Childrearing Outline Chapter 32, 33, 34 & 35

Chapter 32: Nursing Care of a Family With a School-aged Child

1. Physical Growth
a. Height- School aged children gain about 1-2in in
height
b. Weight- School aged children gain about 3-5lbs per
year
c. Brain Development- Brain growth is complete by 10
which means fine motor coordination becomes
refined.
d. Sexual Maturation- Begins between 8-14 years old.
Girls 12-28, boys 14-20.
e. Teeth- malocclusion or malalignmnet may be
present
1. Be familiar with these changes
2. Developmental Milestones
a. Gross Motor- School aged children are able to
jump, tumble, skip, and hop. They have enough
coordination to walk in a straight line and ride a
bike.
b. Fine Motor- School aged children are able to tie
their shoe laces, draw, writing becomes less
awkward
c. Play
3. Language Development
 a. What is expected at this age- Children in this age
group have no problem talking in full sentences
and using language easily. Children like dirty jokes
and bathroom talk
4. Cognitive Development
a. Piaget
1. Accommodation- Accomodation is the ability to
adapt thought process to fit what is perceived
such as understanding that there can be more
than one reason for other peoples actions.
2. Conservation- Conservation is the ability to
appreciate that a change in shape does not
mean a change in size.
3. Class inclusion
1. What is it, how does it progress, what does it
look like in practice and why is it important?
Class inclusion is the ability to
understand that objects can belong to
more than one class.
5. Emotional Development
a. Erickson
1. Home and school setting- Children may stray
more towards friends and find other role
models than their parents. They begin to do
chores sloppily so they have more social time.
 2. Structured activities- To increase a sense of
industry, activities like boy scouts and girl
scouts keep the children active.
3. Problem solving- Problem solving is a very
important part of developing industry. Parents
can help develop the sense of industry by
encouraging the child to practice. If the child
asks, “is this the right way to do something?”
the parent should speak to the child about
multiple ways to complete the task rather than
provide a quick solution.
4. Socialization
1. Know what these emotional development
tasks are, what do they look like in practice,
and why are they important?
6. Kohlberg
a. Preconventional Reasoning
1. Be familiar with this theory and what it looks like
in practice Children only understand an action
is wrong in terms of fairness, not because of
the wrong morality of the action. Eg, in
preconventional reasoning, children don’t
understand that stealing is wrong because it
hurts their neighbor, they view it as wrong
because you get arrested.
7. Safety
a. Accidents/Unintentional Injuries-
 1. What are the biggest concerns for school-aged
children? Motor vehicle accidents and bicyle
injuries
2. Ways to prevent accidents/injuries
3. Anticipatory guidance for parents
8. Nutritional Needs
a. Caloric needs/Recommended Dietary Intake
b. Healthy Eating
1. Obesity
2. Food allergies
c. Fostering industry and nutrition
9. Common Health Problems of School-aged Children
a. Minor GI and Respiratory
b. Dental cavities
c. Malocculusion
10. Daily Activities
a. Dress
b. Sleep
c. Exercise
d. Hygiene
1. Why are these activities important and antipopery
guidance for parents?
11. Discipline
a. What is appropriate for school-aged children?
1. What is needed at this age to eliminate/reduce the
incidence of discipline problems both at home
and school?
Chapter 33: Nursing Care of a Family With an Adolescent
1. Physical Growth
a. Height
b. Weight
c. Teeth
d. Puberty
e. Secondary Sex Changes
1. Be familiar with these changes
2. Developmental Milestones
a. Gross Motor
b. Fine Motor
1. The same assessment categories of younger
children continue to apply to adolescents
c. Play or Recreation
1. Be familiar with the change in interests during
adolescents and what they look like in action
3. Cognitive Development
a. Piaget
1. Formal operational thought
a. What is it, how does it progress, what does it
look like in practice and why is it important?
4. Emotional Development
a. Erickson
1. Early adolescents
a. Identity
b. Role confusion
 c. Body image
d. Self-esteem
e. Value system
f. Social coupling
g. Career Decisions
h. Emancipation from parents
2. Late adolescents developmental task
3. Socialization
*Know what these emotional development tasks are, what do
they look like in practice, and why are they important? *
5. Kohlberg
1. Be familiar with this theory and what it looks like
in practice for adolescents
6. Safety
a. Accidents/Unintentional Injuries
1. What are the biggest concerns for adolescents?
2. Ways to prevent accidents/injuries
3. Anticipatory guidance for parents
7. Nutritional Needs
a. Caloric needs/Recommended Dietary Intake
8. Daily Activities
a. Dress
b. Sleep
c. Exercise
d. Care of teeth
e. Exercise
 f. Sun exposure
g. Hygiene
1. Why are these activities important and antipopery
guidance for parents?
9. Common Health Problems
a. Poor posture
b. Fatigue
c. Acne
d. Hypertension
e. Substance use
f. Scoliosis
*How do you assess for theses and what do you do
when these are identified?

Chapter 34: Child Health Assessment

1. Physical Exam - Four techniques
a. Inspection
b. Palpation
c. Percussion
d. Auscultation
When, where, how and why do you use
these according to child’s age?
2. Interview Techniques
1. Be familiar with types of questions
3. Components of Physical Exam
1. Gross and Fine motor, Speech, Cognitive,
Emotional and Moral assessments have
already been addressed in previous chapters
2. Vital signs
3. General appearance
4. Mental status
5. Body measurements
6. Head to toe assessment
a. Be familiar with HOW these are done
4. Testicular exam and Breast exam
1. How are these done and why
5. Visual exam
1. What tools are used and how?
2. Normal vs. Abnormal
6. Hearing assessment
1. What tools are used and how
2. Normal vs. Abnormal
7. Denver II Developmental Screening Test and
DASE
1. Be familiar with these screening tools
8. Goodenough-Harris Drawing
1. What is this? Why is it used and when?
9. Immunization assessment
 1. You do not have to memorize the entire
immunization schedule, but familiar with the
types of immunizations given and
approximately when they are given; infancy,
preschool, school-aged, adolescents. Be
familiar with when you would NOT
administer an immunization and why.
Chapter 35: Communication and Teaching With Children and
Families
1. What is communication and what are the common ways
that we communicate with each other?
2. What is therapeutic communication? How can you
encourage therapeutic communication with pediatric
patients and their family?
3. What factors interfere with effective communication?
4. What are Levels of Communication? Clue: there are 5
levels of communication. How does a nurse use them to his
or her advantage? What do they look like in practice?
5. What are components of successful communication? What
does this look like in action? How can you assess
successful communication?
6. What does non-verbal communication look like? What
does effective and ineffective non-verbal communication
look like in practice? How can a nurse be sure to use
effective non-verbal communication with patients?
7. What are techniques that can be used to encourage
therapeutic communication with patient? What do they
look like in practice?
8. What are the 3 types of learning expressed in the chapter?
Think about how would you adapt your patient teaching to
meet each level of pediatric growth and development.