Sunteți pe pagina 1din 102

Principles of Pediatric Nursing

Caring for Children


Fifth Edition

CHAPTER

Growth and Development

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Directory
Classroom Response System Lecture Note Presentation

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Classroom Response System

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #1
A mother asks the pediatric nurse about what she should begin to feed her 6-monthold infant. The correct response is:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #1 Choices
1. Egg whites are the least allergenic food to be introduced into the babys diet. 2. Rice cereal is the first solid introduced that is least allergenic of the cereals. 3. Formula is the only source of nutrition given for the first year. 4. Fruits and vegetables are good sources of iron.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #1 Answer
1. Egg whites are the least allergenic food to be introduced into the babys diet. 2. Rice cereal is the first solid introduced that is least allergenic of the cereals. 3. Formula is the only source of nutrition given for the first year. 4. Fruits and vegetables are good sources of iron.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #1 Rationale
Introduction of solid food is recommended at age 4 to 6 months, when the gastrointestinal system has matured sufficiently to handle complex nutrients. The suck reflex and tongue-thrust reflex diminish at 4 months of age. Rice cereal is the first solid food because it is a rich source of iron and rarely induces allergic reactions.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #1 Rationale
Fruits and vegetables, good sources of vitamins and fiber, are introduced after cereal, one at a time to determine allergic reactions. Egg whites are highly allergenic.
Application level

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #2
A 1-year-old male child is scheduled for a routine exam at the pediatric clinic. The childs birth weight was 8 lbs. 2 oz. The child now weighs 18 pounds, 4 oz. The nurse knows that this weight is:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #2 Choices
1. 2. 3. 4. Below the expected weight. Appropriate for the childs age. Above the expected weight. Individualized and thus unpredictable.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #2 Answer
1. 2. 3. 4. Below the expected weight. Appropriate for the childs age. Above the expected weight. Individualized and thus unpredictable.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #2 Rationale
The first year of life is one of rapid growth. The birth weight usually doubles by 5 months and triples by the end of the first year. The other choices are incorrect.
Analysis level

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #3
A school nurse prepares a lecture on puberty for 5th- and 6th-grade girls. She asks the group, What is the first sign of puberty? A student correctly replies:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #3 Choices
The appearance of breast buds. An increase in energy and appetite. The occurrence of the first menarche. Appearance of body odor.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #3 Answer
The appearance of breast buds. An increase in energy and appetite. The occurrence of the first menarche. Appearance of body odor.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #3 Rationale
Puberty is a process that brings about the development of secondary sex characteristics, which begin, with the appearance of breast buds at 9 to 11 years followed by the growth of pubic hair. Menarche follows approximately 1 year later. Body odor may result later because of an increase in secretions from the apocrine glands.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #4
A 4-year-old scores two failures on the Denver II. Which of the following statements is most accurate?

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #4 Choices
1. The child is not as intelligent as expected for age and should be referred to a learning specialist. 2. The child has a speech problem and should be referred to a speech therapist. 3. The child is at risk for school problems and should be retested. 4. The failures are to be expected in preschoolers who may not be cooperative with testing.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #4 Answer
1. The child is not as intelligent as expected for age and should be referred to a learning specialist. 2. The child has a speech problem and should be referred to a speech therapist. 3. The child is at risk for school problems and should be retested. 4. The failures are to be expected in preschoolers who may not be cooperative with testing.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #4 Rationale
The Denver II is a screening test, not a diagnostic test; therefore children who score a failure should be retested. The child is considered at-risk until other diagnostic indicators can determine a specific problem.
Analysis level

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #5
Whenever the parents of a 10-month-old leave their hospitalized child for short periods, he begins to cry and scream. The nurse explains that this behavior demonstrates that the child:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #5 Choices
Needs to remain with his parents at all times. Is experiencing separation anxiety. Is experiencing discomfort. Is extremely spoiled.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #5 Answer
Needs to remain with his parents at all times. Is experiencing separation anxiety. Is experiencing discomfort. Is extremely spoiled.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #5 Rationale
Infants and toddlers between the ages of 6 months and 30 months experience separation anxiety. There are three stages of separation anxiety. The child who demonstrates crying and rejecting anyone other than the parent is in protest, the first stage of separation anxiety. This behavior does not exhibit spoiling or any indication of discomfort. The second is despair.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #5 Rationale
The child expresses hopelessness, appears quiet, and is withdrawn. The third stage is detachment. The child becomes interested in the environment, especially the caregivers. If the parents return, the child ignores them.
Analysis level

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #6
A teenager refuses to wear the clothes his mother bought for him. He states he wants to look like the other kids at school and wear clothes like they wear. The nurse explains this behavior is an example of teenage rebellion related to internal conflicts of:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #6 Choices
Autonomy vs. shame and doubt. Trust vs. mistrust. Identity vs. role confusion. Initiative vs. inferiority.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #6 Answer
Autonomy vs. shame and doubt. Trust vs. mistrust. Identity vs. role confusion. Initiative vs. inferiority.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #6 Rationale
Eriksons theory of psychosocial development states that the child is faced with conflicts that need to be resolved. Erikson identifies stages of personality development. Identity vs. role confusion (12 to 19 years) is a period when adolescents search for answers regarding their future.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #6 Rationale
During this time, the child rejects the identity presented by his parents and attempts to create his own identity. Identity is often based on peers. Positive outcomes result in optimism and confidence. Negative outcomes result in sense of purposelessness or deviance.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #7
The nurse conducts Denver II screenings at a community center for infants and young children. The nurse explains that the purpose of these screenings is to:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #7 Choices
1. Reverse degenerative processes that have occurred. 2. Recognize early infection in order to prevent spread to individuals in close contact with the child. 3. Recognize a disorder early so strategies can be developed to promote optimum development. 4. Measure intelligence and readiness for school.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #7 Answer
1. Reverse degenerative processes that have occurred. 2. Recognize early infection in order to prevent spread to individuals in close contact with the child. 3. Recognize a disorder early so strategies can be developed to promote optimum development. 4. Measure intelligence and readiness for school.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #7 Rationale
The Denver II is a developmental screening test. The primary reason for doing developmental screenings to find children who might be at risk and refer them for further assessment so that possible delays can be identified and appropriate early intervention initiated. The Denver II is not a measure of intelligence. It has nothing to do with infection control nor is it an intervention to correct degenerative processes.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #8
A mother of a 4-year-old tells the nurse that her son is a picky eater. The nurse should inform the mother that she should:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #8 Choices
1. Increase the amount of carbohydrates in the daily menu plan. 2. Administer vitamins twice a day to her child. 3. Be more concerned with the quantity of food than the quality of food. 4. Recognize this is common for preschoolers as their caloric requirements have decreased slightly.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #8 Answer
1. Increase the amount of carbohydrates in the daily menu plan. 2. Administer vitamins twice a day to her child. 3. Be more concerned with the quantity of food than the quality of food. 4. Recognize this is common for preschoolers as their caloric requirements have decreased slightly.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #8 Rationale
The preschooler will be influenced by others eating habits and demonstrate their likes and dislikes for food preferences. The caloric requirement decreases slightly, to 90 kcal/kg/day. Quality, not quantity, is important. It is not necessary to give vitamins after infancy unless the child is at nutritional risk.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #9
A father brings his 5-year-old to the doctors office for a well-child visit. The father is embarrassed by his childs behavior during the visit. The father states that every time the child comes for an immunization she begins to cry and scream. An appropriate response to this father is:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #9 Choices
1. All children have a major fear of needles; preschoolers often believe pain is a punishment. 2. Your child most likely had a traumatic experience at an early age. 3. Next time the mother should accompany the child for an immunization. 4. It is best to ignore this type of behavior as the child is seeking attention.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #9 Answer
1. All children have a major fear of needles; preschoolers often believe pain is a punishment. 2. Your child most likely had a traumatic experience at an early age. 3. Next time the mother should accompany the child for an immunization. 4. It is best to ignore this type of behavior as the child is seeking attention.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #9 Rationale
Preschoolers relate pain to an injury; they fear injections and do not believe an injection takes away pain. This is a normal response to cry and scream, kick and protest. Any supportive caretaker should accompany the child. This behavior does not necessarily indicate the child has experienced a previous traumatic injection.
Analysis level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #10
A mother of a 15-month-old brings her son to the clinic. While doing a nursing assessment, the mother makes the following comments. Which comment merits further investigation by the nurse?

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #10 Choices


My son cries sometimes when I leave him at his grandparents house. My son always takes his blanket with him. My son is not crawling yet. My son likes to eat mashed potatoes.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #10 Answer


My son cries sometimes when I leave him at his grandparents house. My son always takes his blanket with him. My son is not crawling yet. My son likes to eat mashed potatoes.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #10 Rationale


The child crawls or pulls their body along the floor by their arms by 8-10 months. This is a Growth and Developmental milestone during infancy. If the 15-month-old child displays inability to crawl this is an abnormal finding and it should be referred to the pediatrician for follow up. It is a normal response for the infant to cry when left with others.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #10 Rationale


Infants often become attached to security items, such as a blanket. Toddlers begin to display food preferences.
Analysis level

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #11
The mother of a 12-month-old infant who is hospitalized is upset that she must leave her baby to go home for a short time. What should the nurse suggest to this concerned parent?

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #11 Choices


1. Return as soon as possible to attend to her daughters needs. 2. Leave a personal article with the child and reassure her that she will return. 3. Call a family relative to stay at all times with the child when the mother leaves. 4. Ask a nurse to sit at the childs bedside in her absence.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #11 Answer


1. Return as soon as possible to attend to her daughters needs. 2. Leave a personal article with the child and reassure her that she will return. 3. Call a family relative to stay at all times with the child when the mother leaves. 4. Ask a nurse to sit at the childs bedside in her absence.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #11 Rationale


The goal is to preserve the childs trust. Strategies such as leaving a personal article, picture, or favorite toy help minimize the anxiety of separation. The parent may need to leave for short periods. It is unrealistic to expect the nurse to be at the childs bedside at all times.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #12
An inexperienced mother is playing with her 8-month-old in the playroom. The nurse has taught the mother about toys that are developmentally appropriate for the child. The nurse will know the teaching has been successful when the mother selects:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #12 Choices


1. 2. 3. 4. Blocks. Tricycle. Puzzles. Rattles.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #12 Answer


1. 2. 3. 4. Blocks. Tricycle. Puzzles. Rattles.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #12 Rationale


Objects that can be grasped and banged together, such as blocks, are most appropriate for an 8-month-old child. Such play with blocks develops the skill of manipulation. Pleasure is experienced from the feel and sounds of these activities. Tricycles and puzzles are recommended for toddlers, rattles are recommended for infants (1-6 months).
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #13
The nurse is discussing STDs with a 17year-old student. To correctly plan the teaching lesson, the nurse utilizes Piagets theory to determine the adolescents cognitive abilities. The educational plan should be based on the:

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #13 Choices


1. 2. 3. 4. Sensorimotor reactions. Limited cause and effect understanding. Concrete thinking. Mature abstract thinking.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #13 Answer


1. 2. 3. 4. Sensorimotor reactions. Limited cause and effect understanding. Concrete thinking. Mature abstract thinking.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Question #13 Rationale


The adolescent is in the formal operational stage and is capable of mature, abstract thought. The nurse should give clear and complete information, mature thought leads to greater understanding. The other options indicate sensorimotor stage (birth to 2 years), preoperational stage (2 to 7 years), and concrete operational stage (7 to 11 years).
Analysis level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Lecture Note Presentation

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Learning Outcomes
1. 2. 3. 4. Describe Major Developmental Theories Plan Theory-Based Interventions Explain Contemporary Approaches Recognize Major Developmental Milestones 5. Synthesize Approaches in Planning Assessments of Growth and Development
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Learning Outcomes (contd)


6. Describe the Role of Play 7. Use Collected Data Plan Activities That Promote Growth and Development

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Growth and Development Principles


Growth Equals Increased Size Development Equals Increased Capabilities
Cephalocaudal (head-to-tail direction) Proximodistal (center to outside)

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Box 4-1 Developmental Age Groups

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Major Developmental Theories


Freud
Psychosexual stages

Erikson
Developmental tasks

Piaget
Cognitive stages

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Table 4-2 Common Defense Mechanisms Used by Children

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Major Developmental Theories (contd)


Kohlberg
Moral development

Bandura
Social learning theory

John Watson
Behaviorism

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Nursing Application of Theories


Freud
Awareness of body concerns

Erikson
Task achievement promotes psychosocial health

Piaget
Cognitive skills guide client, teaching content and method
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Nursing Application of Theories (contd)


Kohlberg
Childs decision-making skills

Bandura
Parent and nurse as role models

Watson
Reward desirable behaviors

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Contemporary Approaches
Ecologic
Nature plus nurture

Temperament
Personality characteristics

Resiliency
Nature plus nurture plus adaptive skills

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Table 4-4 Assessment of Ecologic Systems in ChildhoodBronfenbrenner

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Nursing Application of Theories


Ecologic Theory
Use child/family strengths to optimize environment

Temperament Theory
Adjust care relative to childs temperament

Resiliency Theory
Identify risks; plan interventions based on child/family skills
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Table 4-4 Assessment of Ecologic Systems in ChildhoodBronfenbrenner

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Table 4-6 Components of Resiliency Model

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Influences on Development
Genetic Inheritance Prenatal Influences Environmental Influences Family Culture

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Pediatric Stages of Life


Newborn: Birth to 1 month Infant: 1 month to 1 year Toddler: 1 to 3 years Preschool: 3 to 6 years School-Age: 6 to 12 years Adolescent: 12 to 18 years

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Developmental Milestones
Physical Growth and Development Cognitive Development Psychosocial Development
Play Personality and temperament Communication

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Assessment Planning
Newborn
Cue to infants alertness Observe attachment behavior

Infant
Fine/gross motor skills Receptive communication more than expressive communication Personality characteristics
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Assessment Planning (contd)


Toddler
Increases gross motor activity Seeks autonomy Increases expressive behavior, both verbal and nonverbal Engages in imitative behavior, parallel play

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Assessment Planning (contd)


Preschooler
Shows greater independence Has interest in body, hygiene Need for concrete language Able to engage in associative play

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Assessment Planning (contd)


School-Age
Seeks achievement Understands idiom Engages in cooperative play Shows interest in sexual issues

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Assessment Planning (contd)


Adolescent
Seeks identity Has abstract-reasoning ability Establishes close ties with peers Achieves sexual maturity

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Play
Occurs at All Stages Affects Physical, Cognitive, Psychosocial Development Nursing Role: Facilitate Play
Necessary in health and illness Can be part of teaching or therapy

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Promoting Development
Newborn
Multisensory stimulation

Infant
Multisensory stimulation Hearing spoken language Fine/gross motor activities

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Promoting Development (contd)


Toddler
Fine/gross motor play Reading aloud, naming objects Parallel play

Preschooler
Dramatic play, puppets Reading together Associative play
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Promoting Development (contd)


School-Age
Sports Puzzles, reading, games Cooperative play

Adolescent
Sports, school activities Games, reading, music

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Summary
Nurses use Theories to Assess, Plan, and Implement Care Nursing Role: Promote Growth and Development

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources
Child Trends www.childtrends.org This group conducts research, gathers data on indicators of childrens health, analyzes trends, and provides a wealth of articles and publications on their website.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
The Annie E. Casey Foundation www.aecf.org A national organization serving and advocating for vulnerable children and families. The national Kids Count, a database of state-by-state indicators of child health and welfare, can be found at this site.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
Morbidity and Mortality Weekly Report http://www.cdc.gov/mmwr/ Provides current information and recommendations on issues such as food safety and vaccinations. National Center for Health Statistics http://www.cdc.gov/nchs/ This site provides a wealth of information about health, health status, and use of the health care system.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
The Brazelton Institute www.brazeltoninstitute.com Promotes the healthy development of young children and their families through education and research.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
American Academy of Pediatrics www.aap.org This professional site offers news, fact sheets, research, and policy guidelines. The You and Your Family section provides information to families, some of which is available in Spanish.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
Zero to Three www.zerotothree.org Supported by the National Center for Infants, Toddlers, and Families, this site provides information for consumers and professionals about children ages zero to three.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
U. S. Food and Drug Administration www.fda.gov The FDAs site provides a wealth of information for both consumers and professionals on topics such as food safety, new drug approvals, cosmetics, and tobacco use.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
Bright Futures http://www.brightfutures.org/ A national health initiative whose website offers downloadable information on prenatal care, health care for children of all ages, guidelines for physical examinations, and related information.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
Childrens Safety Network http://www.childrenssafetynetwork.org/ A national resource center for the prevention of childrens injuries and violence which provides a clearinghouse of useful information for childhood injury prevention professionals.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
Emergency Medical Services for Children http://www.childrensnational.org/EMSC/ A national initiative that works to prevent child disability and/or death due to injury. Research and family teaching and other educational materials can be found here.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
Office of Minority Health http://minorityhealth.hhs.gov/ Here youll find publications and data related to ethnic disparities in health care delivery and the offices work to eliminate them.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
Safety Belt Safe USA http://www.carseat.org/ This organization promotes child passenger safety. Find out here how to select a car seat and which car seats have been recalled. Free publications in English and Spanish available for download.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
National Highway Transportation Safety Administration http://www.nhtsa.gov Information on all aspects of transportation safety, some tailored for health care professionals.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
The National Safe Kids Campaign http://www.safekids.org/ A nonprofit agency dedicated to eliminating preventable injuries in children. Information on state laws, common hazards, etc. OutProud http://www.scarleteen.com The National Coalition for Gay, Lesbian, Bisexual, and Transgender Youth, this site offers resources for youth and educators.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.

Resources (contd)
PFLAG http://community.pflag.org/Page.aspx?pid= 194&srcid=-2 Parents, Families, and Friends of Lesbians and Gays Promotes the health and well-being of lesbians, gays, bisexual, and transgendered persons through advocacy and education.

Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen

Copyright 2012 by Pearson Education, Inc. All rights reserved.