Nursing role in health promotion of child bearing family

Nursing role in health promotion of child bearing family

Principles of growth AND DEVELOPMENT

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)Assessment - plot and measure the weight and height on a standard growth chart Take health history from parents and child and observe what specific task the child can accomplish to assess the developmental milestoneDevelop a 24 hour recall history of nutritional intake, sleep and visual and hearing should be scheduled on standard time

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)II. Nursing Diagnosis-risk for delayed growth and development related to lack of age appropriate toys and activitiesDelayed growth and development related to prolonged illnessReadiness for enhanced family coping related to parents seeking information about a childs growth and developmentHealth seeking behavior related to appropriate stimulation for infants

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)II. Nursing DiagnosisImbalanced nutrition, les than the body requirements, related to parental knowledge deficit regarding childs protein needsDeficient knowledge related to potential long term effects of obesity in school age child

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)III. Outcome identification and PlanningTo be able to provide holistic care , consider all aspects of childs health; physical, emotional, cultural, cognitive, spiritual, nutritional, and socialRemember that each child developmental progress is unique.Children must not be forced to achieve milestone faster then their own time table. However, anticipatory guidance can be encouraged to reach maximum developmental potentia

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)III. Outcome identification and PlanningSuggest expected outcomes and guidance to both the child and the family on ways to encourage child development and preparing children for a new experienceChildren should not be rushed to new experience like toilet training or beginning schoolVaried ways of postering growth and development; discipline , food

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)Following questions can be asked for you to isolate and better understand cultural differences that will help you in planning care that is specific childParents with a child with developmental delay will use denial. So planning should be centered on accepting what is happening

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)IV. Implementation To foster growth and development encourage age appropriate self-care in child and age appropriate toys or activities to parents for children with delayed growth and development motivate a child to reach anticipated upper limits.Modelling is more effective in problem solving then acting out.

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)V. Outcome EvaluationEvaluation must be ongoing, because children do not test well on any given day.On going evaluation provides opportunity for early detection of various problemsExamples of expected outcomeschild, 5 years of age, express less negativism at next clinic visitAt 9th month check- up parents describe how they have made a space in their home

NURSING PROCESS OVERVIEW(FOR PROMOTION OF NORMAL GROWTH AND DEVELOPMENT)for their infants to crawl and not confined to a playpen.3. Parents list household tasks they believe appropriate for 6 year old child by next visit4. Parents state the pattern they use to phase out high carbohydrate, non nutritive snacks for their preschooler..

The Role of the nurse in growth and development1. health promotion and illness preventionBe it known to the parent that parenting style are major influence on the behavior and mental health of children. -know the varied changes that they observed that is part of normal G and DAnticipatory guidance should be offered at appropriate time- Nurse should recognize the predictable stages of G and D

The Role of the nurse in growth and development2. Health restoration and maintenanceKeep developmental stage in mind when teaching a parent or orientating a child about certain procedure that will done to himPhysical growth and development differences; fracture is a 12 year old is more serious than an 8 year old. There are 2 major needs in a 8 year old; healing the fracture and maintaining healthy bone cells. while a 12 year old has 3 needs; calcium for healing , maintaining health bone. Additional amount for period of rapid growth

Principles of Growth and DevelopmentGrowth and development is a complex phenomenon because of many interrelated facetsMaturing involved not only increase in height and weight but the ability to perform skills, to think, to relate to people, and to trust or have self confidenceGrowth and development are different but used interchangeably

Growth Generally denote an increase in physical size or quantitative changeGrowth in weight is measured in pounds or kilogramsGrowth in height is measured in inches or centimeters

Development Used to indicate an increase in skills, or ability to function (qualitative change).Development can be measured by observing specific task like picks up small objects, by recording parents description of a childs progress or by the use of standardized test. Maturation is synonymous with development

Psychosexual DevelopmentThis a specific type of development that refers to developing instincts or sensual pleasure.(Freudian Theory)

Psychosocial DevelopmentRefers to Ericksons stages of personality development

Moral DevelopmentThe ability to know what is right from wrong and to apply this in real life situation.This is the theory of Kohlberg

Cognitive developmentThe ability to learn or understand from experiences, to acquire and retain knowledge, and to respond to a new situation and solve.Piagets theory This is measured by intelligent test and observing the child s ability function effectively in their environment.

Patterns Respiratory , digestive, musculoskeletal, and circulatory proceeds fairly smoothly during childhoodNeurologic (spinal cord and brain)mature rapidly then others for the first two yearsMaturity of the brain occurs at 2 5 years oldLymphoid tissue(spleen, thymus, lymph nodes, and tonsillar tissue) grow rapidly during infancy and childhood so children are protected against infection

Factors Influencing Growth and DevelopmentI. GeneticGender- girls are born lighterHealth- inherited illnessintelligence children with high intelligence generally do not grow faster, they fall behind physical skills

Temperament as influence in G and D Temperament is the usual reaction pattern of an individual s characteristics manner of thinking, behaving or reacting to stimuli in the environmentThis is an inborn characteristics set at birth,.It is essential to understand childrens differences, to care for each child constructively

Temperament as influence in G and D Reaction pattern; 9 separate characteristics that define temperament of childrenActivity levelDiffers widely- some or active, some are not. Display extreme motor activityb. rhythmicity- in sleeping, eating, and bowel movement. On the contrary there are those children with different or inconsistent pattern. In this case parents should adopt to the childs rhythm

Temperament as influence in G and D c. Approach refers to the childs response on initial contact with a new stimulus. d. Adaptability the ability to change ones reaction to stimuli over timee. Intensity reaction- some react to situation with their whole being like when their diapers are wet, hungry or when their parents leavef. distractibility- easily distracted to a new situation. Other children find it difficult to focus on new attention and resist changes,

Temperament as influence in G and D Attention Span and persistence- attention span is the ability to remain interested in a project or activity, that varies among children.The degree of persistence also variesThreshold response- t he intensity level of stimulation that is necessary to evoke a reaction. Mood quality- a child who is always happy and laughing has positive mood quality

Categories of temperamentThe easy child- is they have a predictable rhythmicity, approach and adapt to new situation readily, have a mild to moderate intensity of reaction, and have an overall positive mood quality. Most children are rated by their parents as being in this categoryThe difficult child- if they are irregular in habits, have negative mood quality, and withdraw rather than approach new situation. Only about 10 % of children fall into this catogery.

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Categories of temperamentSlow- to warm up childThey fall in this category if they are overall fairly inactive, respond only mildly and adapt slowly to new situations and have a general negative mood. About 15 % of children display this pattern. When discussing the temperament with parents try to use positive terms such as ways to find a healthy fir for your child rather than stressing ways the child is hard to manage.

Nursing implications regarding temperamentIt is useful to talk to parents about their childs reactivity patterns because this patterns tend to persist; the way the child react in the future depends a great deal on the way the child react today.The way a child react on a toy will have the same reaction on toilet training.Parents should learn that shying away is the childs way coping. They should accept individualism that is essential for successful child rearing

Nursing implications regarding temperamentEffects of environment to G and D- Inadequate nutrition because of socio- economic conditionParents do not give much attention in developing childrens skillsChronic illnessAlcoholic parents provide inconsistency in care and could affect the3 mental health

Environmental influences that most like to affect G and DSocio economic levelParent child relationship- the role of the primary care giver in nurturing the emotional aspect of the childOrdinal position in the familyHealth environmental condition, and illnessNutrition

Servings of the Five Pyramid Food Groups for ChildrenRecommended Daily AmountsGroup Foods Children 2-6Older childrenMajor nutrients providedBread, cereals, pastaWhole grain and enriched6 servings6-11 servingsThiamine, niacin, riboflovin,, iron, incomplete protein, carbohydratesvegetablesVegetables, yellow and green3 servings3-5 servingsVit. A, iron, calcium, carbohydrates,

Servings of the Five Pyramid Food Groups for ChildrenRecommended Daily AmountsGroup Foods Children 2-6Older childrenMajor nutrients providedFruit Fruits 2 servings2-4 servingsVit. C, carbohydratesMilk, yogurt, cheeseWhole milk, other milk product except butter2 servings23 servingsCalcium, phosphorus, complete protein, riboflaavin, niacin, Vit. D

Servings of the Five Pyramid Food Groups for ChildrenRecommended Daily AmountsGroup Foods Children 2-6Older childrenMajor nutrients providedMeat, poultry, fishMuscles meat, dry beans, eggs, fish, poultry2 servings2-3 servingsComplete protein, iron thiamine, riboflavin, niacin, vit. B 12, fatsFats, oils, sweetsCandy, cake, fried foodsUse sparinglyUse sparinglyEssential fatty acids, CHO

Servings of the Five Pyramid Food Groups for ChildrenEat variety of foodsBalance the food you eatChoose diet with plenty of grainsChoose diet low in fat, saturated fat and cholesterolChoose a diet moderate in sugarDrink alcohol in moderation

Components of healthy dietProteinCarbohydratesFatVitamin minerals

Promoting adequate nutritional intake in veggetaEconomic- less expensive than animal based foodEcologic- if every one are lower on food chain, world hunger could be reducedMedical and health related- avoiding animal foods stop ingestion of hormones and chemicals used in meat and poultry production and lowers serum cholesterol, thereby reducing the frequency of atherosclerosis and obesity; avoiding red meat may reduce the likelihood of developing colon cancer. Because of association between saturated fats and bowel cancer and atherosclerosis, avoiding red meat will increase in the future

Promoting adequate nutritional intake in vegetarian dietPhilosophical: a belief that killing animal for food is unnecessary.Religious: Hindus and seventh day Adventist promote vegetarian lifestyle.

Four types of vegetarian dietsLacto-ovo-vegetarian includes dairy products (lacto), eggs (ovo) and plants (vegetables, fruits and grains)Ovovegetarian diets includes eggs, but excludes dairy productsLactovegetarian diets includes dairy products but exclude eggsVegan diets exclude animal product consist of only vegetables, fruits and grains

Theories of growth and development

Theory A systematic statement of principles hat provides a framework for explaining some phenomenon.Developmental theories provide road maps for explaining human develpment

Developmental TaskIs a skill or growth responsibility arising at a particular time in an individuals life, the achievement of which will provide a foundation for the accomplishment of future task. Chronological age does not define the completion of developemental tasks

Sociocultural theoryStress the importance of environment on growth and development

Learning TheoryProposes that children are like blank pages that can be shaped by learning.

Epigenetic TheoryStress that genes are the true basis for growth and development

Freuds stages of childhoodPsychosexual stageNursing implicationsInfant Oral stage; child explore the world by using mouth, especially the tongueProvide oral stimulation by giving pacifiers, do not discourage thumb sucking. Breast feeding may provide more stimulation than formula feeding because it require the infant to expend more energy

Ericksons stages of childhoodDevelopmental taskNursing implicationInfant Developmental task is to form a sense of trust versus mistrust. Child learns to love and be lovedProvide a primary care giver. Provide experiences that add to security, such as soft sounds, and touch. Provide visual stimulation for active child involvement

Summary of Freuds and Ericksons theories on personality developmentFreuds stages of childhood

Psychosexual stageNursing implicationsToddler; (1-3 )Anal stage; child learns to control urination and defecationHelp children achieve bowel and bladder control without undue emphasis on its importance. If at all possible, continue bowel and bladder training if hospitalized

Ericksons stages of childhood

Developmental task Nursing implicationsToddler; Developmental task is to from sense of autonomy versus shame and doubt. Child learns to be independent and make decision for self.Provide opportunities for decision making, such as offering choices of clothes to wear or toys to play with. Praise for ability to make decisions rather than judging the correctness of any one action

Summary of Freuds and Ericksons theories on personality developmentFreuds stages of childhood

Psychosexual stageNursing implicationsPreschooler ;Phallic stage; child learns sexual identity through awareness of genital areaAccept childrens sexual interest, such as fondling their own genitals, as a normal area of exploration. Help parents answer childs questions about birth or sexual differences

Ericksons stages of childhood

Developmental task Nursing implicationsPreschooler; Developmental task is to form a sense of initiative versus guilt. Child learns how to do things (basic problem solving) and doing things is desirable.Provide opportunities for exploring new places or activities. Allow play to include activities involving water, clay (for modeling) or finger paint.

Summary of Freuds and Ericksons theories on personality developmentFreuds stages of childhood

Psychosexual stageNursing implicationsSchool age childLatent stage; childs personality development appears to be non active or dormantHelp child have positive experiences with learning so their self-esteem continues to grow and they can prepare for the conflicts of adolescence

Ericksons stages of childhood

Developmental task Nursing implicationsSchool age; Developmental task is to form a sense of industry versus inferiority. Child learns how to do things wellProvide opportunities such as allowing child to assemble and complete a short project so that child feels rewarded for accomplishment

Summary of Freuds and Ericksons theories on personality developmentFreuds stages of childhood

Psychosexual stageNursing implicationsAdolescent ;Genital stage;Adolescent develops sexual maturity and learns to establish satisfactory relationships with opposite sexProvide opportunities for the child to related with opposite sex; allow child to verbalize feelings about new relationships

Ericksons stages of childhood

Developmental task Nursing implicationsAdolescent;Developmental task is to form a sense of identity versus role confusion. Adolescent learn who they are and what kind of person they will be by adjusting to a new body image, seeking emancipation from parents, choosing a vacation and determining value systemProvide opportunities for adolescent to discuss feelings about events important to him or to her. Offer support and praise for decision making.