Week 1 peds

Family systems

family is a whole system

change in one part affects the whole; domino effect

Family stress

their reaction

offer guidance for adaptation

Family developmental

families are small groups who interact with larger social circles; main fam can affect other groups

family change over time

Family duvall

family stages with a child; life cycle

Traditional nuclear fam

dad provider, mom caretaker

Blended family

children with different parents

Extended

aunts, cousins, friends, etc child living with

Binuclear family

divorced, raising kid together

Communal family

whoever lives in home

First child changes the dynamics

parental sense of self, rebrand for role

sleep habit changes

income/financial responsibilities

relationships (ex. grandparents and work)

Promotion of behavior in children

set clear/realistic expectations

validate feelings

role model and reinforce

discipline with focus on negative behavior

Behaviors during hospitalization - early childhood

cry more frequently

irritable

clinging

regress

fear they are being punished

Behaviors during hospitalization - later childhood

upset

sad

afraid

regress

Behaviors during hospitalization - adolescents

anxious

act out

become introverted

Nurse actions for support systems

explain in age-appropriate language what is happening with hospitalized child (sibling)

encourage fam comm

call home frequently for siblings to keep in touch

maintain steady home routine

First 6 months feed exclusively:

breast milk or iron fortified infant formula

later → water, cereal, fruits, and veggies

no honey

12 month nutrition

may replace breast milk with cow milk or fortified unsweetened soy milk

700-1000 ca a day

Anthropometric measurements

head circumference (and chest till 2)

length/height

weight

BMI

Infant vitals

HR: 110-170

RR: 20-55

• breathing is sporadic; count 1min

SBP: 75-105

Toddler vitals (2+)

HR: 95-150

RR: 20-40

SBP: 70-105

School age vitals (8+)

HR: 70-130

RR: 16-30

SBP: 80-115

Posterior fontanels close

by 2 months

Anterior fontanels close

by 12-24 months

2 month milestones

looks at your face

reacts to loud sound

smiles when being talked to or smiled at

holds head up when on tummy

6 month milestones

knows familiar ppl

takes turns making sounds

reaches to grab toys

rolls from tummy to back

12 month milestones

plays games, like patty cake

says mama and dada

pulls to stand

puts something in container

18 month milestones

points to show you something

tries three+ words

copies you doing chores

tries using a spoon

2 year milestones

looks at face to see your reaction

says two words together (ex. more milk)

tries using switches, knobs, buttons

kicks ball

30 month milestones

says 50+ words

plays pretend

shows what they can do, “look at me”

jumps off ground with both feet

3 year milestones

talks in conversation

draws a circle when shown how

notices other children and joins them to play

uses a fork

4 year milestones

answers simple questions

names a few colors of items

unbuttons some buttons

likes to be a helper

5 years milestones

follows rules or takes turns

uses/recognizes simple rhymes

writes some letters in their name

hops on one foot

Growth/development - newborns 2-28 days bio

HC: 33-35cm, increases 2cm/month

Length: 48-53cm

Weight: 6-9lbs

6-8 diapers

Growth/development - newborns 2-28 days reflexes

moro - spreading out arms

babinski - toes curl

root - finding nipple if stroking near mouth

sucking - involuntary sucking

tonic neck - fencing; head turned one way, arm on same side sticks out while the other bends up

Growth/development 1-3 months - physical and motor

lifts head briefly during tummy time

moves both arms and legs

opens hands briefly

Growth/development 1-3 months - social and emotional

looks at the caregivers face

calms when spoken to or picked up

begins social smiling

Growth/development 1-3 months - comm and cognitive

coos and reacts to loud sounds

watches people move

looks at objects briefly

Growth/development 3-6 months - physical and motor

holds head steady; pushes up on forearms

reaches, grasps toys, and brings hands to mouth

by 6 months, rolls tummy to back and supports sitting with hands

Growth/development 3-6 months - social and emotional

smiles, chuckles, and seeks attention

recognizes familiar ppl

laughs and enjoys looking in a mirror

Growth/development 3-6 months - comm and cognitive

coos, turn towards voices, and takes turns making sounds

reaches for wanted toys and explores objects with mouth

begins showing hunger and fullness cues

Growth/development 6-9 months - physical motor

sits without support and gets into a sitting position

transfers object hand to hand and bangs two objects together

uses fingers to rake food toward the hand

Growth/development 6-9 months - social and emotional

recognizes familiar ppl, may be wary of strangers

responds to names and reacts when a caregiver leaves

shows varied facial expressions and enjoys peek-a-boo

Growth/development 6-9 months - comm and cognitive

babbles repeated sounds such as mama and baba

raises arms to be picked up

looks for dropped objects and explores cause and effect

Growth/development 9-12 months - physical and motor

pulls to stand and cruises while holding furniture

picks up small items with thumb and pointer finger

places objects in containers and drinks from a cup with help

Growth/development 9-12 months - social and emotional

plays interactive games such as patty cake

uses gestures; waving bye

strong attachment and stranger or separation anxiety may continue

Growth/development 9-12 months - comm and cognitive

uses mama or dada

understands “no” and imitates sounds or gestures

searches for hidden objects and explores how objects work

Growth/development 1-3 yrs - physical and motor

progresses from walking to running, kicking a ball, and using stairs

scribbles, turning pages, stacks objects, and develops fine motor control

feeds self with utensils and increasingly helps with dressing

Growth/development 1-3 yrs - social and emotional

autonomy increases; tantrums and separation anxiety are common

imitates adults and develops simple pretend play

parallel play progresses toward joining and interacting with peers

Growth/development 1-3 yrs - comm and cognitive

progresses from single words to phrases and back and forth convo

follows one step, then two step directions

solves simple problems and asks who, where, what