Lifespan, Dementia, Delirium & Rest
Blood vessels become less elastic & more rigid (high risk for cardiovascular disease)
Aging Adult
Body becomes less efficient
Aging Adult
Decrease in cardiac output & blood flow to kidneys
Aging Adult
Decrease in salvia-mucous membrane production decreases/dry (cracked lips, sores in mouth, tooth decay-may need dentures)
Aging Adult
Encourage rest and implement rest interventions
Aging Adult
Erikson's ego integrity vs. despair
Aging Adult
Fall precautions typical for this population
Aging Adult
65+ years
Aging Adult/Older Adult
What culture group: No direct eye contact-seen as disrespectful, holistic treatment first, same sex caregivers
Muslim
Primary, Secondary, or Tertiary: Seatbelt mandate
Primary
Education, classes, information on how to lead a healthier lifestyle
Primary Prevention
Health Promotion geared at a large group of people
Primary Prevention
"What does that mean?"
5 year old
Trace & print letters and numbers
5 year old
Aging Adult: Sleep needs
7-9 hours/night
Head lifting and roll head side to side with tummy time
2 months
Infants need to eat every
4 hours
Young adult sleep
8 hours/night
School-age: Leading cause of death
Accidents
Bladder capacity decreases by 50%
Aging Adult
Acceptance from peer groups/Peer groups are biggest influence
Adolescent
Ages 13-18
Adolescent
What culture group: Avoid technology if possible
Amish
Ageism & prevention
Be aware of age discrimination & be respectful in communication
Start toilet training
Between ages 2 and 3
Menopause causes
Decrease in estrogen (increase risk osteoporosis)-hot flashes, mood swings, fatigue
How to handle temper tantrum (Toddler)
Let it happen, stay calm, stay with child, ensure safety, pick up and move on afterwards, don't shame or punish for it
35-65 years
Middle Adult
Regression will cease
Once adaptation occurs
Acting out your dreams
REM Behavior Disorder
I looked over and found my husband swatting, almost like he was swatting flies.
REM Behavior Disorder
•20-25% of sleep cycle •Dreams
Rapid eye movement (REM)
Before trying sleeping medication, try
Reduce environmental stimuli-shut off TV & no screens
Encourage what during periods of growth
Sleep
Infant toys
Teethers, baby walkers, jumpers
More sleep will be needed if patents notice that the adolescent is:
•Emotional irritability •If poor grades are noticed •Entering a growth spurt
Build 2 large block tower
12 months
Rolling
4 months
Sit with assistance
6 months
Risk for dementia
Advanced age
An 84-year-old client has returned from the post-anesthetic care unit (PACU) following hip arthroplasty. The client is oriented to name only. The client's family is very upset because, before having surgery, the client had no cognitive deficits. The client is subsequently diagnosed with postoperative delirium. What should the nurse explain to the client's family? This problem can be resolved by administering antidotes to the anesthetic that was used in surgery. This problem is self-limiting and there is nothing to worry about. Delirium involves a progressive decline in memory loss and overall cognitive function. Delirium of this type is treatable and her cognition will return to previous levels.
Delirium of this type is treatable and her cognition will return to previous levels.
Which condition is characterized by a decline in intellectual functioning? Delirium Depression Delusion Dementia
Dementia
Dental consideration in toddlers
Dental caries
Sally is complaining that she is never able to get a good night's rest. She is constantly waking up
Insomnia
Dyssomnias
Insomnia, Hypersomnia, Narcolepsy, Sleep Apnea, Restless Leg Syndrome, Sleep Deprivation
Longer response time
Middle Adult
Motivated learners
Middle Adult
Problem-solvers
Middle Adult
Encourage cooperative play-play house, dress up, pretend drive trucks and cars, encourage sharing
Preschool
6-12 years old
School-age
Intervention/Prevention for temper tantrum in toddlers
Breathing technique-when frustrated count to 3
Grinding your teeth during periods of stress
Bruxism
Scoliosis screening is done how:
Child bend forward to touch toes-provider runs finger up spine looking for curvature
Most common STI in Young Adult & in general
Chlamydia
Bulging fontanelle indicates
Hydrocephalus (fluid on brain)
Excessive sleeping, especially during the day (falling asleep during school/work) Health Promotion: Avoid alcohol/caffeine
Hypersomnia
My little Timmy just got in trouble for falling asleep during class for the third time this week
Hypersomnia
What culture group: Headship arrangement (men ahead of women in teaching/leadership)
Jehovah Witness
Toddlers: Bedtime routine in hospital
Keep bedtime routine-allow parents to put them down at typical time to continue expectations
Trans-fatty acids causes
LDL to be high and HDL to be low
Primary, Secondary, or Tertiary: Addressing needs of healthy clients
Primary
Primary, Secondary, or Tertiary: Class on exercise techniques
Primary
Primary, Secondary, or Tertiary: DARE program
Primary
Primary, Secondary, or Tertiary: Discussing a vaccine schedule with soon-to-be parents
Primary
Primary, Secondary, or Tertiary: Educating about the dangers of smoking
Primary
Primary, Secondary, or Tertiary: Fitness and healthy eating course for the public
Primary
Primary, Secondary, or Tertiary: Free blood pressure clinic at the grocery story
Primary
Primary, Secondary, or Tertiary: Free glucose and vision checks for all adults at the community center
Primary
Primary, Secondary, or Tertiary: Health promotion
Primary
Primary, Secondary, or Tertiary: Passing a law to enforce no texting while driving
Primary
Wanting to succeed and accomplish
School-age
When considering the moral development of a 7-year-old child, which actions are most consistent with the anticipated state of development? The child focuses on being a good girl or boy. The child considers the impact of actions on others in his environment. The child only gives consideration to how the actions will impact himself. The child gears his actions to avoid doing the wrong thing and getting "into trouble".
The child focuses on being a good girl or boy.
1-2/3 years
Toddler
Encourage autonomy-dress themselves, make bed
Toddler
Encourage parallel play-objects next to one another
Toddler
Toilet training based off signals or verbals/expressed interest
Toddler
Health Tests & Screenings: Lead level testing Iron deficiency Visual/hearing screening Scheduled immunization Developmental screenings for special needs (milestones) Dental Care
Toddler (1-2 years)
Safety Considerations: Home Safety (environment) Car Seat Water safety (temp, supervision) Accident prevention
Toddler (1-2 years)
Establishing a family
Young Adult
Metabolism starts to slow down-start to see overweight issues (need nutritional counseling)
Young Adult
More rigid in spiritual belief
Young Adult
Question beliefs and practices
Young Adult
Ready to start a family-increasing conceiving issues
Young Adult
•Posterior fontanelle closes •Baby starts to smile
0-3 months (Infant)
Middle adult vision exam every
1-2 years
Which client will the nurse assess first after receiving 0700 shift report? A 6-month-old infant with a respiratory rate of 44 breaths/minute A 12-month-old infant with a blood pressure of 60/40 mm Hg A 1-day-old newborn who just passed a black, sticky stool A 1-month-old infant with positive Moro and root reflexes
A 12-month-old infant with a blood pressure of 60/40 mm Hg
Safety Considerations: Safe sex practices Risky behaviors Drivers Ed Substance Abuse Suicide prevention Social Media - bullying Internet safety
Adolescent (13-18 years)
A parent tells the nurse that the 6-year-old child has been biting his fingernails since beginning first grade. After analysis, the cause is determined to be increased stress. What advice would the nurse give the parent regarding this behavior? Encourage the child to drink more milk for stronger nails. Distract the child by teaching a new skill, such as whistling. Allow some time every day for the child to talk about new experiences Allow the child to choose a reward for not biting the nails.
Allow some time every day for the child to talk about new experiences
Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? Praise the infant when a new milestone is reached. Respond promptly when the infant cries. Read age-appropriate books to the infant daily. Appropriately enunciate words when speaking to the infant.
Respond promptly when the infant cries.
Regression occurs due to
Response to stressful environment (new sibling enters house, in hospital, large public gathering, first day of school)
Weight-bearing exercises decrease
Risk of osteoporosis
The father of a toddler reports his son says "no" every time he attempt to correct him. What is the best advice can the nurse offer to the parent? This is a normal part of toddlerhood. You may need to lessen the amount of correction being given to the child as he seems to be responding to feeling "overly restricted". Continue to correct him because he needs discipline. Saying no is your son's way of trying to exert his independence and is expected.
Saying no is your son's way of trying to exert his independence and is expected.
Health Tests & Screenings: Scoliosis screening Dental care Learning disability/ADD screenings Routine well child checks annually Immunizations
School-Age (6-12 years)
ADD & ADHD screenings with difficulty in focusing
School-age
Become aware of death
School-age
Encourage choices/options & relaxed routines
School-age
Erikson's industry vs. inferiority
School-age
Gain 5-6 lb per year and grow 2.5 in per year
School-age
Independence/relaxed in bedtime routine
School-age
Learning inductive reasoning and logical thinking
School-age
Lose baby teeth
School-age
Start to understand/recognize other persons feelings
School-age
Want to impress others (teachers, parents) and high-achieve
School-age
Checkups include Tdap booster and HPV vaccine Check BMI (anything over 85% talk about healthy food choices)-If increase in need of food consider engagement in activity/energy related
School-age annual checkups
Healthier food options - 2.5 cups of vegetables per day Safety with social media Stranger danger Discourage substance use Sex education Personal hygiene - wear deodorant, shower everyday Traffic lights - when to walk and when you can't, know what color of lights mean Memorize parents/guardians cell phone numbers, addresses, and first/last names Helmet use with bike Booster seat Farm safety
School-age health promotion
Primary, Secondary, or Tertiary: Colonoscopy at age 50
Secondary
Primary, Secondary, or Tertiary: Digital rectal exam
Secondary
Primary, Secondary, or Tertiary: Flu Shot
Secondary
Primary, Secondary, or Tertiary: Mammogram
Secondary
Primary, Secondary, or Tertiary: Monthly self-breast exam
Secondary
Primary, Secondary, or Tertiary: PSA testing at age 50
Secondary
Primary, Secondary, or Tertiary: Pap smear at age 21
Secondary
Benzodiazepines, Antihistamines, Tricyclic antidepressants, SSRI antidepressants Ex: diphenhydramine (Benadryl) or trazodone (Oletro) or zolpidem (Ambien)
Sedatives
A nurse is counseling a client who says that she attends a book club in her neighborhood regularly. She says it troubles her that no one engages in the discussion with her. Applying Maslow's hierarchy of needs to this client this client, this client's needs falls into which of the following levels? Love and belonging Self-esteem Self-actualization
Self-esteem
I noticed I put on weight over the last couple of years. I am so tired during the day. My husband complains that I snore a lot.
Sleep Apnea
Typical for short/larger neck, overweight, Cause : Tongue falls to back and occludes airway or enlarged tonsils/adenoids Health Promotion: Try to loose about 30 lbs if weight related
Sleep Apnea
I just worked three back to back 16 hours shifts and I can honestly say I feel impaired driving home from work.
Sleep Deprivation
SIDS prevention
Sleep on back, no toys or objects in crib (bumpers, stuffed animals, blankets)
My child was screaming, thrashing, & visibly diaphoretic. When I asked if she was okay it seemed like she was still sleeping
Sleep terrors
Eating when you sleep with no recollection
Sleep-related eating disorder
Parasomnias
Somnambulism, REM behavior disorder, sleep terrors, nightmares, enuresis, bruxism, sleep-related eating disorder
"I am not prepared for this. I want to live my life" (midlife crisis)
Stagnation
Infant: Dental Health
Start going to dentist as soon as teeth are in
Amphetamines and amphetamine-like drugs ex: methylphenidate (Ritalin)
Stimulants
A nurse is caring for a client in an ambulatory clinic who attended a blood pressure screening event and the stress management lecture at a community fair. His blood pressure was 150/94 mm Hg at the event, so he saw a provider at the clinic and begin therapy with a beta blocker. Soon after, the client had a mild myocardial infarction, after discharge from the hospital, enrolled in a program of cardiac rehabilitation. Which of the following activities of this client is an example of primary prevention? Blood pressure screening Cardiac rehabilitation Stress management lecture
Stress management lecture
Primary, Secondary, or Tertiary: Annual oncology follow up
Tertiary
Primary, Secondary, or Tertiary: Jaundice recheck in a 10 day old infant
Tertiary
Primary, Secondary, or Tertiary: Minimizing deterioration associated with a disease
Tertiary
Primary, Secondary, or Tertiary: Physical therapy following a hip replacement
Tertiary
Avoid worsening/deterioration of diagnosis
Tertiary Prevention
A nurse is giving a presentation about treating sleep disorders as part of a continuing education program. She should explain that the purpose of using cognitive therapy to treat insomnia is to help clients create an optimal sleep environment develop a positive outlook about sleep access the unconscious mind through relaxation
develop a positive outlook about sleep
A nurse is talking with a parent whose teenage boy is undergoing a sleep study. The parent asks the nurse about narcolepsy. The nurse should explain that the most common manifestation of narcolepsy is
excessive daytime sleepiness
Adolescent: Leading causes of death
#1 Suicide (ages 15-19) #2 Homicide
When do you get your first pap smear & how often? (no underlying conditions)
21 & every 3 years
Can determine if right or left handed
3 year old
Jump
3 year old
Jump off one step successfully
3 year old
Common in children, typically patterns of walking/abnormal behaviors during sleep
Parasomnias
Modifiable vs. Non-modifiable: High Fat Diet
Modifiable
Pay close attention to their body image
Adolescent
Very self-centered
Adolescent
Want to be self-sufficient & independent
Adolescent
Health Tests & Screenings: Immunizations Scoliosis Obesity Depression/Mental Health Screenings Suicide prevention STD/pregnancy screening Annual physicals Dental care Vision, Hearing if concerned. Sunscreen education/no tanning beds
Adolescent (13-18 years)
Nutrition & Exercise: Healthy Diet Vitamins/supplements - Vit D & Calcium Injury prevention - sports Increased need for sleep
Adolescent (13-18 years)
Social Interactions: Bullying Social Media Cell phones Jobs Relationship development/changes Peer pressure Social obligations Independence Responsibility
Adolescent (13-18 years)
Vocabulary starts at 1,000 words at
Age 3
Modifiable vs. Non-modifiable: Sedentary Lifestyle
Modifiable
Nutrition & Exercise: Weight lifting Walking Weight-bearing activities Nutritional supplements Vitamin supplements Managing polypharmacy
Older Adult (65+ years)
Safety Considerations: Fall Prevention Assistive Devices Home Safety, Accessibility Larger print materials Minimize trip hazards Life Alert
Older Adult (65+ years)
Social Interactions: Belonging to group - prevent social isolation Mental Health changes Finding sense of purpose Peer support Spiritual support
Older Adult (65+ years)
What culture group: Kosher-food cannot be cross-contaminated & needs separated
Orthodox Jewish
Social Interactions: Role Confusion Independence Intimate relationships Occupational consideration Social Media
Young Adult (19-34 years)
STI education and screenings Mental health If trying to conceive-hormone testing
Young Adult physical checkup
Social Interactions: Mid-life crisis Empty Nesting Role Changes Family or co-worker relationships Planning for retirement - financial stress? Losing spouses, parents
Middle Adult (35-65 years)
Saturated fats found in
Milk & cheese
Did you heart? Jim fell asleep while driving. Who falls asleep in broad daylight like that?
Narcolepsy
Person can sleep standing up/driving Not related to caffeine or alcohol If they are driving, ask if they have had issues falling asleep at the wheel
Narcolepsy
Preschool sleep consideration
Need night lights (not fluorescent)
Modifiable vs. Non-modifiable: Age
Non-modifiable
Modifiable vs. Non-modifiable: Biological Gender
Non-modifiable
Modifiable vs. Non-modifiable: Family history of COPD
Non-modifiable
Modifiable vs. Non-modifiable: Race
Non-modifiable
•75% of sleep cycle •4 stages- but really only 3 recognized
Non-rapid eye movement (NREM)
Foods low in cholesterol
Nuts, whole grains, oats
Health Tests & Screenings: Cancer screenings Cholesterol BP Vision/Hearing- every year Pneumococcal vaccine at age 65 Cognitive Assessments Nutritional Assessments STD screenings Fall screenings Annual visits to provider
Older Adult (65+ years)
During the toddler years, the child attempts to become autonomous. Which statement by a 3-year-old toddler's caregiver indicates that the toddler is developing autonomy? "My toddler uses the potty chair and is dry all day long." "When my toddler falls down, he or she always wants me to pick him or her up." "My toddler has temper tantrums when we go to the store." "Every night my toddler follows the same routine at bedtime."
"My toddler uses the potty chair and is dry all day long."
First digital rectal exam to test for enlarged prostate at what age
50
Lordosis occurs at age
6
Middle Adult Sleep Patterns
8 hours/night (start to be disturbed)
Preschool sleep pattern
9-16 hours at night (12 is average)
Leading causes of death: Young Adult
#1 MVA #2 Suicide & Homicide
Scoliosis screenings
Age 10 females (males later by age 13 in adolescence)
Slow learners
Aging Adult
Benzodiazepines ex: alprazolam (Xanax)
Antianxiety
Sleeping & Medications
Antianxiety, sedatives, stimulants, and other agents (caffeine, nicotine, chamomile tea, and alcohol)
Regression in potty training, sucking thumb, needing blanket, talk in baby voice
Common in toddler and preschool
Which behavior by a 3 year-old child does not validate Erikson's developmental task for preschoolers? Dresses up and pretends to be a superhero. "Cooks" a meal on the toy stove. Compares his soccer abilities with his peers. Asks the parent "why" about everything that happens.
Compares his soccer abilities with his peers.
Infant: Leading cause of death
Congenital abnormalities
High fiber diet patient
Constipation & bowel routine (narcotics/sedentary lifestyle)
Irreversible
Dementia
Medications to slow progression-Namenda & Aricept (Donepezil) given orally
Dementia
No medications to treat
Dementia
S/S: Difficulty naming objects, memory loss
Dementia
Slow progression-starts with slight foregetfullness
Dementia
Assess patient first to know baseline findings for treatment Gather info, get VS, assess neuro status first
Dementia & Delirium Interventions
•Assess neuro status •Assess functional status-do they need reminders? •Ensure safety-high risk for falls due to impaired judgment/safety awareness •Schedule cares-scheduled reminders (toileting) •Provide simple options-short, sweet & to point •Environmental changes-pictures in rooms/familiar objects + clock in room, calendars/memory aids, decreasing environmental stimuli-keep quiet, low TV sound, light at dim setting (no fluorescent), calm & relaxing
Dementia Interventions
Causes: Infection, hospitalization/prolonged hospital stay, ICU stay (lack of sleep), multiple disease processes, polypharmacy/certain medications (benzodiazepines like ativan)
Delirium
Forgetfulness/lack ability to communicate: came on suddenly and progresses rapidly
Delirium
Life threatening if untreated: Alert physician right away & implement safety precautions
Delirium
Medications to treat: Seroquel (orally), Haldol (IM injection, IV, or oral)
Delirium
Reversible/temporary
Delirium
Birth up to 1 year
Infant
Depressed/sunken fontanelle indicates
Malnutrition (dehydration)
3-5 years old
Preschool
A nurse is giving a series of workshops about health and wellness to a group of older adults at a community center. Which of the following statements from the attendees demonstrate that they understood what the nurse explained about the concept of health? "I have my health when I am physically, mentally, and socially well." "Health means wholeness, so every aspect of me combines to make a healthy whole self." "I am healthy because I see my doctor on a regular basis and he knows what I need." "Health means I do the things that keep me at my best, like exercising and eating right." "I don't have any medical problems right now, so I guess I'm pretty healthy."
"I have my health when I am physically, mentally, and socially well." "Health means wholeness, so every aspect of me combines to make a healthy whole self." "Health means I do the things that keep me at my best, like exercising and eating right."
Erikson's identity vs. role confusion
Adolescent
Growth spurts occur
Adolescent
Increased production of sweat glands
Adolescent
Personal hygiene education begins at age
10
Straight spine by age
10
Tdap booster by age
10
The parent of a 4-year-old child tells the nurse that her daughter seems more restless and irritable during the day than she'd previously been. When the nurse asks about the child's sleep habits, she determines that the child is not getting enough sleep. She should explain to the parent that between the ages of 3 and 6 years, a child needs an average of how many hours of sleep per night?
12
Scoliosis screenings for boys at age of
13
Monthly self breast exams/self testicular exams begin at age
17/18
4-5 word sentences
4 year old
Can use scissors
4 year old
Push limits-swearing
4 year old
Skip & hop (on one foot)
4 year old
Throw ball over head
4 year old
Remove hanging mobile after
4-5 months old
Introduce food
4-6 months (Infant)
Annual checkups start at age
40
Mammograms start at what age & how often? (no underlying conditons)
40 & yearly
Learning how to tie shoes
5 year old
Skip
5 year old
Tell/Develop stories
5 year old
Once you hit 30, pap smears are required every
5 years
HDL's high?
Good-work on exercise routine and consume low cholesterol foods
Health problems typically start here-look at PMH and Family Hx (Hereditary conditions start to form, i.e. cardiac disease, stroke, cancer)
Middle Adult
What patients should avoid caffeine
Anxiety Heart patients Pregnant women
Monthly skin checks: look in mirror front & back for moles, skin changes, and any areas of irritation to report
Middle Adult health promotion
Hormone replacements put you at high risk for
Developing conditions like cancer
Education on infant sleeping in car seat
Don't let them sleep in car seat - can lead to suffocation
A nurse is admitting a 16-year-old male to the floor for an appendectomy. How can the nurse prepare this client for hospitalization? Select all that apply. Encourage him to keep his cell phone nearby to communicate with his friends. Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Remind him that there are strict rules regarding meal times and when lights are turned out on the floor. Encourage parents to do as much as possible for the client, including ADLs and meal selection. Provide privacy when client is changing into the hospital gown or going to the bathroom.
Encourage him to keep his cell phone nearby to communicate with his friends. Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Provide privacy when client is changing into the hospital gown or going to the bathroom.
The father of a 12-year-old reports his child does not have high self-esteem. He asks for suggestions to increase feelings of self-worth. What activities would be appropriate for the nurse to suggest? Select all that apply. Encourage the child to develop new skills. Recommend the child begin to participate in after-school activities. Provide the child with a weekly allowance. Allow the child to begin staying home alone after school when possible. Recommend the child investigate opportunities for volunteering at local charities.
Encourage the child to develop new skills. Recommend the child begin to participate in after-school activities. Recommend the child investigate opportunities for volunteering at local charities
Growth will be complete at
End of adolescence
My brother is 13 and is still wetting the bed. My dad had this issue too
Enuresis
Introduce foods how:
Every 5 days for allergies with bland food (rice, cereal, vegetables)
Low sodium diet patient
Fluid retention/Swelling in lower extremities
Best practice/Education for monthly self breast exams/self testicular exams
In shower with soapy hands, take pads of fingers and rubbing to identify if there are lumps-contact physician right away if lump is identified
Frequent vaccinations
Infant
No honey due to botulism
Infant
Health Tests & Screenings: APGAR Hearing Loss Hep A&B, MMR Eye prophylaxis ointment Hip dysplasia screening Metabolic disorder screening LATCH (breastfeeding) Birth weight triples
Infant (up to 1 year)
Nutrition & Exercise: Rest - up to 15hrs sleep/day Small frequent feedings Tummy-time (improves head/neck strength) Breast/Bottle
Infant (up to 1 year)
Social Interactions: Attachment - parent involvement Reading Exposure to other children Crying Coos/Verbalizations
Infant (up to 1 year)
A nurse has made a commitment to change his eating habits to optimize his health and wellness. He researches various dietary plans and narrows his choices to those that minimize the effect of the lifestyle barriers like eating quickly at work. Which stage of the transtheoretical model is he in? Contemplation Preparation Action
Preparation
Begin to develop permanent teeth
Preschool
Erikson's initiative vs. guilt
Preschool
Imagination/magical thinking
Preschool
Sleep disturbances common
Preschool
Preschool: Leading cause of death
Unintentional injuries (accidents, falls)
A nurse is giving a presentation to a group of nursing students about distinguishing health promotion and disease prevention activities. Which of the following actions should the nurse include as a specific disease prevention activity? Practicing daily meditation Adding more protein to the diet Wearing sunscreen outdoors Receiving an influenza immunization Protecting ears from loud noises
Wearing sunscreen outdoors Receiving an influenza immunization Protecting ears from loud noises
Recommended patients for high protein
Wound healing Extra energy Oncology patients
Can infants have peanut butter?
Yes, 4 times a week starting at 6 months
Creating goals for the future/Future Focused
Young Adult
Use 2 word phrases "bye-bye"
18 months
Infant appointments at:
2 weeks-sleeping safe, eating okay? 2 months 4 months 6 months 9 months 1 year
300 word vocabulary; 3 word sentences
2 years
Sleep 10-12 hours at night, take multiple naps throughout the day (16 hours total a day)
Infant
Modifiable vs. Non-modifiable: High Cholesterol
Modifiable
Erikson's Autonomy vs. Shame & Doubt
Toddler (1-3 years)
Farm safety General safety-looking both ways before you cross All medications and chemicals locked up Remove choking hazards Stranger danger Fall safety-baby gates Burn safety-put pots and pans on back burner, handles facing out, keep coffee cups out of reach Sibling safety-teach limits and safely handling newborn Environmental safety-radon detector in house, lead based paint (house built in 1950's or before) - flakes are sweet
Toddler Health Promotion
Etiology of dementia
Unknown
The World Health Organization's (WHO's) definition of health promotion focuses on the concept of improving control over health elimination risk factors for health problems reducing the consequences of illness
improving control over health
Safety Considerations: Car Seat Supervision Back to sleep Avoid soft bedding - nothing in the crib Water temp
Infant (up to 1 year)
Bone density exam for menopausal or post menopausal women, if you have risk factors, under the age of
65
Acceptance of peers begins at age-peer relationships (typical same sex friends)
7
Transfer objects from hand to hand
7 months
How much caffeine can you have while pregnant
70 mg
Menses cycle starts between ages
9 and 14
May start to crawl
9 months
Adolescent sleep need
9-10 hours/night
Hemoglobin and hematocrit checks-iron deficiency anemia Lead level check Vaccination boosters TB skin test Denver developmental screening test
Preschool annual checkups
Safety Considerations: Immunizations Bodily Harm Accident prevention Substance Abuse Drowning Stranger Danger
School-Age (6-12 years)
Social Interactions: Awareness and empathy for others Increased independence Peer groups/pressure School-based relationships - social influence Sense of identify Goal setting
School-Age (6-12 years)
8-12 hours at night (older children sleep less hours) growth spurts require more sleep-allow it
School-age sleep needs
Primary, Secondary, or Tertiary: Receiving the HPV vaccination
Secondary
Primary, Secondary, or Tertiary: School nurse checking for head lice in a high risk classroom
Secondary
Primary, Secondary, or Tertiary: Screening and early diagnosis
Secondary
Primary, Secondary, or Tertiary: Suicide hotline
Secondary
Prevention: Level
Secondary Prevention
Tests, Screenings, & Vaccines (self breast exam, colonoscopy, HPV vaccine)
Secondary Prevention
An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate? "Once the underlying cause of the confusion is found and treated, your loved one will be better than ever." "What concerns you most about Alzheimer disease?" "Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion." "Alzheimer disease can be a great burden on the family. What community resources do you know about?"
"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."
A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate? "Depression may manifest as dementia in elderly clients." "Dementia is a terrible disease of the elderly." "Drug interactions are the most common cause of dementia in the elderly." "The most common cause of dementia in the elderly is Alzheimer's disease."
"The most common cause of dementia in the elderly is Alzheimer's disease."
The nurse is teaching parents how to avoid a power struggle with their 2-year-old girl. Which comment indicates that more teaching is needed? "We will make sure she shares her toys with cousins her age." "We will give her a choice whenever possible." "Both of us, as parents, will agree on and consistently enforce the limits we set." "Childproofing our home will make it less necessary to say 'No!'"
"We will make sure she shares her toys with cousins her age."
The parents of a 4-day-old infant report concern about his weight loss. What is the best response by the nurse? "With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks." "Babies will begin to rapidly regain weight and will double birth weight around 4 to 6 months of age." "Weight loss after birth is normal." "Babies may lose up to 10% of their body weight in the first month of life."
"With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks."
Nutrition & Exercise: Changes in diet Slowed growth = fewer calories Weaning (bottle or breast) Vit D milk Allergies Finger foods, choking hazards Play - outside exposure/safety, agility
Toddler (1-2 years)
Leading causes of death in toddlers
#1 unintentional injuries (accidents) #2 congenital abnormalities
Baby proofing-no power cords, put all furniture against wall, cabinet locks, corner guards, gates for stairs, outlet/toilet covers Never leave unattended in tub Water temp to 120 degrees or less No screens No small objects-choking hazard Cordless blinds
Infant home safety education
Birth weight triples
1 year
Walking along furniture & pulling themselves up
11 months
Toddler sleep
12 hours for young toddlers (2 naps a day in late morning & afternoon) 8-10 hours for older toddlers (one nap a day)
•Weight triples •Switch to whole milk •Da-da and ma-ma (2-syllabuls)
12 months
Anterior fontanelle closes at
12-18 months (Toddler)
Creep up stairs
15 months
Toddler appointments
15 months 18 months 2 years 3 years
Able to hold a spoon
18 months
Able to walk alone
18 months
Throw ball overhand
18 months
Throw overhand
18 months
An infant has been brought to the clinic for a well-child check. The infant is 12 months of age. The child's birth weight was 6 pounds, 7 ounces. What is the anticipated weight for the child at this visit? 19 pounds, 5 ounces 21 pounds, 9 ounces 18 pounds 20 pounds
19 pounds, 5 ounces
Build 6 block tower
2 years
Four times their birth weight
2 years
Kick a ball
2 years
Walk up stairs one stair at a time
2 years
Head lifting off mattress with tummy time
3 months
Ride tricycle
3 year old
Stand on one foot
3 year old
Balances on one foot
3 years
Begin to ask why?
3 years
Can engage in simple conversation
3 years
Prior to age 40, physicals required every
3 years
Preschool checkups occurs at
3 years, 4 years, 5 years
Catch a ball
5 year old
Jump rope
5 year old
When do you get your first PSA testing & how often? (no underlying conditions)
50 & approximately every 5 years (provider determines how often)
Hold their own bottle
6 months
Weight doubles
6 months (Infant)
Vocabulary goes to 3,000 words
6 year old
•Bottom front 2 teeth come in •Making sounds •Likes peak-a-boo
6-9 months (Infant)
The nurse is caring for an elderly client who is being treated for community-acquired pneumonia. Since the time of admission, the client has been disoriented and agitated to varying degrees. Appropriate referrals were made and the client was subsequently diagnosed with dementia. What nursing diagnosis should the nurse prioritize when planning this client's care? Acute confusion related to dementia Social isolation related to dementia Risk for infection related to dementia Hopelessness related to dementia
Acute confusion related to dementia
Average only 7.5 hours of sleep at night-contributes to doing poorly in school, irritable, having a lot of stress Try to push limits
Adolescent
Changing bodies and feelings due to hormones
Adolescent
Concerned with body image/apperance
Adolescent
Develop intimate relationships
Adolescent
Menses start for girls and boys may have nocturnal emissions
Adolescent
Gun safety Open communication/Share feelings to identify mental health and suicide concerns early Educate on bullying - how to respond and handle that Risk taking behavior - drugs, alcohol, sex Eating disorders - recommendations for food with well balanced diet, ensure they are eating, avoid fad diets, avoid caffeine (racing heart rate, increase BP & RR, insomnia) Routine physicals, esp. for sports Dental exams at least annually or biannually Meningitis vaccine Orthodontist-braces Contraception-increased risk of blood clots (don't smoke)/STI education Driving safety Job requirements and safety Cigarettes and tobacco-vaping, chewing (all products containing nicotine and harm) Relationship goals and what a healthy relationship truly looks like Discourage reckless behavior
Adolescent Health Promotion
Seat belts & car safety - drive speed limit, wear seat belt, do not text and drive How to manage stressors in life/organize life Anxiety, depression, and stress screenings Teach about identity - acceptance Techniques to help with conceiving Divorce/Separation is common Violence and abuse in relationships with cohabitation
Adolescent Health Promotion
Mental health screenings for depression and suicide Obesity screenings (BMI check) Scoliosis screenings for boys
Adolescent annual checkups
When do you get your first colonscopy & how often? (no underlying conditions)
Age 50 & every 10 years
"They are terrible drivers because they are old."
Ageism
"They can't have an iPhone. They don't know how to use it. They are slow."
Ageism
"Have I lived a good life? Am I accomplished?" or "Wow I have not accomplished much in this life. I would do so many things different. I have much more to accomplish."
Aging Adult
Have high BP
Aging Adult
Hypertrophy of prostate exam
Aging Adult
Illness-multiple illnesses
Aging Adult
Issues peeing regularly or peeing an adequate amount/genital tract atrophy or less secretions (dry or may cause incontinence)
Aging Adult
Joints stiffen (arthritis)
Aging Adult
Loss/decrease of sensation in some extremities-pain threshold increases
Aging Adult
Many physiologic changes occur
Aging Adult
May have issues with completing ADL's
Aging Adult
Mobility slows in general
Aging Adult
Muscle mass/tone decreased
Aging Adult
Need toileting schedule due to bladder capacity decrease & atrophy in genital tract
Aging Adult
Polypharmacy-medication interactions
Aging Adult
Restless less syndrome
Aging Adult
Retirement is common
Aging Adult
Skin looses elasticity (tough healing)
Aging Adult
Sleep at night shortens-episodes of taking cat naps
Aging Adult
Technology influence
Aging Adult
Encourage exercising (weight bearing activities like walking)
Aging Adult Health Promotion
Encourage socializing-playing dominos, watching show, having meal together
Aging Adult Health Promotion
A nurse is caring for a client who is immobile. Which of the following actions should she perform when repositioning the client to avoid injuring her own muscle skeletal system? Adjust the bed to its lowest position Align her feet vertically with her shoulders Stand slightly away form the bed when turning the client
Align her feet vertically with her shoulders
A nurse is reviewing the medication history of a client who reports having difficulty sleeping. Which of the following classifications includes some medications that should alert the nurse to the possible adverse effect of insomnia? Antidysrhythmics Anticholinergics Antihistamines
Antidysrhythmics
What culture group: No direct eye contact-seen as disrespectful, holistic treatment first
Asian American & Muslim
Smoking can lead to
Asthma & allergies
Foods high in fiber
Avocado, oats, apples, broccoli
School-age sleep disturbances may be related to
Awareness of death or school stress
Early intervention for scoliosis
Back brace
Safest spot for an baby in a car: Education of car seat safety
Back middle seat rear facing
LDL
Bad cholesterol-lead to plaque buildup in arteries
A nurse is talking with a group of coworkers about changing a rotating shift policy. She explains the importance of circadian synchronization for optimal health and well-being. Which of the following is an example of this phenomenon? Being awake when melatonin levels peak Sleeping when heart rate peaks Being awake when body temperature peaks
Being awake when body temperature peaks
Drinks containing caffeine
Black tea, Colas (pepsi, coke), hot chocolate
Feeding Preferred
Breast is preferred, but fed is best
I just switched jobs. I am so stressed out and now I am waking up with a sore jaw every day.
Bruxism
Health Tests & Screenings: Cancer screenings Routine physicals Immunizations Shingles vaccine at age 60 Vision, Dental, Breast/Testicular exams TB screenings? Cholesterol, blood glucose, BP Family History Mental Health Screenings Menopausal changes
Middle Adult (35-65 years)
Nutrition & Exercise: Walking Weight training Calcium & Vit D Leaner meats Reduced salt
Middle Adult (35-65 years)
Safety Considerations: Driving Safety - night vision Workplace safety Home Safety
Middle Adult (35-65 years)
Causes of vascular dementia
Cardiovascular disease, high BP, high cholesterol, smoking, diabetes, poor blood pressure control
Recommended patients for high Omega 3
Cardiovascular health Prevent cancer
The nurse is preparing the anticipatory guidance sheets that are provided to parents. When organizing the sheets, place the milestones in their proper sequence from earliest to latest. Creep up stairs Engage in parallel play Name one color Run and jump in place Zip up their own jackets
Creep up stairs Run and jump in place Engage in parallel play Name one color Zip up their own jackets
S/S: Confusion, Combative/Irritable, Crying, Poor safety awareness/hard to reason with, Hypoactive-slow to respond/somnolent, can't focus, LOC alters, disorganized thinking/can't follow directions, delusions/hallucinations-suspicious, fearful, anxious
Delirium
Screening: Answer neurological questions appropriately but critical thinking is a struggle "Does a stone float on water?" "What is 3 + 2?" Squeeze my hand every time I say A with "Save A Heart"
Delirium
•Assess neuro status-how delirious/what S/S do they have? •Report & ensure safety-high risk for falls due to impaired judgment/safety awareness •Interventions to prevent further deterioration-side rails up, non-skid socks on, bed/chair alarm on (fall/harm prevention), enforce daily routine •Educate the family •Reorient right away •Environmental changes-at night turn off all lights, TV, radio, & shut blinds, during day turn on lights, open blinds, order breakfast, & get them back into routine, answer alarms quickly/promptly, cluster cares to allow for sleep •Notify the physician
Delirium Interventions
Sleep disorders where you can't sleep or have excessive sleepiness
Dyssomnias
Sleep Disorders
Dyssomnias and Parasomnias
Food high in Omega 3
Fish & fish oil
Low fiber diet patient
GI upset (Crohn's disease, ulcerative colitis, diverticulitis, IBS)
"What is the future for my kids? I want to set them up for the future"
Generativity
Defect on chromosome 14, 19 & 21
Genetic tie with early dementia
A nurse is giving a presentation about health promotion and disease prevention to a group of young adults at a community college. Which of the following instruction should the nurse include? Get an influenza immunization every 2 years Have a vision screening and eye examination every 2 years Get a tetanus and diphtheria immunization every 10 years
Get a tetanus and diphtheria immunization every 10 years
Typically who is potty trained first
Girls
Low cholesterol diet patient
Heart disease Hypertension Plaque buildup
A nurse is talking with a parent who has two young children who sleepwalk. Which of the following information is the priority for the nurse to emphasize with this parent? Keep in mind that many children do outgrow this behavior Try to explore whether or not the children have any new stressors Install gates to block the children's access to stairways
Install gates to block the children's access to stairways
A nurse can communicate well, manage time effectively, weigh options and consequences, and learn from mistakes. The nurse is demonstrating wellness in which of the following dimensions of health? Intellectual Social Cues to action
Intellectual
Sexual & Psychosocial history for adolescent
Interview child way from parent/by themselves
If school-age is hospitalized: Talk to them...
Involve both child and parent in conversation-ask child how they learn best (pictures?) Explain at level of education of the child, talk your way through assessments
Fatigue & Poor School Scores could be related to
Lack of sleep
What culture group: Utilize medical interpreter (not family member)
Latino
Malignant neoplasms (cancer), cardiovascular disease, liver disease (alcohol abuse), diabetes, suicide, stroke, sepsis, nephritis, unintentional injuries (work related injuries, MVA, poisoning, falls)
Leading causes of death in middle adult
Foods low in sodium
Legumes, beans, fish, chicken (not canned)
Alternatives to drinks with caffeine
Lemon-lime sodas White milk
How to handle adolescent with hospitalization
Let them have independence with privacy and time for controlling/managing their life (i.e. give them wifi password)
The nurse is completing a care plan for a preschool child with the nursing diagnosis of imbalanced nutrition, less than body requirements. Which interventions should the nurse include? Select all that apply. Limit juice to 6 to 8 ounces per day. Limit milk to 16 to 24 ounces per day. Provide at least 3 meals and 2 healthy snacks per day. Weigh child weekly on the same scales at home. Feed the child whenever he wants to eat.
Limit milk to 16 to 24 ounces per day. Provide at least 3 meals and 2 healthy snacks per day. Weigh child weekly on the same scales at home.
You want LDL levels to be
Low
Food high in protein
Meat (grilled chicken breast)
Decrease in stage 4 REM sleep-problems staying asleep
Middle Adult
Driving is more difficult (i.e. nighttime vision)
Middle Adult
Emotional changes-empty nest syndrome (can lead to divorce with disconnection), dissatisfaction from job
Middle Adult
Erikson's generativity vs. stagnation
Middle Adult
Financial stability
Middle Adult
Hormonal changes-menopause, testosterone levels change
Middle Adult
Less rigid in spiritual belief
Middle Adult
Like to have freedom
Middle Adult
Sleeping medications very common
Middle Adult
Thinking about retirement-support yourself, kids, and parents?
Middle Adult
Lilly wakes up and is talking about being chased by scary monsters while she is sleeping
Nightmares
Very common sleep disorder in toddlers/preschool
Nightmares
Gain 3-5 lb per year and 2.5 inches on average
Preschool
Sleep disturbances common in the form of sleep walking, nightmares and night terrors
Preschool
Start to slim down and get slightly taller
Preschool
Health Tests & Screenings: Flu shots DTAP, IPB, MMR, Varicella, TB? Developmental/physical screenings Behavioral assessment BMI yearly BP annually F/U Lead screening Hearing/Visual screenings Dental Care
Preschool (3-5 years)
Nutrition & Exercise: Use of utensils. Well-balanced diet, minimal sugar Allergy awareness. Dietary preferences - calcium, Vit D Vitamins Screen Time
Preschool (3-5 years)
Social Interactions: Communication - fuller language Cooperative play Conflict resolution Emergency preparations Stranger Danger Offering choices = control
Preschool (3-5 years)
Safety Considerations: Safety equipment Stranger Danger Car Seat safety Accident Prevention
Preschool (3-5 years)
Street safety Farm safety Stranger danger Water safety Teach diet-encourage snacks and meals high in protein Communicable diseases (common cold, GI bug, flu, Infantigo, hand foot and mouth disease)-teach hand hygiene, proper way to cover and wash hands after, use Kleenex's/tissues Helmet use with tricycle Dental exams
Preschool health promotion
Annual checkups begin
Preschool-at 3 years
Primary, Secondary, or Tertiary: Providing education to adults on healthy eating
Primary
A nurse is providing care to a patient with delirium. Which interventions would be most appropriate to implement? Select all that apply. Supervising nutritional intake Keeping the patient awake as much as possible Providing a calm, quiet environment Using familiar cues about the environment Administering psychoactive drugs
Providing a calm, quiet environment Supervising nutritional intake Using familiar cues about the environment
A group of nursing students are completing a clinical day at a preschool. Which behaviors would they identify as common in this preschool group? Select all that apply. Regression Telling of tall tales Imaginary friends Sibling rivalry Difficulty with sharing Completing multi-step tasks
Regression Telling of tall tales Imaginary friends Sibling rivalry Difficulty with sharing
I can't ever be still when I'm in bed. I need medication to control this so I can relax and sleep.
Restless Leg Syndrome
Sleep disorder where people are very dependent on their medication to treat
Restless Leg Syndrome
The community health nurse is providing a class to a group of teens training to become "safe babysitters". When discussing activities that are appropriate for 3-year-olds, which should be included? Select all that apply. Skipping Skating Riding a tricycle Playing tag Playing catch
Riding a tricycle Playing tag
Nutrition & Exercise: Bigger portions Frequent snacks - nutritious - preventing or managing weight Increased Calcium & Vit D Avoid empty calories Responsibility - chores, daily activities
School-Age (6-12 years)
•Strict bed time routine for children •Avoid excessive caffeine intake-causes insomnia & diuretic-urinate often during night •Keep babies on back for SIDS prevention •Offer bedtime snacks with high carbohydrates •Avoid TV to fall asleep-no TV in bedroom •Increase physical activity and exercise-not right before bed (morning or early afternoon) •Dim lighting/read before bed •Avoid smoking-increases HR & anxiety/jittery from nicotine •Limited alcohol can induce sleep but excessive can cause decreased REM/diuretic-urinate often during night •Keep a consistent sleeping environment/routine
Sleep Nursing Interventions: At home
Reduce alarms Keep bed-time routine (especially for toddler and school-aged children) Minimize interruptions during night-cluster cares/don't wake them up every hour Depending on age avoid excessive day napping-during day engage them in routine/keep them up & active Encourage less caffeine Encourage normal sleep-wake patterns-waking & going to bed same time everyday Adjust room temperature and provide adequate clothing to encourage sleep-wear socks & adjust temp in room, warm blankets to get comfortable at rest
Sleep Nursing Interventions: In hospital setting
A nurse is talking with a client who is about to begin using a continuous positive airway pressure device to treat obstructive sleep apnea. Which of the following instructions should the nurse also recommend for clients who have sleep apnea? Limit fluids Sleep on their side Avoid alcohol Do not smoke Do stretching exercises
Sleep on their side Avoid alcohol Do not smoke
After I slept my husband found a plate, chip bag, and silverware in the nightstand drawer, but I swear that I didn't put it here.
Sleep-related eating disorder
A nurse is preparing a "lunch and learn" presentation for a group of coworkers about sleep deprivation. She should explain that people who are sleep-deprived can develop which of the following manifestations? Slowed reflexes Loss of fine motor control Decreased sensitivity to pain Blurred vision Cardiac dysrhythmias
Slowed reflexes Loss of fine motor control Blurred vision Cardiac dysrhythmias
I caught my brother walking outside again. When I confronted him he seemed like he was still sleeping.
Somnambulism
Sleep walking
Somnambulism
Primary, Secondary, or Tertiary: Anemic toddler getting every 4 month iron checks
Tertiary
Primary, Secondary, or Tertiary: Cardiac rehab class
Tertiary
Primary, Secondary, or Tertiary: Counselor referral following a suicide attempt
Tertiary
Primary, Secondary, or Tertiary: Home health care
Tertiary
Primary, Secondary, or Tertiary: Referral to a weight coach after diagnosis of morbid obesity
Tertiary
Primary, Secondary, or Tertiary: Seeing a cardiologist after a diagnosis of CHF
Tertiary
Primary, Secondary, or Tertiary: Speech therapy after a stroke
Tertiary
Primary, Secondary, or Tertiary: Wound clinic referral for a diabetic foot ulcer patient
Tertiary
Screenings & testing done frequently, wound care, specialists, consults
Tertiary Prevention
Treatment (Have to have diagnosis)
Tertiary Prevention
Social Interactions: Imitation - language and behavior Sign language Parallel play Tantrum management Social language/interactions skills Music play Least invasive first Physical expression during play
Toddler (1-2 years)
"me do it"
Toddler (1-3 years)
A nurse is assessing a 2-year-old's language development. What would the nurse expect to assess? Verbalization of 4 to 6 words Use of a two-word noun-verb sentence Knowledge of full name Ability to name one color
Use of a two-word noun-verb sentence
Toddler house safety with sleep considerations
Wander house with sleep walking-keep doors locked and gates up with stairs
A nurse is teaching a client who is undergoing a sleep study to confirm obstructive sleep apnea (OSA). Which of the following information should the nurse include in the teaching? OSA involves an abnormality in the respiratory center of the brain Common risk factors for OSA include hypertension and heart failure With OSA, oral structures relax during sleep and block the flow of air
With OSA, oral structures relax during sleep and block the flow of air
Ages 19-34
Young Adult
Creative, objective, realistic and less self-centered
Young Adult
Erikson's intimacy vs. isolation
Young Adult
Starting education and life experiences
Young Adult
Starting/changing occupations
Young Adult
Think abstractly
Young Adult
Value conformity, loyalty, & social order
Young Adult
Health Tests & Screenings: BP, TB test Breast/Testicular exams Vision exams Dentist STD screening PAP smear Mammogram (if family history) Meningococcal vaccination-prior to college Tetanus boosters every 10 years HPV vaccinations Mental health screening
Young Adult (19-34 years)
Nutrition & Exercise: Weight management, diet changes related to slowed metabolism Eating out of convenience Maintaining a healthy diet
Young Adult (19-34 years)
Safety Considerations: Driving Safety - operating under the influence Suicide Substance Abuse Gun Safety
Young Adult (19-34 years)
A nurse should share with a group of attendees at a sleep disorders workshop that the primary cause of short-term sleep disturbances is
emotional stress
A nurse is caring for a client who has a long history of abuse of alcohol and opiate opioid analgesics. When counseling this client about the adverse effects of substance abuse, the nurse should explain that these patterns reduce the oxygenation of his tissues and organs because they cause
respiratory depression
The parents of a 12-year-old boy voice concern to the nurse that their child wants to dress like peers and not the way they prefer. Which responses by the nurse are appropriate? Select all that apply. "Children at this age often want to connect with their peers. You should probably allow him to dress like his friends." "Have you spoken with your son about his concerns and about your concerns? Open dialogue often helps in resolving these issues." "Peer acceptance is an important part of development for children, especially at this age. Maybe talking about it with your son can lead to an agreement." "If the way your son's friends are dressing is not against school dress code, is it worth it to argue about his clothes?" "Peer pressure is hard enough for children of this age without pressure from their parents. You need to seek family counseling immediately."
"Have you spoken with your son about his concerns and about your concerns? Open dialogue often helps in resolving these issues." "Peer acceptance is an important part of development for children, especially at this age. Maybe talking about it with your son can lead to an agreement."
Temper tantrums in toddlers are a result of
Frustration in not being able to communicate what they need
Vitals •BP-85/60 •RR- 30-45 •Pulse- 90-170
Infant
Erikson's Trust vs. Mistrust
Infant (0-1 year)
Modifiable vs. Non-modifiable: Drinking alcohol
Modifiable
