Growth and Development PDF

Growth and Development Ch 7 196-236 Immediate Adjustment -​ Respiratory System : -​ Primary thermal stimulus is sudden chilling of infant -> excites sensory impulse in skin to respiratory center -​ Circulatory system: -​ Fetal circulation to postnatal circulat...

Growth and Development Ch 7 196-236 Immediate Adjustment -​ Respiratory System : -​ Primary thermal stimulus is sudden chilling of infant -> excites sensory impulse in skin to respiratory center -​ Circulatory system: -​ Fetal circulation to postnatal circulation involves closure of fetal shunts-> foramen ovale, ductus arteriosus, and then ductus venous -​ Thermoregularion -​ Large body surface area compensated by flexion position to decrease exposed skin -​ Thin subcutaneous fat causes loss of body heat -​ Core temp is about one degree farehenit hotter than surface body temp -​ Cannot shiver so neonate produce heat through nonshivering thermogenesis (NST) -​ Hematpoietic System -​ Blood volume depends on amount of blood transferred via placenta BEFORE cord clamp -​ At birth blood volume is about 80-85 ml/kg of body weight -​ Fluid and electrolyte balance -​ Weight is 73% fluid at birth -​ MORE extracellular fluid and LESS intracellular dluif -​ Infant rate of metabolism is TWICE of adult -> results in more acid formation-> leading to more acidemia -​ Immature kidneys cannot concentrate urine to CONSERVE body water-> more prone to dehydration, acidosis, or overhydration -​ GI -​ Liver most immature of GI -​ Liver stores less glycogen at birth than later in lige-> prone to hypoglycemia -> may be prevented by early and effectie feeding -​ Majority salivary glands dont secrete saliva until 2-3 months age -> when drooling is common -​ meconium-> infant first stool, within first day -​ Transitional stool-> appear by third day after feeding; greenish brown to yellow broen -​ Milk stools-> appear by fourth day -​ Renal system -​ Kidneys are not fully available to concentrate the urine-> more prone to dehydration -​ Bladder volume is only 15 ml-> about 20 voids per day -​ Defenses against infection -​ Formation of specific antibodies to an antigen -> requires exposure to various antigens to form antibody  -​ Receive immunoglobulin G (IgG ) from maternal circulation and human milk -​ Protected from diphtheria, measles, polio, and rubella for about 3 months -​ Sensory Functions -​ Vision: -​ Tear glands not functional until 2-4 weeks -​ Eye structurally incomplete -​ Hearing -​ Infants younger than 3 days can tell mom voice from other females -​ 5 days, infancy can tell between stories from mother during last trimester of pregnancies rather than from a different woman -​ Internal and middle ear large at birth -​ Taste -​ tasteless= no expression; sweet= eager suck and look of satisfaction; sour= puckered lips; bitter= angry look Assessment -​ Four phases of assessment -​ Initial assessment= apgar -​ Transitional assessment= during period of reactivity -​ GA assessment -​ Physical examination -​ APGAR -​ Based on Heart rate, Respiratory effort, Muscle tone, Reflex irritability, and Color -​ Have Rachel Move Robs Car -​ Each one given a score of 0,1,2 -​ Total scores: -​ 0-3= severe distress -​ 4-6= moderate difficulty -​ 7-10- absence of difficulty -​ -​ Transitional Assessment -​ First 30 min-> infant crying loud and is interested in environment; eyes open; resp rate as high as 80/min and heart rate as high as 180 -​ After initial stage-> second stage lasts 2-4 hours-> HR and RR decreases, temp falls, infant is in state of SLEEP and calmness -​ Patterns of sleep and activity  -​ Deep sleep= closed eyes, regular breathing, no movement, no eye movement -​ Light sleep= closed eyes, irregular breathing, slight twitch, rapid eye movement, may smile -​ drowsy= eyes wide open and breight, respond to environment, minimum body activity -​ Active alert = may begin whimpering and slight body mvoemebt, eye open -​ GA Assessment -​ Posture, square window, arm recoid, popliteal angle, scarf sign, heel to ear -​ Please Show Will And Pop Some Heelies -​ Physical Assessment -​ Head circumference= 33-35 cm CHEST 2 cm smaller -​ Birth weight= 2700- 4000g -​ Sutures-> coronal suture CROWNS head and sagittal suture SEPARATES head Body Temperature -​ Evaporation -​ Loss of heat through moisture -​ Amniotic fluid that bathes infant skin factors evaporation -​ Rapidly dry baby with warm towel and place skin to skin to avoid evaposation -​ Radiation -​ Loss of heat to cooler solid objects in environment not in direct contact with infant -​ Place crib far from exterior walls, windows or units -​ Conduction -​ Loss of body heat from direct skin contact with cooler solid object -​ Place baby on padded covered surface while providing insulation with clothes and blankets -​ Convection -​ Heat loss aided by surrounding currents -​ Example is placing baby in direct flow of air from fan Vitamin K Administration -​ Major fucntion is to catalyze synthesis of prothrombin in liver -​ Prothrombin is needed for blood CLOTTING Ch 10 338-372 Promoting Growth and Development Proportional Changes -​ Infants gain 5-7 oz weekly until about 5-6 months old which is when weight has doubled -​ By 1 year, birth weight has TRIPLED -​ Height increased by 1 inch per month during first 6 months and slows during second 6 months -​ By 1 year, height increased by almost 50% Locomotion Development -​ 7 months= infant bears full weight on feet -​ 8 months= infant can maneuver from sitting to kneeling position -​ 8-9 months= infant can stand holding onto furniture -​ 9-10 months= while standing, infant takes deliberate step -​ 9-10 months= infant crawls with abdomen on floor and pulls self forward and then creeps on hands and knees Sensory Changes -​ Bionuclar fixation is established -​ It is the fixation of two ocular images into one cerebral image begins to develop at 6 WEEKS of age and should be established by FOUR months -​ Depth perception= starts to develops at 7-98 months but NOT fully developed until 2-3 years old Major Developmental Characteristics of Vision -​ Birth -​ Visual acuity= 20/100-20/400 -​ Pupillary and corneal blink reflexes present -​ Able to fixate on moving object in range of 45 degrees when held 20-25 cm away -​ Cannot integrate head and eye movements well -​ 4 weeks -​ Can follow in range of 90 degrees -​ Can watch parent intently as he or she speaks -​ Tear glands begin to function -​ Visual acuity hyperoptic because of less spheric eyeball than in adult -​ 6-12 weeks -​ Has peripheral vision to 180 degrees -​ Has binocular vision startign at 6 weeks , established by 4 months -​ Disappearance of dolls eyes reflex -​ 12-20 weeks -​ Able to fixate on 0.5 inch block -​ Looks at hands while sitting or lying on back -​ Able to accommodate near objects -​ 20-28 weeks -​ Adjusts posture to see object -​ Able to rescue dropped toy  -​ Develops color preference for yellow and red -​ Preferes more complex visual stimuli -​ Develops hand eye coordination -​ 28-44 weeks -​ Can fixate on very small objects -​ Depth perception beginning to develop -​ 44-52 weeks -​ Visual acuity 20/40- 20/60 -​ Visual loss developing -​ Can follow rapidly moving objects Major Characteristics of Hearing -​ Birth -​ Responds to loud noise are startle, moro reflex -​ Responds to sound of human voice -​ 8-12 weeks -​ Turns head to side when sound is made at level of ear -​ 12-16 weeks -​ Locates sound by turning head to side and then looking up or down -​ 24-32 weeks -​ Locates sounds by turning head in a curving arc -​ Responds to own name -​ 32-40 -​ Localizes sounds by turning head diagonally and directly toward sound -​ 40-52 weeks -​ Knows several words and their meaning such as no Fine Motor Development -​ Includes behavior of use of hands and fingers in the prehension (grasp) of objects -​ Grasping occurs during first 2-3 months as reflex and gradually becomes voluntary -​ 1 month-> hands are predominantly closed -​ 3 months-> mostly open; desire to grasp objects but they grasp more with eyes than hands-> will hold onto rattle if placed in hands -​ 4 months-> infants regard both a small pellet and hands and then look from object to hands and back again -​ 5 months-> infants are able to voluntarily grasp objects -​ 6 months-> infants have increased manipulative skills; hold bottles, grapes their feet, and pull them to the mouths and feed themselves -​ 7 months-> transfer studd from one hand to another, hold cube in each hand ang bang objects -​ 10 months-> infanct can let go of object and give to someone -​ 11 months-> put objects in a container and like to remove them -​ GRAFUALLY -​ Palmar grapes is replaced with PINCER grasp (using thumb and index finger) -​ By 8-9 months-> infant uses crude pincer grasp and by -​ 10 months grasp is established  -​ 11 months-> neat pincer grasp Head Control -​ 1 month-> complete head lag; momentarily lifts head -​ 2 month-> partial head lag -​ 3 months old-> can hold head well beyond body place -​ 4 months-> can lift heads and front portion of chats about 90 degrees above table and on forearms; only slight head lag is evident when infant pulled from lying to sitting position -​ 4-6 month old-> head control weel established Rolling over -​ 5 month-> from abdomen to back -​ 6 month-> back to abdomen Sitting -​ 1 month-> Back is completely rounded; infant cannot sit upright -​ 2 month-> infant has more control, back still rounded but can try to pull up with some head control -​ 4 months-> back is rounded only in lumbar area, infant is able to sit erect with good head control -​ 7 months-> infant can sit alone leaning on hands for support; transferring objects -​ 8 months-> can sit without support Psychosocial Development Development of body image- -​ 9 month old-> looking at self in mirror -​ 6 months-> preference for primary caregiver -​ 4-8 months-> first stage of separaction anxiety -​ 6-8 months-> stranger danger develops Vocalization -​ 5-6 weeks-> small throaty sounds -​ 2 months-> single vowel sounds -​ 3-4 months-> constants are added and coo gurgle and laugh -​ 9-10 months-> comprehend meaning of no and obey simple commands -​ 1 year-> can say 3-5 words with meaning and may understand Play During Infancy -​ Birth - 1month-> look at infant close, hang bright objects, hang mobiles with black white designs Developmental Milestones Associated with Feeding -​ Birth -​ Sucking, rooting, swallowing  -​ Feels hunger and indicates desire for food by crying -​ Strong extrusion reflex -​ 3-4 months -​ Extrusion reflex fading, beginning eye hand coordination -​ 4-5 months -​ Can approximate lips to the rim of cup but may spill -​ 5-6 months -​ Can use fingers to feed self cracker -​ 6-7 months -​ Chews and bits -​ May hold own bottle, but may not drink from it Common Infant Injuries -​ SAFE PAD -​ S-> suffocation, sleep position -​ A-> asphyzia, animal bites -​ F-> Falls -​ E-> electrical burns or burn -​ P-> poisoning, ingestions -​ A->automobile safety -​ D->drowning Ch 12 396-423, Proportional Changes -​ Average weight at 2 years is 12 kg -​ Birth weight is quadrupled by 2 years old Gross and Fine Motor Development -​ Major gross motor skills during toddler years is development of locomotion -​ 12-13 months-> toddlers will walk alone, using wide stance -​ 18 months-> they try to run but fall easily -​ 2-3 years of age-> refinement of upright position is evident -​ 2 years-> toddlers can walk up and down stairs -​ 2 and a half year-> they jump using both feet, stand on one foot for a second or two, and manage a few steps on tiptoe -​ End of 2 year-> stand on one foot, walk on tiptoe, climb stairs with alternate footing -​ DOMESTIC MIMICRY-> the imitation of household activity Characteristics of Preoperational Thought -​ egocentrisms-> inability to envision situations from perspective other than oneself -​ transductive-> reasoning from particular to the particular -​ Global organization-> belief that a change in any one part of the whole changes the entire whole -​ centration-> focusing on one aspect rather than considering all possible alternatives -​ animism-> attributing lifelike qualities to inanimate objects Toilet Training -​ Voluntary control of anal and urethral sphincter is achieved sometime after walking -​ Between ages 18 and 24 months Developmental Milestones Associated with Feeding -​ 12-18 months-> drool less, drink from cup with lid, hold cup with both hands, begin to use spoon but turns it before reaching mouth -​ 24 months-> can use straw and cup, chews food with mouth closed, and shifts food in mouth, distinguish between finger and spoon foods, uses spoon correctly but with some spilling -​ 36 months-> spills small amount from spoon, begins to use fork, uses adult pattern of chewing Ch 13 425-441 Health Promotion of Preschooler and Family Biologic Development -​ Average weight is 14.5 kg, 16.5 kg, and 18.5 kg at ages 3,4,5 -​ Average annual weight gain remains about 2-3 kg Gross and fine Motor behavior -​ 36 months-> can walk, run, climb, and jiimp -​ 3 years-> can ride a tricycle, tiptoe, balance on one foot for few seconds and broad jump -​ 4 years-> can skip and hop well on one foot and catch a ball -​ 5 years-> can skip on alternate feet, jump rope, and begin to skate and swim Superego-> starts towards end of toddler years and major taks of preschoolers Piagets cognitive theory -​ Preoperational phase covers age span 2-7 and divided into two stages-> preconceptual phase (2-4) and phase of intuitive thought (4-7) Sources of Stress in Preschoolers -​ 3 years-> stubbornness, belonging, separation anxiety, jealousy, confusion, fears, speech, activity level, mealtime -​ 4 years-> insecurity, companionship, belonging, sex, activity level -​ 5 years-> approval, school, worrying, belonging, name calling Ch 15 463-483 Health Promotion of School Age Child and Family Physical Changes -​ 6-12 years-> children grow 2 inches per yeat and double their weight per year -​ Decrease in head circumference relation to height -​ Immune system more competent -​ Bladder capacity Developing Sense of Industry -​ Latency period-> time of tranquility between oedipal phase of early childhood and adolescence Developmental Theorists ​ Sigmund Freud-> Psychosexual ○​ Oral stage birth to 1 year ○​ Anal stage 1-3 year ○​ Phallic stage 3-6 yr ○​ Latency stage 6-12 yr ○​ Genital stage 12 and over Freud -​ Oral stage-> 0-1 pleasure is centered on the mouth, sucking, biting, and chewing, vocalizing provides opportunities for pleasure -​ Anal stage -> 1-3 interest centers on sphincter control. Toilet trained child may feel bad if she/he regresses. I/O and other nursing procedures important -​ Phallic stage 3-6 genitals become interesting and are curious about the differnces between the sexes -​ Latency 6-12 energy channeled into play and gainging knowledge -​ Genital stage-> 12 on begins with puberty and genital organs become source of sexual tension and pleasure. Energy in forming friendships and relationships Erickson-> psychosocial ​ Trust vs mistrust birth to 1 yr ○​ Needs consistent loving care, nurses doster trust by respond to needs ​ Autonomy vs shame and doubt 1-3 years ○​ Want to control their bodies and environment and do things for themselves ​ Initiative vs guilt 3-6 years ○​ Explore their world, vigorous play, develop conscience ​ Industry vs inferiority 6-12 years ○​ Want to engage in activities with real sense of achievement, learn to compete and cooperate with others  ​ Identity vs role confusion 12-18 ○​ Marked by rapid physical changes, preoccupied with how others see them, struggle to fit into the roles they see as important Piaget-> Cognitive Development -​ sensorimotor-> birth to 2 years -​ Preoperational 2-7 years -​ Concrete operation 7-11 years -​ Formal operations 11 and on -​ Sensorimotor 0-2-> progress from simple reflexes to imitative behaviors -​ Preoperation 2-7 egocentric inability to put oneself in place of another -​ Concrete operations 7-11 increasing logic and problem-solving, conservation -​ Formal operations 11 though is more adaptable and flexible and can think of abstract terms Ch, 17 510-535 Health promotion of the Adolescent and Family -​ Puberty involves physical changes -​ Begins as hypothalamus produces increased levels of GnRH -​ GnRH travels through capillary network to anterior pituitary gland, where it stimulates production and secretion of follicle stimulating hormone and LH Females -​ Development and release of an egg every 28 days Males -​ Development of viable sperm -​ FSH acrs on testicular cells, stimulating production of sperm Tanner Stages -​ Described stages of pubertal growth and are numbered from stage 1 immature and stage 5 mature -​ IN females-> tanner stage describe development based on breast size and shape and distribution of pubic hair -​ males-> pubteal development on size and shape of penis and scrotum and distribution of pubic hair Formal Operational thought -​ Being able to think in anstract terms