6-12 yr olds characteristics
sports & grades
must be able to pay attention for at least 45 minutes
progress from the skill of writing or reading to understanding what is written or read
school age children
Erikson: stage of industry
Piaget: concrete operations
think logically and concretely
6-12 yr old physical growth
slows until just before puberty
weight gain is more rapid than increase in height 5.5-7 lbs. per year.
muscular coordination improved
Brain has reached approximately adult size
lower center of gravity
6-12 yr. olds prefer
friends of their own sex-prefer the company of friends over their brother or sister.
loss of primary teeth begins at
age 6 yrs, four permanent teeth erupt per year.
6-12 sex education
questions should be answered simply and matter of factly, correct names for genitalia should also be used, private masturbation in normal. Boys should be prepared for erections and nocturnal emissions. Girls should be prepared for menarche and taught how to use the supplies.
sexually transmitted infection STI's
education on how to prevent sti's and hiv/aids should be presented in simple terms. factual and concrete info is an essential component. facts concerning harmful effects of drugs and unprotected sex should be communicated to the child without scare tactics
when discussing sexuality with the school age children it is necessary to review slang or street terms. most children hear the terms but may be confused about their meaning.
involves increased physical and intellectual skills and some fantasy. Culture of the school age child involves membership in a group of some type.
team sports, competition
enables the child to feel powerful and in control
mastering new skills helps the child feel a sense of accomplishment
some elements to assess observing play
motivation and intensity of engagement
relation to reality or creativity
choosing how to play
skills being used
the 6 yr old
energetic and on the go
likes to start tasks, but doesn't always complete them
talks for a purpose rather than for the sake of talking
vocabulary consists of 2500 words
requires 11-13 hrs of sleep per night
Take to school before they start to meet teacher classmates and classroom
the 6 yr old
boys and girls play together, but begin to prefer to associate with children of the same sex. needs time and support to help adjust to school. parents musr observe children for signs of fatigue and stress. Increased exposure to infectious diseases-stress importance of immunization.
the 7 yr old
sets high standards for themselves, good sense of humor, more modest, enjoys being active but also enjoys periods of rest. Knows seasons and months, understands beginning concept of math, hands are steadier, active play still important, becoming more independent
the 8 yr old
wants to do everything, can play alone for a lone period of time, creative, enjoys group activities, behaves better for company than for family, hero worship evident. hero worship is normal for all school age children
the 8 yr old cont'
arms and hands appear to grow faster than rest of body, muscles better developed, enjoys competitive sports, likes to argue, poor loser, need to teach child how to express anger in an acceptable manner
the 9 yr. old
dependable, shows more interest in family activities, assumes more responsibility - personal belongings, more likely to complete tasks, more able to accept criticism for their actions, worries and mild compulsions are common. nervous ticks or habits may develop such as eye blinking, facial grimacing, shoulder shrugging.
9 yr old cont'.
hand and eye coordination well developed, manual activities are managed with skill, about 10 hours of sleep are needed each night, permanent teeth still erupting, more active in competitive sports, important to teach proper technique and the use of adequate safety devices.
the 10 yr. old
marks beginning of preadolescence, girls more physically mature than boys, begins to show self direction, wants to be independent, group ideas more important than individual ones, sexual curiosity continues.
the 10 yr. old cont'.
girls more poised than boys, slang terms used, begins to identify himself on herself with skills that pertain to the sex role, takes for interest in personal appearance, knows abstract numbers.
11 & 12 yr old
intense, observant, energetic. May be argumentative and meddlesome, hormone influence on physical growth more apparent, need freedom within limits and recognition they are no longer infants, less concerned with appearance, seem preoccupied, ability to concentrate decreases, group participation still important
11 & 12 yr. old cont'.
interested in their bodies and watch for signs of growing up, boys & girls tend to ignore opposite sex at this age but they are much aware of them.
having an allergy to animal dander does not always rule out having a pet. non allergenic labradoodle, poodle.
emergency treatment of lost tooth
pick up by crown to avoid root damage & put in milk
the adolescent general characteristics
appearance of secondary sex characteristics, ends with cessation of growth and emotional maturity, divided into early, middle and late because of the changes that occur between 13-18 years of age.
adolescence major tasks
establishing an identity, separating from family, initiating intimacy, developing career choices for economic independence
adolescence major challenges
adjusting to rapid physical and physiological changes, maintaining privacy, coping with social stresses and pressures, maintaining open communications, developing positive health care practices and lifestyle choices.
adolescent general characteristics cont'.
surge toward independence more pronounced, difficult for adolescent to get along with parents, bodies rapidly changing, experience intense sexual drives, conformity one of strongest needs of adolescents in society.
adolescence - theory -
Erikson: intimacy stage
Piaget: abstract reasoning
physical development adolescence
adolescence begins in girls 10-13 yrs. marked by rapid changes in structure and function of various body parts. distinguished by puberty-during childhood, boys and girls produce somewhat equal amount of androgens and estrogen. Hypothalamus signals pituitary glands to stimulate other endocrine glands to secrete hormones.
Physical development adolescence con't.
age of puberty varies, occurs earlier in girls than boys, growth spurt occurs by 18 yrs., major cause of weight gain is due to increased skeletal mass, general appearance tends to be awkward, long legged and gangling (asnchrony) because different body parts mature at different rates, sweat glands very active, oily skin and acne common.
puberty begins with hormonal changes between 10 and 13 yrs. of age, hair begins to grow on face, chest, axillae and pubic areas, shoulders widen, pectoral muscles enlarge, voice deepens, genitals increase in size, pigment changes occur, errection and nocturnal emissions, important to teach testicular self examination
pubertal changes occur 6 months to 2 yrs. before they occur in boys, easily recognized in girls by onset of menstruation, called menarche, commonly occurs around 12 to 13 yrs., fat is deposited in hips, thighs, and breasts. Energy balance, activity and nutrition are important factors to evaluate when menstruation is delayed. Puberty is a good time to begin teaching self breast examinations.
realistic body image-believe everyone is looking at them.
adolescence Piaget -cognitive development
development is systematic, sequential and orderly. Still in concrete phase of thinking. By middle adolescence, ability to think abstractly has increased. Stage of formal operations. They can consider hypo ethical situations.
adolescence peer relations
help adolescents feel like they belong. School assumes important role. Belonging to a group is extremely important. Cliques form-more popular in early adolescence. Develops close personal relationships with one peer of the same sex, - vitally important in helping adolescents define themselves, social norms and pressures exerted by peers may cause problems.
helps adolescence prepare for real situations
adolescence sexual behavior
sexual experimentation often occurs as a response to peer pressure. can effect growth and development. Unplanned pregnancy and sti's are two major complications of adolescent sexual interaction, because few use protection
sex education can be taught
5th grade or around age 10
studies have shown that adolescents who obtain early sex education from caring parents or well informed adults do not have higher rates of sexual activity.
safety - adolescents
road and off road motor vehicle accidents kill and cripple adolescents at an alarming rate.
female athlete triad
assess for eating disorder, amenorrhea, osteoporosis
depression - adolescent
drugs use can precede the development of depression. a change in school performance, appearance or behavior can be a warning sigh of depression. a threat of suicide is a call for help that must be taken care of without delay. Depression is the 3rd leading cause of death (suicide) in adolescent group.
preparing infant for treatment or procedure
involve parents, include familiar objects, soothe, distract and hug afterwards.
preparing toddler for treatment or procedure
toddlers and preschoolers
involve parents, offer simple explanations, give permission to express discomfort, offer one direction at a time, allow for choices, if possible, use distraction, hug after treatment or procredure
preparing school age child
all of the previous preps plus
let them examine equipment, encourage child to verbalize fears, offer small reward after treatment or procedure, a sticker.
provide privacy, involve teen in treatment or procedure, explain treatment or procedure and equipment, suggest coping techniques.
child's reaction to hospitalization
depends on age, amount of prep given, security of home life, previous hospitalizations, support of family and medical personnel, childs emotional health.
child's reaction to hospitalization cont'.
major cause of stress for children of all ages are separation, pain, fear of body intrusion. this is influenced by development age, maturity of parents, cultural and economics, religious backgrounds, past experiences, family size, state of health on admission, other factors.
occurs in infants age 6 months and older
more pronounced in toddlers
denial or detachment
drugs used for pain
acteaminophen-mild pain. nonsteroidal antiinflammatory NSAIDs mild to mod. pain
Opiods-mod. to severe pain used for long periods of time, tolerance and respiratory depression can occur
managing pain non pharm
drawing, distraction, imagery, relaxation, cognitive strategies, backrub or hand massage.
the loss of an achieved level of functioning to a past level of behavior that was successful during earlier stages of development - normal. Can be minimized by an accurate nursing assessment of the child's abilities and the planning of care to support and maintain growth and development. when the child is free from the stress that caused the regression, praise will motivate the achievement of appropriate behavior.
interdisciplinary plan of care, nursing care plan focuses on the nurse's role, clinical pathway focuses on the team's approach to outcomes of care.
can be frustrating to the infant, used to getting what they want when they want it, may miss continuous affection from their parents, daily schedules are disrupted, nurse must try to meet the needs of the infant while preventing excess frustration. major goal is to assist parent -infant attachment process and promote sensorimotor activities. liberal visit hours. consistantency in caregivers important.
their world revolves around their parents, especially their primary caregiver. cannot understand why they are separated for their caregivers and become distressed. Cohesive staff is essential to meet the needs of children and their parents.
nursing goals of the hospitalized toddler
parents should not wait til their child falls asleep to leave. distractions=blowing bubbles/pop up toys can help anxiety, pain. children should be forewarned about any unpleasant or new experience they may undergo. increase emotional support
fear of bodily harm, magical thinking and fantasy, they may think they got sick because of something they did. Prepare them 4-5 days before hospitalization.
hospitalized school age
stage of industry and independence, they can draw pictures to express their feelings.can participate in own care and make simple choices to foster their feelings of independence.
safety alert Observe of nonverbal clues such as facial grimaces, squirming and finger tapping is important in determining the need for pain relief and support for the child.
experience feeling of loss of control during hospitalization, may cause adolescent to withdraw, be noncompliant or display anger. may become concerned with how the illness will affect their appearance. Incorporating choice, privacy and the opportunity for peer visitors is important.
same sex, age close.
legal and ethical considerations
discharge charting should include who accompanied the child and ID, time of discharge, behavior and condition of the child, method of transportation, vital signs and weight, medications, and instructions given to the parents or caregivers.
PACE memory jogger
P- Parents, peers and pot
A- Alcohol, automobiles
If 2 or more pace letters are problem areas the adolescent may be high risk for drug abuse and require a professional referral.