Developmental Milestones
4,5,6 and at 8 months
-4 months: Holding onto a rattle
-5 Months: Rolling over
-6 Months: A child should be sitting up and some Appropriate toys: Teething rings, large balls, or large stacking blocks
-8 Months: Develop the Pincher Grasp
Stages of Grief
-Denial : disbelief, why me?
-Anger
-Bargaining: trying to postpone the inevitable by bargaining things
-Depression
-Acceptance: No longer depressed, not all might get to this phase
Nursing Education for Nutrition
-Breastfeeding is best up until 12 months
-Introducing foods 1 at a time starting at 4-6 months.
-No more than 4-6 ounces of juice per day
-Finger foods at 8-10 months when they develop a pincher grasp and make sure they do not pose a choking risk
Things to ask a family when performing a home screening. What further questions should be asked in regards to lead in the home?
Determine the amount of Screen time, drinking source of water, how do they heat the home, does anyone smokes, age of the house
Questions to ask in regards to Lead in the home: higher risk from parents occupation, living in old houses, old toys or made in other countries, if sibling has been diagnosed with it
Fifths Disease or Slap Cheek
Occurs after a viral illness, therapeutic treatment, avoid extreme temperature changes, and cannot be cared for by a pregnant caregiver. The cheek is red and looks as if the child was slapped in the face
When do we see separation anxiety occurring in children
Infant stage from 9-10 months and 12-18 months and then it starts dwindling in toddlerhood
Play for the Ill Child
-Therapeutic Play: Physical recovery such as playing toss with a ball to build muscle strength
-Emotional Play: Such as drawing or using a doll as a model to discuss a traumatic event
-Teaching through Play: play/explain how to do something on a doll before doing it to the child
Nursing Education for Dental Care
-Teeth begin coming around 6 months
-Dental care begins with the first tooth. Fluoride treatment at 6 months/first tooth
-First, a visit to the dentist is around a year.
**Encourage and teach parents how to brush their teeth. Remember, Baby teeth are not less important than adult teeth- baby teeth cavities can lead to problems with adult teeth**
What is Tanner Staging?
It is used to determine primary and secondary sexual characteristics
Chickenpox
Very contagious
The child can return to school after the vesicles have scabbed over
Concern for secondary infection due to scratching
No ASA
9-10 Months
11-12 Months
Crawling at months 9-10 and pulling themselves up to their feet in the 11-12 months phase
Stages of Separation Anxiety
-Protest: Child is restless, ignored caregivers, and can be inconsolable
-Despair: The child begins to feel hopeless and withdraws attention and feels apathetic
-Detachment: The child starts ignoring the parents and starts to become more interested in the environment
What are Food Jags?
The child will like the food one day and they do not like it the next. Teah parents to look at the long term not daily. We want to make sure they are eating a pretty consistent diet but some fluctuation is normal
Nursing Education for Safety in the Home
Baby proofing home, medications and cleaning supplies locked up, crib safety, gates at top and bottom of stairs, never leave the child alone in the bathtub.
Hand Foot and Mouth disease
-Very contagious
-Dehydration is a common complication due to the sores in the mouth
-Transmitted through the fecal/oral route
-In premature infants there is concern for myocarditis
18 months
a child should be walking/taking a few steps independently, talking a little saying a few words, separation anxiety should be ending. In this phase transitioning into toddlerhood, this is when we are most likely to see regression and the separation anxiety phase is dwindling
Definition of animism and magical thinking with examples
Animism: thinking everything is alive seen in Preoperational, just before school age
Magical Thinking: a belief in something that wished was true (Santa Claus, tooth fairy, easter bunny) seen in Preoperational, just before school age (preschooler)
What are some signs readiness of to wean off breast milk
-Lack of interest
-Biting at the nipple
Playing with bottle
**not at a certain age- different for all moms**
When you are about to perform a painful procedure on a shool aged child what are some things you should consider?
Go to a special room, don't tell too far ahead of time, explain to them what you are doing at their level, let them keep something comforting with them or a loved one with them if possible, give choices as appropriate
Epstein Barre virus
MONO AKA Kissing disease
Occurs in adolescents
Spread by saliva
Can take months for the fatigue to subside
No contact sports due to hepatosplenomegly
What is one of the most important things to consider when dealing with adolescents?
PRIVACY!
What is something seen with school-aged children in regards to their way of thinking?
They really think with concrete operations- might expect why questions, concrete thinking (when pigs fly), very literally
-The child can undress themselves
-know when they are wet
-can sit and squat well
-walking for about a year
Parental Education for prevention of SIDS
-back to sleep
-nothing in crib
-pacifier to promote deep sleep
-Keep the room at a comfortable temperature
-breast feed
Measles vs German Measles
Measles: Koplik spots, bluish/white with a red base. The rash starts at the head and progresses downwards and turns brown after a week. Should get MMR vaccine. Slow progressing respiratory infection
German Measles: Flu-like symptoms, petechia on the roof of the mouth. Congenital rubella has high infant mortality