Principles of Growth & Development

Presented By Christine Hicks

Nursing Process Overview

Assessment
History Taking with Child & Parent Observation Use of Assessment Tools (such as):
Height & Weight Charts Developmental Milestones Denver II Vision & Hearing Screenings

 Nursing Diagnoses (examples)

Risk for altered growth & development Altered growth & development Family Coping Altered Nutrition Knowledge Deficit

 Planning
Wholistic Care--physical, emotional, cultural, cognitive, spiritual, social, nutritional Individualized NCP

Inclusion of Family members, Caregivers, & Teachers

 Implementation
Goal is to encourage age-appropriate self-care activities Work closely with Parents

Nurse acts as a Role Model

 Evaluation
On-going evaluation hopefully leads to early detection of problems

Role of the Nurse and Growth & Development

Health Promotion & Illness Prevention
Anticipatory Guidance

Safety
Screenings/Health Care

 Health Restoration & Maintenance

Patient Education

Affect of Illness on Physical Growth

Principles of Growth & Development

Terms
Growth Development/Maturation
Psychosexual Psychosocial Moral Cognitive

Developmental Task

 Patterns (p. 749)

Continuous Proceeds in orderly sequence Predictable stages/different rates All body systems do not develop at same rate Development is cephalocaudal Development is proximal to distal

Gross to refined skills Optimum time for experiences Neonatal reflexes must be lost Many behaviors/skills are learned by practice

Factors Influencing Growth & Development

Genetics
Gender Health Intelligence Temperment

 Environment
Socioeconomic Level Parent-Child Relationship Ordinal Position in the Family Health Nutrition

 Nutrition (p.753-754)
Variety of Foods Balance Food & Activity Plenty of Grains, Vegetables, & Fruits Low in Fat, Saturated Fats & Cholesterol Moderation of Sugars, Salt & Sodium

 Patient Education in Nutrition

Use of Food Pyramid Components of Healthy Diet Vegetarian Diets Alcohol Abuse

Theories of Development
Psychosexual--Freud
Psychosocial--Erikson Cognitive--Piaget Moral--Kohlberg

Freud
Id-Ego-Superego of Personality Development
Stages of Psychosexual Development

 Id
Ego Superego

Instinctual Drives
Individual/Reality Society

Stages
Infant--Oral Explores world with mouth/tongue Thumbsucking; Breastfeeding
Control of urination & defecation Toilet Training

Toddler--Anal

 Preschooler--Phallic

Sexual Identity-notices boys & girls Questions about birth

Nonactive development

School-age--Latent

 Adolescent--Genital

Establishes relationships with opposite sex Dating

Erikson
Stages of Social Growth & Development
Differences between Freud & Erikson

 Infant--Trust v. Mistrust

Love Bonding

Toddler--Autonomy v. Shame

Independent Makes Decisions Expresses Opinion

 Preschooler--Sense of Initiative v. Guilt

Learns how to do things Basic problem solving skills

Learns how to do things well Rewards/Satisfaction

School-age--Sense of Industry v. Inferiority

 Adolescent--Sense of Identity v. Role Confusion

Body Image Who he/she is Emancipation Career/College Choice Values Strengthen

Piaget
Stages of Cognitive Development

 Infant-2 Years- Sensorimotor

Environment-Child Relationship Hand-eye Coordination Experiments Memory Imitation

 2-7 Years- Perioperational Thought

Thought becomes more symbolic Mental answers rather than physical Concept of Time is Now Concept of Distance is as far as Child can see

 7-12 Yrs- Concrete Operational Thought

Systematic Reasoning Uses memory for broad concepts Classifications Concept of Reverse

 12 Yrs- Formal Operational Thought

Can solve hypothetical problems Use of scientific reasoning Cause & Effect Concept of Past, Present & Future

Kohlberg
Stages of Moral Development

 2-3 Yrs-Preconventional; Stage 1

Punishment & Obedience--needs clear instructions

4-7 Yrs-Preconventional; Stage 2

Individualism--needs assistance with selfcare

 7-10 Yrs-Conventional; Stage 3

Follows the rules; wants to be good; helps others

Maintenance of Social Order; follows rules from authority; has difficulty modifying procedure

10-12 Yrs-Conventional: Stage 4

 Older than 2 Yrs-Postconventional; Stage 5

Social contract; follows standards of society

Stage 6

Ethical principles; follows internalized standards of conduct

Continuing Themes
Development of Play
Development of Language

Development of Play
Function of Play Classification of Play Age Characteristics of Play Selection of Age-appropriate Toys & Activities Toy Safety

Development of Language
Prelinguistic Stage Holophrastic Stage Telegraphic Stage Preschool Period Middle Childhood Period

Continuing Threads
Nutrition
Family-Child Interaction/Family Functioning

Health Eduation