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Gestational Weight
Gestational Weight
Developmental stages
Neonate (birth -1month)
Infant (1-12 month)
Toddler (12 mos.-3 yrs.)
Preschooler (3-5 yrs.)
School age (6-12 yrs.)
Adolescent (12-18 yrs.)
Sigmund Freud
1856-1939-an austrian neurologist and the
founder of psychoanalysis
Offered the first real theory of personality
development
He described child development as being a
series of psychosexual stages in which a
child's sexual gratification becomes focused
on a particular body part.
SIGMUND FREUD :
MAY 6, 1856 SIGMUND FREUD WAS BORN IN
FREYBERG TOWN, CRECH REPUBLIC
1881 HE GRADUATED FROM MEDICAL
FACULTY, UNIVERSITY OF VIENNA
1900 HE RELEASED INTERPRETATION OF
DREAMS
SEPTEMBER 23, 1939 FREUD PASSED AWAY
IN HAMPSTEAD HOUSE
PSYCHOANALYTIC THEORY
OVERVIEW OF
PSYCHOANALYSIS
2.PRECONSCIOUS
. Facts stored in a part of the brain, which are not
conscious but are available for possible use in
the future
(E.g. A person will never think of her home address
at that moment but when her friend ask for it,
she can easily recall it)
3. CONSCIOUS
.
STRUCTURE OF PERSONALITY
Consist of three
parts :
1.Id
2.Ego
3.Superego
1. Id
Infants are born with Id
intact
Operates on PLEASURE
PRINCIPLE to gain
pleasure, avoid pain
Driven by sexual and
2. Ego
The rational level of
personality
Operates on REALITY
PRINCIPLES does
realistic and logical
thinking
3. Superego
Partially unconscious
Operates on MORAL
PRINCIPLES
Able to differentiate between
good and bad, right and wrong
If people follow their
superego, they will feel proud
but if they dont follow, they
Example:
PSYCHOSEXUAL STAGES
1. Oral Stage
Birth to 18 months
Pleasure centers on the mouth
sucking, biting, Infant suck for enjoyment
or relief of tension as well as for
nourishment
Fixation :
1.If the child is over stimulated in this
stage, as an adult she/he may become
dependent on cigarette or alcohol,
become chatterbox, or derive pleasure
from acquiring possessions(collect
3. Phallic Stage
3 years to 6 years
Cont.
4. Latency Stage
6 years to 11 years, until
puberty
No fixations occur as the childs
energy are focused on peer
activities and personal mastery
of learning and physical skills
5. Genital Stage
12 years onwards
Sexual interest in opposite sex
increase
The child improve their personal
identities, develop caring feeling
towards others, establish loving
and sexual relationship and
progress in successful careers.
Fixation :
I. Frigidity, impotence and unsatisfactory
Eriksons Psychosocial
Stages of Development
Psychosocial
Development
There were two psychologists who had
(birth-18 months).
Babies must learn to
trust there parents
care and affection.
If not done the babies
could develop a
distrust and view the
world as inconsistent
and unpredictable.
Questions ones hope.
years old).
Using initiative in
planning or carrying
out plans.
Or develop a sense of
guilt over misbehavior
regarding parents
limits.
Questions ones
purpose and role in life.
years of age).
Learn to follow the
rules imposed by
schools or home.
Or the child can start
believing they are
inferior to others.
Questions
competency.
years of age).
Acquire a sense of
identity.
Or can become
confused about ones
role in life.
Questions who you
are and if your happy.
years of age).
Develop a relationship
and joint identity with a
partner.
Or can become isolated
and stay away from
meaningful relationships.
Questions if the person is
ready for new
relationships, or if there
is a fear of rejection.
Generativity vs.
Stagnation
Middle adulthood (40-65
years of age).
Making use of time and
having a concern with
helping others and
guiding the next
generation.
Or can become selfcentered, and stagnant.
Questions what the
person will do with their
extra time.
up).
Understand and accept
the meaning of
temporary life.
Or complains about
regrets, not having
enough time, and not
finding a meaning
throughout life.
Questions ones overview
of their entire life.
History of Psychosocial
Theory
Erikson was one of the first psychologists to
Eriksons Philosophy
His basic philosophy rests on two themes:
The world gets bigger as we go along
And failure is cumulative.
If an individual has dealt with a terrible past
Overview
Erikson has eight developmental stages that
Eriksons Psychosocial
Stages of Development
(birth-18 months).
Babies must learn to
trust there parents
care and affection.
If not done the babies
could develop a
distrust and view the
world as inconsistent
and unpredictable.
Questions ones hope.
years old).
Using initiative in
planning or carrying
out plans.
Or develop a sense of
guilt over misbehavior
regarding parents
limits.
Questions ones
purpose and role in life.
years of age).
Learn to follow the
rules imposed by
schools or home.
Or the child can start
believing they are
inferior to others.
Questions
competency.
years of age).
Acquire a sense of
identity.
Or can become
confused about ones
role in life.
Questions who you
are and if your happy.
years of age).
Develop a relationship
and joint identity with a
partner.
Or can become isolated
and stay away from
meaningful relationships.
Questions if the person is
ready for new
relationships, or if there
is a fear of rejection.
Generativity vs.
Stagnation
Middle adulthood (40-65
years of age).
Making use of time and
having a concern with
helping others and
guiding the next
generation.
Or can become selfcentered, and stagnant.
Questions what the
person will do with their
extra time.
up).
Understand and accept
the meaning of
temporary life.
Or complains about
regrets, not having
enough time, and not
finding a meaning
throughout life.
Questions ones overview
of their entire life.
History of Psychosocial
Theory
Erikson was one of the first psychologists to
Eriksons Philosophy
His basic philosophy rests on two themes:
The world gets bigger as we go along
And failure is cumulative.
If an individual has dealt with a terrible past
Overview
Erikson has eight developmental stages that
The
Definition
Prematurity
2. Post maturity
Infants born of a gestation that extend 42 weeks as
calculated from the mothers last menstrual period.
Causes: of PREMATURITY
. Infections
Gestational hypertension
Cervical insufficiency
High unexplained alpha fetoprotein level
in
second trimester
Lack of prenatal care
Multiple pregnancy
Placenta previa
Substance uterine abnormalities
Underlying condition that results in the
delivery of the neonate before term.
ADOLESCENT PREGNANCY
INFECTIONS
Caused by BACTERIA
weaken the membranes around the
Cervical insufficiency(cervical
it means that the
incompetence)
Gestational
hypertension
is the development of newhypertensionin
apregnantwoman after 20 weeks gestation
without the presence of protein in the urine or
other signs of preeclampsia
Previous Preemie
previous premature births, risk is higher
Pre-eclampsia
Pre-eclampsia is a serious condition that only
HELLP SYNDROME
HELLP syndrome is a severe form of pre-eclampsia, and is
PLACENTA PREVIA
Type
Description
Minor
Major
GESTATIONAL DIABETES
Gestational
Substance
abnormalities
Congenital uterine
means that
something is
present at birthits something youre
born with. About 3 in 100 females (3
percent) are born with a defect in the size,
shape or structure of the uterus.
When the baby is developing in the
womb, two small tubes callMullerian ductcome together at about 10 weeks
gestation (10 weeks of pregnancy) to form
her uterus. For some the Mullerian ducts
dont come together completely. This can
cause problems with the uterus, including:
Septate
uterus.
most common
congenital uterine
abnormality, a band of muscle or tissue
divides the uterus into two sections.
This cause women to have repeat
miscarriages.
sohealth care providersoften recommend
surgery to repair the uterus and reduce your
risk of miscarriage.
Miscarriage is the death of a baby in the
womb before 20 weeks of pregnancy.Repeat
miscarriagemeans a woman has two, three
or more miscarriages in a row.
Bicornate uterus
(also
Unicornate
uterus(also called
one-sided uterus).
This condition
happens when only
half the uterus
forms. Surgery cant
make the uterus any
larger.
Didelphic
uterus(also called
double uterus). In
this condition, there
are two small,
separate cavities,
each with its own
cervix (opening).
2.Post maturity
Post maturity is more likely to happenwhen
anencephalic fetus
history of post maturity
delayed fertilization and
ovulation
placenta, which supplies babies with the nutrients and oxygen from
the mother's blood, begins to age toward the end of pregnancy.It
may not function as efficiently as before. Other concerns are:
Less amniotic fluid.Thismay stop the baby fromgaining weight or
may even cause weight loss.
Poor oxygen supply.Babies that don't get enough oxygen may
have problems during labor and delivery.
Large size.A large baby may cause problems for the mother during
labor and delivery.
Meconium aspiration.Babies who stay in the womb longer are
more likely to breathe in fluid containing their first stools (meconium).
Hypoglycemia (low blood sugar).This happens when the baby
has already used up its glucose-producing stores
Ultrasound
Nonstress testing (how the fetal heart rate
assessment of Prematurity
Overall health
The health care provider will check the babys
muscle tone activity
alertness,
and skin colour,
and will assess whether she appears to be in
Assessment findings
Prematurity
Posture:
Infant
.
Ear:
a. Ear cartilages are poorly developed and
the ear may fold easily
b. Hair is fine and feathery
c. Lanugo may cover the back and the face
sole :
a. Sole of the foot of the preterm
infant appears more turgid and may
have only fine wrinkles.
female genitalia:
a. Preterm female infants clitoris is
prominent
Male genitalia:
Scarf sign
Postmaturity
Alert, wide eyed look
Absence of vernix caseosa
Long finger nails
Profuse scalp hair
Long, thin body
Decrease or absent subcutaneous fat
Loose, dry skin
meconium
causes
It is not known why some pregnancies last
length of pregnancy.
The placenta, which supplies babies with the nutrients and
oxygen from the mother's circulation, begins to age toward the
end of pregnancy, and may not function as efficiently as before.
Other concerns include the following:
Amniotic fluid volume may decrease and the fetus may stop
gaining weight or may even lose weight.
Risks can increase during labor and birth for a fetus with poor
oxygen supply.
Problems may occur during birth if the baby is large.
Postmature babies may be at risk for meconium aspiration,
when a baby breathes in fluid containing the first stool.
Hypoglycemia (low blood sugar) can also occur because the
baby has too little glucose-producing stores.
Treatment of postmaturity
Specific treatment for postmaturity will be
include:
Checking for respiratory problems related to
meconium (baby's first bowel movement)
aspiration.
Blood tests for hypoglycemia (low blood
sugar).
Prevention of postmaturity
Accurate pregnancy due dates can help
GESTATIONAL WEIGHT
Gestational size variation
A. Large for gestational age
B. Small for gestational age
C. Appropriate for gestational age
Definition
Large for gestational age (LGA)
Pathophysiology/ causes:
LGA may result from a genetic factor
Assessment Findings
Weight more than 4,000g (8lbs. 13 oz.)
Appear plump and full-faced
Fractures or intracranial hemorrhage due to
Treatment:
Close observation
Episiotomy
Glucose monitoring
Evaluation of jaundice
Management of trauma
Nursing Interventions:
Supporting respiratory effort
Providing a neutral thermal environment
Protecting the neonate from infection
Providing appropriate nutrition
Maintaining adequate hydration
Conserving the neonates energy
Assessing glucose level
Preventing skin breakdown
Definition:
Small for gestational age( SGA)
Pathophysiology:
The underlying problem is intrauterine growth
retardation
Conditions in the mother may contribute to
the birth of SGA neonate
a. perinatal asphyxia
b. hypoglycemia
c. hypocalcaemia
d. aspiration syndrome
Assessment Findings:
Wide-eyed look
Sunken abdomen
Loose dry skin
Decreased chest and abdomen
circumferences
Decrease subcutaneous fat
Thin, dry umbilical cord
Sparse scalp hair
Causes:
Factors that contribute to a neonate being
SGA:
a. Congenital malformation
b. Chromosomal anomalies
c. Maternal infections
d. Gestational hypertension
e. Advanced maternal diabetes
f. Intrauterine malnutrition
g. Maternal smoking
h. Maternal drug or alcohol use
i. Multiple gestation
Acute Conditions:
1.
2.
3.
4.
5.
Definition
1. ARDS(acute respiratory distress syndrome)
Refers to a condition of surfactant deficiency
and physiologic immaturity of the thorax.
A complex disorder manifested by signs of
respiratory distress
- May also be called Hyaline membrane
disease
Pathophysiology:
Lack of surfactant in the lungs
Leads to atelectasis as well as labored
Assessment findings:
Increase respiratory rate
Retractions
Labored breathing
Fine crackles on auscultations
Expiratory grunting
Nasal flaring
cyanosis
If getsworse: S/S
Worsening cyanosis
Flaccidity
Unresponsiveness
Apneic episode
Decrease breath sounds
Treatment:
Prevent preterm delivery
Thermoregulation
Oxygen administration
Mechanical ventilation if needed
Prevention of hypotension
Prevention of hypovolemia
Nursing interventions:
Collecting blood samples
Monitoring pulse oximetry
Suctioning
Implementing thermoregulation
Monitoring nutrition
Administering medication
Providing moth and skin care
Pathophysiology:
Asphyxia in utero leads to increase peristalsis,
cause
Inhalation of meconium
Assessment findings
Dark greenish staining or streaking of the
amniotic fluid
Obvious presence of meconium in the
amniotic fluid
Limp appearance at birth
Cyanosis
Rapid breathing
Labored breathing
Apnea
Signs of post maturity
Low heart rate before birth
Low apgar score
Hypothermia
Hypoglycemia
Hypocalcaemia
Nasal flaring
Grunting
Tachypnea
Irregular gasping respiration
Treatment:
Chest physiotherapy
Antibiotics
Use of radiant warmer
Nursing interventions:
During labor, continuously monitor the fetus
thermal environment
Supporting family members by providing
education and reassurance
Promoting parents-neonate attachment.
SEPSIS /septicemia
Definition
Occurs when pathogenic microorganisms or
ALTERNATIVE NAMES
Sepsis neonatorum; Neonatal septicemia;
Sepsis - infant
Causes
Preterm delivery
Symptoms
Infants with neonatal sepsis may have the following symptoms:
Body temperature changes
Breathing problems
Diarrhea
Low blood sugar
Reduced movements
Reduced sucking
Seizures
Slow heart rate
Swollen belly area
Vomiting
Yellow skin and whites of the eyes (jaundice)
Treatment
Babies in the hospital and those younger than 4
Possible Complications
Disability
Death
Nursing Interventions
Collect specimens to identify causative
organisms
Assess the neonates vital signs at least once
per hour or more frequently as indicated
Expect to administer a brad spectrum
antibiotic before culture results are receive
and switch to specific antibiotic therapy after
result are recieve
thermal environment
Administer nutritional support
Assist respiratory support
Monitor electrolyte balance
Hyperbilirubinemia
Definition
Is an excess of bilirubin in the blood and
Physiologic jaundice
Physiologic jaundice is caused by the inability of
Classification:
Physiologic jaundice arises more than 24
Hemoglobin
Heme
Iron
Globin
Unconjugated bilirubin glucoric
acid
Conjugated bilirubin
glucoronide
Excreted through feces& urine
in the new born, the immature liver cannot conjugate bilirubin
Unconjugated bilirubin is absorbed by the subcutaneous fats
JAUNDICE