Pediatrics

Developmental Age Groups

  • Neonate: 0-28 days

  • Infancy: 0-1 year

  • Toddlerhood: 1-3 years

  • Preschool Age: 3-6 years

  • School Age (Middle Childhood): 6-12 years

  • Adolescence: 12-18 years

Major Developmental Theories

  • Freud: Psychosexual development

  • Erikson: Psychosocial development

  • Piaget: Cognitive development, focusing on assimilation and accommodation

  • Kohlberg: Moral development

Application of Major Developmental Theories

Infancy (0-1 year)

  • Freud's Oral Stage: Pleasure through the mouth.

    • Nursing Application: Offer a pacifier when oral intake is contraindicated.

  • Erikson's Trust vs. Mistrust: Trust arises from meeting basic needs.

    • Nursing Application: Meet needs for food and hygiene; promote parent-infant bonding.

  • Piaget's Sensorimotor Stage: Learning through movement and sensory experiences.

    • Nursing Application: Use toys for distraction during procedures.

Toddlerhood (1-3 years)

  • Freud's Anal Stage: Gratification derived from bodily control.

    • Nursing Application: Support child's elimination patterns; provide potty chairs.

  • Erikson's Autonomy vs. Shame and Doubt: Increased independence.

    • Nursing Application: Encourage personal care tasks like dressing and hygiene.

  • Piaget's Preoperational Stage: Curiosity, language development, and some logical thought.

    • Nursing Application: Ensure safe environments for exploration and provide simple explanations.

Preschool Age (3-6 years)

  • Freud's Phallic Stage: Identification with same-sex parent.

    • Nursing Application: Be attentive to comfort levels with caregivers based on gender.

  • Erikson's Initiative vs. Guilt: Child initiates play activities.

    • Nursing Application: Provide play equipment to ease anxiety.

  • Piaget's Preoperational Stage: Improved verbal skills with limited logical reasoning.

    • Nursing Application: Explain procedures clearly to avoid guilt about illness.

School Age (6-12 years)

  • Freud's Latency Stage: Focus on privacy.

    • Nursing Application: Provide privacy during care.

  • Erikson's Industry vs. Inferiority: Sense of self-worth from achievements.

    • Nursing Application: Encourage school activities and projects.

  • Piaget's Concrete Operational Stage: Logical thought process when manipulating objects.

    • Nursing Application: Introduce equipment related to treatment.

Adolescence (12-18 years)

  • Freud's Genital Stage: Focus on relationships and genital maturation.

    • Nursing Application: Provide information on sexuality and health care access.

  • Erikson's Identity vs. Role Confusion: Search for self-identity.

    • Nursing Application: Allow confidential health history and care discussions without parents.

  • Piaget's Formal Operational Stage: Abstract thinking skills.

    • Nursing Application: Provide detailed health education and support for chronic illness management.

Promoting Development Through Play

  • Parallel Play (2-3 years): Non-interactive play alongside others.

  • Constructive Play (2 years and older): Building or creating activities enhancing motor skills.

  • Associative Play (3-4 years): Interaction begins; sharing toys without full cooperation.

  • Dramatic Play (3 years and older): Role-playing enhances emotional and cognitive development.

  • Cooperative Play (4 years and older): Shared roles and goals in play.

  • Games With Rules (5 years and older): Teach social rules and cooperation through organized play.

Defense Mechanisms in Children

  • Regression: Return to earlier behaviors during stress.

  • Repression: Involuntary forgetting of traumatic events.

  • Rationalization: Justifying negative behaviors.

  • Fantasy: Imaginary scenarios to cope with challenges.

  • Magical Thinking: Belief that thoughts can influence outcomes.

Essential Health Supervision Guidelines

  • Preventative Health Maintenance Levels:

    • Primary: Immunizations and education.

    • Secondary: Screening processes.

    • Tertiary: Rehabilitation initiatives.

Key Developmental Milestones (0-24 months)

  • 1 Month: Lift head briefly; hands in fists.

  • 2 Months: Lift head at 45 degrees; beginning to open hands.

  • 4 Months: Steady head lift; may begin to roll.

  • 6 Months: Rolls over and reaches for objects.

  • 12 Months: Pulls to stand; may take steps.

  • 15 Months: Walks independently.

  • 24 Months: Runs, kicks a ball, and walks up stairs.

Pediatric Healthcare Settings

  • Nursing roles span hospitals, outpatient facilities, schools, and community settings.

  • Family-centered care emphasizes cooperation and communication among families and healthcare providers.

  • Nurses must be culturally competent and aware of societal influences affecting pediatric health.