Pediatric+G&D


 * Developmental Stages **

It is important to know and understand the developmental stages of infants and children. Knowing these ages, stages, common milestones and abilities allows the nurse to interact  with the child appropriately, use play  effectively, and teach  the child in an understandable way. Knowing normal growth and development also equips the nurse to identify developmental lags  which can aid parents and caregivers to intervene as necessary.

Development is sequential and directional. Cephalocaudal  (head down...head control then trunk, then feet). Proximodistal  (inside out, trunk to arms to fingers).

**Prenatal life, fetus, or newborn: ** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Can be infected by <span style="color: #e24b4b; font-family: 'Times New Roman',Times,serif; font-size: 18px;">'//vertical transmission'// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> from mother during pregnancy, through the placenta, during delivery or during breast feeding <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Infections transmitted this way include // rubella, herpes, hepatitis B and C, HIV //  <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Newborns are particularly susceptible to // Staphylococci and Escherichia coli //  <span style="color: #e24b4b; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Maternal antibodies// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> decrease with time  <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">The newborn has an <span style="color: #e24b4b; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//immature immune system//  <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Frequent // hand to mouth // exploration of the environment  <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Caregiver // kissing // hands and feet  <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Illness increases // risk for fever, decrease in appetite and fluid intake // <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">// Diarrhea and dehydration //

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Maternal history <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Birth history <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Reflexes - moro, palmar, dance, tonic neck, rooting...gag, yawn, cough, blink, sneeze <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Physical Characteristics - SGA, AGA, LGA, mongolian spots, stork bites <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Thermoregulation heat loss - head, temperature low, sick <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">I&O - Stool (meconium) in 1st 24-48 hours, 6-8 wets/day <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Education - follow up care, immunizations, car safety
 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 31px;">Newborn: first 28 days or 4 weeks **

<span style="color: #7011ab; font-family: 'Times New Roman',Times,serif; font-size: 180%; line-height: 1.5;">What is... [|The Period of Purple Crying]



<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Freud <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Oral stage : comfort through oral stimulation : offer pacifier if NPO and not contraindicated, breast, bottle or Sweet Ease <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Erikson <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Trust versus Mistrust: Meet the care needs by holding, feeding, cleaning and comforting <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Piaget <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Sensorimotor: Use bright toys to distract and interest, object permanence...peek a boo ;) <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Kohlberg <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - preconventional (birth - 7 years)
 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 240%;">Infants: <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 230%;">Birth to 1 year **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Trust versus Mistrust media type="youtube" key="HEHW8oTj0BA" width="504" height="377"

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">A one year timeline... <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">2 months posterior fontanel closes, social smile <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">3 months head turns to locate sounds <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">4 months moro reflex disappears, child has steady head control <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Grasps objects, rolls over, social, shows memory <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">5-6 months rolls from abdomen to back and back to abdomen, creeps, peek a boo, birth weight doubles at 6 months <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">After 6 months can remember pain <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">7 months transfers objects from hand to hand <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">8 months sits alone <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">7-9 months stranger anxiety, 10 months crawls, <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">10-12 pincer grasp, walks with assistance, <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">12 months says a few words, birth weight triples, length increases by 50%

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Vital Signs: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">T - 96.8 - 99.0; P - 90-130; R - 20-40; BP - 90/56

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">***This period of growth is characterized by rapid growth, change, and formation of trusting familiar relationships.**

<span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 20px;">What are parenting/nursing challenges? <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Education Health Promotion - vision, hearing, dental, teething, nutrition, weaning, pacifiers, normal growth <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Immunization <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Colic <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Sudden Infant Death Syndrome (SIDS) <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Failure to thrive <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Poisoning - lead, plants, medications and ??? Poison Control Center

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Separation anxiety 4- 8 months <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Child care <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Safety - car seats, stairs, pets, tub drowning, electrical outlets, sunscreen, small objects

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">May regress <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Inconsolable <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Parental involvement in care <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Teach family but speak to and console child! <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Toys - mobiles, rattles, squeaky toys, picture books, balls, large soft colored blocks, activity boxes <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Swaddling, soothing talk <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Pacifier <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Routines and rituals <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Comfort items
 * <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Hospital Nursing Plan of care for the first year? **

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 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 230%;">Toddler: 1-3 years **

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Freud <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Anal: Satisfaction over control over body excretions: inquire about normal habits, support normal patterns, understand regression. <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Erikson <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Autonomy versus Shame: Allow child self-care with feeding, dressing, toiletry. <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Piaget <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Sensorimotor to Preoperational: Child increasingly curious and talkative: Name objects, give simple explanations, allow interaction and manipulation, provide co <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">mfort <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Kohlberg <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">: preconventional

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Autonomy versus Shame/Doubt <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">media type="youtube" key="Ru74VlqC8MU" width="560" height="315"

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">12-18 months anterior fontanelle closes <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Potbellied and bowlegged appearance <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Physiologic anorexia <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">20 primary teeth <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">14-15 months walks alone, explores away from mother <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">18 months throws ball overhand <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">24 months kicks ball <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">2 years feeds self with spoon/cup <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toilet training begins, bowel and bladder control <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">2 years -2-3 word sentences <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">3 years 3-4 word sentences <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Temper tantrums <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Can name body parts
 * <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toddler Timeline... **

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Vital Signs: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">T - 97.5 - 98.6; P - 80-120; R - 20-30; BP - 92/55

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">*This developmental stage is characterized by gains in motor abilities, increased coordination, sensory skills, sense of self and independence. Parallel play.

<span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 160%;">What are parenting concerns/nursing challenges? <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Parental education continues <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Car Safety <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Water Safety <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toy and gun safety <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Negativism <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Rituals, regression <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Discipline <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Temper tantrums <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Sibling Rivalry <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toilet training <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Exploration - safety <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Fear intrusive activities

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Hospital Nursing Plan of care for the toddler: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Simple brief explanations <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Time concepts - back after nap...after snack, after Barney <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Provide for routine and ritual <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Separation from caregivers greatest threat, regression probable <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Comfort by acknowledging child's routines and security items from home <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Guided choices <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toys - stuffed animals, push-pull toys, toy telephones, story books with pictures <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Allow protest, anticipate tantrums

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Excellent links with examples:

[|Magical thinking of children]

[|Piaget's preoperational ages 2-7]

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<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Freud <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Phallic stage - identifies with opposite sex parent then same sex, Oedipal, Electra: Be alert to child's preference for male or female nurses, involve parents. <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Erikson <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Initiative versus guilt: Child initiates play, offer a variety of materials for self expression, medical equipment models, observe drawings <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Piaget <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Preoperational - Verbal skills increase but thoughts are not complex. Egocentric. Idiosyncratic system for organization using transductive reasoning to link things. Animism. Causes for conditions or circumstances can be confused so offer simple explanations and help the child understand the illness is not their fault. <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Kohlberg <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - preconventional
 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 230%;">Preschooler: 3-6 years **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Initiative versus Guilt?

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%; line-height: 0px; overflow: hidden;">media type="youtube" key="qR3rK0kZFkg" width="546" height="408"

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Preschooler Timeline: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Gains 5 lbs and 2-3 inches a year <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Taller, more slender <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">At 3 can run, skip, hop, ride tricycle, use scissors <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">At 4 can use scissors, concrete egocentric thinking, aggressive <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">At 5 ties shoes, learns colors, shapes, vision 20/20, more independent <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Sentences with 5-8 words <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">learns sexual identity, curious, imaginary playmates and fears

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Vital signs: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">T - 97.5 - 98.6; P - 70-110; R - 16-22; BP - 95/57

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">***This developmental stage is characterized by physiological, psychological, cognitive growth; increasing ability to care for selves and play 'with' other children.**

<span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 160%;">Parenting concerns and nursing challenges <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Misunderstanding of causative factors, guilt, mutilation <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Literacy <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Safety <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Sleep disturbances nightmares, night terrors <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Teeth grinding

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">*Fear of mutilation, invasive procedures and pain <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">*Bandaids to the rescue! <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">*Explain they did not cause, illness not from a thought or deed <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Simple explanations of what will be fixed, models, pictures <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Therapeutic play to resolve feelings about procedures <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toys - coloring books, puzzles, cutting and pasting, clay, blocks, dolls... <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Accept regression, allow to express anger
 * <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Hospital Nursing Plan of Care for the Preschooler: **

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<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Freud <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Latency phase: Gender role adopted, awareness of society. Child places importance on privacy so provide gowns, covers, knock and explain treatments and procedures <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Erikson <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Industry versus inferiority: Encourage to continue school work, peer interactions and and hobbies <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Piaget <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Concrete operational: Child can understand objects and ideas which can be manipulated so give instructions, examples and models of equipment. Understands 'classification', 'conservation', and 'reversibility'. <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Kohlberg <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Conventional
 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 230%;">School age: 6-12 years **

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">School age Timeline: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Gains 4-6 lbs and 2-3 inches/year <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Menarche <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Lose primary teeth, gain permanent <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Can dress self, write script, tell time, understand past, present and future <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Socialization increases, less egocentric <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Understands cause and effect

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Vital signs: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">T - 97.5-98.6; P - 60-100; R - 16-20; BP - 107/64

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">***Understanding broadens, interested in reading, writing, academic achievement, love to please.**

<span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 160%;">Parenting concerns and nursing challenges <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Ambivalence about parental support <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Sports <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Peers <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Body image <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Bullying <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Stress <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Latchkey <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Honesty <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Limit setting <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Sexuality

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Fears injury, pain, disability, death <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Maintain contact with peers, concerned with missing friends <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> Explain procedures, offer books, pictures, demonstrations <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> *Maintain privacy and modesty <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Allow choices, participation and involvement in care, likes to please <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toys - card games, board games, video games, hobbies, puzzles, <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Obtain assent and consent <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Allow freedom of expression
 * <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Hospital Nursing Plan of care for school age: **

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<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Freud <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Genital stage: focus on genital functions/relationships: Take a private history, ensure privacy, separate teen recreation area, information on sexuality as needed. <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Erikson <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Identity versus role confusion: Provide opportunities to meet other teens with the same condition <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Piaget <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Formal operations. Able to think and reason abstractly, maturely: Offer verbal and written instructions with mature explanations <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Kohlberg <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> - Post conventional
 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 230%;">Adolescent: 12-18 years **



<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Adolescent Timeline: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Girls growth spurts around 10-15 <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Boys growth spurt 14-17 <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Secondary sex characteristics develop and are guaged by Tanner Stages <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Adult/abstract thinking and problem solving <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Tendency to stay up late, sleep late <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Strength and endurance increase <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Enjoy sports, movies, music, games, parties, experiment with hair, makeup, lifestyles <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Family conflicts

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Vital Signs: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">T - 97.5 - 98.6; P - 55-90; R - 12-20; BP - 121/70

<span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 160%;">Common parenting and nursing difficulties during adolescent years? <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">*Risk taking, peer dependence, increased independence lead to increased choices and safety issues - MVA, water safety, gangs, drugs, alcohol, violence, choices, sexual experimentation

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Hospital Nursing Plan of Care for adolescents: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Maintain contact with peers and school activities <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Teaching time / history without parents to increase interactivity, time for questions <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Obtain assent <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Parental consent <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Teens major concern is body image and identity, fear being different <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Allow own clothes, posters, bedding <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Explain how things will affect them right here and now <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Provide privacy <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Allow favorite foods, friends <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Loss of control may induce anger, withdrawal, un-cooperativeness <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">May feign bravery

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 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 250%;">Adolescent Risk Taking **


 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 250%;">Quizlet: Unit 1: iRAT, tRAT **


 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 250%;">Activities: **
 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 250%;"> How Old Am I (behaviors)? + Nursing explanations **
 * <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 250%;">Ages/Stages + Nursing actions **

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 170%;">Erikson's developmental stages

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 170%;">Piaget's Developmental Theory

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<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 170%;">Kohlberg's Stages of Moral Development

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<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 170%;">Duvall's Family Development theory: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">The <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 20px;">family developmental or life cycle theory believes that the family is a social group that evolves and changes through specific stages. Each stage is characterized by different tasks. <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Duvall 's (1977) theory is the most notable. This theory proposes the family progresses through <span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 17px;">8 different family stages:

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">1. The beginning family <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">2. The childbearing family <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">3. Families with preschoolers <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">4. Families with school age children <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">5. Families with teens <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">6. Families launching young adults <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">7. Middle age parents <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">8. Families in the later years.

<span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 180%;">Test: <span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 180%;">Do you recognize this developmental stage?

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<span style="color: #33c41c; font-family: 'Times New Roman',Times,serif; font-size: 160%;">Nursing theorists which lend themselves to the study of pediatrics include:

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Roy - The Adaptation Model

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Neuman – The Systems Theory

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">King – The Theory of Goal Attainment

<span style="color: #c41c1c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">References:

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Hockenberry, M. J., & Wilson, D. (2009). Wong's essentials of pediatric nursing (8th ed.). St. Louis, MO: Mosby Elsevier.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px; line-height: 25px;">Potts, N. L., & Mandleco, B. L. (2012). Pediatric nursing: Caring for children and their families (3rd ed.). New York, NY: Delmar Cengage Learning.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Videos located at: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">http://purplecrying.info/what-is-the-period-of-purple-crying.php <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%; line-height: 1.5;">http://youtu.be/mtlKXofxT-4 <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%; line-height: 1.5;">Trust versus Mistrust: https://youtu.be/HEHW8oTj0BA Rugrats: https://youtu.be/Ru74VlqC8MU Initiative versus Guilt: Jessica's daily affirmation: https://youtu.be/qR3rK0kZFkg <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">http://youtu.be/lEam9lpa6TQ <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">http://youtu.be/29NFdPxZmS0 <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Infancy - http://youtu.be/tcqXsdU7Lm0 <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Toddlers - http://youtu.be/N8GJGHnmZ1Y <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Preschoolers - http://youtu.be/P5Ntw-TwNnE <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Schoolage - http://youtu.be/Gl8tfQC-iDI <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Adolescence - http://youtu.be/f5MYXo8amUs <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Adolescent risk: https://youtu.be/A71Kms6Mvhc <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Piaget - http://youtu.be/Jw33CBsEmR4 <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Tantrum - http://youtu.be/Gk-OfmmRaqs