Assessment of Growth and Development of the Infant

Head Should measure 13.75 cm at birth

-Posterior fontanel should close by 2nd month
-Anterior fontanel should close in 12-18 months Well checkup schedule
● Second week of life
Height and weight ● 2, 4, 6, 9 months of age.
- In the first 6 months birth weight doubles and baby should grow 6 inches
- By 12 months birth weight should triple and baby should grow 10-12 in.
Skelton Vitals
- Is made up of cartilage at 3month gestation and continues to ossify and grow HR: 70 resting - 180 awake and crying ( accurate
HR is taken apically)
throughout life.
- Bone age, injury, abuse or nutritional deficits can be determined by X-Ray. RR: 30 but can range from 20-50 with
Circulation increase or decrease of activity.
- Hemoglobin and RBCs decrease when respiratory system takes over until
BP: 85/60 mmHg
3 months of age
Temp: 98.6
Neuro
- Nerve cells grow and coordination begins in an orderly pattern.

Physical milestones Psychological milestones

● Jerky quivering arm movements, ● Focuses 8-12 in away
● Brings hands to mouth , makes fists ● Eyes wonder and cross
● Head flops back if unprepared ● Likes black and white/ high contrast patterns.
● Strong reflexes ● Prefers human face to other patterns
● 5-8 feedings per day - 3 meals 2 snacks ● Hearing is fully mature, may turn toward sound
● Progresses from sleeping 20 hours a day to 10-12 ● Likes sweet smells, dislikes sour
hours at night and two naps by 12 months,place ● Likes soft sensations
awake child in crib to sleep ● Likes to be handled gently

Social Milestones Emotional growth

● 0-1 month: extensive sleep, dependent, eye contact ● 0-1 mo: general tension
● 0-3 months: smiles and fixes on faces,solitary play ● 1 mo: happy and sad emotions
● 3-6 mo: enjoys peekaboo, smiles at familiar faces ● 6 mo: separation anxiety
● 6-12 mo: knows name, gives and takes objects, ● 6-12 mo: stranger anxiety, shows curiosity by
understands easy commands. 12 months .

Language Nutrition
● 0-3 mo: Cries, grunts and Rapid growth causes a need for the greatest amount of nutrients
Coo ● 4-6 mo- 12mo: breast milk or commercial formula, introduction of solid foods.
● 0-6 mo: babbling, vowels, One food at a time starting with veggies.
● You may need to supplement Vit C/D iron, fluoride.
half consonants ● 6mo: iron rich foods are needed to supplement
● 12 mo: 1-2 words, imitation, ● 7-8mos: self feeding begins by grasping and bringing food to mouth. Ends with
responding to simple use of utensils
commands ● WIC program helps children and women get proper nutrition when they qualify

Age Theroist Stage Description Nursing care

Sigmund Freud Oral Pleasure center in Encourage self feeding.

Birth -18 mo Avoid putting objects in
mouth
mouth

Erik Erikson Trust vs Depends on parents Encourage bonding and

1st year to meet needs to family relationships
mistrust create trust

Jean Piaget Sensorimotor Coordinates sensory Plan tactile activities

Birth -2 yrs experiences with with use of colorful
stage physical action materials
 Assessment of Growth and Development of the Toddler 1-3 years
Physical growth slows Discipline
Communication and mobility skills increase Training and instructing to produce positive
Stubbornness , explore, dependent Safety behavior patterns
Begin to explore Autonomy “ I DO MYSELF” ● Proper restraint in ● Self control is gradual
Bed rituals are important car seat ● 2yrs: begin accepting responsibility
● Never leave the ● Consistency and timing are key
Height and weight toddler alone in ● Calmly remove the child from the
- Gain 5 to 10 LBs per year water even buckets situation
- Grow 3 inches per year pose a drowning ● Tell child the behavior is bad, not them
- Normal to go on food jags risk
● Put away poisons
and medications Well visits
Learns to stand alone and walk,
with locks ● 15 mo for shots
1 year Need 12-14 hours a day of sleep ● Burns from hot ● Annually after that
3 years need 10-12 hours appliances and ● Assess growth/ development, caregiver skill,and
water are common relationship between toddler and parent

Physical milestones Psychological milestones

● More slender body, organs adapt moderately to ● Well established walking
stress ● Hand eye coordination
● Well established walking ● Progressive development of fine motor skills
● Growth is slowed and stable ● They begin to draw and write
● Bones and muscles still immature requires nutrition ● Bladder control is gained , with occasional
an exercise for adequate development relapses
● Brain is 90% developed by age 5

Social Milestones Emotional growth

● Moves to parallel play, mostly imitates role models ● Many emotions in one day
● Does Not share readily until later toddler years ● Increased use of emotion language and
● Separation anxiety is overcome easily understanding of emotion
● ● causes/ consequence understanding

Language Nutrition
● Vocabulary begins to increase names objects, ● Require about 1000-1400 calories a day
body parts, animals, and familiar locations ● Toddlers should be active 60 min a day
● Primary method of communication ● Fruites: 1-1.5 cups
● Continuous questioning “why” ● Veggies: 1-1.5 cups
● Toys that talk are preferred ● Grains : 3-5 oz
● Brief sentences ● Protein : 2-4 oz
● Dairy : 2-2.5 cups
Allow children to eat when hungry instead of forcing meals.

Age Theroist Stage Description Nursing care

Sigmund Freud Anal Pleasure center in Encourage the family to

18 mo- 3 teach good hygiene
the anus
years

Erik Erikson Autonomy vs Mastering Support bonding and

1- 3 years environment and family relationships
shame and building self esteem
doubt

Jean Piaget Pre operational Sensory / action Plan drawing and

2-7 coordination, writing, tactile
symbolic thinking. experiences. Use
Represent world and colorful materials to
words together stimulate senses.
 Assessment of Growth and Development of the preschool child
Growth rate has slowed Well checkup schedule
-Language and play change remarkedly ● Boosters and vaccines 4-6yrs
- soak up info “little sponges, let them choose their own clothes” ● Annual exams for growth and
- 3yrs still chubby faced health
- 5 yrs leaner and taller and better coordinated but can't distinguish fantasy from real life.
Height and weight
- Gains 3-5 lb a year and grows 2.5 in. a year
- By 12 months birth weight should triple and baby should grow 10-12 in.
Vision
Skelton - Still immature
- Gross motor skills improve by age 5 they can climb, jump, catch and throw
- Distance judgement faulty
A ball and ride a bicycle.
- 5 yrs, leaner taller and better coordinated, teach them to wash hands thoroughly - Screen for amblyopia
- Bathing and brushing teeth still need supervised, can't wash own hair. - 20/20 vision by age 6
Dentition - Depth perception occurs at
- The skull is 90% of adult size by age 6 8-10 yrs old.
- Early preschool insidious teeth have completely emerged ,you floss their teeth.
- End of preschool teeth have erupted w/ incisors being first.

Physical milestones Psychological milestones

● Aware of their sexuality ● Develop imagination
● May have an imaginary friend
● May be attracted to parent of the opposite sex
● Magical thinking
● Parents should teach accurate sexual info ● May be afraid of the dark or have nightmares
● Teach the difference between good and bad touch ● 4:Temper tantrums, pushing, hitting, and
● Calm matter of fact response to masturbation manipulating environment
● Teach safety and privacy regarding genitals ● Discipline: teach the child responsibility and self
control and consistency.
● Taking favorited away is more effective than hitting

Social Milestones Emotional growth

● Preschoolers use imitative play, all types of play are
● 0-1 mo: general tension
needed for development
● Dramatic play: act out situations and control it ● 1 mo: happy and sad emotions
● Cooperative play: organized groups ● 6 mo: separation anxiety
● Associative play: play together but unorganized and no ● 6-12 mo: stranger anxiety, shows curiosity by
leader 12 months .
● Solitary : playing alone away from groups

Language
● 3-4: non communicative w/
language
● 4: communicate with language
● 4-5: use naughty words
● Converse in a way they can
understand
● Delays can be caused by:
hearing impairment, lack of
stimulation,
Nutrition
● Do not need large quantities of food, keep portions small.
● Requires high amount of protein
● Erratic appetite, frequent small meals are better
● Guide them when choosing food
● Provide healthy snacks
● Rituals are important.

Age Theroist Stage Description Nursing care

Sigmund Freud Phallic Pleasure center in Explain to the family and

3-6 yrs teach hygiene
the genitals

Erik Erikson Initiative vs guilt Child develops a Monitor and protect from
3-5 yrs conscious and sense injury and poisoning.
of right and wrong Encourage them to ask
questions

Jean Piaget Pre operational The child sees the Plan drawing and writing
2-7 yrs world egocentrically activities.
phase
 Assessment of Growth and Development of the school aged child 6-10yrs
Head Should measure 13.75 cm at birth Well checkup schedule
- School starts
- Thinking skills develop
● Annual physicals
● Booster tetanus and diphtheria
● Visit the dentist 2x a year
Height and weight ● Screening for scoliosis at 10-11
- Growth is slow and steady gains 5-6 lb a year. ● Vision and hearing screen .
- Grows 2.5 in. a year until pre-teen.
- Spine straightens and abdomen flattens
- Long bone growth is noted
Substance abuse
Dentition The birds and the bees
● Teach family values
- Starts to lose baby teeth at about 6 ● Teach right and wrong
● Help develop a positive attitude
of sexuality
- Eruption of permanent teeth begins ● Set rules and enforce ● Sexual roles
Neuro ● Teach facts about ● Satisfaction with being a boy
drugs and alcohol
-Refines motor and cognitive skills or girl
● Actively listen
- Engages in meaningful tasks

Physical milestones Psychological milestones

● Slowed growth, graceful on their feet ● Displays a sense of duty and accomplishment
● Strength and abilities double ● Applies energy from play to complete tasks
● Loss of baby teeth ● Develops positive sense of self
● Structural bone changes ● Magical thinking, sit still for short periods
● Girls begin to experience secondary sex ● Understands taking turns , enjoys groups
characteristics ● Enjoys real life activities
● Give consistent rules, positive attention, and
clear expectations, questions parents
standards,

Social Milestones
● Develop confidence in family and explore Emotional growth
relationships outside of family ● Greater understanding of complex emotions
● Peers become important ● Understands they can have more than one
● Motivated by accomplishment emotion
● success/ failure have a strong impact ● Greater ability to control emotion
● Uses strategies to redirect feelings

Language
● Language is refined vis
grammar education
● Ability to use words to express
knowledge
● Narrative skills improve
● Able to make inferences
● Able to evaluate speech and
messages
Nutrition
● Requires more food for increased energy demands
● Choose foods from all food groups
● Food jags and increased appetite are normal
● Limit fat intake, supervise snack habits
● Offer choices.

Age Theroist Stage Description Nursing care

Sigmund Freud Latency Preparing for adult Encourage sibling and

6-10 yrs peer contact. Assess for
life but awaiting
maturity sexual activity in later
stage

Erik Erikson Industry vs Developing sense of Provide activities based

6-10 yrs self worth and talent on talents and abilities
Inferiority

Jean Piaget Pre operational The child sees the Plan drawing and writing
2-7 yrs world egocentrically activities.
phase
 Assessment of Growth and Development of the Adolescent 11-18yrs
Early adolescents Well checkup schedule
-puberty : reproductive maturity ● 2x during teens
- starts at age 10 in girls and ends with menstruation
- starts age 12 in boys and ends sperm production ● Immunizations, hearing,
vision, scoliosis, thyroid
Growth and pelvic for sexually
- Girls achieve 98% of height of 16 active girls..
- Skeletal growth outpaces muscle growth
- Nonvoluntary with early menses, 13-15 ovulation begins
● BP, height and weight
- Boys : grow rapidly from 13-20
- Muscle strength and coordination develop rapidly
- Larynx becomes enlarged
- Both sexs : body takes on contours
- Primary sex organs develop, hormonal activity increases
- Bone growth continues until 20s
- Anorexia and bulimia can happen due to body image issues

Physical milestones Psychological milestones

● Girls : 9-11: growth spurts last 18 months ● They wonder who they are
● Grows 3 in annually until menarche ● What will they become
● Begin to develop figure ● More mobile
● Boys: 11-13: slower and steadier than girls ● Seek out intimate relationships
● Changes in penis testes and scrotum ● Most are heterosexual, homosexuality can be
● Nocturnal emissions “ wet dreams” difficult emotionally
● Body image is closely related to self esteem
● Underdevelopment causes anxiety

Social Milestones Emotional growth

● Greater focus on peers develops a separate self ● Rebellious
from parents ● Emotional highs and lows
● Moral development ● Focus on appearance
● Less egocentric ● Sexually active teens may have impaired self image
● Focused on mixed gender friendships ● Privacy becomes important. .

Language Nutrition
● Able to communicate Rapid growth causes a need for the greatest amount of nutrients
complex thoughts ● Appetite increases and teens eat frequently
● Food choices not always wise
● May skip meals
● Can have nutritional deficits of vit A, D and B. folic acid, iron and zinc. Due to
menses girls need additional iron.

Age Theroist Stage Description Nursing care

Sigmund Freud Genital Pleasure center in Encourage safe sex,

Puberty educate on teen
the genitals
pregnancy and STI

Erik Erikson Identity vs role Integrating multiple Support self esteem, be

10-20yrs roles, self image and honest maximize
confusion peer pressure positive aspects of
image and minimize
defects

Jean Piaget Formal Reasons in more Discuss conditions

11- adulthood abstract idealistic openly with client. Allow
operational ways privacy to discuss
stage