NUR 220 - Human development: conception through adolescence

Growth

The process of increasing in physical size

• Height and weight

• Proceeds in an orderly and predictable pattern from head to toe

Development

The progressive acquisition of various skills

• Head support, speaking, learning, expressing feelings, and relating to other people

Nature vs nurture

Development is predetermined at birth (nature), or is the child’s environment (nurture) the controlling factor for how development progresses

Continuous theories of human development

State that development is a gradual, continuous process from infancy to adulthood

Discontinuous theories of human development

State that development occurs in a series of distinct stages triggered by inborn factors

Newborn (sub-stage)

Birth to 3 months of age

Infant

Birth to 1 year

Erikson’s stage - infant

Trust vs mistrust (birth to 1 year)

• Trust that others will meet their feeding, comfort, stimulation, and caring needs

• Their behavior will influence their social development

Newborn and infant development - eating

• Formula or breastmilk (fed is best) → should be iron fortified formula

  • Cows milk should only be used >1 year

• Eat roughly Q2-3H

• Solid food starts around 6 months

  • Know indicators for readiness

    • Are they interested in your food?

    • Have to be able to sit unsupported

Newborn and infant development - sleep patterns

• Can be reversed for several months (daytime sleepiness, nighttime wakefulness)

• Should average 15 hours of sleep each day

Newborn and infant development - motor functions

• The newborn is cuddling, sleeping, and feeding for the first few months → eat, sleep, poop

• Newborns might be able to follow your face with their eyes

  • They can focus on objects 8 to 14 inches away from their face

• Cry as a form of communication

• Movements are still random and jerky

• As neural connections increase and mature, so do the child’s physical abilities

• Physical development is a rapid and sequential pattern

Newborn and infant development - attention span

Short attention span

• Do not interact with others at play → solitary play

• What are some appropriate toys and activities for children this age?

  • Rattle

  • Stuffed animal

  • Mobiles

Newborn and infant development - medical care

• Well-child visits

  • Nurses perform screening tests to ensure the child is meeting developmental milestones

    • 2 weeks and 2, 4, 6, 9, and 12 months

• Immunizations:

  • The CDC puts out recommendations that you should follow – change periodically

  • What happens if a child misses a vaccine?

    • Catch-up vaccines (i.e. might get two doses of the vaccine closer together than normal)

3 month old infant

• Raises head and chest when prone

• Brings hands to mouth

• Follows a moving object with eyes

• Babbles and smiles at the caregiver’s voice

4-6 month old infant

• Begins to play

• Holds and reaches for toys

• Rolls (rolls on the floor rhymes with four)

• Sits with support

8-9 month old infant

• Stranger anxiety!!

• Sits without support

• Pincer grasp and object permanence

• Responds to own name and finds partially hidden objects

12 month old infant

• Walking

• Crawls forward on belly, using arms and legs to push

• Says ma-ma and da-da

• Seperation anxiety

Newborn and infant development - safety

• Handwashing

• Safe sleep

  • What does safe sleep look like?

    • Baby should sleep alone (NOTHING in the crib)

    • On their back

    • In a crib

• Aspiration risk

  • Button batteries!!!!

• Bodily harm

• Falls

  • Safety gates, place carseat on the ground

By the end of the _________, infants distinguish themselves as separate from their parents.

first year

Toddler

1 to 3 years of age

Erikson’s stage - toddler

Autonomy vs shame and doubt

• INDEPENDENT

• Can show regression as a response to anxiety

  • Regression is NORMAL

Toddler physical growth

Slows after the infant stage

• Heart and respiratory rate slow

• Most body systems are mature

  • Can tolerate a variety of foods

• Visual acuity improves

Toddler emotional growth

• Tantrums – have age appropriate expectations

• Offer choices when able to allow for independence – peas or carrots

  • Picky eaters!! – aspiration risk

Toddler development - sleep expectations

• Transfer to toddler bed

  • Ready when they crawl out of the crib

• Don’t want to go to bed - FOMO

Toddler development - mobility

• 12 to 13 months, begins to ambulate

• By age 2 child can walk up and down stairs

Toddler development - play

• Engages in parallel play

  • Playing beside other kids

• What are some age appropriate toys/activities?

  • Small puzzles

  • Themes

  • Hard-backed books

Toddler development - safety

• Car seat

  • Follow manufacturer guidelines

• Pools

• Cooking/burns

  • Turn the handle away from the edge

Taking care of toddlers in the hospital

Mimic ROUTINES AND HOME RITUALS

15 month old toddler

• Walks independently

• Uses index finger to point

• Understands 100-150 words

• Repeats words

18 month old toddler

• Turns pages in a book

• Understands 200 words

• Removes shoes and socks

24 month old toddler

• Kicks a ball

• Turns door knobs

• Point to named body parts

• 2-3 word sentences

30 month old toddler

• Follows a series of 2 independent commands

• Vocab 150-300 words

Preschooler

3 to 6 years old

Erikson’s stage - preschooler

Initiative vs guilt

• When they are unable to complete a task they become guilty

Preschool years - thought process

• Preschoolers are very egocentric in their thought process

  • Egocentric thinking - everything is about them and everyone sees the world like them

• Also have magical thinking

  • Believe that they can cause events by simply wishing them to happen

• Growing away from the separation anxiety – able to make more friends and explore

Preschool years - sleep

Nightmares/night terrors common

• 12 hours a day

Preschool years - play

Associative play, however not highly organized

• Normal to have imaginary friends

• What are some age appropriate activities?

  • Harder puzzles

  • Tricycles

  • Simple videogames

Preschool years - health screenings

• Vision – Snellen eye chart

  • Objects on the chart instead of lettters

• Child maltreatment is a term used to describe intentional physical, emotional, and sexual abuse of children

  • Appropriate names for genitalia

  • Parents give vague or mismatched explanations of why child is hurt

    • Notify nurse manager who will get CPS involved

• Sickness common

School-age children

6 to 12 years old

School-age years

• Delight in developing new skills

• Enjoy competition and working with others to accomplish goals

• Become capable of making judgments based on reasoning rather than on just what they see

• One of the biggest concerns: SAFETY

• Active children are at risk for accidents while riding bicycles and skateboards

• Children who are sedentary are at risk for developing childhood obesity and its side effects

• Bullying

Taking care of school-aged children in the hospital

Can explain procedures in simple terms with props if appropriate

Adolescents

• Rely on peers for friendship

• Nutritional needs increase

  • High caloric and protein needs

    • Avoid letting adolescents skip meals

  • Healthy dietary habits

    • Overeating, fad diets, and nutritional misinformation are common

• Develop a false sense of security and invincibility

Taking care of adolescents in the hospital

Encourage friends to visit in the hospital