N329 - FINAL EXAM

What is growth?

Physical size and body proportions

What is key about infant growth?

they double their birthweight by 4 mos, triple by 1 yr

What is growth pattern?

It is predictable; large growth as a child and during puberty

What is FTT related to growth?

<5% is FTT on a growth chart

What are the growth concepts?

cephalocaudal growth and proximodistal growth

What is cephalocaudal growth?

growth head to toe

G+D happens this way (large head then body follow; control the head/neck then arms, etc)

What is proximodistal growth?

center of the body out

Development moves this way (learn to sit then reach, then hands/pincer)

What are key points of growth up to 1yr old?

wt is 3-4kg at birth; double 4-6 mos; 2lb/mos for 6 mos, then 1 lbs/mos for 6 mos

Wt is then tripled by 1 year old

What are growth charts?

monitor physical development, track patterns, assist with early ID of concerns

what is the height section of growth charts?

cm/inch

done at 2 years; before then its length

what is the weight section of growth charts?

kg/lbs

assess growth and nutrition. stats

what is the head circumfrence section of growth charts?

important for infancy; brain G+D (monitor inflammation)

what is the interpretation of growth charts?

50th percentile is the median. <5% is too little, >95% is too much

what is the percentile interpretation of growth charts?

compare measurements to other children

what is the curve interpretation of growth charts?

Show expected growth patter; should follow consistent curve over time

what is the red flags when interpreting growth charts?

sudden changes in % or crossing multiple % lines

What is development?

Physio/psych/cognitive changes in life from maturation and growth

• An increase in function/skills/abilites

• Observed abilities and behaviours

What are the developmental differences between children/adults?

decision making, reflexes, metabolic rate, bone growth, moral reasoning, social relationship

What are the developmental ages/stages?

neonatal - birth to 28 days

infancy - birth to 1 yr

toddler - 1 to 3 yr

preschool - 3 to 5 yr

school age - 5 to 12 yr

adoles - 12 to 18 years

What are the main developmental theories?

psychosocial (erikson), cognitive (piaget), moral (kohlberg)

What is the psychosocial theory of development?

complex interactions between emotion and physical variables

infancy - trust/mistrust

toddler - autonomy/shame

preschool - initiative/guilt

school - industry/inferiority

adoles - identity/role confusion

What is the cognitive theory of development?

piagets theory;

it orderly

preoperation; operational, concrete operation, abstract

What is the moral theory of development?

kohlbers theory — looks at morality and development of right vs wrong

What are factors that impact development?

genetics, child temperment, parental guidance, nutrition, SDOH

What is maturation?

G+D together (physical and mental); inherited traits/potentials

What is biological readiness in relation to maturation?

walking is possible when neuro/muscle systems are ready

Has genetic/environmental components

What is anticipatory guidance?

info to help family prepare for unexpected physical/behavioural changes during current and next development stages

What are the reflexes associated with infant G+D?

grasp 3 mos, moro/rooting 4-6 mos, babinski 2 yrs

What is the lagnuage development of an infant?

coo 4 mos, laugh 6 mos, babble 9 mos, ‘mama’/’dada’ 12 mos

What is the motor development of an infant?

hold rattle, push self up 3 mos, roll to back 4 mos, sit with hands 6 mos, crawl/stand 8 most, assist walk/pincer 12 mos

What is the physical development of an infant?

rapid growth; fontanelles close 6-8 weeks, anterior at 18 mos; grow avg of 74 cm by 1 yr, 9.75kg by 1 yr

What is the nurses role with the G+D of an infant?

nutriiton, cars, sleep, caregiver interactions

What is the NR of nutrition/feeding with infant G+D?

exclussive BF.formula fir 6 mos, start introducing solids at 6 mos following BF, full fat milk at 9 mos, monitor for choking (bottle propping)

What is the NR of cars with infant G+D?

rear facing, back seat, stay in carseat until 10kg/2 yr

What is the NR of sleep with infant G+D?

sleep on back, no cosleep, no stuffies/pillows

What is the NR of caregiver interactions with infant G+D?

monitor cues, sensitive/responsibe, guiding, self soothe promoting

What is the NR of safety with infant G+D?

What is the physical development of a toddler?

protuberant abdomen until 2 yr, abdominal resps, spinal cord myelinates by 2 yr (control sphincter— toilet learn)

What is the play development of a toddler?

its parallel play from 1-2 yrs, play in tandem, not together

What is the language development of a toddler?

2 yr = 2 word sentence with vocab of

3 yr = 3+ word sentences with vocab of

What is the motor development of a toddler?

walk alone at 18 mos, run and climb 24 mos, tricycle/dresses self 36 mos

What is the discipline used for a toddler?

teaxh not punish, time outs (not under 3 yrs)

What is the nurses role with toddler G+D?

safety, sleep, dental, nutrition, toilet, temper tantrum, caregiver interactions

What is the NR of safety for a toddler?

rear facing in care, cleaners locked away (poison), watch near water (drown), cover sockets (electric shock), falls, guns, animals

What is the NR of sleep for a toddler?

implement routines, provide comfort items

What is the NR of dental hygiene for a toddler?

avoid treat, bottles at bed, brush teeth

What is the NR of nutrition for a toddler?

picky eating is common, 500-750ml milk, increase calories

What is the NR of toilet learning for a toddler?

child centered, watch cues (dry 2 hrs, regular BM, communicates)

What is the NR of temper tantrums for a toddler?

peak at 2 yrs, watch cues (frustration), intervention early is best; ignore if safe to do, then talk about emotions

What is the NR of caregiver interactions for a toddler?

senstive and responsive, firm and gentle, routines

What is the physical development of a preschooler?

grow taller and thin out

What is the play development of a preschooler?

dramatic play

What is the language development of a preschooler?

full sentences, asks lots of questions

What is the social/emotional development of a preschooler?

learn about feelings, like to help around the house

What is the cognitive development of a preschooler?

magical thinking (belive their thoughts/actions cause bad things to happen)

What is the discipline used for a preschooler?

teach not punish, need to know their limits, time in vs time out (last as long as they are old), positive reinforcement

What is the nurses role for preschoolers G+D?

nutrition, sleep, safety, caregiver intercations

What is the NR for nutrition of a preschooler?

dense meals, limit sweets, dont force to finish

What is the NR for sleep of a preschooler?

10-13 hours of sleep with naps, follow routines, nightmares common at 4 yrs

What is the NR for safety of a preschooler?

falls, outside play, poision, burns, strangers, guns

What is the NR for caregiver interactions of a preschooler?

sensitive, consistent, time in vs time out

What is the cognitive development of a school age child (4-7)?

intuitive, pre-logical thinking

What is the cognitive development of a school age child (7-11)?

concrete logical thinking, cause/effect

What is the growth development of a school age child?

steafy and slow until spurt before puberty

What is the play development of a school age child?

new environments, sports, recreation activites

What is the health concerns of a school age child?

eneuresis — involuntaryl over age of 5

Avoid fluids before bed, get up at night, preserve esteem

What is the nurses role with school age childrens G+D?

safety, nutrition, sleep, academic, mental health, psychosocial

What is the NR of safety for a school age child?

falls, cars, sports

What is the NR of nutrition for a school age child?

eat as a family

What is the NR of sleep for a school age child?

monitor for eneuresis

What is the NR of academics for a school age child?

new learning at school (fail, success)

What is the NR of mental health for a school age child?

bullying or peer pressure

What is the NR of psychosocial for a school age child?

relationships

What is the cognitive development of an adolescent?

concrete to abstract thinking

What is the identity development of an adolescent?

who am I, self esteem (peers, family, media, accomplishments),

What is the puberty development of an adolescent (male)?

increase muscle, deep voice, penile growth, sperm production, hair growth

What is the puberty development of an adolescent (female)?

first sign is breat buds (7-12), fat at hips, menarch (10-15), hair growth

What is the physical development of an adolescent?

What is the nurses role with adolescent G+D?

MH, sexuality, nutrition, academic, safety, approach

What is the NR of mental health in an adolescent?

substance use, depression

What is the NR of sexuality in an adolescent?

sexual health

What is the NR of nutrition in an adolescent?

increase requirements, diet influenced by media

What is the NR of academics in an adolescent?

school requirments

What is the NR of safety in an adolescent?

increased injury risk, sensation seeking, sports, sex, driving

What is the NR in approach to an adolescent?

open communication, humour, privacy, open questions

What are child health indicators?

quantifiable, stats to make a statement

What does child health indicators help us understand?

measure of population health, identify at risk children, support anticipatory guidance

What are examples of child health indicators?

infant mortality rate, premature birth, obesity, vaccination

What are childhood warning signs for stress?

regression, temper tantrum, sleep distrubances, bed wetting, withdrawan

What is the childs reaction to stress in hospital?

fear, anxiety, regression

What is the parents reaction to stress in hospital?

fear and anxiety

What is the siblings reaction to stress in hospital?

behaviour disruption

What are infants fears?

loss of support, loud noise, bright light, strangers

How to alleviate infant fears?

prevention, have parents, comfort items

What are toddlers fears?

separattion ,lose control , routine changes

How to alleviate toddler fears?

autonomy, play, honestly

What are school age fears?

supernatural, injury, storms, alone, death

HOw to alleviate school age fears?

parents, decision making, honesty

What are adolescent fears?

isolation, public speaking, pain, crashes

How to alleviate adolescent fears?

honesty, decision making, involve in care