Child Development and Stages (Infant/Toddler/Pre-schooler/School-Age/Adolescent)

-1 to 3 years of age -Preoccupied with the ability to eliminate -Sexual urges gratified by learning to voluntarily defecate -Sphincter muscles maturing

What is the anal stage of Freuds psychosexual theory?

-1-3 years -The child is learning to control bodily functions. -Independence starts to emerge; for example, toddlers control their worlds by deciding when and where elimination will occur. -They vocalize by saying no to something and direct their motor activity. -Children who are consistently criticized for showing independence and autonomy will develop shame and doubt in their abilities. -Toddlers also need to recognize the feelings and needs of others; excessive autonomy could lead to disregard for and an inability to play with others - -Play during this stage is known as parallel

What is the autonomy vs. shame and doubt stage of Erikson's psychosocial theory?

7.5 lbs

What is the average birth weight?

20 inches

What is the average length (height) at birth?

Classical conditioning is "a learning process that occurs through associations between an environmental stimulus and a naturally occurring stimulus" Operant conditioning is a change in behavior based on rewards, reinforcement, and punishment

What is the difference between classical conditioning and operant conditioning?

70 + 2 × age in years = lower end of systolic BP; 90 + 2 × age in years = upper end of systolic BP

What is the formula for calculating the normal BP range for a small child?

-begins at around 12 years of age and lasts to adulthood -Struggle with sexuality -Sexual desires return and are related to physiological changes and fluctuating hormones -Changing social relationships -Dealing with struggle of dependence and independence issues with parents -Learning to form loving, appropriate relationships -Must manage sexual urges in socially accepted ways

What is the genital stage of Freuds psychosexual theory?

-12-18 years -Children of this age are preoccupied with how they are seen in the eyes of others. -They are working to establish their own identity. -They are trying out new roles to see what best fits for them. -If they are unable to provide a meaningful definition of self, they are at risk for role confusion in one or more roles throughout life. -Some confusion is good and will result in self-reflection and self-examination.

What is the identity versus role confusion stage of Erikson's psychosocial theory?

-6-12 years -The child develops interests and takes pride in accomplishments. -The child enjoys working in groups and forming social relationships. -Projects are enjoyable. -The child follows rules and order. -Developing a sense of industry provides the child with purpose and confidence in being successful. -If a child is unable to be successful, this can result in a sense of inferiority. -A child must learn balance, an understanding that he or she cannot succeed at everything and that there is always more to learn. -Play during this stage is known as cooperative play

What is the industry vs. inferiority stage of Erikson's psychosocial theory?

-At 6 months of age, when the child is more mobile, use distraction to keep the child away from dangerous areas. -Temper tantrums are the infant's way of expressing frustration, hunger, anger, illness, or fatigue. -Reward good behavior. -Remain calm, firm, and consistent. -Maintain a set routine.

What should discipline be like for an infant?

-Assess for lice -Assess hair for dryness and brittleness that can indicate nutrition status. -Assess for open lesions/signs of trauma. -Assess for symptoms or recent history of head trauma, including headaches, difficulty concentrating, or loss of consciousness.

What should the head be assessed for in school-aged child?

Head and chest circumference are usually equal, with chest slightly smaller, usually 1 to 2 cm less than head.

What should the head circumference be equal to?

infant fatalities from an unknown cause and are not associated with infection, choking, vomiting, or abuse

What are Sudden infant death syndrome (SIDS) and sudden unexplained infant death (SUID)?

-Bullying -Physical violence -Rejection -Suicidal thoughts -High-risk behavior such as sexual and substance abuse

Compared with heterosexual youth, what are LGBTQ (lesbian, gay, bisexual, transgender, or questioning) teens more likely to experience?

-Vision: least-developed sense; infants are attracted to bright colors and black and white because of limited vision; objects appear two-dimensional with poor peripheral vision until 2 to 3 months of age -Smell: well-developed sense; especially recognizes smell of own mother -Taste: well-developed sense; sweet tastes are preferred -Hearing: can hear beginning in the womb and can identify mother's voice; differentiates between male and female voices; hearing is critical for language development

What is sensory development like for an infant?

-Proportionately larger heads as compared with bodies -Greater ratio of body surface area to total weight -Larger tongues and greater proportion of soft tissue in and around the airway -Shorter, more narrow airway that is more elastic and collapsible -More pliable chest -Weaker abdominal muscles, creating the look of distention -Belly breathers -Higher metabolic rates -Higher fluid requirements -Higher total blood volumes

How are small children's bodies physically different from adults?

the structure or the relationship between individuals that provides the financial and emotional support needed for social functioning

How is a family defined?

at least 1 hour of physical activity a day

How much physical activity should school-aged children get?

Have a thermometer at home. Give medication with dosage appropriate to the weight of the child Use patient cooling techniques Promote dehydration prevention -Small, frequent sips of fluids -Electrolyte-replacement beverages -Broths -Popsicles -Diet advancement (as tolerated) -Clear liquids May begin with a BRAT diet (bananas, rice, applesauce, and toast) and quickly advance to soft foods; the BRAT diet by itself does not provide the proper nutrition intake. -Soft/bland foods -Solids: when able, it is best for the child to resume a well-balanced diet to ensure proper nutrition intake

How should a child with a fever be cared for at home?

-Look: Assess the child's appearance, muscle tone, and skin. -Talk: Discuss with the child and the parents/caregivers any recent history or problems. Listen to what the child tells you. -Touch: Be nonthreatening by avoiding sudden movements and staying at the level of the child whenever possible. -Allow for privacy. -Appropriate rewards such as stickers or small toys may be given after the examination. -If a procedure must be performed, have the instruments ready and inform the child immediately before the procedure. The longer a child is aware that a painful or uncomfortable procedure is coming, the greater the stress that can occur. -Do the least invasive parts of an examination first. If part of the examination is invasive or painful, this will make the child fearful of further, even noninvasive, painless parts of the examination.

How should a school-aged child be approached when doing assessments or procedures?

-Orient caregivers to unit. -Explain all procedures in a step-by-step manner. -Review the plan of care with caregivers daily or as it changes. -Encourage families to stay informed by asking for test results, updates on patient care, and changes in patient status. -Encourage caregivers to ask questions and express concerns. -Instruct caregivers to ask for further explanation when needed. -Urge caregivers to learn about the child's medications. Encourage involvement in decision making. -Reassure caregivers that it is normal to feel scared, helpless, overwhelmed, guilty, sad, worried, confused, frustrated, angry, alone, and tired. -Remind caregivers to care for themselves. Reassure them that it is fine to go home for a while, whether to relieve stress, take a shower, go to sleep, and/or take care of other responsibilities.

How should young children be cared for in the hospital?

-Have the child practice sitting on the potty for a few minutes at a time. -Practice hand washing; encourage the child to sing a song to wash for the appropriate amount of time. -Teach proper use of hand sanitizer: must cover hands and dry completely; do not place hands in mouth (can be toxic to children). -Teach girls to wipe front to back to minimize risk for urinary tract infections. -Teach boys to urinate in the sitting position first. Once mastered, then move on to standing. May use flushable toilet targets for teaching purposes (do not put toys in the toilet for this purpose). -Provide encouragement in the form of praise and celebration, along with rewards and incentives such as treats, stickers, and new underwear. -Do not be severe or punitive when accidents happen.

If a child shows signs of readiness for potty-training, what should caregivers do?

On their backs

In what position should infants sleep?

head trauma results from injuries caused by vigorously shaking a child.

What is shaken baby syndrome?

-Encourage caregivers to room-in. -Educate caregivers on the normal developmental milestones and stages, noting that a hospitalized infant may regress in behavior. Child life specialists are essential in describing developmental aspects related to play. -Encourage caregivers to provide security items such as a favorite toy or blanket. -Educate caregivers on safety risks in the hospital, such as lowered crib rails, the infant's crawling on the floor, or the presence of items that may not be in the infant's home. -Reinforce the importance of therapeutic play. -Perform the least invasive and least painful procedures first. -Invasive procedures should be performed in the treatment room, not at the crib site. -At 6 months of age, infants suffer separation anxiety and can be sensitive to caregiver cues.

What are guidelines for providing hospital care for an infant?

Appropriate for gestational age between the 10th and 90th percentiles

What AGA?

-Brazelton Neonatal Behavioral Assessment Scale: Tests an infant's neurological development, behavior, and responsiveness. It is used only in the neonatal period. -Gesell Developmental Schedules: Test for fine and gross motor skills, language, eye-hand coordination, imitation, object recovery, personal-social behavior, and play response. -Denver Developmental Screening Test: Used to identify problems or delays. It measures personal/social, fine and gross motor, language, and social skills. -Bayley Scales of Infant Development: Test the cognitive, behavioral, and motor domains of the infant. The assessment is used to identify infants with developmental disabilities. It is a highly reliable tool that uses mental, motor, and behavioral scales to rate an infant's functioning. The mental test screens for such items as whether the infant turns to a sound or looks for a fallen object. The motor test screens for gross and fine motor skill development.

What are assessment tools for infants' cognitive development?

-Weight: gains 5 to 7 oz weekly during the first month and then 1 to 2 lb per month -Feeding: Breastfed every 2 to 3 hours, formula-fed every 3 to 4 hours -Height: grows 1 inch per month for first 6 months of life -Head circumference: grows a half inch per month for first 6 months of life -Wobbly at first, but soon can lift head when on abdomen -Grasps an object, kicks vigorously, and turns head from side to side -Needs to have the head and neck supported -Can get their hands and thumbs to their mouths -Reflexes: primitive reflexes remain -Hearing: should respond to parent's voice and respond to loud noises by blinking, startling, frowning, or waking from light sleep -Vision: most newborns focus best on objects about 8 to 10 inches away, -Communication: sensitive to the way they are held, rocked, and fed. By age 2 months, the infant should smile on purpose (social smile), blow bubbles, and coo when spoken to. At 3 months the infant may laugh out loud and express moods.

What are developmental milestones from birth to three months?

-Birth weight triples -Birth length increases by 50% -Head and chest circumference are equal -Total of six to eight teeth -Knows name -Creeps along furniture -Drinks from a cup; should be weaned from a bottle -Stands alone for brief periods of time; raises arms when wants to be picked up -May take first steps or walk alone -Eats with spoon and cup but prefers fingers -Enjoys familiar surroundings and people, expresses dissatisfaction with strangers or strange surroundings (stranger anxiety) -May develop security objects such as favorite toys or blankets -Enjoys books, especially board books -Can understand simple communication or direction; says two or three words beyond Dada and Mama -One or both feet may slightly turn in; the infant's lower legs are normally bowed -At around 12 months of age can transition to whole cow's milk; do not use 1% or 2% because the infant needs the fat content for continuing brain development

What are developmental milestones from nine to twelve months?

-All infants should be screened for developmental delays and disabilities at 9 months at the well-child visit -Rolls from back to stomach and stomach to back -Sits unsupported by 8 months -Transfers objects from hand to hand, points at objects, and picks them up at 9 months -Fine motor skills continue to develop -Puts feet in mouth, plays pat-a-cake, loves to see own image in a mirror -Develops and expresses taste preferences -Begins to understand differences between inanimate and animate objects -Displays stranger anxiety -Develops object permanence -Vocalizes with many-syllable vowel sounds and "m-m" with crying -Around 9 months, says "Dada" and "Mama" and understands bye-bye and no -Around 8 to 9 months begins to pull to stand, develops pincer grasp, crawls backward and then forward, and responds to own name (Figure 7-18) -Understands where to look for an object that has been dropped; practices grasp-release movements -Begins to test parent's responses, such as watching the parent while dropping food on the floor -Distinguishes colors -Distance vision -Expresses emotions, including frustration and anger

What are developmental milestones from six to nine months?

-Birth weight doubles by 6 months of age -Height increases 1 inch per month for first 6 months -Can raise head and support it by 4 months -Reaches and grasps objects, plays with hands, moves objects to mouth, plays with toes -Rolls from abdomen to back -More stabilized sleeping patterns at 3 months -Opens mouth for spoon -Binocular vision: ability to see with both eyes coordinated -Primitive reflexes begin to disappear -Begins to drool, chew on toys as teething begins (6 months) -Can sit when propped at 6 months -Can support some weight when held in a standing position -Recognizes familiar objects and people, expresses displeasure when those objects or people are removed, babbles to self

What are developmental milestones from three to six months?

Medical -Not providing common medical care -Not allowing a child who is ill to consult a health-care provider -Death of a child from an illness that is considered treatable by Western health care Emotional -Not attending to the child's emotional needs -Ignoring the child -Leaving the child alone for significant amounts of time Educational -Not providing education for the child in any manner -Not providing the child needed aids to encourage education (hearing aids, speech therapy, etc.) Abandonment -Leaving a child to care for himself or herself -Not providing adequate adult supervision

What are different forms of child neglect?

-Cooked macaroni -Small pieces of cheese -Soft cooked vegetables such as potatoes -Small pieces of fruit such as bananas, peaches, or pears -Small pieces of toast -Grapes cut into fourths Best practices to prevent choking include: -Thoroughly cook and cut all foods into small pieces. -Remove pits or seeds from fruit. -Grind, mash, and add liquid to foods for younger infants

What are foods that result in a decreased risk for choking in the infant?

-Nonnutritive sucking is a self-soothing or comforting measure used by infants. -The infant's sucking ability is necessary for neurological development and survival. -Pacifiers, fingers, or fists are used in self-sucking. -Suckling, which the infant does at the breast, requires a different set of mouth movements than does bottle feeding or the use of fingers, fists, or a pacifier. -Avoid using pacifiers in the early days of breastfeeding. -Educate caregivers on the use of a pacifier, such as not using it as a substitute for feeding or holding. -Never tie or clip the pacifier to the child's clothing because this can be a source of strangulation, even in older infants. -Limit the use of the pacifier as the infant gets older to prevent creating a habit that will be difficult to break; distract the infant with an alternative.

What are guidelines for nonnutritive sucking?

-No attempts by the infant to lift head when lying facedown -No improvement in head control -Does not respond to loud noises -Extreme floppiness -Lack of response to sounds or visual cues, such as loud noises or bright lights -Inability to focus on a caregiver's eyes -Poor weight gain -Does not crawl by 12 months

What are milestone concerns for infants?

-Sufficient protein is needed to support growth and development. -Fats are needed to provide calories and support brain development. -Carbohydrates are needed to provide energy. Infants need 100 to 116 kcal/kg/day for basic growth and development. -Adequate fluid and electrolyte intake is necessary. -Fluids, mainly water, should total 120 to 150 mL/kg/day for infants. -Supplemental iron is not necessary for breastfed infants before 6 months of age. -All infants 6 months or older require iron supplementation. Iron can be supplied through lean red meats, fortified infant cereals, spinach, broccoli, green peas, or beans. -Do not feed cow's milk until after 1 year of age. -Soy formula is used for galactosemia, lactose intolerance, and allergies to cow's milk.

What are nutritional guidelines for infants 6-12 months of age?

-Minimize falls risk by keeping the side rails on beds/cribs up. -Remind caregivers to never leave the crib side if the rail is in the down position. -Check equipment regularly—wire and cord placement to minimize entanglement, suction availability at crib side, and minimal equipment and crib attachments to decrease choking and suffocation hazards. -Check temperature of water, food, and drinks to prevent burns. -Explore any signs or symptoms that potentially may require a referral to child protective services. This is a legal requirement in most states that provides assistance for children and families of abuse. A child may experience abuse at any age. -Educate caregiver on basic home, outdoor play, and car safety measures to ensure environmental safety for children. -Install smoke and carbon monoxide detectors, and ensure they are operational by changing the batteries every 6 months.

What are safety guidelines for caring for toddlers/preschoolers?

-Aggressive or withdrawn behavior -Shying away from physical contact with parents or adults -Basic needs of food, warmth, and cuddling not met

What are signs of emotional abuse in infants?

-Axillary temperature greater than 99.3°F or rectal temperature greater than 100.3°F -Vomiting -Decrease in the number of wet diapers -Sunken or bulging fontanels -Loss of appetite -Foul odor or bleeding from the cord or circumcision -Decreased level of consciousness; lethargy -Increased irritability -Blue or cool hands and feet -Skin rash -Drooling not associated with teething -Refusal to lie down if 8 months of age or older

What are signs of illness in a newborn/infant?

-Consistent failure to respond to the child's need for stimulation, nurturing, encouragement, and protection, or failure to acknowledge the child's presence -Actively refusing to respond to the child's needs, such as refusing to show affection -Parents/caregivers expressing the fact that they are not going to spoil the baby or referring to the baby as evil -Infant with malnourished appearance -Obvious neglect of the child (e.g., dirty, undernourished, inappropriate clothes for the weather, lack of medical or dental care) -Failure to provide necessary medications for chronic conditions, such as inhalers for children with asthma -Delays in calling for help or taking infant to the doctor

What are signs of neglect in an infant?

-Unexplained or repeated injuries such as welts, bruises, burns, fractured skull, and broken bones, especially spiral fractures -Injuries in the shape of an object (e.g., belt buckle, electrical cord, cigarette) -Injuries that are unlikely given the age or ability of the child, such as broken bones in a child too young to walk or climb -Disagreement or inconsistency in parent/caregiver explanation of the injury -Unreasonable explanation of the injury -Fearful or detached behavior by the infant

What are signs of physical abuse in infants?

-Ability to have dry diaper for a few hours at a time or during a nap -Regularly timed bowel movements -Interest in the potty or going to the potty with others -Physical ability to get to potty and pull up/down pants -Ability to follow simple directions -Unhappiness with the feeling of a wet or dirty diaper -Ability to vocalize when they went and/or if they have to go

What are signs of readiness for potty training?

-Stained or bloody diapers -Genital or rectal pain, swelling, redness, or discharge -Bruises or other injuries in the genital or rectal area -Difficulty eating or sleeping -Excessive crying -Withdrawing from others -Failure to thrive

What are signs of sexual abuse in infants?

-Be more independent -Be proud of their abilities -Show interest in new things -Want to do things by themselves -Obey rules -Engage in role-play -Play well with others; this is known as associative play Want to please and be like friends -Try to negotiate problem solving -Have trouble in differentiating between reality and fantasy (later preschoolers can tell the difference) -Believe in monsters or be afraid of the dark -Begin to understand gender and racial differences -Begin to explore their genitalia through masturbation -Can be demanding or eager to help -Can be jealous over the arrival of a new sibling -Place importance on body integrity

What are social and emotional milestones of a preschooler?

-Imitate others -Have awareness of self as separate from others -Begin to enjoy spending time with other children -Engage in parallel play, playing near other toddlers but not consistently interacting or playing together -Show affection openly -Begin to display defiance -Display separation anxiety until approximately the end of the second year -Express jealousy at the arrival of a new sibling

What are social and emotional milestones of a toddler?

-Younger school-age children may choose to take oral liquids from an oral syringe or a medicine cup. If appropriate, the nurse may choose food or drink as a reward. -If the medication tastes bad, you can offer a "chaser," numb the child's tongue beforehand with a popsicle, or have the child pinch his or her nose while ingesting the medication. The child's caregiver may administer medications, under nursing supervision, when appropriate. Be sure to monitor all administration of medication to the child. -Oral medications can often be prepared in a flavored liquid provided by the pharmacy. Use caution with flavorings that taste like candy, and educate parents to store medications in a safe area so younger children cannot access them.

What are some suggestions for giving medications to school-age children?

-Recall parts of a story -Count to 10, but no concept of numbers -Correctly identify at least four colors -Begin to understand the concept of time -Know the meaning of same and different -Begin to use imagination and creativity -Ask "why" questions

What cognitive abilities are expected in a preschooler?

-Finding objects that are hidden -Beginning to identify and sort colors and shapes -Beginning to play make-believe -Beginning to scribble and show preference for one hand versus the other

What cognitive development is expected in a toddler?

-In the hospital, infants will be banded with electronic tags to prevent abduction. -Hospital staff should be properly identified with hospital badges to identify that they have access to the postpartum and newborn areas. -Be suspicious of casual acquaintances or strangers who attempt to befriend the parent. -Learn hospital procedures for care after discharge if a visiting nurse is to come to your home. -Demand positive identification before allowing anyone into your home. -Do not post information about the infant on social media. -Under no circumstances should the caregiver give the baby to a stranger. -Do not allow casual acquaintances or strangers to babysit the infant. -Never leave the infant alone at home. -Do not place birth announcements in the newspaper. -In shopping areas, do not turn your back on the infant. -Make sure the infant is secured in a car seat that is buckled into a shopping cart. -Place the infant in the car seat in the car, lock the doors, and then load your groceries or items from the store. -Educate family members and friends who babysit the infant about infant security. -Call police anytime you are suspicious or concerned about the infant's safety.

What are strategies to prevent abduction in infants?

-Do not hold infant when smoking, drinking hot liquids, or cooking. -Do not heat formula or breast milk in the microwave because it causes uneven heating and may also inactivate nutrients in breast milk. -An infant's skin is very sensitive to the sun. -Keep infants out of direct sunlight to prevent sunburn. Use sunscreen for infants older than 6 months. -Infants should wear hats when out in the sun. -Turn pot handles away from the outside of the stove, where they can be pulled on by infants beginning to pull themselves to a standing position. -Check the water temperature before putting a child in the tub. -Reduce the water heater setting to less than 120°F to lessen the chance of an accidental burning. -Keep electrical cords out of infant reach; cap electrical outlets. -Use flame-retardant sleepwear for the infant.

What are strategies to prevent burns in infants?

-Do not attach pacifiers or other objects to the crib or body with a string or cord. -Keep small objects away from infants, including toys or stuffed animals with small breakaway parts. -Never leave plastic bags or wrappings where the infant can reach them. -Keep objects that are choking hazards away from the infant, such as batteries (especially watch batteries), magnets, and balloons. -Cut or remove pull cords on blinds and drapes. -Anything smaller than an adult pinky finger can cause a choking situation. This includes foods such as hot dogs, whole grapes, raw carrots, raw celery, peanuts, popcorn, chips, candy, marshmallows, pretzels, and peanut butter. -Cut all foods into small-sized bites.

What are strategies to prevent choking in infants?

-Never leave the infant alone in water or near standing water. -Do not leave the infant to answer the phone or doorbell. -Keep toilet lids closed. -Empty buckets immediately

What are strategies to prevent drowning in infants?

-Never leave the infant alone on a changing table, couch, chair, or bed. -Always keep a hand on the baby. -Use gates at the top of stairwells. -Do not use walkers; they have resulted in serious injuries and even death if they cause the infant to fall down stairs. -Make sure that heavy furniture is secure and cannot be toppled over on top of an infant. -Educate caregivers on how young children should hold an infant and protect their head and necks.

What are strategies to prevent falls in infants?

-Keep the poison control number at every phone. -Keep all medicines, cleaning products, nail polish remover, alcohol, and other household chemicals locked in their original containers and out of reach. -Take all suspected poisons to the phone when poison control is called to be able to read the ingredients to the center. -Remove lead paint from older cribs, infant furniture, walls, and window sills. -Never leave an infant alone in a yard. -Do not apply sunscreen or perfumed creams or lotions, because they will be absorbed in an infant younger than 6 months of age. -Keep indoor plants out of the infant's reach.

What are strategies to prevent poisoning in infants?

-Remove excess bedding from crib. -Remove stuffed toys from crib. -Keep all plastic garbage bags, shopping bags, and dry cleaning bags out of reach of the infant. -Monitor for issues in sling carriers; make sure that infant does not get wrapped up in clothing and that the head does not fall forward, cutting off the airway.

What are strategies to suffocation falls in infants?

Infant—birth to 1 year Toddler—1 to 3 years Preschool—3 to 6 years School-age—6 to 12 years Adolescence—12 to 18 years

What are the 5 stages that childhood is divided into?

Level one: Physiological needs must be met first: food, rest, air, water. Level two: The child has the need to be protected from harm and feel safe. Level three: Feeling loved and part of a group. Level four: Esteem needs to develop—the need to respect yourself and be respected by others. Level five: Self-actualization, or becoming a complete person and reaching your greatest potential

What are the levels of Maslow's hierarchy of needs?

Breastfeeding Nonnutritive sucking Kangaroo care Swaddling Limiting environmental stimuli Attention to behavioral cues

What are types of non-pharmalogical pain management for infants?

-Furrowed brow and open-mouth-type grimace, or lack of expression -Restlessness or sleeping and withdrawal (ways to cope with pain) -Wariness/fear of movement -Irritability/agitation -No vocalization to harsh/high-pitched cry

What behaviors indicate pain in small children?

-Distract the child, say goodbye, and leave quickly. The quicker you leave, the quicker the episode will end. -Practice leaving at home by going to another room and saying you will be back soon. -Stay calm, be consistent, and give reassurance that you will be back.

What can be done to reduce separation anxiety?

-Gain 3 kg/year in weight -Gain 5 cm/year in height -Experience a growth spurt at age 10 to 12 years for girls and around age 12 years for boys

What changes in height and weight are expected during the school age years?

-Development is a sequential and orderly process, moving from stages that are relatively simple to more complex -Cognitive acts occur as the child adapts to the surrounding environment. -The child's experience with the environment naturally encourages growth and maturation. -The child must accommodate to new or complex problems by drawing on past experiences. -There can be overlap between the child's age and stage of development. Each stage does not start and end at exactly the same age for each child.

What characteristics did Piaget develop for cognitive development?

-Preparation for medical procedures, including medical play: For example, using a doll to help a child act out a planned procedure can significantly decrease his or her anxiety; this is known as therapeutic play. -Accompanying a school-age child to a procedure or test to provide distraction and coaching Planning celebrations for children who are in the hospital for a major milestone, such as a birthday or holiday -Offering music or art therapy to provide distraction and a creative outlet for stress -Offering therapeutic puppetry featuring characters to whom children can relate: For example, Rainbow Babies and Children's Hospital in Cleveland, Ohio, has a puppet mascot named Buddy who can visit children and host shows on the hospital's closed circuit television channel. -Coordinating an activity room where children can play with toys and games or participate in organized activities: Children who are in isolation may have toys brought to their rooms. All toys should be able to be cleaned with water and disinfectant.

What does a child life specialist do for children when they are hospitalized?

-Make sure the infant is burped frequently. -Parents should not change formula, unless directed by the pediatrician. -If the infant is breastfed, the mother should decrease the intake of spicy or gaseous food; dairy and corn can also cause gastrointestinal disturbances. -Infants tend to be sensitive to stimulation. Try a car ride, movement, infant massage, carrying the infant in a carrier, or creating a white noise environment. -If a pacifier is used, it can help calm the infant; pacifiers have also been shown to decrease the incidence of sudden infant death syndrome (SIDS). -Colic usually disappears by about 12 to 16 weeks of age.

What education should be provided for parents of infants with colic?

-Fruits and vegetables -Milk, yogurt, and cheese -Whole-grain crackers and cereal -Nuts and peanut butter

What foods make good snacks for young children?

six areas of neuromuscular maturity and six areas of observed physical maturity, which is used to assess gestational age

What is Ballard Maturational Scoring?

Large for gestational age above the 90th percentile

What is LGA?

-7 to 11 years -Shows increase in accommodation skills -Develops an ability to think abstractly and to make rational judgments about concrete or observable phenomena -In teaching, give the opportunity to ask questions and explain things back to the nurse. This allows the child to mentally manipulate information.

What is Piaget's concrete operational stage?

-11 years to adulthood -This stage brings cognition to its final form. -The individual no longer requires concrete objects to make rational judgments. -Individuals are capable of hypothetical and deductive reasoning. -Teaching for adolescents may be wide ranging because they can consider many possibilities from several perspectives.

What is Piaget's formal operational stage?

-2 to 7 years -Application of language -Use of symbols to represent objects -Ability to think about things and events that are not immediately present -Oriented to the present; difficulty conceptualizing time -Thinking influenced by fantasy Teaching must account for the child's vivid fantasies and undeveloped sense of time

What is Piaget's preoperational stage?

birth to 2 years: The child learns through motor and reflex actions, and begins to understand that he or she is separate from the environment and from others.

What is Piaget's sensorimotor stage?

Small for gestational age below 10th percentile

What is SGA?

65-110

What is a normal pulse rate for preschoolers?

70-110

What is a normal pulse rate for toddlers?

-Each state has its own specific laws related to car seats. -Always use a car seat when traveling in a car or airplane. -Use approved car seats correctly. -Check the age and weight limits for the seat. Put the car seat in the backseat of the car and secure it facing backward. Check state laws. -Never put the infant in a front seat with a safety airbag. -Rear-facing infant seats are used from birth up to 2 years of age, per 2017 AAP guidelines (AAP, 2017b). Parents can contact a certified child passenger safety technician (CPST) to correctly install infant car seats. -Caregivers should never leave an infant in the car unattended.

What is car seat safety for infants?

intestinal gas, resulting in frequent crying

What is colic?

2,500 g or less (5.5 lb)

What is considered low birth weight?

1,500 g or less (3.5 lb)

What is considered very low birth weight?

The extent to which hereditary factors and environmental influences shape the various personal traits and characteristics of a child

What is meant by nature vs. nurture?

-Pulse oximetry values should be the same as adult values (93% to 100%). -Pulse oximetry values may be different if there is an underlying cardiac or pulmonary diagnosis. -A fever is generally considered to be a temperature greater than 101.4°F or 38.5°C. Fevers do not cause seizures, although a sudden increase in body temperature may result in a febrile seizure. High fevers greater than 104°F or 40°C in children do not indicate that the infection is more serious, as they may in adults, because less-refined pediatric immune systems may produce higher fevers than needed

What is notable about vital signs for school-age children?

-Childproof swimming areas, including access to pools, ponds, and lakes. -Never leave children unattended near swimming areas, even if they can swim. -Use flotation devices (Fig. 8-2). -Never leave toys in a pool because children may be tempted to retrieve them. -Playgrounds and unfamiliar play areas post an increased risk for danger because of the unfamiliarity of the environment. -Teach playground and play area safety rules, such as no running near roped areas, no putting head through bars, and no trampoline use. Trampolines are a safety risk for children of all ages. -Teach crosswalk safety, such as how to cross correctly; running into the street for toys is not allowed; playing in the street is not allowed. -Children should always wear a bicycle helmet and never ride bicycles in the street. -Always use child safety/booster seats and place children in the backseat. -Required U.S. child restraint laws by state are available from the Insurance Institute for Highway Safety and Highway Loss Data Institute

What is outdoor safety for small children?

-3-6 years -The preschool child is exposed to new people and new activities; the child becomes involved and very busy. -The child learns about the environment through play. -The child learns new responsibilities and can act based on established principles. -The child develops a conscience. -If the child is constantly criticized for his or her actions, this can lead to guilt and a lack of purpose. -Play at this stage is known as associative play

What is the initiative vs. guilt stage of Erikson's psychosocial theory?

-6 to 11 years of age -Sexual drives submerged -Energy focus on socialization and increasing problem-solving abilities -Appropriate gender roles adopted -Oedipal or Electra conflicts resolved -Identifies with same-gender peers and same-gender caregiver -Superego developed to a point where it keeps id under control

What is the latency stage of Freuds psychosexual theory?

-birth to 1 year -Children at this stage are preoccupied with activities associated with the mouth. -Sexual urges are gratified with oral behaviors: sucking, biting, chewing, and eating. -Children who do not have their oral needs met may become thumb suckers or nail biters. -In adulthood, they may become compulsive eaters or smokers. -Normal development requires not depriving oral gratification, such as weaning too soon or a rigid feeding schedule.

What is the oral stage of Freuds psychosexual theory?

-3 to 6 years -Preoccupation with the genitals -Curious about childbirth, masturbation, and anatomic differences -Girls experience penis envy and wish they had one; boys suffer from castration anxiety, the fear of losing the penis -Children develop strong incestuous desire for caregiver of the opposite gender -Oedipal complex—attachment of boy to his mother -Electra complex—attachment of girl to her father -Children need to identify with caregiver of same gender to form male or female identity

What is the phallic stage of Freuds psychosexual theory?

-Birth to 1 year -An infant requires that basic needs are met—food, clothing, touch, and comfort. -If these needs are not met, the infant will develop a mistrust of others. -If a sense of trust is developed, the infant will see the world as a safe place. -Play is usually considered a psychosocial activity. --During this stage play is referred to as solitary

What is the trust vs. mistrust stage of Erikson's psychosocial theory?

Speak clearly enough for strangers to understand (by age 5 years) Speak in three- to four-word sentences at age 3 years Speak in four- to five-word sentences at age 4 years Speak in sentences of five or more words at age 5 years Tell stories Use future tense Comprehend rhyming State full name and address (later in stage) Have concrete or literal interpretation of language

What language development is expected in a preschooler?

-Pointing to objects when named by others -Recognizing the names of well-known people and things -Learning own name -Understanding more than they can speak -Repeating words that are overheard -Saying five words by 12 months -Saying 50 words by 18 months -Speaking in two- to three-word sentences by age 2 years -Converses using two to three sentences by age 3 years -Uses words "I," "me," and "you" by age 3 years

What language development is expected in a toddler?

-Dress and undress self with assistance at age 3 years (later without assistance) -Go up and down the stairs without assistance at age 3 years -Draw squares, circles, and later triangles at age 3 years -Begin learning to use utensils and drinking from a cup at age 3 years -Hop and stand on one foot for 5 to 10 seconds at age 4 years -Throw objects overhand at age 4 years -Catch a bounced ball at age 4 years -Draw stick figures with more than two body parts at age 4 years (later draws people with bodies) -Use scissors at age 4 years -Brush own teeth and go to the toilet without assistance at age 5 -Learn to skip, ride a bicycle, and swim at age 5

What motor development is expected in a preschooler?

-Walk alone by 15 months -Begin to run -Stand on tiptoes -Climb stairs while holding on to support by 21 months -Build towers of four or more blocks by age 2 years -Build towers of more than six blocks by age 3 years -Kick a ball -Climb on furniture by age 2 years -Pull or carry toys while walking -Run and jump by age 2 years -Play on a riding toy (i.e., tricycle) by age 3 years (3 -years to three wheels) -Can turn a door knob

What motor development is expected in a toddler?

While a child who licks a tiny amount of hand sanitizer off of his or her hands is unlikely to become sick, a child ingesting any more than a taste of hand sanitizer could be at risk for alcohol poisoning

What risk does hand sanitizer pose for small children?

-Height: standing when able to stand. Recumbent for young toddler, because lordosis is common in this age group. -Weight: minimal clothing, diaper, or underwear only preferred for accuracy. Include body mass index for children older than 2 years. -Head circumference: measured for all children younger than 2 years. May be assessed after 2 years of age if difficulty with bone growth or issues identified that impact the growth of the head. -Vital signs: heart rate, respiratory rate, temperature, pulse oximetry, and blood pressure (BP) within normal range). Use an appropriate-size cuff to measure the BP

What should be included in a physical assessment of a small child?

-Do not carry hot liquids around children or while holding a child. -Do not allow young children around stoves and fireplaces. -Use the back burners on the stove and turn pot handles in toward back. -Do not allow children around smaller hot appliances, such as irons, curling irons, and toasters. -Set the temperature of hot water tanks to 120°F or lower to prevent scalds -Always check the temperature of water, food, and formula before use. -Use safety gates to block stairs. If placed at top of staircase, secure to wall. -Secure heavy furniture such as televisions and bookcases to walls to prevent tipping injuries. -Keep windows closed. Screens will not hold children in and prevent falls. -Do not leave young children alone on porches or balconies. -Use night-lights. -Keep all medications and poisonous products (e.g., hand sanitizer, laundry packets, household cleaners, and chemicals) in high places out of reach or in a locked cabinet. -Have the number of local poison control center available or call the American Association of Poison Control Centers (AAPCC, 2017) at 1-800-222-1222. Keep poisonous materials in original containers so that the information on the labels can be accessed. -Buy products with childproof tops. -Clean up old, chipping paint around the house. -Look for and take away small toys that could present a choking hazard. -Buy age-appropriate toys. -Throw away anything that is broken. -Secure any loose cords from blinds, curtains, and clothing out of reach to minimize strangulation hazard. -Keep up-to-date on recalled toys and furniture. -Do not allow children to eat and play at the same time. -Cut food into bite-size pieces and avoid foods such as nuts, hot dogs, hard candy, popcorn, and grapes that could cause choking. -Do not allow children to play with coin money or latex balloons. -Lock rooms that are not childproofed. -Supervise children closely around all animals, including family pets. -Do not leave water in the bathtub or cleaning buckets. -Close bathroom doors. -Never leave children alone near any basin of water.

What should care givers of toddlers/preschoolers be educated on?

-Encourage caregivers to have an active role in caring for the child. -Encourage caregivers to bring items from home that help the child feel more comfortable and reduce stress. -Depending on facility policy, children may feel more comfortable wearing their own clothes or pajamas in the hospital. -Allow walks with caregivers when possible based on the child's diagnosis and facility policy. -Encourage visitation of siblings to promote a normal environment, provided siblings are free of illness. -------Siblings can participate in activities with the sick child whenever possible. -Ensure that siblings admitted together get a double room or are placed in rooms next to each other to facilitate care for the primary caregivers and help the children cope with hospitalization.

What should the nurse do if a school-age child is hospitalized?

-Assess for signs of child abuse, such as bruises in various stages of healing, bruises on unusual parts of the body, and cigarette burns. -Assess for dryness, rashes, eczema, abrasions, and contusions or scratches. -Abused children in this age group may fear that they have done something wrong or that they somehow deserve what is happening to them. Primary caregivers should make sure that children understand good touch/bad touch and the danger of engaging with strangers. Caregivers should listen to children's concerns, ask questions about the adults/peers at school/activities, and monitor for changes in mood or behavior, which may indicate that abuse has taken place. After-school time should be supervised and structured.

What should the skin be assessed for in school-aged child?

-Dairy products -Seafood -Nuts -Soy products

What sources of protein commonly trigger allergies in young children?

Moral development, which according to Kohlberg includes three major levels, can be advanced and promoted through formal education

What was Kohlberg's theory?

Conduct head-to-toe assessment from least to most invasive/intrusive, leaving painful areas for last. The child will be more cooperative with the examination when performed in this order.

When conducting a head to to assessment on a small child, what order should it be done in?

-Call 911 for all emergencies. -Child is not breathing properly or adequately. -Child's face is blue or extremities are blue. -Child has decreased responsiveness -Child becomes injured and has excessive bleeding -Call for all perceived emergencies.

When should 911 be called for a young child?

-Follow instructions as provided. -Call if there has been a negative change from what the primary care provider (PCP) has first assessed. -It is best to call the PCP whenever there is immediate information that the provider needs to know. -Bring to the PCP if the child is no longer able to perform a skill that he or she was once able to perform. -Bring to PCP whenever the caregiver believes the child is ill or his or her behavior has changed and there is suspicion that something is wrong.

When should a health care provider be called for a young child?