Foundation of Nursing Practice G&D NOTES PDF

Foundation of Nursing Practice: Grow & Development CHAPTER 1: GROWTH & DEVELOPMENT OVERVIEW KEY TERMS: - Asynchronous growth: not all parts of our body grow at the same rate and time - Cephalocaudal: growth proceeding from head to tail - Development: an increase in complexity and/or...

Foundation of Nursing Practice: Grow & Development CHAPTER 1: GROWTH & DEVELOPMENT OVERVIEW KEY TERMS: - Asynchronous growth: not all parts of our body grow at the same rate and time - Cephalocaudal: growth proceeding from head to tail - Development: an increase in complexity and/or maturation of behavior - Exposure: condition of being subjected to something such as an infectious agent, radiation, or harsh weather conditions, which may cause harm - General-to-Specific Development: the manner of progression in refinement of movement, for example, babies respond with both arms and legs, then progress to just arms, then to one arm, one hand, and ultimately to a pincer grasp (thumb-finger precision) - Growth: the increase in size or number of cells, organs, bodies - Nature: the Growth and Development forces that are genetically inherited - Nurture: the Growth and Development forces that evolve with environmental exposure - Progressive differentiation and autonomy: a description of human progression that is characterized by an increased uniqueness related to the extent of our interaction with one another - Proximodistal: growth proceeding near to far meaning that it proceeds from the midline to the lateral extremities - Sequential growth: progressive and sequential increase in size meaning that growth cannot be reversed or un-done - Simple-to-Complex Development: the manner of progression in complexity of movement, for example, we stand before we walk, and we walk before we run. In language, we proceed from one word to two, to simple phrases, to simple sentences, to compound sentences - Susceptibility: Predisposition to developing a certain disease as a result of genetic and/or environmental factors - Symmetrical growth: appearance that is balanced and aligned proportionately to a central axis GROWTH & DEVELOPMENT THEORY RELATED TO OPTIMAL NURSING CARE Core Difference Between Nursing and Medicine - Nursing focuses on facilitating the patient's holistic response to illness or wellness, addressing the entire person rather than merely treating a disease or condition. - Nurses consider unique bio-psycho-social-cultural-religious aspects, reflecting a comprehensive approach that addresses physical, emotional, and social needs. - The goal is to understand and treat the person’s overall experience of health or illness rather than only focusing on clinical symptoms. Holistic Patient Care - Every individual responds uniquely to health and illness, requiring a personalized care approach. - A nurse’s understanding must encompass: o Biological factors (physical health) o Psychological aspects (mental and emotional health) o Cultural influences (values and beliefs) o Social and religious factors (community and spirituality) - Holistic nursing care is relevant across the lifespan, from infancy to old age. Importance of Growth and Development Theory - Nurses need to understand principles of human Growth and Development, as these principles manifest in behavior. - Assessing developmental stages is crucial to individualizing care, as behavior changes with each stage. - Growth and Development theories guide nurses to better respond to a patient’s needs and behaviors at various life stages. Maslow’s Hierarchy of Needs - Abraham Maslow (1968) identified a hierarchy of basic human needs: o Survival: Basic needs like food, water, and air. o Safety: Protection from harm or environmental threats. o Security: A sense of stability and love. o Self-esteem: Pride in personal achievements. o Self-actualization: Achieving one’s full potential. - These needs provide a framework for understanding how humans prioritize their well-being. Impact of the COVID-19 Pandemic on Human Needs - Survival: The pandemic posed severe physical health threats, with patients often dependent on ventilators and struggling to breathe. - Safety and Security: Psychological effects included fear, anxiety, and stress due to the risk of infection, social isolation, and economic uncertainty. - Social and Emotional Challenges: o Many people feared unknowingly infecting loved ones. o Safety was compromised, and security became fragile with job losses, financial difficulties, and school closures. - Self-Esteem and Self-Actualization: o Isolation disrupted young people’s development, career prospects, and relationship-building. o Middle-aged adults missed opportunities to excel professionally or connect with family.  o Older adults faced isolation, unable to see family and friends, hindering their sense of fulfillment. Role of Nurses During the Pandemic - Nurses managed not only the physical care of COVID-19 patients but also the psychological and emotional impacts on patients and families. - The pandemic highlighted nurses’ resilience, as they faced immense challenges, such as: o Burnout due to long hours and staff shortages. o Risks from inadequate personal protective equipment (PPE). o Emotional toll from high patient mortality rates. Principles of Human Behavior in Nursing - Shared and Purposeful: Human behavior is directional, with actions driven by goals rather than instinctual reflexes. - Irreversibility: Actions cannot be undone, though apologies may mitigate their effects. - Cultural Context: Behavior reflects societal norms and varies by location: o Smoking perceptions have shifted from being widely accepted to largely frowned upon in the U.S. o Adolescent pregnancy, once stigmatized, is now more integrated into societal norms. Progressive Differentiation and Autonomy: - Human behavior becomes more individualistic as experiences and interactions grow. - Understanding others helps us understand ourselves and vice versa. - This concept is crucial in communication, perception, and patient-nurse interactions. Cultural Sensitivity in Nursing - Nurses must be aware that cultural standards influence behaviors and patient expectations. - For example, what is acceptable in one culture may be frowned upon in another, affecting how care is delivered. The Dichotomy of Self and Others - Nurses must balance understanding patients’ perspectives while being self-aware of their biases and reactions. - Effective communication and empathy stem from recognizing this interplay, making cultural competency vital in nursing practice. GROWTH VS. DEVELOPMENT & NATURE VS. NURTURE Growth vs. Development: - Growth and development are different but interdependent. - Growth is often accompanied by developmental maturation, though the sequence can vary. - Growth is genetically influenced (nature), while development, especially psycho- social and cognitive traits, is influenced by external factors (nurture). - Growth and development can occur simultaneously, precede, or follow one another. Nature vs. Nurture: - Growth is largely influenced by genetics (nature), such as height or bone structure. - Nurture (environmental factors) also plays a role in growth, especially through nutrition and rest. - Nurture can influence development through bonding, affection, and environmental exposure. Interdependency of Nature and Nurture: - Nature (genetics) and nurture (environment) are interdependent in growth and development. - Susceptibility to diseases is influenced by both genetics and environmental factors. - Exposure to external factors (e.g., disease, vaccines) affects risk potential. Genetics and Development: - Genetics determines physical traits (e.g., eye color, height, immunity). - Hormones (genetically based) influence emotional and personality tendencies. - Nurture shapes how inherited traits are expressed (e.g., parental care, education, and experiences). Definition of Growth: - Growth is an increase in size or number, such as height, weight, organ size, or cellular multiplication. - Growth occurs in a cephalocaudal (head to toe) and proximodistal (near to far) direction. - Growth is symmetrical (e.g., balanced body appearance) and sequential (cannot be undone, though it can be stunted). - Growth is asynchronous—different body parts grow at different rates and times. Definition of Development: - Development is an increase in complexity and maturation (e.g., cognitive abilities, organ functions, motor skills). - Development proceeds from general-to-specific (e.g., gross to fine motor skills). - It follows a simple-to-complex format (e.g., standing before walking, one-word speech to full sentences). Nurses' Role: - Nurses contribute to growth through monitoring, nutrition, and rest. - They also contribute to development through nurturing, providing exposure, opportunities, stimulation, and guidance. - Understanding developmental theories helps nurses tailor care to individuals at different stages of growth and development. DEVELOPMENTAL THEORISTS Erik Erikson: Psychosocial Theory - Influence of Freud: Erikson’s stages draw from Freud’s psychosexual theory but emphasize psychosocial development rather than sexual aspects. - Stages of Crisis: Erikson posits that each stage of life presents a crisis that must be resolved for healthy development. - Examples include: Infants must achieve trust through care. Toddlers must gain autonomy (e.g., body control). Preschoolers strive for initiative, often through imitating parents, much like Freud's Oedipal complex. - Pandemic Impact: COVID-19 has affected individuals' ability to resolve these developmental crises, which will be elaborated in subsequent discussions. Jean Piaget: Cognitive Development Theory Stages of Cognitive Development: 1. Sensorimotor (birth to 2 years): Infants learn through senses and reflexes. Substages include learning through trial and error, developing object permanence (realizing things exist even when not seen). 2. Preoperational (2 to 7 years): Problem-solving begins to rely on memory and language rather than just physical manipulation. Children tend to focus on one aspect of a situation at a time. 3. Concrete Operations (7 to 11 years): Children develop skills like reversibility (understanding that subtraction is the reverse of addition) and conservation (e.g., realizing the same amount of water can be in different shaped containers). 4. Formal Operations (12+ years): Adolescents develop the ability to think abstractly, hypothesize, and understand consequences. - Crystallized Intelligence: As adults age, their wisdom and structured thinking increase. Lawrence Kohlberg: Moral Development Theory Stages of Morality: 1. Amoral: Infants and some adults act without considering morality, driven by self-interest.  2. Preconventional: Morality is motivated by avoiding punishment and seeking rewards. Children behave based on the presence or absence of authority. 3. Conventional: The individual follows societal rules and seeks approval from others, as seen in school-age children's adherence to rules. 4. Postconventional: Moral reasoning is guided by universal ethical principles, like justice and human dignity. - Gender Considerations: Carol Gilligan critiqued Kohlberg's theory for its male bias, introducing an "ethics of care" perspective more associated with women's moral reasoning. - Pandemic Impact: The COVID-19 pandemic challenged moral reasoning, with varying responses to public health measures like mask-wearing and vaccines indicating differences in moral development stages. THEORIES OF SPIRITUAL DEVELOPMENT James Fowler’s Theory of Spiritual Development: - Fowler's theory is a valuable framework for nurses to assess the spiritual aspects of their patients’ lives. His seven stages of faith development, which align with Erikson,  Piaget, and Kohlberg’s developmental theories, describe spirituality as a significant and evolving aspect of human existence. - Fowler emphasizes that faith is not tied to a specific religion but is a way of understanding oneself in the universe and finding deeper meaning in life. John Westerhoff’s Four Stages of Faith: - Westerhoff's theory also provides a useful approach to understanding spiritual development. He suggests that faith originates from family and society during childhood, becomes internalized in adulthood, and shapes personal actions. - For individuals facing illness, their faith in a higher power, in themselves, or in the healthcare team can provide strength and trust. CHAPTER 2: PREGNANCY & FIRST YEAR OF LIFE KEY WORDS: - Anticipatory guidance: health promotion strategies that inform parents and caregivers about expected normals for growth and developmental milestones - Apgar: a health rating system that evaluates the health status of newborns at one minute and five minutes of life - Bonding: an infant’s obvious demonstration of comfort and relaxation upon hearing the mother’s or father’s voice or feeling his/her touch - Developmental milestones: specific behavioral achievements that indicate progression of abilities, for example, rolling over, sitting up, crawling, standing, walking - Myelination: the maturation of specialized nerve cells (neurons) in which a layer of myelin form around axons that allow nerve cells to transmit electric signals between them more quickly - Object permanence: cognitive ability to know that objects exist even though they may not be visibly apparent - Stimulation: exposure to sensory and environmental factors that facilitates cognitive processing - Swaddling: snugly wrapping of infants in a blanket - Weaning: gradual withdrawal from usual practice; during infancy this is the term used for helping infants to withdraw from the breast or bottle and to learn to receive hydration from a cup PRE-NATAL CONSIDERATIONS Preconception Health: - Growth and development begin before conception. - Parents should be in optimal health before considering pregnancy. - This includes proper nutrition, avoiding drugs (prescription, OTC, recreational), tobacco, and moderating alcohol intake. Early Pregnancy: - The first trimester is critical for cell division and development, often occurring before parents know they’ve conceived. - Factors that can affect fetal health include blunt force trauma, chemical exposure (e.g., radiation, pesticides), medications, alcohol, and certain diseases. Risks to Fetal Health: - Exposure to communicable diseases (e.g., rubella, varicella), sexually transmitted infections (e.g., gonorrhea, syphilis, HIV), and chronic diseases (e.g., diabetes, heart disease). - Blood type incompatibility (Rh factor) can be treated with early prenatal care. Impact of Unplanned Pregnancies: - Unplanned pregnancies can result in physical and emotional harm to infants and young children (e.g., failure to thrive, increased risk of abuse). - Contraception is key to preventing unwanted pregnancies; lack of contraception can lead to high-risk pregnancies. Role of Contraception: - Historically, women have borne the responsibility for contraception, but men are now being encouraged to take a more active role. - The reversal of Roe vs. Wade (June 2022) led to increased demand for vasectomies and varying state regulations on abortion. Teenage Pregnancies: - Teenage pregnancies are often unplanned, with adolescent mothers facing health issues due to poor nutrition, lack of sleep, and risky behaviors (e.g., tobacco, alcohol, drug use). - These pregnancies are considered high-risk, with increased chances of pregnancy- induced hypertension, premature births, and low birth weight babies. Healthcare and Advocacy: - Nurses play a crucial role in advancing reproductive health and advocating for patients in a changing legal and healthcare landscape INFANCY: BIRTH TO ONE YEAR OF AGE Assessments: Apgar Assessment - Evaluates color, heart rate, reflex irritability, muscle tone, and lung function. - Scores range from 0 to 2 in each category, with a total score of 0-10. - Conducted at 1 and 5 minutes after birth. Newborn Screening: - Blood sample taken from heel to screen for disorders (e.g., phenylketonuria, congenital heart defects).  - Early diagnosis can prevent cognitive delays. - Hearing Assessment: Essential for bonding and learning; checked shortly after birth. - Visual Assessment: Eyes checked for infection; visual acuity develops by age 6 & First eye exam recommended at 6 months, then at ages 3 and 5/6. - Sucking Assessment: Necessary for nutrient intake; weak reflex may require special feeding methods & Non-nutritive sucking (e.g., pacifiers) is comforting and may reduce SIDS risk. - Bonding Assessment: Observes infant's responsiveness to caregivers, important for development. - Growth Monitoring: Average newborn weight: 7-9 pounds; length: 18-22 inches, Low birth weight (