WEEK 14 Nursing process for promotion of normal growth and development

INFANT

— Nursing assessment of an infant begins with interview with the primary caregiver

— Assessment must be done quickly but thoroughly

— Using a calm approach helps stay calm

Lateral incisors (UPPER)

— 9-13 months

Lateral incisors (LOWER)

— 10-16 months

Central incisors(UPPER)

— 8-12 months 

Central incisors (LOWER)

— 6-10 months 

Month 1 — infant

— Largely reflex actions

— Keeps hands fisted; able to follow object to midline with eyes

— Enjoys watching face of primary caregiver; Needs play time in prone position 

Month 2 — infant 

— Holds head up when prone 

— Demonstrates social smile

— Makes cooing sounds; differentiates from cry

— Grasp reflex fading

— Enjoys bright-colored mobiles

3 months — Infant 

— Holds head and chest when in prone 

— Follows object past midline with eyes 

— Laughs out loud

— Landau reflex is strong 

— Spends time looking at hands(hand regard)

— Tummy time important during the day 

4 Months — Infant

— Turns back to front

— No longer has head lag

— Bears partial weight on feet

— Stepping, tonic neck, extrusion reflexes are fading

— Needs space to practice turning 

5 Months — Infant 

— Should turn readily front to back and back to front

— Tonic neck reflex fading

— Handles rattles well

6 Months — Infant 

— Begins to show ability to sit

— Uses palmar grasp

— May say vowel sounds

— Moro and tonic neck reflex have faded 

— Enjoys bathtub toys, rubber ring for teething

7 Months — Infant

— Reaches out to be picked up— First tooth( central incisors) erupts

— Transfers objects hand to hand 

— Shows beginning fear of strangers

— Likes objects that are good size for transferring

8 Months — Infant

— Sits securely without support

— Fear of strangers peaks

— Enjoys manipulation, rattles, and toys of different textures

9 Months — infant

— Creeps or crawls(abdomen off floor)

— Says first word

— Needs safe space for creeping

10 Months — Infant

— Pulls self to standing

— Uses pincer grasp(thumb and finger) to pick up small objects 

— Plays games like patty-cake and peek-a-boo

11 Months — Infant

— Cruises (walks with support)

— Cruising can be main activity 

12 Months — Infant

— Stands alone; some infants take first step

— Holds cup and spoon well; helps to dress (pushes arm into the sleeve)

— Says four words

— Landau reflex fades

— Likes toys that fit inside each other(pots and pans), nursery rhymes, will like pull toys as soon as walking

Toddler

— Assessment begins with taking a careful health history

— Asking parents about a toddler’s ability to carry out activities of daily living offers assessment information not only on the child’s developmental progress but also important clues about the child-parent relationship

— A typical sign they are not feeling weel is acting “out of sorts” or “different”

15 Months — Toddler 

— Puts small pellets into small bottles; scribbles voluntarily with a pencil or crayon; holds a spoon well but may still turn it upside down on the way to the mouth

— Walks alone well; can seat self in chair; can creep up stairs

— 4-6 words

— Can stack two blocks; enjoys being read to; drops toys for adult to recover(exploring sense of permanence) 

18 Months — Toddler 

— No longer rotates spoon to bring it to mouth 

— Can run and jump in place; can walk up and down stairs holding too a person’s hand or railing; typically places both feet on one step before advancing 

— 7-20 words; ses jargoning; names one body part

— Imitates household chores such as dusting; begins parallel playing(playing beside, not with another child)

24 Months — Toddler

— Can open doors by turning doorknobs; can unscrew lids

— Walks up stairs alone, still using both feet at the same time

— 50 words; two word

— Parallel play evident

30 Months — Toddler

— Makes simple lines or strokes for crosses with a pencil

— Can jump down from chairs

— Verbal language increasing steadily; knows full name; can name one color; holds up fingers to show age

— Spends time playing house, imitating parents’ actions, play is “roughhousing” or active

Good rule

— is to think of a toddler as a visitor from a foreign land who wants to participate in everything the family is doing but does not know the customs or the language.

3 years — Preschooler

— Undresses self; stacks tower of blocks; draws a cross

— Runs; alternates feet on stairs; rides tricycle; stands on one foot

— Vocabulary of 900 words

— Able to take turns; very imaginative

4 Years — Preschooler

— Can do simple buttons

— Constantly in motion; jumps, skips

— Vocabulary of 1500 words

— Pretending is major activity

5 years — PReschool

—Can draw a six- part figure; can lace shoes

— Throws overhand

— Vocabulary of 2100 words

— Likes games with numbers or letters

Oedipus complex

— Strong emotional attachment a preschool boy demonstrated toward his mother

Preschool

— Assessment includes obtaining a health history and performing both a physical and developmental evaluation.

— speak very little during a health assessment; they may even revert to baby talk or babyish actions such as thumb-sucking if they find a health visit stressful.

Electra complex

— Attachment f a preschool girl to her father

School age child

— Use both history and physical examination to assess growth and development. Include questions about school activities and progress.

— interested and able to contribute to their own health history; to allow for this, it is useful to interview children 10 years or older at least in part without their parents present.

6 Years — School-age

— A year of constant motion; skipping is a new skill; first molars erupt

— First-grade teacher become authority figure; adjustment to all-day school may be difficult and may lead to nervous manifestations of fingernail biting

— Defines heir words by their use 

7 Years — School-age

— central incisors erupt; differences in sex become apparent in play

— Spends time in a quiet play

8 Years — School age

— coordination definitely improved; eyesight full y develops; playing with friends become important

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9 Years — School Age

— All activities done with friends

10 Years — School-age

— Coordination improves

11 Years — school age

— Active, but awkward and ungainly

— Insecure with members of opposite sex; repeats off-color jokes

12 Years — School age

— Coordination improves

— A sense of humor is present; is social ad cooperative

The family with an adolescence 

— generally do not come to health care facilities on their own unless they are ill.

Social coupling

— Tend to dress ad behave similarly to other members of their peer group

— Bullying behavior may be directed at individuals who dont conform to or associate with a peer group