Growth and Development

Question 1

0-1 year old growth(Infant)

Answer 1

Birth weight doubles in 6; triple in 12
Length increase by 50% at 12

Question 2

0-1 year development(Infant)

Answer 2

Social smile @ 6 – 8 weeks
Steady head control @ 3 – 4 months
Rolls @ 5 – 6 months
Plays peek-a-boo after 6 months (object permanence)
Transfers objects hand  hand @ 7 months
Stranger anxiety @ 7 – 9 months
Sits unsupported @ 8 – 9 months
Crawls @ 10 months
Pincer grasp @ 10 – 12 months
Walks w assistance @ 10 – 12 months
Language: “Mama” & “Dada” plus a few words @ 12 months
Explores environment by motor & oral means

Question 3

0-1 Erickson

Answer 3

Trust vs Mistrust
Infant is exploring who it can depend on

Question 4

0-1 Piaget

Answer 4

Sensorimotor stage
Development of both sensory and motor function

Question 5

1-3 Physical growth(Toddler)

Answer 5

50% of adult height
Anterior fontanel close at 12-18 moths

Question 6

1-3 Development(toddler)

Answer 6

Throws ball overhand @ 18 months
Kicks ball @ 24 months (can balance on 1 foot)
Feeds self w spoon & cup @ 2 years
Daytime toilet training can be started @ 2 years
2 – 3 word sentences by 2 years
3 – 4 word sentences by 3 years

Question 7

1-3 Erikson

Answer 7

Autonomy vs Shame & Doubt
temper tantrums will be common

Question 8

1-3 Piaget

Answer 8

up to 2 is sensorimotor
2-7 is Pre operational
Pre operational- They also develop memory and imagination, which allows them to understand the difference between past and future, and engage in make-believe

Question 9

3-6 Growth(Preschooler)

Answer 9

Stands erect w more slender posture
Visual acuity reaches 20/20

Question 10

3-6 Development(Preschooler)

Answer 10

Can run, jump, skip & hop
Can ride a tricycle
Handedness established
Can use scissors @ 4 years
Can tie shoelaces @ 5 years
Learns colors & shapes
Thinking is egocentric & concrete
Uses sentences of 5 – 8 words
Learns sexual identity (curiosity & masturbation common)
Imaginary playmates & fears are common (magical thinking)
Aggressiveness @ 4 years replaced by more independence @ 5 years

Question 11

3-6 Erikson

Answer 11

Initiative v Guilt
Preschooler begins to explore their own interests and personality against how it is perceived

Question 12

3-6 Piaget

Answer 12

Pre operational stage

Question 13

6-12 Growth(school age)

Answer 13

Girls may experience menarche
Loss of most primary teeth & eruption of most of the permanent teeth occurs; 6-yr molars erup

Question 14

6-12 Development(School age)

Answer 14

Fine & gross motor skills mature
Able to write script @ 8 years
Can dress self completely
Egocentric thinking replaced by social awareness
Learns to tell time. Understands past, present & future
Learns cause & effect relationship
Socialization w peers important

Question 15

6-12 Erikson

Answer 15

Industry vs Inferiority
Begins to weigh their worth against the world and their colleagues

Question 16

6-12 Piaget

Answer 16

Concrete Operations
During this stage, children begin to develop logical thinking skills and can perform operations on concrete objects and events

Question 17

12-18 Growth(Adolescent)

Answer 17

Girls’ (10 -15 yrs) growth spurt during adolescence begins earlier than boys (11 – 17 yrs)
Secondary sex characteristics develop

Question 18

12-18 Development(Adolescent)

Answer 18

Adult-like thinking begins around 15 yrs: one can problem solve & think abstractly
Become more independent of the family: conflicts develop

Question 19

12-18 Erickson

Answer 19

Identity v Role Confusion
Will be begin to find out what they value and who they want to be

Question 20

12-18 Piaget

Answer 20

Abstract operations

Question 21

0-1 Nursing interventions

Answer 21

During hospitalization, an infant’s emerging skills may disappear.
Baby may be inconsolable due to separation anxiety.
Parents must be part of infant’s care.
Respect schedule & implement similar.
Speak to & console infant. Direct preparation & teaching to parents.
Toys for hospitalized infants: mobiles, rattles, squeak toys, cloth picture books, balls, colored blocks & activity boxes.

Question 22

1-3 Nursing interventions

Answer 22

Enforced separation from parents is the greatest threat to the toddler’s psychological & emotional integrity.
Security objects or favorite toys from home should be provided.
Encourage parents to explain their plans to the child (“I’ll be back after your nap”)
Respect schedule & implement similar.
Expect regression (bed-wetting)
Toys for hospitalized toddlers: board & mallet, push-pull toys, toy telephones, stuffed animals, storybooks with pictures (can be related to the reason for hospitalization)
Hospital playroom (mobility important to development)
Can name body parts & demonstrate concern for their bodies.
Basic explanations prior to procedures according to level.
Provide guided choices to support autonomy

Question 23

3-6 Nursing interventions

Answer 23

Nursing care should emphasize understanding of child’s egocentricity (believes he/she caused illness & painful procedures are punishment for misdeeds)
Answer questions @ child’s level. Use simple words @ child’s level.
Therapeutic or medical play allows child to act out his/her experiences/perceptions.
Fear of mutilation by procedures is common. Band-aids helpful in restoring body integrity.
Toys & play: coloring books, puzzles, cutting & pasting, dolls, building blocks, clay, & toys that allow preschooler to work out hospital experiences.
Preschoolers need preparation for procedures: Explain what is going to be fixed. Simple explanations & basic pictures are helpful. Allow to handle equipment or models of equipment. Body concept: simple systems

Question 24

6-12 Nursing interventions

Answer 24

May need support from parents, but hesitant to admit it
Maintaining contact w peers & school activities important
Explanation of all procedures: use explanations, pix, books, & handling equipment
Privacy & modesty must be respected (close curtains)
Participation in care & planning w staff fosters a sense of involvement & accomplishment
Toys: board games, card games, hobbies, crafts, puzzles, & video games

Question 25

12-18 Nursing interventions

Answer 25

Hospitalization disrupts school & peer activities; adolescents need to maintain contact with both.
If the room is shared, the roommate should be a like-aged adolescent.
Illnesses, treatments & procedures that alter the adolescent’s body image can be viewed by the adolescent as being devastating.
Teaching about health matters or procedures should include time without the parents being present. When parents are present, direct questions to the adolescent & not the parent.
Some assessment questions should be asked without the parents present.
The age of assent for making medical decisions ranges from 7 to 14 years of age. Until 18 yrs, parental consent is also needed for treatment.
For prolonged hospitalization, adolescents need to maintain identity (have their own clothing, posers, & visitors). A teen room or teen night is helpful. Unless a teen is critically ill, parents should not room in.
Teaching should focus on the here & now: “How will this affect me today?