Upload
midori-san
View
27
Download
3
Embed Size (px)
DESCRIPTION
GnD
Citation preview
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Maternal & Child Nursing Care
Second Edition
Lecture NotesChapter 33
Growth and Development
Marcia L. LondonPatricia W. Ladewig
Jane W. BallRuth C. Bindler
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Developmental Theory: Freud
• Early childhood experiences form unconscious motivation for action later in life
• Sexual energy is centered in specific parts of the body at certain ages
• Unresolved conflict at a certain stage leads to a fixation of development at that stage
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Freud’s Stages of Development
• Oral (birth to 1 year): Derives pleasure from mouth
• Anal (1 to 3 years): Control over body secretions• Phallic (3 to 6 years): Works out relationships
with parents• Latency (6 to 12 years): Sexual energy is at rest• Genital (12 years to adulthood): Mature sexuality
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Developmental Theory: Erikson
• Eight periods of psychosocial development• Occur from birth through old age• Two possible outcomes
Healthy: Move on to next stage Unhealthy: Problem with future relationships
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Erikson’s Stages of Development (Pediatric)
• Trust versus mistrust (birth to 1 year)• Autonomy versus shame and doubt (1 to 3
years)• Initiative versus guilt (3 to 6 years)• Industry versus inferiority (6 to 12 years)• Identity versus role confusion (12 to 18
years)
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Developmental Theory: Piaget
• Child’s view of the world is largely influenced by
Age Experience Maturational ability
• Focuses on cognitive (or intellectual) development
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Piaget’s Stages of Development
• Sensorimotor (birth to 2 years)• Preoperational (2 to 7 years)• Concrete operational (7 to 11 years)• Formal operational (11 years to adulthood)
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Developmental Theory: Kohlberg
• Examines moral development• Three levels of moral reasoning• Described age guidelines - many people
never reach highest stage
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Kohlberg’s Stages of Moral Development
• Preconventional (4 to 7 years)• Conventional (7 to 12 years)• Postconventional (12 years and older)
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Social Learning Theorists
• Children learn attitudes, beliefs, and customs through social contact
• Children imitate behaviors they see• If positively rewarded, they repeat
behaviors• Concept of self-efficacy - expectation that
someone can produce desired event
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Behaviorism Theories
• Applied ideas of Pavlov and Skinner to children
• Can elicit behaviors through positive reinforcement
• Can extinguish behaviors through negative reinforcement
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Nursing Interventions: Infants
• Encourage parents to hold and stay with infant
• Provide opportunities for sucking• Provide toys that give comfort or stimulate
interest• Pain control (trust)
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Nursing Interventions: Toddlers
• Toilet-training procedures Do not begin toilet-training in hospital Accept regression during hospitalization
• Encourage independent behaviors - feeding, hygiene, dressing self
• Give short explanations• Reward appropriate behavior
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Nursing Interventions: Preschoolers
• Encourage parental involvement• Provide safe versions of medical
equipment for play• Give clear explanations about illness -
explain that child is not responsible for the illness
• Allow child to draw
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Nursing Interventions: School-Age
• Provide gowns, covers, and underwear• Explain treatments and procedures• Encourage school work• Encourage hobbies, favorite activities
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Nursing Interventions: Adolescents
• Provide privacy• Interview separately from parents when
possible• Encourage participation in care and
decision-making• Encourage peer visitation• Provide information on sexuality
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Ecologic Theory (Bronfenbrenner)
• Each child is unique• Emphasizes presence of mutual
interactions between child and various settings
• Neither nature nor nurture is more important
• Levels and systems
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Temperament Theory
• Focuses on wide spectrum of behaviors in children
• How children respond to daily events• Based on New York Longitudinal Study
(1956 to present)
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
TABLE 33–5 Nine Parameters of Personality
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
TABLE 33–6 Patterns of Temperament
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Resilience: Basic Ideas
• Resilience: Ability to function with healthy responses, even when faced with stress and adversity
• Protective factors Provide strength Examples
• Risk factors Contribute to the challenge Examples
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Resiliency Theory
• All individuals experience crises that lead to adaptation and development of inner strengths
• Increases ability to handle future crises
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Development During Infancy
• Time of rapid growth and change• Birth weight
Doubles by 5 months Triples by 1 year
• Begins to understand meanings of sounds and words
• By 1 year, able to feed self
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Major Developmental Milestones During Infancy
• Rolls over• Sits up• Stands• Able to say 1 or 2 words• Uses pincer grasp well
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Development: Toddlers
• Typically independent and negative• Proud of new accomplishments• Rate of growth and food intake slows• Birth weight quadruples by 2 years• At 2 years, child is one-half of adult height
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Major Developmental Milestones: Toddlers
• Walks up and down stairs• Undresses self• Scribbles on paper• Kicks a ball• Has a vocabulary of 1,000 words - uses
short sentences
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Development: Preschoolers
• Most children in daycare or school• Increased social activities and contacts• Language skills well-developed• Writing ability improved• Physical skills developed
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Major Developmental Milestones: Preschoolers
• Uses scissors• Rides bicycle with training wheels• Throws a ball• Holds a bat• Writes a few letters• All parts of speech are well-developed
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Development: School-Age Children
• Very industrious• Find activities they enjoy and excel in• Contributes to sense of achievement, self
esteem• Peers becoming more important
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Major Developmental Milestones: School-Age Children
• Possesses reading ability• Rides a two-wheeled bike• Jumps rope• Plays organized sports• Mature use of language
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Development: Adolescents
• Transition: End of childhood and beginning of adulthood
• Identity formation: “Who am I?”• Puberty and rapid growth changes• New activities• Less dependent on parents for
transportation• Peers are important
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Major Developmental Milestones: Adolescence
• Fine motor skills well-developed• Gross motor skills improve due to growth
spurts• Able to apply abstract thought and analysis
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Assessing Growth and Development
• Use combination of developmental theories and assessments
• Holistic approach• Categories of Assessment
Physical growth Cognitive development Psychosocial development Personality and temperament Communication Sexuality
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Children at Play
• Play is the “work of childhood”• Play contributes to:
Cognitive growth Physical development: Gross motor skills and
fine motor skills Social interaction
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Infants at Play
• Primarily enjoy solitary play• Others may teach infants how to play with
new objects• Progress from reacting to objects (rattle) to
manipulating them• Once they become mobile, sphere of play
enlarges
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Toddlers at Play
• Increased motor skills allow new types of toys and play
• Play becomes more social, often with other toddlers - parallel play
• Imitates behavior• Manipulating objects helps them to learn
about their qualities (Example: Square block will not fit in round hole)
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Preschoolers at Play
• Interacts with others during play• Enjoys large motor activities• Increased manual dexterity• Fantasy play
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
School-Age Children at Play
• Increased physical abilities allow for wide variety of play
• Understanding of rules of a game - like for rules to be followed during play
• Cooperative play
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Adolescents at Play
• Increased maturity leads to new activities and ways to play
• Peer group becomes focus of activities• Less reliant on parents for transportation• Social interactions important
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
Nursing Interventions and Development
• Assess growth and development - holistic approach
• Tailor nursing interventions based on this data
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
General Principles: Interventions and Development
• Discuss proper nutrition and feeding techniques
• Conduct health teachings and screenings based on child’s age
• Encourage family to discover child’s personality and temperament
• Instruct parents about expected language skills
Maternal & Child Nursing Care, 2/eBy London / Ladewig / Ball / Bindler
© 2007 by Pearson Education, Inc.Pearson Prentice Hall
Upper Saddle River, New Jersey 07458
General Principles: Interventions and Development
• Give parents information about normal sexual behavior of children
• Instruct school-age children about expected changes of puberty
• Give adolescents information about Birth control Sexually transmitted diseases