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Family centered care
- Aim is to aid the patient and his/her family when it comes to making final decisions by providing them the pro and cons

Goal
- Promote and maintain an optimal family health to ensure the cycle of optimal childbearing and childbearing
- Optimal health at the beginning of life

Expected to do as Maternal and Child health nurses
1. Provide preconceptual healthcare
- Both men and women of reproductive age
- Focuses on the health of mother and father to ensure the health of a baby in the future
- Includes health promotion activities
2. Care of women during 3 trimesters of pregnancy and the peurperium
- Care of pregnancy during (antenatal or prenatal), labor and childbirth (intrapartal care) and during recovery (post - partal care)
3. Care of infants during the perinatal period
- Perinatal period is the period of 6 weeks after birth
- Includes preconceptual healthcare, assessment of fetal well-being (pregnancy) and direct care of a newborn
4. Care of children from birth through adolescence
- Knowledge of growth and development (infancy to elderly)
- Manage common conditions associated with their development
5. Care in settings as varied as the birthing room, pediatric intensive care unit, and home
- Direct care in different settings where care is needed

Side note: Keeping the family at the center of care considering the family as the primary unit of care is a goal

Principles:
1. Family-centered
2. Family is a basic unit of the society
3. Family comes in different forms and sizes
4. Children grow both individually and as part of a family

What is expected to do as maternal and child health nurses?
1. Health promotion
- Educating clients to be aware
- Further improves health
- Example: Teaching sex education to adolescents
2. Health Maintenance
- Prevents the risk occurring
- Example: Prenatal care to a becoming mother
3. Health Restoration
-Promptly diagnosing a patient in a hospital that can return the patient from a normal state but not fully
4. Health Rehabilitation
-Bring the client back from his/her optimal health

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1. Growth and Development
-Both are independent but still must be interrelated  with each other
2. Growth
-Physical change; changes in size and height; quantitative change
-Rapid when it reaches it peak during infancy but slows down during adolescence
3. Development
-Heightened changes in skill or ability
-Capacity and skill to adapt
4. Behavior
-Most comprehensive indicator of developmental status

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1. Continuous process from conception until death
2. Proceed in an orderly sequence
3. Different children pass through the predictable stages at different stages
4. All body systems do not develop at the same rate
5. Development is cephalocaudal
6. Development proceeds from proximal to distal
7. Development proceeds from gross to refined skills
8. There is an optimum time for initiation of experiences can proceed
9. Neonatal reflexes must be lost before development can proceed
10. A great deal of skill and behavior is learned by practice

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1. Psychosexual Development
-Proposed by Erik Erikson
-Development of an individual is a function of an EGO (conscious)
-Stages of Psychosexual Theory
a. Trust vs Mistrust (Infancy)
b. Autonomy vs Shame and Doubt (Toddler)
c. Initiative vs Guilt (3 to 6)
d. Industry vs Inferiority (6 to 12)
e. Identity vs Role confusion (12 to 20)
f. Intimacy vs Isolation (20 to 30)
g. Generativity vs Stagnation (30 to 65)
2. Cognitive Development
-Proposed by Jean Piaget
-Cognitive occur when an individual is adapting to and organizing the perceived environment
-Piaget's Stages of Cognitive Development
a. Sensorimotor (birth to 2)
b. Preoperational (2 to 7)
c. Concrete operational (7 to 11)
d. Formal operational (11 to 20)
3. Psychosexual Development
-Proposed by Sigmund Frued
-Development of human sexuality is influenced by physical, emotional, and cultural aspects of the society
-Stages of Psychosexual Development
a. Oral stage (birth to 1)
b. Anal stage (1 to 3)
c. Phallic stage (3 to 6)
d. Genitalia stage
4. Moral Development
-Proposed by Lawrence Kohlberg
-Based on the premise that, at birth, all beings are devoid of morals, ethics, and honesty
-Levels of Moral Development
a. Egocentric Focus (Preschooler to school age)
b. Conventional level of morality (7 to 12)
c. Postconventional Autonomous Level of Morality (12 and older)

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Family with a Toddler
-Enormous CHANGES takes place in the toddler period
-Change from largely immobile infants into young children with a growing sense of Autonomy
-Parents must also GROW during this period

Parent's Task
-SUPPORT the child's growing independence with patience and sensitivity
-Learn methods for handling child's frustration

Things to Expect:
-Sphincter controls begin at age of 2
-All deciduous teeth erupt by 2 1/2 yrs
-Pot bellied appearance

Development Milestones
1. At 18 months
-Understands the word "my"
-Vocabulary of 25 words
-Walks independently
-Can use a spoon
-Learns how to climb
-Appropriate toys: Push/pull toys, blocks

2. At 24 months
-Negativistic
-Temper tantrums
-Transitional objects
-2 to 4 words sentences
-Walks up and down the stairs
-Knows how to turn doorknobs
-Build a tower of 6 blocks
-Removes clothes

3. At 30 months
-Makes simple lines using a pencil
-Can jump down a chair (remember safety)
-Knows his/her full name
-Name one color (R,B,Y)
-Likes to imitate parent's action
-Loves to play house (girls) and 'rough housing' (boys)

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School-Age
-Also known as middle childhood
-A child becomes independent and begins to separate from the family for a long period of time

Growth and Development: Physical Growth
-Annual average weight gain is approximately 3-5lb (1.3 to 2.2kg)
-Increase in height is 1-2 inches (2.5 to 5cm)
-Posture: more erect
-10 y/o: complete brain growth
-Fine motor coordination: refined
-Adult vision level is achieved
-Teeth malalignment: Malocclusion may be present   -(deviation from normal)

Growth and Development: Sexual maturation
Girls: usually occurs between 12-18 years
-Breasts develop
-Waistline slims
-Hips broaden
-Pubic hair
-Menstruation
-Taller than boys

Boys: between 14-20 years
-Broad shoulders
-Voice deepens
-Chest hair
-Underarm hair

-Increasing genital size

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1. What's the meaning of peurperium po ulit?

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Developmental Milestones

1. 6 years
-Can ride a bicycle
-Draws person in detail
-Can write: may reverse letters
-Rough play and quiet time with books
-Talks in a full sentence with meaning
-Can defines objects by use

2. 7 years
-Appears quiet compared with a rough-and-tumble 6 years old
-Gender differences begin to manifest in play: there are “girl gamers” such as dressing dolls and “boy games” such as pretending to be pirates.

3. 8 years
-More graceful than those of younger children, although as their arms and legs grow, they may stumble a few times
-Ride bicycles well and enjoy sports
-Table games
-Reads comic books
-Writes script rather than print

4. 9 years

-On the go constantly

-They have enough eye-hand coordination to enjoy playing games

-“Gang age” starts

5. 10 years

-More interested in perfecting their athletic skills

-Enjoy groups and privacy

6.11 years

-Active but awkward

-Drop out of sports activities rather than look ungainly in their attempts

-They may channel their energy into constant motion instead (e.g. drumming their fingers)

-Insecurity with the opposite sex

7. 12 years

-Sense of humor is present

-Dives into activities with intensity and concentration

-Enjoy participating in sports events for charities

-Cooperative around the house

-Able to handle a great deal of responsibility and complete given tasks

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-Adolescents both grow rapidly and mature dramatically during this period
-Major Milestone: Onset of puberty at 9-12 years of age and the cessation of body growth at 16-20 years of age

Puberty: (11-14 years of age)

-Time where the individual is 1st capable of sexual reproduction

-When the girl begins menstruation

-When boys begin to produce spermatozoa

Secondary Sex Characteristics:

-Body hair configuration

-Breast growth

Four main areas in which adolescents must make gains to achieve a sense of IDENTITY:

1. Accepting their changed body image

2. Establishing a value system of what kind of person they want to be

3. Making a career decision

4. Becoming emancipated from their parents

Emotional Development

Task: IDENTITY VS ROLE CONFUSION (Erikson)

Cognitive Development

Formal Operational - Ability to think in the abstract; Use scientific method; Problem-solving

Moral & Spiritual Development

Empathy - where they put themselves  in the shoes of another person to feel what they are feeling

Start questioning whether God is real or not

Common Health Problems of an Adolescence
1. Poor Posture
2. Tattoo
3. Acne
4. Obesity
5. Sexual & sexual activity
6. Stalking
7. Hazing
8. Substance Abuse
9. Attempted suicide
10. Runaway

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ADULTHOOD
-The adult phase of development encompasses the years from the end of adolescence to death.
-Because the developmental tasks of young adults differ from those of older adults.

3 PHASES OF ADULTHOOD

Young Adulthood (20-40 years)

Middle Adulthood (40-65 years)

Late Adulthood (>65 years)

Physical Development

1. Prime physical years

2. PEAK: most efficient functioning

3. High-risk takers: risk for injury

4. Health outcomes in older years: begins in this stage

5. Tend to ignore illness symptoms

6. Postpone seeking health care

Personal lifestyle assessment: health risks
Psychosocial Development

Genital Stage: mature sexual relationship

Task: INTIMACY VS ISOLATION

Cognitive Development
1. Formal Operational Thought

Ability to think in abstract

Employ logic

Creativity and intuition

2. Post-Conventional Level

Separating self from others

Morality: personal principles

“Principled reasoning”

Health Risks
1. Injuries
2. Suicide
3. Hypertension
4. Substance Abuse
5. STD
6. Eating disorders
7. Violence
8. Malignancies

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Middle Adulthood
-Occurs between the mid to late 30’s and the mid 60’s

-Aware that changes in reproductive and physical abilities signify the beginning of another stage in life

-A time of continuing transitions when individuals may reassess their goals in life and add new goals

-Years of Stability and Consolidation

Physical Development

Task: GENERATIVITY VS STAGNATION

Psychosocial Development

Midlife Crisis:

Realization: reached half-away mark

Time is at a premium and life infinite

Youthfulness and physical strength: given importance

Cognitive Development

Little changes: abilities

Maintaining mental abilities

Personal experiences

Moral Development

Post-Conventional level - Extensive experience

Health Problems
1. Injuries

2. Cancer

3. Cardiovascular disease

4. Obesity

5. Alcoholism

6. Mental health alterations

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Older Adulthood
- 65 to 74 years old; 85 years and over
- Chronic illness starts to develop
- Just remember to always assist them, physically and socially active, and maintain peer group interactions

Roles of a Gerontological Nurse
1. Provider for care
2. Teachers
3. Managers
4. Advocate
5. Research consumer

Developmental Task
- According to Erickson, the developmental task is Ego integrity vs. Despair
- Attain ego integrity to view life with a sense of wholeness and derive satisfaction from past accomplishments

Cognitive Development
- Piaget's phases of cognitive development

end with the formal operations phase
- Intellectual capacity includes perception, cognitive agility, memory, and learning

Moral Development/Reasoning
- Kohlberg hypothesized that an older person at the pre-conventional level obeys rules to avoid pain and the displeasure of others

Spiritual and Aging
- Older adults can contemplate new religious and philosophical views and try to understand ideas missed previously or interpreted differently

Health Problems
1. Injuries
2.  Chronic Disabling Illness
3. Drug Abuse and misuse
4. Alcoholism
5. Dementia
6. Mistreatment of older adults