GROWTH AND DEVELOPMENT OF CHILDREN - PEDIATRIC NURSING LECTURE

GROWTH AND DEVELOPMENT OF CHILDREN - PEDIATRIC NURSING LECTURE

MON ANTHONY ERA - PEDIATRIC NURSING LECTURE

GROWTH- IS AN INCREASE IN PHYSICAL SIZE OF THE WHOLE BODY OR ANY OF ITS PARTS AND CAN BE MEASURED BY INCHES OR CENTIMETER AND IN POUNDS AND KILOGRAMS.

 GENERAL PRINCIPLES OF CHILD DEVELOPMENT

 1. CHILDREN ARE COMPETENT - THEY WELL-ENDOWED WITH THE QUALITIES AND ABILITIES NEEDED TO ENSURE THEIR SURVIVAL AND PROMOTE THEIR DEVELOPMENT.

2. CHILDREN RESEMBLE ONE ANOTHER - THE PHYSICAL AND BEHAVIORAL CHARACTERISTICS OF EACH AGE AND THE CHANGES THAT OCCUR WITH INCREASING AGE ARE SIMILAR FROM CHILD TO CHILD.

 3. EACH CHILD IS UNIQUE - THE DIFFERENCES FROM CHILD TO CHILD ARE DUE TO A COMBINATION OF:

- HEREDITARY AND CONSTITUTIONAL MAKE UP

- RACIAL AND RATIONAL CHARACTERISTIC

- SEX

- ENVIRONMENT

4. GROWTH AND DEVELOPMENT ARE DIMENSIONAL:

A. CEPHALOCAUDAL - GROWTH IS MORE ADVANCED AT AND NEAR THE HEAD GRADUAL PROGRESSES DOWNWARD TO THE NECK, THE TRUNK AND TRUNK EXTREMITIES.

B. PROXIMODISTAL - GROWTH PROCEEDS OUTWARD FROM THE CENTRAL AXIS OF THE BODY TOWARD PERIPHERY.

C. GENERAL TO SPECIFIC - E.G FROM CRYING AT BIRTH TO COMPLETE SENTENCES AT PRESCHOOL AGE.

D. SIMPLE TO COMPLEX - E.G FROM WALKING AT 12 MONTHS OF AGE..

 5. ASYNCHRONOUS GROWTH - THE WHOLE BODY DOES NOT GROW AT ONCE; DIFFERENT REGIONS AND SUBSYSTEM DEVELOP AT DIFFERENT RATES AND TIMES.

 6. DISCONTINUING OF GROWTH RATE - THERE ARE ONLY TWO PERIODS VERY RAPID GROWTH; THE FETAL - INFANCY PERIOD AND ADOLESCENCE.

 7. DEVELOPMENT IS TIMELY - THE NOTION OF READINESS AND MATURATION STATES THAT LEARNING WOULD COME QUICKLY AND EFFORTLESSLY ONCE THE CHILD IS READY.

 8. NEW SKILLS TEND TO PREDOMINATE - THE CURRENT DEVELOPMENTAL ISSUE BECOMES A PRE OCCUPATION FOR THE CHILD.

 9. THE MANY ASPECTS OF DEVELOPMENT ARE INTERRELATED - THEY ACT UPON AND REACT WITH ONE ANOTHER.

? THEORIES OF CHILD DEVELOPMENT

Freud's Theory

a. Oral Stage 

- birth - 18 months

- sexual gratification through mouth

- dependent drives

- pleausre of biting

- all id pleasure - center of attention / self centered

- aggressive drives and body range develop

- diferentiate self from mother

 b. Anal Stage

 - 18 months - 3 years (toddler)

- excretory control learned (bowel and bladder)

- concepts of cleanliness, punctuality, self control, personal, independence learned

- temper tantrums

 c. Phallic / Oedipal Stage

 - 3-6 years (preschool)

- pleasure through genitals

- males: castration fear ; female: penis envy

- attachment to parent of same sex

- Oedipal Stage -> male child - mother

                           -> female child - father

- competition with parent of same sex

- resolves by identifying with parent of same sex.

- develops sexual identity guilt

- fantasy

- inquisitive

- oedipal/ electra complex

 d. Latency Stage

 - 6 - 12 years (school age)

- limited sexual image

- socialization outside home

- intellectual and social growth

- friends

- affinity with the same sex

- quiet

- control over aggressive, destrcutive impulses

- school competition

 e. Genital Stage

?- 2 to 20 years ( adolescence)

- sexuality focuses on genitals

- establishes identity

- learn independence from parents, responsibility for self.

- intimacy with one of opposite sex

- emergence of lust

- ambivalent

- peer values are normal 

- physical appearances changes.

 Erik Erikson 

- a psychoanalyst which extended the works of Freud's personality development across the life span and focused on social development in different life stages.

THE PSYCHOLOGICAL DEVELOPMENTAL THEORY

 Age: 0 to 18 months

Stage Of Development: Infant

Development of taste: trust vs. mistrust

Virtue: hope

Task: viewing the world as safe and reliable relationship as nurturing stable and dependable.

 

Age: 18 months

Stage of development: Toddler

Development of taste: Autonomy vs. shame and doubt

Virtue: will

Task: achieving a sense of control and free will

 Age: 3 to 6 years

Stage of development: Preschool

Development of taste: initiative vs. guilt

Virtue: purpose

Task: Beginning development of conscience; learning to manage conflict and anxiety.

 Age: 6 to 12 years old

Stage of development: School age

Development of taste: industry inferiority

Virtue: competence

Task: emerging confidence in own abilities, taking pleasure in accomplishments.

 Age: 12 to 18 years old

Stage of development: Adolescence 

Development of taste: identity vs. role confusion

Virtue: Fidelity

Task: Formulating a sense of self and belonging

 Age: 14 to 40 years old

Stage of development: Young Adult

Development of taste: intimacy vs. isolation

Virtue: Love

Task: Forming adult loving relationship and meaningful attachments to others.

 Age: 40 to 65 years old

Stage of development: Middle Adult

Development of taste: Generativity vs. Stagnation

Virtue: Care

Task: Being creative and productive; establishing the next generation.

 Age: 65 years old and above

Stage of development: Late adult

Development of taste: Ego integrity vs. despair

Virtue: Wisdom

Task: Accepting responsibility for one self and life.

?CARE OF THE CHILD

 Moro or startle reflex - allow head to fall backward at least 30 degree angle.

                                    - abduction " C " formation.

*Hold supine infant by arms a few inches above bed.

*Gently drop infant back to elicit startle.

*Baby throws arms out in extension and baby grimaces.

 * this startle reflex appears with a sudden loud noise or any intense stimulation. The arms and legs extend and the fingers fan outward, with the thumb and forefinger forming a C-shape. This reflex usually disappears within three to four months.

 Babinski Reflex - stroke inner side

                           - toes curl around ("grasp")

                           - stroke outer side (babinski)

                           - toes spread, great toe dorsiflexion

*Disappears from 3 months to 1 year.

*Disapperance indicates maturity of the central nervous system.

 * the baby's toes will hyperextend when the bottom of his foot is stroked upward from the sole to the ball of his foot. This reflex disappears within a year.

 Rooting Reflex - touch the newborn on either side of the cheek.

                          - baby turns to find breast.

*Sucking mechanism on finger is divided into 3 steps:

                         1. Front of tongue laps on finger.

                         2. Back of tongue massages middle of the finger.

                         3. Esophagus pulls on tip of the finger.

 *Disappears after 3 - 4 months.

* when a finger or nipple is placed into the baby's mouth, the baby begins to suck. Also, if you lightly stroke the cheek, the newborn will turn towards the stroking and open her mouth to accept the nipple. This reflex usually lasts for up to seven months.

 Stepping Reflex - Disappears 3 to 4 months

                           - Hold the baby at the abdomen

 Palmar Grasp Reflex - (disappear 3 to 4 months)

* the baby will grasp an object placed in his hands or curl his toes around fingers placed near his toes. The palmar reflex usually lasts three to four months and the plantar can last up to a year.

 Plantar Reflex - (disappear 8 months)

 Extrusion Reflex - to prevent swallowing of inedible substances.

                            - disappears 4 months.

                            - disappearance indicates " Readiness to semi solid foods".

 Tonic Neck Reflex - when the baby's head is turned to one side, "the arm on that side", stretchces out and the opposite arm bends up at the elbow. This is often called "fencing position". The tonic neck reflex lasts about 6 to 7 months.

 Doll's Eye - as with a doll's eyes, when a baby is lying on her back, if you turn her head from side to side, her eyes remain fixed. This reflex lasts up to two months of age.

 Protective Reflex - soft cloth is placed over the babies eyes and nose.

                              - Baby arches head and turns head side to side

                              - Brings both hands to face to swipe cloth away

 Swimmers (Gallant) Response - Hold baby prone while supporting belly with hand

                               - Stroke along one side of babies spine

                               - baby flexes whole body toward the stroked side.

Crawling Reflex - Newborn placed on Abdomen.

                              - Baby flexes legs under him and starts to crawl.

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