Chapter 29 A Differences from adults: continuing physiologic, intellectual, emotional maturation evidenced by developmental milestones 1. Physiologic: genetics, nutrition 2. Psychosocial: home and environment, parental attitudes, culture 2. Preschool to puberty: slower and uniform rate 3. Puberty: second most rapid period (growth spurt) 1. Cephalocaudal: from head to toe 2. Proximodistal: from center of body to periphery 3. Different parts of body grow at different rates a. Prenatal: head and brain grow fastest b. First year: elongation of trunk dominates, continued rapid brain growth F Critical time: most vulnerable time in development A Heart rate: decreases with increasing age 1. Birth to 3 months: 100 to 160 beats/min 2. Three months to 2 years: 80 to 150 beats/min 3. Two years to 10 years: 70 to 110 beats/min 4. Preadolescence to adulthood: 55 to 90 beats/min B Blood pressure: increases with age 1. 50th percentile ranges from 55 to 70 mm Hg diastolic to 100 to 110 mm Hg systolic 2. Levels increase about 2 to 3 mm Hg/year starting at age 7 years 3. Systolic pressure in adolescence: higher in males than females 4. Appropriate size cuff is 45% to 70% of arm width 5. Sites for assessment: lower extremity for younger children; upper extremity for older children a. 17 g/100 mL of blood; then decreases to 10 to 15 g/100 mL by 1 year b. Fetal hemoglobin (60% to 90% of total hemoglobin) gradually decreases during first year to less than 5% 2. 1 to 12 years: gradual increase to 14.5 g/100 mL 1. Total body water (TBW): 80% of body weight at birth; 60%, with small variations, from1 year of age to maturity 2. Extracellular fluid (ECF): 45% of body weight at birth, 25% at 2 years of age, 20% at maturity 3. Intracellular fluid (ICF): 35% of body weight from birth to 1 year, with small variations; increases to 40% from 5 years of age to maturity A Stomach size: small at birth; rapidly increases during infancy and childhood B Peristaltic activity decreases with age 1. Preterm infants: lower than full-term infants 2. Gradually increase from 75 to 80 mg/100 mL of blood in infancy to 95 to 100 mg/100 mL during adolescence D Enzymes: present at birth to digest proteins, moderate amount of fat, simple sugars, amylase produced as starch is introduced E Hydrochloric acid and salivary enzymes: secretion increases with age until adolescence; then decreases with advancing age A Natural medium for expression, communication, and growth B Educational: teaches about physical world; helps to associate names with objects C Recreational: helps to release surplus energy D Sensorimotor: stimulates muscle development, and tactile, auditory, visual, and kinesthetic senses E Social and emotional: aids in learning moral values; helps develop concept of sharing and cooperation with peers F Therapeutic: releases tension and stress; encourages manipulation of equipment used for treatment and procedures (e.g., syringe, stethoscope, otoscope, IV bag, incentive spirometer, bandages) to help gain control over threatening events; helpful to have appropriate size doll for “practicing”
Foundations of Child Health Nursing
Growth and Development of the Child
Principles of Growth
Characteristics of Growth
Circulatory System
Respiratory System
Digestive System
Play
Functions of Play
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Foundations of Child Health Nursing
