Beruflich Dokumente
Kultur Dokumente
Sensorimotor 1 mon-24 mo
- relate through senses, separate from environment,
practical intelligence
Preoperational Thought 2-7 yo
toddler: symbolic thought, simple abstractions, literal
thinking, poor concept of time and distance, transductive
reasoning
pre-schooler: centering, egocentric, no reversibility, no
cause and effect, assimilation, role fantasy
Concrete Operational Thought 7-12 yo
- systematic reasoning
- memory to learn broad concepts and subgroups
- seriation and classification
- reversibility
- inductive reasoning (specific to general)
- conservation (7 yo – numbers; 7-8 yo quantity; 9 yo –
weight; 11 yo – volume)
Formal Operational Thought 12 yo
- solve hypothetical problems, causality, time
- talk time to sort attitudes and opinions
TODDLER – 1 –3 yo
TODDLER – holding on,
letting go
Slowed growth
Wt gain 5-6 lbs (2.5 kg) - 3 words other
BW quadruples 2.5 yo than dada, mama
5 in (12 cm) 18 mos - uses phrases
Baby fat disappears 2 yo - short sentences; 2-3
brain 90 % adult size words; 300 words
CC > HC; inc by 2 cm - pronouns
HR 90 bpm - points to one body
BP 99/64 part
TODDLER 2 ½ - full name
Protruberant abdomen 3 yo - speaks fluently using
bowlegged longer sentences
Stomach capacity increases - tells stories
Control of urinary and anal - plurals
sphincters PERSONAL/SOCIAL
IgG and IgM 15 mos - pats pictures
20 deciduous teeth - imitates
housework
GROWTH AND 18 mos - turns page 2-3 at a
DEVELOPMENTAL time
MILESTONES - uses spoon
Gross 2 yo - removes garments
15 mos – walks alone well - toilet trained by day
18 mos – run and jump in (2-3 yrs old)
place 3 yo - dry by night (3-4 yrs
- walk up & down stairs old)
holding on to railing - washes and dries
- seat self in chair hands
24 mos – walks up & down NUTRITION
stairs one step at a time Decrease in appetite/
2 ½ yo – tiptoes, jumps Physiologic anorexia
3 yo - throws balls, rides picky eaters, food jags
tricycles Milk – 1L/day
- stands on 1 foot 1, 300 kcal/day
momentarily Single food instead of
Fine motor mixtures
15 mos - 2 tower blocks, Allow self feeding
scribbles Allow choice between 2 types
18 mos – 3-4 tower blocks of food
24 mos – vertical stroke Offer finger food
30 months – 8 tower blocks Risk of aspiration
LANGUAGE PLAY - parallel play
15 mos - vocalizes wants - imitation
- jargon Babbling and talking
Ball games Sibling rivalry
Clay Discipline
Listening to music -consistent, planned, private,
Listening to stories initiated after behavior
Large blocks Separation anxiety – 18 mos
Making music and noise Transitional objects
Push and Pull toys
Puppet play REACTION TO ILLNESS and
Scribbling NURSING
Stack-and-dump toys INTERVENTIONS
DAILY CARE
- dressing – can put on socks, fear of separation - Assure of
underpants, undershirt parents return
- sleep – 8-12 hours sleep w/ phases: protest, despair,
1 nap detachment
- bathing Defense mech: Regressive
- care of teeth behaviors - reassurance
CONCERNS Nutrition – allow finger food
Toilet Training Dressing changes – allow to
bowel control – 18 mos pull off tape
daytime bladder ctrl – 2- Medication – allow choices of
3 yo “chaser” after oral medication
nighttime bladder ctrl – Hygiene – allow choice of
3-4 yo bathtime toy, allow to put
CONDITIONS: toothpaste
1. control of sphincters Pain – allow to express pain
2. cognitive understanding Stimulation
3. delay immediate Elimination – continue potty
gratification training
4. mature nervous system Rest – allow choice of toy at
* Should not be initiated bedtime
during times of stress
Negativism
Temper Tantrums –
“extinction”
Accidents
Rituals
Egocentrism
Fears: loss of parents, loud
noises, going to sleep, large PRE SCHOOL 3-5 yo
animals PRE SCHOOL
Future body build apparent
Increased skeletal growth
Handedness LANGUAGE
5 yo - may have permanent 3 ½ yo - knows sex
teeth - counts to 3 or more
Tonsils inc in size - 900 words
IgG and IgA increases 4 yo - exaggerates and boasts
PRE SCHOOL - 1, 500 words
- why questions
HR 85 bpm 5 yo- talks constantly
BP 100/60 - 2, 100 words
3 - 5 kg/yr PERSONAL/SOCIAL
2 - 3.5 in/yr 3 ½ yo - dresses w/
Frequent voiding supervision
- separates more easily
from mother
GROWTH AND yo – buttons up
DEVELOPMENTAL 4 ½ - dresses w/o
MILESTONES supervision
Gross 5 yo – uses a knife, spoon
3 1/2 yo - stands on 1 foot 5 fork; focus on social
sec aspects of eating
- upstairs on 1 foot/step; NUTRITION
down 2 feet /step Slow/Steady growth
4 – 4 ½ - climbs stairs Decreased appetite
- hops on 1 foot, skip Reject vegetables, mixed
- catch ball dishes, liver
5 yo – heel to toe walk Offer small servings
- skips Alternate foot and Discourage “grazing” – eating
runs small amounts of non
- throw and catch a ball, nutritious food
jump rope, balance on Healthy snack food
alternate feet PLAY – associative play
FINE MOTOR Dress up clothes
3 yo – copies circle, imitates Housekeeping toys
cross Dolls and other toys for
4 –4 1/2 pretending
- draws man w/ 3 parts Bikes and climbing toys
- copies square, trace Paper and crayons
diamond simple crafts
- lace shoes Large blocks
5 yo - copies triangle and DAILY CARE
diamond - accidents – bicycle
- writes alphabet, first safety, seat belts
name
- dressing – choose own - dressing change – allow
clothes to measure, cut tape, see
- sleep – 11-13 h per incision site
day; resist taking naps - medication – allow to
- exercise – very active choose “chaser”
- bathing – can wash and - hygiene – allow choice of
dry hands; need toys, wash hands and face
supervision - pain – allow pain
- care of teeth – expression, handle syringe,
independent brushing; 1st analgesic
dental visit - stimulation
CONCERNS
- imitation
- Oedipus and electra
complex
- gender roles – need
exposure to parents of
opposite sex
- Socialization – capable of
sharing
- Discipline – “time out”
- Common fears – dark,
mutilation/castration,
separation, animals, ghosts
- Telling tales
- Imaginary friends
- sharing – define limits and
teach property rights
- Regression –reaction to
stress
- Sibling rivalry
- sex education
- pre-school center
- broken fluency
- swearing
- High energy level
- Curiosity
REACTIONS/CONCERNS IN
ILLNESS AND NURSING
INTERVENTIONS
- nutrition – food in
animal/alphabet shapes School Age 7 – 11 yo
SCHOOL AGE
3-5 lb/yr playing w/ gang important;
1-2 in /yr eyes fully developed
10 yo – brain growth complete GROWTH AND
Adult vision DEVELOPMENTAL
Abundant tonsillar and MILESTONES
adenoid tissue 8 yo – script writing
“innocent” heart murmurs 9 yo – all activities done w/
HR 70 bpm gang
BP 112/60 - hero worship; adult
28 permanent teeth articulation;
Pubertal onset 10 yo – more improved
SECONDARY SEX coordination
CHARACTERISTICS - well mannered w/
Female breast devt adults
St 1 (prepubertal) 11 yo – active but awkward
St 2 – breast buds - mixed sex activities
St 3 – further enlargement of 12 yo – coordination improves
breasts and areola; no - joins organizations
separation of contours PERSONAL/SOCIAL/PLAY
St 4 – breast mound Competitive play and
St 5 – adult configuration recreational activities
Male genitalia devt Hobbies and personal
St 1 – prepubertal interests
St 2 – enlargement of testes Arts and crafts
and scrotum; rugae, Biking
reddening of scrotum Board games
St 3 – further enlargement, Clubs
lengthening of penis Collecting items
St 4 – increase length and Chess
width of penis, devt of Comic Books – ability to read
glans, darkening of scrotum one of most significant skills
St 5 – adult configuration NUTRITION
Good appetite
GROWTH AND May go on food jags
DEVELOPMENTAL Food w/ high nutritional value
MILESTONES - more calories and
6 yo – skip, jump, tumble, nutrients
hop, ride bicycle, walk a - hungry after school – give
straight line; first molars snacks and make
7 yo – central incisors; sexual mealtimes enjoyable
differences seen in play; quiet DAILY CARE
play - dressing – influenced
8 yo – improved coordination; by peers
- sleep – 8-12 hrs; no - Death and disability,
naps immobilization - Still need
- exercise – games, bike comfort
riding, walking - Unknown events &
- hygiene – 8 yo – procedures - Allow to
capable of bathing alone help
- care of teeth – 2x yearly w/ care & treatment
visit to the dentist; brush - Loss of ctrl &
daily independence - Give
* 6 yo – eruption of choices
permanent teeth - Loss of contact w/
- safety – bicycle, school peers - Allow visits
bus safety, prevention of - Disruption of school - Talk
falls and sports injuries about interests
CONCERNS - concerns over modesty
- problems w/ articulation nutrition – allow choices
– disappears 9 yo - dressing – ask opinions
- Sex education on bulk of dressing and
- Stealing – 7 yo – where to apply tape
importance of money - medicine – teach name
- Violence/terrorism – and action, allow to
education;reassurance choose form if possible
- School anxiety and - body injury, pain – allow
phobia, bullying, intimidating expression of pain, explain
teachers, something bad source and cause
happening to parents - stimulation
- Recreational drug and
alcohol use
- Obesity
- nocturnal enuresis and
encopresis (stool leakage;
boys > girls)
REACTION TO ILLNESS
AND NURSING
INTERVENTIONS
Cause of illness – external
forces; aware of
significance of different
illnesses
Defense mech: reaction ADOLESCENT 13-18 yo
formation ADOLESCENT
Girls taller than boys 2-8 in,
15-55 lbs
Growth stops 16-17 yo - Acne
Boys grow 4-12 in and gain - Body piercing
15-65 lbs - Fatigue - emotional
Growth stops 18-20 yo fatigue
Heart and lung size increase - Menstrual irregularities
more slowly - Sexuality and sexual
HR 70 bpm activity
RR 20 breaths/min - Poor posture
BP 120/70 - Stalking – educate girls
ADOLESCENT - Substance abuse
Androgen inc sebaceous - Suicide
gland activity resulting in - runaways
acne - discipline – firm, limit
Apocrine glands inc activity setting
13 yo – 2nd molars REACTION TO ILLNESS
PUBERTY – capable of AND NURSING
sexual reproduction INTERVENTION
Secondary sexual Defense mech: Denial and
characteristics displacement
GROWTH AND Main issue – body image –
DEVELOPMENTAL educate and Allow
MILESTONES participation in tx decisions;
13 yo – sports compassionate understanding
15 yo - enjoys privacy Fears loss of control and
- stays in room independence - Respect
16 yo - part time job privacy and confidentiality
- charitable causes Fears injury and pain -
NUTRITION Provide opportunities for
- faddish diet self expression
- give responsibility for Separation from peers and
food planning lack of emotional support -
- increased calories, Ca, Approach w/ caring and
protein understanding, age
DAILY CARE compatible roommate,
- dressing and hygiene Phone at bedside
- care of teeth - Nutrition – food
- sleep – need more preferences
sleep - Dressing – final
- exercise – daily appearance of dressing,
CONCERNS and time for changing
- Socialization – falling in - Medicine – choice for
love injection site, teach name
- Obesity; Diseases – HPN and action
- Rest – time and length
of rest periods
- Hygiene – respect
modesty, extent of self care
- Pain – allow pain
expression, ask for
analgesics
- stimulation