Growth and Development Lecture 1 PDF

Growth and development physical assessment of a child INTRODUCTION  The major goal for pediatric nursing is to improve the quality of health care for children and their families  Health care is moving from acute care settings to the community, the home, short-stay centers, and clinics.  Nu...

Growth and development physical assessment of a child INTRODUCTION  The major goal for pediatric nursing is to improve the quality of health care for children and their families  Health care is moving from acute care settings to the community, the home, short-stay centers, and clinics.  Nurses must be prepared to function in all settings. To be successful, you must understand the pathophysiology, diagnosis, and treatment of health conditions.  Competent nursing care flows from this knowledge and is enhanced by an awareness of childhood development, family dynamics, and communication skills. Important definition Growth—an increase in number and size of cells as they divide and synthesize new proteins; results in increased size and weight of the whole or any of its parts Development—a gradual change and expansion; advancement from lower to more advanced stages of complexity; the expanding of the individual's capacities through growth, maturation, and learning.  Very simply, growth can be viewed as a quantitative change and development as a qualitative change.  Each child grows in his or her own unique and personal way. The sequence of events is predictable; the exact timing is not.  Rates of growth vary, and measurements are defined in terms of ranges to allow for individual differences. What affect growth and development Gender is an influential factor because girls seem to be more advanced in physiologic growth at all ages. Factors affecting growth and development: 1. - genetic and constitutional, 2. -endocrine, 3. -environmental, and 4. -nutritional influences Stages of development Patterns of Growth and Development Directional trend 1-cephalocaudal, or head-to-tail, direction 2-proximodistal, or near-to-far These trends or patterns are bilateral and appear symmetric Sequential Trend : Head support before sitting and so on  Average weight at birth is 3.5 kg  Average length at birth is 50 cm  Average OFC at birth is 35 cm Length and height  Length is measured with a supine stadiometer in an infant  In general, length in full-term infants increases about 30% by 5 months and > 50% by 12 months. Infants grow about 25 cm during the first year, and height at 5 years is about double the birth length.  Most boys reach half their adult height by about age 2 years; most girls reach half their adult height at about age 19 months. Equation used for height  (Age in years *5)+80  For example for a child with 5 years old, its is expected that average height is 105 cm Short stature is defined as a condition in which an individual's height is in the 3rd (95th). Weight  Full-term neonates generally lose 5 to 8% of birth weight in the first few days after delivery but regain their birth weight within 2 weeks.  750gm in 1st four month, then 500gm in the 2nd four months and 250gm in the last 4 months  Doubling their birth weight by 5 months, tripling it by 12 months, and almost quadrupling it by 2 years. Between age 2 years and puberty, weight increases approximately 2 kg/year. Methods of measuring the weight Equation for average weight  (Age in years *2)+8  For example for a child of 2 years old the average weight is 12kg  Failure to thrive (underweight) in children is weight consistently below the 3rd to 5th percentile for age and sex or, or a decrease in 2 major growth percentiles in a short period of time.  The cause may be a medical condition or may be related to environmental factors.  Most types of failure to thrive relate to inadequate nutrition. Treatment is aimed at restoring proper nutrition. Occipitofrontal circumference  Head circumference increases an average 1 cm/month during the first year  Head circumference increases 3.5 cm over the next 2 years;  Routinely measured up to 36 months.  The brain is 80% of adult size by age 3 years and 90% by age 7 years. How to measure the OFC Macrocephaly  Macrocephaly can also be a sign of serious acquired conditions such as progressive hydrocephalus, vascular anomalies, or intracranial masses that may necessitate urgent intervention or in chronic conditions as rickets or chronic hemolytic anemia Microcephaly Tooth eruption Deciduous teeth are replaced by permanent teeth between the ages of 5 years and 13 years Teething Temporary They are 20 in number, 10 in each jaw At 6 months……lower central incisors 8 months…..upper central incisors 10 months...upper lateral incisors 12 months…lower central incisors 15 months…1 molars st 18 months…canines 24 months…2 molars nd Permanent They are 32 in number At 6 years…..1 molar st 8 years…..central incisors 9 years…..lateral incisors 10 years…canines 11 years…1 premolars st 12 years…2 premolars nd 13 years…2 molars nd 17-25 years…3 molarsrd  Teething is the process in infants of tooth eruption through the gums.  The child may cry, be fussy, and sleep and eat poorly  The child may drool, have red and tender gums, and chew constantly on objects such as toys  Teething infants get some relief from chewing on hard (eg, teething biscuits) or cold objects (eg, firm rubber or gel- containing teething rings).  Massaging the child's gums with or without ice also may help. Children may be treated with weight-based doses of acetaminophen or ibuprofen  Teething gels are not recommended because they are not any Delayed teething in children  premature birth,  low birth weight,  poor nutrition, or  Genetics e.g Down syndrome,  endocrine DEVELOPMENT (GROSS MOTOR) DEVELOPMENT (FINE MOTOR) SPEECH DEVELOPMENT BOWEL and bladder DEVELOPMENT  Children normally gain control over their bladders somewhere between ages 2 and 4—each in their own time.  Diurnal (daytime) incontinence is usually not diagnosed until age 5 or 6. Nocturnal (nighttime) incontinence (that is, enuresis) is usually not diagnosed until age 7.  Most children have bowel control by age 3  Stool incontinence is the voluntary or involuntary passage of stool in inappropriate places in children > 4 years of age (or developmental equivalent) who do not have an organic defect or illness with the exception of constipation. Social development Causes of developmental delay Quiz (T/F)  Growth is quantitative change while development is a qualitative change (T)  Infancy is the first 28 days of life (F)  Failure to thrive is weight persistently below 25 th centile (F)  stool incontinence is diagnosed if the child can not control bowel at 2 years (F)  Pre term babies are liable to developmental delay (T)