Growth and development and immunizations

Family theories

Family systems: not viewed as individuals, change affects all

Family stress: family reactions to stress

Developmental: family as small groups that interact with larger systems, families change overtime, stages affect future ones.

Authoritarian parental style

(too strict/hard), make rules, unquestioning obedience, no reasons for the rules, punish physically. Outcome is wellbehaved kids with poor self esteem, can lead to aggression and rebellion.

Authoritative parental style

high but realistic standards, open communication, independence is encouraged, warm, supportive and nurturing, respect your opinion. Outcome: best high self esteem

Permissive parenting style

parents make few demands and rarely use punishment, very nurturing. Outcome: demanding impulsive behavior, lack of self regulation and social skills.

Neglectful

low support and detached from child, Outcome: self sufficient out of need, low emotional regulation

Communication with birth to 2years

use toys and comfort items, allow to be held.

Communication with 2-7years

PRAISE, simple explanations., let client touch equipment, give client choices,

Communication with 7-11years

detailed explanations, demonstrations

Nutrition for birth to 12mo.

first 6 months after birth: exclusively fed breast milk or iron-fortified infant formula. At around 6 months, parents can introduce water and cereal, fruits, and vegetables.- most calories and nutrients still come from breast milk or iron-fortified infant formula. At 12 months, parents may replace breast milk or formula with whole cow's milk or fortified unsweetened soy milk. The recommended caloric intake for clients who are this age is 700 to 1,000 calories per

day.

Some cultures will give infants sprite: seizures because increased Na+

Nutrition for 12mo and older

After 12 months, pediatric clients' caloric intake demands will increase. Children who are 2 to 4 years old require 1,000 to 1,600 calories per day. Children who are 5 to 8 years old require 1,200 to 2,000 calories per day. Children who are 9 to 13 years old require 1,400 to 2,200 calories per day. Adolescents who are 14 to 18 years old require 1,800 to 3,300 calories per day

Vital signs values in general

A fever is defined as a rectal temperature above 100.4 F / 38 C, Minimum systolic BP = 70 mm Hg + 2 x age in years (4 year old minimum SBP= 78), Normal oxygen saturation should be 92% - 100% for all children

HR and RR for birth to 4 weeks

110-160, 30-60

HR and RR for 1-12mo

90-160, 25-30

HR and RR for 1-2years

80-140, 25-30

HR and RR for 3-5years

70-120, 20-25

HR and RR for 6-12years

60-110, 20-25

HR and RR for 13-18years

50-100, 16-20

FLACC scale

2mo to 3 years or nonverbal, 0 is normal.

FACES

for 3 years and older

Assessment triangle for the client

Appearance (tone, gaze), Work of breathing (positioning/tripod, retractions, nasal flaring), Circulation (pallor, molting, cyanosis).

Pediatric Early warning signs

done every 30 mins, for behavior (activity) cardio (cap refill and molting) and respiratory (RR and retractions). score 0-3, 3 being the worst.

Infant growth

weight doubles by 4-6 mo and triples by 12 mo, length goes up by 50% by 12 mo, head circumference goes up by 10cm by 12 mo. Posterior fontanel closes by 2 mo, anterior closes by 18mo.

Tonic neck reflex

infant looks left, extends left arm, and flexing right arm, until 3mo.

Grasp reflex

touching middle of hand or foot causes flex of toes/fingers until 4mo

Rooting reflex

stroke cheek/mouth infant turns towards and sucks until 4mo.

Moro reflex

infant falls/startles and extends arms and legs until 6mo

Babinski reflex

move finger from sole to toes and the toes will fan out until 1year, if toes flex down it is negative/absent.

Ericksons for birth to 1 year

trust v mistrust: infant learns delayed gratification, and trust the caregiver will provide. Learns stranger danger by 8 mo.

Goss motor skills for infants

5-6mo: infant can hold bottle with both hands. 7-8mo: infant can sit leaning forward on both hands. 9-10mo: infant can crawl. 11-12mo: infant can place objects in a container and walk with their hand held.

Warning signs for infants

Hearing: does not babble or make sounds by 4mo. Language: should use words with meaning by 12mo.

Promoting eating in infants:

1 new food every 3-4 days and introduce sippy cups by 6mo.

Promoting healthy sleep and preventing SIDS

Place newborns and young infants on their back to sleep, to decrease risk of SIDS - Newborns sleep up to 20 hours per day (waking only to feed)

By 3 months: Infants sleep 7 to 8 hours per night, Take 2 to 3 naps per day

Around 4 months, establish a bedtime routine, Facilitates relaxation and predictable sleep time

By 12 months, Infants sleep 8 to 12 hours per night, Take 2 naps per day

Growth of the toddler

gain 3-5lbs/year, 3in/year, Swayback and pot belly until 3 years old

Ericksons theory for toddler

1-3years: autonomy vs shame/doubt: starts to see self as separate from parent, focus on self,

Motor skills for toddlers

12mo: pulls up to stand, walk holding onto furniture, picks up stuff with thumb.

18mo: walks independently, climbs on and off furniture

24mo: kicks ball, walks up stairs

30mo: takes some clothes off, jumps, turns book page - uses parallel play.

Sleep recommendations

18mo: 13.5 hours

24mo: 13 hours

3 years: 12 hours of sleep- discontinue napping

Growth for preschoolers

increases 5lb/year, 2.5/3.5 in / year, loses baby fat and gains muscle.

Motor skills for preschoolers

3years: strings beads, puts on clothes, builds 9-10 block tower, rides tricycle.

4year: catches ball, unbuttons, holds pencil

5year: buttons, throws ball, laces shoes.

Ericksons theory for preschoolers

3-6years, initiative vs guilt: make own decision snd guilty when not able to accomplish something.

Cognitive development fro preschoolers

transduction: they corollate things with no correlation, animism: inanimate objects have feelings,

Language of preeschoolers

4years: complete sentences, vocab of 1500 words, uses me and you correctly.

5years: can explain how to use something, answers why and when, vocab of 2100 words, can use plurals and past tense.

Growth of school aged child

2in/year, 6lbs/year, secondary sex characteristics develop, 10-12 hours of sleep

Visual issues in school aged

eye rubbing/squinting, frequent headaches, amblyopia: lazy eye,

Language in school aged

8000-14000, metaphors begin being understood,

Ericksons for school aged

6-12 years, industry vs inferiority: interested in learning and peers and trying to master a skill.

adolecent growth

rapid growth second to infancy in fast, puberty around 9-10 for girls and 11-10 for boys, peaks height velocity is 12 for girls and 14 for boys, muscle increases in boys and fat increases in girls. apocrine glands activate in axilla and genitals, growth plates begin to close.

Ericksons theory for adolescents

identity vs role confusion: peer culture become primary importance,

major causes of death by age group

0-1: Developmental genetic conditions present at birth, Premature birth, SIDS

1-4years: Accidents(unintentional injuries) Developmental, genetic conditions present at birth, Homicide

5-14 years: Accidents (unintentional injuries), Cancer, Suicide

What are the vaccines for 2 months

Be DR. HIP (Hep B, DTap, Rotavirus, HiB, IPV, PCV)

What are the vaccines for 4 months

DR. HIP (DTap, Rotavirus, HiB, IPV, PCV)

What are the vaccines for 6 months?

Be DR. HIP in 6 mo (Hep B, DTap, Rotavirus, HiB, IPV, PCV, Influenza)

What are the vaccines for 1 year to 15 mo

Very MAD HIP-ster (Varicella, MMR, Hep A, DTaP, HiB, IPV, PCV)

what are the vaccines for 4 to 6 years?

Very DIM between 4-6pm (Varicella, DTap, IVP, MMR)