PEDS EXAM 2

bathroom language

many preschoolers imitate the vocabularies of their parents or older children in the family so well during this time that they incorporate swear words into their vocabularies if they hear these used

recreational drug use for school-age child

marijuana, cocaine, and amphetamines are now available to children as early as elementary school and certainly by the time they reach the seventh and eighth grade - suspect if child regularly appears irritable, inattentive, or drowsy - counsel against use of steroids; highlight future cardiovascular irregularities, uncontrollable aggressiveness, and possible cancer - teach to recognize tobacco advertising manipulation; caution against experimenting with smokeless tobacco - role model excellent nonsmoking health behavior

menstrual irregularities

menstrual irregularities can be a major health concern of adolescent girls as they learn to adjust to their individual body cycles

obesity (teenagers)

most overweight adolescents have obese parents, suggesting that both inheritance and environment play a part in the development of adolescent obesity

hearing for infants

newborn should have intact acoustic blink reflexes to sudden sounds - infants should turn toward sounds

accidents

(unintentional injuries) are the major cause of death in infants through young adults in the United States - unintentional ingestions (poisoning) and auto accidents are the types of unintentional injuries that occur most frequently in toddlers

fears and anxiety

- a fear of attending school - children who resist attending school this way develop physical signs of illness, such as vomiting, diarrhea, headache, or abdominal pain on school days

promoting infant safety: car safety

- teaching car safety for infants is an important protective health measure - infants should be placed in backward facing seats in the back seat because an inflating front seat airbag could suffocate an infant

glycogen loading diet (teenagers)

- a procedure used to ensure there is adequate glycogen to sustain energy through an athletic event - before the event they lower their carb intake and exercise heavily - then they switch to a diet high in carbs - then the renewed carb intake, muscle glycogen is stored at two or three times the usual level, which supplies them with up to twice the glucose needed for sustained energy

acne

- a self-limiting inflammatory disease that involves the sebaceous glands, which empty into hair shafts - the most common skin disorder of this age group

autonomy

- according to Erikson - autonomy versus shame and doubt - independence is paramount for toddlers, who are attempting to do everything for themselves - toddlers often use negativism, or negative responses, as they begin to express their independence

hazing or bullying (teenagers)

- actually becomes more serious because this can be the time the bullied child has the ability to retaliate through self-destructive behavior or school violence - hazing, a form or organized bullying, refers to demeaning or humiliating rituals that prospective members have to undergo to join sororities, fraternities, adolescent gangs, or sport teams

problem solving (school-age child)

- an important part of developing a sense of industry is learning how to solve problems - parents and teachers can help children develop this skill by encouraging practice - developmental task: INDUSTRY VS. INFERIORITY

weight, height, head circumference, BMI in toddlers

- at 30 months of age, toddlers should weigh four times their birth weight - height: toddlers grow about 3 inches per year - anterior fontanels close by 18 months of age - head and chest circumference are usually equal by 1 to 2 years of age

body image (teenagers)

- base their own normality on comparisons with peers - the image established during adolescence is retained throughout life

development in daily activities

- bathing - diaper-area care - dental care - dressing - sleep - exercise

language development of school-age child

- because children discover "dirty" jokes at about age 9, they like to tell them to friends or try to understand those told by adults - they can carry on conversations, although stories are limited because of a lack of experience

vegetarian diet (teenagers)

- because vegetables generally contain fewer calories than meat, adolescents need to consume large amount of them to achieve an adequate caloric intake from a vegetarian diet - tofu and vegetable protein can help

infants: body proportion

- body proportion changes during the first year from that of a newborn to a more typical infant appearance - by the end of the infant period, the lower jaw is definitely prominent and remains that way throughout life

sexual, physical concerns of school-age boys

- boys become more aware of increasing genital size - hypertrophy of breast tissue can occur - have pubic hair before anywhere else - boys notice ejaculation during sleep, termed nocturnal emissions

object permanence

- by 10 months, infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear

nutrition and diet of school-age child

- by the end of the school-age years, children should eat adult portions of food - they need quality nutritious snacks - obesity is an increasing concern of this age group

quantities and types of food for infants

- cereal - vegetables and fruit - meat and eggs - table food

secondary sex changes in girls

- changes occur in the following order - breast development, pubic hair growth, axillary hair growth and menstruation

toddler nutrition

- children may establish lifetime eating habits during early childhood - toddlers begin developing taste preferences, and are generally picky eaters who repeatedly request their favorite foods - toddlers generally prefer finger foods because of increasing autonomy

lack of adult supervision

- children whose parents both work outside the home may spend time alone without adult supervision for a part of each weekday - a major concern of children staying home alone is that they will experience an increased number of unintentional injuries, delinquent behavior, alcohol or substance abuse, or decreased school performance

teeth of school age kid

- deciduous teeth are lost and permanent teeth erupt during the school-age period - the average child gains 28 teeth between 6 and 12 years of age

daily activities for school-age child

- dress: they can fully dress themselves, they are not skilled at taking care of their clothes until late in the school-age years. These children have definite opinions about clothing styles - possible bullying - sleep: required sleep is highly variable in the school-age years, and is dependent on the following: age, level of activity, and health status - exercise: need daily exercise - hygiene: generally able to bathe themselves, but may not do it well because they are too busy to take the time or because they do not find bathing as important as their parents do. These kids may want to start showering. - care of teeth: with proper dental care, the average child today can expect to grow up cavity free

dental caries and malocclusion (school-age child)

- floss daily, have regular checkups - brush after meals and snacks and at bedtime - malocclusion should be evaluated by an orthodontist for braces

infants: cardiovascular system

- heart rate slows from 110 to 160 beats/min to 100 to 120 beats/min by the end of the first year - infants are prone to develop a physiologic anemia at 2 to 3 months of age - the respiratory rate of an infant slows from 30 to 60 breaths/min to 20 to 30 breaths/min by the end of the first year

pre-conventional reasoning (school-age child)

- in early years, they believe what they think is wrong, and what others tell them is right, that judgment is guided by rewards and punishment and sometimes interpret accidents as punishment - in later years, are able to judge the intentions of an act rather than just its consequences, understand different points of view instead of just whether or not an act is right or wrong

language development for toddlers

- language increases to about 300 words by the age of 2 years - start using sentences

self-esteem (teenagers)

- may undergo major changes during the adolescent years and can be challenged by all the changes that occur during adolescence - they view themselves according to their unique characteristics as the adolescent years progress

socialization for toddlers

- once toddlers are walking well, they become resistant to sitting in laps and being cuddled - this is not lack of a desire for socialization but a function of being independent

socialization of school-age child

- peer groups play an important part in social development - peer pressure begins to take effect - clubs and best friends are popular - conformity becomes evident

physical, psychosocial, cognitive development of 6 y/o

- physical: a year of constant motion; skipping is a new skill; first molars erupt - psychosocial & cognitive: 1st grade teacher becomes authority figure; adjustment to all-day school may be difficult and may lead to nervous manifestations of fingernail biting, etc. Defines words by their use (ex: a key is to unlock a door, not a metal object)

recommended dietary reference intake (teenagers)

- rapid growth and high metabolism require increases in quality nutrients, and make adolescents unable to tolerate caloric restrictions - both overeating and under-eating present special challenges during the adolescent years

health promotion: nutrition of preschooler

- recommended dietary reference intakes: preschoolers need 13 to 19 g/day of protein, in addition to adequate calcium, iron, folate, and vitamins A and C - nutritional health with vegetarian diet: a vegetarian diet is usually colorful and therefore appeals to preschoolers - if vegetarian diets are deficient in any aspects, it is usually in calcium, vitamin B12 and vitamin D

sexual education for school-age child

- reproductive organ function and physiology of reproduction, so children understand what menstruation is and why it occurs - secondary sexual characteristics, so children will understand what is happening in their bodies - male sexual functioning, including why the production of increased amounts of seminal fluid leads to nocturnal emissions - the physiology of pregnancy and the possibility for unintended pregnancies, which will come with sexual maturity - social and moral implications of sexual maturity

promoting adequate intake with vegetarian diet for toddlers

- sedentary children ages 1 to 3 years should consume 1,000 kcal daily; active children in this age group may need up to 1,400 kcal daily - calories are best supplied by a variety of foods spaced into three meals a day - protein and carbohydrate needs are often those most easily met during the toddler period; diets high in sugar should be avoided to help prevent toddler obesity - fats should generally not be restricted for children under 2 years old; however, children over 2 years old should have a total fat intake between 30% and 35% of calories, with most fat coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils, the same as adults. - trans fats should be kept to a minimum - adequate calcium and phosphorus intake is important for bone mineralization. Milk should be whole milk until age 2 years, after which 2% milk can be introduced

depression and self-injury (teenagers)

- self injury's include a range of self-destructive actions from cutting to suicide, the planned intent to end one's life - some degree of depression is present in most adolescents because they are not only losing their parents while they grow apart from them but also their carefree childhood - if school failure, loss of a girlfriend or boyfriend, loss of a competition with loss of self-esteem, or rejection by a peer group is superimposed on existing depression, the pressure may be great enough to attempt suicide

fatigue (teenagers)

- sleep habits change with puberty due to increased metabolism and rapid growth - adolescents tend to stay up late, sleep in later in the morning, and sleep more than during the school-age years - during periods of active growth, the need for sleep increases

sleeping (teenagers)

- sleep habits change with puberty due to increased metabolism and rapid growth - adolescents tend to stay up late, sleep in later in the morning, and sleep more than during the school-age years - during periods of active growth, the need for sleep increases

moral and spiritual development in adolescents

- solve moral dilemma using internalized moral principles - questioning relevance of existing moral values to society and individuals - because adolescents enlarge their thought processes to include formal reasoning, they are able to respond to the question, "Why is it wrong to steal from your neighbor's house?"

emancipation

- some parents may not yet be ready for their child to be totally independent, and some adolescents may not yet be sure they want to be on their own - the closer the tie adolescents feel with their parents, the more severe can be their struggle

lead screening

- sources: windowsills, paint chips, furniture, toys from other countries, soil, dust, pottery, colored print, lead dust - testing: CDC recommends screening for all children between the ages of 9 and 12 months at least once and again at 18 to 24 months of age. A small amount of blood taken by a finger prick is analyzed. - effects: low, but positive levels, can cause learning and behavioral problems. High levels can cause seizures, cognitive challenges, coma, and even death

telling tall tales

- stretching stories to make them seem more interesting is a phenomenon frequently encountered in preschoolers - a child perceives you want something exciting to have happened, so they stretch the truth

parental concerns and problems for infants

- teething - thumb sucking - use of pacifiers - head banging - sleep concerns - constipation - loose stools - colic - spitting up - diaper dermatitis - prickly heat - baby-bottle tooth decay syndrome - infant obesity

behavior variations of preschoolers

- telling tall tales - imaginary friends - sharing - regression - sibling rivalry - new sibling - sex education - choosing preschool or child care center - preparing child for school - broken fluency - bathroom language

infants: GI tract, liver, kidneys

- the GI tract is immature in its ability to digest food and mechanically move it along - the liver remains immature, possible causing an inadequate conjugation of drugs (if needed) and the inefficient formation of carbohydrate, protein, and vitamins for storage - the kidneys remain immature and not as efficient at eliminating body wastes as in an adult

infants: adjust to cold and fluid shifts

- the ability to adjust to cold is mature by age 6 months - although the fluid in body compartments shifts to some extent, extracellular fluid accounts for approximately 35% of an infant's body weight, with intracellular fluid accounting for approximately 40%

infants: endocrine and immune system

- the endocrine system remains particularly immature in response to pituitary stimulation, such as adrenocorticotropic hormone, or insulin production from the pancreas - the immune system becomes functional by at least 2 months of age

physical growth in adolescent (12-20 y/o)

- the final 20% to 25% of height is achieved during puberty - acne may appear during adolescence - girls stop growing 2 to 2.5 years after the onset of menarche - boys stop growing at around 18 to 20 years of age - teeth: corrective appliances are most common with this age group

puberty

- the time at which an individual first becomes capable of sexual reproduction - puberty creates many questions for early teenagers about what is normal and what is not

safety for school-age child

- these children are ready for time on their own without direct adult supervision - this means that they need good education on safety practices - sexual maltreatment is an unfortunate and all-too-common hazard for children

living with others (school-age child)

- these children are sometimes so interested in tasks and in accomplishing physical projects that they forget, they must work with people to achieve these goals - this is a good time to urge children to learn compassion and thoughtfulness toward others during the early school years

dress and hygiene (teenagers)

- they can be acutely aware of how their peers dress - because of their body awareness, they may even be overly conscientious about personal hygiene and appearance

substance abuse (teenagers)

- this is so common among adolescents that as many as 50% of high school seniors report having experimented with some form of drug - use of drugs occurs in adolescence from a desire to expand consciousness, peer pressure, or a desire to feel more confident and mature; it also can be a form of adolescent rebellion related to childhood adversity or violence

cognitive development in teenagers

- this is the final cognitive development, the stage of formal operational thought - this step involves the ability to think in abstract terms and use the scientific method (deductive reasoning) to arrive at conclusions - with this reasoning, adolescents can plan their future

poor posture (teenagers)

- those who reach their adult height before their peers, demonstrate poor posture, a tendency to round shoulders and a shambling, slouchy walk to not be taller than those around them - screenings for scoliosis should continue during adolescents

parental concerns during the toddler years

- toilet training - ritualistic behavior - negativism - discipline - separation anxiety - temper tantrums

runaway youth

- usually preceded by last-straw argument with parents, following long-term disagreements; possibly loneliness; pregnancy; problems with friends, school, police - common health concerns: STIs, substance abuse, hepatitis, vaginitis, suicide attempts

sexual, physical concerns of school-age girls

- usually taller than boys - hips are broadening - breast development - early preparation for menstruation - vaginal discharge

drug abuse education (teenagers)

- whether a drug is inhaled, swallowed, or injected, it still is absorbed, enters the body, and is potentially harmful - relying on drugs to give courage to solve problems (or to help forget you have problems) prevents you from learning to handle life situations and maturing - the bottom line of substance abuse is that you have the final say: you are the only one who can stop chemical dependency from happening. - despite their social acceptability, alcohol and nicotine are drugs. A short span of daily use of either can make you addicted

An infant's mother asks you, "When should I expect my daughter to begin to walk?" Which of the following is an appropriate response? A. "Probably by 9 months." B. "Most children walk around 12 months." C. "It varies so much I couldn't even guess." D. "Try not to worry. When she's ready, she'll walk."

B. "Most children walk around 12 months." Rationale: Children typically walk by 12 months, although there is a wide range from 7 to 22 months.

The nurse evaluates some of the anticipatory guidance that provided to Raul with the goal of fostering his sense of identity. The nurse identifies which statement as suggesting he is successfully working toward this goal? Select all that apply. a. "I'm debating whether I'd like to be a pilot or a race car driver." b. "I ask my parents at least once a week to let me do more things." c. "I handle money at my part-time job and it's sometimes tempting to take some of it." d. "I'm getting used to being so much taller than my younger sister."

A, B, C, D. The nurse recognizes that all the options represent tasks adolescents must complete to achieve a sense of identity: emancipation, body image, values, and career choice.

The parents of an adolescent boy are concerned about the amount of sleep he seems to require. What advice would you give them? A. "As long as he seems otherwise well, this sounds like a typical teenager." B. "Adolescents only need 8 hours of sleep a night; anything over this is excessive." C. "Your son is probably engaged in too many activities and is wearing himself out." D. "Your son may be taking drugs; the side effect of many drugs is to cause sleepiness."

A. "As long as he seems otherwise well, this sounds like a typical teenager." Rationale: Many teenagers feel fatigued from a combination of quick-food diets, many activities, and a rapid growth spurt.

The nurse working with adolescents understands which to be the most widely used drug among adolescents? A. Alcohol B. Heroin C. Cocaine D. Speed

A. Alcohol Rationale: Alcohol is the most abused drug among adolescents because it is often readily available and is inexpensive compared to other drugs.

Beginning verbal communication is one of the most important tasks that infants need to achieve. The nurse teaches Bryan's mother that by 12 months of age he should display which characteristics? a. "Children this age can usually say around two words, plus 'ma-ma' and 'da-da.'" b. "One-year-olds can usually say more words than they are able to understand." c. "A 12-month-old child can express his or her basic needs verbally." d. "An infant who is this age usually can't understand spoken words."

A. Children at 12 months usually say two words beside "ma-ma" and "da-da." They are not incapable of understanding, but they cannot express their needs verbally.

A toddler seems unable to remain dry despite toilet training. Which patient teaching should be included in his plan of care? A. He probably is not yet physically ready for toilet training. B. He is reacting to her emotional outbursts, responsible for delaying toilet training. C. He may need to be examined by a child psychologist to solve this problem. D. He must be under undue stress to behaving this way

A. He is probably not yet physically ready for toilet training. Rationale: Children must have both physical and mental maturity for toilet training. For many children, this point is not reached until they are 2½ or 3 years old.

The nurse is discussing object permanence with Bryan's mother. Which action by her infant best illustrates that he understands object permanence? a. The child looks for the mother after she walks away. b. The child cries when either hungry or lonely. c. The child prefers a large yellow ball to a small red one. d. The child smiles when the mobile on the crib jingles.

A. Infants understand permanence when they look for someone or something out of sight.

Cathy's family is expecting a new baby. When Cathy is visiting the birthing center, the nurse should promote which behavior as a means of fostering family bonding during this time of transition? a. Take action to help Cathy spend as much time with her mother and the infant as possible. b. Teach Cathy about the ways that her life might change after the birth of the baby. c. Remind Cathy that her parents love her very much. d. Explain to Cathy that she's very lucky because sisters grow up to become best friends.

A. It is important for the nurse to encourage women to maintain contact with their preschooler during the short time they are hospitalized for the new birth. This fosters family cohesion. Each of the other teaching points may be necessary, but none so clearly promotes family bonding.

When encouraging an adolescent who is hospitalized and physically challenged or chronically ill to develop and maintain a sense of identity, which is the best nursing action? A. Providing the opportunity for individual decision making B. Providing physical comfort to the individual C. Asking the parents what the adolescent is capable of doing D. Providing care until the adolescent insists on being independent

A. Providing the opportunity for individual decision making Rationale: Knowing who you are includes how to make decisions to advance your welfare. Providing opportunities to do this is important.

Jason's mother would prefer to use a time-out for punishment. What should the nurse teach Jason's mother or his daycare setting caregivers about the use of this technique? a. The child should sit still for as many minutes as his age. b. The child should sit still for as many minutes as he misbehaved. c. Time-out activities can include quiet play or reading books. d. Children are not ready for time-outs until school age.

A. The nurse enforces the rule that a child should sit still in time-out for as many minutes as his age. This seems like a short time, but for a 2-year-old, sitting still for 2 minutes is a long time.

Teaching safety is an important area to consider for school-age children. Which advice would be best? a. "Keep your backpack filled to capacity to avoid falling on frequent trips back to your locker." b. "As soon as you no longer need an automobile booster seat, you'll no longer need a seatbelt either." c. "Gaining weight isn't serious in the school-age years; it only becomes a real problem after age 18 years." d. "You're old enough to tell if you are sick or not; your mother's opinion isn't as important as when you were younger."

A. The nurse should advise that heavy backpacks can put unnecessary strain on the back of school-age children. School-age children still need assistance with evaluating illness. Eating healthy to avoid being overweight should start before 18 years of age. Booster seats are usually unnecessary at this age.

You discover that an infant's mother is propping a bottle at bedtime to help her fall asleep. Which patient teaching would the nurse provide this mother? A. This can promote tooth decay. B. This can cause a facial rash. C. The bottle could break, injuring the infant. D. Calcium can be drained from the bones.

A. This can promote tooth decay. Rationale: Falling asleep with a bottle of formula allows formula to remain in contact with teeth for an extended time, which leads to "baby-bottle syndrome," or tooth decay.

fantasy

make judgments based on visual appearances - variations in thinking during this age include: magical thinking, animism (inanimate objects are alive), concentration (focus on one aspect instead of considering the whole)

Which patient education should the nurse provide a mother of a preschooler with broken fluency? A. Encourage the preschooler to recite in front of friends. B. Allow the preschooler to have time to talk. C. Encourage the preschooler to speak slowly. D. Stop the preschooler and tell him or her to start over.

B. Allow the preschooler to have time to talk. Rationale: Children who do not feel rushed to speak have less broken fluency.

A 12-year-old recently began smoking cigarettes. What patient teaching should the nurse provide at a health maintenance visit? A. Cigarette abuse invariably leads to other forms of drug abuse. B. Cigarette smoking is associated with long-term respiratory and cardiovascular effects. C. He or she will probably begin stealing to pay for cigarettes. D. At age 12 years, bone growth is severely retarded by the effect of nicotine.

B. Cigarette smoking is associated with long-term respiratory and cardiovascular effects. Rationale: It is difficult for school-age children to appreciate long-term effects of their actions without counseling.

imaginary friends

many preschoolers have an imaginary friend who plays with them

A previously toilet trained 4-year-old child has many episodes of urinary incontinence while in the hospital for a fractured femur. Which of the following actions should the nurse implement? A. Awaken the child every 2 hours through the night to try to use the bedpan. B. Explain that children will usually quickly regain control over a previously mastered skill once home again. C. Send a urine specimen for analysis. D. Limit consumption of fluids between meals.

B. Explain that children will usually quickly regain control over a previously mastered skill once home again. Rationale: Stressful events may cause a child to regress back from a previously mastered task. Hospitalization, trauma, and separation from parents are all examples of what may induce this.

Raul is prescribed both a topical cream and oral tetracycline to treat his acne. The nurse identifies that he needs additional health information from which statements (list all that apply)? a. "I know acne is not contagious even though all my friends seem to have it." b. "My girlfriend wants to borrow my tetracycline; I don't mind sharing it." c. "I know not to take hot showers as hot water can create new lesions." d. "I know not to eat chocolate because that always makes lesions worse."

B. The nurse should counsel that medications should not be shared with other people. The nurse should also teach the warnings and precautions involved with the administration of this drug, including the fact that it is a teratogen.

The nurse provides patient education to Jason's father who had asked if it is normal for his 2-year-old son to spread his feet wide apart when he walks. Which of his statements suggests that he received accurate teaching? a. "Jason may be all right, but toddlers with dislocated hips also walk that way." b. "A wide-spaced gait is a common characteristic of toddlers." c. "Most toddlers walk with feet close together to better stabilize themselves." d. "His shoes may not have a good arch and this could be causing him to walk unsteadily."

B. The nurse should reaffirm with Jason's father that toddlers typically walk with a wide-based gait. Strong arch support would not make a difference.

Many preschoolers have difficulty falling asleep or wake during the night with nightmares. To see if changes in the type of television watched could improve preschooler's sleep, researchers encouraged half of a group of families studied to replace television watching with quality educational and prosocial video content through use of an initial home visit and follow-up telephone calls over 6 months. Among the 565 children studied, the most common sleep problem was delayed sleep onset (38%). Results at the end of 18 months showed that children in the intervention group had significantly lower odds of any sleep problems. Based on the study, what is the best advice the nurse could give the Edwards family? a. Don't allow Cathy to watch television until she is 5 years of age. b. Encourage Cathy to watch specific DVDs that her parents choose for her. c. Discuss with Cathy that TV does not necessarily reflect reality. d. Allow her to only watch cartoons so she won't be seeing violence.

B. The nurse should suggest that watching chosen DVDs could improve the quality of video material to which Cathy is exposed. Cartoons are often violent. TV should be carefully limited but does not necessarily need to be withheld until age 5 years.

The nurse realizes Raul is concerned about developing body odor and that he has consulted some websites that address this problem. The nurse recognizes a valid and reliable website would cite which aspect is true of body odor in adolescents? a. It is largely dependent on ethnicity and body type. b. It is caused by an increase in the activity of apocrine glands. c. Poor hygiene is the main cause of adolescent body odor. d. Body odor can result from clogged sebaceous glands.

B. The nurse should teach that apocrine glands, found predominantly in the axilla and groin, are responsible for body odor. This problem does not result from sebaceous activity or ethnicity, and hygiene is not the major contributing factor.

Shelly tells the nurse she collected "a ton of candy on Halloween. Because of how common this phenomenon is, in consultation with a dental hygienist, you would teach children that what type of candy is less likely to cause dental caries? a. Salt water taffy b. A chocolate bar c. Chewy caramels d. Hard candy

B. The nurse should teach that candy that dissolves rapidly remains in contact with teeth for the shortest time. This may be associated with a reduced risk of dental caries.

Toddlers learn a great deal about oral communication in the course of their development. The nurse expects Jason, a 2-year-old, to have mastered which statement? a. "Red tomatoes." b. "Daddy come." c. "Old MacDonald." d. "Please, please."

B. The nurse would expect 2-year-olds to speak with two-word, noun-verb sentences.

You learn that a friend's 4-month-old son rolled off a changing table. Which of the following would you conclude from this? A. The parents were neglectful. B. The parents lacked knowledge of infant development. C. The changing table was poorly built. D. The infant was unusually advanced in development.

B. The parents lacked knowledge of infant development. Rationale: Most 4-month-olds are capable of turning over. If parents are not aware of this, "rolling over" accidents tend to happen during this month.

A toddler's mother is concerned because her toddler takes her blanket everywhere. Which advice would be most appropriate for her regarding this? A. Have her daughter evaluated by a child psychologist. B. Understand that this is probably a normal event. C. Make subtle efforts to remove the blanket. D. Destroy the blanket by cutting off a strip from it every day.

B. Understand that this is probably a normal event. Rationale: Blankets or favorite toys serve as transitional objects or security objects.

Cathy keeps her entire family awake at night because she is so afraid of the dark. The nurse teaches Cathy's parent to take which action to help overcome this fear? a. Assure Cathy the room's window is locked so no one can kidnap her. b. Suggest Cathy temporarily sleep in the living room in front of the television set for safety. c. Buy a night-light for Cathy's room and inspect the room to be certain it appears safe. d. Teach Cathy that her fear is not grounded in reality.

C. Allowing a child to use a night-light, inspecting the child's room for objects that look particularly scary after dark, and limiting the child's television viewing to programs not as frightening are recommendations that the nurse can make to help decrease a child's fears.

Cathy, who is 3 years old, constantly asks questions. When teaching her father about communication skills in children of this age, the nurse should state that a child of Cathy's age typically asks how many questions in a day? a. Around 50 b. 100 to 200 c. 300 to 400 d. 600 or more

C. Although this is variable, the nurse should point out that preschoolers typically ask 300 to 400 questions a day.

Bryan is 2 months old, and the nurse is collaborating with the occupational therapist in his care. When planning care, the nurse identifies that John should sit securely at what age? a. 2.5 months b. 6 months c. 8 months d. 12 months

C. Infants sit steadily at 8 months of age.

A 4-year-old boy will not stop throwing sand at his sister. Which of the following punishments would be most effective with this child? A. Send him to his room for 15 minutes. B. Restrict television viewing for a day. C. Sit him in "time-out" for 4 minutes. D. Spank him on his bottom.

C. Sit him in "time-out" for 4 minutes. Rationale: Trying to correct behavior while allowing the child the right to his or her opinion works best without use of physical punishment.

It has long been theorized there may be a "gateway" drug or one that, when used first, leads to further and more dangerous substance use disorders. To determine whether alcohol, tobacco, or marijuana was the gateway drug, researchers obtained information on the drug use of a nationally representative sample of high school seniors. Results of the study showed alcohol was the gateway drug, leading to tobacco, marijuana, and then other illicit substances. Based on the previous study, which statement by Raul would give you the most concern? a. "Some of my friends got hammered last weekend but I decided not to stick around." b. "Some of my friends use weed; they tell me it really helps them relax." c. "My parents said I could celebrate my next birthday by drinking my first beer." d. "My mother eats some kind of chocolate almost every day. Is that hereditary?"

C. The nurse is aware that alcohol is identified as the gateway drug or is the one which is most apt to lead to further substance use disorders, especially if parents condone early use.

The school-age period is the time when many young people begin smoking. To design interventions that are effective and patient-centered, the nurse should begin by acknowledging which of the following? a. Most children who try smoking do not like it. b. The media have occasionally exaggerated the risks of smoking. c. Many people view smoking as being an "adult" activity. d. Children under puberty cannot become addicted to smoking.

C. The nurse should acknowledge that smoking is viewed as an adult activity; therefore, adopting the habit can be considered a giant step on the road to adulthood. Antismoking interventions must acknowledge this reality. The media are not known to have exaggerated the risks of smoking.

Jason replies to every request by his mother with, "No!" His mother admits that she is exasperated and embarrassed by this, and she states that she is desperate to change this behavior. How can the nurse best meet the mother's expressed learning needs? a. Have her tell Jason she doesn't want him to say no anymore. b. Instruct her to answer all Jason's questions by saying, "No!" c. Encourage her to reduce the number of questions she asks Jason. d. Tell her to explain he is not using good communication skills.

C. The nurse should advise that reducing the number of questions asked reduces the number of times a toddler can say no. Reasoning with toddlers or mimicking behavior is rarely effective.

The nurse is drafting an educational handout for parents of preschoolers that addresses the topic of sex education. What guideline should be included in this educational material? a. Tell your child that you will explain these matters when they are old enough to start kindergarten. b. Emphasize the fact that sexual intercourse between adults must always be consensual. c. Describe some of the differences between boys and girls in clear and accurate terms. d. Distract your child from questions about sexuality for as long as possible.

C. The nurse should state that sexual education should be approached in a clear but age-appropriate manner. At this age, it is not normally necessary to address sexual intercourse and its consensual nature.

Raul is depressed because his girlfriend broke up with him. Which of his statements could be interpreted as stalking? a. "I keep her photo on my bedside stand so I can kiss her goodnight." b. "We take the same route to school every day so I often still see her." c. "I e-mail her every night to tell her what a huge mistake she's made." d. "I took down her photo from Facebook but wish I could put it back."

C. The nurse would note that whether stalking is done in person or by the Internet, continuous, unwelcome actions are stalking.

Shelly belonged to a series of clubs when she was 9 years old. How would the school nurse describe the typical characteristic of a 9-year-old's club to the nursing student? a. Clubs have formal rules and regulations. b. Clubs are designed to help shy children get outside of their "comfort zone." c. Clubs invariably exclude one or more children. d. Clubs always include both boys and girls.

C. The school nurse could state that clubs can potentially foster social interaction between children whose interests are similar. Clubs are frequently single-gender, and they do not always have formal rules and regulations.

The parents of a 2-year-old child are concerned because their child's back seems curved. Which is the nurse's best response? A. The child needs to be screened for scoliosis. B. The child needs referral for a spine radiograph. C. This is normal for this age. D. The nurse should perform a full neurologic assessment.

C. This is normal for this age. Rationale: Toddlers have a natural lordosis (forward curvature of the spine) that resolves as they grow. It is not within a nurse's scope of care to order radiographs.

discipline for toddlers

should be consistent with well-defined boundaries that are established to develop appropriate social behavior

Scalding injuries occur in infants when caretakers spill hot beverages while holding them in their lap or, toward the end of the first year, the infant is able to pull a pan of hot liquid off the stove. To confirm the incidence of this type of injury, researchers studied the admission records of an urban pediatric emergency department in Ireland. Of 280 children seen for burns, 161 (57%) were scalds. Of these, 79% occurred in children under 5 years of age, 65% were caused by hot beverages, 16% were caused by hot water, and 16% by hot food. The areas of children most affected were upper limbs and upper trunks. The researchers concluded that more parent education as to the danger of scalding is needed to reduce the number of these very painful injuries in young children Based on the study, the nurse is most concerned about which remark by Bryan's mother? a. "I never drive without a cup of coffee in my cup holder." b. "I'm going to switch to drinking tea to reduce my caffeine intake." c. "I drank coffee during Bryan's pregnancy; it's why he's so high strung." d. "I'm a coffee addict; I always have a fresh cup in my hand."

D. A mother who "always has a hot cup of coffee in her hand" could easily spill that on the infant while giving care or holding the infant.

The nurse reviews infant safety with Bryan's mother. It is most important to teach his mother about preventing which common injuries among infants? a. Drowning and hypersensitivities b. Poisoning and suffocation c. Auto accidents and burns d. Aspiration and falls

D. Aspiration and falls are the most frequent unintentional injuries in infants.

A 10-year-old becomes very upset and expresses sympathy for his friend whose dog has just died. This kind of reaction is an indication that he has achieved which step in cognitive thought? A. Conservation B. Accommodation C. Comprehension D. Decentering

D. Decentering Rationale: Decentering means the ability to project one's self into other people's situations and see the world from their viewpoint.

When planning care for an infant who has unique needs, the nurse best promotes the parents' psychosocial well-being by which means? a. Lowering the family's expectations around their infant's skills b. Clearly describing the etiology of the infant's development deficits c. Encouraging the family to have more children d. Emphasizing what the infant can do more than what he or she cannot do

D. Focusing on abilities rather than inabilities promotes efficacy and well-being among the family members of a child with unique needs. This practice exemplifies patient-centered care. Lowering the family's expectations is normally inappropriate and unnecessary.

According to Erikson, a sense of industry or accomplishment is the developmental task of the school-age period. When planning care, what would be the best activity to introduce to Shelly to help her achieve this? a. Encourage her to establish a new club. b. Suggest she begin a diary in which she records her secret thoughts. c. Help her with spelling so over a year's time she becomes an expert at this. d. Locate small projects she could complete in 1 day and feel rewarded.

D. The nurse can establish a sense of industry in Shelly by encouraging her to complete small projects or tasks that offer a reward when completed.

At the conclusion of a long conversation, Raul admits he has experimented with cocaine. Which assessment finding would most strongly warrant a referral to addiction services? a. Raul has frown lines in his forehead. b. Raul has thin, fissured lips. c. Raul's eyebrows appear thin. d. Raul lacks nasal hair.

D. The nurse is aware that sniffing cocaine can cause loss of nasal hair. Upon assessment, the absence of nasal hair would suggest more extensive cocaine use.

Cathy's father, a police detective, says that he and his wife wish to take measures to prevent Cathy from being kidnapped. What action should the nurse recommend to this family? a. Limit playdates to Cathy's own home. b. Withdraw Cathy from daycare to limit her exposure to other adults. c. Describe common kidnapping culprits the father knows. d. Be certain Cathy understands not to leave daycare with anyone but her parents.

D. The nurse should advise the parents to instruct their child not to leave daycare with anyone but them or a designated person. If the parents wish, it is acceptable to have a child's fingerprints taken and recorded. It is not likely necessary to limit Cathy to her own home. Describing kidnapping is likely to elicit fear.

Jason's grandmother often visits the family. When she does, she brings a number of medications with her. The nurse teaches the family to follow which precautions about unintentional poisoning? a. Advise the grandmother to keep her medicine in her purse and stress that no one should open her purse but her. b. Show Jason his grandmother's pills and emphasize that he is not permitted to touch them. c. Assure the grandmother that as long as her vials of medicine have childproof caps, there is no danger. d. Buy the grandmother a medicine case that locks and place it on a high shelf when she visits.

D. The nurse should teach that locking medicine or placing it out of reach is the best safeguard. Young children can occasionally open childproof caps.

As television sets become larger and thinner, viewing becomes easier. To investigate if television sets can also be a threat to young children, researchers reviewed a Canadian trauma database over a 15-year period as to how many emergency room visits were caused by a television set falling onto a young child. They identified a total of 179 injuries (20 to 24 per year). Toddlers were the most frequently injured age group, and head and neck injuries were the most common consequences of a television pulled down onto a young child. Based on the study and the AAP recommendations on television viewing, the nurse advises Jason's parents to take which action? a. Encourage Jason to watch television in his room where the television set is smaller. b. Teach Jason to always watch television from a distance of no less than 12 feet. c. Teach Jason to use the remote control so he can watch television safely by himself. d. Allow Jason to watch television only when a parent is free to supervise his actions.

D. The nurse should teach that television viewing for toddlers should be carefully limited; they need supervision to prevent pulling a television onto themselves.

Shelly has told the nurse she wants to try out for cheerleading when she gets to high school. This is a sport appealing to school-age children and adolescents because of its combinations of dance and gymnastics, the friendships that can develop, and the school status it almost automatically creates. To investigate what type of injuries typically occur with cheerleading, researchers reviewed all cheerleading injuries (over 4,000) presented to U.S. emergency departments during a 5-year period. The types of injuries most often seen were sprains/strains (44%), fractures (16%), and contusions (16%). The activities resulting in the most injuries were body collisions (29%), stunting (19%), tumbling (11%), and tossing (2.5%) (Currie, Fields, Patterson, et al., 2016). Based on the study, how would the nurse best advise Shelly? a. Cheerleading will be good for her because she is likely to lose weight from the exercise. b. She will need to drink an extra source of calcium every day to avoid broken bones. c. She should pursue a sport or activity that is safer. d. She should be aware that cheerleading may be beneficial to her but does carry some risks.

D. The study documents the fact that injuries occur in cheerleading activities. However, the nurse should state that taking part is likely of benefit, provided Shelly is cognizant of some of the risks. No mention is made of weight or calcium intake.

An 8-year-old eats lunch daily in the school cafeteria. Which is the best way to feel assured that he will eat a balanced lunch daily? A. Encourage him to include a vegetable daily B. Help him memorize a list of acceptable foods C. Teach him to eat everything on his plate D. Use visual aids to demonstrate appropriate food selections

D. Use visual aids to demonstrate appropriate food selections. Rationale: School-age children are concrete thinkers, so they respond best to concrete examples.

sexual maturation of school-age child

at a set point in brain maturity, the hypothalamus transmits an enzyme to the anterior pituitary gland to begin production of gonadotropic hormones, which then activate changes in the testes and ovaries to cause puberty

deferred imitation

at this stage, children are able to remember an action and imitate it later - ex: pretend to drive a car or put a baby to sleep

health problems of preschooler

major cause of death being automobile accidents, followed by poisoning and falls - the number of major illnesses is few in this age group, the number of minor illnesses, such as common colds and ear infections, are high

infant standing position

a newborn stepping reflex can still be demonstrated at 1 month of age - in a standing position, the infant's knees and hips flex rather than support more than momentary weight

choosing preschool or child care center

a school or child care experience is helpful for preschoolers because peer exposure appears to have a positive effect on social development

homosexuality (teenagers)

a time when teenagers deal with the realization that they're gay or lesbian

colic

abdominal pain caused from overfeeding or air in stomach

infant fine motor development: thumb opposition

ability to bring the thumb and fingers together begins, but the motion is a scooping or raking one, not a picking-up one, and is not very accurate

initiative

according to Erikson - these children achieve a sense of initiative versus guilt - children with a well-developed sense of initiative like to explore because they have discovered that learning new things is fun

bullying of school-age child

actions are intended to cause harm or to control someone, and are sometimes attributed to poor relationships with peers and difficulty identifying with a group

moral and spiritual development of preschooler

actions are taken based on whether or not it will result in a reward or punishment - they primarily take actions based on satisfying personal needs, yet are beginning to understand the concepts of justice and fairness

school for school age child

adjusting to and achieving in school are two of the major tasks for this age group

emotional development (teenagers)

adolescents develop a sense of personal identity, and come to view themselves as unique individuals

hypertension (teenagers)

adolescents who are obese, who are African American, who eat a diet high in salt, or who have a family history of hypertension are most susceptible to developing the condition

nutrition and diet for toddlers

all toddlers need experience feeding themselves if at all possible, but allowing a child with neurologic deficits do this can be difficult for parents - help them accept the accidents that occur and suggest finger foods of possible

infants: motor development

an average infant progresses through systematic motor growth during the first year, strongly, reflecting the principles of cephalocaudal (head to toe) and gross to fine motor development

family concerns with an infant with unique needs

an infant born with a cognitive or physical challenge is usually hospitalized immediately after birth for diagnosis and treatment. - cognitive challenge - physical challenge; chronically ill - trust versus mistrust: helping parents to interact more fully with their infants this way helps to build a sense of trust in the infant. - nutrition

infants: height

an infant increases in height during the first year by 50%, or grows from the average birth length of 20 inches to about 30 inches

infants: weight

as a rule, most infants double their birth weight by 4 to 6 months and triple it by 1 year

promoting infant safety: bathing and swimming safety

as babies begin to develop good back support, many parents begin to bathe them in an adult tub - never leave unattended, even when propped up or sitting in a bath ring

promoting infant safety: aspiration prevention

aspiration is a chief injury threat to infants throughout the first year

play of preschooler

associative play during these years - play is not highly organized, but cooperation does exist between children

sleep for toddlers

toddlers typically average 11 to 12 hours of sleep per day, including one nap - maintaining a regular bedtime and bedtime routines are helpful to promote sleep

violence or terrorism (for school-age child)

basically view their world as safe, so it is a shock when violence such as a school shooting or reports of terrorists enter their lives - assure children they are safe - observe for signs of stress - do not allow children or adolescents to view footage of traumatic events repeatedly - watch news programs with children; explain the situation portrayed - prepare a family disaster plan; designate a "rally point" to meet if ever separated

home schooling

because of religious or personal preference or because of disillusionment with the school system, a growing number of children are homeschooled today

fears of preschooler

because their imaginations are so active, this leads to a number of fears - dark - mutilation - separation or abandonment

pre-operational thought

because they are not able to change their thoughts to fit a situation, they learn to change the situation (or how they perceive it) - this ability is what causes toddlers to use toys in the "wrong" way

body piercing and tattoos

body piercing and tattoos are a strong mark of adolescence

toddler body systems

body systems continue to mature at this time - toilet training can begin when toddlers have the sensation of needing to urinate or defecate

recommended dietary allowances

breastfeeding provides a complete diet for infants during the first 6 months - iron-fortified formula is an acceptable alternative to breast milk - cow's milk is not recommended

secondary circular reaction

by 6 months of age infants pass into this phase - when infants reach for a mobile above the crib, hit it, watch it move, they realize it was their hand that initiated the motion, and so they hit it again

infants: head circumference

by the end of the first year, the brain already reaches two thirds of its adult size - head circumference increases rapidly during the infant period to reflect this rapid brain growth

toilet training for toddlers

can begin - nighttime control may develop last

dressing for preschooler

can dress themselves except for difficult buttons, although there may be a conflict over what the child will wear

infant safety: childproofing

child proofing your home is important to prevent burns, aspiration, poisoning, drowning - lock down furniture

sex education for preschooler

children become acutely aware of the difference between boys and girls, possibly because it is a normal progression in development and possibly because this may be the first time they are exposed to the genitalia of the opposite sex as they watch while a new brother or sister has a diaper changed, they see other children using the bathroom at a preschool, or they see a parent nude

preparing child for school

children begin a formal school experience as they enter kindergarten - essential to this preparation is the parent's attitude

sharing for preschooler

children begin to understand some things are theirs, some belong to others, and some can belong to both - for the first time, they can stand in line to wait for a drink, take turns using a shovel at a sandbox, and share a box of crayons

emotional development for toddlers

children change a great deal in their ability to understand the world and how they relate to people during the toddler years - autonomy - socialization - play behavior

emotional development for preschooler

children change a great deal in their ability to understand their world and how they relate to other people during the preschool years

emotional development of school-age child

children enter the school-age period with the ability to trust others and with a sense of respect for their own worth

fine motor development (school-age child)

children should be challenged with tasks that need to be accomplished, and be allowed to work through individual differences in order to complete the tasks

drug use for school-age child

children who report being happy and are able to communicate with their family are less likely to be regular users than others

play of school-age child

competitive and cooperative play is predominant

teeth of preschooler

continue good dental care - night grinding - (bruxism) may begin at this age as a way of "letting go", similar to body rocking, which children do for a short time each night before falling asleep

victim of violence, terrorism, bullying of school-age child

counseling may help the child manage the situation better

sense of intimacy (teenagers)

developing a sense of intimacy means a young adult is able to form long-term, meaningful relationships with persons of the opposite as well as their same sex

bathing a preschooler

don't leave unattended - children this age are not paragons of neatness and may not clean their hands thoroughly

socialization in teenagers

early teenagers may feel more self-doubt than self-confidence when they meet another adolescent with whom they would like to begin a lasting relationship

sun exposure (teenagers)

encourage teenagers to use sunscreen, avoid tanning beds, and report to their primary health care provider any skin changes

preschooler teeth

eruption of primary teeth is finalized by the beginning of the preschool years

bathing for toddlers

should depend on the parent's and the child's wishes and schedule - however, the time is not as important as the attempt to establish a sense of routine and a sense that life has order

health promotion: nutrition for school-age child

establishing healthy eating patterns - avoid using food as a reward - emphasize physical activity, model healthy behaviors fostering industry and nutrition - usually enjoy helping to plan meals - most parents would like children to develop better table manners recommended dietary reference intakes - both girls and boys require more calories and other nutrients at this time - both girls and boys also require more iron, adequate calcium and fluoride intake for good teeth and bone growth - a major deficit may be fiber because these children typically dislike vegetables vegetarian diet - a potential problem to assess with vegetarian school-age children is whether they are obtaining enough protein and calcium so their body is prepared for the rapid growth spurt of puberty

promoting infant safety: fall prevention

falls are a second major cause of infant injuries - no infant, beginning with newborn, should be left unattended on a raised surface

separation or abandonment

fear of separation is a concern for preschoolers - their sense of time is still so distorted that they cannot be comforted by assurances - their sense of distance is also limited

toddler's teeth

flossing and brushing should be performed by the adult caregiver, and is the best method of removing plaque - early childhood caries is a form of tooth decay that develops in toddlers

infant gross motor development

four positions - ventral suspension, prone, sitting, and standing - are used to assess gross motor development

prickly heat (Miliaria)

heat rash from warm weather or when babies are overdressed

early teen developmental task

identity vs. role confusion

assimilation

if a child is given a toy hammer, instead of pounding with it, she may shake it to see if it rattles (the child has changed the toy's use to fit her thought, or used assimilation)

parent attitude

if school is discussed as something to look forward to, as an adventure that will be satisfying and rewarding, a child comes to look forward to it as a positive experience

imitation

imitating the actions of the people around them peaks during preschool age - role modeling this way should be fun and does not have to be accurate

developmental milestones of infant

in addition to the gross and fine motor skills developing at this time, language and play behavior also reach major milestones: - language development: language develops step by step the same as motor development. Infants begin to make small, cooing sounds by the end of the first month. - play: infants are interested in mobile over their bed. Mobiles are best if they are black and white or brightly colored

cognitive development for infants

in the first month of life, an infant mainly uses simple reflex activity - they demonstrate they are very people-oriented moments after birth by cuddling against an adult's chest - primary circular reaction - secondary circular reaction - object permanence

smell for infants

infants can smell accurately within 1 or 2 hours after birth - they respond to an irritating smell by turning their head away from it

taste for infants

infants demonstrate they have an acute sense of taste by turning away from or spitting out a taste they do not enjoy

touch for infants

infants need to be touched so they can experience skin-to-skin contact

late teen developmental task (teenagers)

intimacy vs. isolation

new sibling

introduction of a new sibling is such a major happening that parents need to take special steps to be certain their preschooler will be prepared

autism spectrum disorder

is a complex range of neurodevelopment disorders characterized by communication difficulties, poor social interaction, and frequent repetitive and stereotyped movement

child readiness

it's important for parents to take time to prepare preschoolers not only physically, by being certain their immunizations are up to date, but also emotionally

sex education of school-age child

it's important that school-age children be educated about pubertal changes and responsible sexual practices

sibling rivalry

jealousy of a brother or sister may first become evident during the preschool period because this is the first time children have enough vocabulary to express how they feel and partly because preschoolers are more aware of family roles and how responsibilities at home are divided

health promotion: safety for preschooler

keeping children safe, strong, and free: firearms should be kept in locked cabinets or containers - preschoolers should be taught pedestrian safety - they should also be taught about stranger safety. motor vehicle and bicycle safety: preschoolers should be taught to wear protective equipment (helmet, pads) - preschoolers are safest in the backseat of the car - they transition to a booster seat at this age

ritualistic behavior

maintaining routines and reliability, provides a sense of comfort for toddlers as they begin to explore the environment beyond those most familiar to them

concerns with physically challenged or chronically ill preschooler

nutrition: experiences with eating help to reinforce a sense of initiative with preschoolers - chronically ill preschoolers who are limited in the foods they can eat or in their ability to help with food preparation may miss this reinforcement

stealing (school-age child)

occurs because, although a child is gaining an appreciation for money, this appreciation is not yet balanced by strong moral principles or an understanding of ownership - early childhood stealing is best handled without a great deal of emotion - shoplifting must be taken seriously by parents - parents should set good examples

secondary sex changes in boys

occurs in the following order: testicular enlargement, pubic hair growth, facial hair growth, and vocal changes

fear and anxiety for school-age child

old enough to experience adult reactions to problems at home or school

sleep for preschooler

on average preschoolers need about 12 hours of sleep per day - some still require a daytime nap - keep consistent bedtime routine

home for school age child

parents continue to influence the school-age child's self-ideals, but by middle childhood the opinions of peers and teachers become more valuable

career decisions

part of knowing what kind of person you are, is knowing what kind of occupation will be a fit

physical, psychosocial, cognitive development of 11 y/o

physical: active, but awkward and ungainly psychosocial & cognitive: insecure with members of opposite sex; repeats off-color jokes

physical, psychosocial, cognitive development of 9 y/o

physical: all activities done with friends psychosocial & cognitive: friend or club age; a 9-year-old club is formed to spite someone, has secret codes, is all boy or all girl; clubs disband and reform quickly

physical, psychosocial, cognitive development of 7 y/o

physical: central incisors erupt; difference between sexes becomes apparent in play (ex: video games vs. dolls); spends time in quiet play. psychosocial & cognitive: a quiet year; striving for perfection leads to this year being called an eraser year. Learns conservation (ex: water poured from tall container to a wide, flat one is the same amount of water); can tell time; can make simple change

physical, psychosocial, cognitive development of 8 y/o

physical: coordination definitely improved; eyesight fully develops; playing with friends becomes important psychosocial & cognitive: "best friends" develop; whispering and giggling begin; can write in cursive as well as print; understands concepts of past, present, and future.

physical, psychosocial, cognitive development of 12 y/o

physical: coordination improves psychosocial & cognitive: a sense of humor is present; is social and cooperative

physical, psychosocial, cognitive development of 10 y/o

physical: coordination improves psychosocial & cognitive: ready for camp away from home; collecting age; likes rules; ready for competitive games

developmental milestones (teenagers)

play or recreation - more adult forms of recreation - team loyalty becomes intense - much time talking with peers, face to face or electronically - part-time job - charitable endeavors

mutilation

poor understanding of anatomy makes intrusive experiences, such as injections or cuts, frightening to preschoolers

lunch protocols

prepare a bagged lunch at home to show how that would be

gender roles

preschoolers begin to be aware of the difference between sexes and so need to be introduced to both gender roles

socialization for preschooler

preschoolers generally do not exhibit stranger anxiety and have less separation anxiety - prolonged separation, such as during hospitalization, can provoke anxiety

height, weight, body mass index, and head circumference of preschooler

preschoolers should gain about 4.4 to 6.6 lb. per year - they should grow about 2.6 to 3.5 inches per year - their bodies evolve away from the characteristically unsteady wide stances and protruding abdomens of toddlers, into a more graceful, postural erect, and ant sturdy physically - head circumference is not routinely measured at physical assessments on children over 2 years of age because it changes little after this time

STIs (teenagers)

provide adolescents with accurate information and discuss what is heard from peers

pregnancy (teenagers)

provide information about getting pregnant

date rape (teenagers)

provide information on date rape and rape prevention in a discussion of sexual behaviors because adolescents are in a high-risk age group for date rape

infant: ventral suspension position

refers to an infant's appearance when held in midair on a horizontal plane and supported by a hand under the abdomen

stalking (teenagers)

refers to repetitive, intrusive, and unwanted actions such as constant and threatening pursuit directed at an individual to gain the individual's attention or to evoke fear

Oedipus complex

refers to the strong emotional attachment a preschool boy demonstrates towards his mother

temper tantrums

result when toddlers are frustrated with restrictions on independence - providing consistent, age appropriate expectations helps toddlers to work through frustration

poisonings

safety locks should be placed - medications should be kept in childproof containers - a working carbon monoxide detector should be placed in the home

emotional development for infants

socialization, or learning how to interact with others, is an extensive phenomenon - social development is initially influenced by infant's reflexive behaviors and includes attachment, separation, recognition/anxiety and stranger fear

introduction of solid foods

solids are introduced around 4 to 6 months of age

play behavior for toddlers

solitary play evolves into parallel play, in which toddlers observe other children then may engage in activities nearby

regression

some preschoolers, generally in relation to stress, revert to behavior they previously outgrew, such as thumb-sucking, negativism, loss of bladder control and inability to separate from their parents

structural activities (school-age child)

the Girl Scouts, the Boy Scouts, the Campfire Girls, and 4-H clubs are respected school-age activities

accommodation (school-age child)

the ability to adapt thought processes to fit what is perceived such as understanding that there can be more than one reason for other people's actions

conservation (school-age child)

the ability to appreciate that a change in shape does not necessarily mean a change in size

decentering (school-age child)

the ability to project one's self into other people's situations and see the world from their viewpoint rather than focusing only on their own view

class inclusion (school-age child)

the ability to understand that objects can belong to more than one classification

electra complex

the attachment of a preschool girl to her father

infants: teeth

the first baby tooth (typically a central incisor) usually erupts at age 6 months, followed by a new one monthly

primary circular reaction

the infant explores objects by grasping them with the hands or by mouthing them - this is by 3 months

techniques for feeding solid foods to infants

the introduction of solid food begins a new type of interaction between parents and their infant and can require a period of adjustment

language problems for school-age child

the most common problem with this age group is articulation (westroom instead of restroom)

cognitive development for preschooler

the preschooler moves from totally egocentric thought to social awareness and the ability to understand the viewpoints of others

dark

the tendency to fear the dark is an example of a fear heightened by a child's vivid imagination - a stuffed toy by daylight becomes a threatening monster at night

language development for preschooler

the vocabulary increases to more than 2,100 words by the end of the fifth year - they speak in sentences - this age group enjoys talking, and language becomes their primary method of communication

discipline for preschooler

they have a definite opinion on things such as what they want to eat, where they want to go, and what they want to wear and these opinions may bring them into opposition with parents - a "time out" is a useful technique

value system (teenagers)

this age group need an attentive adult ear, so they can discuss fears, hopes, and the pressures they feel about wanting to do something and yet, not knowing what to do or how to do it

broken fluency

this is a prolongation of sounds, syllables, and words - ex: a child may begin to repeat words or syllables, saying "I-I-I want a n-n-new spoon-spoon-spoon."

infant fine motor development: pincer grasp

this is when, at 10 months old, they have the ability to bring the thumb and first finger together

exercise for preschooler

this period is an active phase, so preschool play tends to be vigorous

homeless youth

thorough history to not miss that homelessness; do not reveal shock at report of homelessness

following instructions for preschoolers

to do well in school setting, they must be able to follow instruction and sit at a table and chair for a short period of time

cognitive development for toddlers

toddlers are able to try out various actions mentally rather than having to actually perform them, the beginning of problem solving or symbolic thought - deferred imitation - pre-operational thought - assimilation

dressing for toddlers

toddlers can put on their own socks and underpants - some may also be able to pull on slacks, pullover shirts or simple dresses

care of teeth for toddlers

toddlers often need between-meal snacks - to help prevent dental caries from frequent snacking, offer healthy food - fluoride is supplemented for children living in areas without adequate levels in drinking water

negativism

toddlers often use negativism, or negative responses, as they begin to express their independence

separation anxiety for toddlers

toddlers progressively see themselves as separate from their parents and increase their explorations away from them

body contour in toddlers

toddlers tend to have a prominent abdomen because, although they are walking well, their abdominal muscles are not yet strong enough to support abdominal contents as well as they will be able to do later

loss of extrusion reflex

until 3 or 4 months, food placed on an infant's tongue is thrust forward and out of the mouth preventing some infants from eating effectively if they are offered solid food this early - not recommended

speech problems for school-age child

usually disappears by the third grade, but if not, may need speech therapy

vision for infants

visual acuity in infants can be assessed by holding an object in front of the eyes and checking to see whether the infant is able to fix on the object and follow it

practice for preschoolers

waking up, developing a routine - transportation - take the child on a public bus, just to practice or walk the route to school

infant: prone position

when lying on their stomach, newborns can turn their head to move it out of a position where breathing is impaired, but they cannot hold their head raised for an extended time

infant: sitting position

when placed on his or her back and then pulled to a sitting position, a newborn has extreme head lag; this lag is present until about 1 month

baby bottle tooth decay syndrome

when the bottle is filled with sugar, juice or milk - these solutions demineralize the tooth enamel until it decays - never put baby to bed with a bottle

rule orientation for school-age child

when they ask for something, because they were good, they expect to receive what they are asking

trust vs. mistrust

• met needs: developed by meeting comfort, feeding, stimulation, and caring needs • routines: repetition can help them feel secure in their world • rituals: same thing every-day- bedtime rituals, eating or using the same spoon for eating • consistent caregiver: it is important that there is a rhythm to the care and that one main person is the caregiver