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Maternal and child health nursing

Mrs. Lal Joy Sanchez-Ruba

Normal growth and

5. Development is timely
• The are recognized critical (sensitive)
periods of development
development FACTORS INFLUENCING G&D
ENVIRONMENT
TOPIC OUTLINE
o Socioeconomic level
1 Theories of Child Development o Parent-child relationship
o Family position
2 Basic Principles of Child Development
o Health/Genetics
3 Factors Influencing G&D o Nutrition
o Genetics
o Temperament

THEORIES OF CHILD DEVELOPMENT INFANT (1-12 MONTHS)

FREUD – PSYCHOSEXUAL DEVELOPMENT Trust vs Mistrust

- Double birth weight at 6 months

1. Oral stage
- Triple at 12 months
2. Anal stage
- Rolls over 4 months
3. Phallic stage
- Holds head steady at 6 months
4. Latency stage
- Sitting 6-8 months
- Walking 12 months
ERIKSON – THE FOUR AGES OF CHILDHOOD
- Pincer grasp 10 months
- 2 words by 12 months
1. Infancy (Trust vs Mistrust) - Solid food at 6 months
2. Toddlerhood (Autonomy vs Shame and Doubt) - Object permanence
3. Preschooler (Initiative vs Guilt) - Separation anxiety at 8 months
4. School-age (Industry vs. Inferiority - Risk for aspiration
- Eruption of teeth – lower incisor are 1st teeth
PIAGET – THEORY OF INTELLECTUAL DEVELOPMENT at 6-10 months

• Sensoriomotor Thought 0-2 years NURSING MANAGEMENT - INFANCY

• Preoperational Thought 2-7 years
o Egocentrism 1. Discuss age-appropriate recommendations
o Transductive reasoning 2. Teach nutrition
o Centration 3. Sleep patterns
o Animism 4. Foster attachment
o Magical thinking 5. Explore family support systems
• Concrete Operatioons 7-11 years 6. Safety
• Formal Operations >11 years
NUTRITION

BASIC PRINCIPLES OF CHILD DEVELOPMENT o Breast milk a/o formula 1st year
o Solids at 4-6 months – iron fortified rice cereal
1. Children are competent 1sr
2. Children resemble one another o Next veggies, fruit, then meat 8-10 months
3. Each child is unique
4. Development is Directional TODDLER (1-3 YEARS OLD)
• Which body systems grow most rapidly
during early childhood? o 2-word sentences by age 2
o Screening for lead poisoning
o Decreased appetite (physiologic anorexia)
o Temper tantrums
o Toilet training
o Negativism
o Sibling rivalry (expect regressive behavior with
arrival of new baby)
o Parallel play (won’t share)
o Transitional objects
o Temper tantrums

NURSING MANAGEMENT

1. Discuss age-appropriate recommendations

2. Growth and development
3. Toilet training
4. Negativism
5. Encourage gross motor skills

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 6. Sibling rivalry NURSING INTERVENTIONS: HEALTH CARE SETTINGS
7. Regression
8. Sleep patterns
9. Safety

NUTRITION

o Physiologic anorexia
o Food jags
o Serving amounts?
o If on a food jag, may only eat yogurt for days
o Provide for self-feeding: Finger foods/spoon

Toddlers are at high risk for injuries r/t to their increasing

cognitive and motor skills curiosity.

- Falls
- Poisoning
- Burns
- Motor Vehicle Crashes
- Drowning

PRESCHOOLER (3-5 YEARS OLD)

- Body contour changes

- Social/language skills increases
- Appetite is diminished
- Fear of dark, mutilation, and abandonment
- Self-centered
- Magical thinking “If I am mad at mommy and she
gets sick, I caused it!”
- Bedtime issues
- Associative play with strong imaginative and
dramatic themes…like to assume adult roles in
play.

NURSING MANAGEMENT

1. Discuss age-appropriate recommendations

2. Teach nutrition
3. Sleep patterns
4. Discuss G&D
5. Family
6. Fears
7. Safety

SCHOOL-AGE (6-12 YEARS)

- Slimmer, stronger, increased fine motor skills

- Growth spurt/prepubescent period
o Girls – 10 yrs. Boys – 13 yrs.
- Permanent teeth erupt
- Latch-key children
- Concrete thought
- Cooperative play/rules/routine
- Obesity risk begins
- Peer group bigger influence
- Sexuality/Inappropriate touch

NURSING MANAGEMENT

1. Discuss age-appropriate recommendations

2. Teach nutrition
3. Sleep patterns
4. Discuss G&D
5. Family
6. Promote skill development in school, sports, and
play
7. Safety

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