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INDEPENDENT AND INTERRELATED.

Growth - Physical Change
Development - In Skill or Ability to Function

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A. Neurologic System
- First 2 years
B. Lymphatic System
- Infancy and childhood
C. Reproductive system
- Puberty
D. Musculoskeletal system
Childhood

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1. Continuous processes from conception until
death.
2. Proceed in an orderly sequence.
3. Different children pass through the
predictable stages at different rates.
4. All body systems do not develop at the
same rate.
5. Development is cephalocaudal.
6. Development proceeds from proximal to distal
body parts.
7. Development proceeds from gross to refined
skills.
8. There is an optimum time for initiation of
experiences or learning.
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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FACTORS INFLUENCING GROWTH AND DEVELOPMENT

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FACTORS INFLUENCING GROWTH AND DEVELOPMENT

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1. Genetic Inheritance
2. Environmental Influences

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Psychosexual Development (FREUD) - developing instincts or
sensual pleasure.
Psychosocial Development (ERICKSON) - personality development
Moral Development (KOHLBERG) - know right from wrong and
apply in real-life situations
Cognitive Development (PIAGET) - learn or understand from
experience, to acquire and retain knowledge to
respond to new situation and solve problems

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1. TRUST vs. MISTRUST (birth-1)
2. AUTONOMY vs. SHAME & DOUBT (1-3)
3. INITIATIVE vs GUILT (3-6)
4. INDUSTRY vs INFERIORITY (6-12)
5. IDENTITY vs ROLE CONFUSION (12-20)
6. INTIMACY vs. ISOLATION (20-30)
7. GENERATIVITY vs. STAGNATION (30-65)
8. EGO INTEGRITY vs. DESPAIR (65-death)

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1. SENSORIMOTOR (birth-2)
2. PREOPERATIONAL (2-7)
3. CONCRETE OPERATIONAL (7-11)
4. FORMAL OPERATIONAL THOUGHT (11-20)

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ID

Ego

Superego

1. ORAL STAGE (birth-1)
2. ANAL STAGE (1-3)
3. PHALLIC STAGE (3-6)
4. LATENT STAGE (6-12)
5. GENITALIA STAGE (12-older)

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1. Preconventional Level of Morality (2-7)
2. Egocentric focus (preschooler-school age)
3. Conventional Level of Morality (7-12)
4. Postconventional Autonomous Level of Morality (12-older)

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Rapid brain growth

Walks, runs, kicks, climb, rides a tricycle, drinks from a cup

Four times birth weight

Bladder control

Uses fingers to pick up small objects

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STAGE 5 (12 & 18 months)

Tertiary Circular Reaction Stage

STAGE 6 (18 & 24 months)

Deferred Imitation

Preoperational Thought

Assimilation

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FREUD

Anal stage, toilet training

ERIKSON

Autonomy versus shame and doubt

HAVIGHURST

Tasks of learning to control the elimination process, learn sex differences, form concepts, learn a language, and distinguish right from wrong

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PHYSIOLOGIC DEVELOPMENT OF A PRESCHOOLER

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PHYSIOLOGIC DEVELOPMENT OF A PRESCHOOLER

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Head is close to adult size by six years old

Pulse rate is about 85 beats per minute;
blood pressure holds at about 100/60 mm Hg

Bladder is easily palpable above the symphysis pubis

Voiding is 9 or 10 times a day that play must be interrupted

Motor abilities include jumping, skipping, throwing a
ball, printing letters, and numbers

Full set of 20 deciduous teeth

Weight gain is slight (4.5 lb (2 kg) a year)

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PSYCHOSOCIAL DEVELOPMENT OF A PRESCHOOLER

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PSYCHOSOCIAL DEVELOPMENT OF A PRESCHOOLER

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Developmental Task: Initiative Versus Guilt
EMOTIONAL DEVELOPMENT:

imitation

fantasy

Oedipus and Electra Complexes

gender roles

socialization

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PIAGET: preoperational

centering

enter a second phase called intuitional thought (intuitive thought phase)

egocentrism

basic curiosity results in constant questions and improved reasoning ability

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MORAL AND SPIRITUAL DEVELOPMENT OF A PRESCHOOLER

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MORAL AND SPIRITUAL DEVELOPMENT OF A PRESCHOOLER

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determine right from wrong based on their parents’ rules

have little understanding of the rationale for these rules

difficulty seeing that the rules they know may also apply to a new situation

begin to have an elemental concept of God

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weight gain is approximately 3 to 5 lb

increase in height is 1 to 2 in

adult vision level is achieved

pulse rate is about 70 to 80 beats per minute

blood pressure rises to about 112/60 mm Hg

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prepubertal girls are usually taller

the girl notices the change in her pelvic contour

girls are usually conscious of breast development

menarche usually starts around age 12 but can occur as early as age 9 and still be considered normal

the menstrual cycle may be irregular at first

vaginal secretions will begin to be present

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aware of increasing genital size

testicular development precedes penis growth

although they have pubic hair, they cannot yet grow a beard or do not have chest hair

seminal fluid is produced, boys begin to notice
ejaculation during sleep. (termed nocturnal emissions)

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PHYSIOLOGICAL DEVELOPMENT OF SCHOOL-AGED CHILD

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PHYSIOLOGICAL DEVELOPMENT OF SCHOOL-AGED CHILD

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The brain reaches 90% to 95% of adult size

Motor abilities progress to writing in the script and in
sentences

Sexual organs grow but are dormant

All permanent teeth present except for 2nd and
3rd molars

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PSYCHOLOGICAL DEVELOPMENT OF A SCHOOL-AGED CHILD

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PSYCHOLOGICAL DEVELOPMENT OF A SCHOOL-AGED CHILD

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acceleration in the separation of the child from his parents

introduces the child to a new set of authority figures

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PSYCHOSOCIAL DEVELOPMENT OF A SCHOOL-AGED CHILD

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PSYCHOSOCIAL DEVELOPMENT OF A SCHOOL-AGED CHILD

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Erikson’s stage of industry versus inferiority

Language development and socialization

Children also begin discovering the Internet and how other children out there are waiting to talk to them in chat rooms

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COGNITIVE DEVELOPMENT OF A SCHOOL-AGED CHILD

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COGNITIVE DEVELOPMENT OF A SCHOOL-AGED CHILD

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In Piaget’s concrete operational stage, organizing facts and problem-solving

Thinks logically and develops concepts of
measurement

New Concepts Learned

Decentering

Accommodation

Conservation

Class Inclusion

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EMOTIONAL DEVELOPMENT OF A SCHOOLD-AGED CHILD

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EMOTIONAL DEVELOPMENT OF A SCHOOLD-AGED CHILD

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ability to trust others and with a sense of respect for their own worth

should have learned to share, to have Discovered that learning is fun and an adventure

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MORAL AND SPIRITUAL DEVELOPMENT OF A SCHOOL-AGED CHILD

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MORAL AND SPIRITUAL DEVELOPMENT OF A SCHOOL-AGED CHILD

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Kohlberg’s Conventional Level

Parental guidance, love, and support are absolutely essential for the development of values during this time

Begin to learn about the rituals and meaning behind their religious practices, so the distinction between right and wrong becomes more important

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FORMAL OPERATIONS

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

Becoming emancipated from their parents

Accepting their changed body image

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heart and lungs increase in size more slowly than the rest of the body

PR:70 beats per minute

RR: 20 breaths per minute

BP: 120/70 mm Hg

Major milestone: Onset of puberty at 9 to 12 years of age and the cessation of body growth at 16-20 years of age

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FEMALE:

breasts grow, pubic hair grows, wide hips develop

MALE:

body hair grows, voice breaks, muscle growth increases

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HEALTH PROMOTION FOR AN ADOLESCENT AND FAMILY

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HEALTH PROMOTION FOR AN ADOLESCENT AND FAMILY

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accidents are the leading cause of deaths

drowning is another chief of accident

homicide and suicide

athletic injuries

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Hypertension

Poor posture

Body piercing and tattoos

Fatigue

Changes associated with puberty (acne)

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PHYSICAL DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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PHYSICAL DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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YOUNG ADULT

human body is at its most efficient functioning at about age 25 years

the musculoskeletal system is well developed and coordinated

physical changes are minimal during this stage, weight and muscle mass may change as a result of diet and exercise.

MIDDLE-AGED ADULT

A number of changes that start when young adults are in their mid-20s become noticeable as the fifth decade approaches

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PSYCHOSOCIAL DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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PSYCHOSOCIAL DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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YOUNG ADULT
Sense of intimacy versus isolation

the basic developmental task is establishing intimacy or very close friendship

MIDDLE-AGED ADULT
Generativity versus Stagnation

the concern about providing for the welfare of humankind is equal to the concern of providing for self

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COGNITIVE DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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COGNITIVE DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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YOUNG ADULT

Young adults are able to use formal operations, characterized by the ability to think abstractly and employ logic

MIDDLE-AGED ADULT

Cognitive processes include reaction time, memory, perception, learning, problem-solving, and creativity.

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MORAL AND SPIRITUAL DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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MORAL AND SPIRITUAL DEVELOPMENT OF YOUNG AND MIDDLE-AGED ADULT

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YOUNG ADULT

enter the post-conventional level on Kohlberg's theory

the person is able to separate self from the expectations and rules of others and to define morality in terms of personal principles

The religious teaching that the young adult had as a child may now be accepted or redefined

MIDDLE-AGED ADULT

According to Kohlberg, the adult can move beyond the conventional level to the post-conventional level

At this stage, the individual can view “truth” from a number of viewpoints

People in this age group often rely on spiritual beliefs to help them deal with illness, death, and tragedy

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STAGES OF GROWTH AND DEVELOPMENT OF OLDER ADULTS

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STAGES OF GROWTH AND DEVELOPMENT OF OLDER ADULTS

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Gerontological nursing involves advocating for the health of older adults at all levels of prevention
Older adulthood
Middle old
Old-old

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Acute Care Facilities

Long-Term Care Facilities

Hospice

Rehabilitation

Community

Different levels of care:

Assisted Living

Intermediate Care

Skilled Care Units or Skilled Nursing Facilities (SNFs)

Alzheimer’s units.

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Ego Integrity versus Despair

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COGNITIVE ABILITIES AND AGING OF OLDER ADULTS

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COGNITIVE ABILITIES AND AGING OF OLDER ADULTS

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Piaget’s phases of cognitive development end with the formal operations phase

perception

memory

learning

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MORAL REASONING AND SPIRITUAL OF OLDER ADULTS

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MORAL REASONING AND SPIRITUAL OF OLDER ADULTS

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Kohlberg hypothesized that an older person at the preconventional level obeys rules to avoid pain and the displeasure of others

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

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demography

chief concern

family and social

past medical history

gynecological history

obstetric history

Review of Systems

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NAEGELE'S RULE

the standard method used to predict the length of pregnancy (-3+7+1)

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gravida

para

term

pre-term

aborted

living children

multiple pregnancies

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LABORATORY ASSESSMENT OF A PREGNANT WOMAN

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LABORATORY ASSESSMENT OF A PREGNANT WOMAN

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complete blood count

genetic screen

serologic test for syphilis

blood typing (including Rh factor)

maternal serum for alpha-fetoprotein

An indirect Coombs’ test

Antibody titers for rubella and hepatitis B (HBsAg)

HIV screening

glucose loading or tolerance test

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Urinalysis

Tuberculosis Screening

Ultrasonography

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ASSESSMENT OF FETAL MATURITY AND WELL-BEING

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ASSESSMENT OF FETAL MATURITY AND WELL-BEING

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Amniocentesis

L/S Ratio

Oxytocin Test

Non-stress test

Estriol Test

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fetal reactivity

fetal breathing

fetal body movement

fetal tone

amniotic fluid volume

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Reduce anxiety related to the procedure.

Reduce pain and discomfort related to the procedure

Reduce the potential for traumatic injury to the fetus, placenta, or maternal structures