PEDIATRICS

Weight grams

STAGES OF DEVELOPMENT 2.5 to 3.5 kilogram

INFANT ● Age: 1st month to 12 months >3,500 grams =

Note: LGA (Large for
● Sigmund Freud (Psych): 18 Gestational Age)
months /Macrosomia
(Gestational
● Neonate: Delivery to 28 days
diabetes)

Key Concept (observable traits): <2,500 grams =

● Fastest Growth Pattern of SGA (small for
the Child gestational age)/
○ it is normal that they Microsomia
tend to outgrow their
Birth Height Appropriate
shirt in a very
Position: Supine
increase phasing (for accuracy)
● Fastest Development
Tape Measure
How to Determine Growth Pattern: (in/cm): use
● Changes: Size (Height, centimeter unit -
more specific
Weight, Head and Chest
Circumference), it is 45 to 55 cm
measurable (normal)
○ Weight Gain
○ Height Spurt Head 33 to 35 cm
● Other Name: Quantitative
Changes (of the child- due Chest 31 to 33 cm
to its measurable measure)
● Parameter: 2 parameters Nursing Responsibility:
○ (H & W) ● Routinely measure the
○ Weight (more Height and Weight of the
important Child
parameter)- most
salient & sensitive How to Determine Fastest
○ Height: Linear Development (Process of
(Vertical) Growth Maturation)
Note:
● Heavier at birth is Baby Changes: Skills
Boy ● Sit
● Lengthier at birth is still ● Stand
the baby boy ● Walk
○ Mom’s abdomen is ● Language
heavier and larger Other Name: Qualitative Changes
abdominal size (cbq)
● Measurable (still)
○ can be observed
Birth 2,500 to 3500
● Assessment Tool
 ○ It depends on the
race Old Lift Head and Chest-
○ DDST (Denver Prevent the SIDS
Developmental (Sudden Infant Death
Syndrome)
Screening Test)-
Foreign Child 5 Roll Over (Rolling of
○ MMDST (Metro months the infant from prone to
Manila Old supine)
Developmental ● High Risk for
Screening Test)- Fall
● Implement
For Filipino Child
Safety
Parameter:
● Gross Motor Skills 6 Sounds like“Six”
○ Sitting months
○ Walking Old Sit with support: Chair
○ Standing should have back
● Fine Motor Skills support
○ Hands Development 7 Bouncing
● Language Development months ● Putting or
● Social Development Old bouncing of the
○ NCMH: 1st born are foot to the
prone to Autism mouth
○ 1nd Child: Prone to ● This is
beneficial - na
Schizophrenia
strengthening
of the leg
Based on MMDST (Metro Manila muscle
Developmental Screening Test) ● Preparation for
standing
Gross Motor Skills
8 Sit without support
Pattern: months ● Infant can sit
● CephaloCaudal old alone
Development (Head to ● Body of the
Toe) child is balance
● Infant can sit in
0 to 1 Head Lag: Unstable a chair without
Month Neck - Support the support
head and Neck of the
baby 9 Crawling
months
2 Lift Head: Capability to old
months lift their part (1st part to
lift is head) 10 Standing with Support
months ● By holding in
(+) Head Lag Persist: Old the furniture
Suspect for ● Lift their body
Hydrocephalus vertically

4 Prone Position: 11 Cruising

months months ● Child will try to
 old walk with 1-3 Hands: Close Fist
mother holding months
both of their Old Arm: Noticeable
hands Arm Movement

5 Hands:
Vs. months ● Hands
old Closes and
opens
● ● Hold Objects
(Rattle )
12 12 may 2 (2 Note: Benefits of
months development) Rattle - enhances,
stimulate and develop
Stand without sense of seeing and
Support hearing

Walk with support: 7 Hands:

● Mother is not or months ● Crude
seldomly hold Old Pincer
child’s hand Grasp (ability
while they try to to transfer
walk and grasp
● They walk by object to the
stepping other hands)
forward
9 Neat Pincer Grasp
15 Walk without Support: months ● They have
months ● They can walk old the ability to
old alone grasp things
with with their
18 Jumping thumb and
months index finger
Old ● They are in
Oral phase -
3 years Running and eat it
old ● Risk for
Biking aspiration,
● But Three poisoning
Wheels
(Tribike) 12 Can draw Circles
months
Ball Throwing
Fine Motor Skills
3 years Draw Circle
Pattern: Proximo-Distal (Near to Old
Far)
● Note: Odd Numbers 6 years Draw all Objects
Old
Based on MMDST (Metro Manila
Developmental Screening Test)

Language Development
First Language of the Child:
7 Crying (mmmmmm
● Cry
months cry)
○ Indicates several
old ● Close mouth
various thing such
as pain,
Break in the sound language
discomfort, hunger
○ It is important to 9 2 words
determine the months ● Mama/mami -
kind of Cry old first word
First Word = Mama (from
mmmmm
Loud Dry, Normal Cry sound)
Vigorous, ● DaDa/dadi
small Cry
12 4 vocanu;aty words
High Abnormal Cry months ● Mama
Pitched Cry Old ● Dada
Increased ● Additional 2
Intracranial new words
Pressure
2 years 50 vocabulary words
No.1 cause of old
increase ICP = Delay language and
Hydrocephalus social development =
exposure to gadget
Based on MMDST (Metro Manila 3 years 100 vocabulary word
Developmental Screening Test) old

4 years 200 to 300 words

1 to 2 Cry old
months ● Open Mouth - Curious
Old produces ● Always ask
Loud Cry why
(normal cry)

3 Cooing Sounds Toddler

months ● Coo-coo ● Age: 1 year old to 3 years old
Old

4 Vowel Sounds Key Concept (observable traits):

months ● Aaaaa ● R: Ritualistic
Old ● Eeeee ○ Repetitive and
● Iiiiii Habitual
● Oooo ○ Have Favorite Toy
● uuuuu and Pillow =
Security Objects
5 Consonant Sounds ○ Temper Tantrums -
months ● Gaa common in toddler
old ● Baa (Language is not yet
● Daaaaa well developed)- so
● maaaa he act out his
frustration
Management for Temper ● Bladder
Tantrums: ○ 2nd to develop
○ Daytime control
○ Last to control =
● (1st) Head Banging: night time
Implement Safety bladder control
○ Helmet/Pillow - to
protect the head of
the baby Infant Oral Stage
● (2nd) Ignore the Child ● Breastfeeding

Toddler Anal Stage

● E: EgoCentric
● Pooping
○ Self - centered
● Toilet
child -
Training
selfish/possessive
should start
○ This is mine/they
have their own toys
= parallel play DECIDUOUS TEETH
● N: Negativism Other Name:
○ Always says “no” ● Milk teeth/temporary teeth
○ Child sees himself Complete Set:
separate from their ● Adult (permanent teeth):
caregiver 32 teeth
● Child (Temporary): 20
teeth
Management for Negativism
○ 10 up
○ 10 down
Provide Choices:
● Allows Autonomy for the
child Crooked Teeth

● Sunki
● T: Toilet Training
● Cause: small jaw, lack
○ According to
spaces for tooth growth
Sigmund Freud:
Anal must be
gratified
First 6 months old
○ 18 months:
Eruption ● Reason why
Maturation of
we can
sphincter
supplement
solid food
● T: Toothbrushing
○ Ritualiti phases: very
Lower Central
good time to
Incisors (pair)
introduce
toothbrushing
Teething Discomfort:
○ 30 months/2.5
Fever
years old- child has
● TSB (Tepid
complete milkteeth
sponge bath)
● Paracetamol q
Development of Sphincter 4 hours
Teething Discomfort:
● Anal Stage (Bowel) Pain
○ 1st to develop ● Teether - cold
 ○ Fear of Mutilation
(vasoconstrict)
○ Imaginary Friend
Teething Discomfort:
● I: Imitative
Diarrhea
○ Role playing (of
● Continue
roles of the parents)
Breastfeedin
● S: Shared Playing
g: priority cbq
○ Cooperative
● Increase oral
○ A.k.a Associative
fluid: if no
play
breast feeding
● Y: Why?
○ Always curious
Second 7 months old
○ They ask 200 to
eruption
300 why questions
Upper central incisor
everyday (according
(pair)
to pillitteri)
Third 9 months
Phallic Stage
Eruption
● “phallus”: Penis
Upper Lateral
● Penis is the side of
Incisors (pair)
gratification
30 months/2.5 years old - ● Infantile Masturbation:
complete set of milk teeth ○ Purpose:
exploration of the
● Dental Check up should body (normal)
start ○ Management:
● Tooth Brushing should be Teach him to
implemented mastubate in a
● For negativism child: private place; Divert
Provide fruits PEARS the attention
(new book); APPLE (old) ● Castration Fear
○ Problem:
Start to 6 to 7 years old Exhibitionism
Loosen: ● 6 years old= ● Female: They don't have
1st option penis and cant do infantile
masturbation
Bad: 8 years old milk ○ Penis Envy
teeth is still present:
● Teeth School Age:
malocclusion Age ● 7 to 12 years old
● Crooked ○ 6+ years old (6
teeth years old and 1
Breastfeeding is still month)- School
preferable: prevent Age
less dental cavities ● Exact 6 years old =
preschooler

Pre Age:
schooler ● 4 to 6 years old
○ 3+ years old (3 Psychosocial Development:
years old and 1 Sigmund Freud
month)-
Preschooler School Age:
● Exact 3 years old = toddler ● Gratification
Common Key Concept: (MISY)
● M: Magical Thinker Latency Period: Rest Period
 ○ Monitor Blood Sugar of the
● Decrease Growth pattern Newborn - Hypoglycemia
and slow development (from abrupt lowering of the
sugar in the blood due to the
Common Key Concept: (WAT) sudden withdrawal of newborn
● W: Winner or Loser to the mother’s sugar rich
○ Competitive play environment)
● A: Afraid
○ Hypoglycemia is Fatal in
○
● T: The significant Newborn
Person/Teacher ■ Sugar: Source of Heat
○ Idols ■ Low sugar:
Hypothermia
Adolesce Age: ○ Hypoglycemia=Hypothermia
nt ● 13 to 18 years old ● Site for Blood Sugar Monitoring
○ 12+ years old (12
○ Heel of Newborn (Corner)-less
years old and 1
month)- painful
Adolescence ● Newborn Blood Sugar Level
● Exact 12 years old = ○ 40 to 60 mg/dL
School Age ● Nursing Intervention (Hypoglycemia):
● Sigmund Freud: ○ Instruct Mother to Breastfeed
○ Extended till 21 the Newborn (conscious)
years old
Key Concept (PBA): ○ D50 (IV) for Unconscious
● P: Puberty
○ After Latent State
there will be a surge Microsomia
of growth ● Number one Factor:
○ Puberty: surge of ○ Smokin - it constrict the vessels
secondary sex
(vasoconstriction) thus restrict
development
○ Thelarche (budding the nutrients that are being
of boobs), delivered to the baby
Menarche ● How to determine the Umbilical Cord
(menses); (AVA) intactness:
Adrenarche (pubic ○ Cross sectional-
hair) ○ Large Diameter- 1 Vein
○ All influenced by
■ Larger because it is
ESTROGEN
● B the carrier of Oxygen
● A and fetal nutrients
○ Small Diameter - 2 arteries
Gestational Diabetes (LGA/Macrosomia)
● Transient organ that lead to Diabetes: Infant Oral Stage
Placenta ● Breastfeeding
● Mother only provides the need
○ It has the capability to produce
● Consistent: Trust
hormones. In this case Human
Placental Lactogen Problem: Oral Fixation (cause: not
(Antagonist of Insulin)- causes provided in infants)
Hyperglycemia ● Smoking
● Priority Intervention (CBQ) ● Alcoholism
● Thumb sucking
Toddler Anal Stage Asthma
● Pooping
● Toilet Training should start Toddler Parallel Play:
● Principle: Same similar toy
Toilet Training: as their other paymate
● Presence of Mother is ● For Physical
needed Development:
● Rigid Mother: Guilt Feeling ○ Ball. Push and pull
development toy, Tri-bike:
○ OCD development walking
● Lax Mother: Low Guilt ○ walkie=talkie =
Feeling language
○ Antisocial development
Personality
Pre- Cooperative Play aka associative
Pre-school Phallic Stage school play
● “phallus”: Penis er ● Role playing
● Penis is the side of ○ Cooking Set
gratification ○ Housing Play
● Infantile Masturbation: ○ Clay
○ Purpose: ○ Coloring book
exploration of the ○ Lego/Blocks: Not
body (normal) for children with
○ Management: cast! - she will
Teach him to insert the lego
mastubate in a (compartment
private place; syndrome)
Divert the
attention School Latent/rest period
● Castration Fear Age Competitive Play
○ Problem: ● Ball games (indoor)
Exhibitionism ● Bowl games
● Female: They don't have ● Traditional games
penis and cant do infantile
masturbation Adoles Competitive Play:
○ Penis Envy cence ● Outdoor Ball Games
○ Baseball
○ Basketball
○ Volleyball
Play And Toy of the Child

Solitary Definition: They want to play alone

Play Toy: should develop sensory Fear
development
● Seeing = colorful Infant Stranger Anxiety
● Hearing: Rattle ● Onset: 6 to 7 months
Best Toy: old
● Rattle ● Peak: 8 months
● Musical mobile: the things ● End: 9 months
hanged in the crib
● Squeeze toy with sound Toddler Separation Anxiety:
● Soft stuff toys-
○ without button - to Stages
avoid aspiration ● Protest: They cry so
○ Not for child with intensely
 ● Despair: they dont Adolescence Peers
cry; socially isolated; ● Related to peer
withdrawn; quite pressure
● Denial: they ignore
the primary caregiver;
dedma

● DABDA
○ Denial
○ Anger
○ Bargaining
○ Depression
○ Acceptance

Pre- Magical Thinking:

schooler ● Fear of Mutilation
● Fear of Castration
● Fear of Ghost
● Fear of Dark (they
prefer sleeping with
lights on)

School Fear of Death (cbq)

Age
Concept of Death
● 1 to 6 years old:
sleeping
● 7 to 9 years old:
Punishment from
Boogeyman
(kamatayan)
● 10 and Above years
old: Death is
irreversible; end of
life

Significant other

Infant Mother/Caregiver

Toddler Mother and Father

(Parents)

Pre- Mother, Father, and

schooler Siblings (Family)

Related to Role Playing

(Bahay bahay)

School Teacher
Age ● We loved to be
recognized by our
teachers