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Pedi NCTC Unit 1
| Question | Answer |
|---|---|
| Growth | increase in size measured in inches and pounds |
| Development | progressive increase in function of the body |
| Maturation | dictated by inheritance and refers to the total way a person grows and develops |
| Cephalocaudal | development from head to toe Raises head before sitting Controls truck before walking |
| Proximodistal | is inner to outer |
| Average length at birth | 20 inches |
| Linear growth is 1 inch per month for first 6 months | Birth length increases 50% by age 1 (mostly in trunk area) |
| Average weight at birth | 6-9 pounds |
| Birth weight usually doubles by | 5 - 6 months |
| Birth weight usually triples by | 1 year |
| weight usually increases by 4-6 pounds per year until puberty spurt | After 1 |
| Body proportions | Head is fastest-growing during fetal life During infancy, the trunk grows most rapidly Legs grow most rapidly during childhood Sex characteristics characterize adolescence |
| Metabolic rate | Higher in children than in adults Are accompanied by increased production of heat and wastes Surface area is higher in children than adults in relation to body weight Children lose more fluid from pulmonary and integ systems |
| normal kidney function is achieved | By end of age 2 |
| Sleep patterns | Neonate - 8-9 hours of sleep at night with equal amount of daytime sleep Toddler - 10 hours of sleep at night with short daytime nap School age child - 8-8½ hours of sleep at night with rare daytime nap |
| most critical during the first year | Sense of trust and learning readiness |
| Growth standards | Growth is measured with a standard of comparison and depicted in growth charts |
| A difference of 2+ percentile levels from an established growth pattern | requires further evaluation |
| Denver II is screening too | Tests 4 categories: personal-social, fine motor adaptive, language, gross motor Abnormal scores indicate need for further assessment |
| Hereditary traits | Examples: eye color, hair color, and physical resemblance |
| Nationality and race | Ethnic differences extend into many areas: speech, food preferences, family structure, religious orientation and moral code There is some blurring of nationalities and races within common environments |
| Ordinal position in the family | Youngest and middle children learn from older siblings Motor development of the youngest may be delayed by babying Only or oldest children may excel in language development because of adult conversation |
| Nuclear family | Basic unit of American society Now constitutes only 25% of the household configurations |
| Extended families | 3 generations: grandparents, parents, and children |
| Family APGAR - assesses family functioning to determine home care needs | A - affection emotional interactions R - resolve involves how time, money, and space are allocated |
| Personality | is the unique organization of characteristics that determine the individual’s typical or recurrent pattern of behavior. |
| Maslow's hierarchy of needs Physiologic needs: | air, water, food, elimination, rest |
| Maslow's hierarchy of needs - Activity: | need for stimulation, novelty, change |
| Maslow's hierarchy of needs -Safety | Safety and Protection from harm |
| Maslow's hierarchy of needs -Love/Belonging | Love/Belonging to someone or some group |
| Maslow's hierarchy of needs - Esteem: | need to respect oneself and to be respected by others |
| Maslow's hierarchy of needs - Self-actualization: | Self-actualization: state of becoming a complete person, fulfilling your potential |
| Infancy = trust/mistrust | Infancy = trust/mistrust is achieved when infant recognizes mother as distinct from all others and self, tolerates frustration in small doses |
| Early childhood = autonomy/shame and doub | Early childhood = autonomy/shame and doubt is learned by trying out speech,acceptance of reality vs pleasure |
| Late childhood = initiative/guilt | Late childhood = initiative/guilt is questioning, exploring body and environment, differentiation of sexes |
| School age = industry/inferiority | School age = industry/inferiority is learning win by production, learning to relate to own sex |
| Adolescence = identity/role confusion | Adolescence = identity/role confusion is moving toward heterosexuality, selecting a vocation, beginning separation from family, and integrating personality |
| Piaget believes that intelligence consists of interaction and coping with the environment | Infancy = sensorimotor Childhood = Preoperational (2-7) Preconceptual (2-4) Perceptual (4-7)child is capable of some reasoning School age = Concrete operations (7-11) adolescence = Formal operational (11-16) |
| Kohlberg (theorist) states that moral development is sequential in 3 levels | Preconventional (4-7yrs) = children try to be obedient for fear of punishment Conventional (7-11yrs) = children show conformity and loyalty and focus on obeying rules Postconventional (12+yrs) = moral values are developed to solve complex problems |
| Grasp reflex: | flexion occurs when palms are touched and disappears by age 3 mo |
| Prehension reflex: | grasping objects between fingers and opposing thumbs occurs 5-6 mo |
| Parachute reflex: | is protective extension when infant is thrust downward when prone occurs 7-9 mo |
| Pincer grasp | coordination of index finger and thumb is well established by 1 year |
| 1 mo: | Lifts head slightly when placed on stomach and turns head when prone Makes throaty noises and cries when hungry or uncomfortable |
| 2 mo: | Posterior fontanel closes, can hold head erect in midposition, follows light with eyes Smiles in response to mom's voice |
| 3 mo: | Reaches for but misses items, can follow objects R to L and up and down Supports head steadily and holds rattle Cries less and can wait a few minutes for attention |
| 4 mo: | Drools, turns from back to side, lifts head and abdomen to look around, sits with support Coos, chuckles, laughs aloud, likes an audience, sleeps through the night |
| 5 mo: | Sits with support, Grasps objects offered, puts everything in mouth, plays with toes Talks to himself, knows familiar people, tries to hold bottle |
| 6 mo: | Sits alone momentarily, turns over, moves backward when sitting, bangs rattle, pulls to a sitting position without head lag Cries loudly when interrupted from play, Babbles and squeals, sucks food from spoon |
| 7 mo: | 2 lower teeth appear, begins to crawl, moves forward with dragging legs, transfers objects from hand to hand, holds hand to bounce when standing Shifts moods easily, shows fear of strangers, anticipates spoon feedings |
| 8 mo: | Sits steadily alone, uses pincer grasp, drops articles into a cup Plays patty-cake, amuses self for longer times, fusses and sucks thumb when sleepy |
| 9 mo: | Shows preference for one hand over the other, assumes sitting position, creeps Tries to imitate sounds "da-da", cries if scolded, may fall asleep after evening feeding, drops food from highchair during feeding |
| 10 mo: | Pulls to standing position, throws toys for parent to pick up, walks around furniture while holding onto it Knows name, plays peek-a-boo, feeds some finger food |
| 11 mo: | Stands upright while holding onto parent's hand Understands simple directions, impatient when held, drinks from a cup |
| 12 mo: | Stands alone for short periods, may walk, puts arm through sleeve Recognizes "no no", repeats acts that elicit a response, plays with food, shows emotion, enjoys rhythmic music Pincer grasp is well established |
| Infant should be seen by physician at least 5 times during the first year | (2, 4, 6, 9, and 1 year) |
| Addition of solid foods Recommended addition at 6 mo: | B - 4 mo: milk 4 - 6 mo: cereal (rice is recommended because is less allergy-causing) 6 - 8 mo: fruit/vegetables 7 - 9 mo: meat/beans 9 - 12 mo: eggs |
| Summary of major developmental changes in the first year: | Weight doubles by 6 months, triples by 1 year Height increases by 1 inch per month for the first 6 months Between 5 and 6 months, infants can voluntarily roll over By 1 year, infants can take some independent steps tooth eruption begins by 6 months |
| Major aspects of cognitive development by 1 year: | Separation of self from others Object permanence - objects exist even if out of visual field Symbols - saying bye-bye means someone is leaving |
| THE TODDLER | Children between ages 1 - 3 Have tripled birth weight Rebel with tantrums when corrected Are negative and say "no" frequently |
| Erikson's task:Toddler | acquire a sense of autonomy (self-control) while overcoming shame and doubt |
| 12 - 16 mo | Drinks from cup Begins to walk Prefers finger feeding Follows simple commands |
| 16 - 18 mo | Parallel play Self-feeding Walks alone Uses symbolic language ("bye-bye") |
| 24 mo | Egocentric ("mine") Climbs steps Block towers of 6-7 blocks Names familiar objects Jumps on both feet Develops likes and dislikes |
| 36 mo | Establishes toilet independence Imaginary playmate Holds cup by handle Jumps on 1 foot (hops) Climbs stairs with alternate feet Asks "why" and "how" Knows 2 colors Imitates parental roles |
| Sensorimotor and cognitive development Toddler | Confuse essential and non-essential body parts (upset with flushing feces) Become aware of cause and effect Object permanence continues Can correlate sight with sound Assimilate information through trial and error |
| Toddler speech development | Language development parallels cognitive growth By 3, there is 900 word vocabulary (at first will refer to animals by sounds they make) Speech is 90% intelligible |
| Toddler Key Points | B-weight X4 by 2½ years of age self-regulatory functions -toilet independence, self-feeding, tolerating delayed gratification, separation from parents, and perfecting new physical skills and speech skills accidents and poisoning leading causes of death |
| THE PRESCHOOL CHILD GENERAL CHARACTERISTICS (Age 3 - 6) | Infant has tripled birth weight by age 1, and doubled that weight by age 5 |
| Animism | attribute life to inanimate objects |
| artificialism | Believes the world and everything in it are created by people |
| The 3 - year old | Helpful and assist with simple household chores Make friends outside the family using parallel and associative play Fear bodily harm, particularly loss of body parts Resent being disturbed from play |
| The 4 - year old | Boisterous, tattle, and swear around others who use profanity Imaginative and like to pretend in their play Begin to be curious about sex |
| The 5 - year old | More responsible and have more patience Are inquisitive and talk constantly Can play games with rules Become less fearful because they feel their environment is controlled by authority figures Begin to loose deciduous teeth Begin to print their names |
| Play and the mentally retarded or handicapped child | Nurse should consider the mental age rather than the chronological age |
| Therapeutic play | Useful for retraining muscles, improving hand-eye coordination, walking Blowing instruments is a prerequisite for speech |
| Play therapy | Counselor is present to observe struggles, fears, resentments, and feelings toward self and others "Dramatic play" allows children to act out feelings and relieve tension |
| Art therapy | Useful for communicating with children and adults Allows children to express feelings, especially those who have been sexually abused |
| School age 6 - 12 | More engrossed in fact than fantasy Develop first close peer relationships Self-esteem is directly influenced by ability to become accepted in a peer group Child needs to work to a delayed reward |
| The 6 year old | Alive with energy and always on the go Soon become overtired Start tasks that may not get finished Are bossy but sensitive to criticism Loss of deciduous teeth Prefer to play with members of the same gender |
| The 7 year old | Are quieter than before and do not go looking for trouble Good sense of humor and like to tease May get their first "crush" Know that money is valuable |
| The 8 year old | Are self-assured and pragmatic Want to do everything Can play alone for long periods Enjoy group activities Still prefer companions of same sex Enjoys competitive sports but is poor loser May be argumentative Need to be taught how to handle anger |
| The 9 year old | Is dependable and assumes responsibility for younger sibs More likely to complete tasks Show interest in family activities Worries and mild compulsions are common Requires 10 hours of sleep at night Interest in musical instruments includes taking lessons |
| The 10 year old | Show self-direction and courtesy Desires independence Resents being told what to do Intolerant of the opposite sex Fairly reliable in performance of household duties Take more interest in appearance |
| 11 and 12 year olds | Characterized by intense, observant, all-knowing, energetic, meddlesome, and argumentative natures Hungry all the time (no table manners) Boys ignore girls but are very much interested and aware of them Group participation is still important |
| Pet ownership | After 7, can care for needs of pets Pets provide positive benefits in improving medical and psychological outcomes after illness or surgery May be compromised due to allergies or immunosuppression of child or other family members |
| THE ADOLESCENT | Def: the period of life beginning with the appearance of secondary sex characteristics and ending with cessation of growth and emotional maturity Means "to grow up" |
| Sources of zinc | meat, liver, eggs, seafood, nuts, beans, wheat germ, cheese Necessary for growth and sexual maturation |
| Sources of calcium | dairy products Necessary for bone formation |
| Sources of iron | liver, poultry, fish, dried beans, vegetables, egg yolk, enriched breads Necessary for increased muscle mass and blood volume |
| Dietary deficiencies | are likely to occur because teen needs food to accommodate rapid growth Eating patterns become more irregular - skipped meals, more between-meal snacks, eating out more often |
| Homosexuality | Homosexuality is not uncommon during adolescence Can merely be experimentation rather than alternative lifestyle |
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