This study guide takes you through the module study guides from beginning to end in order to find the appropriate
information.
Modul Chapter Areas of Focus
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Modul 31 − Know the difference between Cephalocaudal and Proximodistal development
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o Cephalocaudal: proceeds from head downward through the body and toward the feet
▪ Infant’s head is much larger proportionately than trunk and extremities
▪ Infants learn to hold up head before sitting and to sit before standing
▪ Child gains control of the head and neck before the trunk and limbs.
o Proximodistal: proceeds from the center of the body outward toward the extremities
▪ infants are first able to control trunk, then arms; then fine motor in fingers
▪ As child grows, both physical and cognitive skills differentiate from general to
more specific skills. Child controls arm movements before hand movements;
child reaches for objects before being able to grasp them – controls their
hands before their fingers; can hold with entire hand before they can pick
something up with just their fingers
− Know Erickson’s stages of development and how you would apply those in talking with parents.
o Trust vs. Mistrust (Birth to 1 year) hold hospitalized baby often; offer comfort after painful
procedures; meet baby’s needs for food and hygiene
o Autonomy vs. Shame and Doubt (1 to 3 years) allow self-feeding opportunities;
encourage them to remove and put on own clothes, brush teeth, or assist with hygiene; if
immobilization for a procedure is necessary, proceed quickly, providing explanations and
comfort
o Initiative vs. Guilt (3 to 6 years) Offer medical equipment for play to lessen anxiety about
strange objects; assess kid’s concerns as expressed through their drawings; accept their
choices and expressions of feelings.
o Industry vs. Inferiority (6 to 12 years) encourage them to continue schoolwork while
hospitalized; encourage them to bring favorite pastimes to hospital; help child adjust to
limitations on favorite activities
o Identity vs. Role Confusion (12 to 18 years) Provide a separate recreation from for teens
who are hospitalized; take health Hx and perform exams w/o parents present; introduce
them to other teens w/ same health problems
o Parents benefit from learning what the child’s developmental tasks are at each stage
and from discussing ideas about how to encourage healthy psychosocial development.
o Help highlight parental concerns and provide reassurance about normal developmental
characteristics
o Child’s usual support is interrupted by hospitalization which also adds a situational
crisis to the normal developmental crisis a child is experiencing. Continued parental
, involvement is necessary during and after hospitalization to ensure progression thru
expected developmental stages
− Appropriate growth for infants.
o Birth weight usually doubles by about 5 months and triples by the end of the first year
o Height increases by about a foot
o Teeth begin to erupt at about 6 months, and by the end of the first year, infant has 6 to
8 deciduous teeth
− Milestones for infants, r/t motor development.
o Birth to 1 month
▪ Fine Motor
● Hold hand in fist
● Draws arms and legs to body when crying
▪ Gross Motor
● Inborn reflexes such as startle and rooting are predominant activity
● May lift head briefly if prone
● Alerts to high-pitched voices
● Comforts with touch
o 2 to 4 months
▪ Fine Motor
● Holds rattle and other objects when placed in hand
● Looks at and plays with own fingers
● Brings hands to midline
▪ Gross motor
● Moro reflex fading in strength
● Can turn from side to back and then return
● Decrease in head lag when pulled to sitting position; sits with head
Held in midline with some bobbing
● When prone, holds head and supports weight on forearms
o 4 to 6 months
▪ Fine Motor
● Grasps rattles and other objects at will; drops them to pick up another
offered object
● Mouths objects