Exam 4: NSG222/ NSG 222 (Latest 2024/ 2025 Update) Family Nursing | Review with Questions and Verified Answers| 100% Correct| Grade A- Herzing
Exam 4: NSG222/ NSG 222 (Latest 2024/
2025 Update) Family Nursing | Review with
Questions and Verified Answers| 100%
Correct| Grade A- Herzing
Q: What toys are appropriate for ages 1-4 months?
Answer:
•Age 1-4 months: mobile, mirrors, rattles, music/singing, high-contrast patterns in books
Q: What toys are appropriate for 4-7 months?
Answer:
4-7 months: fabric/board books, music, toys that do things and are easy to hold, toys that float or
squirt water, soft dills/animals
Q: What toys are appropriate for 6-12 months?
Answer:
6-12 months: plastic cups, bowls or buckets, mirror, blocks, stacking toys, busy boxes, balls,
dolls, toy phone, push-pull toys, board books with pictures
Q: What factors are important for infant nutrition?
Answer:
Infants should have breast milk or formula until age 6 months. Solid foods can be introduced
around 6 months, introducing 1 new food a week. Continue breast milk or formula until age 1
year. Then the infant can be switched to whole milk.
Q: What is safety related to infant care?
Answer:
•Keep small objects or hard foods out of reach.
Cover outlets, protect from falls, prevent poisoning from medications or household chemicals.
Never leave unattended by water. Car seat should be rear facing throughout infancy and in the
back seat. Crib should have firm mattress that fits snugly in crib
Q: What are some developmental concerns related to growth/development in the infant period?
Answer:
Colic
Spitting up
Thumb Sucking
Teething Pain
Q: How to address Colic?
(Infant developmental concerns)
Answer:
•inconsolable crying that lasts 3 hours or more. It happens more often in the evening and usually
resolves around 3 months of age. Parents should develop stepwise approach to make sure the
basic needs are met. When needs are met, they attempt to soothe by reducing stimulation,
carrying, swings/vibration, pacifier (try 1 intervention at a time).
Q: How to address spitting up?
(Infant developmental concerns)
Answer:
•normal after feedings. Encourage to burp frequently and keep upright (not in a seat) for 30
minutes after feeding.
Q: How to address thumb sucking/security?
(Infant developmental concerns)
Answer:
•thumb sucking is a healthy, self-comforting activity. Pacifiers work but can be linked to
increased incidence of otitis. If use pacifier, wean by age 2-3 or can negatively affect teeth. If
have security object, wean after infancy.
Q: How to address teething pain?
(Infant developmental concerns)
Answer:
•application of cold can be soothing, over-the-counter topical anesthetics may be helpful
Q: Piaget Infant Development
Answer:
•sensorimotor, uses senses to explore the world. Discusses separation anxiety, object
permanence, ability to use symbols
Q: Erikson Infant Development
Answer:
•Trust vs mistrust, infant develops trust when needs met. Caregivers learn infant signals and
responds to them to meet needs, signals include crying, cooing and facial expressions
Q: Freud Infant Development
Answer:
•oral stage, sexual urges gratified through mouth
Q: What type of discipline is appropriates in infants?
Answer:
•Setting limits for safety
•Reward good behavior (Positive reinforcement)
•Be consistent
•Maintain routines
Q: What are expectations related to growth in toddlers?
Answer:
•Weight: gain 3-5 pounds a year
•Height: grow about 3 inches per year, reach half of adult height by age 2.
•Head circumference: grows 1 inch between ages 1 and 2, then half an inch per year until age 5
•Anterior fontanel should be closed by age 18 months
Q: Developmental Expectations by 15 months
Answer:
•Walks alone by 15 months, creeps up stairs, begins to run, uses cup, builds tower of 2 blocks
Q: Developmental Expectations by 18 months
Answer:
•kicks a ball, jumps in place with both feet, uses push-pull toys (toys they can manipulate),
builds tower of 3-4 blocks
Q: Developmental Expectations by age 2
Answer:
•climbs on furniture, walks up and down stairs, builds tower of 4 or more blocks, runs and jumps
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What type of reflexes are neonates born with?When do they disappear? Neonates are born with many reflexes called primitive reflexes. They are the Moro reflex, root, suck, asymmetric tonic neck, plantar and palmar grasp, step and Babinski reflexes.The Babinski reflex disappears at about age 1 year, the other reflexes diminish over the first few months of life
What types of reflexes do Neonates develop? When the primitive reflexes diminish, the infant develops protective or postural response reflexes. They help with motor development and remain for life once established. They are the righting and parachute reactions.
What development is expected in infants that are 3 months old? •Lifts head and neck when on abdomen•Grasps objects•Turns head side to side•Reflexes still present but palmar and plantar grasps disappearing (3-4 months)
What development is expected of a 6 month old? •Moro reflex disappears around 6 months, startle at 4 months, tonic neck 4-6 months.•Birth weight double by 6 months•Rolls front to back around 5 months, back to front around 6 months•Reaches for and grasps object, puts them in mouth•Chews/teething, babbles•Sits when propped, can support some weight if held in standing position•Recognizes familiar objects, expresses displeasure if removed, developing object permanence
What are developmental findings in a 9 month old? •Sits unsupported by 8 months, pulls to standing 8-9 months and crawls, responds to name•Transfers objects hand to hand, points to and picks them up, uses pincer grasp•Likes mirrors•Develops separation anxiety between 8-9 months, around 9 months also develops stranger anxiety
What development is expected by age 1 year? •Birth weight tripled•Has 6-8 teeth•Knows name•Cruises or walks when 1 hand held•Places object in container•May have security object•Drink from cup and use spoon but prefers fingers
What toys are appropriate for ages 1-4 months? •Age 1-4 months: mobile, mirrors, rattles, music/singing, high-contrast patterns in books
What toys are appropriate for 4-7 months? 4-7 months: fabric/board books, music, toys that do things and are easy to hold, toys that float or squirt water, soft dills/animals
What toys are appropriate for 6-12 months? 6-12 months: plastic cups, bowls or buckets, mirror, blocks, stacking toys, busy boxes, balls, dolls, toy phone, push-pull toys, board books with pictures
What factors are important for infant nutrition? Infants should have breast milk or formula until age 6 months. Solid foods can be introduced around 6 months, introducing 1 new food a week. Continue breast milk or formula until age 1 year. Then the infant can be switched to whole milk.
What is safety related to infant care? •Keep small objects or hard foods out of reach. Cover outlets, protect from falls, prevent poisoning from medications or household chemicals. Never leave unattended by water. Car seat should be rear facing throughout infancy and in the back seat. Crib should have firm mattress that fits snugly in crib
What are some developmental concerns related to growth/development in the infant period? ColicSpitting upThumb SuckingTeething Pain
How to address Colic? (Infant developmental concerns) •inconsolable crying that lasts 3 hours or more. It happens more often in the evening and usually resolves around 3 months of age. Parents should develop stepwise approach to make sure the basic needs are met. When needs are met, they attempt to soothe by reducing stimulation, carrying, swings/vibration, pacifier (try 1 intervention at a time).
How to address spitting up?(Infant developmental concerns) •normal after feedings. Encourage to burp frequently and keep upright (not in a seat) for 30 minutes after feeding.
How to address thumb sucking/security?(Infant developmental concerns) •thumb sucking is a healthy, self-comforting activity. Pacifiers work but can be linked to increased incidence of otitis. If use pacifier, wean by age 2-3 or can negatively affect teeth. If have security object, wean after infancy.
How to address teething pain?(Infant developmental concerns) •application of cold can be soothing, over-the-counter topical anesthetics may be helpful
Piaget Infant Development •sensorimotor, uses senses to explore the world. Discusses separation anxiety, object permanence, ability to use symbols
Erikson Infant Development •Trust vs mistrust, infant develops trust when needs met. Caregivers learn infant signals and responds to them to meet needs, signals include crying, cooing and facial expressions
Freud Infant Development •oral stage, sexual urges gratified through mouth
What type of discipline is appropriates in infants? •Setting limits for safety•Reward good behavior (Positive reinforcement)•Be consistent•Maintain routines
What are expectations related to growth in toddlers? •Weight: gain 3-5 pounds a year•Height: grow about 3 inches per year, reach half of adult height by age 2.•Head circumference: grows 1 inch between ages 1 and 2, then half an inch per year until age 5•Anterior fontanel should be closed by age 18 months
Developmental Expectations by 15 months •Walks alone by 15 months, creeps up stairs, begins to run, uses cup, builds tower of 2 blocks
Developmental Expectations by 18 months •kicks a ball, jumps in place with both feet, uses push-pull toys (toys they can manipulate), builds tower of 3-4 blocks
Developmental Expectations by age 2 •climbs on furniture, walks up and down stairs, builds tower of 4 or more blocks, runs and jumps
Developmental Expectations by age 3 •builds tower of >6 blocks, plays on riding toys, takes steps on tiptoe, stands on one foot, draws circles, dresses and undresses self with assistance, scribbles, shows hand preference, has most of baby teeth
How do toddlers play? •Toddlers exhibit parallel play, they like to imitate others, also like make believe
What toys are appropriate for toddlers? •Appropriate toys are:•Blocks•Books•Push-pull toys•Balls•Finger paints•Puzzles with large pieces•Thick crayons•Containers they can fill and empty
Erikson Toddler Development •autonomy versus shame and doubt, seek autonomy by gaining more control over toileting and food preferences, success leads to self-confidence and self control, if not successful leads to shame and doubt
Piaget Toddler Development •in preoperational stage, displays magical thinking-think their thoughts impact the real world, play make believe, imitate others, are egocentric, can’t see things from other’s perspective
Feud Toddler Development •anal stage, derive pleasure from controlling bowel movements
Kohlberg Toddler Development •preconventional stage starts at age 2, follow rules for fear of punishment
What do parents need to do to promote growth and development for toddlers? •Frustration leads to temper tantrums, parents need to provide consistent, age-appropriate expectations to assist with this. When tantrums happen, ignore the behavior and make sure the child is safe. Parents need to model self-control.•Maintain routines, this provides comfort•Discipline should be consistent with well-defined boundaries to develop appropriate behaviors
Toddlers and Nutrition to promote growth and development Should be weaning from bottle by 12-15 months, Dairy products are primary source of calcium. Milk should be limited to 16 ounces a day to prevent iron-deficiency anemia. Include iron-fortified cereals in diet. Cur all foods into bite-sized pieces to prevent choking.
Safety Related to Toddlers •Car seat: use appropriate size/style for weight and age. Should be rear-facing until age 2, then may be forward facing•Home: avoid exposure to tobacco smoke, use safety gates, lock doors that may have dangerous contents, cover outlets and try to hide electrical cords, lock firearms, wear helmet when on bike. Begin teaching about crossing streets and avoiding animals they do not know. Lock cabinets containing chemical•Water safety: Supervise in and around water at all times
Age 3 Milestones for Preschool Development • climbs well, runs easily, walks up and down stairs with alternate feet, undresses self, builds tower of 9-10 blocks, screws/unscrews lids, turns book pages
Age 4 Milestones for Preschool Development •hop and stand on one foot, throws overhand, catches a bounced ball, kicks ball, uses scissors, draws circles and squares, laces shoes, draws a person with 2-4 body parts
Age 5 Milestones for Preschool Development •Speak so strangers can understand by 5, brushes teeth and uses toilet and dresses without assistance, can skip, swim and ride a bike, jumps rope, walks backward heel to toe, prints some letters, ties shoes, uses utensils well
Growth in height and weight for preschool ages 3-5 •They will grow about 2.5-3 inches a year and gain 4-5 pounds a year
How do preschoolers play? •Preschoolers exhibit associative play, it is not organized but they can cooperate with others
Appropriate Activities for Preschoolers •Playing ball•Puzzles, simple sewing, electronic games•Plays make believe and dress-up•Role play, sand boxes, skating, wading pools•Painting•Puppets•Books•Musical toys/instruments
Piaget Preschooler Development •preoperational phase, have some ability to consider the viewpoint of others. Focus on one aspect, understand sequences, have magical thinking, give lifelike qualities to inanimate objects.
Erikson Preschooler Development •initiative versus guilt, feel guilty if they cannot accomplish a task or think they misbehaved.
Kohlberg Preschool Development •preconventional, early preschool same as toddlers, older preschoolers can begin to understand justice and fairness.
Freud Preschool Development •phallic stage 3-6 years old, preoccupied with genitals, curious about anatomic differences
What are signs that the preschooler is ready for kindergarten? •Children can follow rules and expectations set fo rthem•Can tolerate being in school 5 days a week•Start new routines early to help them transition•Plan ahead for immunizations required by school or obtain appropriate waivers
What Are Important Safety Measures For Preschoolers? •Car seat: use forward facing seat with top tether until age 4, after reaching car seat height restrictions can use booster that uses lap and shoulder belt•Home: prevent tobacco exposure, safety by streets/on bikes, prevent poisoning by keeping medication and chemicals locked/out of reach•Water safety: good time for swim lessons but still too young to be left unattended
•What is important regarding promoting nutrition in preschoolers? •Continue to learn healthy eating habits•Limit sweets and fast foods•May be picky eaters, may not try new things or eat only a small variety of foods. If they are growing well, is not a concern. Avoid coaxing or threatening behaviors as they may create negative relationships related to mealtime•Maintain a matter-of-fact approach to eating, offer the meal or snack and allow them to decide how much of the food if any they eat
Other Considerations of Preschoolers -may believe in monsters or be afraid of the dark-lying may be common due to fear of getting in trouble or because of their imagination-body integrity is important-uses future tense-knows same and different-Asks why
What is expected growth and development in the school-age years? •From ages 6-12, grow about 2.5 inches a year and gain about 7 pounds a year•Growth will slow for boys between ages 10-12, which may lead to obesity. Girls may grow rapidly an they will have changes in their body that will soften their body lines.•All 20 primary teeth are lost and will be replaced by 28 permanent teeth (the 4 third molars or wisdom teeth will not be in).
Expected Activities for ages 9-12 make crafts, build models, start hobbies, collect things, solve jigsaw puzzles, play board and card games, involved in organized competitive sports
Expected Activities for ages 6-9 •ride bikes, jump rope, play hopscotch, have collections, play simple board and number games, build simple models, join organized sports
What type of play do school age children do? •School age children engage in cooperative play, they can complete complex tasks due to improved coordination, balance and fine motor skills
What is important for safety for school-age children? •Increased independence may lead to increased self-confidence and decreased fears, which contributes to accidental injuries•Car safety: when child is 4ft 9in or taller, may sit in car without booster using shoulder and lap belt. Should not be in front seat with airbag before age 13.•Pedestrian safety: children under age 10 should not walk alone•Bicycle/sport: use of helmets for bicycles and skating•Fire: supervise matches, cooking and ironing•Water: supervise to prevent water-related accidents•TV/internet: Limit TV watching, internet activity and video game activity and do not use these activities as rewards.
What is important related to nutrition for school-age children? •Diet: Diet preferences continue•Influence: Outside activities, family, media and peers can influence eating habits.•Need: Need calcium from milk, yogurt and cheese for development of strong bones and teeth. Need lean meats, poultry, fish and eggs to provide protein, vitamins and minerals•Promote: Promote balanced diet, avoiding fatty meats, high-fat dairy products, eggs.•Encourage: Encourage exercise and limit sedentary activities to prevent obesity
Piaget School Age Children Development •concrete operations stage, tell time, classify complex information, can solve problems and see the perspective of others, can think abstractly, can master math and reading skills, understands cause and effect
Erikson School Age Development •industry versus inferiority, sense of accomplishment gained through ability to cooperate and compete with others, have sense of inferiority if unable to master tasks, wants to form relationships.
Kohlberg School Age Development •preconventional to age 7, then conventional, they seek conformity and loyalty, follow rules and want to maintain social order, like to do activities with a friend, forms clubs with rules
Freud School Age Development •latency stage, focuses on peer relationships, wants privacy and to understand body
What development is expected in adolescence? •Coordination may be an issue due to uneven growth spurts•Handwriting is neat, have precise hand-eye coordination and finger dexterity
How is development for adolscence different between boys and girls? •Girls reach physical maturity before boys, the first menstrual period begins between age of 9 and 15 (average 12.8 years). Height increases rapidly before menarche and ends 2-2.5 years after menarche.•Boys growth spurt is later (between ages of 10.5 and 16 years) and ends between ages 13.5 and 17.5 years. Muscle mass increase in boys.
How do we promote healthy weight in an adolescent? •Assess the knowledge of the parents an adolescent on healthy eating•Encourage the adolescent to keep a detailed food and exercise dairy for 1 week to determine patterns of eating and exercise•Analyze data with adolescent and recommend changes•Have adolescent create meal and plans and help with grocery shopping to give them a sense of control and decision-making•Assist with adding exercise to daily routine to decrease/avoid obesity
Piaget Adolescences Development •10 and 11 year olds are still in the concrete operations stage. At age 12 they transition to the formal operations stge. They develop analytic and abstract thinking, show concern for politics and social issues, they are able to think long term and set goals, they compare themselves with their peers, start to have an awareness of personal limitations, they are able to predict outcomes and consequences.
Freud Adolescence Development • latency stage until 12, then they are in the genital stage. During this stage, they struggle with sexuality, their body changes and fluctuating hormones brings back sexual desire, their social relationships are changing, they struggle with dependence versus independence from their parents, they are learning to form loving relationships, they must manage sexual urges in socially acceptable ways.
Erikson Adolescent Development •Adolescents are in the identity versus role confusion stage according to Erikson. They are preoccupied with how they are seen in the eyes of others and are working to establish their own identity. They try out new roles to see what is best for them. If they cannot find a meaningful definition of self they are at risk for role confusion in one or more roles in their life. Some confusion is good and can result in self-reflection and self-examination.
Kohlberg Adolescent Development •Kohlberg believes that they are in the postconventional stage of development. They construct a personal and functional value system that is independent of their authority figures and peers.
T/F Suicide is the second leading cause of death in youths 10 to 24 years of age. True
T/F Fine motor skills develop in a cephalocaudal fashion (from the head to tail). False.Fine motor skills develop in a proximodistal fashion (from the center to the periphery). Gross motor skills develop in a cephalocaudal fashion (from the head to the tail).
The nurse is assessing a 7-month-old premature infant born at 28 weeks’ gestation. What would be the adjusted age upon which the nurse would base assessment of the infant growth and developmental milestones? 4 months. The nurse assessing developmental milestones for a 7-month-old premature infant born at 28 weeks’ gestation would adjust the age to 4 months.
The nurse praises a 3-year-old child for using the potty. Which of the following theorists focuses on the satisfaction/frustration of expelling feces? b. FreudFreud’s theory focuses on the satisfaction and/or frustration of expelling feces (anal stage).
What does Piaget’s theory focus on for toddlers? Piaget’s theory focuses on development of the senses of the toddler
What does Erikson’s theory focus on for toddlers? Erickson’s theory focuses on achievement of autonomy and self-control
What does Kohlberg’s theory focus on for toddlers? Kohlberg’s theory focuses on the moral development of the toddler.
T/F A colorful simple board game that requires multiple players to cooperate with each other for a common goal would be the best type of toy for toddlers. False. Toddlers tend to engage in parallel, solitary play and are not likely to cooperate in a group game situation because of their basic egocentric nature.
The nurse is planning a diet for a toddler that is rich in vitamin A. Which of the following foods might the nurse include? d. Carrots. Carrots are rich in vitamin A. Other foods rich in vitamin A include apricots, cantaloupe, spinach, mangos, dark greens, and sweet potatoes.
The nurse is assessing a 3-year-old for gross motor skill development. Which of the following would the nurse expect this preschooler to have accomplished? bend over without falling. The 3-year-old should be able to bend over without falling.
The nurse is assessing a 5-year-old child for signs of developmental delay. Which of the following would alert the nurse to a potential problem? the child does not play with other children. This is a sign of a potential developmental delay.
T/FThe nurse should recommend that parents of a 3- to 5-year-old receive 700 to 1,000 mg calcium and 7 to 10 mg iron daily. True
T/F The school nurse conducting a vision screening program identifies a child with amblyopia. Both eyes were noted to have visual acuity less than expected for the child’s age. False. Amblyopia, or lazy eye, occurs when one eye is more nearsighted, farsighted, or astigmatic than the other eye causing an imbalance in vision.
The nurse obtains a nutrition history for a school-age child. The parent indicates the child’s favorite beverage is apple juice and consumes three large glasses per day. The mother asks if this is a good thing.Which of the following would be the best response for the nurse to reply to the mother? An 8-oz serving of apple juice has about 24 g of sugar—the equivalent of 3 teaspoons of sugar, with none of the fruit fiber that would be available in a whole apple.Rationale: Children need both fruit and fiber daily as part of a healthy diet. Apple juice, while made from apples, concentrates the sugar and takes out the fiber. Water and milk are good alternatives for beverages.
The nurse is assessing the cognitive development of an adolescent. Which of the following statements accurately represents a normal finding at this stage? The adolescent develops the ability to think outside the present.Rationale: According to Piaget, the adolescent progresses from a concrete framework of thinking to an abstract one. During this period, the adolescent develops the ability to think outside of the present; that is, he or she can incorporate into thinking concepts that do exist as well as concepts that might exist. Not all adolescents achieve formal operational reasoning at the same time. Adolescent thinking starts out egocentric and then becomes very introspective and idealistic.
Erikson Theory Infants Birth to 1 yearTrust vs. Mistrust Caregivers respond to the infant’s basic needs by feeding, changing diapers, cleaning, touching, holding, and talking to the infant. This creates a sense of trust in the infant.As the nervous system matures, the infant realize they are separate beings from their caregivers. Over time, the infant learns to tolerate small amounts of frustration and trusts that although gratification may be delayed, it will eventually be provided
Erikson’s Theory Toddlers Ages 1-3Autonomy vs. Shame & DoubtAchieves autonomy and self controlSeparates from parent/caregiverWithstands delayed gratificationNegativism aboundsImitates adults and playmatesSpontaneously shows affectionIs increasingly enthusiastic about playmatesCannot take turns in games until 3
Erikson’s Theory Preschool Ages 3-6Initiative vs. GuiltLikes to please parentsBegins to plan activities and make up gamesInitiates activities with othersActs out of the roles of other peopleDevelops sexual identity and conscienceMay take frustrations out on siblingsLike to explore new thingsFeels remorse when wrong choices are madeCooperates with other children and negotiates solutions to conflict
Erikson’s Theory School Age Industry vs. InferiorityInterested in how things are madeSuccess in personal and social tasksIncreased activities outside home, increased interactions with peers, and increased interest in knowledgeNeeds support and encouragementInferiority occurs with repeated failures with no support
Piaget Infants What are the different stages? SensorimotorSubstage 1: Use of reflexes (birth to 1 month)Substage 2: primary circular reactions (1-4 months)Substage 3: Secondary Circular reactions (4-8 months)Substage 4: coordination of secondary schemes (8-12 months)
Piaget Infants Activities for Phase Infant uses senses and motor skills to learn the worldReflexes sucking brings the pleasure of ingesting nutrition. Infant begins to gain control over reflexes and recognizes familiar objects, odors, and sounds.Thumb sucking may occur by chance, then infant repeats it on purpose to show pleasure. Beginning of imitation and object permanence (Object permanence complete by 8 months)Infant repeats actions to achieve wanted results. Actions are purposefulInfants coordinate previously learned schemes with previously learned behaviors.Infant begins to associate symbols with events
Piaget Toddlers Different Phases SensorimotorSubstage 5: Tertiary circular reactions (12-18 months)Substage 6: Mental Combinations(18-24 months)Preoperational Ages 2-7Differentiates self from objectsIncreased object permanence beginning symbolic thought
Piaget Toddler Activities “Differentiates self from objectsIncreased object permanenceUses all senses to explorePlaces items in and out of containersImitates domestic chores and is more symbolicStarts to think before actingUnderstands requests and is capable of following simple directionsHas a sense of ownershipTime, space, and causality understanding is increasingUses mental trail and errorMakes mechanical toys workPlays make-believeIncreased use of languageUnderstands concept of “”two””Starts to make connections between an experience in the past and a new one that is occurringSorts objects by shape and colorCompletes puzzles with four pieces”
Piaget Preschoolers Preconceptual Phase Preconceptual(2 to 4 years)Exhibits egocentric thinkingHas short attention span and learns through observing and imitatingDisplays animism and Active ImaginationForms concepts that are not as completeIs able to make simple classificationsBy age 4, understands oppositesReasoning that is specific to specific
Piaget Preschoolers Intuitive Phase Intuitive phases(4 to 7 years)Is able to classify and relate objectsHas intuitive thought processes and knows right vs wrongTolerates others differences but does not understandIs curious about factsKnows acceptable cultural rulesUses words appropriately but often without true understandingMay begin to question parental values
Piaget School Age Phase & Activities Concrete OperationalLearns by manipulating objects, no abstract thinkingUnderstands timeClassifies or groups objects by their common elements and understands relationships among objectsStarts to collect itemsCan reverse thought process
Piaget Adolence Phase Early Formal OperationEarly 10-13 yearsLimited abstract thought processEgocentric thinkingEager to apply limited abstract process to different situations
Piaget Adolescence Phase Middle Formal Operation Middle 14-17 yearsIncreased ability to think abstractly or in more idealistic termsAble to solve verbal and mental problemsThink he or she is invincible- risky behaviorsLikes to make independent decisions
Piaget Adolescence Phase Late Formal Operation Late: 17-20 yearsAbstract thinking is establishedDevelops critical thinking skillsLess risky behaviorDevelopsrealistic goals and career plan
Freud Infant Oral StagePleasure is focused on oral activities such as feeding and sucking
Freud Toddler AnalFocus is no achieving sphincter controlSatisfaction and/or frustration may occur as toddler learns to withhold and expel stool
Freud Preschool 3-7 Phallic StageChild’s pleasure centers on genitalia and masturbationSuperego is developing and conscience is emergingOedipal stage occurs, jealous or rivalry towards same-sex parent which resolves by end of preschool years when child develops identification with same sex parent
Freud School Age LatencyA time of tranquility between the oedipal phase of early childhood and adolescence andFocus on activities that develop social/cognitive skillsDevelops social skills in relating to same-sex friends
Kohlberg Punishment-Obedience Orientation Ages 2-7Determines good vs bad dependent upon associated punishmentChildren may learn inappropriate behavior at this stage if parental intervention does not occur
Kohlberg Conventional Phase “Stage 3: Interpersonal conforming “”good child, bad child”” (Age 7-10)Stage 4: “”Law & Order”” (Ages 10-12)Acts are wrong because you get punishedBehavior is right or wrongDoes not understand the reason behind rolesCan put self in another person’s positionBegins to exercise “”golden rule””Acts are judged in terms of intention not just punishment”
Kohlberg Post Conventional Early: Asks broad, usually unanswerable questionsMiddle: Developing own set of morals- evaluates individual moralsLate: Internalizes own morals and valuesContinues to compare own morals and values to those of societyEvaluates morals of others
Atraumatic Care Family centered care, distraction methods, decrease stress, allow family members in the room, consider the age of the child. Atraumatic care is defined as therapeutic care that minimizes or eliminates the psychological and physical distress experienced by children and their families in the health care system
Communication Strategies for Children Introduce yourself and explain your role.Position yourself at the child’s level.Allow the child to remain near the parent if needed, so the child can remain comfortable and relaxed.Smile and make eye contact with the child if culturally appropriate.Direct your questions and explanations to the child.Listen attentively and pause to allow time for the child to formulate his or her thoughts.Use the child’s or family’s terms for body parts and medical care when possible.Speak in a calm, quiet, confident, and unhurried voice.Use positive, rather than negative, statements and directions.Encourage the child to express his or her feelings and ask questions.Observe for nonverbal cues.Ask for permission if you need to approach the child to avoid appearing threatening.
Health Supervision vs. Health Surveillance Proactively to prevent safety, screenings. Health supervision includes developmental surveillance and screening, injury and disease prevention, and health promotionHealth Surveillance:Concern that is already there
Anticipatory Guidance Anticipatory guidance is primary prevention. Early education in advance, when you think someone may be at risk for something, proactive care
DTaP Immunization Age Immunization against diphtheria, tetanus, and pertussis diseases is given via a combination vaccine. The vaccine currently used for children younger than age 7 is diphtheria, tetanus, acellular pertussis (DTaP).
Haemophilus Influenzae type B Immunization Age Two or three doses are needed for the primary infant series depending on the vaccine product used. A booster vaccine is needed at 12 to 15 months
Hep A & B immunization ages HepA is recommended to be given to all children at age 12 months, followed by a repeat dose in 6 to 18 monthsHepatitis B vaccination is recommended at birth, preferably within the first 12 hours, then at 1 to 2 months and 6 to 18 months. A total of four doses are acceptable when a combination vaccine with hepatitis B is used after birth
Varicella Immunization Age Varicella vaccine is a live attenuated virus vaccine. All children aged 12 to 15 months who have not had varicella (chickenpox) should be immunized. A second dose is recommended at age 4 to 6 year
PVC: Pneumococcal vaccine Age It stimulates an immune response in infants and is given at 2, 4, 6, and 12 to 15 months of age as part of the initial immunization series
Influenza Immunization Age Influenza immunization is recommended yearly for all persons 6 months of age or older. All children 6 months to 8 years of age who have not received at least two doses of the influenza vaccine will require two doses separated by 4 weeks
HPV Immunization Age HPV: Children aged 11 to 12 years old, and as young as 9 years old, should receive two shots 6 to 12 months apart. If the child is 15 or older, they will need to receive three shots
Examples of Community Nursing “Outpatient FacilitiesPhysicians’ offices, clinics, health departments, and urgent care centersMedically Fragile Daycare Centers: The medically fragile child, recently termed child with medical complexity, is defined as a child with “”substantial health care needs, one or more chronic conditions, functional limitations often associated with technology assistance, and health care use””SchoolsHome Health Care”
School Nurse Roles Conduct health screenings (such as vision, hearing, and scoliosis)Assess growth and developmentProvide emergency first aid, care for acute and chronic illnesses, such as medication administration and diabetes monitoringTrain and educate staff on cardiopulmonary resuscitation (CPR), first aid, and health issuesAssess, monitor, and refer students with communicable diseasesEducate on health promotion and disease prevention (such as immunizations; bike and car safety; decreasing high-risk behaviors, such as smoking, drinking, drug use, and sexual activity)Serve as a resource for health issues and educationAct as a liaison between health care provider and schoolReinforce client and family health education (such as discharge instructions, self-care measures)Monitor long-term illness in studentsNetwork with community agencies and make necessary referrals
Enternal Feedings keep site clean, education for family/child, education on what can go in and how to access, what position the child should be in, pump, free flow,Enteral nutrition, commonly called tube feedings, involves the insertion of a tube, so that feedings can be delivered directly into the child’s gastrointestinal tract. Enteral feedings can be given continuously or intermittently, regardless of the type of tube used. Checking for tube placement is a priority before administering any intermittent tube feeding and periodically during continuous tube feedings, regardless of the type of tube being used. Assess the abdomen for distension and bowel sounds. Also, measure the gastric residual. Begin the feeding by placing the child in a supine position with the head and shoulders elevated approximately 30 degrees so that the feeding will remain in the stomach area.Flush the tube with a small amount of water to clear it and prevent occlusion
Toddler Reaction to Pain Frustrated
Adolescent Reaction of Pain Have an attitude or be withdrawn
Primitive Reflexes Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski.
Protective Reflexes Protective reflexes (also termed postural responses or reflexes) are gross motor responses related to maintenance of equilibrium. These responses are prerequisites for appropriate motor development and remain throughout life once they are established. The protective reflexes include the righting and parachute reaction
By 6 Months, I would be concerned if my child is not……. (chart from study guide review) Does not smile or interact with peopleNot starting to babble (ahh, ooohh)Not reaching for or holding toysHands frequently clenchedDoes not explore objects with hands, eyes, and mouthDoes not bring hands together at midlineNot holding head and shoulders with good control when lying on stomachNot holding head with control in supported sitting
By 8 Months, I would be concerned if my child is not……. (chart from study guide review) “Not sharing enjoyment with others using eye contact or facial expressionNot using gestures (pointing, showing, waving)Not using 2 part babble (baba, dada)Does not hold objectsDoes not “”give”” objects on requestCannot move toy from one hand to anotherNot rollingNot sitting independentlyNot movingNot taking weight on legs when held in stand”
By 12 Months, I would be concerned if my child is not……. (chart from study guide review) Does not notice someone newDoes not play early turn-taking games (peekaboo, rolling a ball)No babble phrases that sound like talkingNo response to familiar wordsDoes not feed self-finger foods or hold own bottle/cupUnable to pick up small items using index finger and thumbNo form of independent mobilityNot pulling to stand independently and holding on for support
By 18 Months, I would be concerned if my child……. (chart from study guide review) Lacks interest in playing and interacting with othersNo clear wordsNot able to understand short requestsDoes not scribble with a crayon Does not attempt to stack blocks after demonstrationNot standing independentlyNot attempting to walk without support
By 2 years, I would be concerned if my child……. (chart from study guide review) When playing with tows tends to band, drop, or throw rather than use them for their purposeNot learning new wordsNot putting words together (push car)Does not attempt to feed self-using a spoor or/and does not help with dressing themselvesNot able to walk independentlyNot able to walk up and down stairs holding on
By 3 years, I would be concerned if my child……. (chart from study guide review) No interest in pretend play or interacting with other childrenDifficultly noticing and understanding feelings in themselves and othersSpeech difficult for familiar people to understandNot using simple sentences (big car go)Does not attempt everyday self care skillsDifficulty in manipulating small objects (threading beads)Not able to walk up and down stairs independentlyNot able to run or jump
By 4 years, I would be concerned if my child……. (chart from study guide review) Unwilling or unable to play cooperativelySpeech difficult to understandNot able to follow directions with 2 steps (put your bag away and then go play)Not toilet trained by dayNot able to draw lines and circlesNot able to walk, run, climb, jump or use stairs confidentlyNot able to catch throw or kick a ball
By 5 years, I would be concerned if my child……. (chart from study guide review) Play is different than their friendsDifficulty telling a parent what is wrongNot able to answer questions in a simple conversationConcerns from teachers about school readinessNot able to independently complete everyday routines such as feeding and dressingNot able to draw simple picturesNot able to walk, run, climb, jump or use stairs confidentlyNot able to hop 5 times on one leg and stand on one leg for 5 seconds