TOPRANK REVIEW ACADEMY *Small diameter in the BV in umbilical cord:

artery – large diameter in the BV in umbilical cord:

PEDIATRIC NURSING vein (carries O2 blood) // adult: oxygenated blood
Professor: Mr. John Anthony Octubre – artery

STAGES OF DEVELOPMENT Birth Length:

INFANT - Supine position – to make assessment

accurate
➢ Age: 1-12 months (psych concept: until 18 - Tape measure: centimeters/cm – to
months) determine birth length
➢ Erickson: psychosocial – trust vs mistrust - Normal birth length: 45-55 cm
➢ Freud: psychosexual – oral stage –
breastfeeding – consistency of the mother Development
→ TRUST ➢ Process of maturation
➢ Neonate: 0-28 days ➢ Changes: skills/capabilities – every child
➢ Key concept: fastest – growth and is unique
development ➢ Other name: Qualitative Changes –
Growth changes in skills - (measurable)
➢ Tool:
➢ Changes: size – weight, height - DDST (Denver Developmental
(measurable) Screening Test) - foreigner
➢ Other name: Quantitative Changes - MMDST (Metro Manila
➢ Parameters: Developmental Screening Test) –
- Weight: most sensitive parameter to Filipino/local
determine the growth of the child, to - Half-half: tool used will depend on
determine drug dose to administer to the environment
the child - Filipino blood while live
: Boy is heavier at birth – internationally: tool used will depend
larger body mass on the genes
- Height: linear growth of the child ➢ Parameters:
: Boy is lengthier at birth – - Gross-motor skills
larger body mass - Fine-motor skills
- Language development
Birth weight: 2,500-3500 g/2.5-3.5 kg
- Social skills
➢ >3,500 grams
GROSS-MOTOR DEVELOPMENT
- LGA/macrosomia
- cause: Gest. DM Cephalo-caudal development
- effect: hyperglycemia (inc sugar →
placenta → fetus) ➢ 0-1 month old: head lag
- newborn: monitor the blood sugar – ➢ 2 months old: lift head
hypoglycemia (heat production) → 2 months (+) head lag: ABNORMAL –
fatal effect of hypoglycemia: hydrocephalus
hypothermia ➢ 4 months old: lift head and chest (month
- use heel (corner) to collect blood – that will reduce the risk of SIDS)
normal blood sugar: 40-60 mg/dl ➢ 5 months old: roll over – WOF: risk for
➢ <2,500 grams fall
- SGA/microsomia ➢ 6 months old: sit with support
- Cause: smoking – vasoconstriction of ➢ 7 months old: bouncing (strengthen leg
blood vessels muscle – preparation for
standing/walking)
 ➢ 8 months old: sit w/o support *3 y/o child: all shapes (for 6 y/0) – early
➢ 9 months old: crawl development, increased IQ – GOOD!
➢ 10 months old: stand with support
➢ 11 months old: cruising *3 y/o child: close open (for 5 months) – delayed
➢ 12 months old: stand w/o support and development, decreased IQ – BAD! – sign of
walk with support mental retardation
➢ 15 months old: walk w/o support *95% of the IQ coming from the mother, 5% of the
➢ 18 months old: jump IQ coming from the father
➢ 3 years old: run and using tri-bike
TODDLER (R.E.N.T)
FINE-MOTOR DEVELOPMENT
➢ Age: 1-3 years old
Proximo-distal development & hands ➢ Erickson: psychosocial theory –
➢ 1-3 months old: close fist autonomy vs shame and doubt
➢ 5 months old: close & open / hold object ➢ Freud: psychosexual – Anal stage
(toy: rattle – stimulate sight, hearing) ➢ Ritualistic
➢ 7 months old: ability to transfer the object - Security objects
– crude pincer grasps - Temper tantrums – no language
➢ 9 months old (oral stage): pick tiny - Management: 1.) safety (helmet or
objects – neat pincer grasp - WOF: risk pillow – to protect the head), 2.)
for choking, aspiration, poisoning Ignore
➢ 12 months old: throw ball → walk and ➢ Ego centric
controlling of spoon - self-centered (mine)
➢ 2 years old: 1, lines (------) - Parallel play
➢ 3 years old: circle, curve, cross ➢ Negativism
➢ 4 years old: square, rectangle - “NO”
➢ 5 years old: pointed parts – triangle, - Management: 1.) provide
diamond, star choices/options (developing sense of
➢ 6 years old: all shapes autonomy)
➢ Toileting (Toilet Training)
LANGUAGE DEVELOPMENT - 18 months old (maturation of
sphincters)
➢ First language: cry - Bowel control first
- Loud, vigorous, strong cry: - Bladder control – daytime first, before
NORMAL nighttime
- High pitch cry: ABNORMAL – sign ➢ Toothbrushing
of increased intracranial pressure - 30 months old (complete milk teeth)
(ICP): hydrocephalus
➢ 1-2 months old: cry (open mouth: loud DECIDIOUS TEETH
cry)
➢ 3 months old: cooing sounds ➢ Other name: Milk teeth/Temporary teeth
➢ 4 months old: vowel sounds ➢ Complete set: 20 (10-10) – 30 months
➢ 5 months old: consonant sounds (toothbrushing & dental checkup)
➢ 7 months old: mmmm cry ➢ First eruption: 6 months (lower central
➢ 9 months old: 2 words (mama/dada) incisor – 2)
First word of a child: mama – nle Discomforts of the child:
First word of a child: dada – nclex - Fever: TSB/Paracetamol every 4
➢ 12 months old: 4 words (mama, dada, + 2 hours
words) - Pain: Teether (cold)
➢ 2 years old: 50 words - Diarrhea: continue breastfeeding
➢ 3 years old: 100 words ➢ Second eruption: 7 months (upper central
➢ 4 years old: 200-300 words incisor – 2)
 ➢ Thid Eruption: 9 months (upper lateral - Secondary sex development: thelarche
incisor – 2) (breast), adrenarche (pubic hair),
menarche (menstruation) – caused by
*Fruits to promote good oral health: PEAR!, if increase estrogen
have asthma: APPLE! ➢ Fear: Body image – prone to eating
➢ Start to loosen: 6-7 years old disorder
- Sugar: formula milk - Anorexia
- 9 yo: crooked teeth – delayed to - Bulimia
loosen milk teeth ➢ Fear: Acne – inc sebaceous gland → inc
oil production
*Natal teeth: teeth present at birth – excessive
calcium during pregnancy – located in lower Infant: oral stage AND trust vs mistrust
central incisor – when intact: NORMAL – when - Promote breastfeeding of the mother
loosen: need to extract to prevent aspiration - Consistency → Trust
PRE-SCHOOLER (M.I.S.Y) - If cannot grant the oral area, the child
may lead to oral fixation → effect
➢ Age: 4-6 years old when adult: smoking, alcoholism,
➢ Magical Thinking thumb sucking
- Imaginary friend - Solitary play (alone) → sensory
- Fear: body mutilation development
- Management: 1.) cover the wound - Fear: Stranger anxiety → onset: 6-7
➢ Imitative months, peak: 8 months, end: 9
- role play months
➢ Share
- Cooperative/associative play Toddler: anal stage AND autonomy vs. shame and
➢ Y? doubt
- Always asking why - Toilet training/toileting
- 200-300 questions/day (Pilliteri) - Primary caregiver: mother (guilt)
SCHOOL-AGE - If too rigid, it can lead to increase
guilt feeling → will result to
➢ 7-12 years old - - OCD
➢ Freud Psychosexual stage: Latency stage - If too lax, it can lead to decrease guilt
– rest period feeling → will result to anti-social
➢ Growth/Development: decreased/slow - Parallel play → promotion of physical
grow pattern development → ball, push-pull toys,
➢ Winner/Loser: competitive play tri-bike, walkie-talkie
➢ Afraid/Fear: Death - Fear: Separation anxiety → Stages –
Thoughts about death: protest (cry), despair (withdrawn),
- 1-6 y/o: sleeping denial (detachment)
- 7-9 y/o: punishment → from
boogeyman (Pilliteri) Preschooler: phallic stage AND initiative vs guilt
- 10 y/o–above: end of life - Phallic: phallus = penis → infantile
(irreversible) masturbation → for exploration →
➢ Teacher: significant person of school-age NORMAL → Management: divert
ADOLESCENT attention
- Penis envy: castration fear →
➢ Age: 13-18 y/o (Psych: until 21 y/o) exhibitionism
➢ Growth/Development: increased grow - Cooperative play/Associative play
pattern (role playing) → promotion of
➢ Puberty
 creativity → coloring books, clay,
lego
- Fear: Body mutilations, Castration
fear, ghosts, monsters, dark areas,
School Age: latency stage AND industry vs
inferiority
- Competitive play → indoor ball
games, traditional games, educational
board games
- Fear: Death
Adolescent: genital stage AND identity vs role
confusion
- Competitive play → outdoor ball
games
- Fear: Body Image