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Pediatric Nursing

Pediatric Nursing

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Published by Bheru Lal

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Published by: Bheru Lal on Jan 11, 2011
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10/28/2012

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Growth and Development
Growth
- increase in physical size of a structure or whole.-quantitative change.Two parameters of Growth1.weight- most sensitive measure of growth, especially low birth rate. Wt doubles 6 months3x 1yr 4x 2-2 ½ yrs2. Height- increase by 1”/mo during 1
st
6 months- average increase in ht - 1
st
year = 50%stoppage of ht coincide with eruption of wisdom tooth.
Development
- increase skills or capability to function-qualitativeHow to measure development1.Observe child doing specific task.2.Role description of child’s progress3.DDST- Denver development screening test.MMDST (Phil) Metro Manila Developmental Screening Test.DDST measures mental4 main rated categories of DDST1. Language communication2. personal social-interaction3. fine motor adaptive- ability to use hand movement4. gross motor skills- large body movementmaturation- same with development “readiness”
Cognitive development
 –ability to learn and understand from experience to acquire and retain knowledge.To respond to a new situation and to solve problems.IQ test- test to determine cognitive developmentMental age x 100 = IQChronological ageAverage IQ – 90-100Gifted child- > 130 IQBasic Divisions of LifeI.Prenatal stage from conception- birthII.Period of infancy
1.
 Neonatal- 1
st
28 days or 1
st
4 weeks of life2.Formal infancy- 29 day – 1 year III.Early childhood1.Toddler – 1-3 yrs2.Pre school 4-6 yearsIV.Middle childhood1.School age- 7 – 12 yrs
1
 
V.Late childhood1.Pre adolescent 11 – 13 yrs2.Adolescent 12 - 18 – 21Principles of G & D1.G&D is a continuous process-begins form conception- ends in death- womb to tomb principles
2
. not all parts of the body grow at the same time or at same rate.- asynchronismPatterns of G&D1.)renaldigestive grows rapidly during childhoodcirculatorymusculoskeletal2.)Neuromuscular tissue (CNS, brain, S. cord)-grow rapidly 1-2 years of life-brain achieved its adult proportion by 5 years.3.)Lymphatic system- lymph nodes, spleen grows rapidly- infancy and childhood to provide protection-infection
-
tonsil adult proportion by 5 years4.)Repro organ- grows rapidly at pubertyRates of G&D1.fetal and infancy – most rapid G&D2.adolescent- rapid G&D3.toddler- slow G period4.Toddler and preschool- alternating rapid and slow5.school age- slower growthfetal and infancy- prone to develop anemia3.Each child is unique2 primary factors affecting G&DA. Heredity - R raceI – intelligenceS – sex N - nationalityFemales are born less in weight than males by 1 oz.Females are born less in length than males by 1 inchB. EnvironmentQ – quality of nutritionS – socio eco. statusH – healthO – ordinal pos in familyP – parent child relationshipEldest- skillful in language and social skillsYounger- toilet trained self 4.G&D occurs in a regular direction reflecting a definitive and predictable patterns or trends.
2
 
Directional trends- occur in a regular direction reflecting the development of neuromuscular function.These apply to physical, mental, social and emotional development and includes.a.cephalo-caudal “head to tail-occurs along bodies long axis in which control over head, mouth and eye movements and precedes control over upper body torso and legs. b.proximo- distal “Centro distal”-progressing form center of body to extremities.c.Symmetrical- at side of body develop on same direction at same time at same rate.d.Mass specific “differentiation”- child learns form simple operations before complex function of move from a broad general patternof behavior. To a bore refined pattern.B. Sequential- involves a predictable sequence of G&D to which the child no9rmally passes.a. locomotion- creep than crawls, sit then stand. b. socio and language skills- solitary games, parallel gamesC. Secular- worldwide trend of maturing earlier and growing larger as compared to succeeding generations.5.Behavioral in the most compressive indicator of developmental status.6.universal language of child- play7. great deal of skill and behavior is learned by practice. Practice makes perfect.9. neonatal reflexes us must be lost before one can proceed.-plantar reflex should disappear before baby can walk -moro reflex should disappear before baby can roll persistent primitive infantile reflexes- case of cerebral palsyTheories of G&DDevelopmental tasks- different form chronological age-skill or growth responsibility arising at a particular time in the individuals life.The successful achievement of which will ------- a foundation for the accomplishments of future tasks.Theorists1.
Sigmund Freud 
1856-1939 Austrian neurologists. Founder of psychoanalysis- offered personality developmentPsychosexual theorya.)
Oral Phase 0-18 months
- mouths site of gratification-activity of infant- biting, sucking crying.-why do babies suck?- enjoyment and release of tension.-provide oral stimulation even if baby was placed on NPO.-pacifier.-never discourage thumb sucking. b.)
ANAL- 18 months-3 years
-site of gratification- anus-activity- elimination, retention or defecation of feces make take place- principle of holding on or letting go.-mother wins or child wins-child wins- stubborn, hardheaded anti social. (anak pupu na, child holds pupu, child wins)-mother wins- obedient, kind, perfectionist, meticulousOC-anal phase-help child achieve bowel and bladder control even if child is hospitalized.c.)
Phallic- 3-6 years
site of gratification-genitalsactivity- may show exhibitionism-increase knowledge of a sexes-accept child fondling his/her own genitalia as normal exploration
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