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VNSG 1234 –
PEDIATRICS
Chapter 15 – Overview of
Growth, Development, and
Nutrition
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2
Growth Development,
Maturation
• Directional patterns
– Cephalocaudal – he...
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3
• Metabolic rate – higher in
children than adults
–Surface area higher in
...
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4
Growth standards
– Allows child to be compared to
others and himself
– Con...
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5
Influencing factors of uniqueness
– Hereditary traits (eye and hair
color,...
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6
Ordinal Position – Birth
Order
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7
Families
• Traditional – two
parents and their
children
• Nuclear family –...
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8
Nuclear
Family
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9
Extende
d
Families
• 3 generations
• Addition of
grandparents,
etc
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10
One Parent Families
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11
Blended Family
Mom with children
remarries dad with
children and then
hav...
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12
Homeless Families –
modern day problem
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13
Personality
Development
Characteristics that
determine the
individual’s t...
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14
Personality Development:
Maslow’s Hierarchy of Needs
Hierarchy of needs m...
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15
Freud
• Infancy – orality
• Early childhood – anality
• Late childhood – ...
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16
Erikson
• Infancy – trust vs. mistrust
• Early childhood – autonomy vs.
s...
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17
Piaget - Cognitive Development
– Infancy – self-centered
– Childhood
• Pr...
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18
Moral Development -
Kohlberg
• Preconventional (4-7 yrs) – children try t...
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19
Nutritio
n
• Child’s nutritional heritage
– Factors influencing feeding c...
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20
Nutrition and Illness (diarrhea)
– World Health Organization
distribute P...
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21
Feeding the Healthy Child
• Infant
– Milk substitutes available for thera...
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22
Toddler
– Feed self by
2 years leads
to increased
independence
– May begi...
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23
Preschooler
– Likes finger
foods & may
dawdle while
eating
– Snacks – dry...
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24
School Age child
– Love sweets
• Decreases appetite & provides empty
calo...
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25
Adolescent
Good nutrition essential for appearance
and fitness
• Peer app...
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26
Characteristics of a healthy
child• Steady weight & height gain
• Alert
•...
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27
Feeding the Ill Child
• 1 tbsp of food per year of life
• Introduce one f...
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28
Teeth and Oral
Care
• Deciduous teeth
– First appear about 7 months & all...
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29
Oral Care
• Limit frequency
of sugar intake
• Sticky, retentive
foods pro...
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30
• Safe snacks
– Cheese, peanuts, milk, sugarless gum, raw
veggies
• Fluor...
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31
Play
• Business of childhood
– Can be therapeutic
(“blowing” bubbles or b...
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32
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Pedi 15

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Pedi 15

  1. 1. VNSG 1234 – PEDIATRICS Chapter 15 – Overview of Growth, Development, and Nutrition
  2. 2. Free powerpoint template: www.brainybetty.com 2 Growth Development, Maturation • Directional patterns – Cephalocaudal – head to toe – Proximodistal – inner to outer • Height – family trait, linear due to skeletal growth • Weight – composed of high percentage of water – Birth weight doubles by 6 months – Birth weight triples by 12 months – After 1 yr – weight 4 - 6 lbs/yr until puberty
  3. 3. Free powerpoint template: www.brainybetty.com 3 • Metabolic rate – higher in children than adults –Surface area higher in children than adults • Sleep patterns – may be altered by culture
  4. 4. Free powerpoint template: www.brainybetty.com 4 Growth standards – Allows child to be compared to others and himself – Considerations • Should follow predictable pattern (Denver II Screening) Developmental Screening • Difference of 2+ percentiles from established pattern indicates need for further evaluation
  5. 5. Free powerpoint template: www.brainybetty.com 5 Influencing factors of uniqueness – Hereditary traits (eye and hair color, physical resemblance) – Nationality and race – Gender – Environment – Ordinal position in the family
  6. 6. Free powerpoint template: www.brainybetty.com 6 Ordinal Position – Birth Order
  7. 7. Free powerpoint template: www.brainybetty.com 7 Families • Traditional – two parents and their children • Nuclear family – basic unit of American society • 25% of households
  8. 8. Free powerpoint template: www.brainybetty.com 8 Nuclear Family
  9. 9. Free powerpoint template: www.brainybetty.com 9 Extende d Families • 3 generations • Addition of grandparents, etc
  10. 10. Free powerpoint template: www.brainybetty.com 10 One Parent Families
  11. 11. Free powerpoint template: www.brainybetty.com 11 Blended Family Mom with children remarries dad with children and then have their own children Family success requires: – problem-solving – communication – flexibility
  12. 12. Free powerpoint template: www.brainybetty.com 12 Homeless Families – modern day problem
  13. 13. Free powerpoint template: www.brainybetty.com 13 Personality Development Characteristics that determine the individual’s typical or recurrent pattern of behavior
  14. 14. Free powerpoint template: www.brainybetty.com 14 Personality Development: Maslow’s Hierarchy of Needs Hierarchy of needs must be met to fulfill potential
  15. 15. Free powerpoint template: www.brainybetty.com 15 Freud • Infancy – orality • Early childhood – anality • Late childhood – phallic/oedipal (aware of sexuality) • School age – latency (focus on peers and groups) • Adolescence – genitality
  16. 16. Free powerpoint template: www.brainybetty.com 16 Erikson • Infancy – trust vs. mistrust • Early childhood – autonomy vs. shame and doubt • Late childhood – initiative vs. guilt • School age – industry vs. inferiority • Adolescence – identity vs. role confusion
  17. 17. Free powerpoint template: www.brainybetty.com 17 Piaget - Cognitive Development – Infancy – self-centered – Childhood • Preoperational (2-7 yrs) – egocentric; thinks all see the world as the child does – Preconceptual (2-4 yrs) – child not capable of reason – Perceptual (4-7 yrs) – some reason but only able to concentrate on one thing at a time – School age (7-11 yrs) – concrete operational • Reasoning is logical but limited to own experience – Adolescence (11-16 yrs) – formal operational • Develops abstract concepts and problem-solving
  18. 18. Free powerpoint template: www.brainybetty.com 18 Moral Development - Kohlberg • Preconventional (4-7 yrs) – children try to be obedient for fear of punishment • Conventional (7-11 yrs) – children show conformity & loyalty & focus on obeying rules • Postconventional (12+yrs) – moral values are developed to solve complex problems with emphasis on individual conscience within the society
  19. 19. Free powerpoint template: www.brainybetty.com 19 Nutritio n • Child’s nutritional heritage – Factors influencing feeding children: misinformation, income, folklore, fads, religion, culture, ethnicity • Hispanic diet – rice, beans, tortillas, corn • American Indian – corn (maize), bread, wild meat • Asian – rice, chicken, pork, vegetables • Italian – pasta, spices, cheeses
  20. 20. Free powerpoint template: www.brainybetty.com 20 Nutrition and Illness (diarrhea) – World Health Organization distribute Pedialyte to third world countries – Cereal solution – 1/2 c infant rice cereal, 2 c water, 1/4 tsp salt – Other options - saltine crackers, half-strength apple juice
  21. 21. Free powerpoint template: www.brainybetty.com 21 Feeding the Healthy Child • Infant – Milk substitutes available for therapeutic use – Signs of Underfeeding • Restlessness, crying, failure to gain weight – Signs of Overfeeding • Regurgitation, mild diarrhea, too rapid weight gain – Introduce solid foods at 4 - 6 months • Rice cereal first! – No whole milk prior to age 1 yr
  22. 22. Free powerpoint template: www.brainybetty.com 22 Toddler – Feed self by 2 years leads to increased independence – May begin to refuse foods
  23. 23. Free powerpoint template: www.brainybetty.com 23 Preschooler – Likes finger foods & may dawdle while eating – Snacks – dry cereal, graham crackers, fruit juices, ice cream
  24. 24. Free powerpoint template: www.brainybetty.com 24 School Age child – Love sweets • Decreases appetite & provides empty calories • High-fat & cholesterol diets may be decreased by ↓ fried foods, ↓ fast foods, fruit instead of candy snacks – Food attitudes unpredictable
  25. 25. Free powerpoint template: www.brainybetty.com 25 Adolescent Good nutrition essential for appearance and fitness • Peer approval influences food fads & skipped meals –Results in malnutrition • Suspect anemia with fatigue, anorexia, irritability
  26. 26. Free powerpoint template: www.brainybetty.com 26 Characteristics of a healthy child• Steady weight & height gain • Alert • Shiny hair • No fatigue circles under eyes • Normal skin color • Erect posture • Healthy mucous membranes • Good appetite • Regular elimination • Sleep well
  27. 27. Free powerpoint template: www.brainybetty.com 27 Feeding the Ill Child • 1 tbsp of food per year of life • Introduce one food at a time • Do not transmit own preferences • Do not serve sweets before meals
  28. 28. Free powerpoint template: www.brainybetty.com 28 Teeth and Oral Care • Deciduous teeth – First appear about 7 months & all in by 2 ½ years • By age 1, should have 4 upper & 2 lower teeth • Should see dentist by age 3 – AAPD advise dental visit by age 1 – If lost early, permanent teeth are poorly aligned • Permanent teeth – 32 teeth begin to erupt about age 6 • Wisdom teeth appear between 18-23 yrs
  29. 29. Free powerpoint template: www.brainybetty.com 29 Oral Care • Limit frequency of sugar intake • Sticky, retentive foods promote caries Raisins Caramels Peanut Butter
  30. 30. Free powerpoint template: www.brainybetty.com 30 • Safe snacks – Cheese, peanuts, milk, sugarless gum, raw veggies • Fluorinated water is community prevention of caries • Tooth brushing care – Replace toothbrush q3 months or after viral/bacterial illness – Do not store in closed container – Do not share toothbrushes
  31. 31. Free powerpoint template: www.brainybetty.com 31 Play • Business of childhood – Can be therapeutic (“blowing” bubbles or balloons) – Art and coloring allows non-verbal expression of feelings – Computer games assists in problem solving – Teach to select age- appropriate toys – Cooperative play – play with each other
  32. 32. Free powerpoint template: www.brainybetty.com 32

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