Review Box 15-1 on page 348 and discuss the emerging behavior patterns that can be anticipated based on age. Growth, such as height and weight, is measurable. The process of development is the mastery of a skill that allows the infant or child to progress to the next skill. Give examples of growth and developmental skills for each of these categories: physical, social, emotional, and intellectual skills.
Children are not miniature adults. For this reason, their plan of care is different than the plan of care for an adult. Recognizing developmental and growth delays will assist the nurse in formulating his/her plan of care but may also provide an opportunity for early intervention by the health care team to prevent further developmental delays. How are infants and children different from adults?
Give examples of different methods to obtain height and weight on a neonate, infant, and child. What is the purpose of a growth chart? What are some developmental milestones for an infant? How will the nurse obtain the information to assess developmental milestones?
Review Box 15-2 on page 349, The Nursing Process Applied to Growth and Development. Examples of appropriate nursing diagnoses: Breastfeeding, ineffective, related to inability of infant to nurse properly Caregiver role strain, related to inexperience Family coping, compromised, related to infant’s medical diagnosis
Give an example of how a nurse might evaluate effective communication between a parent and a toddler. Why is evaluation an ongoing process for growth and development?
How can these terms related to age benefit health care professionals? Give an example of a toddler and maturation. Give an example of progressing development of a preschool child. Stages of growth and development Fetus: 9 th gestational week to birth Neonate: birth to 4 weeks Infant: 4 weeks to 1 year Toddler: 1-3 years Preschool: 3-6 years School-age: 6-12 years Adolescent: 12-18 years
What are examples of cephalocaudal development? Raising head and chest precedes sitting; sitting precedes standing. Proximodistal begins at the central portion of the body and extends outward to the extremities (i.e., the infant grasps with the hands before developing the pincer grasp or the infant bats at an object before being able to grasp the object). Audience Response Question #1 Cephalocaudal : head to toe as proximodistal : __________________. 1. midline to periphery 2. crown to rump 3. neck to waist 4. weight to length
Why is it important for the nurse to recognize the differences between children and adults? How is an infant’s metabolic rate different from an adult’s? How are the following body systems of a child different from an adult’s: renal, nervous, musculoskeletal, respiratory, immune, and cardiovascular?
Why do we have growth standards? How does this benefit the nurse, pediatric patient, and/or parent? Why does the nurse compare a child’s former growth rate to the current growth rate?
Give an example of when this tool might be utilized. Why are there separate growth charts for boys and girls? Audience Response Question #2 Childhood obesity is decreasing in the United States. 1. True 2. False
In what instances would the Denver Developmental Screening Test be utilized? Why would a nurse want this information?
How do these factors affect growth and development of a child? Audience Response Question #3 Environment plays a minimal role in childhood development. 1. Strongly agree 2. Agree 3. Disagree 4. Strongly disagree 5. Unsure
Give an example of each of the types of families listed. How do these different types affect children of school age?
Adaptation: How the family helps and shares resources. Give examples of types of resources. Partnership: Lines of communication and partnership in the family. Give an example of a familial partnership. Growth: How responsibilities for growth and development of child are shared. Give an example of shared responsibilities. Affection: Overt and covert emotional interactions among family members. Give an example of overt and covert emotions. Resolve: How time, money, and space are allocated to prevent and solve problems. Give an example of how time, money, and space can be manipulated to solve a familial problem.
How do these factors affect the family? What can nurses do within their community to cause effective change in the community?
How does homelessness affect growth and development of a child? How can the nurse assist these families to receive adequate health care? How can the nurse become informed regarding available resources within his/her community?
Give an example of how one’s environment can affect one’s personality. Why is nursing concerned about a child’s personality?
Why does nursing focus on these developmental theorists? How do they affect the nursing plan of care? Audience Response Question #4 The theorist that has most influenced knowledge on childhood development is: 1. Freud. 2. Erikson. 3. Piaget. 4. Kohlberg.
Describe how Maslow’s Hierarchy of Basic Needs affects nursing care. How would you utilize this pyramid in your nursing plan of care?
Give an example of how the child must adjust to his/her environment. Give an example of how the nurse might instruct a parent on caring for the infant.
Give an example of how a child might interact with his/her parent if trust hasn’t been developed. What cues might the parents assess regarding their infant?
Give an example of a toddler who is striving to attain autonomy. How might the nurse educate the parents during this frustrating developmental stage?
Give an example of a child asserting initiative. Why must the parent learn to separate from the child? Why are these children striving for independence? How does this help them in the future?
Give an example of industry. Why must parents practice patience at this stage? How does patience on the parent’s part assist the child’s development?
Give an example of a cognitive skill for each of Piaget’s stages. Why would nurses want to assess cognitive ability? Give an example of a child who has not progressed to the cognitive level of a peer.
Why would a nurse want to assess moral development? Give an example of moral development for each of the three levels.
Refer to Table 15-6, page 369, for culturally diverse food patterns. Why should the nurse be informed regarding food and one’s culture? Give examples of how a nurse might apply this information in his/her plan of care.
Give an example of a well-balanced diet for a school-age child. What can result if a child has a poor diet?
Give an example of how a good versus a poor diet might affect a child’s body when recovering from an illness.
Describe how a nurse might apply this food pyramid to the plan of care. How could an elementary school nurse utilize this Food Guide Pyramid?
Describe a situation in which the nurse might utilize this Food Guide Pyramid. Is this child receiving proper nutrition utilizing this pyramid?
Why do infants require more of these nutrients than a toddler? Why does the nurse assess the infant’s hydration status?
Does the American culture obtain enough fiber in its diet? Why should the growing child receive fewer calories? Why is this an issue in the American culture?
Describe the process of digestion. Why does water absorption take place? In what area does the body absorb most of the nutrients from food?
Give an example of a nutritional care plan for each: hospital, home, and outpatient departments. Why should the information be kept in one place?
Why must foods be introduced slowly during the first year of life? At what age are complex carbohydrates digested efficiently? How does the liver function during the first year of life?
Why is the development of the central nervous system crucial during the first year of life? Give an example of parenteral and enteral nutrition. When might these types of feeding be implemented?
Provide a nursing intervention for the infant who is failing to gain weight. Provide a nursing intervention to address overfeeding an infant.
Why should whole milk not be introduced during the first year of life? Why does a child require whole milk during the second year of his/her life?
Why is it important for a toddler to develop a sense of independence? Why should a parent be present at mealtimes? Why might the parent be anxious?
Give examples of finger-foods. What is dawdling? Why is this population more vulnerable to protein deficiencies?
How does an increase in sweets affect the child’s appetite? How might the parent impact this population’s diet?
Give an example of types of foods adolescents typically consume. How could parents impact their adolescent’s diet? Why is fatigue common at this age?
Why does the U.S. struggle with an obesity problem? What types of foods do Americans typically consume? How can nursing affect this cultural problem?
How might the nurse manage feeding a child with lesions in his/her mouth? How would the nurse assess the hydration status of a child?
Give an example of educating a parent about feeding an infant, toddler, and preschool child.
Give an example of a food-drug interaction. How should the nurse plan care of an infant who is receiving medications and formula? Give an example of drug-environment interactions.
What are deciduous teeth? How do teeth affect digestion? When does the first tooth typically appear in an infant?
What is bottle mouth? Why is it important for the permanent teeth to develop in alignment? How would the nurse instruct a parent to care for his/her infant’s teeth?
How does eating a balanced diet affect the development of the infant’s teeth? How does sugar affect teeth? At what age should toothbrushing begin?
How might nursing caries affect the infant’s permanent teeth? Give an example of a nursing intervention regarding nursing caries.
Why should a toothbrush be replaced every 3 months? Why should closed toothbrush containers be avoided? Why should parents avoid tasting their baby’s food?
Describe how play is a child’s work. How do children benefit from play? Why should stuffed animals be avoided in the asthmatic child? Give an age-appropriate activity for each of the following: infant, toddler, preschooler, school-age child, and adolescent.