Growth and Development

What is growth?

The process by which an increase in size occurs. Measured in humans as height and weight.

What is development?

An increase in and maturation of physical ability, thought processes, and behaviors over time.

What is Erikson’s stage for birth to 18 months called?

Trust vs. Mistrust
“Infant”

Which one of Erikson’s stages includes caregiver meeting all needs of the child and the development of sense of trust in others by having needs met?

Birth to 18 months
Trust vs. Mistrust

What is Erikson’s stage for 18 months to 3 years called?

Autonomy vs. Shame and Doubt
“Toddler”

Which one of Erikson's stages includes the child striving to make decisions for themselves and achieving a balance between holding on and letting go?

18 months to 3 years
Autonomy vs. Shame and Doubt

What is Erikson’s stage for 3 years to 6 years called?

Initiative vs. Guilt
“Preschool Child”

Which one of Erikson's stages include the child exploring their world and abilities (running, jumping, throwing) and initiating activities without fear of reprimand from caregivers?

Initiative vs. Guilt
3 years to 6 years old

What is Erikson’s stage for 6 years to 12 years called?

Industry vs. Inferiority
“School-aged child”

Which one of Erikson’s stages includes the child refining skills acquired previously and developing a peer social network that exerts great influence on oneself and developing a sense of self-worth based on accomplishments while avoiding feelings of failure?

Industry vs. Inferiority
6 years to 12 years old

What is Erikson’s stage for 12 years to 18 years called?

Identity vs. Role Confusion
“Adolescent”

Which one of Erikson’s stages includes exploring and integrating multiple roles: student, athlete, child, and adult? Emotional fluctuation and stress are common as one struggles to sort out self-identity and emerging from the stage with a strong sense of individuality/identity?

Identity vs. Role Confusion
12 years to 18 years old

What is Erikson’s stage for 18 years to 35 years called?

Intimacy vs. Isolation
“Young Adults”

Which one of Erikson’s stages include a person searching for a partner who supports and complements them and seeking fulfilling love and family relationships? Starting a family is common.

Intimacy vs. Isolation
18 years to 35 years old

What is Erikson’s stage for 35 years to 55 years called?

Generativity vs. Stagnation
“Middle Adults”

Which one of Erikson’s stages include a person who seeks involvement in creative and meaningful work and transmits culture and values to younger generations and developing a sense of self-worth as children leave the home?

Generativity vs. Stagnation
35 years to 55 years old

What is Erikson’s stage for 55 years and older called?

Integrity vs. Despair
“Older Adult”

Which one of Erikson’s stages include a person reviewing life events, accepting the finality of death, and achieving a sense of fulfillment in life’s accomplishments?

Integrity vs. Despair
55 years and older

What term describes growth and development following a pattern that starts with the head and then proceeds to the rest of the body (head-to-toe)?

Cephalocaudal Principle

What term describes development that starts in the center of the body and progresses outward?

Proximodorsal Principle

What term describes a simple task or topic that must be taught first where complex can follow later?

Simple to Complex

What term describes small, incremental changes that move processes toward excellence?

Continuous Process

What term describes movement from something broad, general, or known to the readers, to more specific, and perhaps unknown, detail?

General to Specific

What term describes individual differences in development rates that cause people to be careful about using and relying on age and stage characteristics to describe or label people? There is a range of ages for any developmental task to take place.

Individualized Rates

Posterior closes by 2 months of age?

Infant Fontanel

How is infant size tracked?

Using weight, height, and head circumference.

How long do infants typically sleep daily?

14-15 hours with a longer stretch of sleep during the night.

Crying is a form of what?

Communication

What can change to reflect different needs?

Cry Patterns

How many teeth does a child have by the end of the 1st year?

6-8 Teeth

How can teething pain be soothed?

• Frozen Teething Rings

• Ice Cubes Wrapped in Washcloths

• Over the Counter Teething Gels

Ibuprofen is used only in infants over the age of what?

6 months

Why avoid giving bottles to infants when they are falling asleep?

Prolonged exposure to milk or juice can cause early dental issues

What do positive interactions promote in infants?

Nurturing and Attachment

What is Erickson’s infant stage called?

Trust vs. Mistrust

How is trust developed?

By meeting comfort, feeding, stimulation, and caring needs

When does separation anxiety begin?

Around 4 to 8 months old

When is fear of strangers evident by?

6 to 8 months old

What type of play do infants engage in?

Solitary Play

What type of play includes short attention spans where child will not interact with other children?

Solitary Play

What is the recommended age an infant should receive breast milk through?

Infants should solely receive breast milk for 6 months and should continue with complementary foods for up to 2 years or longer

Is cow’s milk acceptable?

No, it is not recommended

Alternative sources of fluid are not needed for the first 4 months. Why not?

Excessive intake of water could result in hyponatremia and water intoxication

Closes by 18 months of age?

Anterior Fontanel

What is Erickson’s toddler stage called?

Autonomy vs. Doubt and Shame

What might a toddler show as a response to anxiety or separation?

Regression

What type of play do toddlers engage in?

Parallel Play

What type of play includes beginning to play and communicate with others?

Parallel Play

What causes temper tantrums?

Toddlers being frustrated with restrictions on independence

How can caregivers minimize toddlers’ frustrations?

By providing consistent, age-appropriate expectations to help them work through their frustrations

When can toilet training begin?

With awareness of sensation of needing to urinate or defecate

Instead of providing an opportunity for a yes/no response from a toddler, you can?

Offer choices (juice/milk)

T/F: Toddlers are picky eaters who prefer finger foods.

True

When can toddlers switch from whole milk to drinking low-fat or fat-free milk?

At 2 years old

What is the typical serving size for a toddler?

1 tbsp for each year of age

What types of food should be avoided for toddlers?

Snacks and desserts high in sugar, fat, or sodium. Foods that pose choking hazards (nuts, grapes, hot dogs, peanut butter, raw carrots, tough meats, popcorn)

Should food be used as a reward or punishment?

No

What occurs at a slow and steady pace where both gross and fine motor skills become more refined?

Physical Development

How does the unsteady wide stance and protruding abdomen of a toddler evolve for the preschooler?

Into a more graceful, posturally erect, and sturdy physicality stance

When do children understand the concepts of past, present, and future and begin to understand the days of the week?

In the preschool years (3-6 years old)

What is Erickson’s preschool stage called?

Initiative vs. Guilt

What does pretend play help differentiate between?

Reality and Fantasy

When a child has sleep disturbances that cause difficulty going to bed due to night terrors, what should the nurse advise parents?

• Assess whether bedtime is too early for children who still take daytime naps

• Keep a consistent bedtime routine

• Use a night light

• Reassure frightened children

• Ensure media content is age-appropriate and nonviolent

What type of play do preschoolers engage in?

Associative Play

What type of play includes play that is not highly organized and preschoolers do not cooperate during play?

Associative Play

What is the estimated caloric intake appropriate for preschoolers?

1200-1400 calories per day

What is the recommended amount of protein for preschoolers?

13 to 19 grams of protein (2-4 oz) per day

What is the 5-2-1-0 framework?

• 5 servings of fruits and veggies per day

• 2 hours or less of screen time

• 1 hour of physical activity

• 0 servings of sugar-sweetened beverages

T/F: Females exceed males in height and weight near the end of school age.

True

What happens to the teeth of school-aged children?

Their permanent teeth erupt

How does the female body change during school aged years?

• Budding of breasts

• Appearance of pubic hair

• Menarche

How does the male body change during school aged years?

• Enlargement of testicles with changes in the scrotum

• Appearance of pubic hair

During what period of life does cognition include becoming self-motivated and the understanding of jokes and riddles?

School-Aged Children

What is Erickson’s school aged stage called?

Industry vs. Inferiority

Why types of tasks are motivating for the school-aged child?

Tasks that increase self-worth

What are the stressors for school-aged children?

• Parental and peer expectations

• Their environment

• Observed Violence

What is the role of friendships amongst school-aged children?

Friendships begin to form among same-gender peers. Clubs and best friends are popular.

What type of play do school-aged children engage in?

Competitive Play (6-9 years old)
Cooperative Play (9-12 years old)

What conditions does obesity predispose students to?

• Low self-esteem

• Diabetes mellitus

• Heart disease

• High blood pressure

What does the nurse advise caregivers of school-aged children?

• Don’t use food as a reward

• Emphasize physical activity

• Provide a balanced diet

• Teach healthy food selections

• Avoid fast food

• Avoid skipping meals

How should school-aged children maintain oral health?

Brush and floss daily

What period of growth is a time of dramatic physical, cognitive, and psychosocial growth?

Adolescence

When is the final 20-25% of height gained?

During puberty

What is the sexual maturations of females during adolescence?

• Grow 5-20cm (2-8 inches) and gain 7 to 25 kg (15.5-55 lb)

• Appearance of breast buds

• Growth of pubic hair

• Axillary hair growth

• Onset of menstruation

What is the sexual maturations of males during adolescence?

• Grow 10-20cm (4-12 inches) and gain 7 to 30 kg (15.5 to 66 lb)

• Increase in size in the testes and scrotum

• Appearance of pubic hair

• Penile enlargement

• Growth of axillary hair

• Facial hair growth

• Change in voice

What type of questions should be used to communicate and discuss sensitive issues with adolescents and why?

Use open-ended questions to communicate and discuss sensitive issues with adolescents. They communicate one way with the peer group and another way with adults.

What is Erickson’s adolescent stage called?

Identity vs. Role Confusion

What is an important consideration about risky behaviors for adolescents?

Adolescents can view themselves as invincible to bad outcomes of risky behaviors

How many hours of sleep is recommended for adolescents each night?

About 9 hours of sleep each night

How does the adolescent sleep pattern change?

Sleep habits change with puberty due to increased metabolism and rapid growth

How does oral health change for adolescents?

Corrective appliances are most common with this age group

How does rapid growth impact nutritional needs?

Rapid growth and high metabolism require increases in quality nutrients and make adolescents unable to tolerate caloric restrictions. During times of rapid growth, additional calcium, iron, protein, and zinc are needed.

What eating disorders are common in adolescents?

Anorexia and Bulimia

What nutrition education does the nurse provide parents of adolescents?

• Avoid using food as rewards

• Emphasize physical activity

• Ensure they eat a balanced and healthy diet

• Encourage healthy food selection

What age has growth concluded by?

Age 20

What period of life is the optimal time for childbearing?

Young adults 20-35 years old

When does the memory peak?

In the 20’s

What is Erickson’s young adult stage called?

Intimacy vs. Isolation

What are some examples of social development in young adults?

• Leaving home

• Living independently

• Establishing close friends

• Forming a family

What gender does calcium intake need to be monitored in?

Female