PEDIATRIC, GERIATRIC, &

CULTURAL ADAPTATIONS

GALANG, JAMES LORD CABALDE

HEALTH ASSESSMENT
 NURSING PRELIMS
REVIEWER | FIRST SEMESTER HEALTH ASSESSMENT

PEDIATRIC ADAPTATIONS KOHLBERG – MORALITY STAGE

(Preconventional Level)
GROWTH
• punishment as a reward
• refers to an increase in body size and
function to the point of optimum maturity. PRESCHOOL (3 to 6 years)
DEVELOPMENT PIAGET – PREOPERATIONAL CONTINUES
• refers to patterned and predictable FREUD – PHALLIC
increases in physical, cognitive,
• attracted to opposite sex parent
socioemotional, and moral capacities of
individuals. ERIKSON – INITIATIVE VS GUILT
DEVELOPMENTAL THEORIES • direction, purpose, and conscience
• Piaget’s Theory of Cognitive Development KOHLBERG – INDIVIDUALISM, INSTRUMENTAL
• Freud’s Psychoanalytic Theory of PURPOSE, EXCHANGE STAGE
Personality Development (Preconventional Level)
• Erik Erikson’s Epigenetic Theory of
Personality • right is relative, follow rules
• Kohlberg’s Theory of Moral Development SCHOOL AGE (6 to 12 years)
INFANCY (Birth to 1 year) PIAGET – PREOPERATIONAL CONTINUES;
PIAGET – SENSORIMOTOR (birth to 2 years) CONCRETE OPERATIONS (7 to 12 years)

• begins to acquire language; object • engage in inductive reasoning and

permanence concrete problem solving

FREUD – ORAL FREUD – LATENCY

• pleasure from exploration with mouth • identification with same-sex parent

through sucking ERIKSON – INDUSTRY VS INFERIORITY
ERIKSON – TRUST VS MISTRUST • competence
• hope KOHLBERG – MUTUAL EXPECTATIONS,
TODDLER (1 to 3 years) RELATIONSHIPS, & CONFORMITY TO MORAL
NORM STAGE (Conventional Level)
PIAGET – SENSORIMOTOR CONTINUES;
PREOPERATIONAL (2 to 7 years) • need to be “good”

• begins to use representational ADOLESCENCE (12 to 18 years)

thought PIAGET – FORMAL OPERATIONS (12 years to
FREUD – ANAL adulthood)

• control of elimination • engage in abstract reasoning and

analytical problem solving
ERIKSON – AUTONOMY VS SHAME & DOUBT
FREUD – GENITAL
• self-control and will power
• develop sexual relationships

BACHELOR
ST
OF SCIENCE IN NURSING 1
1 YEAR COLLEGE
 NURSING PRELIMS
REVIEWER | FIRST SEMESTER HEALTH ASSESSMENT

ERIKSON – IDENTITY VS ROLE CONFUSION

• fidelity & devotion to others, personal
and sociocultural values
KOHLBERG – SOCIAL SYSTEM AND
CONSCIENCE STAGE (Conventional Level)
• uphold laws
YOUNG ADULT (18 to 30 years)
PIAGET – FORMAL OPERATION CONTINUES
ERIKSON – INTIMACY VS ISOLATION
• intimate affiliation and love
KOHLBERG – SOCIAL CONTRACT OR UTILITY
AND INDIVIDUAL RIGHTS STAGE
(Preconventional Level)
• utilitarianism; protect universal rights
EARLY MIDDLE AGE (30 to 50)
ERIKSON – GENERATIVITY VS STAGNATION
(30 to 65 years)
• productivity, perseverance, charity, &
considerations
KOHLBERG – SOCIAL CONTRACT OR UTILITY
AND INDIVIDUAL RIGHTS STAGE
(Postconventional Level) CONTINUES
LATE MIDDLE AGE (50 to 70 years)
ERIKSON – GENERATIVITY VS STAGNATION
CONTINUES
KOHLBERG – UNIVERSAL ETHICAL PRINCIPLES
STAGE (Postconventional Level)
• support universal moral principles
regardless of the price for doing so.
LATE ADULT (70 years to death)
ERIKSON – EGO INTEGRITY DESPAIR (65 years
to death)
• wisdom

BACHELOR
ST
OF SCIENCE IN NURSING 2
1 YEAR COLLEGE
 NURSING PRELIMS
REVIEWER | FIRST SEMESTER HEALTH ASSESSMENT

PRESCHOOL (3 to 6 years)
Position: parent should be present
3 y/o – may hold on to lap
4 to 5 y/o – Big Girl/Boy examination table
Preparation:
1. Short, simple explanations
2. Explain exactly the procedure
3. Guide feedback (“Your tummy feels just
fine.”)
Examine the thorax, abdomen, extremities,
and genitalia first.
Head, eye, ear, and throat last.

DEVELOPMENTAL CONSIDERATIONS WHEN SCHOOL AGE CHILD (6 to 12 years)

PERFORMING PHYSICAL ASSESSMENT
Position: sitting on examination table
INFANT (Birth to 1 year)
Preparation:
Position: flat on padded examination table
1. Divert child’s attention with small talk
Preparation: 2. Let do undressing; provide gown/drape
3. Demonstrate equipment
1. Time – 1 to 2 hours after feeding
2. Warm environment Head to toe (Cephalocaudal) approach
3. Lock eyes from time to time
AGING ADULT (13 years to death)
4. Smile; take time to play
5. Pacifier for crying or during invasive Position: sitting on examination table
procedure
Preparation:
Sleeping baby – auscultate heart, lungs &
abdomen first 1. Arrange positioning to allow few
positions changes
Perform least distressing steps 2. Adjust examination pace
3. Use physical touch
TODDLER (1 to 3 years)
4. Be aware of life stresses (e.g., Loss of
Position: sitting up on the parent’s lap for all the loved ones)
examination
Head to toe (Cephalocaudal) approach
Preparation:
1. Security object (eg. Teddy bear)
PADAYON NURSING!!!
2. Do not offer a choice when there really
is NONE. However, give choices when
possible.
3. Begin with “games”

BACHELOR
ST
OF SCIENCE IN NURSING 3
1 YEAR COLLEGE
 NURSING PRELIMS
REVIEWER | FIRST SEMESTER HEALTH ASSESSMENT

BACHELOR
ST
OF SCIENCE IN NURSING 4
1 YEAR COLLEGE