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Unit IV-Potential Threats to Wellness and Well-bing in Infancy and Childhood

Gallagher/SPC/Nursing III Theory


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Key Point
Children's vulnerability and reaction to stress depend to a large extent on their age, coping behaviors, and support systems.
Nursing Alert
Infants should face the rear from birth to 20 pounds and as close to 1 year of age as possible. If the child weighs 20 pounds but is not 1 year old, the rear-facing position is still recommended.
gastric lavage
May be performed to empty the stomach of the toxic agent.
lead encephalopathy
A metabolic encephalopathy, caused by the ingestion of lead compounds and seen particularly in early childhood; it is characterised pathologically by extensive cerebral oedema, status spongiosus, neurocytolysis, and some reactive inflammation; clinical manifestations include convulsions, delirium, and hallucinations.
Key Point
Maturation, a qualitative change, describes the aging process or an increase in competence and adaptability.
emotional deprivation
When children fail to have quality interpersonal relationships with "mothering" persons, they experience this. The most prominent feature of it, particularly during the first year, is developmental delays.
Nursing Alert
The use of teething powders or procedures such as cutting or rubbing the gums with aspirin are discouraged, because ingestion of the powder, infection or irritation of the tissue, or aspiration of the aspirin can occur. Hard candy may cause accidental choking or aspiration and should be avoided at this age.
Key Point
The three broad classifications of child temperament are the easy child, the difficult child, and the slow-to-warm-up child.
Key Point
Physical development includes increase in height and weight and changes in body proportion, dentition, and some body tissues.
developmental tasks
A set of skills and competencies peculiar to each developmental stage that children must accomplish or master in order to deal effectively with their environment.
Also called denial. Superficially it appears that the child has finally adjusted t the loss. However, this behavior is the result of resignation and is not a sign of contentment.
Nursing Alert
Be alert to parents' reports about maternal postpartum depression and infant crying, because these concerns may indicate a stressed mother-infant relationship.
Used to measure disease and injury.
An increase in competence and adaptability; aging; usually used to describe a qualitative change; a change in the complexity of a structure that makes it possible for that structure to begin functioning; to function at a higher level.
When crying stops, and depression is evident.
Use of a chemical compound that combines with the metal for rapid and safe excretion.
Key Point
Play provides a means of development in the areas of sensorimotor and intellectual progress, socialization, creativity, self-awareness, and moral behavior; it serves as a means for release of tension and expression of emotions.
The value that an individual places on oneself and refers to an overall evaluation of oneself.
Key Point
The developmental theories most widely used in explaining child growth and development are Freud's psychosexual stages, Erikson's stages of psychosocial development, Piaget's stages of cognitive development, and Kohlberg's stages of moral development.
therapeutic play
Includes activities such as permitting the child to give an injection to a doll or stuffed toy to reduce the stress of injections.
Nursing Tip
Double the child's height at the age of 2 years to estimate how tall he or she may be as an adult.
Nursing Alert
In the first several months before the infant can roll over the head should be positioned on alternating sides to prevent positional plagiocephaly (when asleep in the supine position or awake and supine).
Nursing Alert
Encourage adults to: Blow up balloons for children/Supervise children's balloon play/Pick up and dispose of broken balloon pieces/Warn older children of dangers of chewing or sucking on balloons/Substitute Mylar or paper balloons for latex balloons.
sequential trend
In all dimensions of growth and development theory there is a definite, predictable sequence, with each child normally passing through every stage.
Nursing Tip
A quick guide to assessment of deciduous teeth during the first 2 years is: age of the child in months - 6 = number of teeth. For example: 8 months of age - 6 = 2 teeth at this time.
expressive activities
Allow for emotional expression, including the safe release of anger and hostility.
A substance that exerts its action through irritation of the gastric mucosa and by stimulation of the vomiting center.
diversional activities
Activities age appropriate that divert the childs attention away from the stressor.
Nursing Alert
An infant who does not pull to a standing position by 11 to 12 months of age should be further evaluated for possible developmental dysplasia of the hip. Although there is considerable variation among infants for the achievement of these milestones, they provide guidelines for early intervention.
Nursing Alert
Children as young as 4 years can recognize that cartoons are "make-believe," but children as old as age 6 continue to assume that noncartoon features are at least roughly analogous to social reality. Therefore, young children are especially vulnerable to misinterpreting what they see and need guidance in choosing approriate programs.
Nursing Alert
Rear-facing infant safety seats must not be placed in the front seats of cars equipped with an air bag on the passanger side. If an infant safety seat is placed in the passenger seat with an air bag, the child could be seriously injured if the air bag is released, because rear-facing infant seats extend closer to the dashboard.
Nursing Alert
The use of meningococcal and diptheria proteins in combination vaccines does not mean the child has received adequate immunization for meningococcal or diphtheria illnesses; the child must be given the appropriate vaccine for that specific disease.
Nursing Alert
Whole milk should not be introduced to infants until after 1 year of age.
Processes by which early cells and structures are systematically modified and altered to achieve specific and characteristic physical and chemical properties; sometimes used to describe the trend of mass to specific; development from simple to more complex activities and functions.
Key Point
The mass media can be influential in children's learning and behavior.
Nursing Alert
Any child who displays head lag at 6 months of age should have a developmental/neurologic evaluation.
It has been reported that the television is on for more than 6 hours per day in more than half of American homes and that children watch an average of 21 to 28 hours of television per week.
family-centered care
This philosophy recognizes the family as the one constant in a child's life. Three key components of this care are respect, collaboration, and support.
Head to tail direction.
Key Point
The directional trends in growth and development are cephalocaudal, proximodistal and mass to specific.
Is the work of the child. Children continually practice the complicated, stressful processes of living, communicating, and achieving satisfactory relationships with other people.
Key Point
To develop a positive self-concept, children need recognition for their achievements and the approval of others.
Key Point
The five major developmental periods are prenatal, infancy, early childhood, middle childhood, and later childhood (pubescence and adolescence).
Key Point
Development involves change from a lower to a more advanced stage of complexity.
A gradual change and expansion; advancement from lower to more advanced stages of complexity; the emerging and expanding of the individual's capacities through growth, maturation, and learning.
Nursing Tip
During an assessment, consider that parents may not be aware of how much time their children spend watching television. Parents may also not understand the child's inability to distinguish between the "fantasy" of television and life events.
Nursing Alert
To prevent oral burns from uneven warming of the milk, breast milk should never be thawed or rewarmed in a microwave oven. To thaw the frozen milk, either place the container under a lukewarm water bath (105 deg) or place in the refrigerator overnight.
Nursing Alert
Although microwaving of bottles and baby food is not recommended, it remains a common practice. Guidelines have been developed for microwave heating of refrigerated formula, and these should be given to the family.
Key Point
Growth and development proceed in predictable patterns of direction, sequence, and pace.
Inherited characteristics directs both the pattern of growth and the behavior of others toward the child.
Nursing Tip
Toys need to have several levels of challenge to keep from becoming obsolete too quickly, such as the Balls in the Bowl.
Key Point
Differentiation refers to a biologic description of the processes by which early cells and structures are modified and altered to achieve specific and characteristic physical and chemical properties.
Nursing Alert
Formal infant exercise programs do not provide any long-term benefit to normal infants, and the possibility for damage to the infant's skeletal system exists. For these reasons, such programs are not recommended.
Nursing Alert
Offer fruit juice from a cup, rather than a bottle, to prevent the development of nursing caries.
Nursing Alert
For several decades pertussis vaccine was considered a rare cause of serious, permanent brain damage or death. After reviewing studies, experts have concluded that whole-cell pertussis vaccine has not been proved to cause neurologic damage. Previous contraindications to whole-cell pertussis vaccination are now considered precautions.
An increase in number and size of cells as they divide and synthesize new proteins; results in increased size and weight of the whole or any of its parts.
Key Point
Growth describes a change in quantity and occurs when cells divide and synthesize new proteins.
Key Point
Through play, children learn about their world and how to relate to things, people, and situations.
Children react aggressively to the separation from the parent. They cry and scream for their parents, refuce attention from anyone else, and are inconsolable in their grief.
Key Point
Growth and development are affected by a variety of coditions and circumstances, including heredity, physiologic function, gender, disease, physical environment, nutrition, and interpersonal relationships.
separation anxiety
Between ages 4 and 8 months when the infant progresses through the first stage of separation individuation and begins to have some awareness of self and mother as separate beings.
anticipatory guidance
Guidance given before the stage.
Nursing Alert
If infants are being fed powdered or concentrated formula, they may receive a substantial amount of lead from tap water, placing them at risk for lead poisoning. Bottled water for mixing powdered or concentrated formula is a relatively safe alternative to tap water.
atraumatic care
The provision of therapeutic care in settings, by personnel, and through the use of interentions that eliminate or minimize the psychologic and physical distress experienced by children and their families in the health care system.
Nursing Alert
Dietary fat should not be restricted. Substituting skim or low-fat milk is unacceptable, because the essential fatty acids are inadequate and the solute concentration of protein and electrolytes, such as sodium, is too high.
nonpharmacologic pain management
A number of techniques, such as distraction, relaxation, guided imagery, and cutaneous stimulation, provide coping strategies that may help reduce pain perception, make pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics.

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