MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.
- They are easily influenced by the

Outline attitude of their friends

Definition of Terms - May select activities based on the
Physiologic Development
Sexual Maturation interest of their peers
Teeth - Initiation of independent decision
Gross Motor
making
Fine Motor
Freud’s Theory of Psychosexual Development - Parents unprepared for this may
Social and emotional Development experience conflicts with their child
Language Development
Erikson’s Theory of Psychosocial
Development Definition of Terms
Play
Piaget’s Theory of Cognitive Development
Kohlberg’s Theory of Moral Development Accommodation – ability to adapt thought
Nutrition processes to fit what is perceived such as
Assessment
Nursing Diagnosis understanding that there can be more than
Implementation of Safe and Quality Nursing one reason for other people’s actions
Interventions
Evaluation Caries – dental cavity

- 6 – 12 yrs Class Inclusion – ability to understand that

- A time of slow physical growth objects can belong to more than 1

- The school age child’s cognitive growth classification such as by diff. materials by

and development continue to proceed at sizes, by shapes , by weight, by appearance

rapid rates Conservation – ability to appreciate that a

- Child may demonstrate contradictory change in shape does not necessarily mean a
responses change in size
• The child would say yes but then
Decentering – ability to project oneself into
after they may say no
other people’s situation and see the world
- What the child enjoys on one occasion
from their viewpoint, they will not only
may change over time
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.
focus on their own views but they will start
to look into other’s viewpoint
Malocclusion – deviation of tooth position
from the normal
Nocturnal Emissions – increased seminal
fluid begins to be produced, boys begin to
notice ejaculation during sleep (wet dreams)
Physiologic Development
- A relatively long time span, grow and
develop extensively during this time
period
Physical Growth
- Average annual weight gain is
approximately 3-5 lb (1.3 to 2.2 kg)
- Increase in height is 1-2 inches (2.5 – 5
cm)
- Lordosis and knock-kneed appearance is
lost now
- Girls are usually taller by 2 inches (5cm)
more than the preadolescent boys
because their typical growth spurt
begins earlier
- Hips among girls become broader
- At 10 yr :
• Brain growth is complete, fine
motor coordination is refined
• Eye globe reaches its final shape
and adult vision level is achieved
- Immune globulins IgG and IgA each
reach adult levels and lymphatic tissue
continues to grow in size until about age
9 yrs
- Lymphatic system grows rapidly
- Tonsils seem to fill the entire back of the
throat causing eustachian tube
obstruction resulting in temporary
conduction deafness until the tissue
recedes normally
- Enlarged tonsils are usually seen
- Test for conduction deafness: Weber’s
Test, Rinne’s Test
- The appendix being lined with
lymphatic tissue, so swelling of this
tissue in the narrow tube can lead to
trapped fecal material and inflammation
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.
- Frontal sinuses develop at about 6 yrs so
sinus headaches become a possibility
- Headaches in children is rarely caused
by a sinus infection
• Gonadotrophin Releasing Hormones
- Left ventricle of the heart enlarges to be
• Chapter 5 in book
strong enough to pump blood to the
- Timing of the onset of puberty varies
growing body
widely bet. 8-14 yrs, partly due to
- Innocent heart murmurs become
• Genetic
apparent due to the extra blood crossing
• Cultural differences and is rated
heart valves
according to Tanner Stages
- Length of time from puberty until sexual
maturity is complete, also varies
- Sexual maturation in girls: bet. 12 – 18
- Exertion ability and stamina increases
yrs
due to maturation of the respiratory
- Sexual maturation in boys: bet. 14-20
system which leads to increased oxygen-
yrs
carbon dioxide exchange
- Stage for sex education
- Scoliosis may become apparent for the
- In boys, increased seminal fluid begins
first time in late childhood
to be produced, boys begin to notice
Sexual Maturation ejaculation during sleep (nocturnal
ejaculation)
- As brain matures: the hypothalamus
transmits an enzyme to the anterior
pituitary gland to begin production of
gonadotrophic hormones
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.

- Suset: suso maliit

- Susuki: suso malaki
- Susan: suso nasaan
- Jobel: joga sa bilbil
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.

Teeth
- Deciduous teeth are lost and permanent
teeth etupt during this period
- The average child gains 28 teeth bet. 6-
12 y.o Fine Motor
- The central and lateral incisors
- 1st, 2nd, and 3rd cuspids
- 1st and 2nd molars

Freud’s theory of
Psychosexual Development
Latency stage

- Age of suppression
- Sexual drive is suppressed and energy is
used to gain new skills and social
relationship and knowledge
Gross Motor - Achievement oriented years
- Emphasis is development of skills and
talents
- Normally homosexual (same sex only)
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.
- Major conflict has to overcome is to rewarding than watching things being
establish relationship with same sex done (sense of initiative)
peers - They usually explore the social
environment
Nursing Significance

- Help the child achieve positive

experience

Social and Emotional

Development 9 y.o
Emotional Development
- Take the values of their peer grp
Children enter this period with: seriously
- Gang age
- Ability to trust others
- They choose their own preferred clothes
- Sense of respect for their own worth
than those their parents want them to
- Ability to accomplish small takss
wear
independently
- Club age because they form groups,
- Ability to practice or mimic adult roles
usually “spite clubs” :
- Ability to share
• Grp is divided
- Learning is fun
• Have a secret password and secret
- Doing things is more important than
meeting place
watching things being done (sense of
• Membership is generally all boys or
initiative)
all girls
- Children discovered that learning is an
- Parents should not intervene because
adventure, and grasped the idea that
loyalties shift quickly
doing things is more important and more
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.
- They are ready for social interactions,
thus, are ready for activities away from
home (camp out)

- Parents should refrain bad words and tell

the child that a word is inappropriate if
they use it

- This socialization patterns should not be Erikson’s Theory of

rushed
- They should encounter uncomfortable
scenarios first before they feel
comfortable in building relationships
especially with the other sex
- Some children would develop faster and
some slower that would make social
interest difficult
Language Development
- Appear to have incorporated language
permanently
Psychosocial Development
Industry vs Inferiority
Industry
- learning how to do the things well
- Those who lack industry are expected to
have difficulty tackling new situations in
life
- How to develop industry:
• Give short assignments and projects
• Give them small chores that can be
finished quickly and the difference
is visible from the previous one
- Develops sense of competency vs sense
of inadequacy
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.
- Industry develops when a child is Nursing Implications
permitted to do things by himself and
praised for the results - Provide opportunities such as allowing
- Interested in learning how to do things child to assemble and complete a short
well project so that child feels rewarded for
- Inferiority develops if the child’s accomplishment
activities are seen as nuisance
- They begin to create and develop a
Play
sense of competence and perseverance
and master skill that will help them
function in the adult world
- They are motivated by activities that
provide a sense of worth
- These children compare themselves with
others and obtain feedback from
teachers and peers
- Settings where to learn industry:
• Home
• Structured activities
• School
• Problem solving
- Behaviors to Observe:
• Wants to learn to do things well and
completely
• Participates in variety of activities
especially in school
• Takes pride in accomplishments
MATERNAL AND CHILD NURSING CARE
Growth and Development
– School Age
Lec 1/30/23 – Aly G.
Piaget’s Theory of Cognitive
Development
- The school age is in the Concrete
Operational Stage or the ability to
Concrete Operations (7-12 yrs)
reason through any problem they can
actually visualize
• Decentering – project oneself into
other people’s problems/situations
and see the world from their
viewpoint rather than focusing only
on their own view
• Accommodation – ability to adapt
thought processes to fit what is
perceived such as understanding that
there can be more than one reason
for other people’s actions, they will
understand that different nurses
work different shifts
• Class Inclusion – ability to
understand that objects can belong
to more than one classification such
as by different materials, by sizes,
by shapes
• Conservation – appreciate that a
change in shape does not necessarily
mean a change in size, if you pour
30ml of water from a thin glass to a
wide one, a school age child will
know that both glasses hold an equal
amount
- Children can use logic, but tend to be
literalistic
- Abstract concepts are not easily
understood
- Concrete problem solving, some
reversibility, categorical labels
- Includes systematic reasoning and
recognize cause-and-effect relationship
- Uses broad concepts and subgroups of
concepts
- Knows how to classify
- Child is aware of reversibility
- Activity: sorting, classifying
- Understand conservation, sees constancy
despite transformation
- Uses memory to learn broad concepts
and subgroup
- Classification involves sorting objects
accordingly
- Activity: collecting and classifying
natural objects
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.
Stage 3 Good Boy-Nice Girl Orientation

- Ethical decisions are based on concern

for of the opinions of others

Conventional Level II Stage 3: Good

Kohlberg’s Theory of Moral Boy-Nice Girl Relationship (7-10 yrs)
Development - See morality as more than simple deals
- Believe that people should live up to the
- School age children belong to stage 3:
expectations of the family and
conventional reasoning (as early as 5 yrs
community, and behave in good ways
of age)
- Good behavior means having good
- Begin to mature in terms of moral
motives and interpersonal feelings such
development
as love, empathy, trust, and concern for
- They concentrate in niceness or fairness
others
and cannot see yet that stealing hurts
- Child follows rules because of a need to
their neighbor, the highest level of moral
be good person in own eyes and eyes of
reasoning
others
- Because they are still limited in their
- Lying is coming to disguise that they
ability to understand other’s views, they
have been involved in an action that is
may interpret something as being right
not nice
because it is good for them, not because
it is right for humanity as a whole
- The good boy / girl stage

Level II Conventional Morality (10-13 yrs)

- People at this stage conform to the “When people see what I have done, they will
conventions/ rules of a society think I am a good person”
MATERNAL AND CHILD NURSING CARE

Growth and Development

– School Age
Lec 1/30/23 – Aly G.

Nutrition Nursing Diagnosis

- They have good appetites, although
meals may be influence by the day’s
activity
- Boys need more calories than girls
though both need iron, adequate
calcium, fluoride
- Major deficit may be fiber because
children typically dislike vegetable Implementation of Safe and
- Encourage outside activities for sun Quality Nursing Interventions
exposure to increase vitamin D

Assessment

Evaluation