objective 9 (2)

Question 1

– Trust versus mistrust
– Meeting basic needs is paramount
– Separation anxiety begins as early as 6 months

Answer 1

4 weeks to 1 year

Question 2

what is the main goal of infant developmental level?

Answer 2

– Assist with parent-infant bonding and promote
sensorimotor stimulation
– May abandon some milestones
– Should not be expected to develop new habits during
hospitalization

Question 3

what are the needs of a hospitalized infant?

Answer 3

*Can be frustrating for the infant
*Used to getting what they want when they want it
*May miss continuous affection of their parents
*Daily schedules are disrupted
*Can be frustrating for the infant
*Used to getting what they want when they want it
*May miss continuous affection of their parents
*Daily schedules are disrupted

Question 4

• Developmental Tasks: Autonomy vs. shame and doubt
• Object permanence continues to develop
• Fears of instruments e.g. needles

Answer 4

1-3 years

Question 5

what is the social development of 1-3 years?

Answer 5

– Parallel Play at 16-18 months
– Sharing
– Often says no
– Increased independence
– Egocentric, everything is “mine”

Question 6

what is the fine motor development of a 1-3 year old?

Answer 6

• At 12-16 months, toddler can drink from a cup
• At 24 months, toddler can turn the page of a book; undress self
• 36 months, holds cup by handle and spoon with 2 fingers; copies
  a circle

Question 7

what is the gross motor development of a 1-3 year old?

Answer 7

• At 12-16 months, toddler begins to walk
• At 16-18 months, toddler walks alone and walk backward
• At 24 months, toddler climbs steps; runs; throws ball; jumps with
  both feet; imitates oral hygiene

Question 8

can follow simple commands; object
permanence developing

Answer 8

12-16 months L&C

Question 9

ses symbolic language (bye-bye); able
to point to familiar objects; begins to realize cause and
effect

Answer 9

16-18 months L&C

Question 10

uses plural words, words to tell story, names
familiar objects. Develops likes and dislikes

Answer 10

24 months L&C

Question 11

can say full name; curious as to why? How?
Understands one concept at a time, knows two colors
and imitates parental roles

Answer 11

36 months L&C

Question 12

how do we prepare toddlers for treatment/procedure?

Answer 12

– 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 procedure

Question 13

• Developmental task: initiative vs. guilt
• Cannot understand abstract concepts
• Can understand time relationships
• Slowing of physical growth
• Mastering and refining of motor, social, and
  cognitive abilities

Answer 13

2-5 years

Question 14

have difficulty seeing any point of view
other than their own

Answer 14

egocentric

Question 15

what are the major tasks of preschool age child?

Answer 15

• Preparation to enter school
• Development of a cooperative-type play
• Control of body functions
• Acceptance of separation
• Increase in communication skills, memory &
  attention span

Question 16

what are the needs of hospitalized preschooler?

Answer 16

• Explanations must be
  made in realistic terms;
  they also need to be
  clear, understandable,
  and truthful
  – Afraid of bodily harm
  – Engage in magical
  thinking and fantasy
• Understand Time in relation to
  activities
• Teach parents that upon
  discharge, the child may be
  demanding and irritable
• May believe they are sick
  because of something they did

Question 17

• Developmental Tasks: industry vs Independence
• More engrossed in fact than fantasy
• Develop first close peer relationships outside the
  family group and first affiliation with adults outside
  the family

Answer 17

6-12 years

Question 18

what are the needs of hospitalized school aged children?

Answer 18

• Separation anxiety continues with a “brave”
  approach
  – Observe body language
• Forced dependency- loss of control &security
• Like to feel “grown up”- simple choices can help
  foster independence

Question 19

how do we prepare school aged children for treatment/procedure?

Answer 19

• All of the previously mentioned
  strategies for younger age groups, plus
  – Let them examine equipment
  – Encourage child to verbalize fears
  – Offer small reward after treatment or
  procedure, for example, a sticker

Question 20

• Developmental Tasks: Identity vs Role Confusion
• Divided into early, middle, and late because of the changes
  that occur between 13 and 20 years of age
• learns to understand self in relation to others’ perceptions
  and expectations.
• main concerns are self-definition and self-esteem.
• experiences an identity crisis brought on by physical
  (including sexual) changes and conflict about future choices
  and expectations of others.

Answer 20

1-20

Question 21

what are the major tasks of adolescence?

Answer 21

Establishing an
identity
– Separating from family
– Initiating intimacy
– Developing career
choices for economic
independence

Question 22

what are the major challenges of adolescence?

Answer 22

– 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

Question 23

threat to body image

Answer 23

11-14

Question 24

ability to appeal to opposite sex

Answer 24

15-17

Question 25

school,career

Answer 25

18-20

Question 26

what are the needs of the hospitalized adolescent?

Answer 26

* Experiences feelings of loss of control during hospitalization * May cause adolescent to withdraw, be noncompliant, or display anger * May be concerned with how the illness will affect appearance * Incorporating choice, privacy, and the opportunity for peer visitors is important

Question 27

how do we prepare adolscence for treatment/procedure?

Answer 27

* Provide privacy * Involve teen in treatment or procedure * Explain treatment or procedure and equipment * Suggest coping techniques

Question 28

what do we DO with hospitalized child?

Answer 28

Keep crib sides up and locked in place at all times when the child is unattended in bed – Identify a child by ID bracelet and NOT by room or bed number – Use a bubble-top or plastic-top crib for infants and children capable of climbing over the crib rails – Place cribs so that children cannot reach sockets and appliances – Provide age appropriate supervision – Inspect toys for sharp edges and removable parts – Keep medications and solutions out of reach of the child – Prevent cross-infection; Diapers, toys, and materials that belong in one patient’s unit should not be borrowed for another patient’s use. – Remain with child who uses tub or shower – Take proper precautions whenever oxygen is in use. – Locate fire exits and extinguishers , become familiar with hospital’s fire procedure

Question 29

what do we NOT DO with hospitalized child?

Answer 29

allow ambulatory patients to use wheelchairs or stretchers as toys – leave an active child in a baby swing, feeding table, or high chair unattended – leave a small child unattended when out of the crib – leave medications at the bedside – prop nursing bottles or force-feed small children—risk of choking

Question 30

what is crib safety?

Answer 30

The mattress must fit securely into the crib – Blankets should NOT be tucked in – Soft or contour pillows should not be placed in cribs – The distance between crib rails should be no more than 6cm (2 3/8 inches) – Decorative extensions on the corners of cribs can become caught on clothing and strangle a child – A bubble top or extension should be in place if the child is capable of climbing over the side of the crib