Six month old infant grasp objects with all their fingers in a raking motion the nine month old he is or thumbs and four fingers fine motor skill called the pincer grasp, Provides infants with a useful yet potentially dangerous ability to grab insert tiny objects into their mouth's -Nine months can wave bye-bye and clap their hands together, can you pick up objects but I have difficulty releasing them on request -One year we can extend an object and release it into an offered hand moleskin balance well enough to walk when holding another person's hand but often resort to crawling as a more rapid and efficient way to move about -Increased ability to move about which objects and explore the world places in pins at great risk for accidents and injuries

Motor development in the toddler and preschooler

Motor development in the toddler and preschooler Toddler> -Learning to walk is the achievement of the toddler Phase -Child is in perpetual motion, seemingly compelled to pull up do you few steps for and repeat the process over and over obvious to bumps and bruises -Will repeat this performance hundreds of times until the skill of walking has been perfected -Most can walk alone by 15 months -By 18 months can walk well and try to run but fall often -At 15 months many become avid climbers - Chairs tables and bookcases present challenges and risk for injury -Parents have difficulty keeping toddler in a crib and decide to move them to a regular bed -Engage and perfecting fine motor skills -Hand I coordination improves with maturity and practice -Meal times are still messy -Most 18 month olds can hold a cup with both hands and drink from it without spilling but eating with a spoon is difficult -Most of the food conveyed in a spoon is spilled -Children a great deal of practice with a spoon before they can feed themselves without spilling -Both can feed by themselves with a spoon by their second birthday -At 18 months toddler enjoys removing clothing -By 24 months they can put on simple items of clothing but cannot differentiate friend from back -Can zip large zippers put on shoes in wash and dry their hands -Two-year-olds brush their teeth but need help removing Plaque -Increasing motor skills of a more independence in all areas of daily life -Feeding dressing play help the child to develop autonomy -Motor development in this age group is far ahead of development of judgment and perception -This difference in timing of development is different skills increases the risk for injury Preschooler> -Coordination and muscle strength increase -Brain size in nerve myelinization increase enabling the trailer to perfect fine and gross motor skills -Motor skills are less influence by environment than other areas of development such as language opportunities to practice may contribute a better motor skills -Before you all too often plays catch with a sibling or parent generally find playing Little League baseball as a seven-year-old easier than a child without similar experience -Handedness begins at three years and is usually clearly established by four years -Nurse encouraged parents to provide left-handed children with appropriate tools particularly left-handed scissors -Left-handed children should not be forced to use the right hands because coordination is usually better when they use the dominant side -I coordination good enough by age 5 for a child to hit nail head with a hammer -Increase coordination allows child to perform any self-care skills and become more independent -45 years, child is independent and can dressed eat and go to the bathroom without help -The older preschooler can usually be trusted to heed verbal warnings of danger

Nutrition

Nutrition -Ages 2 to 8 should consume 2 cups a day of fat-free or low-fat milk -Yogurt and cheese -That's from fatty acids such as fish nuts and vegetables oil's -Poultry fish and lean meat are good sources of iron -Low sugar breakfast cereals are sources of iron and vitamins -If milk remains the primary food it will replace foods rich in iron vitamins and minerals such as dark green leafy vegetables meats and legumes -Giving children a daily multivitamin is not harmful in general the child who is in healthy does not need vitamin Supplementation -The exception is vitamin D children should consume fewer than 33 ounces of milk or dairy products a day Solid foods> -By age 12 most are eating the same foods as the rest of the family child should be offered three meals and two snacks a day -I 3 to 4 child begins to use a fork -Child continues to develop fine motor skills in by the end of the preschool. Should begin to use a rounded knife for cutting -1 tablespoon of solid food per year of age -Likely to try new foods and eat nutritious meals in smaller portions are served -Who are the different textures color is consistencies taste in temperatures should be offered -Child should sit in a chair that allows easy access to the food -Big shorthanded spoons and forks allow these holders ability to eat successfully -Avoid foods that can be aspirated during toddler. -Soft drinks and candy should be discouraged -Sugar naturally present in breast milk has lactose and fruits as fructose in in grain as maltose -A diet with too much sugar can replace other more nutritious foods and increase tooth decay -Artificial sweeteners not recommended younger than two Age related nutrition challenges> -Food jags> -May want same food at every meal and suddenly reject the food completely -Mary fuse foods because of odor or temperature -Not like mixing foods -Does not seem to apply to foods such as pizza spaghetti and macaroni and cheese -Preferred juices to milk and water -Too much milk is not good but neither is too much juice which can replace other foods in nutrients -For toddlers and preschoolers juices should be limited to no more than 4-6 ounces a day -Parents and siblings should be careful our child abuse food and should be careful about making negative comments about food Physiologic anorexia> -Advise parents not to allow their child to fill up with snacks milk and juices -Small portions offered -Mealtimes should be pleasant and not times to discuss discipline problems or even a child poor appetite -Parents maintain a balance between ignoring child's nutritional intake and making it the focus of their parenting -Parents should focus more on their child weekly nutrition intake rather than daily intake Obesity risk> -Increase fruits and vegetables increase whole grains increase calcium and iron decrease solid fats sodium and sugar -Screening for overweight and obesity begins at two years -

Nutrition adolescence

Nutrition adolescence -Accelerated growth and learning your height weight and muscle mass and sexual maturation during adolescence increase teenagers nutritional needs including that for protein calories think calcium and iron -Periods of intense growth requires increased caloric intake and adolescent appears constantly hungry -Snacks and regular meals need to contain adequate nutrients to meet the bodies anabolic needs -Adolescence generally interested in nutrition and the effect food has on their bodies -Teenagers tend to be concerned about their weight complexion sexual development and acceptance by their peer - Age related nutritional challenges> -Foood habits are influenced by many factors -Happens at a time when the body has greater nutritional needs -Boys tend to have your nutritional deficiencies than girls because we taking more food and are less likely to be dieting -Soft drinks frequently replace milk -Fast foods in the nutrient junk food become the mainstay of adolescence diet -Social aspect of food consumption canes importance and may prefer to eat meals with Perez at social gatherings in restaurants of their choice -Nutritional guidance for adolescent> -Nurse understands growth and development to be successful in counseling adolescents and their parents about nutrition -Increasing need to be independent and make their own choices should go to the nurse in teaching nutrition -Adolescence should drink at least 3 cups of milk a day limit fats and avoid added sugars -I'm in vitamin D supervision future osteoporosis and girls require adequate iron and folic acid supplements *Factors influencing adolescent diet #-Busy schedule -Body image concerns which can lead to under eating -Skipping breakfast -Eating away from home -Eating fast food frequently -Beginning to buy and prepare own food -Peer pressure -Psychologic and emotional problems -Increase in the regular conception of energy drinks increase risk taking an adolescent population -Help in selecting nutrition fast foods such as salads with nonfat or low-fat dressing's grill chicken sandwiches pasta and nonfat yogurt -Fat and salt contents have been reduced and vegetable fats have replaced animal fats at some restaurants -Vegetarian diet is healthy for this population because of low fat aspect of the diet can prevent future cardiovascular problems -If they wish to follow a vegetarian diet there is Candices with planning food choices that will provide sufficient calories and necessary nutrients -Focus is on obtaining sufficient calories for growth and energy throw fruits vegetables whole-grain's nuts legumes seats tofu soy milk #-May need calcium and vitamin D deficient so it's important to intake dark leafy green vegetables and fortified drinks -Body image particular importance to adolescence -Media reinforce believe that thin is in -Hold them selves to standards set by entertainment and advertising world which emphasize fitness glmOur and sexuality -Fasting diabetic diet pills laxatives self induced vomiting fad diet's low calorie -Unsound nutritional habits altar growth and development

Psycho social development

Psycho social development -Infancy is a crucial. During which children develop the foundation of their personalities and their sense of self -According to Ericksons theory of psychosocial development infant struggle to establish a sense of basic dress rather than a sense of basic Miss trust in the world, caregivers, and themselves. If provided with consistent satisfying experience is delivered in a timely manner and Vince come to rely on the fact that there needs will be met and that intern they will be able to tolerate some degree of frustration and Discomfort until those needs are met -Sense of confidence is an early form of trust and provides foundation for a healthy personality -If infants needs or ignored or met any consistently Is adequate manner they have no reason to believe that there needs will be met or that their environment is safe -Eric's in states that without consistent satisfaction of these individual develops the basic sense of suspicion or miss trust -Freudian theory, Regards infancy as the oral stage -The mouth is a major focus during this stage -Observation of infants for a few minutes shows that most of their behavior centers on their mouth's -Sensory stimulation and pleasure as well as nourishment our experience thru their mouth -Sucking is an adaptive behavior that provides comfort and satisfaction well enabling infants to experience in exploring the world -As teething progresses the mouth becomes an effective tool for aggressive behavior Parents infant attachment> -Attachment is a sense of belonging to or connection with each other this bond between infant and a parent is critical to normal development and even survival -It's initiated immediately after birth and is strengthened by many mutual satisfying interactions between the parents and the infant throughout the first months of life -Example, noisy distress in infants signal a need such as hunger -Parents respond by providing food -Infants respond by quieting and accepting nourishment -Derive pleasure from having their hunger satiated In the parents room successfully caring for their children -Parents learn to regulate infant feeding sleep and activity through a series of interactions in these include rocking touching talking smiling singing in the infants respond by finding eating watching smiling sleeping -Inability or unwillingness of parents to meet needs of infants foster insecurity and satisfaction in the infants -Cycle of dissatisfaction established in which parents become frustrated as caregivers and have further difficulty providing for the infant needs -If parents adapt to the infant meet their needs provide nurturance then attachment is secure -Psychosocial development proceeds on the basis of a strong foundation of attachment -If parents personalities and abilities to cope with infant do not match then fence needs their relationship is considered at risk -Trust depends heavily on the quality of parental interaction the infant also needs consistent satisfying social interactions within a family structure -Family routines help provide this consistency -Touch is an important tool that can be used by our family members to convey a sense of caring stranger anxiety> -6-7 months, infants can differentiate between caregivers and strangers and to be wary of the latter -display an obvious preference for parents over other caregivers and unfamiliar people - anxiety, demonstrated by crying, clinging, And turning away from the stranger occurs when separation occurs -Behavior peaks at 7 to 9 months and during toddler hood -Stranger anxiety is normal and occurs because of cognitive development -Leaving them for short periods does no harm

Theories of language development

Theories of language development -Human language that has numerous characteristics that are not shared with other species of animals that communicate with each other -Humans language has meaning provide a mechanism for thought and permits tremendous creativity -Because language is such a complex process and involves such a vast number of neuromuscular structures brain growth and differentiation must reach a certain level of maturity before a child can speak -Language development which closely parallels cognitive development is discussed by most cognitive theorist is explain the maturation of thinking abilities however the process of how language develops remains a mystery -Passive or receptive language is the ability to understand the spoken word xExpressive language is the ability to produce meeting for vocalizations -In most people the areas in the brain responsible for expressive language or close to Motor centers in the left cerebral area that controls muscle movement of the mouth tongue and hands -Humans use various facial on hand movements as well as words to convey ideas -Crying is the infants first method of communication -These vocalizations quickly become distant an individual and accurately convey such states as hunger diaper discomfort pain and loneliness and boredom -Vowel sounds appear first as early as two weeks of age followed by consonants at approximately five months of age -By age 2 children have a vocabulary of roughly 300 words and can construct simple sentences -By age for children have gain a sense of correct grammar and articulation but several continents include i and r -For example the sentence the red and blue bird flew up to the tree might be pronounced by the preschooler ass do you where in blue bird flew up to the tree -The language of school-age children as well as concrete and much more articulate then that of the preschooler -School age children learn and understand language construction use More sophisticated language terminology and use varied meaning for words and write and express ideas and paragraphs and stories -Infants learn much other language from their parents -Children who are raised in homes were verbalization is encouraged and modeled 10 to display advanced language skills -In infancy receptive ability which is the understanding of language is more developed than expressive skills which is the articulation of words -This tendency which persist throughout life is important to realize when caring for children -In clinical situations nurses must communicate what is happening to their young patients by use of simple age appropriate words although the child may not be verbalizing understanding -Nurses in another health providers need to assess for any concerns about a young child's language development at each well visit -Parent concern or positive family history of language problems can help identify children who may be at risk for Sorters associated with altered expressive or receptive language and who might need a formal language evaluation

Unstructured play

-Children can control events ideas and relationships -Music therapy can we can give children choices to play instruments such as drums in bells or to join in while the music therapist lead songs and plays a guitar -Animal therapy is another popular type of plate or a child can interact with animals and their trainers

Physical growth and maturation of body systems

-Infants usually double or their birthweight by six months and triple it by one year of age -Average birth weight of 7.5 to 8 pounds you need to lose 10% of her bodyweight shortly after birth but regain birthweight by two weeks -During the first 5 to 6 months the average weight gain is 1.5 pounds per month -Next six months we increase 1 pound per month and weight gain in formula fed infants is higher than breast-fed infants -During for six months they increase their birth length by 1 inch per month in .5 inch over the next six months -Buy one year most intense increase their birth length by 50% -Head circumference during the first year is 1.2 cm a month -Posterior fun and now close to three months -Anterior fontanelle remain open until 18 months - —In addition to height and weight organ systems grow and mature rapidly in the infant -The infants organs differ from Those of older children and adults and both structure and function -The differences place the infinite risk for problems that may not be expected and older individuals -Resemble the immature respiratory and immune system's place the infant at risk for various infections in the amateur renal system increases the risk of fluid and electrolyte imbalances -Neurological system> -Brain growth occurs rapidly during the first year and they depend on nutrition and the function of other organ systems -By age one the brain has doubled its way with a major growth spurt occurring between 15 and 20 weeks of age and another between 30 weeks in one year -Synopsis and myelinization of nerves increase to contribute to maturation of the System during infancy -Primitive reflexes disappear as the cerebral cortex Thickens and motor areas of the brain continue to develop proceeding in cephalocaudal patterns: Arms first then legs Respiratory system> -In the first year of life the lungs increase to three times or wait and six times the volume at birth -In the newborn Alviola approximately 20 million and increased to 300 million by age 8 -The trachea remain small supported only buy soft Cartlidge -The size of the trachea and bronchi and bronchioles increase with age -Collapsible air passages leave infants vulnerable to respiratory difficulties caused by infection or foreign bodies -Eustachian tube is short and relatively horizontal increasing the risk for middle ear infections Cardiovascular system> -Undergoes dramatic changes in the transition from fetal to extrauterine circulation -Fetal Shauns clothes and pulmonary circulation increases drastically -The heart doubles in size and weight and Heart rate gradually slow's and blood pressure increases Immune system> -Imgur respiratory system in place as an infant a risk for respiratory infection -Immature immune system place as an infant a risk for infection -Immature renal system places the infant for fluid and electrolyte in balance -Transplacenal Of maternal antibodies supplement the infants week response to infection until 3 to 4 months -Breast milk transmits IGA protection -Do you lymphocytes also increase after birth -Immune system ventures during infancy maximum protection against infection is not achieved until early childhood -Immaturity places infant a risk for infection Gastrointestinal system> -stomach capacity is 10 to 20 ML with feedings it increases to 200 ML at one year -Enzymes needed for the digestion and absorption of proteins fats and carbs richer and increase in concentration -The newborn infants system is capable of digesting protein and lactose the ability to digest and absorb fat does not reach adult levels until 6 to 9 months Renal system> -Kidney mass increases during the first year of life -Glomeruli in large considerably during the first few months the glomerular filtration rate remains low -Because I'm functional maturity of the renal system the infant is at great risk for fluid and electrolyte in balance

Language development toddler and preschooler

Language development toddler and preschooler -Toddler> -Language is one of the most dramatic developments of early childhood -Most can verbally communicate by second birthday -Rate of language development depends on physical maturity and the amount of reinforcement that the child has received -Between 15 and 24 monthsmonths of age language ability rapidly develops -Understand many more words than they can say because receptive language with the child understands develops earlier and faster the speech -After 18 months mini children experience a sudden spurt in speech production and comprehension resulting in a vocabulary of 300 and more words at 24 months -24 to 30 months less ego centric and better able to consider another's point of view -AAP recommends screening for speech and language delay at eating in 24 months -Children of bilingual families who are twins or four firstborns may have slower language development -Language development depends on adequate hearing, delayed language can be seen in children who have had repeated ear infections or whoever had undiagnosed hearing loss -Parents can promote language development by talking to the children and incorporating teaching into Daily routines -Feeding bathing dressing going on outings to both new and familiar places offer opportunities for verbal interaction and the practice of growing language skills -Child is encouraged to express needs rather than have the parent anticipate and provide what the child wants before the child asked for it -Reading simple entertaining stories with colorful pictures provide quiet enjoyable times for toddlers and parents and enhance his speech and language development Preschooler> -Increase in language scale promote self control and increases their ability to direct and be directed -Maybe her talking to them selves about things that they have heard or been taught -The vocabulary increases rapidly from 300 words at two years to more than 2100 words at five years - Less than three years child grows from a toner and there's only a few words into a child who skillfully uses an extensive vocabulary -Three-year-old speaking short telegraphic sentences -Talk to themselves or to imaginary friends -Delightful characteristic of young preschoolers is the tendency to engage in line for your monologues regardless if anyone is listening or present -Self talk provide the child with opportunities to practice speech and is often accompanied by symbolic play -Buy for years children talk incessantly and 10 to boast and exaggerate -Enjoy rhymes in Philly ways to use similar words -Expect more detailed answers to their questions -May use speech aggressively and may use profanity to gain attention -Bad language should be ignored by the depriving the child of reinforcement of the behavior -Five-year-olds speak in sentences of adult link and use all parts of speech -Use proficient storytellers who produce elaborate tales for anyone who will listen -Tendency to mix fantasy with reality may be perceived by adults as lying -Can recite the days of the week and can name the seasons -It's important for parents to talk with the child and respond to the Childs a chance that communication -Reading to the child and making reading materials available can help build vocabulary and promote a lifelong love of reading -Watching educational programs or videos with their children may augment parents communication skills with their child -Spend a lot of time asking how and why questions often taxing parents patience -Short simple honest answers encourage vocab building and boost self-esteem

Play

Play -Play is those tasks done to us in oneself that have behavioral social and psycho motor rewards -Two adult observers children's play may appear on organized meaningless and even chaotic -Anyone who watches carefully quickly discover is that plate is a rich activity intricately woven With meaning and purpose -In adulthood and work is any activity during which one uses time and energy to create a product or achieve a goal -In childhood is similar to adult work and that it is undertaken by the child to accomplish developmental task and master the environment -It's an important part of the development process -Is how children learn about shape color cause effect and themselves -In addition to cognitive thinking play helps the child learn social interaction and psycho motor skills it's a way of communicating joy fear sorrow and anxiety

Piagets theory of cognitive develop,ent

Piaget's Theory of Cognitive Development Jean Piaget (1896-1980), a Swiss theorist, made major contributions to the study of how children learn. His complex theory provides a framework for understanding how thinking during childhood progresses and differs from adult thinking. Like other developmental theorists, Piaget postulated that children pass through progressive stages as they develop intellectually (Piaget, 1962, 1967). The ages assigned to these periods are only averages. Piaget (1962, 1967) describes these stages as follows. During the sensorimotor period of development, infant thinking seems to involve the entire body. Reflexive behavior is gradually replaced by more complex activities. The world becomes increasingly solid through the development of the concept of object permanence, which is the awareness that objects continue to exist even when they disappear from sight. By the end of this stage, the infant shows some evidence of reasoning. During the period of preoperational thought, language becomes increasingly useful. Judgments are dominated by perception and are illogical, and thinking is characterized, especially during the early part of this stage, by egocentrism. In other words, children are unable to think about another person's viewpoint and believe that everyone perceives situations as they do. Magical thinking (the belief that events occur because of wishing) and animism (the perception that all objects have life and feeling) characterize this period. At the end of the preoperational stage, the child shifts from egocentric thinking and begins to be able to look at the world from another person's view. This shifting enables the child to move into the period of concrete operations, where the child is no longer bound by perceptions and can distinguish fact from fantasy. The concept of time becomes increasingly clear during this stage, although far past and far future events remain obscure. Although reasoning powers increase rapidly during this stage, the child cannot deal with abstractions or with socialized thinking. Adolescents normally progress to the period of formal operations. In this period the adolescent proceeds from concrete to abstract and symbolic and from self-centered to other centered. Adolescents can develop hypotheses and then systematically deduce the best strategies for solving a particular problem because they use a formal operations cognitive style. Newer theories of adolescent cognitive development suggest that appropriate adolescent decision-making is based on a combination of experiential and analytical thinking (Dansereau, Knight & Flynn, 2013). This theory may explain why some adolescents appear to have entered the period of formal operations and others have not, or why adolescent thinking and decision-making varies according to how they process their experiences at a given moment in time. Nursing Implications of Piaget's Theory Although other developmental theorists have disputed Piaget's theories, especially the ages at which cognitive changes occur, his work provides a basis for learning about and understanding cognitive development. Piaget's theory is especially significant to nurses as they develop teaching plans of care for children. 69 Piaget believed that learning should be geared to the child's level of understanding and that the child should be an active participant in the learning process. For the child's optimal and active participation in learning about health or illness, nurses need to understand the different cognitive abilities of children at various ages. However, nurses should also assess each child's cognitive ability and readiness to learn, even if a child has not yet reached the expected age for a particular stage of cognitive development, because many children are capable of learning concepts more advanced than their age would suggest. Conversely, some children who might be expected to understand health issues might not have the literacy capabilities to do so (Lambert & Keogh, 2014). Nurses also need to know how to engage children in the learning process with developmentally appropriate activities. Because illness and hospitalization are often frightening to children, especially toddlers and preschoolers, nurses need to understand the cognitive basis of fears related to treatment and be able to intervene appropriately

Psychosexual development, hormonal changes and sexual maturation

Psychosexual development, hormonal changes and sexual maturation -This correspond to Fred's final stage of psychosexual development the genital stage -Genital stage begins with production of sex hormones and maturation of reproductive system -Sexual tension and energy are manifested in development of sexual relationships with others and sexual gratification is sought -Read theory suggests that personality development is related to psychosexual development with an emphasis on aggressive and sexual impulses as determining factors of personality -Fruits theory about male dominance, sexual repression and oedipus and Electra Complexes make psychosexual theory of development highly controversial even today -Girls ridge physical maturation before boys with onset of menstruation -Menarche between nine and 15 years -Black and Hispanic girls begin puberty before white girls -Overweigh Or obese affect timing of puberty -Reproductive maturity reached 2 to 5 years after start of menstruation -Female sex hormones gradually increase and ovulation occurs in menstrual periods become regular -Diet exercise and hereditary factors influence adolescence height weight and body build -Physical growth of boys and girls related to sexual maturation and occurs in a predictable sequence -Secretion of sex hormones estrogen and girls and testosterone and boys stimulate development of breast tissue pubic hair and genitalia -Purity brings our growth spurt changes in body composition and development of primary and secondary sexual characteristics in both sexes -Big boys puberty is delayed if testicular enlargement or pubic hair development has not occurred by age 14 -Absence of breast-feeding or pubic hair development and girls by 13 is reason for referral -Delayed puberty may be caused by chronic illnesses no nutrition extreme exercise and hypothyroidism Female sexual maturation> -Begins with appearance of breast buds which is first sign of ovarian function -Thelarcge occurs age 8 to 11 followed by a growth of pubic hair -Growth spurt reach during thelarche Usually in tanner stage two or three -When are your growth slows and menarche begins one year after growth spurt - African sweat glands reach signatory capacity in stage three or four -With increasing her mono activity girls develop a more adult body contour -breazt mature nipples project more and pubic hair extensions to medial thighs at stage5 Male sexual maturation> -First sign of puberty changes in boys is testicular enlargement in response to testosterone secretion which occurs in stage two -Slight pubic hair present smooth skin on scrotum -Testosterone increases in the penis testes in scrotum enlarge -Growth spurt occurs during stage is three and four and voice deepens in cracks as cartilage in the larynx enlarges -Armpit hair develops and apocrine sweat glands secrete to strress -Skin surface bacteria metabolize secretions from apocrine glands and body odor develops -Gynecomastia no breast enlargement may occur during early early adolescence and maybe unilateral or bilateral -The breast tissue will decrease over time -Stages four and five rising levels of testosterone can cause sebaceous glands to enlarge and excessive sebum May result in Acne -Who is continue to deepen facial hair appears at the corners of the upper lip and chin and ejaculation may occur -Nocturnal emissions of seminal fluid or wet dreams are a normal occurrence -Stage five Jenna tow maturation complete, spermatogenesis established, facial hair present on fees and mail physique is adult like

Psychosocial development

Psychosocial development Development of sense of industry> -Ericsson describe essential task of the school-age years as development of sense of industry -Child is prepared for this task with a secure sense of self a separate from love ones in the family -Should have learned to trust others and should have developed a sense of autonomy and initiative during proceeding years -Replace his fantasy with work at school craft stores hobbies in athletics -Enjoy taking new task and completing them -Purpose for activity leads to a sense of worth and competence -Learn skills that they will need later to complete in the adult world -Presence fundamental attitude toward work is established during this phase Fostering self-esteem> -Negative component of this development stage is a sense of inferiority (Erickson) -If child can't separate psychology from parent or if expectations are set to high for the chow to achieve feelings of inferiority develop -If Chata believes success is unattainable confidence is lost and child will not take pleasure in attempting new experiences -Those who have this experience will then have a pervasive feeling of inferiority and incompetence that will affect all aspects of their lives -Those who lack a sense of industry has a poor foundation and mastering the task of adolescence -Every child wiill feel deficit or inferior at some thing -The task of caring parent or teacher is what identify areas in which a child is competent and to build on successful experience is to foster feelings of mastery and success -Approval and a steam of those outside the family especially Peers become important -Learn that their parents are not infallible -Begin to test parents authority and knowledge the fluids of teachers and adults is felt more and more -Peer group becomes child's major socializing influence -Insta prefer activities with friends then activities family -Child becomes more dependent increase in time with friends and away from family -Six and seven years old children form friendships on the basis of who lives nearby who has toys that they enjoy -9 to 10 years friendships based on emotional bonds warm feelings and trust building experiences -Children learn that friendship is more than just being -Children at 11 and 12 years as well to their friends out and sharing problems and giving emotional support -Form friendships with peers of the same sex -Friends teach children skills they will use in future relationships -They learn a body of rules sayings and superstitions -Rules are important for children because they provide predictability and offer a security -Learning the saints jokes and riddles is an important part of social interaction - —Become sensitive to the norms and values epic peer group because pressure is to conform is great -Find that it is painful to be different -Pure approval is a strong motivating force and allows the child to risk disapproval from parents -Informal clubs in 67 and eight-year-olds -Membership changes frequently is based on interest such as baseball or riding bicycles -Children learn interpersonal skills such as sharing cooperation and tolerance -Clams a month older children are more structured characterized by secret codes rituals and Rigid rules -Club may be formed for the purpose of exclusion -Scouts or Girl Scouts foster self-esteem and competence

Emotional Outlet play

-Often called dramatic play -Child acts out or dramatizes real life stressors -Include emotional stressors such as abuse or neglect or a painful physical stressor such as a bone marrow aspiration -The child who has been sexually abused might not be able to communicate the experience verbally but may use it anatomically correct doll to show what happen -Terminally L children have been reported to use plates each other stories into express thoughts and feelings an important part of the emotional healing process for children and parents -Mini commercial capture toys are available for dramatic play -Injection play appropriate for the child who has to undergo frequent blood work injections IV therapy involving syringes and needles -If a needle is used for this type of activity safety easier most importance and the nurse should assess the child's growth and development level before using this type of directed play -Adult is always present of a needle is used -Child can give Don injection and work through anger and anxiety -Wooden hammers peg boards from Bas boxing gloves are avenues for a release of stress or anger

Functions of playing

Functions of playing -Play contributes to physical cognitive emotional and social development -Physical development in play> -Aids in the development of both fine and gross motor activity -Children repeat certain body movements purely for pleasure in these movements intern aid in the development of body control -Example an infant Wolfers hit a rattle then will attempt to grasp it and eventually will be able to pick up that same rattle -Next to infant will shake the rattle or perhaps bring it to the mouth -The parent and child may make a game of repeating sounds such as mama or data which increases the child's language ability -Repeating rhymes and songs can be a fun way for children to increase Their vocabulary -Children love to color on a paper with a crown and will scribble before being able to draw pictures into color -This is the child with eventually learning how to write letters and numerals Play and cognitive development> -Once a child has learned a general concept further experiences with that concept expand from that beginning knowledge -Paget gave the example of an infant learning to swing in object and then subsequently swinging other objects -This could apply for example two things to be eaten read or ridden -Progression takes place as a child begins to have certain experiences does believe and understanding the surrounding world -Children increase their problem-solving abilities through games and puzzles -Pretend play can stimulate several types of learning -Language abilities are strengthened as a child model significant others in role-playing -The child must organize thoughts and be able to communicate with others involved in the play scenario -Children who play house create elaborate details of what the characters do and say -Children also increase their understanding of size shape and texture through play they begin to understand relationships are the attempt to put a square peg into a round hole for example -Books and videos increase a child vocabulary while increasing understanding of the world Play and emotional development> -Children and a anxiety-producing situation are often helped by role-playing -Play can be a way of coping with emotional conflict -Can be a way to determine what is real and what is not -Children may escape through play entire world of fantasy and make believe to make sense out of me sometimes senseless world -Can increase a child self-awareness as an event or situation is explored the role-playing or symbolic play -Our significant others and children slimes respond to their initiation of play children begin to learn that they are important and cared for -Whether the child initiates the play or the dog does when is significant person plays a boardgame with the child shares a bike ride plays baseball read the story the child gets the message you are more important than anything else at this time and this increase is a child's self-esteem Play and social development> -The newborn infant cannot distinguish self from others and is narcissistic -As the infant begins to play with others and things realization of self and others begins to develop -The infant begin to experience the joy of interacting with others in soon initiates behavior that involves others -Infants discover that when they coo their mothers Coo back - Children will soon expect this response and make a game of playing with their mothers -Make-believe allows the child to try a different roles when children play restaurant or hospital the experiment with rules that govern the settings -The children learn boundaries taking turns teamwork in competition -Also learn how to negotiate with different personalities and their feelings associated with winning and losing and they learn to share and take turns -Play and moral development: -Children engage in play with their peers and their families they begin to learn which behaviors are acceptable and which are not -Quickly they learn that taking turns is rewarding and cheating is not -Group place is a child and recognizing the importance of teamwork sharing and being aware of the feelings of others

Psychosocial development

Parents often expressed concern about such behavior but the nurse helps parents handle the situations by explaining that self comforting behaviors are normal for this agePsychosocial development Toddler> -Developing a sense of autonomy giving up the comfort of dependence enjoy during infancy -According to Ericsson the toddler is struggling with the developmental task of acquiring a sense of autonomy wow overcoming a sense of shame and doubt -ToddlersDiscover that they have a welder on and that they can control others -Asserting their will of their own And insisting on their own way often lead to conflict with Thursday love whereas submissive behavior is rewarded with affection and approval -Experience conflict because they want to assert their own will but do not want to risk losing the approval of loved ones -If they continue to practice dependent behavior doubt related to abilities developed -We feel shame for independent impulses especially a frequent punishment is associated with their actions -Learns which behaviors gain approval and which results in censur and punishment -Two-year-olds don't have a Conscience But avoid punishment by controlling their behavior -Right and wrong are determined by the consequences of actions -The months toddler's begin to demonstrate their developing autonomy with two almost universal behaviors and negativism and ritualistic Behaviors Negativism in the toddler> -Dramatic expression of independence -Favorite word is no -Can't distinguish between requests and directives and seems to believe that saying yes would mean giving up free will -Seems to delight in this test of Wills Within the parent -May result in screaming kicking hitting biting or breath holding -Often interpret the child's negative behavior as being bad or stubborn -Can help parents understand their toddler's behavior as an important sign of the child's progress from dependence to autonomy and independence -General permissiveness is not recommended too much pressure and forceful method of control often lead to defiance tantrums and prolong to negative behavior Ritualism and importance of routine in the toddler> -Helps the child venture out and away from the safety of parents by ensuring uniformity and security -Allows a toddler to have a sense of control -Feels more confident with a secure homebase -Insist on sameness -Milk may have to be poured into the same cup parents may have to sit in the same chairs at dinner time and a routine may have to be followed countless times through the day -Maybe an able to go to sleep unless a bedtime ritual is followed exactly -Child may experience distress of the routine is not followed exactly -Hospitalization are difficult for the toddler -Incorporate the child to usual routine rituals and routines from home and into nursing care activities -It gives a toddler some sense of control and security and feelings of helplessness and fear Separation anxiety in the toddler> -Peaks in toddler phase - Difficulty differentiating their own feelings from those of their parents -They fear that their mothers also want to leave them -May strike out independently across the room only to rush back into years to the mother as if the child or frightened and angry with the mother for leaving -Apparently fine talking on the telephone without interruption or even going into the bathroom without being followed virtually impossible -Brief separations are acceptable to a toner if it's their idea with the parents departure may cause desperate clinging and crying -Hide and seek help the child master fears of separation -Repeating separation can help the toddler overcome anxiety associated with separation -Being left with a stranger is stressful -Should be told honestly about a separation shortly before it occurs -Reassure the child of the parent coming back -One parent returns off then toddler shoes anger due to the parent leaving them -Or ignore parent by focusing on play -Tolerating separations from parents is an important developmental task for the toddler -Transition objects such as a favorite blanket or a toy provide comfort in stressful situations such as separation illness and at bed time -Objects help children make the transition from dependency to autonomy -Colors may become so attached to an object that they can hardly bear to part with it even for a brief time while it is being laundered -This behavior is a normal growth and development milestones and parents should show plenty of affection and attention to help the toddler cope -Advised to leave the toddler briefly at first until delay extended separations until the toddler can handle them better Play: in the toddler> -Serious business to the toddler it is a child's work -Hours are spent each day and play perfecting fine and gross motor skills learning to control and urges and gaining self-esteem -Play during this. Reflects the ego centric toddler's developmental level -Toddler engages in parallel play in which children play alongside but not with other children -Frequently grab toys away from other children or me hit or fight to obtain a wanted toy -They do not realize that they are hurting the other child and feel no shame for aggressive actions -Imitating and acting out every day life is common in the toddler -Large muscle play house the toddler vent frustrations dissipate excess energy -Encourage parents to play with their toddlers and provide opportunities for the toddler to play with other children -Teach About child proofing and checking the house on a daily basis -Toys mess be strong and save and two large to swallow or place in the ear or nose Psychosexual development in the toddler> -18 months they enter freuds anal stage -Fred theoruzed that a child Focus on the mastery of bowel and bladder function and their attention is directed to the genital area -Even before 2 children are aware of their own gender begin to develop a sense of gender identity -Buy 2 1/2 or three years toddlers can correctly identify an atomic pictures of boys and girls -Jenner identity not completely established until five years when they understand gender is permanent -Begin to be aware of expected general behaviors at an early age -Buy three most show an awareness of gender roles stereotypes and 10 to imitate same gender parent during play -Gender identification continues throughout early childhood as a child incorporates the attitudes rules and values of the same gender parent -Children behave according to adult expectations -Learned behavior by reinforcement and punishment as well as by imitation -If a boy repeatedly here is that boys do not play with dolls he will Spohn such girl toys and will play with toys that his parents considered masculine to gain their praise and approval -Nurses support the parents and their choice of toys and activities for their child -Sex play and masturbation are common among toddler's -Nurses reassure parents that self-exploration of another toddler's body is normal behavior during early adulthood -Parents should respect the child's curiosity as normal without judging the child as bad -Child should we tell that touching private part is something that is done only in private -When parents discover children involved in sex play casual Lee telling them to dress and directing them to another activity can limit six play without producing feelings of shame or anxiety -Explain to parents that positive attitude Towards sexuality are learned from parents who are comfortable with their own sexuality -Yeah children learn about their bodies and a place and explore a atomic differences -Ask questions about where babies come from and why honest and straightforward answers are use the correct terminology satisfy that Tyler's curiosity and lay the foundation for a healthy sexual attitude *Important task for the toddler. Phase -Recognition of self as a separate person with own will -Control of impulses and acquisition of socially acceptable ways to communicate wants and needs -Control of elimination -Toleration of separation from the parent Preschooler> -Critical period for development of socialization -Meet opportunities to play with others to learn communication and social skills -Inappropriate guidance to learn acceptable behavior -Cording to Ereckson the preschoolers developmental task is to achieve a sense of initiaive - The preschooler is busy learning how to do things and takes great pride in new accomplishments -If the child act inappropriately or is repeatedly criticized or punished for attempts to explore and learn feelings of guilt and anxiety shame and fear may result -For example an adult may comment that's nice but it would look better if you did it this way because a child to feel inferior -Such septal criticism I can make the child reluctant to try new activities -A feeling of inferiority may develop if adults are always doing things for the child rather than encouraging independence -Childhood is not achieve a sense of initiative will feel defeated angry and afraid of people and new situations -Nurses help preschoolers gain a sense of initiative by teaching parents the importance of providing the child with opportunities to explore and I save stimulating environment -Adults encourage the preschoolers imagination and creativity and she praise appropriate behavior Play in the preschooler> -Learning to relate to age-mates is another developmental task -Need experience playing with other children to learn how to relate to other people -Three rolls capable of sharing and likely to Do so than toddlers -Orioles tend to be more argumentative and less generous with playmates -Behavior may appear to be a step backwards parents it's actually a sign of growth because for yawls feel more secure in a group in our testing their roles and communication skills -Five-year-old enjoys playing with other children and generally play with another child for longer periods before arguments develop -Between three and five years enjoy parallel and associative play -Learn to share and cooperate called cooperative play as a play in small groups -Learn simple games in rules language concepts and social roles -Please often imitativemdramatic and creative -Various roles explored through play as children imitate significant adults -Enjoy dress up clothes housekeeping toys doll houses that encourage pretending -Tricycles and climbing toys helped develop muscles in coordination -Enjoy materials for cutting pasting and painting -Create materials stimulate imagination and fine motor development -Immaginary friends common age 3 -Boundaries between reality and fantasy are blurred and pretend can seem real especially during play -Imaginary friendsServe many purposes -May take the blame when the child misbehaves allowing the child to save face one feeling guilty about a certain Certain behavior -Maybe companions during lonely times -We accomplish a task with which the child is struggling or allow the child to practice roles -Example the child my schools in imaginary friend and give punishment just as a parent would Psychosexual development in preschoolers> -Sexual identity and body image are developing -Sexual curiosity and explorations our normal -Curious about an atomic differences and seek to investigate them -Show interest in the differences between sexes and often compare their bodies with those of others -Play doctor and hiding with a friend to investigate an atomic differences are common activities during the preschool period -Nurses reassure parents that the child is simply learning about his or her body into direct the child to another activity -Interested in where they come from and how babies are made -Parents should assess with the child those into determine why the child is asking -Parents should answer honestly and matter-of-factly -Positive signs of physical and emotional intimacy between parents and a positive signal to the child -Warm excepting matter-of-fact attitude towards sexual partners promote a positive healthy perspective in children -Parents green atmospheres acceptance in the early preschool years and the first questions arise -Masturbation common and increases when the child is under stress -Parents often expressed concern about such behavior but the nurse helps parents handle the situations by explaining that self-comforting behaviors are normal for this age -The para discovers child masturbating simple redirection of child attention without punishing shaming reprimanding is best children should be taught that charging generals in public is not appropriate -Sense of rivalry with same gender parent develops -Preschool boys commonly compete with their dad for attention of their moms -Girl may do the same with their moms -Rivalry is usually resolves early in the school age. As child identify strongly with the same gender parent -According to Fred theory the Oedipal Stage is resolved when the child strongly identified with a parent of the same gender -And single parent families child should have a friendly stable relationship with the adult -By age 3 children no gender differences Spiritual and moral development and preschoolers> -Learning between right and wrong is another important task -According to Kohlberg Children between four and seven are in the second stage of the preconventional level of moral development and in this stage children obey rules out of self interest -Believe that if the consequences of an action or personally advantageous the action is rightBelieve that if the consequences of an action or personally advantageous the action is right -Begins to use self-control to resist temptation and tries to be good to avoid feelings of guilt -Determine right from wrong by the consequences of disobeying their parents rules have a little understanding of the reason for a rule -I'm here to parents rules deciding whether to break a rule on the basis of the resulting punishment -Have difficulty applying rules in different situations -Child may know that hitting is wrong but may not understand that hitting another child at daycare is also wrong -Preschooler is egocentric understanding another's viewpoint is difficult -Child begins to develop a conscience as a result of consistent rewards for good behavior and punishment for bad behavior -Preschool child concept of God is concrete -Family is religious beliefs and customs such as bedtime prayers mill time grease in the Bible stories are important to preschoolers -Such a ritual practice in an atmosphere of love can be deeply meaningful and comforting to children of this age

Adolescent sensory development

Add a lesson sensory development -Their eyes and ears fully developed may have occasional minor infections in the eyes and ears and sinuses the sensory system remains healthy -Myopia may occur in early adolescence between 11 and 13 years often requiring frequent changes in corrective lenses -Due to increased participation in sports and outdoor activities there at risk for I injuries -They should always be required to wear safety or a protective equipment when competing in sports or participating in any activity that may compromise Eye safety

Critical periods

Critical periods -After birth critical or sensitive. Exist for optimal growth and development -Similar to times during embryologic in Fetal life In which certain organs are formed in our particularly vulnerable to injury critical periods are blocks of time during which children are ready to master specific developmental task -Children can master task outside these critical. But some tasks are learned more easily during particular periods -Factors affect a child sensitive learning periods such as injury illness and malnutrition -He's sensitive. For learning to walk seems to be during the latter part of the first year and the beginning of the second year -Children seem to be driven by an irresistible urge to practice walking and display great pride as they succeed -A child who is immobilized for the treatment of a orthopedic condition from age 10 months to 18 months may have difficulty learning to walk -The child can learn to walk but the task may be more difficult then for other children

Dental care

Dental care -Most toddlers have complete set of 20 deciduous teeth By the time they are 30 months old -Rule of thumb to assess number of teeth is the age of the toddler in months -6 -One tooth usually rubs from each month of each past six months up to 30 months of age -Permanent teeth classifying during toner. Long before they are visible -The teeth play in important role in growth and development of the jaw and face and in speech development -Premature loss of the teeth complicates eruption of permanent teeth often leading to malocclusion - —Parents are responsible for cleaning their teeth to remove plaque -Children and courage to brush teeth after parents have clean them -Watching parents brush their teeth can be motivating -Small soft nylon bristle brush works best -Optimal access and visibility are provided his parents sit on the floor or bad with the child's head and parent lap -Lesson three years Kinsmere a small amount of fluoride toothpaste -After three years P sized amount appropriate -Brush teeth after every meal and at bedtime and flossing to remove plaque -Fluoride makes tooth enamel resistant to acid attack preventing DEcay -Or a fluoride prescribe for children without access to a community fluoridated water source -Does a fluoride supplementation 6 months to 3 years -Bacteria organisms contributed to Tooth decay and can acquire them from their mother -Should see the dentist by six months after First primary to the reps in no later than 12 months -Enamel on primary teeth is dinner then on permanent teeth preschoolers are prone to destruction from decay -The distance from the tooth surface to the pope is shorter also so tooth abscess can occur rapidly -Untreated carries can lead to a pain abscess formation in for digestion because of ineffective chewing -Many parents don't realize that the deciduous do youth are lost early and the remaining teeth may drift out of position walking proper irruption of the permanent teeth and leading to malocclusion -Preschoolers can usually brush their own teeth -Short back-and-forth and up-and-down strokes are easiest for the child to manage

Developmental assessment

Developmental assessment -The nurse misuse knowledge of theories of growth and development to create plans of care for both healthy and ill children #-A list of strengths and problems related to growth and development is generated Interview> -The nurse asked questions about the child's cognitive, language, motor, emotional development -The parents emotional state, level of education and culture must be considered when information is gathered -The nurse my use the following question and statements we are interviewing the parents have it for your child such as what is your child like to do at home or does your child know the days of the week or describe your child's typical day or does your child attend preschool or can your child throw a ball -The nurse assesses the child's ability to think through situations and to communicate verbally -How the child interact with other children and adults can be a measure of cognitive abilities -The number type Lane appropriateness correct use of words and sentences are also noted -Carefully observing the child in various situations including play provide valuable information about cognitive development -Emotional development> -From Eric's in theory it is expected that a Forio child major conflict would be developing a sense of initiative rather than a sense of guilt however if the child is hospitalized regressive behaviors might be exhibited if the anxiety of hospitalization becomes overwhelming -Questions directed to parents could help validate interferences about the child psychosocial development such as what type of activities does your child like or how does your child get along with other children or how does your child handle stressful situations is the behavior exhibited your child usual behavior -Nurse can also get information from careful observation of a child who is hospitalized and should know how the child deals with pain procedures and separation from parents

Enhancing cooperation through play

Enhancing cooperation through play -Children with illnesses that require unpleasant or Painful therapies often are uncooperative -Developing a plan that will stimulate and engage such a child in the activity is a challenge -Nurse should include age appropriate growth and development activities when planning care -School age child who loves competition and games are more likely to increase range of motion of an arm if points can be made each time a foam ball is thrown through a hoop -Allowing the child to blow bubbles a whistle or a pin wheel or to stimulate blowing out the nurses penlight can enhance deep breathing exercises -Range of motion done by throwing foam balls bean bags and paper balls -Child who needs to increase intake sometimes to be motivated to drink more fluids if a graph shows amount taken in and child receives a reward when A selected goal is reached -Colorful stickers baseball cards small toys special pencils can be used as rewards Unstructured

Evaluation of play

Evaluation of play -Therapeutic play should be reflected in the child's nursing care plan

Exercise and activity adolescents

Exercise and activity adolescents -Regular in exercise in Hanses physical and emotional development and promotes healthy sleep patterns -Healthy diet and exercise habits formed during adolescence can follow into adulthood and significantly reduce risk of cardiovascular disease -Adolescence is ideal time to initiate an exercise program in there as a team sport or as an individual activity -Vigorous exercise for at least 60 minutes daily -Gradual fitness in warm up and cool down sessions encouraged

Factors influencing growth and development

Factors influencing growth and development Genetics> -Genetic potential is affected by many factors. Environmental influences how in to what extent particular genetic traits are manifested Environment> -Both physical and psychosocial is a significant determinant of growth and development outcomes before and after birth -Prenatal exposure's which include maternal smoking alcohol chemical exposures infectious diseases diabetes can affect the developing fetus -Socioeconomic status mainly poverty has the effect on developing child -Imported toys and other equipment for children can pose hazards particularly if they have multiple small pieces or components with high concentrations of lead or lead paint -Immature and rapidly developing tissue in multiple body systems especially the neurologic system increases the risk for injury from exposure to low water level environmental toxins -Increased metabolic rate and growth which necessitate a higher intake in relation to body mass of food and liquids result in a higher concentration of ingested toxins -More rapid respirations increase inhalation of air pollutants -Larger body surface area and Enhances. absorption through the skin -Developmental behaviors such as mouthing or playing outdoors increase the risk for hazardous ingestion from hand to mouth transfer -Decreased ability to metabolically clear ingested toxins -Environmental toxins can be passed to an infant through breastmilk -Avoid sun exposure, secondhand smoke or air politicians, lead in the house, lead and toys, mercury in foods, use of pesticides in gardens in a playground equipment, pest in test decides, Radon will provide parents with the information they need to reduce risk -Hand hygiene -Nurses perform a brief or expanded environmental health screening AAP -I am concerned that toxic chemicals are not being regulated to the extent required to protect children and pregnant woman -Recommend revisions to the toxic substances control act that would be his decisions about toxic chemical exposures on a reasonable concern for harm especially their potential for harm to children in the pregnant woman -Recommends increased funding of evidence-based research to examine the effects of chemical exposures on children -Increase focus on global climate change and it's effects on children's health -Climate change affects air pollutants water quality environmental temperature weather and Vector habits -Poor children could experience increased respiratory conditions from food supply and vectorborne illnesses -The AAP policy on global climate change recommends educating parents and politicians and it's effects on children advocating for decreased toxic emissions reducing the carbon footprints of buildings and decreasing greenhouse gas emissions Culture> -How the culture affects children performance on assessment test -The child cultural and ethnic background must be considered when assessing growth and Development -Standard growth curve math test do not necessarily reflect the normal growth and development of children of different cultural groups -Growth curve is for children of various racial and cultural backgrounds are increasingly available -Nurse researchers another conduct studies to determine the effectiveness of measurement tools for culturally diverse populations Nutrition> -Children are growing consistently I need continuous supply of the nutrients as it plays an important role throughout -Need more nutritious food and rip proportion to size and adults do -Children's diet and physical activity patterns can forecast the risk for later obesity -Major nutrition factors of concern include inappropriate food advertising directed toward children, decreased access to affordable foods, ready availability of unhealthy sweetened beverages, free drinks, lack of breast-feeding support, providing appropriate portion sizes, many parents cannot adequately controlled with their children are being fed because so many children eat at least one meal away from home Health status> -Inherited or acquired disease can affect the delivery of nutrients hormones or oxygen to organs and can also affect organ growth and function -Disease states that affect growth and development include digestive or Malabsortive of disorders, Sorry illness heart defects and metabolic disease Family> -The special bond and influence of the family on the child there can be no separation of a child from the family in the healthcare setting -Example, miniature anxiety and Child know sometimes attempt to reduce parental anxiety which may reduce the stress of the child -Changes in the family can influence on children develop due to marriage birth divorce stuff new roles and responsibilities -Population shifts migration change our children are raised Parental attitudes> -Education, childhood experiences, financial pressures, marital status, available support systems influence parental attitudes -Affected by the child's temperament or the child is unique way of relating to the world -Different temperaments affect parenting practices and have a bearing on whether a child unique personality trait develop into assets or problems Child-rearing philosophies> -Influence our children grow and development -Example, well educated well-read parents often provide their children with extra stimulation and opportunities for learning beginning at a young age -The enrichment includes extra parental attention and interaction not necessarily expensive toys -Development progress is best when children have access to in Riched opportunities for learning -Other parents may not recognize the value of providing a rich learning environment at home then I'll have time and children of these parents may not progress at the same rate as I was raised in a more enriching atmosphere -Important port point for parents to remember is that children must be ready to learn -If motor and neurologic structures are not mature a task related to those structures can be frustrating for both child and parent for example a child who is six months old when I'll be able to walk alone no matter how much time and effort the patient expends -12 to 14 months a child usually is ready to begin walking and will do so with ease of giving opportunities to practice Theories of growth and development> -No theory can adequately explain the wondrous journey from infancy to adulthood -Each theorist contributes a piece of the puzzle -Theories are not facts for nearly attempts to explain human behavior

Adolsescnet physical growth and development

Girls experience budding of breast followed by pubic hair -One year after breast development high increases rapidly until it reaches its peak -Growth in height in girls stops 2 to 2.5 years after menarche -Boys experience testicular enlargement proximately one year by penile enlargement -Pubic hair proceeds growth of penis -Growth spurt in boys occurs later than in girls between ages 10.5 and 16 years and ending between 13.5 and 17 years -Growth continues at a slower pace Are usually stops between 18 and 20 years of age -Muscle mass increases in boys and fat deposits increase in girls -Adolescent boys tend to be larger and stronger than adolescent girls

Language development

Language development -OK Abby Larry expands and sentence structure becomes more complex -By six tiles will cab is approximately 8000 to 14,000 words -Bilingual children may speak English at school in a different language at home -Reading improve language skills -Regular trips to library or child can borrow books and promote and love of reading and enhance school performance -Enjoy being read to as well as reading on their own -Older children enjoy horror stories mysteries romances and adventure stories -School-age children often go through. In which the experiment with profanity and dirty jokes

Moral and spiritual development in adolescence

Moral and spiritual development in adolescence -Move from concrete too analytical thinking they advanced to Kohlbergs stage for conventional level Or Coburg stage five postconventional level of moral development -Those who remain concrete thinkers may never advanced beyond stage III of moral reasoning which is conformity to please others and avoid punishment -The teenagers sense of justice is developed through interpersonal relationships with peers family other adult role models -Behaviors that are rewarding such as helping the less fortunate contribute to the development of a conscience which operates as a moral guide for subsequent behavior for example the middle to late teenager can appreciate that stealing from others is wrong with her caught or not caught -Develop a respect for Lauren daughter and his society maintaining orientation (kohlberg 4) -Young adults advance to societal perspective stage five which honors moral rules of right and wrong contractual agreements majority opinion -Question the values of family and society and challenge existing moral codes before integrating their experiences and believes into a personal moral framework -What is moral framework develops into a personal relationships tend to be with those whose values and believes are similar -Young adolescents in stage of concrete operational thoughts are able to think logically -Children deal well with observing football but begin to see other points of view and examine what they have learned -Young adolescent walk sept religious teaching and examine how religious concepts relate to every day life -Young adolescents inclined to look to God for guidance when troubled -Middle to late adolescence capable of analytic far and may begin to question the religious affiliation of the family -Older adolescents me explore different kinds of religion and share religious activities with the peer group -Spirituality has a positive effects on health related quality of life and holistic wellness in adolescents -Nurses include an assessment of spiritual believes and values

Play for the ill child

Play for the ill child -Important part of hospitalization for the child -Can help reveal how a child is coping with the stress of the hospitalization -Unstructured play is an outlet for the trial to control events ideas and relationships -Allows time for children to process and express their feelings and fears -Give the child control over his or her perception of the experience and provides an outlet for emotional release -Siblings can also benefit from play -Nurses evaluate how children and their siblings are coping with hospitalization by observing their play and identifying any educational or further support needs -Play for the ill child is believed t+o decrease potential negative effects of hospitalization by promoting expression of feelings and enabling control over stressful experiences -Play is familiar and comfortable for children child life programs provide opportunities for play in a variety of healthcare settings including inpatient units I see use outpatient clinics emergency departments and pre-surgical waiting area's -Preferred activities Very according to stage of development for example a young child engages in make-believe play is going to child joints others in a structured game and adolescent uses a computer to communicate electronically with peers outside the hospital

Sensory development

Sensory development -Vision> -The size of the eye at birth is approximately 1/2 to 3/4 the size of the adult Eye -Growth of the eye including its internal structures is rapid during the first year -Infants eyes remain open for longer periods -They show a preference for a familiar faces and are increasingly able to fixate on objects -Invanz have 20/100 220/150 at birth but improves rapidly during infancy and toddler hood -Show a preference for high contrast colors such as black white and primary colors -Pastel colors are not easily distinguished until six months -Made that coordination of a movement and extraocular muscle But should achieve proper coordination by age 4 to 6 months -Persistent lack of eye muscle control be on 4 to 6 months need further evaluation -Depth perception appears to begin 7 to 9 months Hearing> -AQ at birth shown by reflexive reactions to noise -Responses to sound become increasingly more specialized -Four months, infants return their eyes and head toward a sound coming from behind -10 months, should respond to the sound of their name -12 3/1000 newborns experience some degree of hearing impairment -Joint committee of infant hearing recommends the newborn infants be screen for hearing impairment either as neonates room before one month of age and for those newborn to fail the exam to verify hearing impairment before H3 months -Infants who demonstrate confirmed hearing loss be eligible for early intervention services and specialize hearing and language services as early as possible but no later than six months of age -Newborn hearing screening generally is done before hospital discharge -Rescreening of both ears within one month of this charge is recommended for those newborns with questionable results -Screening should be available to those infants born at home or an in and out of hospital birthing center -Risk factors of hearing deficits include structural abnormalities of the year, family history, pre-or post natal infections known to contribute to hearing deficit, drama, persistent otitis media, developmental delay, parental concerns

Sleep and rest adolescent

Sleep and rest adolescent —Commonly stay up late if they're working on a school project or attended a week and party and have difficulty waking up in the morning -Sitting ones on bedtime and sleeping late on weekends or behaviors associated with gaining independence -8 to 9 hours recommended for adolescents and young adults -3/4 of adolescence report sleeping fewer than eight hours a night -Babcock Suggest that adolescents are more often than not in a state of sleep deprivation -Factors include after school activities electronic devices socializing late into the night -Signs of sleep deformation include fatigue such as falling asleep in class distracted attention poor school performance -Rapid physical growth and increased activities contribute adolescence fatigue and frustrated parents may complain that their children are teenagers energies ask for everything but household and family chores -Adult sleep cycles are formed during adolescence and sleep disturbances continue with the adult years -Persistent difficulty falling asleep wakefulness during the night and early waking maybe signs of emotional problems associated with tension and anxiety depression -Adolescence sleep patterns can interfere with her academic performance because the interaction between natural circadian sweeper them in social activities makes him less alert in the morning -Avoid caffeine intake before bed and shut down all like Tronic devices except for playing quiet music before bed

Summary of growth and development in the infant part two

Summary of growth and development in the infant part two

Teaching through play

Teaching through play -Used to educate -Used in preoperative teaching and teaching before a new painful for extensive procedure -hospital Equipment used -Nurse demonstrates taking a blood pressure on tryouts stuffed animal before putting the cuff on the child -Breathing treatment might be given to the child stop before the child is giving the treatment -Nurse might use drawings in diaphragms to explain procedures or surgery -Use of play for children experiencing invasive painful procedures such as IV line insertion has been shown to be effective in teaching what to expect before procedure in to improve coping skills -Hospitals have preoperative visit surgery which children come to meet the people who will be taking care of them and see the physical surroundings -They can see the scrub gowns and masks one by the surgical staff and visit a typical room -

Therapeutic play

Therapeutic play -When a child is hospitalized one component of child's plan of care is using therapeutically play -Differs from normal plate and its design and intent -Members of the healthcare team guided in activities are planned to meet physical and psychological needs of the child -Interpretations of child's play behavior and some types of play therapy required guidance by a train to play therapist -Provide an emotional outlet instruct and improve physiologic abilities -Supervise play with medical equipment helps reduce fear and separate Reality from fantasy -Child life specialist available in many hospitals to share their expertise in child growth and development and use of play -Child life program goals include maintaining normal living patterns minimizing psychological trauma in promoting Optimal Development of the child

Types of play

Types of play -Dramatic play> -Allows children to act out rules and experiences that may have happened to them, that they fear will happen or that they have observed in others -Can be spontaneous or guided and it often includes medical and nursing equipment -Valuable for children who have had or will have multiple procedures or hospitalizations -The nurse may choose to observe spontaneous play or be an active participant with the child -Nurses will want to structure the dramatic play to review a specific treatment or procedure -In guided play situations the nurse directs the focus of the play -Specialized play kids may be developed for specific procedures such as central line care casting bone marrow aspiration lumbar punctures in surgery using supplies related to the hospital Familiarization play> -Allows children to handle and explore healthcare materials in non-threatening and fun ways -Helpful for but not limited to preparing children for procedures in the whole experience of hospitalization -Examples include using sponge mouth swabs as painting and gluing tools, making jewelry from bandages, tape, goggles, and laptops, creating mobile's and colleges with health care supplies, Making finger puppets with plaster casting material, feeling a basin with water and using tubing syringes without needles medicine cups and Bob syringe is for water play, decorating bed wheelchairs and intravenous poles with health care supplies and using syringe is for painting activities

Sensory development

Sensory development Vision> -Fully developed at six years -Before puberty, some children's eyes undergo a growth spurt resulting in myopia - Those who have poor visual acuity do not complain of visual problems because it changes occur gradually and are difficult to notice -Squinting moving closer to TV or complains of frequent headaches Hearing> -Maturation and growth of eustachian tube middle ear infections occur less frequently -Infections can cause hearing loss -

Cognitive development

Cognitive development -Cognition those from concrete to abstract do analytical thinking during the three phases of adolescent development -According to the Padgett formal operations or abstract thinking characterize the last stage of cognitive development -Early abstract thinking encompasses inductive and deductive reasoning, the ability to connect separate events and the ability to understand later consequences -Abstract thinking in late adolescence is increasingly logical and young adults are capable of using scientific reasoning, understanding complex concepts and using analytical methods -Because of logical reasoning they are able to differentiate between others perceptions in their own interview social situations from societal perspective perspective -Holland Hall and Bernstein say that the brain is still maturing throughout adolescents and beyond and this maturational process affects cognitive and emotional processing -Increased myelinization of neurons and Nero maturation facilitates impulse control decision making skills and the ability to understand consequences of alternative actions and prioritization -This also allows for increased organization problem-solving skills and critical thinking -Adolescent judgment and decision making capabilities result from interaction a cognitive maturation and life experiences as well as analytical thinking and self regulation -All of these factors including emotional influences can affect adolescent stress and risk taking behavior -They think in different ways than adults -Ninth grade sex education is quite different from college freshman or adolescents with her first full-time jobs -College freshman should be able to appreciate later consequences of sexual behavior whereas young adolescent is focused on here and now -Counseling adolescent substance abuse or's may be in effective if the consequence of their behaviors is tied to the future when they're thinking is in the present -A professional approach to communicating with teens includes no adolescent development and consider how the team will look to peers, be open to their ideas and opinions and willing to negotiate choices, Keeping criticism to a minimum and listening nonjudgmentally -Encourage problem-solving and mutual decision making, maintain confidentiality, being advocate but don't take sides against a parent

Health promotion for adolescent and family

Health promotion for adolescent and family -Seek healthcare for sports physicals skin conditions minor illnesses conditions related to sexuality and management of chronic illnesses -Important for adolescence to receive regular well care as a mental health needs during adolescence can contribute to less than optimal health in adulthood -Reasons that adolescents don't see Cal care include concerns about confidentiality not believing that preventative health is important problems with access believe that cares only necessary when ill and cost -Confer privately with the nurses and healthcare provider separately parents are asked about any concerns they might have -Confidentiality often an issue when adolescents are seen in the healthcare setting -Nurses encourage adolescents to involve their parents but frequently asked that communication be kept confidential -Adolescent misunderstand that the nurse will respect this confidentiality and less the information shared suggest a potentially life-threatening danger -They need to be directly asked about questions on their health including diet exercise sexual risk behavior substance use preventative safety measures violence and emotional health -Recommends routine screening for depression beginning at age 12 -Some providers publicly display their policy on Confidentiality always underlining the need to share information only if someone is in danger -Issues related to the time necessary for adequate interview may rise -Many adolescents and their parents perceive the yearly sports physical is being sufficient -Yes physical often performed by a school position is not comprehensive enough to identify several problems nor is it likely to provide time for confidential communication of adolescent concerns to the provider

Parameters of growth

Parameters of growth -Throughout infancy and childhood and adolescence growth occurs in bursts separated by periods when growth is stable or consistent -Wait length and head circumference our parameters that are used to monitor a growth -The wait is measured at regular intervals during infancy and childhood -The average weight of a newborn infant is 7.5 pounds -Male infants are heavier than female infants -The birth weight usually doubles by sixpence of age triples by one year of age in quadrupled between two and three years of age -Slow steady weight gain during childhood is followed by a growth spurt during adolescence -Average newborn infant is approximately 20 inches and increase is approximately 1 inch per month for the first six months -.5 inches per month for the remainder of the first year. -Child games 3 inches per year from each one through seven then 2 inches per year from age 8 through 15 -Boys add more high during adolescence than do girls -Head circuthmference indicates brain growth -Normal occipital frontal circumference of the term newborn head is 13 to 15 inches -Average hair growth occurs according to the following pattern 4.8 inches during first year, 1 inch during second year, .5 inch from 3 to 5 years, .5 inch from five years to puberty -Average adult head circumference 21 inches -Primary dentition Emerge at 6 to 8 months -Children have 20 teeth by age 2. Five years -Permanent teeth 32 in our irrupt at six years accompanied by the loss of primary teeth -Dentition Is not related to the level or rate of development

Physical growth and development toddler And preschooler

Physical growth and development toddlerAnd preschooler -During early childhood physical growth slows -Child away has quadrupled at age 2 to 3 years -Average Toddler grows 7.5 cm a year -Children's attain have to adult height between two and three years -Brain grows at a slower rate than during infancy -1.5 inches and head circumference during toddler years compared to infancy which is 4.5 inches doing first 12 months -My age to head circumference reach 90% of its adult size Toddler> -Immature abdominal muscle gifts toddler a potbellied appearance with exaggerated lumbar curve -Legs look slightly bowed in feet seem flat do you to plantar fat pad disappearing around two years -During toddler years muscle tissue replaced much of adipose tissue that was presented during Infancy -Muscle skeletal system matures and child walks and runs more the child grows into a taller and leaner preschooler Preschooler> -Growth occurs more rapidly and the legs thing in the trunk, adipose tissue declines, Child's appetite decreases -This is the potbelly appearance of the toddler becoming slimmer -Muscles grow faster than bones -Muscle strength influenced by nutrition, genetic makeup and opportunity to exercise and use muscles -Knock knees common and associated with stumbling and falling -Knock knees correct During 4 to 5 years -Longs grow Cassidy increases and respiratory rate slows -Respirations remain diaphragmatic until five or six years -Heart rate decreases and blood pressure rises as heart increases in size -Cardiovascular matures -20 decidious teeth Percent by three years -The teeth may begin to follow at the end of the preschool Phase -The back molars first teeth to appear In early school age years

Play rooms

Play rooms -Where children can go to play with toys participate in age-appropriate arts and crafts and socialize with other children -Children should always see this area as a safe place where procedures and treatments to not take place -When their condition is stable children can be taken to the play room in their beds in and wheelchairs -Hey separate activity area should be provided for adolescence to listen to music play video games use computers to access email and Internet sites and visit with their peers -If play rooms are not available is supply of developmental appropriate toys games and books should be maintained so nurses can give them to pediatric patients

Adolescent growth and development

Adolescent growth and development -Tries out many roles as part of the important developmental task of identity formation -Peer group most important as a experiment with new rules outside the family unit -When identity formation is complete the young adult is emancipated from the family and establishes independence -Physical growth is at a rapid rate and is second only to that of infancy -Secondary sexual characteristics develop and eight intense interest in romantic relationships -Adolescence moved from the same sex friendships of childhood To the capacity for intimate long lasting relationships as young adults -Sexual orientation and gender identity recognized as they engaged in exploration and self discovery

Classifications of play

Classifications of play -Paget describe the following three types of play that relate to. Sensorimotor, preoperational and concrete operational functioning -Healing firm to stages of cognitive development -Play contribute positively to developmental outcomes in children -Demonstrations of play my different according to a child's or families culture -Sensory motor also known as functional play, occurs when a child activates or manipulates an object and derives enjoyment from the result -The child will repeat the action for the pure fun involved -And example is an infant throwing a spoon on the floor to see what happens then repeats it after the parents have replaced it -This type of players prominent during infancy as infants begin to explore the world -Symbolic play, which includes pretend play Occurs when a young child plays with an object or toy but uses that object to represent another for example a part in Witherspoon as a drum or a cardboard box becomes a tent -The same object and become something else in a different place scenario -Pretend play also includes using objects or materials in return situations such as when a child uses a toy so phone to talk to a friend or dress up clothes to be a policeman -There are no rules and symbolic play in the variety of places tuitions is only limited by the child's imagination -He can help assist a child to adjust to a new or painful experience -Name and code rules can usually are played by more than one person although some games can be played by oneself -The card game solitaire is played by one person as are many video games -Children younger than four years of age really play games with rules games are most commonly seen in the school-age child -Games continue throughout life as adults play board games cards in sports -Children learn to play by the rules and to take turns -Young children often make up games with any sets of rules which may change each time the game is played -Older children have games with specific rules you have a children tend to change the rules

Series of growth and development only focus on pageants and Ericksons stages

Series of growth and development only focus on pageants and Ericksons stages

Growth and development during early childhood

Growth and development during early childhood -Toddler years characterized by struggle for autonomy as a child develops a sense of self separate from the parent -They have boundless energy and insatiable Curiosity that allows them to explore the environment and master new skills -They are at risk for injury due to increased motor skills, immaturity and lack of experience -They are egocentric and demanding behaviors marked by temper tantrum's and negativism give them the label terrible twos -Preschooler becomes independent and mastering many self-care and motor skills and developing greater social and emotional maturity -Their imaginative, creative and curious -Parents enjoy this age as a watch the dramatic transformation of a chubby toddler into a particular child who's ready to enter the world of peers and school -Well child check ups provide the nurse with opportunities for anticipatory guidance related to growth and development, safety, nutrition in common age related concerns of parents -Pediatric providers conduct developmental surveillance which assassins developmental milestones and determining risk for developmental delay at every well visit -Autism specific screening is performed at the 18 and 24 month visit -gabrielson, Farley, Speer conducted a study to determine whether providers could recognize the signs of autism within a 10 minute window -Their findings indicated that children with autism demonstrated more typical developmental appropriate behaviors than a typical and the children without autism frequently demonstrated a typical behaviors

Growth and development of the infant

Growth and development of the infant -Infant can organize their experiences in meaningful ways and adapt to changes in the environment -Evidence shows that infants form strong bonds with their caregivers communicate their needs and wants is socially interact -By the end of the first year of life infants can independently move elicit responses from adults communicate through the use of rudimentary language and solve simple problems -Infancy is characterized by the need to establish harmony between the self in the world -To achieve this harmony the infant requires food warm comfort oral satisfaction environmental stimulation opportunities for self exploration and self expression -Competent caregivers satisfy the needs of help with infants providing a warm nurturing relationships so that the children have a sense of trust in the world and in themselves -The leading cause of death in infants younger than one or a congenital anomalies followed by conditions related to prematurity or Low birth weight -SIDS is now the fourth leading cause of death primarily because of international efforts such as the back to sleep campaign -Unintentional injuries ranked fifth -During the first year after birth the infant development as dramatic as he or she grows toward independence -Knowledge regarding developmental milestones help caregivers determine whether in the baby is growing and maturing as expected -Some infants reach each mile stone later than the most -Knowledge of normal growth and development health centers from our children safey -Providing parents with information about immunizations feeding sleep hygiene safety is an important nursing responsibility -Nurses are in a good position to offer anticipatory guidance on the basis of the infants growth in achievement of developmental milestones

Hygiene and dental care

Hygiene and dental care -Major concern is acne as it contributes to self consciousness and decreased self image -Dental care> -Dental caries decrease in adolescence -Most permanent teeth have erupted with the possible exception of third molars wisdom teeth -Continuing oral fluoride supplements until adolescent reaches 16 years if no access to fluoridated water -Several dental conditions are prevailant during adolescent years such as gingivitis malocclusion dental trauma -Gingivitis is the information and breakdown of ginge ivL epithelium -Malocclusion which is in proper contact occurs because of facial and mandibular bone growth and dental crowding -Treatment generally in tails dental devices such as braces to correct tooth position and redirect facial growth -Maybe self-conscious of their peers are no longer in braces -For economic reasons some are an able to undergo correction of malocclusions and suffer consequences -People with uncorrected in malocclusions are greater risk for dental trauma -Caring for the teeth and gums are critical to prevent dental caries associated with orthodontic appliance -Tooth that has been completely knocked out of the mouth can be re-implanted -Prognosis best of injury is treated within 30 minutes *Caring for a child with knocked out tooth -It should be touched only by the crown and placed in Saline, milk or commercial tooth preserving liquid -Tooth should not be scrubbed and cleaning agents and disinfectants should be avoided -Child should be seen as soon as possible by a dentist or taken to emergency department

Language development

Language development -Able to understand abstract concepts, process complex thoughts and express themselves verbally -Who read extensively are more articulate and have a larger vocabulary than those who do not -Social development and self-confidence play significant role in how well adolescents express themselves verbally to others - Shy introverted may have difficulty speaking to a group or members of opposite sex but may write expressively -Extroverted social adolescents who have no trouble with verbal expression may like reading and writing skills for affective written communication -Computer technology has added to their avenues for creative expression -Capable of expressing ideas and symbols an abstract concepts and enjoy interpreting or even developing complex computer programs or applications for mobile phones and electronics devices -Do you does become more proficient with computer technology than their parents -Teaching adult lessons basic computer literacy -Social media email texting blogs contribute to abbreviated communication techniques which illuminate grammar and sentence construction but also word construction -Do you to safety concerns using the Internet in various social media and communication sides parents need to monitor computer use and investigate parental controls -Intensely private and may not wish to express their thoughts and feelings to others -Verbally expressive 12-year-old return to uncommunicative 14-year-old -Conflict with parents increase tension in communication -Nurses who work with adolescents who develop communication include assuring confidentiality making no assumptions remaining nonjudgmental posing open ended questions *Communicating with adolescents -Parents need to maintain open communication will not appearing too intrusive. Asking adolescence question is are going through their belongings causes feelings of invasion and lack of trust -They get more out of discussions in which they participate then they divided lectures and are likely to respond positively to adults who listened and I'm here interested in what they have to say

Language development

Language development -Child becomes increasingly intrigued with sound, begins to realize that words have meaning and eventually use a simple sounds to communicate -Young infants understand tones and inflections a voice rather than words themselves -It is not long before repetition and practice of sounds enable them to understand and communicate with words -Can't understand more than they can express -Social smile develops early usually buy 3 to 5 weeks -This helps to foster attachment and demonstrate that the infant can differentiate between people and objects within the environment -The infant who does not display is social smile by 8 to 12 weeks of age need further evaluation and close follow up -During infancy connections form within the central nervous system providing fine motor Control of the numerous muscles required for speech -Maturation of the mouth, jog, lyrics, bone growth and development of the face help prepare the infant to speak -Vocalization or speech does not appear to be reflexive but it's similar to conversation -Parents elicit localization in their infant better than other adults can -Language includes understanding word meanings, how To combine words into meaningful sentences and phrases and social use of conversation -Development of speech and language is intimately connected to adequate hearing -Development of both speech and language also can be influenced by sociodemographic factors, quality of communication in the environment, and atomic defects, neurologic disorders, developmental disorders and family history -Most children begin to make sounds such as ma, da, By 4 to 6 months -Sounds become meaningful in specific by 9:15 months in by age one year child has vocabulary of several words such as mama, dada, bye bye -Infants who have older siblings or who are raised in Burberry Ridge in moments sometimes meet these development milestones earlier then other infants

Motor development

Motor development -Engage in various forms of motor activity from aerobic exercise to football -Sports and dancing provide an outlet for adolescents energy as well as an opportunity for competition team work and social relationships -Large muscle mass increases and adolescents and coordination of grown and fine muscle group improves xBecome more adept at Adam Athletics in star at our music sewing -Ends are not completely calcified until after puberty and are still fairly resistant to breaking in the young adolescent -Participants in sports activities should be grouped cording to their size and sexual maturity rating rather than their chronological age -A small thin late-maturing boy is less capable of competing with an early maturing muscular classmate and injuries are more likely to occur -Should have a yearly physical examination and concussion screening is participating in high school athletics -Schools Sports examination should not substitute for the recommended complete Adolsecnt physical examination with counseling -Cardiopulmonary capacity increases in this amateur late adolescent the cardiovascular pump is not as efficient as young adults who's Lungs are smaller -Generally cannot run as fast or as long as young adults -Athletes aerobic power body composition joint flexibility strength of skeletal muscles determine physical fitness *Adolescent who is involved in athletics -Adequate equipment, appropriate training schedules, frequent rest periods, adequate fluids to prevent injury dehydration and exhaustion appropriate removal one concussion is suspected

Overview of growth and development

Overview of growth and development -Nurses reassure parents about normal variations in development and he can identify problems early so that development so delays can be addressed as soon as possible -Nurses who work with ill children must have a clear understanding of how children differ from adults in for me each other at various stages Definition of terms> - growth refers to a increase in physical size of a hole or any of its parts or an increase in the number and size of cells. It can be measured easily in accurately. Example any observer can see that an infant rose rapidly doing the first year of life. The growth can be measured readily by determining changes in weight and length. -The difference in size between a newborn and a 12 month old infant is an obvious sign of remarkable growth that occurs during the first year of life -Development is considered to be a continuous orderly series of conditions and leading to activities new motors for activities and patterns of behavior. It also means an increase in function and complexity that occurs through growth maturation and learning in other words it increases and capabilities. The process of language acquisition provides an example of development. The use of language becomes increasingly complex as a child matures. At 10 to 12 months of age a child uses single words to communicate simple desires and needs. By age 4-5 years completes and complex sentences are used to relate elaborate towels. Language development can be measured by determining vocabulary , Articulation skills and word use -Maturity and learning also affect development. Maturation is the physical change in body structures that enable a child to function at increasingly higher levels and is programmed to genetically and make her as a result of several changes. For example maturation of the CNS depends on changes that occur throughout the body such as an increase in the number of neurons myelinization of nerve fibers lengthening of muscles -Learning involves changes in behavior that occurs as a result of maturation and experience with the environment -Predictable patterns are observed in learning in these patterns are sequential orderly and progressive -For example when learning to walk Babys first learn to control her head then to roll over next to say it then to crawl and finally to walk the child's muscle mass and nervous system is grow and mature well -These examples show how complex and into related the processes of growth development maturation and learning are -Children must be monitored carefully to ensure that these complicated events and activities unfold normally -Wide variations of her as children grow and develop each child has a unique rate and pattern of development although parameters are used to identify abnormalities nurses must be familiar with normal parameters so that delays can be detected early

Patterns of growth and development

Patterns of growth and development -The first direction of growth is cephalocaudal, or head to toe -Structures and functions originating in the head developed before those in the lower parts of the body. At birth the head as large a four 1/4 of the entire body length the trunk is long, the arms are longer than the legs -As a child matures the body proportions gradually change by adulthood the legs increased in size -Directional growth and development or further illustrated by myelinization of the nerves which begin in the brain and spreads downward as a child matures -Growth of the myelin sheath and other nerve structures contribute to cephalocaudal Development which is illustrated by an infants ability to raise the head before being able to sit in to sit before being able to stand -A second directional aspect of growth and development in proximodistal, Which means progression from the center outward or from the midline to the periphery -Growth and branching pattern of the respiratory track illustrate the concept xThe trachea which is a central structure of the respiratory tree forms in the embryo by 24 days of gestation -Branching and growth outward occur in the bronchi bronchioles and Ialveoli throughout out for your life and infancy -Alveoli continue to grow and develop and number and function until middle childhood -A neonate response to pain is usually a whole body responds with flailing Of the arms and legs even if the pain is in the abdomen -As a child matures the pain response becomes more localized to the stimulus -An older child with abdominal pain guards the abdomen -A toddler's for senses are formed simply using only a noun and a verb -By age 5 years the child constructs detailed stories using many complex modifiers -The rate of growth is not constant as a child matures - Growth spurt's alternating with periods of slow or stagnant growth or observed throughout childhood -Spirits are frequently seen as a child repairs to master a significant developmental task such as walking -An increase in growth around a child's first birthday may promote the neuromuscular maturation required for taking the first steps -Developmental stages do not always correlate with the chronological age - Children progress through developmental stages of varying rates within normal limits and May master developmental task going to regress to earlier levels when ill or stressed -People can struggle repeatedly with particular developmental tasks throughout life

Sleep and rest

Sleep and rest -During second your children need 12 to 14 hours a day -Take one nap each day until the end of the second or third year -Condors resist going to bed Using temper tantrum's to postpone separation from loved ones in the exciting events of the day -Asking for one or more drinks of water -Warning the child a few minutes before it's time for bed may reduce bedtime protest -Winding down with a quiet activity for 30 minutes beforeWinding down with a quiet activity for 30 minutes before helps -Bedtime offers opportunity for snuggle time when the parent and Tyler can read a story and share events of the day -Children have trouble relaxing and falling asleep -A warm bath promotes relaxation -Bedtime rituals are important and should be followed consistently -Transition objects such as a favorite blanket or stuffed animal or important part of the child's bedtime routine -preschoolers needvaverage 10 to 12 hours of sleep -Resistance to naps is common at this age -Child usually does not want to leave Family or playmates toys and exciting activities to go into a darkened room to lay down and rest -Music or looking at a favorite book my help child relax -Insufficient restoration day may lead to irritability decreased resistance to infection and difficulty sleeping at night -Sleep problems Common during preschool years -Often have nightmares and have trouble falling asleep at night -Boundaries between reality and fantasy or not well defined for children of this age so monsters And scary creatures become real to the child after the light is turned off -Nightmares are common -Comfort with a hug and verbal reassurance from her. Enables a child to return to sleep -Night terrors occur during deep sleep and child remains asleep even though the eyes are open -Child screams moms or cries but Child does not awaken -The child will not remember the episode in the morning even if they were awake and during the night to her parents should not attempt to come for a week and the child during a tear but should allow the child to sleep -Resistance to go in a bed beers and nightmares are normal for children of this age -Avoid high carbohydrate snacks and excitement before bedtime -Not be forced to face their fears alone by sleeping in a completely dark room with the door shut -Parents can search the room to reassure the preschooler that the room is safe -Progressive head to toe relaxation is an effective technique for helping preschoolers fall asleep -Is it bedtime from the security and healthy sleep habits -Atown who slept for a long time at babysitters for daycare's may not be ready to sleep again -Communication with the child's daytime caretaker is important to determine whether the child is maintaining a balance of activity rest and sleep

Social aspects of play

Social aspects of play -Solitary play> -Characterized by independently play -The child plays along with toys that are very different from those chosen by other children -Begins in infancy and is common in toddlers because of the limited social cognitive and physical skills - It's important for children and our age groups to have some time to play by themselves Parallel play> -Associated with toddlers although we can be found in any age group -Children place side-by-side with similar toys but there is a lack of Interactive activity Associative play> -Characterized by group play without group goals -Children in this type of way do not step group rules although they may all be playing with the same types of toys and may even trade toys and there is a lack of formal organization -This type of play can begin during toddler hood and continue into the preschool age Cooperative play> -Begins in the late preschool years -Organized and has group goals -Usually at least one later in children are definitely in or out of the group Onlooker play> -Present when a child observes others playing -The child may ask questions of the players and the child does not attempt to join the play -Usually during the toddler years but can be observed at any age

Spiritual and moral development

Spiritual and moral development -Middle childhood years pedro and development of a conscience and internalization of values -Tremendous strides are made in moral development during six year piaget> -Said that young school-age children obey rules because powerful adults hand them down -Children know the rules but not the reasons behind them -Roles are interpreted in a litter away and the child isn't able to adjust rules to fit different circumstances -Perception of guilt changes as a child matures -Piaget Stated that up to eight years children charge degrees of guilt by amount of damage done -Child believes that a child who broke 5 cups by accident is guilty or than a child who broke one cup on purpose -Buy 10 years children are able to consider the intent of the action other children are more flexible on their decisions and can take into account the circumstances kohlberg> -Describe moral development in terms of three levels containing six stages -Children 4-7 years are in stage two of pre-conventional level and what is right and wrong are determined by physical consequences -The child of days because of fear of punishment -The child is not car or punished a towel does not consider the act wrong -At this stage children conform to rose out of self interest or in terms of what others can do in return -Children conform to the rules out of self interest or in terms of what others can do in return -Describes children between seven and 12 years as being in threes three of conventional level -A good boy or a good girl characterizes the stage in which child conforms to rules to please others and avoid disapproval -Around 12 years children interstate for a conventional level -There is an orientation toward respecting authority obeying rules and maintaining social order Family influence> -Cheating lying stealing are not uncommon -Manifest antisocial behaviors during this phase -Liar cheat to get out of an embarrassing situation or to make themselves look more important to their peers -If they are severe or persistent the child may need a referral for counseling -Parents teach right and wrong -Tomorrow atmosphere and the home is a critical factor in the child's personality development -Learn self-discipline and internalization of values through obedience to external rules -Squeeze children are legalistic and they feel loved and secure when they know that firm limits are set on their behavior -Want and expect discipline for wrongdoings -For moral teaching to be affective parents must be consistent in expectations of their children