Health Alterations Class 1- Child development and impact of hospitalization

Key terms/ideas

Trust Vs mistrust age group

birth to 1 year

Automony vs shame and doubt age group

1-3 years

Initiative vs guilt age group

3-5 years

Industry vs inferiority age group

6-12 years

Identity vs role confusion age group

12-19 years

What two groups expereince rapid growth and change

Infants and teenagers

When should infants get their first tooth

By 8 months

Signs of language development in infants

1. Watching your mouth when you speak

2. Touching mouth

3. Making sounds

Trust vs Mistrust: Trust

1. Caregiver meets needs (Baby is fed, bathed, changed, burped etc)

2. Baby knows caregiver will meet needs and develops trust

Trust vs Mistrust: Mistrust

1. Care giver does not meed babys needs adequately or consistently

2. Needs are not continuously met before baby cries (vocalizes needs)

What happens if an infants needs are met and they are left to cry?

Learns to self soothe

Infant nutrition

Bottle/breastfed until 6 months, then start introducing solids

Infants sleep and rest

Wake up to eat every couple hours (Bellies are small)

When should an infant go to the dentist?

By 1 year, to get used to the environment

Infant dental hygiene

Wipe gums with wash cloth (No toothbrush necessary)

Where should an infant sleep for the first 6 months

In their own crib in the caregivers room (Not in the same bed!)

SIDS prevention

1. No co sleeping

2. Baby sleeps on back

3. No objects in crib (Toys, pillows etc)

4. No swaddle

5. Dressed for temp (Like parents)

6. Pacifier

Why is a pacifier important for SIDS prevention

Sucking stimulates an infants brain

Most common causes of injuries in infants

1. Falls (Learning to walk/crawl/stand)

2. Ingestion (Exploring the world with their hands)

3. Burns (Crawling, knocking down hot objects, being held over a stove)

Period of developing independance

Toddlerhood (1-3 years)

When does a toddlers growth rate slow?

In the second year of life

Why does a toddlers food intake decrease?

1. Steady growth rate

2. Too busy learning, exploring independence

When should all teeth be present?

33 months

Autonomy vs shame and doubt: Autonomy

1. Independance is enouraged/explored

2. Learning to do things by themselves

3. Use negativism (No) to express independance

Autonomy vs shame and doubt: Shame and doubt

1. Caregiver discourages independence

2. Toddler questions their decisions/independence

Why is maintaining a routine and reliability important for toddlers?

It gives them a sense of comfort as they explore their environment beyond those most familiar to them

Toddler nutrition

1. Should eat what the family eats

2. Might be picky/unwilling to try new foods

3. Give 75% familiar foods, 25% new food

Toddler sleep and activity

1. Should sleep for 11-12 hours

2. Fears (The dark, monsters etc)

Toddler denist visits

Still going regularly, getting used to environment

Toddler dental hygiene

Should start brushing their own teeth (Then a caregiver should check)

Maincauses of injuries in toddlers

1. MVA’s (Improper car seat or not installed correctly)

2. Drowning

3. Burns

Preschool age psychological development

1. More social development (playing with friends, day care and preschool)

2. Language

3. Play

Initiative vs guilt: Initiative

1. preschoolers are energetic learners, despite not being able to do everything

2. Established by making games and doing activities withing their capabilities (With appropriate limits)

Initiative vs guilt: guilt

1. Guilt can occur when preschoolers believe they have misbehaved or are unable to accomplish a task

2. Ideas are frequently turned down

Preschool age nutrition

Often influenced by seeing what friends are eating

Preschoolers sleep and activity

1. Need about 12 hours of sleep

2. Will often wake up caregiver to talk about what happened at preschool/daycare

Preschool age dental health

1. Regular dental visits

2. Primary teeth are in

3. Can brush their teeth on their own (Then a parent checks and flosses for them)

Preschool age most common injuries

1. MVAs (Chasing balls into the road)

2. ATVs (Proper fitting helmet)

3. Bicycle injuries

School age physical development

1. Pubertal changes

2. Maturation of systems

School age psychological development

1. Efficient language (Will copy what they hear)

2. Structured play with friends

Industry vs inferiority: Industry

1. Child feels they fit in with society/peers (through development of skills and knowledge)

2. Sense of accomplishment when competing and cooperating with others

3. Children should be taught not everyone will master every skill

Industry vs inferiority: inferiority

1. Child doesn’t feel as though they fit in with society/their peers

2. When mastery of skills is rewarded children who can’t complete the, may feel inferior

School aged children nutrition and sleep

Individualized, imitate peers and caregivers

Most common injuries for School aged children

1. MVAs (improper car/booster seat or sittting up front too early (airbags))

2. Drowning (learning to swim)

School aged children other considerations

1. Body image: use proper terms and functions, answer questions honestly

2. Sex education should start early

Adolescence growth and development

1. Rapid growth

2. Development of secondary sex characteristics

Identity vs role confusion: Identity

1. Trying different roles and experiences to develop a sense of personal identity

2. Part of a peer group that will influence behaviour

3. Figuring out what to do in life. (Uni, work etc)

Identity vs role confusion: role confusion

Not knowing what to do in life

Main health issues/concerns with adolescence

1. Parenting/family adjustment

2. Psychosocial adjustment

3. Intentional (self harm or suicide) and unintentional injuries (MVAs)

4. Sexual behaviour, STIs, pregnancy

5. Substance abuse

6. Depression, suicide and abuse screening are important

Adolescence nutrition

1. Greatest needs (Increased calories for growth)

2. Need increased calcium

Adolescence sleep

Most are sleep deprived (phones)

Four common stressors of hospitalization

1. Separation

2. Loss of control

3. Bodily injury

4. Pain (fear of pain)

What age group is separation anxiety most common in?

6-30 month olds

Separation anxiety phases

1. Protest

2. Despair

3. Detachment

Protest

1. First stage of separation anxiety

2. Child cries/screams to get caregiver to stay

3. Will push others away (such as nurses)

Despair

1. Second stage of separation anxiety

2. Child is sad caregiver left

3. May regress (potty trained toddlers may have accidents)

4. May not want to play, eat etc

Detachment

1. Third and final stage of separation anxiety

2. Child accepts caregiver isn’t coming back

3. Seems happier

4. Pays more attention to nurses/other caregivers

Separation anxiety: Nursing interventions

1. Minimize separations

2. Primary nursing (Same pts)

3. Rooming in

4. Establish daily routine (as close to home routine as possible)

Nursing interventions for preschoolers

Use simple explanations

Nursing interventions for school aged children

Want control, get them to help where possible

Adolescence nursing interventions

Want information (will look at nurse to match verbal and non verbal clues)

Infant pain control methods

1. Distraction doesn’t work

2. Sucrose water before injections

3. Inject during breastfeeding