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. GROWTH is generally used to denote an increase in physical size or quantitative change. DEVELOPMENT is used to denote an increase in skills or ability to function. COGNITIVE DEV’T is the ability to learn or understand from experience, to retain knowledge and to solve problems (Intelligence). Factors affecting Growth and Development 1. Genetic Influences 6. Environment 2. Gender 7. Nutrition 3. Race and Nationality 8. Socio-Economic Level 4. Intelligence 9. Parent-Child Relationship 5. Health 10. Ordinal Position (Family) Developmental Screening for Newborn – done by Pediatrician 1.Denver II Developmental Screening Test - divide streams of Development into gross motor, Fine motor, language and personal-social. 2. Clinical Adaptive Test - rates problem solving and visual motor ability. Criteria for Suitability of Toys 1. Is it safe? 2. Is it Useful? 3. Is it compatible? Infancy Toddler Solitary Parallel stack toys, blocks, pots drums to bang push and pull toys rocking horse, swing finger paints, puzzle Trucks, dollhouse Doctor and nurse kits Sandbox, outdoor gym Games and Sports Board games, books and TV
PLAY medium form expression, communication and growth in children
4.Autonomy / Independence . C. 2.stays dry for 2 hours with regular bowel mov’t .Sexual identity is important to preschool in play (Boys-toy guns / Girls-dolls) .Vit.mother should not expect too much from infant Health Maintainace Toddler (1-3) .Solid food introduce at 4 to 6 months Psychosocial Dev’t . D and Iron is not found in milk .reply to every request is definite NO! Temper tantrums Pre-school (4-5) Oedipus and Electral Complexes .undergo extreme negativism. sexual roles and organs Phallic Stage . walk and squat . Educational Recreational Physical Dev’t Social and Emotional Adjustment Therapeutic Growth and Development Throughout Lifespan Infancy (0-1) Nutrition .Aware of body’s anatomy and sexual identity (Male and Female) .differentiate boy from girl Toilet Training . 5.aware of sexuality.imitates what she/ he sees .Functions of Play 1.Can verbalize the desire to void or defecate Negativism . 3.Recognize that they are separate individual > negativistic > Difficult to manage Socialization . hates to do anything .Can sit.
posters.Deal with masturbation in non-judgmental manner School Age (6-12) Strives for Achievements of: 1. Guiding children to perform task in w/c they are likely to succeed. Guiding the child to complete task 4. peer groups) Psychosocial Development . marbles etc. cause and effect Moral and Spiritual Dev’t .Aware of body’s anatomy and sexual identity (Male and Female) .Penis envy or castration fear .collecting age begins (Cards.Hygiene and Nutrition Adolescent (12-18) Period during w/c the person becomes physically and psychologically mature and acquires personal identity. sexual roles and organs Phallic Stage ..master skills that will help them fxn in the adult world . Social mastery (friends.Sexual identity is important to preschool in play (Boys-toy guns / Girls-dolls) . Teaching the child to get along with peers 5. Teaching the child to get along with adut Play . Puberty – first stage of adolescent in w/c sexual organ begins to grow and mature. Gross motor competency (Sports) 2. 2. 3.Stealing is a common school-age problem Ways to assist a school-age child develop psychosocially 1. Recognizing success and providing praise for achievements. math) 4.Penis envy or castration fear .Deal with masturbation in non-judgmental manner Oedipus and Electral Complexes .aware of sexuality. Fine motor dexterity (crafts/arts) 3.God is good and always present to help .) Cognitive Dev’t . girls – 10 to 14 boys – 12 to 16 . Cognitive proficiency (reading.develop logical reasoning.
Suicide .task is to establish identity and self-concept . . it is equally difficult to be teenagers .Motor Vehicular Accident Physiologic Status of Newborn CIRCULATORY STATUS • • • • • • UMBILICAL VEIN and DUCTUS VENOSUS constrict after cord is clamped.Adolescent Pregnancy . acne Cognitive Dev’t .Adolescent are sexually active and may engage in masturbation or heterosexual activity. but anatomic or permanent closure may take several months. Promoting Healthy Family Functioning .STD .ability to use scientific thought – plan their future Psychosocial Dev’t .Dating helps prepare them for marriage by teaching them how to act with members of opposite sex.Glandular changes – sweat. FORAMEN OVALE closes functionally as respirations are established. DUCTUS ARTERIOSUS constricts w/ establishment of respiratory function.Acne . Sex Education Common Health Problems . HEART RATE averages 140 bmn BP 73/55 mmHg PERIPHERAL CIRCULATION acrocyanosis w/n 24H .Obesity .Drug / Alcoholism .Teenagers need good adult role models so that they can see that adult roles are not frightening but desirable.adolescent growth Spurt .occurs in boys Physical Dev’t .Menarche – occurs in girls Ejaculation .It is not easy to be with teenagers.
8 to 99ºF • NB’s body temp drops quickly after birth.Renal System • Urine present in the bladder at birth.usually passed within 12. tarry residue from lower intestine. . . • Cold stress increases O2 consumption.normal for the first few days .cold stress occurs easily. .Loose and golden yellow b. EPSTEIN’S PEARLS Newborn can’t move food from lips to pharynx. WEIGHT • normal= 2500 . • Urine is pale and straw colored.24 hours after birth. • Body stabilizes temp in 8-10 hours if unstressed.Formed and pale yellow TEMPERATURE • HEAT PRODUCTION . small raised white areas on the palate are normal. a. MILK STOOLS for BF-INFANT . but NB may not void for 1st 12-24 hours.4300 g (5.black.this should be regained in 1-2 weeks LENGTH .5 lbs) at term. After 3 days MILK STOOLS are usually passed. . MILK STOOLS for FORMULA-FED .indicative of sufficient fluid intake.5 to 9. . capable of digesting simple CHO and simple CHON but fats Stomach capacity caries= 50-60 ml Feeding patterns • FIRST STOOL is MECONIUM.initial voidings may leave brick-red spots on diaperd/t passage of uric acid crystals in urine • Infant unable to concentrate urine for the 1st 3 mos DIGESTIVE SYSTEM • • • • • Hard palate should be intact.Metabolism of “BROWN FAT” • Axillary temperature: 96.may lead to metabolic acidosis and respi distress. • Later pattern is 6-10 voidings/day . • Initial loss of 5-10% of body weight .
9 cm (18-22 in) CHEST CIRCUMFERENCE • 30-33 cm (12-13 inches) • should be equal to or 2-3 cm < head circumference HEAD 25% of the body length.• Average 45.7-55. retractions and • Obtain vital signs • Observe NB for signs of hypothermia or hyperthermia. circumference 33-37cm • Bones of the skull are not fused • Palpable sutures • Fontanels • Molding . • Dry baby and stimulate crying by rubbing. • Position newborn on the side or abdomen or in modified Trendelenburg position to facilitate drainage of mucus. then nares with bulb syringe. • Place newborn in a warmer. NURSING INTERVENTION • Suction mouth.Caput Succedaneum. • Maintain temperature stability. • ACROCYANOSIS • Small amounts of lanugo and vernix caseosa still seen • May develop “NEONATAL RASH • HARLEQUIN SIGN INITIAL CARE OF THE NEWBORN • Observe and assist with initiation of respirations • Assess Apgar score • Note characteristics of cry • Monitor for nasal flaring. • Place newborn at mother’s breast if breastfeeding is planned or place on mother’s abdomen.Cephalohematoma • SKIN • Pigmentation increases after birth • Skin may be dry. grunting. • Ensure proper NB ID • Footprint NB & fingerprint mother on ID sheet/ agency’s policies & procedures • Place matching ID bracelets on mother & NB abnormal respirations . • Keep newborn with mother to facilitate bonding.
2. Pediatric Neuro Disorders Hydrocephalus – accumulation of CSF more than normal volume Types: 1.8 hrs. Air – trendelenburg Mgt: Shunting Spina Bifida – baby born without fusion of backbone Cause: folic acid deficiency Types: 1. Water – head elevation 6 hrs. Oculta – dimple 2. Comunicating 2. • A score of 3-6 is considered moderately depressed. • If the score is less than 7 at 5 mins. • A score of 7-10 indicates a healthy newborn. the Apgar score shld beperform at 10 mins. Non-comunicating Dx Test: Myelogram Dyes: 1. Oil – FOB 6.APGAR SCORING SYSTEM • Perform and record Apgar score at 1 min & at 5 mins. • A score of 0-2 is severely depressed.. Cystica – sac protrusion Meningocoele – sac contains CSF Myeloeningocoele – sac contains CSF and Spinal cord Mgt : Surgery within 24 hrs after birth Crede’s maneouver Reye’s Syndrome – degeneration of aftes in the liver Cause: aspirin toxicity Mani : Decorticate and Decerebrate posture Mgt: Oxygenation (No ore than 4L/min – Retrolental Fibroplasia) Tumor – space occupying lesion Medulloblastoma – fatal type -death within hours to days Mgt: surgery . 3.
Mist tent Suction PRN Chest physiotherapy Bed rest Lie on the affected side Isolation precaution Anti-tussives.child displays respiratory distress despite vigorous treatment . antimicrobial therapy.blood streak sputum NURSING CARE Administer O2.air is trapped behind occluded or narrow airways and hypoxemia can occur STATUS ASTHMATICUS . antipyretics Thoracenthesis ASTHMA Wheezing Dyspnea Chest tightness Exacerbations .RESPIRATORY DISORDERS BRONCHIOLITIS Mani: Rhinorrhea & ⇓ fever Lethargy Poor feeding Irritablity Tachypnea Dyspnea Nasal flaring Wheezing Diminished breath sounds Mgt: Ribavirin (Virazole) PNEUMONIA Types: Viral : Whitish sputum Bacterial: non productive hacking cough Primary Atypical: Non productive – productive.
Recognize early symptoms . and a well-balanced diet .Allergens control . Orchipexy . .may result in respiratory failure & death if untreated HOME CARE MEASURES .Instruct the child in the administration of medications as Rx . • If not descended by age 8-9 mos.If the testes remains in the abdomen.Adequate fluid intake .preformed between ages 1-3 years NURSING CARE • Advise parents of absence of testes and provide nformation about treatment options. . sleep. • Avoid contamination of incision.Avoid extremes of temperature .Adequate rest. .. Post-op • Avoid disturbing the tension mechanism.Avoid exposure to viral respiratory infection .Exercise as tolerated SUDDEN INFANT ‘s DEATH SYNDROME MATERNAL RISK FACTORS Maternal smoking Substance abuse Younger mothers APPEARANCE WHEN FOUND Apneic & blue Frothy blood-tinged fluid in the nose & mouth Typically found in a disheveled bed. damage to the testes (sterility) is possible because of increased body temperature. chorionic gonadotropin can be given. Diaper is wet & full of stool GUT Cryptorchidism • Whether or not to treat is still controversial.surgical procedure to retrieve and secure testes placement .will be in place for about 1 week. with blankets over the head. • Support parents if surgery is to performed.
Increase in amino acid glutamine Monitor gluten free diet Provide supplement fat-soluble vitamins Provide client teaching and discharge planning concerning: a.GIT DISORDERS Celiac’s dse aka Gluten Enteropathy . importance of long term ff-up management. importance of adhering to diet d. Gluten-free diet b. avoidance of infection. c. IMPERFORATED ANUS • Surgery to reconstruct the anus and perform a colon pull-through or sigmoid colostomy with anastomosis and pull-through 1 year later .
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