school age children and adolescents growth and development

definition and general characteristics of "school age" children

"School-age" generally defined as 6 to 12 years Physiologically begins with shedding of first deciduous teeth and ends at puberty with acquisition of final permanent teeth Gradual growth and development Progress with physical and emotional maturity

nursing care management for adolescents

-Address developmental and health needs -Collaboration with community, parents, and the adolescent -Delivery of culturally appropriate health-promotion interventions -Support and guidance for parents -Health promotion special groups Minority adolescents Gay, lesbian, and bisexual adolescents Rural adolescents

adolescence concept of self

-Adolescent egocentrism -Self-absorption -Health-related beliefs Imaginary audience (everyone is watching) Personal fable (won't happen to me) -Changes in social cognition Understanding of others' thoughts and feelings Mutual role taking Effect on health-related choices

sexual maturation in adolescents including tanner stages

-Age timeline Early—ages 11 to 14 Middle—ages 15 to 17 Late—ages 18 to 20 -Biologic events Neuroendocrine events of puberty -Changes in reproductive hormones Females Menarche Ovulation Males -Tanner stages 1 through 5 -Sequence is predictable -Age of occurrence varies -Average age of menarche in United States 12.55 years for Caucasian 12.06 years for African American 12.25 years for Mexican American

maturation of systems in school age children

-Bladder capacity increases -Heart smaller in relation to the rest of body -RR and HR decreases as they get older -Immune system increasingly effective -Bones increase in ossification -Physical maturity not necessarily correlated with emotional and social maturity

general characteristics of growth and development in adolescents

-Complex interplay of biologic, cognitive, psychologic, and social change, perhaps more so than at any other time of life -Change on multiple levels Biologic maturation Cognitive development Psychologic development -Misguided views of adolescence Raging hormones (gonadrtopic releasing for boys LH and FSH for girls) determine behaviors Risky and misguided behavior is the norm

prepubescents

-Defined as 2 years preceding puberty -Typically occurs during preadolescence -Varying ages from 9 to 12 (girls about 2 years earlier than boys) -Average age of puberty is 12 in girls and 14 in boys

development of self concept in school age children

-Definition—a conscious awareness of a variety of self-perceptions (abilities, values, appearance, etc.) -Importance of significant adults in shaping child's self-concept -Positive self-concept leads to feelings of self-respect, self-confidence, and happiness

moral development in school age children

-Development of conscience and moral standards -Age 6 to 7—reward and punishment guide choices -Older school-age—able to judge an act by the intentions that prompted it -Rules and judgments become more founded on needs and desires of others

development of achievement in adolescence

-Development of motives, capabilities, interests, and behaviors -Progress toward occupational achievement -Relationship between social class and educational and occupational achievement

interventions for promoting optimal health during adolescence

-Empowering individuals, families, and communities -Power, authority, and opportunities to make healthy choices -Risk reduction in areas of mental health, substance use, sexual behavior, violence, unintentional injury, nutrition, physical activity and fitness, and oral health

physical activity and exercise during school age

-Exercise essential for development and function -Importance of physical fitness for children -Sports Controversy regarding early participation in competitive sports Concerns with physical and emotional maturity in competitive environment -Acquisition of skills -Generally like competition

adolescence perspective on health

-Factors promoting adolescent health and well-being -Contexts for adolescent health promotion -School-based and school-linked health services -Adolescent health screening "SAFE TIMES": -Method for screening interviews with teens Sexual issues Affects of drugs Family time/ relationships Exams sensitive and appropriate exams for this patient Timing of development of body image Immunizations Minerals and nutrients Education/employment Safety

erikson inferiority in school age children

-Feelings may derive from self or social environment -May occur if incapable or unprepared to assume the responsibilities associated with developing a sense of accomplishment -All children feel some degree of inferiority regarding skill(s) they cannot master

cognitive development in adolescence

-Formal operational thinking—ages 11 to 14 -Abstract terms, possibilities, and hypotheses -Decision-making abilities increase -May not use formal operational thought and reasoned decision making all the time— "choices"

social environment effects of adolescence

-Internet chat rooms and social networking sites have created "virtual" communities -Try out identities and interpersonal skills with wider network of people -Anonymity -Risks -Media influences -Community's economic resources play role in health and well-being of young people -Resources for health promotion

play in school age children

-Involves physical skill, intellectual ability, and fantasy -Children form groups, cliques, clubs, secret societies -Rules and rituals -See need for rules in games they play -Team play -Quiet games and activities -Ego mastery

injury prevention in school age children

-Most common cause of severe injury and death in school-age children is motor vehicle crashes—pedestrian and passenger -Bicycle injuries—benefits of bike helmets -Appropriate safety equipment for all sports

moral and spiritual development in adolescence

-Parallels advances in reasoning and social cognition -Conventional level of moral reasoning -Principled moral reasoning Religious beliefs may become more abstract during adolescence Late adolescents may reexamine and reevaluate beliefs and values of their childhood

health concerns with adolescence

-Parenting and family adjustment -Psychosocial adjustment -Intentional and unintentional injury -Dietary habits, eating disorders, and obesity -Physical fitness -Sexual behavior, STDs, and unintended pregnancy -Use of tobacco, alcohol, and other substances -Depression and suicide -Physical, sexual, and emotional abuse -School and learning problems -Hypertension -Hyperlipidemia -Infectious diseases/immunizations -Sleep deprivation and insomnia -Tanning

anticipatory guidelines for care of school age children

-Parents adjust to child's increasing independence -Parents provide support as unobtrusively as possible -Child moves from narrow family relationships to broader world of relationships

relationship with families in school age children

-Parents are primary influence in shaping child's personality, behavior, and value system -Increasing independence from parents is primary goal of middle childhood -Children not ready to abandon parental control

dental health during school age

-Permanent teeth eruption -Good dental hygiene -Prevention of dental caries -Malocclusion -Dental injury -Dental evulsion—replacement or reattachment

physiological growth during puberty

-Pubertal growth spurt -Gains in growth Final 20% to 25% of linear growth Up to 50% of ideal adult body weight -Heart, blood volume, and systolic BP -increase in size and strength -Heart rate decreases -Respiratory vital capacity increases -Change in BMR it increases which is why they are more hungry

psychosocial development in school age children

-Relationships center around same-sex peers -Freud described it as "latency" period of psychosexual development

stress reduction in school age children

-Relaxation techniques -Deep-breathing exercises -Progressive relaxation of muscle groups -Positive imagery -Physical activity

school health in school age children

-Responsibilities of parents, schools, and health departments -Ongoing assessment, screening, and referrals -Routine services, emergency care, and safety and infection control instruction -Increase knowledge of health and health habits

sex education for school age children including nurses rule

-Sex play as part of normal curiosity during preadolescence -Middle childhood is ideal time for formal sex education -Life span approach -Information on sexual maturity and process of reproduction -Effective communication with parents -Treat sex as normal part of growth and development -Questions and answers -Differentiate between "sex" and "sexuality" -Values, problem-solving skills -Open for communication with parents

identity development in adolescence

-Social forces shape sense of self -Identity achievement stages: -"Moratorium": the status in which an adolescent is actively in the process of establishing an identity -"Foreclosure": taking on an identity you think you want without really exploring -"Diffusion": lack of firm identity commitment don't know who you are but don't want to make the effort to find out

stress in school age children

-Stress from parents -Stress from peers -Violence -Internalizing Withdrawal, delaying tactics, and daydreaming -Externalizing Aggression and delinquency common stress responses: -Stomach pains or headache -Sleep problems -Bed-wetting -Changes in eating habits -Aggressive or stubborn behavior -Reluctance to participate -Regression to earlier behaviors (e.g., thumb sucking)

autonomy in adolescence

-Struggle to clarify values -Development of a personal value system -Gradual process in late adolescence -Development of autonomy -Emotional -Cognitive -Behavioral

self esteem in school age children

-The process of self-evaluation is approached from a framework of either self-confidence or self-doubt. -Begins to internalize outside opinions -Pets can have positive effect on physical and emotional health -Parents should be honest -Small successes can improve self-esteem

erikson in school age children

-developing a sense of industry -Eager to develop skills and participate in meaningful and socially useful work -Acquire sense of personal and interpersonal competence -Growing sense of independence -Peer approval is strong motivator

When talking to adolescents about health promotion, the health nurse should also include which additional topics? (Select all that apply.) a. Body Art b. Hearing c. Posture d. Tanning e. Upper respiratory infection f. Vision

Answer(s): A, B, C, D, F Rationale: A. Body art (piercing and tattooing) is an aspect of adolescent identity formation. A qualified operator using proper sterile technique should perform the procedure. B. Hearing damage has become a considerable concern due to loud sound levels from continuous exposure from earphones inserted into the ear canal. C. Rapid skeletal growth is often associated with slower muscular growth, and some adolescents may appear awkward or slump, fail to stand or sit upright. However, postural defects, such as scoliosis, may occur in the spine and need early intervention. D. Tanning is popular among adolescents and long-term effects include premature aging of the skin, increased risk of skin cancer, and in some susceptible individuals, phototoxic reactions. E. Upper respiratory infection, although it can effect adolescents, would not be a health promotion topic. F. Regular vision testing is an important part of an adolescent's health care. During adolescence, visual refractive difficulties reach a peak that is not exceeded until the fifth decade of life.

The greatest single cause of death in the adolescent group and claims more lives than all other causes combined is: a.Firearms b.Motor vehicle-related injuries c.Physical injuries d.Sports injuries

Answer(s): C Rationale: A. Firearms are the major cause of intentional fatal injuries in the United States B. Motor vehicle-related injuries are primarily due to lack of driving experience and lack of maturity. C. Physical injuries are the greatest single cause of death in the adolescent age-group and claim more lives than all other causes combined. Their propensity for risk-taking behavior plus feelings of indestructibility make adolescents especially prone to injuries. The most vulnerable ages are between 15 and 24, when accidental injuries account for 60% of deaths in boys and 40% of deaths in girls. D. Every sport has some potential for injury, whether for serious competition or enjoyment. A large number of severe or fatal injuries occur to youths who are not physically prepared for the activity.

biologic development of school age children

Biologic -Height increases by 2 inches per year -Weight increases by 2 to 3 kg per year -Males and females differ little in size but females are often starting to gain height earlier than boys -chest and waist circumference is smaller compared to body/height at this point

development of body image and sexuality in school age children

Body image -Generally children like their physical selves less as they grow older -Body image is influenced by significant others -Increased awareness of "differences" may influence feelings of inferiority -Sexuality -Normal curiosity of childhood -Attitudes toward sex -Use of terminology

families and work during adolescence

Families Changes in family structure and parent employment Parenting styles Socioeconomic influences Work Workplace as fourth microsystem Positive or negative May encourage development of intellectual and social skills, autonomy May result in decreased interest in school, fewer extracurricular activities, and poorer grades

language development in school age children

Language Efficient language skills Important linguistic accomplishments Correct syntax, improved grammar, word usage "Metalinguistic awareness"

nutrition and sleep/rest in school age children

Nutrition -Importance of balanced diet to promote growth -Quality of diet related to family's pattern of eating -Fast-food concerns Sleep and Rest -Average 9½ hr/night during school-age (11½ hr for 5-year-olds and 9 hr for 11-year-olds) but highly individualized -Ages 8 to 11 may resist going to bed -12 years and older generally less resistant to bedtimes

peer groups and schools in adolescence

Peer groups Significance in socialization Significance in development Value placed on peer relationships Schools Play increasingly important role in preparation for adulthood Parental involvement in schools Effect of academic success or failure on self-esteem

cognitive development in school age children

Piaget -Concrete operations: - Use thought processes to experience events and actions -Develop understanding of relationships between things and ideas -Able to make judgments based on reason ("conceptual thinking") -Conservation—physical matter does not appear and disappear by magic

coping with developmental changes during the school age years

School experience Second only to the family as socializing agent Transmission of values of the society Peer relationships become increasingly important Teachers Parents Limit setting and discipline Dishonest behavior Stress and fear

sexuality and intimacy in adolescence

Sexuality Hormonal, physical, cognitive, and social changes affect sexual development Body image Sexual identity Sexual orientation Intimacy Intimate relationship begins to emerge in adolescence Developmental course of intimacy Self-focused Role-focused: does what a "good girlfriend does" Individual-connected: realize complex differences in their specific relationship and the pros and cons to adapt into a health relationship

social development in school age children

Social development Importance of the peer group Identification with peers is a strong influence in child gaining independence from parents Sex roles strongly influenced by peer relationships Formation of groups or clubs

spiritual development in school age children

Spiritual Children think in very concrete terms Children expect punishment for misbehavior May view illness or injury as punishment for a real or imagined misdeed

The task of identity formation is to: a. Develop a coherent picture of self. b. Put past experiences behind oneself. c. Become autonomous. d. Commit to identity without exploration.

a. develop a coherent picture of self

In regards to social development, which statement is true for the school-aged child? a. Gaining independence from parents is important. b. Peers are the main influence. c. Boys associate more with girls. d. Girls will not play boy games.

a. gaining independence from parents is important

Which concept has the most significant impact for teaching safety strategies among teenagers? a. Invincibility of self b. Causation of injury c. Individual accountability d. Religious expectation

a. invincibility of self

The nurse overhears a father telling his 10-year-old son to "grow up and act your age." The nurse recognizes that which of the following is true? a. Physical and emotional maturation do not always coincide. b. Setting strong limits enhances the attainment of maturation. c. Ten-year-old children do not have the cognitive development to match their chronologic age. d. This indicates inadequate parenting behavior.

a. physical and emotional maturation do not always coincide

When talking to adolescents about stress, the most common areas of stress in their lives include? (Select all that apply.) a.Body image b.Conflicts with sexuality c. Competitive pressures d.Relationships with parents e.Relationships with peers f. Vehicle safety

all but f

The school nurse is proposing a sex education class for public school students. The nurse explains that the best age for sex education is which of the following? a. Middle school—because children are mature enough to understand and may consider becoming sexually active b. High school—because they are likely to be sexually active, and they are mature enough to understand c. Fifth grade—because most females have not reached menarche and are likely to become sexually active soon d. Third grade—because children reach menarche earlier, and they are unlikely to be sexually active

c. fifth grade-because most females have not reached menarche and are likely to become sexually active soon

Characteristics of middle childhood include: a. Formation of clubs b. Has best friend c. Values teachers d. All of the above

d. all of the above