Maternal Lec Milestones (Preschooler to Adolescence) KMA

During preschool stage, a child’s weight increases about how many pounds per year and what is the average weight of preschoolers?

4.5 lbs/year ; 42 lbs

During preschool stage, a child’s height increases about how many inches per year and what is the average height of preschoolers?

3.5 inches/year ; 44 inches

Are the movements we make with large muscles, like those in your legs, arms and torso.

Gross Motor Skills

Mnemonic for preschooler milestone;

• Physical Changes

• Reduced Separation Anxiety

• Erickson and Piaget’s Theory

• Scared of Things “Fear”

• Child Safety

• Healthy Eating

• Others are starting to become important for play time

• Outline behavior expectation for parents

• Language Explosion

What are the gross motor skills that a preschooler develops?

• Ride a tricycle

• Play with a ball

• Run

• Hop

• Skip

• Climb

What are the fine motor skills that preschoolers develop?

• Write their first name

• Zip-up jacket

• Button up shirt

• Cut with Scissors

• Copy shapes

What is the age range of a preschooler?

3 - 5 years old

Preschoolers on Separation Anxiety;

• Disappears by 4-5 years

• Tolerates better than toddlers

• Protest: less intense

• Despair and Detachment same as the toddler

• It is said that during this age, children strongly believe that their personal thoughts have a direct effect on the rest of the world.

  • E.g. preschoolers will think that their parents are kidnap if they disappear, so always reassure the child.

Magical Thinking

• The goal of this stage is for preschoolers to find their sense of purpose

• Needs opportunities to try new things; make decision and challenge them (conscience developed)

• If the preschooler is strained from opportunities, they will struggle trying new things which leads to guilt.

Initiative vs Guilt

Intervention to help preschooler have a sense of purpose for them to progress to the next stage.

• Encourage play (Ex. imaginary (Magical thinking))

• Give freedom within reason to try new things and make choices

• Encourage when they fail (don’t criticize)

• Avoid controlling all aspects of decisions

• Still egocentric like toddler

• Magical thinkers

• Literal thinkers (Will interpret me metaphors literally)

Preoperational Stage (2-7 years old) - Piaget Theory

Is the belief that objects, ideas, or places have living characteristics or a spirit.

Animism / Animistic

Scared of Thing (Fear): Preschooler

• Preschooler cannot differentiate fact from fiction mainly because they are magical thinkers.

• They fear hospitalization, mainly because they think that this is a form of punishment and possible mutilation of their body.

  • To avoid this you need to be honest with them, explain to them in simple terms, initiate in medical play, answer their questions, and give opportunities for independence

Child Safety: Preschooler

• Gun safety

• Swimming

• Bike Helmets

• Strangers

Health Eating: Preschooler

• Not as picky as toddlers

• Decrease in ritualism

• By 3 years old, all milk teeth erupts and start to lose at 5 to 6

Other are starting to become important for Play;

• From parallel play (toddler), the preschooler progress to associative play (not working together, but still playing together)

• Cooperative play (4-5 years)

What are the outline behavior expectations to a preschooler;

• Loss of control

• Anxiety

• Aggression

• Decreased negativism and ritualism

• Nightmare

Language Explosion: Preschooler

• 2,400 works + 5 word sentences by 5

• Stammering (Stuttering) normal AT THIS AGE

  • Reassure patient

  • Do not rush of finish words

  • Don’t make a big deal about it

  • May need referral if still present after 5.

What is the age range of a School-Age Child?

6 - 12 years old

School-Age Children;

• This is when school starts

• Fine motor skills:

  • Writing

  • Detailed Drawing

  • Typing

  • Cooking and cleaning

• Gross Motor Skills:

  • Riding a bike

  • Swim

  • Team Sports

  • Hobbies

• Cognitive Skills:

  • Concentrate

  • Read and memorize

  • Mathemathics

• Language Skills

  • Adult like speech

  • Grammar Rules

• Social Skills

  • Not egocentric anymore

  • Start to form relationships

  • Starting with same-gender relationships

Mnemonics for School-Age Children; SCHOOL

• Skills

• Changes

• Harmful Risks

Changes (School-Age Child)

• 2.5 inches per year

  • Average height (6 yrs) = 45 inches

  • Average height (12 yrs) = 59 inches

• 4.5 to 7 lbs per year

  • Average weight (6 yrs) = 45 lbs

  • Average weight (12 yrs) = 90 lbs

• Loses all the milk teeth and child will have 28 teeth by the end of this stage (12 years old)

On average, at what age does puberty hit girls?

8 - 13 years old

On average, at what age does puberty hit boys?

9 - 14 years old

Harmful Risk (School-Age Child)

• School-Age Children like to “show off”

  • Biking safety

  • Swimming safety

  • Strangers

  • Gun Safety

• Children under 12 should sit in the back seat

Obstacles at this age (School-Age Child)

• Self - concept (Who am I)

  • Approval of peers and teachers

• Bullying and Signs

  • Unexplained Injuries

  • Missing Items

  • Avoiding school / poor grades

  • Behavior changes

  • Self - harm

• Weight Obesity

• Exposure to drugs, violence, and sexual content

Signs of Obesity (School-Age Child): HEAVY

• High Calorie Diet

• Exercise Lacking

• Access to healthy foods limited

• View foods as stress

• Your genes / family dynamics

Outcome of Hospitalizations

• Fears

  • Encourage honesty

  • Medical play

  • Interrupt school routines

  • Separate from friends

The 7 T’s of a Nurse’s Role in Hospitalized Child

• Take time to express their fears

• Talk about fears; coping methods

• Truthful about procedures

• Teach with pictures

• Tactful with privacy

• Time for activities

• Their friends (stay in contact)

Learn Developmental Theories (School Aged)

• School aged children yearns for accomplishment

• They are currently at the Industry vs Inferiority stage

  • Where they want competency (Erickson)

• Piagets; Preoperational until 7

  • Concrete Operations 7 - 12 years

  • Decresed egocentric

  • Concrete thinkers

• Moral Development (Kohlberg)

  • Early until 7

  • Later on until 10

  • Older school age?

Refers to the understanding that rearranging material would not affect the object's number, mass, or volume; this is a characteristic learning tool during the concrete operations stage of Piaget's cognitive development theory, ranging between 7 to 11 years.

Conservation (Preschooler)

Under what age range is a child considered an adolescent (TEEN)?

13 - 18 or 19 years old

Mnemonics for Adolescence; TEEN

• The BIG Changes

The BIG Changes (Adolescence)

• Reproductive organs become active

  • Tanner Stages can be used to determine the maturity

• All 32 permanent teeth erupted

• Peer influence is a major part of life

• Body Image (Feedback seeking)

Puberty (Adolescence)

• 1st Sign: Breast Development

• Hair growth

• Increased Weight (125 lbs) fat stores

• Increased Height (64 inches): Increase of 8 inches during puberty

What is the average height of 18 year old females?

5’4 (64 inches)

When do girls tend to stop growing?

2 years after the start of menstruation

When does puberty start for females?

2 - 3 years after puberty starts

Male Changes (Adolescence)

• Increased size of penis and testes

• Hair growth

• Voice Changes

• Increased Muscle Mass

  • Average Weight (147.5 lbs)

  • Average Height (5’9)

How to avoid negative body image in your child?

• Role Model

• Eating Disorder Signs (Be Aware)

• Avoid the media trap

• Love your teen

Education (Adolescence)

• Safety

  • Driving safety

  • Self - harm prevention

  • Substance Abus

• Health Education

  • Sleep 8 - 10 hours per night

  • Limit bluelight exposure

  • Exercise regularly

Erickson, Piaget, and Kohlberg’s

• Identity vs. Role Confusion

  • The goal of this stage is fidelity or commitment to obligations

• Format Operation’s (12 years to Adulthood)

  • Abstract thinkers

  • Plan for future

  • Cause and effect

  • Manipulate Ideas

• Social Contract Driven

Nurse’s Role in a Hospitalized Teen

• Fears

  • Separation from peers

  • Loss of control

  • Privacy Invaded

  • Death, deform

Apocrine Vs Sebaceous Glands

Apocrine glands secretes sweat and is responsible for body odor, while sebaceous glands secretes oils that contributes to acne.

BMI;

• Underweight: BMI less that 5th percentile for age, height, and gender,

• Normal: BMI is 5th percentile or greater but not higher than 85th percentile,

• Overweight: BMI is 85th percentile or greater but less than 95th percentile,

• Obese: BMI is 95th percentile or greater

At which stage of development, are children’s imitating behavior at peak?

Preschooler Age

When does sibling rivalry, first becomes evident?

• Preschooler Age

  • Because this is when they have the vocabulary to express how they feel.

At what age is the brain fully developed?

10 Years Old

Chronological Order of Hair growth for male adolescent

• Pubic Hair

• Chest Hair

• Facial Hair

• Develops at school age

• The ability to understand that objects can belong to more than one classification.

Class Inclusion

Refer to children lacking the insight to view themselves as others see them or to put themselves in another’s place.

Centering

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.

Decentering (Preschooler)

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.

Accommodation

Confirmity Rules (School Age) - Kohlberg’s

• < 7 = Self - Interest Orientation

• Up until 10 - Good boy/girl Orientation

• Older School Age = Law and Order Orientation