NUR 121 Maternal-Child Care Nursing 1 Final Term Release 1 PDF

TABLE OF CONTENTS Intro to Growth and Development p.2...

TABLE OF CONTENTS Intro to Growth and Development p.2 Infancy p.8 Toddler p.15 Preschooler p.20 bill School Age p.23 Adolescence p.27 Scope and Standards p.30 Communication and Teaching p.35 BATCH 2027 TRANXCN TEAM Nursing Care Planning p. 37 DEPUTY HEADS Picache, Ma. Lourine Kassandra Related Studied p.39 C. Haum, Jazentha Kim G. Filipino Culture p.46 Loyola, Tim A. Maternal and Child Care TRANXCN TEAM Entrep. p.50 Bondoc, Alissa S. Candelaria, Aisha Francine Brosas, Carmela Dawn C. De Jesus, Althaea Timothy NUR 121 Gonzales, Jaira Marielle M. Haum, Jazentha Kim G. Kobayashi, Samantha May B. Loyola, Tim A. MATERNAL-CHILD Macha, Elaena Katrine P. Medrano, Ma. Samantha E. Pegarido, Khristel B. Perido, Kurt Cedrick L. Pescasio, Kirsten Marianne C. CARE NURSING 1 Pili, Edrik Gene M. Quiaz, Vanessa Mae Rafols, Kisha Belle M. Sanchez, Rayben William L. Solon, Cahn Zyrah L. Soquila, Reinne Haizen R. A.Y. 2024-2025 Tejero, Angela P. Valdez, Mariah Richlyn E. TranxCN: FINAL TERM RELEASE 1 Guidelines: The Tranx CN is NOT FOR SALE and shall only be utilized by the bona fide nursing students from De La Salle medical and Health Sciences Institute. The students are permitted to download and print the Tranx CN. However, reproducing, imitating, altering or tampering any information on the transcriptions is strictly prohibited. Failure to abide by the Tranx CN guidelines will result in immediate termination of access to the transcriptions. Disclaimer: Please use at your own discretion. Tranx CN is not intended as a substitute for resource materials such as handouts, videos, and books provided by the college. All information on these transcripts is provided in good faith and is subjected to quality control. Regardless, the Tranx CN Team makes no representation or warranties of any kind regarding the accuracy, and completeness of any information in the transcripts. The College of Nursing Faculty/Professors are not liable for any mistakes or false information that may inadvertently be included in this transcript. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 2. All humans follow the same pattern of growth & development 3. The sequence of each stage is predictable, OUTLINE although the of onset, the length of stage & the effects of each stage vary with the person A. Growth and Development 4. Learning can either help or hinder the maturational a. Principles process, depending on what is learned b. Factors 5. Each developmental stage has its own c. Foundations characteristics B. Biologic Growth & Development 6. Growth & development occur in cephalocaudal C. Development of Personality & Mental Function direction a. Theoretic foundations of personality 7. Growth & development occur in proximodistal development direction b. Theoretic foundations of mental development 8. Development proceeds from simple to complex, or D. Development of Self - Concept, Body Image, Self - from single acts to integrated acts Esteem, & Sexuality 9. Development becomes increasingly differentiated GROWTH & DEVELOPMENT 10. Certain stages of growth & development are more critical than others 11. The pace of growth & development is uneven GROWTH DEVELOPMENT Increase in physical size A gradual change and FACTORS INFLUENCING GROWTH & Represents quantitative expansion DEVELOPMENT changes Advancement from lower 1. Genetics to a more advanced stage Gender of complexity The emerging and Health expanding of the intelligence individual’s capacities 2. Environment through growth, Socio-economic level maturation & learning Parent-child relationship Ordinal position in the family Growth + Development → Numerous changes that take Health place during the lifetime of an individual nutrition 3. Temperament MATURATION DIFFERENTIATION 9 different characteristics that define temperament: Aging Processes by which early Activity level An increase in cells & structures are Distractibility competence and systematically modified & Rhythmicity adaptability altered to achieve specific Change in the complexity characteristics, physical & Attention span and persistence of a structure that makes chemical properties Approach it possible for that Development from simple Threshold of response structure to begin to more complex Adaptability functioning activities & functions To function at a higher Mood quality level Intensity of reaction Describes a qualitative change FOUNDATIONS OF GROWTH & DEVELOPMENT PRINCIPLES OF GROWTH & DEVELOPMENT AGE PERIODS 1. Growth & development are continuous, orderly sequential process influenced by maturational, Prenatal Conception to birth environmental, & genetic factors Germinal: conception CANDELARIA 2 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 to approx. 2wks METHODS OF STUDYING Embryonic: 2 to 8 weeks Observing & measuring Results to full Fetal: 8 to 40 weeks children understanding of (birth) At different stages growth process ○ Most crucial Comparing in terms of period in the IQ, memory, etc. development Done at one time only process & repeatedly over long ○ Characterized by periods of time rapid growth rate & total Cross-sectional study dependency Longitudinal study Infancy Birth to 12 months DIRECTIONAL TRENDS Neonatal: birth to 27 or 28 weeks Infancy: 1 to approximately 12 months ○ First month - critical period ○ Rapid motor, cognitive, and social development Early Childhood 1 to 6 years old Toddler: 1 to 3 years Preschool: 3 to 6 years ○ Intense activity & discovery ○ Marked physical, social, language, personality, & beginning self-concept development Middle Childhood 6 to 11/12 years old “School age” Steady advancement in physical, mental, & social development Critical period in self-concept development Late Childhood 11 to 19 years old Prepubertal: 10-13 years old Adolescence: 13 to SEQUENTIAL TRENDS approx. 18 years old Tumultuous period of In all dimensions of growth & development, there is a rapid maturation definite, predictable sequence, which each child Transitional period normally passing through every stage Re-defining of self-concept CANDELARIA 3 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 DEVELOPMENT PACE Although there is a fixed, precise order to development, it does not progress at the same rate or pace BIOLOGICAL GROWTH & DEVELOPMENT External Proportions SENSITIVE PERIODS Periods termed as critical, sensitive, vulnerable, & optimal are those times in the lifetime of an organism when it is more susceptible to positive or negative influences Biological Determinants of Growth & Development ○ Linear growth and height ○ Skeletal Growth & Maturation INDIVIDUAL DIFFERENCES CANDELARIA 4 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 ○ Neurological Maturation PERSONALITY DEVELOPMENT SIGMUND FREUD PSYCHOSEXUAL STAGES OF DEVELOPMENT AGE PERIOD STAGES Infant Oral Stage Provide oral stimulation by giving pacifiers, do not discourage thumbsucking ○ Lymphoid Tissues Toddler bladder Anal Stage Help children achieve bowel and control without undue emphasis on its importance Preschool Phallic Stage Accept children’s sexual interests, such as fondling his or her own genitals, as ○ Development of Organ Systems normal area of exploration School Age Latent Stage Help children have positive experiences with learning so their self-esteem continues to grow Adolescent Genital Provide appropriate opportunities for the child to relate with DEVELOPMENT OF PERSONALITY & MENTAL opposite and FUNCTION own sex Theoretic foundations of personality development relationships ○ Psychosexual development (Freud) ○ Psychosocial development (Erikson) ERIKSON’S PSYCHOSOCIAL DEVELOPMENT Theoretic foundations of mental development THEORY ○ Cognitive development (Piaget) ○ Moral development (Kohlberg) AGE PERIOD STAGES Infant Trust vs Mistrust Provide a primary caregiver, provide CANDELARIA 5 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 experiences that actions can cause add to security things to happen in the world around them Toddler Autonomy vs Provide Shame opportunities for Preoperational (2-7 yrs) Children begin to think independent symbolically and learn decision-making to use words and , such as pictures to represent choosing their objects own clothes Children at this stage tend to be egocentric Preschooler Initiative vs Guilt Provide and struggle to see opportunities for things from the exploring new perspective of others places or While they are getting activities. Allow better with language free form of play and thinking, they still tend to think about in Industry vs Provide very concrete terms Inferiority opportunities such as allowing Concrete Operational Children begin to think child to logically about assemble and concrete events complete a Children begin to short project understand the concept of Adolescent Identity vs Role Provide conversation Confusion opportunities for Their thinking becomes an adolescent more logical and to discuss organized, but still very feelings about concrete events Children begin using important to inductive logic, or him/her. Offer reasoning from specific support and information to a praise for general principle decision-making Formal Operational (12 yrs Adolescent or young above) adult begins to think MENTAL DEVELOPMENT abstractly and reason PIAGET’S STAGE OF COGNITIVE DEVELOPMENT about hypothetical problems Begin to think more STAGES DEFINITION about moral, philosophical, ethical, Sensory Motor (birth - 2 yrs) They learn about the social, and political world through basic issues that require actions such as theoretical and sucking, grasping, abstract reasoning looking, and listening Begin to use deductive Infants learn that things logic, or reasoning continue to exist even from a general principle though they cannot be to specific information seen (object permanence) They are separate beings from people or object around them They realize that their CANDELARIA 6 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 KOHLBERG’S THEORY OF MORAL DEVELOPMENT AGE STAG DESCRIPTION NURSING (IN E IMPLICATION YRS) PRECONVENTIONAL (LEVEL I) 2-3 1 Punishment/ Child needs help to Obedience determine what are Orientation the right actions. Give clear instructions to avoid confusion 4-7 2 Individualism Child is unable to recognize that like situations require like actions BODY IMAGE CONVENTIONAL (LEVEL II) Subjective concepts & attitudes that individuals have toward their own bodies 7-10 3 Orientation to Child enjoys helping Physiologic, psychologic, & social nature of one’s image interpersonal others because this of self relations of is nice behavior mutuality SELF - ESTEEM 10-12 4 Maintenance of Child often asks Overall evaluation of self social order, what the rules are Personal, subjective judgement of one’s worthiness fixed, rules, and and if something is Derived from & influenced by the social groups in the authority right immediate environment & individual’s perception of how they are valued by others POST-CONVENTIONAL (LEVEL III) Factors that influence the formation of a child’s self-esteem: Older 5 Social Contract, Adolescents can be Own temperament & personality than utilitarian responsible for Social roles assumed & expectations 12 law-making self-care because Abilities & opportunities perspectives they view this as a Significant others standard of adult behavior SEXUALITY 6 Universal ethical Many adults do not A multidimensional phenomenon principle reach this level of Includes feelings, attitudes, & actions orientation moral development Has both biologic & cultural components Encompasses & gives direction to person’s physical, emotional, social, & intellectual responses throughout life DEVELOPMENT OF SELF-CONCEPT, BODY IMAGE, SELF-ESTEEM, & SEXUALITY SELF-CONCEPT Individual’s description of himself/herself Includes all notions, beliefs, & convictions that constitute an individual’s relationship with others Develops gradually CANDELARIA 7 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 CLOSURE OF CRANIAL SUTURES Anterior fontanel closes by 12th to 18th month ○ Average is 14 months OUTLINE Posterior fontanel closes by 6th to 8th week A. Infancy CHEST B. Proportional Changes Lateral diameter > Anteroposterior (AP) diameter C. Maturation of Systems By 1 year old chest circumference will equal the size D. Fine Motor Development of the head circumference and the weight of the E. Gross Motor Development heart is doubled. F. Infancy as Described by Theorist By the end of the infant period the lower jaw is a. Psychosocial Development prominent. The circumference of the chest is less b. Cognitive Development than that of the at birth by about 2 cm. The Abdomen c. Social Development remains protuberant until the child has been walking. G. Language Development The Cervical, Thoracic, Lumbar Vertebral Curves H. Play develop as the infant holds up their head. I. Temperament J. Coping with Concerns Related to Normal Growth MATURATION OF SYSTEMS and Development SENSES K. Injury Prevention Auditory acuity at adult level a. Age: Birth to 4 Months Visual acuity begins to improve b. Age 4 to 7 Months Binocular fixation (the fixation of 2 ocular images c. Age 8 to 12 Months into one cerebral picture): begins to develop by 6 L. Promoting Nutritional Health of Infan weeks of age and should be well established by age 4 months. INFANCY Depth perception (stereopsis) which is the ability A period of dramatic physical changes and to perceive depth or 3D space begins to develop by developmental achievements 7 to 9 months but may exist earlier. Rapid developmental period PROPORTIONAL CHANGES WEIGHT 0.68kg/month 5-6 months - double the weight 1 year - triple the weight Infants should be on exclusive breastfeeding beyond 6 months of age and bottle-fed after 6 months of age. HEIGHT Increases by 2.5cm (1in.)/month during the first 6 months. ○ Averages 65 cm by 6th month Slows during the next 6 months (1.25 cm or ½ inch) During the first year the infant increases height by 50% ○ Averages 74 cm by the 12th month HEAD CIRCUMFERENCE Increases by 2 cm/month for the first 3 months. DEVELOPMENT OF SENSES Increases by 1 cm/month during the next 3 months VISION ○ Averages 43 cm by 6th month Ask parents to consider how all these trapping must 33% increase during the 12th month appear from an infant’s viewpoint. ○ Averages 46 cm by 12th month HEARING 2 and a half times increase in brain weight by 12th Provide soft musical sound or cooing voices. month Avoid harsh or loud bangs to avoid startle (-) primitive reflexes by 12th month CANDELARIA 8 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 Recording of maternal heart or family voices sounds Immune system becomes functional by at least 2 can be soothing months Encourage parents to read to their child daily Can actively produce both immune globulin IgG and TOUCH IgM antibodies by 1 year. Maintain skin to skin contact THERMOREGULATION Clothes should feel comfortable, soft rather than More efficient rough Shivering in response to cold increases Diapers should be dry rather than wet Increased ability to adjust to cold is mature by 6 Teach parents to handle infants with assurance yet months with gentleness Has developed adipose tissue for insulation Reminds parents that their child is a baby RENAL STRUCTURES TASTE Immaturity of renal structures leads to dehydration Solid food is introduced as early as 6 months (DHN) Urge parents to make a mealtime for fostering trust Complete maturity of kidneys at latter half of 2nd as well as supplying nutrition year when cuboidal epithelium of the glomeruli SMELL becomes flattened 1 to 2 hours after birth infant can smell accurately Kidney remain immature They identify the familiar smell of breastmilk FINE MOTOR DEVELOPMENT RESPIRATORY SYSTEM Ability to coordinate hand movements Respiratory rate slows down from 30 - 60 Grasping and manipulating breaths/min to 20 - 30 breaths/min by the end of the first year Abdominal respiratory movements GRASPING Short straight eustachian tube 1 month Hands predominantly Trachea is proximal to the short bronchi closed HEART Heart rate from 110 -160 bpm to 100 - 120 bpm by 2 - 3 months Grasping is still a reflex the end of the first year Rhythm - Sinus arrhythmia 3 months Hands predominantly Systolic pressure rises during the first 2 months open Diastolic pressure decreases during the first 3 4 months Hand and object regard months and then gradually rises to values close to those at birth 5 months Voluntary grasping Blood pressure is fluctuating HEMATOPOIETIC 8 - 9 months Crude Pincer Grasp Fetal hemoglobin (HgbF) Present for the first 5 months 10 - 11 months Neat pincer/finger grasp (+) physiologic anemia at 2 - 3 months DIGESTIVE SYSTEM Digestive process are relatively immature MANIPULATIVE SKILLS Saliva is secreted in small amounts 6 months Holds bottle; grasp feet Drooling is common and pull them to mouth; Majority of the digestive processes begin at 3 feeds self crackers months Immaturity of the digestive processes is evident in 7 months Transfers objects: from the appearance of stools one hand to the other Liver is the most immature of all GI organs At 12 months: 3 times meal per day + 1 bottle of 10 months Lets go and offers object milk at night to others May have 1 or 2 breast milk daily. 11 months Puts and removes objects IMMUNOLOGIC in container IgA present in large amounts in colostrum 12 months Tries tower of 2 blocks CANDELARIA 9 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 but fail 4 - 6 months Backward crawling 6 -7 months Bears weight on legs with GROSS MOTOR DEVELOPMENT assistance Ability to accomplish large body movements Head control, sitting, rolling over, locomotion 9 months Creeps; pulls up to stand 11 months Walks holding on HEAD CONTROL 12 months Walks held on one hand 1 month Momentarily lifts head 3 months Holds head beyond body INFANCY AS DESCRIBED BY THEORIST plane Focus and Description Implication 4 months Lifts head and chest Proponent Head control is Psychosocial Crucial element Meeting well-established Development to achieve infant’s needs by Erik Erikson trust: quality of at the right 5-6 months Head control is well - Development parent time and of a sense of (caregiver)-chil consistently trust: trust of d relationship ROLLING OVER self, others, and care that and the world infant receives 5 months From abdomen to back Learning to delay 6 months From back to abdomen gratification 7 months Parachute reflex - when the baby is turned face Focus and Proponent Description down towards the mat, the arms will extend as Cognitive Development Period from birth to 24 if the baby is trying to by Piaget - Sensorimotor months catch himself Stage Infants progress from reflex behavior to simple repetitive acts to imitate SITTING activity Crucial events: 1 month (-) sitting separation, object permanence, ability to 2-3 months Back uniformly rounded; use symbols or mental pulls up with some head representation control First Stage (from birth to 1 month) 4 months Back rounded at lumbar Identified by the infant’s area’ with good head use of reflexes control At birth, an infant's individuality is expressed 7 months Sits with support through the physiologic reflexes of sucking, 8 months Sits without support roothing, grasping, and crying. 10 months From prone to sitting Second Stage: Primary Circular Reactions (1 - 4 months) Beginning of the replacement of reflexive LOCOMOTION behavior with voluntary CANDELARIA 10 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 acts Infants incorporate and DEVELOPMENT OF BODY IMAGE adapt their reactions to Kinesthetic and tactile experiences are the first the environment and perceptions of their body recognize the stimulus Mouth is the principal area of pleasurable that produces a sensations response. By the end of the first year they recognize that they Ex. Babies wiggle their are distinct from their parents and has increasing fingers, kick their legs, interest in image (mirror) and suck their thumbs. These are not reflex DEVELOPMENT OF GENDER IDENTITY actions. They are done Begins in utero intentionally - for the sake Influenced by parents and significant others’ actions of the pleasurable or responses to a child’s early manifestations of stimulation produced. sexuality Third Stage: Secondary SOCIAL DEVELOPMENT Circular Reactions (4 - 8 ATTACHMENT months) For the first few weeks, respond indiscriminately to Primary circular reactions are repeated and anyone prolonged for the 8 to 12 weeks: cry, smile, and vocalize more to the response that results mother than to anyone else New processes of human during 6th month they show a distinct preference for behavior: Imitation, play, the mother affect (including stranger Reactive attachment disorder may happen: anxiety) ○ Not being cuddly with parents Ex. A child purposefully ○ Failing to make eye contact with significant pick up a toy in order to others put it in his or her mouth or infant who shakes the ○ Poor impulse control rattle for the pleasure of ○ Being destructive to self and others hearing the sound that it SEPARATION ANXIETY produces. Between ages 4 to 8 months, infant progresses through the first stage of separation-individuation ○ Awareness of self and mother as a separate Cognitive Fourth Stage: Provision of being Development Coordination of age-appropriat By 11 to 12 months, they are able to anticipate by Piaget - secondary e stimuli imminent departure by watching mother’s Sensorimotor schemas and including toys behaviors, and begins to protest before she leaves Stage (Piaget) their application Ex. Infant will to new situations not just shake STRANGER FEAR (8 to 12 months) the rattle, but Between 6 to 8 months, fear of strangers and Increasing will reach out stranger anxiety become prominent motor skills and knock to LANGUAGE DEVELOPMENT allow for one side an First means of verbal communication is crying greater object that Crying can be a message of urgency, can be a exploration of stands in the signal of displeasure, and mostly related to the way of it physiologic needs environment getting hold of Crying tends to decrease by 12 weeks Object the rattle permanence Vocalizations heard during crying eventually Marks become syllables and words beginning of Vocalizes as early as 5 to 6 weeks of age by making intellectual small throaty sounds reasoning By 2 months, they make single vowel sounds such (ability to use as ah, eh, uh their acquired By 3 to 4 months they imitate sounds, add knowledge to constants, t, d and w and combine syllables (eg. reach a goal) CANDELARIA 11 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 “Dada”), but do not ascribe meaning to the word Quick guide to assessment of deciduous teeth until 10 to 11 months of age. during the first 2 years is: Age of the child in By 9 to 10 months they comprehend the meaning months - 6 = the number of teeth of the word “no” and obey simple commands Signs of teething: drooling, finger sucking, or biting By age 1 year, they can say 3 to 5 words with of hard objects meaning Discomforts due to teething is common PLAY Management: Give frozen teething ring or ice cubes Primarily narcissistic; revolves on own body wrapped in clean cloth or towel Play is dependent; pleasure is demonstrated by a WEANING quieting attitude (1 month), a smile (2 months), or a Process of giving up one method of feeling for squeal (3 months) another (from breast or bottle to a cup) By 4 months, they laugh aloud, show preference for More infants show signs of readiness during the certain toys and become excited when food or a second half of the first year when they have learned favorite object is brought that good things come from spoons. By 6 months to 1 year, actual games such as Imitation becomes a powerful motivator by age 8 or peek-a-boo and pat-a-cake are played 9 months, and they enjoy using a cup or glass like at 6 to 8 months, they usually refuse to play with others do. strangers HEAD BANGING At 6 months, they extend their arms to be picked Advise parents to pad the rails of the crib so infants up cannot hurt themselves and reassure them this is a At 7 months, they cough to make their presence normal mechanism for the relief of tension in known children of this age At 10 months, they pull their parent’s clothing SLEEP CONCERNS At 12 months, they can be called by name Infants should be placed on their back to sleep until TEMPERAMENT they are able to roll over on their own at 4 months of Features of a person that reflect an individual’s age emotional disposition. Co-sleeping is discouraged Important in determining parent-child relationships Breastfeeding babies tend to wake more often than The more discord or lack of harmony with the child’s those who are formula fed temperament and parent’s ability to accept and deal with the behavior, the more at risk for parent-child CONSTIPATION conflicts. Breastfeed infants are rarely constipated because COPING WITH CONCERNS RELATED TO NORMAL their stool tends to naturally loose. GROWTH AND DEVELOPMENT Constipation may occur in formula fed infants from something as simple as if their diet is deficient in SEPARATION AND STRANGER FEAR fluid. This can be corrected simply by offering more To accustom the infant to new people, parents are fluid. encouraged to have close friends and relatives visit often. LOOSE STOOL Talking to infants when leaving the room, allowing Stools of breastfed infants are generally softer than them to hear one’s voice on the telephone and those of formula fed infants. using transitional objects. An infant who is formula fed can have loose stool if the formula fed is not diluted properly. THUMB SUCKING AND USE OF A PACIFIER Occasionally loose stool may begin with the Infancy and early childhood: No need to restrain introduction of vegetables and fruits. non-nutritive sucking of fingers. Malocclusion may occur if thumb sucking persists COLIC past 4 years of age, or 6 years as indicated by some A paroxysmal abdominal pain that generally occurs authorities, or when the permanent teeth erupt. in infants younger than 3 months and is marked by loud and intense crying. TEETHING Caused by overfeeding or swallowing too much air Eruption of the deciduous (primary) teeth. while feeding. First primary teeth to erupt - lower central incisors ○ Make sure to burp the baby (6 to 8 months) Followed closely by the upper central incisors CANDELARIA 12 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 SPITTING UP BURNS Almost all infants spit up, although the formula feed baby appears to do this more than breastfed babies due to overfeeding. DIAPER DERMATITIS Promote frequent diaper change MILIARIA Prickly heat rash Bath an infant twice a day during hot weather Add a small amount of baking soda to the bath MOTOR VEHICLES water BABY BOTTLE TOOTH DECAY SYNDROME Putting the infant to bed with a bottle can result in decay of all the upper teeth and lower posterior teeth ○ Give bottle with water during bed time OBESITY IN INFANTS BODILY DAMAGE As a general rule, an infant should take no more than 32 oz of formula and shouldn’t be breastfeeding more often than every 2 hours INJURY PREVENTION AGE 4 TO 7 MONTHS AGE: BIRTH TO 4 MONTHS ASPIRATION ASPIRATION SUFFOCATION/DROWNING SUFFOCATION/DROWNING FALLS FALLS POISONING BURNS CANDELARIA 13 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 BODILY DAMAGE TIPS TO HELP INTRODUCE SOLID FOOD TO INFANT AGE 8 TO 12 MONTHS ASPIRATION SUFFOCATION/DROWNING PROMOTING INFANT DEVELOPMENT IN DAILY ACTIVITIES Bathing: Bath time should be enjoyable Diaper area care: ○ Change diaper every 2 to 4 hours ○ Wash the skin every diaper change ○ Do not use baby powder ○ Remind parents to wash their hands after diaper FALLS change Dental Care: ○ Toothbrushing can begin even before the teeth erupt ○ Use soft washcloth over the gum pads Dressing: ○ Clothing for infants should be easy to launder POISONING and simply constructed so neither dressing or undressing are a struggle. Sleep: ○ Most require 10 to 12 hours of sleep at night and one or several naps during the day. Exercise: BURNS ○ Infants benefit from outing in a carriage or stroller because sunlight provides vitamin D. PROMOTING NUTRITIONAL HEALTH OF INFANT INTRODUCTION OF SOLID FOOD First solid food is introduced at 6 months Offer formula or breastmilk for the first 6 months Extrusion reflex needs to fade before the infants accept food readily Cereal, vegetable and fruits, meat and eggs, table food CANDELARIA 14 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 Head Circumference At 1 to 2 years old: equal to chest circumference Total increase during the OUTLINE second year: 2.5 cm A. Toddler Rate of increase slows B. Biological/Physical Development until 5 y/o - less than a. Proportional Changes 1.25/year Between 12 and 18 b. Sensory Changes months old: anterior c. Maturation of Systems fontanel closes d. Gross & Fine Motor Skills A. Psychosocial Development Chest Circumference Continues to increase in a. Sensorimotor Stage size and exceeds head b. Preoperational Stage circumference c. Sex-Role Behavior After second year: d. Domestic Mimicry exceeds the abdominal B. Psychosexual Development measurement C. Cognitive Development D. Moral Development SENSORY CHANGES E. Spiritual Development F. Development of Body Image Eyes 20/40 G. Development of Gender Identity Well-developed full H. Social Development binocular vision I. Coping with Concerns related to Normal G&D Depth perception a. Toilet Training continues to develop b. Sibling Rivalry c. Temper Tantrums d. Negativism Mouth With specific taste preferences e. Stress Become increasingly J. Promoting Health During Toddlerhood well-developed a. Nutrition b. Sleep and Activity Nose, Ears, and hands Become increasingly c. Dental Health well-developed TODDLER Feet Increased sensation 1-3 years old Walking, talking young children With a growing sense of autonomy MATURATION OF SYSTEMS Time of intense environmental exploration Period of toilet training and sibling rivalry Increased attention span Temper tantrums, negativism and obstinacy Almost complete myelination of spinal cord BIOLOGICAL/PHYSICAL DEVELOPMENT Develops to about 90% of adults size PROPORTIONAL CHANGES Height Slow rate of increase HR: 90 bpm Elongation of legs BP: 99/64 mmHg 7.5 cm/yr Ave. 86.6 cm Weight Ave. yearly wt. Gain: 1.8 - 2.7kg CANDELARIA 15 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 Slightly slow; abdominal without hand Volume continue to support but Can release a increase cannot throw a pellet into a ball without narrow neck falling bottle Scribbles spontaneously Can use the Fairly complete GIT cup well often Increased stomach capacity 18 months Can run Can build a Increased acidity clumsily tower of 3 to 4 Control of elimination They can walk cubes the stairs with Turn 2 to 3 one hand help pages of a Hold and push book at a time Functionally matures toys Can manage a Minimum sebum and Jump in place spoon without sweat production with both feet rotation Hyperplasia of muscle Sit themselves cells on a chair Throw overhand without falling 24 months Can run fairly Build a tower Effficient phagocytosis well of 6 to 7 cubes Well established antibody Can pick up Can align production objects cubes into a Passive immunity without falling train disappears Can turn pages 1 at a time Can imitate circular or vertical strokes Learns mechanisms to Can turn control body temperature doorknobs Can conserve core body temperature 30 months Can jump with Build a tower both feet of 8 cubes Can take a few Good steps on tiptoe hand-finger combination Can draw circles GROSS AND FINE MOTOR DEVELOPMENT PSYCHOSOCIAL DEVELOPMENT AGE GROSS FINE MOTOR MOTOR AGE STAGE OF DEVELOPMENTAL DEVELOPMENT TASK 15 months Can walk Can constantly without help catch objects Early Autonomy vs Potty training and Kneel without on the floor Childhood Shame & Doubt Self-maintenance support Build a tower Assume of two cubes standing Hold two position cubes in one CANDELARIA 16 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 DOMESTIC MIMICRY PSYCHOSEXUAL DEVELOPMENT 15-18 months STAGE AGE FOCUS MAJOR ADULT Imitating household behaviors DEVELOP FIXATION MENT EXAMPLE MORAL DEVELOPMENT LEVEL 1: PRECONVENTIONAL MORALITY Anal 1-3 Anus Toilet Orderliness Right and wrong determined by rewards/punishment training Messiness STAGE 1 STAGE 2 COGNITIVE DEVELOPMENT Punishment/obedience. Rewards Whatever leads to The right way to behave punishment is wrong is the way that is rewarded SPIRITUAL DEVELOPMENT Vague idea of God and religious teachings Learn about God through the words and actions of those closest to them God = something special Near the end of toddlerhood: some advancement of understanding of God SENSORIMOTOR STAGE Religious teachings & moral development → Behavior 13-18 months Child uses active experimentation to achieve previously unattainable goals DEVELOPMENT OF BODY IMAGE Newly acquired skills and previous knowledge are Recognize usefulness of body parts important for new situations Gradually learn names of body parts Develops intellectual reasoning and rational judgment At 2 years old Tries to experiment and explore while being separated ○ Recognize gender differences from the caregiver ○ Refer to self by name 19-24 months: Child is in the final sensorimotor At 3 years old stage-completed primitive thought process ○ Gender identity is developed Achievement: Object Permanence DEVELOPMENT OF GENDER IDENTITY PREOPERATIONAL STAGE Explore their bodies Spans ages 2-7 years old Touching certain body parts-pleasurable The child cannot think in terms of operation Genital fondling (masturbation) can occur No ability to manipulate objects with each other on a SOCIAL DEVELOPMENT logical level Major Task: Differentiation Problem solving is based on what they see and hear ○ Separation directly rather than what they recall about an object or ○ individualization event Greater independence Transitional objects SEX-ROLE BEHAVIOR ○ ex. Blankets, toys Start understanding gender role at 2-3 years old By the age of 3, they tend to play with toys, clothing, COPING WITH CONCERNS R/T NORMAL GROWTH and colors that interest them AND DEVELOPMENT Ex. girls=pink; boys=blue TOILET TRAINING Well-balanced diet Begin with readiness phase of toilet training by teaching the child about how the body functions in relation to voiding and having a stool CANDELARIA 17 of 55 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 121: MATERNAL-CHILD CARE NURSING 1 FINAL TERM RELEASE 1 - NUR121 - 210-2027 Consider the child’s clothing, potty chair, or use of the ○ Prepare child for change toilet ○ Help child cope with stress Limit practice sessions to 5-8 minutes ○ Play Stay with the child ○ Use of relaxation and imagery Practice sanitary habits after every session Praise children for cooperative behavior and SOURCE successful elimination Negativism Regression MARKERS FOR READINESS Rigidity Bladder Readiness Lack of sociability Bowel Readiness Self-centeredness Cognitive Readiness Separation anxiety Motor Readiness Stranger anxiety Psychological Readiness Toilet training Mental Readiness Bedtime Parental Readiness Tantrums Physical Readiness Security of object Overdoing SIBLING RIVALRY Illness and hospitalization Talk about the new baby when the toddlers become violence aware of the pregnancy and the changes occurring in the home in anticipation of the new member PROMOTING HEALTH DURING TODDLERHOOD Stress what activities there would be when the new NUTRITION child arrives Make mealtimes enjoyable rather than times for Allow toddlers to help with the care of the newborn discipline or family arguments Call children 15 min. Before mealtime TEMPER TANTRUMS Offer less food than toddlers may eat and let the child Best approach: ask for more ○ Consistency Provide substitutions for foods they do not enjoy ○ Developmentally appropriate expectations and Let them use the same dish, cup, or spoon every time rewards they eat Ignore behavior during tantrums Use plastic dishes and cups Offer the child options instead of “all or none’’ Have a regular mealtime schedule position Introduce at least three items from the group at each Give comfort once the child is able to control meal emotions but not giving in to the original request Allow them to eat with their fingers and enjoy food of Praise the child for positive behavior when he or she different colors and shapes is not having tantrums AGE NEGATIVISM Assertion of control 12-18 months old Decreased need for Subsides as most children prepare for preschool and calories, protein, and fluid enter kindergarten CHON requirement: 1.2 Approach: reduce the opportunities to a “no’’ answer g/kg Caloric requirement: 102 kcal/kg STRESS Slightly increased Small amounts of stress is beneficial requirements for most Excessive stress is destructive vitamins and minerals Parents must be aware of the signs of stress and be Milk intake: average of able to identify the source 2-3 cups/day Best approach: prevention 18 months old Decreased nutritional ○ Monitor the amount of stress need ○ Increase rest periods CANDELARIA 18