Growth and Development: Nursing Interventions and Theories

Growth and Development Tamar Avedissian RN, MSN  Growth Growth: is increase in physical size. Growth is measured in a quantitative way (e.g. height in centimeters). Common growth indicators are height, weight and head circumference. Need to plot...

Growth and Development Tamar Avedissian RN, MSN  Growth Growth: is increase in physical size. Growth is measured in a quantitative way (e.g. height in centimeters). Common growth indicators are height, weight and head circumference. Need to plot them on growth charts to identify if there are concerns. Growth charts for ages birth to 24 months Growth charts for ages 2 to 20 years  Development Development: is increase in skill or ability to function. Development is measured by observing a child’s ability to perform tasks and asking questions to the parents by using standardized tests Screening tests (e.g. Denver II or Ages and Stages Questionnaire). Diagnostic tests e.g. Bayley Scales of Infant and Toddler Development (3rd ed). Common development domains are cognitive, language, gross motor, fine motor, personal- Denver II  Factors influencing growth and development (1) Genetics: In utero the basic makeup of an individual is present. Gender of the child: on average females are born weighing less and measuring shorter than males. Females however, until pre- puberty grow faster than males. Around 14-16 years old, males tend to be taller and weigh more than females. Temperament: is the innate character of a child. Usually temperament is observed in the following responses: activity level, approach, threshold of response, adaptability and shyness of the child. Categories of temperament  Factors influencing growth and development (2) Environment: the home, school, neighborhood and community affect the growth and development of the child. Parent-child relationship: loving parental response to the child’s needs and democratic (authoritative) parenting style (showing respect towards the child) have shown to promote development of children. Whereas, neglectful, authoritarian (dictatorship) and permissive parenting styles have negative health outcomes on children. Sibling relationship: jealousy and conflicts between children will occur. It is important that  Factors influencing growth and development (3) Physical activity: physical activity is essential for body and mental well-being of children. Obesity can be overcome by physical activity. It is recommended that children practice 60 minutes or more of physical activity every day. Health: promoting health and preventing diseases should start from childhood. Prolonged illnesses can affect growth and development. Nutrition: quality of nutrition has a major influence on growth and development. Important developme nt milestones Developmental milestones Development Red Flags Theories of development Freud Erikson Piaget Freud’s personality fixation theory Erikson’s psychosocial theory Piaget’s cognitive development theory Nursing diagnoses related to growth and development Delayed growth and development related to lack of age appropriate activities Delayed growth and development related to prolonged illness Interventions for growth delays Assessing genetic factors Assessing growth hormone deficiency Balanced diet Supplement feeding Supplement medications  Interventions for developmental delays (1) Complete assessments for brain and neurologic status (such as CT, EEG, MRI…) Identifying fetal and pregnancy factors Complete health check Neurocognitive diagnostic assessments (such as Bayley…) Assessment of hearing and vision problems Assessing school performance and teacher’s feedback Speech therapy  Interventions for developmental delays (2) Proper provision of stimulus (cutting, drawing, variety of play activities…) Playing is very important for children to learn and develop Proper parent-child relationship Responding to children in a predictable way Showing warmth and sensitivity (authoritative/democratic parenting style) Having routines and household rules Sharing books and talking with children Supporting health and safety Using appropriate discipline without harshness Putting limits and proper discipline to child behavior Use of Positive reinforcement for behavior problems rather than punishment and negative reinforcement Encouraging autonomy and independence Thank you 