PEDS 4130: Peds Study Guide Test 1. Study Guide.

Review growth and development-focusing on Erikson's theory, review childhood vaccines focusing on 5 years and under, read up on anticipatory guidance-by age group focusing on nutrition, safety and developmentally appropriate toys. Read up on how to administer medications and the proper way to assess a child (least invasive to most invasive). Know age appropriate play, nutrition, safety, anticipatory guidance, psychosocial development and physical development and vaccines. Growth and Development Ch. 32 - Growth refers to an increase in physical size. o Quantitative changes such as height, weight, blood pressure, and number of words in the child’s vocabulary. - Development refers to a qualitative increase in capability or function. o Ability to sit without support or to throw a ball overhand. - Skill development proceeds according to two processes: from the head downward; and from the center of the body outward. o Cephalocaudal Development: proceeds from the head downward through the body and toward the feet. Head to toe (tail) KNOW!  At birth an infant’s head is larger proportionately than the trunk or extremities. Infants learn to hold up their heads before sitting and to sit before standing. o Proximodistal Development: proceeds from the center of the body outward toward the extremities. Center to the periphery  Infants are first able to control the trunk, then the arms; only later are fine motor movements of the fingers possible. Anticipatory Guidance - Health teaching BEFORE characteristic behaviors and concerns occur - Teach about what child is capable of doing Major Theories of Development Erikson’s Theory of Psychosocial Development - For each stage, Erikson identified a crisis, that is, a particular challenge that exists for healthy personality development to occur. - The word “crisis” refers to normal maturational social needs rather than to a single critical event. - When needs are met, the consequence is healthy and the individual moves on to future stages with particular strengths. - When needs are not met, an unhealthy outcome occurs that will influence future social relationships. o Critical period for the development of Trust versus mistrust Stages: 1. Trust versus Mistrust (birth to 1 year) INFANT: the task of the first year of life is to establish trust in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and comfort. If basic needs are not met, the infant learns to mistrust others. - Consistent primary caregiver meets infant’s needs o Nutrition, warmth, stimulation, sleep, comfort - Hold the hospitalized baby often. - Offer comfort after painful procedures. - Meet the baby’s needs for food and hygiene. - Encourage parents to room in. Manage pain effectively with use of pain meds and other measures. 2. Autonomy versus shame and doubt (1 to 3 years) TODDLER: the toddler’s sense of autonomy or independence is shown by controlling body excretions, saying “no” when asked to do something, and directing motor activity and play. Children who are consistently criticized for expressions of autonomy or for lack of control, for example, during toilet training will develop a sense of shame about themselves and doubt in their abilities. - Allow self-feeding opportunities. - Encourage child 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. 3. Initiative Versus Guilt (3 to 6 years) PRESCHOOL: the young child initiates new activities and considers new ideas creating a child who is involved and busy. Constant criticism, leads to feelings of guilt and a lack or purpose. - Offer medical equipment for play to lessen anxiety about strange objects - Assess children’s concerns as expressed through their drawings - Accept the child’s choices and expressions of feelings 4. Industry versus inferiority (6 to 12 years) SCHOOL AGE: the middle years of childhood are characterized by development of new interests and by involvement in activities. The child takes pride in accomplishments in sports, school, home, and community. If the child cannot accomplish what is expected, the result will be a sense of inferiority. - Encourage the child to continue schoolwork while hospitalized. - Encourage the child to bring favorite pastimes to the hospital. - Help the child adjust to limitations on favorite activities. 5. Identity versus role confusion (12 to 18 years) ADOLESCENT: in adolescents, as the body matures and thought processes become more complex, a new sense of identity or self is established. The self, family, peer group, and community are all examined and redefined. The adolescent who is unable to establish a meaningful definition of self will experience confusion in one more roles of life. - Provide separate recreation room for teens who are hospitalized. - Take health history and perform examinations without parents present. - Introduce adolescent to other teens with same health problem. Infant (Birth to 1 Year) Pg. 825 Trust versus Mistrust Physical Growth and Development - The birth weight usually doubles by about 5-6 months KNOW! o Birth weight: 6 lbs 10 oz o Six months: (12 lbs 20 oz ) = 13 lbs 4 oz - Triples by the end of the first year