Pediatric nursing chapter 6

Question 1

GENERAL PRINCIPLES OF GROWTH AND DEVELOPMENT

Answer 1

Although highly individualized, growth and development follow an orderly pattern characterized by periods of rapid growth and plateaus (spurts and lulls):

Question 2

Cephalocaudal

Answer 2

Cephalocaudal—starts at the head and moves downward

Example: The child can control his or her head and neck before it can control his or her arms and legs.

Question 3

Proximodistal

Answer 3

Proximodistal—starts in the center and processes to the periphery
Example: Movement and control of the trunk section of the body occurs before movement and control of the arms.

Question 4

Differentiation

Answer 4

Differentiation—simple to complex progression of achievement of developmental milestones
Example: The child learns to crawl before learning to walk.

Question 5

Developmental tasks

Answer 5

Variation at different ages is based on specific body structure and organ growth.

Developmental tasks are the sets of skills and competencies that are unique to each developmental stage. Certain tasks must be mastered for the child to progress to the next level. Developmental tasks for each stage are detailed in Table 6–1.

Question 6

Childhood is divided into the following five stages:

Answer 6

Infant—birth to 1 year
Toddler—1 to 3 years
Preschool—3 to 6 years
School-age—6 to 12 years
Adolescence—12 to 18 years

Question 7

Failure to thrive

Answer 7

Failure to grow and develop at an expected rate can mean that a child is failing to thrive. The diagnosis of failure to thrive (FTT) is given to children who fall below the 5th percentile ranges on height and weight charts. For infants, it usually presents first with an absence of weight gain or weight loss (Price & Gwin, 2012). Then a drop in height is followed by a drop in head circumference. FTT be caused by organic or nonorganic causes, which can contribute to developmental delays in the child.

Question 8

Reflexes

Answer 8

Nurses need to know normal infant reflexes and recognize when they are not present. Reflexes that remain can be a sign of growth and developmental issues and delays (Beckett & Taylor, 2016). A few of the most common reflexes to watch for are:

Tonic neck/fencing reflex—disappears around 4–6 months
Moro/startle reflex—disappears around 4–6 months
Babinski’s—disappears by 1 year of age

Question 9

Family centered care

Answer 9

As part of family-centered care, nurses need to adapt their care and nursing interventions to the child’s stage of growth and development. They will need to explain what is happening to a child in language and on a developmental level the family can understand. A child’s caretaker should always be included in the child’s care and interventions. Nurses need to remember that we are not caring for just a child, but for the entire family unit

Question 10

Developmental milestones; age, fine motor, gross motor

2-3 months

Answer 10

2–3 months Grasps toys, can open and close hands Raises head and chest when lying on stomach
Eyes follow object to midline Supports upper body with arms when lying on stomach
Blows bubbles Stretches legs out and kicks when lying on stomach or back

Question 11

6-8 months

Answer 11

6–8 months Bangs objects on table Can roll from side to side
Can transfer objects from hand to hand Can sit unsupported by 7 or 8 months
Start of pincer grasp Supports whole weight on legs

Question 12

1 year

Answer 12

1 year Can hold crayon, may mark on paper Pulls self up to stand
Walks holding on to furniture
Begins to use objects correctly May walk two or three steps independently

Question 13

2-3 years

Answer 13

Learning to dress self Jumps
Kicks ball
Can draw simple shapes (e.g., a circle) Learning to pedal tricycle

Question 14

4-5 years

Answer 14

4–5 years Dresses independently Goes up and down stairs independently
Uses scissors Throws a ball overhand
Learning to tie shoes Hops on one foot
Brushes teeth

Question 15

PSYCHOINTELLECTUAL DEVELOPMENT

Jean Piaget

Answer 15

The key theorist within cognitive development is Jean Piaget, a Swiss child psychologist who lived from 1896 to 1980. Piaget identified the following characteristics of cognitive development:

Development is a sequential and orderly process, moving from stages that are relatively simple to more complex (Table 6–3).
Cognitive acts occur as the child adapts to the surrounding environment.
The child’s experience with the environment naturally encourages growth and maturation.
The child must accommodate to new or complex problems by drawing on past experiences.
There can be overlap between the child’s age and stage of development. Each stage does not start and end at exactly the same age for each child.

Question 16

Overview of Growth and Development by Age

Answer 16

Infant: age birth to 1 year
Weight:
•Doubles by 5–6 months
•Triples by 1 year
Height:
•Increase of 1 foot by 1 year of age
Teeth:
•Erupt by 6 months
•Has six to eight deciduous teeth by 1 year of age

Question 17

Toddler: age 1–3 years

Answer 17

Weight:
•Gains 8 oz or more a month from 1–2 years
•Gains 3–5 lb a year from 2–3 years of age
Height:
•From 1 to 2 years of age, grows 3–5 inches
•From 2 to 3 years of age, grows 2–2.5 inches per year
Teeth:
•By 3 years of age, has 20 deciduous teeth

Question 18

Preschool: age 3–6 years

Answer 18

Weight:
•Gains 3–5 lb a year
Height:
•Grows 1.5–2.5 inches a year

Question 19

School-age: age 6–12 years

Answer 19

Weight:
•Gains 3–5 lb a year
Height:
•Grows 1.5–2.5 inches a year

Question 20

Adolescence: age 12–18 years

Puberty usually will last somewhere around 2–5 years.)

Answer 20

Variations
(Puberty usually will last somewhere around 2–5 years.) Weight: The gain that occurs during puberty years
•Girls: Gain 15–55 pounds
•Boys: Gain 15–65 pounds
Height: The growth that occurs during puberty years
•Girls: 2–8 inches
Growth occurs during puberty. Girls usually stop growing taller 2 years after the start of their menstrual periods.
•Boys: 4.5–12 inches

Question 21

Key Stages of Piaget’s Theory

Answer 21

Piaget’s theory of cognitive development defines developmental stages as follows:

Sensorimotor—birth to 2 years: The child learns through motor and reflex actions, and begins to understand that he or she is separate from the environment and from others.
Stage 1: Reflexes—birth to 2 months
The child understands the environment purely through inborn reflexes such as sucking.
Stage 2: Primary circular reactions—1 to 4 months
The child begins to coordinate reflexes and sensations. For example, he or she may find the thumb by accident, find pleasure in sucking it, then later repeat sucking it for pleasure.
Stage 3: Secondary circular reactions—4 to 8 months
The child focuses on his or her environment and begins to repeat actions that will trigger a response. For example, the child puts a toy rattle in his or her mouth.
Stage 4: Coordination of secondary schemata—8 to 12 months
To achieve a desired effect, the child will repeat the action, such as repeatedly shaking a rattle to make the sound.
Stage 5: Tertiary circular reactions—12 to 18 months
The child begins trial-and-error approaches: for example, making a sound to see whether it will get attention from the caregiver.
Stage 6: Inventions of new means/mental combinations—18 to 24 months
The child learns that objects and symbols represent events, such as that the appearance of a bowl and spoon means dinner is coming.
Preoperational—2 to 7 years
Application of language
Use of symbols to represent objects
Ability to think about things and events that are not immediately present
Oriented to the present; difficulty conceptualizing time
Thinking influenced by fantasy
Teaching must account for the child’s vivid fantasies and undeveloped sense of time
Concrete operational—7 to 11 years
Shows increase in accommodation skills
Develops an ability to think abstractly and to make rational judgments about concrete or observable phenomena
In teaching, give the opportunity to ask questions and explain things back to the nurse. This allows the child to mentally manipulate information.
Formal operational—11 years to adulthood
This stage brings cognition to its final form.
The individual no longer requires concrete objects to make rational judgments.
Individuals are capable of hypothetical and deductive reasoning.
Teaching for adolescents may be wide ranging because they can consider many possibilities from several perspectives.

Question 22

Object Permanence

Answer 22

Object permanence is one of the most important developments in the sensorimotor stage. The child now knows that an object exists even when it cannot be seen or heard. This is a wonderful time to introduce the game peekaboo; by the end of this stage the child will understand that you did not disappear just because your hands are over your face.

Question 23

The Procedure From the Child’s Perspectiv

Answer 23

In this stage the child is egocentric, or unable to take the view of others. While the child is hospitalized, the nurse should introduce role-playing and medical play therapy. The child needs to understand the procedure from his or her own perspective, such as by touching and playing with the equipment before its use. In addition, language is not fully developed; therefore, teaching through discussion will not be effective.

Question 24

Formal Operational

Answer 24

The child in this stage begins to consider that his or her actions will result in possible consequences. It is important to remember when caring for a patient in this stage that you should explain reasons for the hospitalization, the disease process, and possible outcomes, especially those related to the patient’s behavior.

Question 25

PSYCHOSEXUAL DEVELOPMENT

Answer 25

Freud, a physician from Vienna, Austria, who lived from 1856 to 1939, proposed a theory of psychosexual development and an approach called psychoanalysis to explore the unconscious mind. His psychosexual theory is based on the belief that experiences from our early childhood form the unconscious motivation for the things we do later in life as adults. The theory proposes that sexual energy is stronger in certain parts of the body at specific ages. Sexual feelings are present in different forms depending on age. Fixation of development can occur at a specific stage if needs are not met or conflicts are not resolved. Freud’s theory views the personality as consisting of three parts: the id, the ego, and the superego

Question 26

Id

Answer 26

Id—the basic sexual energy that is present at birth and drives the seeking of pleasure

Question 27

Ego

Answer 27

Ego—the realistic part of a person, which develops during infancy and searches for acceptable methods to meet impulses

Question 28

Superego

Answer 28

Superego—the moral and ethical system that develops in childhood and contains values as well as conscious thoughts

Question 29

According to Freud, human nature has two sides:

Answer 29

Rational intellect—being able to think about others, and do what is right. Example: delayed gratification
Irrational desires—following the unconscious mind, which is driven by uncontrollable instincts that are irrational and pleasure seeking. Example: getting what you want when you want it even if the timing is not right or others are affected negatively

Question 30

Key Stages of Freud’s Psychosexual Theory

Oral birth to 1 yr

Answer 30

Oral—birth to 1 year
Children at this stage are preoccupied with activities associated with the mouth.
Sexual urges are gratified with oral behaviors: sucking, biting, chewing, and eating.
Children who do not have their oral needs met may become thumb suckers or nail biters.
In adulthood, they may become compulsive eaters or smokers.
Normal development requires not depriving oral gratification, such as weaning too soon or a rigid feeding schedule.

Question 31

Anal 1-3 years

Answer 31

Anal—1 to 3 years of age
Preoccupied with the ability to eliminate
Sexual urges gratified by learning to voluntarily defecate
Sphincter muscles maturing

Question 32

Phallic stage—3 to 6 years

Answer 32

Phallic stage—3 to 6 years
Preoccupation with the genitals
Curious about childbirth, masturbation, and anatomic differences
Girls experience penis envy and wish they had one; boys suffer from castration anxiety, the fear of losing the penis
Children develop strong incestuous desire for caregiver of the opposite gender
Oedipal complex—attachment of boy to his mother
Electra complex—attachment of girl to her father
Children need to identify with caregiver of same gender to form male or female identity

Question 33

Latency stage—6 to 11 years of age

Answer 33

Latency stage—6 to 11 years of age
Sexual drives submerged
Energy focus on socialization and increasing problem-solving abilities
Appropriate gender roles adopted
Oedipal or Electra conflicts resolved
Identifies with same-gender peers and same-gender caregiver
Superego developed to a point where it keeps id under control

Question 34

Genital stage—begins at around 12 years of age and lasts to adulthood

Answer 34

Genital stage—begins at around 12 years of age and lasts to adulthood
Struggle with sexuality
Sexual desires return and are related to physiological changes and fluctuating hormones
Changing social relationships
Dealing with struggle of dependence and independence issues with parents
Learning to form loving, appropriate relationships
Must manage sexual urges in socially accepted ways

Question 35

Toilet training

Answer 35

Toilet Training

Nurses should explain to caregivers the basic biological characteristics that allow a child to be toilet trained. Freud believed that how a child is toilet trained can have lasting effects on personality. If toilet training is too rigid or scheduled, the child can develop behaviors that are hypercritical or meticulous later in life

Question 36

PSYCHOSOCIAL DEVELOPMENT

Answer 36

The primary theory of psychosocial development was established in 1959 by Erik Erikson, who lived from 1902 to 1994 and studied under Freud’s daughter, Anna. Erikson’s psychosocial development theory consists of eight different stages that address development over the life span. Each stage has a crisis that exists; healthy personality development occurs as each crisis, a challenge between the ego and social and biological processes, is resolved (Table 6–6). A person must master these psychosocial crises to grow and progress to the next stage of development. An individual either meets the healthy needs or does not, and this will influence future social relationships.

Question 37

Key Stages of Erikson’s Psychosocial Development Theory;

trust vs mistrust (birth to 1 yr

Answer 37

Trust versus mistrust (birth to 1 year) (Fig. 6–1)
An infant requires that basic needs are met—food, clothing, touch, and comfort.
If these needs are not met, the infant will develop a mistrust of others.
If a sense of trust is developed, the infant will see the world as a safe place.
Play is usually considered a psychosocial activity. During this stage play is referred to as solitary

Question 38

Autonomy versus shame and doubt (1–3 years)

Answer 38

Autonomy versus shame and doubt (1–3 years) (Fig. 6–2)
The child is learning to control bodily functions.
Independence starts to emerge; for example, toddlers control their worlds by deciding when and where elimination will occur.
They vocalize by saying no to something and direct their motor activity.
Children who are consistently criticized for showing independence and autonomy will develop shame and doubt in their abilities.
Toddlers also need to recognize the feelings and needs of others; excessive autonomy could lead to disregard for and an inability to play with others (Beckett & Taylor, 2016).
Play during this stage is known as parallel

Question 39

Age appropriate toys

Answer 39

Toys that are age-appropriate for toddlers and account for their growth and development include stuffed animals, building blocks, books, play dough, tricycles, small cars and trains, and pretend toys to play housekeeping, such as pots, pans, spoons, and cups.

Question 40

Initiative versus guilt (3–6 years)

Answer 40

Initiative versus guilt (3–6 years) (Fig. 6–3)
The preschool child is exposed to new people and new activities; the child becomes involved and very busy.
The child learns about the environment through play.
The child learns new responsibilities and can act based on established principles.
The child develops a conscience.
If the child is constantly criticized for his or her actions, this can lead to guilt and a lack of purpose.
Play at this stage is known as associative play

Question 41

Industry versus inferiority (6–12 years)

Answer 41

Industry versus inferiority (6–12 years) (Fig. 6–4)
The child develops interests and takes pride in accomplishments.
The child enjoys working in groups and forming social relationships.
Projects are enjoyable.
The child follows rules and order.
Developing a sense of industry provides the child with purpose and confidence in being successful.
If a child is unable to be successful, this can result in a sense of inferiority.
A child must learn balance, an understanding that he or she cannot succeed at everything and that there is always more to learn.
Play during this stage is known as cooperative play

Question 42

Identity versus role confusion (12–18 years)

Answer 42

Identity versus role confusion (12–18 years) (Fig. 6–5)
Children of this age are preoccupied with how they are seen in the eyes of others.
They are working to establish their own identity.
They are trying out new roles to see what best fits for them.
If they are unable to provide a meaningful definition of self, they are at risk for role confusion in one or more roles throughout life.
Some confusion is good and will result in self-reflection and self-examination.

Question 43

Cultural competence

LGBTQ teens

Answer 43

Compared with heterosexual youth, LGBTQ (lesbian, gay, bisexual, transgender, or questioning) teens are more likely to experience:

Bullying
Physical violence
Rejection
Suicidal thoughts
High-risk behavior such as sexual and substance abuse

Question 44

Adolescents promoting safety

Answer 44

Adolescents feel that nothing bad will happen to them, and because of this they engage in risky behaviors. They are risk takers. Care should be given to educate this age group on safe practices, such as wearing a seat belt when driving, avoiding alcohol and drug use, safe sex practice, and suicide prevention. Noncompliance with a needed medical regimen may occur, and hospitalization may be the outcome. For example, the adolescent with asthma who chooses not to use his or her inhaler during activity may end up in respiratory distress that can result in a trip to the emergency department.

Question 45

SOCIAL-MORAL DEVELOPMENT

Answer 45

Based on the cognitive-developmental theory of Piaget, Lawrence Kohlberg theorized that children acquire moral reasoning in a specific developmental sequence. In 1958, Kohlberg developed a stage-based theory established on the premise that at birth, we are void of morals or ethics; thus, moral development occurs through social interaction with the environment around us. Kohlberg analyzed children in Germany, Kenya, Taiwan, and Mexico based on the motives of people when faced with making decisions. Moral development, which according to Kohlberg includes three major levels, can be advanced and promoted through formal education (Beckett & Taylor, 2016). Kohlberg has been criticized for insensitivity to cultural differences, sexual biases, and lack of consideration for family moral development. See Table 6–7 for Kohlberg’s theory of moral development.(in learning outcomes-couldnt put in here)

Question 46

NATURE VERSUS NURTURE

Answer 46

This has been a debated topic in growth and development, also referred to as heredity versus environment or maturation versus learning. Both nature and nurture play a part in shaping us to be who we are, although the extent of influence of each is debated.

Nature refers to the traits, capacities, and limitations that a person inherits from parents at conception.

Examples: hair and eye color, body type, and inherited diseases
Possible examples: athletic or musical ability
Nurture refers to the environmental influences that occur after conception, including the mother’s health before birth and the child’s environment thereafter. Nurture takes what nature gives us and molds us as we grow and mature. The interaction between the two is a critical influence in our development.

Question 47

Family

Answer 47

The nuclear family is composed of a mother, a father, and a biological or adopted child or children. The term nonnuclear family describes family forms other than traditional, such as single-parent homes, grandparents functioning in the role of parents, same-sex parents with a child or children, and blended families, in which families from divorce are joined together by remarriage. This can also occur when a spouse has died and the remaining spouse remarries.

Question 48

BEHAVIORIST AND SOCIAL LEARNING THEORY

Answer 48

Developed as a response to psychoanalytical theories, behaviorist and social learning theories describe the importance of the environment and nurturing of a child. Behaviorist theory was the dominant view from the 1920s through 1960s, with John B. Watson, Ivan Pavlov, and B. F. Skinner as some of the most noted theorists. Behaviorist theories are based on observable behaviors that arise from either classical or operant conditioning.

Question 49

Definition of family

Answer 49

Family is defined as the structure or the relationship between individuals that provides the financial and emotional support needed for social functioning (Friedemann, 1995). Nurses should not be judgmental when caring for patients and their families. We must remember that every family acts as a unique unit.

Question 50

Classical conditioning

Answer 50

Classical conditioning is “a learning process that occurs through associations between an environmental stimulus and a naturally occurring stimulus” (

Question 51

Operant conditioning

Answer 51

Operant conditioning is a change in behavior based on rewards, reinforcement, and punishment

Question 52

Growth Based on Experiences

Answer 52

Behaviorists believe that children are born with a “blank slate,” and as they grow and develop they are changed based on their experiences. Nursing and child life specialists can use stickers, rewards, and praise to let children know they did a great job after a procedure such as an IV insertion or a blood pressure reading.

Question 53

Social Learning Theory: Albert Bandura

Answer 53

Albert Bandura was born in 1925 and is still alive today. He completed the famous Bobo doll experiment that demonstrated the power of observation. When children observed violent acts, they mimicked them; when an adult was praised for those acts, the children were more likely to repeat them (Bandura, 2006). Bandura’s theory posits that children learn through observing others in their environment, as well as from rewards and punishments. Intrinsic reinforcements such as satisfaction and accomplishment lead to learning. Through observing the actions of other people, children develop new skills and acquire new information.

Question 54

Environment and Culture

Answer 54

A child’s ability to master tasks and grow and develop in the proper way is affected by numerous factors. The environment and culture are two areas that should always be assessed. A child needs an appropriate environment and proper stimuli, or development may be delayed.

Question 55

FACTORS THAT AFFECT GROWTH AND DEVELOPMENT

Answer 55

Although growth and development follow predictable patterns, these patterns are influenced by a number of factors.

Question 56

Intrauterine Factors

Answer 56

The mother’s health and nutritional status while pregnant affect the fetus.

Poor nutrition in the mother can lead to low-birth-weight babies, as well as slow development, compromised neurological performance, and impaired immune status (Ward & Hisley, 2015).
Low iron levels in the mother can result in anemia in the infant (National Institutes of Health, 2016).
Maternal smoking can result in infants with low birth weight and/or congenital anomalies such as cleft lip and cleft palate.
Ingestion of alcohol during pregnancy may lead to delays and fetal alcohol syndrome.
Substance and drug abuse prenatally may result in neonatal addiction, convulsions, hyperirritability, poor social responsiveness, neurological disturbances, and changes in the cognitive functioning of the child (Ward & Hisley, 2015).
Prescription and nonprescription drugs may affect the unborn child.
Certain maternal illnesses can harm the fetus, such as rubella.
Exposure of the mother to environmental factors, such as chemicals or radiation, can harm the fetus.

Question 57

Birth Events (Prematurity, Birth Trauma)

Answer 57

Premature infants can experience delayed growth and development, and are thus expected to reach developmental milestones at the same age they would have reached them if born at normal gestational age. Age is adjusted for assessments: subtract the weeks/months that the infant was born prematurely from the current chronological age. The child should be reaching the adjusted age milestones. Most premature children have caught up with all the milestones/developmental tasks by age 2 years

Question 58

Chronic Illness and Hospitalization

Answer 58

Illness and hospitalization are stressful events for a child and family. A child’s physical state of well-being can affect developmental levels, because illness may interfere with normal progression by causing the child delays in acquiring the skills needed to progress to the next level. When a child is hospitalized, the family routine is disrupted, and the child and family are not able to do what they normally do. The possible separation of family members because of the child’s illness adds stress.

Question 59

Play as a Stress Reducer

Answer 59

Play is what children do and should not be overlooked when a child is in the hospital. Play can be a diversional activity and a stress reducer, and provides the hospitalized child with an opportunity to act out fears and anxieties. Many children’s hospitals provide the ill child with a playroom and the services of a child life specialist who can assist the child in fostering growth and developmental needs through play. The child life specialist has a strong background in growth and development, and can use this training to assist the medical team in preparing a child for hospitalization and procedures.

Question 60

Separation Anxiety

Answer 60

Nurses need to take into account growth and developmental stages when a child is hospitalized or ill. Ages 6 to 9 months often go through separation anxiety. They will often find more comfort in familiar people than strangers. Being in the hospital can trigger separation anxiety for toddlers (2–3 years). Preschoolers can fear body mutilations, the dark, being left alone, and ghosts

Question 61

Environmental Factors

Answer 61

Children who are abused or neglected experience problems in numerous areas of growth and development; examples of common problem areas are sleeping and feeding disorders. The child may also experience delays in learning to trust others and disorders of attachment.Abuse can be physical, including beatings, burns, or other physical injuries; emotional, including constantly yelling at, ridiculing, or putting a child down; or sexual, including any sexual activity with a child younger than 18 years and commanding a child to perform sexual acts with another adult or child.

Question 62

Areas that are considered neglect include:

Answer 62

Medical
Not providing common medical care
Not allowing a child who is ill to consult a health-care provider
Death of a child from an illness that is considered treatable by Western health care
Emotional
Not attending to the child’s emotional needs
Ignoring the child
Leaving the child alone for significant amounts of time
Educational
Not providing education for the child in any manner
Not providing the child needed aids to encourage education (hearing aids, speech therapy, etc.)
Abandonment
Leaving a child to care for himself or herself
Not providing adequate adult supervision

Question 63

Physical Home Environment

Answer 63

A safe and healthy home environment is needed for normal growth and development. The quality of housing and access to basic services—such as clean water, sanitation and waste disposal, fuel for cooking and heating, and ventilation—need to be addressed with the family. Exposure to lead paint, radon, and electromagnetic sources should also be assessed, because these can affect normal growth and development

Question 64

BASIC NEEDS

Answer 64

Basic needs at each level of someone’s life must be met before they can progress to the next level of growth and development. These are outlined by Maslow’s hierarchy of needs:

Level one: Physiological needs must be met first: food, rest, air, water.
Level two: The child has the need to be protected from harm and feel safe.
Level three: Feeling loved and part of a group.
Level four: Esteem needs to develop—the need to respect yourself and be respected by others.
Level five: Self-actualization, or becoming a complete person and reaching your greatest potential

Question 65

Sleep Deprivation

Answer 65

Children need more sleep than adults. Sleep deprivation can impact the growth and development of a child and cause delays. Preschoolers, for example, need 12 hours of sleep a day

Question 66

Early Parent–Child Relationships

Answer 66

Early parent–child relationships have been shown to play a major role in a child’s social-emotional development. This relationship also influences and is linked to cognitive development and learning patterns. Feeling loved and cared for can enhance development in these areas

Question 67

Socioeconomic Factors

Answer 67

Lack of income can affect a child’s health and development; families who are struggling to make ends meet may be unable to afford healthy food and lack transportation to health-care facilities. When both parents work, they may have little time to devote to meeting their children’s emotional needs.

Question 68

Cultural Background

Answer 68

Cultural background influences how children are socialized and how they experience the world around them. Beliefs, customs, and values are learned from cultural surroundings.
Everyone is a product of their cultural background. Culture does more than shape our pre­ferences; it is the foundation of our worldviews. The cultural identity of a child and the family is always relevant and must be considered in the care that we give

Question 69

Cultural Factors

Answer 69

Nurses must consider a child’s cultural background when doing developmental testing. Children may not be familiar with specific games or activities used in the test. There could be possible language barriers that interfere with reliable testing. Another part of culture, religion, may be meaningful to the family. The need for spiritual clergy can be important to both the child and the family.