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  • The term knock knee describes a large distance between the ankles when the knees are touching.

Finals fhn1stweek-110925083116-phpapp01 Finals fhn1stweek-110925083116-phpapp01 Presentation Transcript

  • GROWTH AND DEVELOPMENT OF INFANT Pg 811- 817
  • Physical growth
    • Infants grow more rapidly both size and their ability to perform tasks.
    • More infants double weight by 6 months of age
    • Triple by 1 year.
    • Height increase at 1 year by 50%
    • Head circumference increases due to rapid brain growth
    • Body proportion changes to amore typically infant appearance. Mandible becomes prominent and remain throughout life.
    • Chest is less than the size of the head at birth by about 2 cm.
    • Even with the head at 6 months and in most 12 months.
    • Cervical, thoracic, and lumbar vertebrae curves develop as infants hold up their head, sit, and walk.
    • Lengtening of the lower extremities during the last 6 months of infancy readies the child for walking and often changes as
    • “ baby like” to “ toddler like”
    • Teeth
    • First baby tooth is the central incisor- erupts at age 6 months followed by a new one monthly
    • 1 in 2000 may be born with natal teeth
    • Or have erupt at first 4 weeks of life called neonatal teeth.
    • Deciduous teeth or temporary or baby teeth are essential for protecting the growth of the dental arch.
  • 0-1 month
    • Largely reflexes- motor
    • Keeps hand fisted: able to follow object to midline- fine
    • Play: Enjoys watching of primary caregiver: listening to soothing sounds
  • 2 month
    • Holds head up when prone- motor
    • Has social smile- fine
    • Makes cooing sounds- socialization and language
    • Play: Enjoys bright colored mobiles
  • 3 month
    • Holds head and chest up when prone
    • Follows object past midline- fine
    • Socialization and language- Laughs out loud
    • Spends time looking at hands or uses them as toy during the month ( hand regard)
  • 4 month
    • Grasp, stepping, tonic-neck reflexs are fading- motor
    • Play: needs space to turn
  • 5month
    • Turns from front to back- motor
    • No longer head lag
    • Bears Partial weight when upright
    • Play- Handles rattles well
  • 6 month
    • Turn both ways
    • Moro reflex fading- motor
    • Uses palmar grasp- fine
    • May say vowel (oh-oh)-socialization and language
    • Play- Enjoys bathtub toys, rubber ring for teething
  • 7 months
    • Reaches out in anticipation of being picked up first tooth central incisor)- motor
    • Sits unsteadily or with support- motor
    • Transfers objects hand to hand- fine
    • Shows beginning fear of strangers- socialization and play
    • Play- likes objects that are good size for transferring
  • 8 months
    • Sits securely without support-motor
    • Socialization and language- Has peak fear of strangers ( ability to tell known from unknown people)
    • Play- Enjoys manipulation, rattles and toys of different textures
  • 9 months
    • Creeps or crawls- motor( abdomen off floor)
    • Socialization and language- Says first word ( da- da)
    • Play- needs space for creeping
  • 10 months
    • Pulls self to standing- motor
    • Uses pincer grasp- socialization and language
    • Play- Plays like patty cake and peek-a-boo
  • 11 months
    • Cruises “ Walks with support ”- motor
    • Play- Cruises
  • 12 months
    • Stands alone : some infants take first step- motor
    • Holds cup and spoon well:
    • Helps to dress( pushes arm into sleeve)
    • Says to word da-da or ma- ma
    • Play- likes toys that fit inside each other, nursery rhymes
  • Promoting infant safety
    • Accidents are leading cause of death from 1 month through 24 years of age.
    • They are only second to acute infections as a cause of morbidity
    • Most accidents in infants occur due to underestimation or overestimation of child’s ability.
  • Aspiration prevention
    • Round and cylindrical objects are dangerous because it can obstruct the airway( hotdog and carrots)
    • Educate the parents of the infant not to prop the bottles
    • Educate the parents to secure that the infant will not even reach a small object to be put into the mouth
    • When solid foods are introduced, encourage parents to offer a small pieces of food.
  • Fall prevention- second major cause of infant accidents
    • As a preventive measure, no infant, should be left unattended on a raised surface.
    • Be sure that the crib sides are raised and secure before anyone walks away from the crib.
  • Motor vehicle
    • Never transport unless the infant is buckled into an infant car seat in the back seat of the car
    • Do not be distracted while driving
    • Do not leave the infant unattended in the car park
  • Suffocation
    • Allow no plastic bag’s within the reach of the infant
    • Do not use pillows in the crib
    • Store unused appliances with the doors removed
    • Remove constricting clothing such as bib at bedtime
  • Drowning
    • Do not leave infant alone in the bath tub or unsupervised near water
  • Animal bites
    • Do not allow an infant to approach a strange dog
  • Poisoning
    • Never present medication as candy
    • Never take medications in front of a child
    • Place all medications in a secure cabinets
    • Never leave the medications on a pocket or handbag
    • Hang plants or set on a high surfaces
  • Burns
    • Test warmth formula and food before feeding
    • Do not smoke or drink hot liquids while holding the infant
    • Buy flame or retardant clothing
    • Use sunscreen on a child over6 months when out in direct or indirect sunlight
    • Turn handles of pans toward back of the stove
    • Monitor infants carefully near candles
    • Donot allow infants to blow matches
    • Keep electric wires out of reach
  • Toddler - great strides developmentally but growth are slow
    • Speaks in two word sentences
    • 20 deciduous teeth present at 2.5 years
    • Chest circumference becomes bigger than the head circumference at 2 years
    • Heart ate 90- 110 bpm
    • “ pouchy” abdomen from weak abdominal muscles
    • Noticeable lordosis
    • “ baby fat” begins to disappear
    • Wide based gait
  • 15months
    • Puts a small pellets into small bottles- fine
    • Scribbles voluntarily with a pencil or a crayon and holds a spoon well but may still turn upside down- fine
    • Walks alone well: can seat self in chair: can creep upstairs- gross
    • 4- 6 words
    • Play- can stack 2 blocks enjoys being read to; drop toys for adult to recover ( exploring sense of permanence)
  • 18 months
    • No longer rotates a spoon to bring it to mouth-fine
    • Can run and jump in place. Can walk up and down stairs holding onto a person’s hand or railing.
    • Typically places both feet on one step before advancing- gross
    • 7-20 words , uses of jargoning:
    • Names 1 body part- language
    • Play- Imitates household chores, dusting etc.
    • Begins parallel play (playing beside but not with another child)
  • 24 months
    • Can open doors by turning doorknobs, unscrew lids- fine
    • Walks up stairs alone still using both feet on same step at the same time
    • 50 words , 2 word sentences( such as noun, pronoun, verb) “Daddy go” “me come”
    • Parallel play evident
  • 30 months
    • Makes simple lines or strokes for crosses with a pencil- fine
    • Can jump down from chairs- gross
    • Verbal language increasing steadily. Knows full name: can name one color and holds up finger to show age
    • Play- Spends time playing house, imitating parents actions; play is “ rough- housing” or active
  • QUIZ
    • 1. First baby tooth erupts? is the central incisor
    • 2. Play: Enjoys watching of primary caregiver 1m o
    • 3. Holds head and chest up when prone 3mo
    • 4. Uses palmar grasp- fineMay say vowel (oh-oh)- 6 mos
    • 5. Sits securely without support-motor- 8mos
    • 6. Creeps or crawls- 9mos
    • 7. Walks with support- 11mos
    • 8. Uses pincer grasp- 10mos
    • 9-11. 3 mngt for burns or prevention
    • 12. Walks alone well- 15 mos
    • 13.Scribbles voluntarily with a pencil or a crayon and holds a spoon well but may still turn upside down- fine 15
    • 14. No longer rotates a spoon to bring it to mouth-fine- 18
    • 15. Can jump down from chairs- 30 mos
  • Problem concerns associated with the toddler period
    • -Toilet training
    • It should begin when the infant is ready to accomplish it
    • They must have the control of rectal and urethral spinchter
    • They must have a cognitive understanding of what it means to hold urine and stools- so they can release it on time and proper place
    • They must have the desire to delay immediate gratification for a more socially accepted action
  • Ritualistic Behavior
    • They will use their spoon at meal time
    • They will not go outside unless mother locates his cap
    • You need more guidelines and rule”
  • NEGATIVISM
    • They always say “no”
    • Just make a staement not a question
    • Example: Are you ready for dinner?
    • Instead tell come to table its dinnertime
  • DISCIPLINE-means setting rules or road signs so children know what is expected of them
    • Punishment- is a consequence that results from a breakdown in discipline
    • A. Parents need to be consistent
    • B. rules are learned best if correct behavior is praised than wrong nehavior is punished
    • “ timeout:”- help children that their actions have consequences
  • SEPARATION ANXIETY
    • 6 mos persists up to preschool period
    • Inform the child before leaving
    • But they will still cry if they don’t see their parents
    • Sneaking can prevent crying but increases abandonment
  • TEMPER TANTRUMS
    • Child may kick, scream, stamp, shout
    • No no no and lie on the floor
    • Sometimes they are holding their breath, true breath holding is a neurologic problem in wc children under stress
    • Just ignore!
  • PRESCHOOL CHILD
  • Physical Growth
    • -Definitive changes in the body contour- ectomorphic( slim) endomorphic( large)
    • Vocabulary increases
    • Tonsils appear enlarged
    • Growth is only 2- 3.5 inches a year
    • Pulse rates decreases to about 85bpm
    • Genu valgus (knock knees) may be evident
    • Increase coordination makes bicycle riding, running, kicking if possible
    • Weight gain- child gains only about 4.5lb (2kg)
    • Height gain- only 2 to 3.5 in (6-8cm)
    • Teeth- generally have 20 deciduous teeth by 3 years of age.
    • Oedipus complex- strong emotional attachment a preschool boy demonstrates toward his mother
    • Electra complex- preschool girl to her father
  • Developmental milestones 3 years old
    • Undresses self; stacks tower of blocks; draws a cross-fine motor
    • Runs; alternate feet on stairs; rides tricycle; stand on one foot- gross
    • Vocabulary of 900 words
    • Play- Able to take turns; very imaginative
  • 4 years old
    • Can do simple buttons- fine
    • Constantly in motion jumps; skips- Gross
    • Vocabulary of 1500 words- language
    • Play: Pretending is major activity
    • Ex: imaginary friends are normal
  • 5 years
    • Draws a 6 part man, can lace shoes- fine motor
    • Throws overhead- gross
    • Vocabulary of 2100 words- language
    • Play: likes games with numbers or letters
  • PARENTAL CONCERNS ASSOCIATED WITH PRESCHOOL PROBLEMS
  • COMMON FEARS OF THE PRESCHOOLER
    • Fear of darkness- sleep with the child
    • Fear of mutilation-which involves the loss of, or incapacity to use, a bodily member
    • - need of good explanation
    • Separation abandonment- explain on the time and place that a child can relates
    • Ex: television shows, or a friends house
  • Preparing for new sibling
    • Eliminate the sibling rivalry by explaining that the preschool is already big boy
    • Tell the preschool child in advance
    • Allow the child to visit in the hospital
  • SEX EDUCATION
    • Why does james looks differ from mine?
    • Answer: “boys look different from girls”
    • The different part is penis
    • Where does the babies come from?
    • Answer: “Babies grow in a special place in a mothers body called uterus.”
  • SCHOOL AGE CHILD
  • Chronological Devt of secondary characteristics Age Boys GIrls 9-11 Prepubertal weight gain Breasts: elevation of papilla with breast bud formation, areolar diameter enlarges 11-12 Sparse growth of straight, downy slightly pigmented hair at base of penis Scrotum become textured Growth of penis and testes Perspiration increases Straight hair along the labia, vaginal epithelium cornified Perspiration also increases 12-13 Pubic hair present across pubis Penis lengthens Dramatic linear growth spurt Breast enlargement occurs Pubic hair grows darker; spreads all over pubis Breast enlarges, still no protrusion of nipples axillary hair is present Menarche occurs
  • School age development
  • 6 years
    • A year of constant motion, skipping is a new skill- physical
    • Teacher becomes authority figure- psychosocial
    • Define words by their use- cognitive
    • Ex: a key is to unlock a door not a metal object
  • 7 years
    • Central incisor erupt-permanent
    • Play: video games and dolls- quiet play
    • A quiet year: striving for perfection leads to this year being called an eraser year.
    • Can tell time, can make simple changes
  • 8 years
    • Coordination definitely improved;
    • playing with gang becomes important; eyes become fully developed
    • Best friends develop
    • Whispering and giggling begins
    • Can write as well as print
    • Can tell the present, past and future
  • 9 years
    • All activities done with a gang
    • Gang age- secrets
    • All boys or all girls
    • If gang disband and reform quickly
  • 10 years
    • Coordination improves
    • Ready to camp away from home
    • Ready for competitive games
  • 11 years
    • Active but awkward and ungainly
    • Insecure with members of the opposite sex, repeats off color jokes
  • 12 years
    • Coordination improves
    • A sense of humor is present: is social and cooperative
  • CONCERNS OF PROBLEMS DURING SCHOOL AGE
  • Common
    • Attention deficit hyperactivity disorders
    • Fears
    • Language
    • Responsibility
  • Language
    • Articulation- the child is difficult in saying
    • S,z, th,l r, and w substitutes for “westroom” or “radies room”
  • Fears
    • Anxiety related to beginning school- adjusting to the environment
    • School refusal or phobia- resist to attend school just like agoraphobia
    • Cause: bully harsh teacher, showering in the gym class
    • Manage by counseling or transferring to another room
  • Sex education
    • Reproductive organ function
    • Secondary sexual characteristics-aware of their body
    • Physiology of reproduction-understand menstruation
    • Explanation of the physiology of pregnancy and the possibility that comes with sexual maturity for unplanned or unwanted pregnancies
    • Social and moral implications sexual maturity
  • Stealing- during early age it is normal- around 7 yrs old
    • Tell your child that the money is missing
    • Not pointing that the child steal the money
    • The importance of money is reviewed
    • Mother and father is theirs
    • Child;s money is the childs money
  • Violence and tourism- such as shooting or reports of terrorism
    • COMMON RECOMENDATIONS
    • Assure children they are safe;
    • Assure children their parents are actively involved in keeping them safe.
    • Observe for signs of stress- sleep disturbance, fatigue, lack of pleasure,
    • Not allow children or adolescents to view footage of traumatic events over and over
    • Watch news programs with children so they can explain that the situation.
    • Explain there are bad people in the world, and bad people do bad things. But encourage not to see only one side of it.
    • Prepare a family disaster plan
  • BULLYING
    • Tell the child that it should be reported
    • School age child bullying has long term effects on mental health
  • ADOLESCENTS
    • Puberty- is the time at which an individual first become capable of sexual reproduction
    • Range 11- 14years
    • Girls- < 13 years- menstruation
    • Boys- begins producing spermatozoa
  • SECONDARY SEX CHARACTERISTICS Age Males Females 13-15 Growth spurt coninues Pubic hair is abundant and curly Testis, scrotum and penis enlarging further Facial hair, voice changes Pubic hair is thick and curly- triangular Menstruation is ovulatory Pregnancy is possible 15-16 Genitalia adult Scrotum dark and heavily rugated Facial and body hair is present Sperm production is mature Pubic hair abindant Areolas no longer project as separates ridges from the breast Facial acne 16-17 Pubic hair curly and abundant may extend to the medial aspect of the thigh Facial acne Gynecomastia – enlarged breast tissue End of skeletal growth 17-18 End of skeletal organ
  • Play or recreation
    • Change from more adults forms of recreation such as: listening to music, chatting on computers, following a sports teams wins or losses.
  • Emotional devt: identity vs. role confusion
    • Four main areas to achieve a sense of identity
    • 1. accepting a change or body image
    • 2. establishing a value system or what kind of person they want to be
    • 3. making a career decision
    • 4. becoming emancipated from their parents
    • 13 years old
    • feel self doubt than self confidence
    • Because they still look children but want to grown up
    • 14 years old
    • Becoming used of their body changes and quieter- have more self confidence
    • 15 years old
    • Fall in love 5 to six times a year
    • Based on physical features
    • 16 years
    • Becoming sexually mature- trust their own bodies
    • 17 years
    • Left behind the childish behaviors they used in early adolescence
    • Shoving and punching- to get the attention of the opposite sex
  • COGNITIVE DEVT
    • FORMAL OPERATIONAL THOUGHT 12-13yrs
    • This step is the ability to think in abstract terms and use scientific method to arrive at conclusions.
    • Review pg 811-946 vol 2 maternal and child health nursing by adelle pilitteri
    • Don’t depend on the slides goodluck guys!