Nursing 104

N104: Essentials of Nursing Care – Health Safety Study Guide • School age children want to know reasons for everything. At this age, the word "why" will be one of the primary words in the child's vocabulary. The school age child wants to know how things work, so explanations can be more in-depth. Words should still be simple, but the explanations should be more extensive. • Adolescents may bemorewilling to talkwith the nurse thanwith parents. At this age, the nurse can speak with the patient alone and then involve the parents later. Respect the privacy of the adolescent, but be matter of fact when exams must be done. Adolescents are very aware of when the nurse is being dishonest. They are able to think more abstractly and the adolescent is able to understand long range planning and interventions. Growth and Development in Pediatric Care Growth and development is a critical area of knowledge for the pediatric nurse. Every child develops at his or her own pace, but the sequence of development is predictable. Human growth is from head to toe. Thus, when the child is born, his head is large in comparison to his body and is very complex and relatively more well developed. As the child ages, his torso, arms, and legs begin to grow more quickly. There are several components of growth and development that the pediatric nurse must understand in order to safely care for thechild. • Temperature: Infants are unable to adequately control their temperatures. The infant will use stored fat in an attempt to maintain body temperature. The nurse must be aware of this need and keep the infant covered and in a controlled environment. By the age of 12 to 15, most children will have a relatively stable temperature. • Motor development: Motor development depends on the development of the child's nervous and muscular-skeletal systems. At birth, reflexive movements are present. As the term implies, the infant does not have control over these movements and they will, for the most part, disappear over time. During early childhood, the child will normally develop certain fundamental skills, including crawling, sitting, standing, walking, and throwing. The child without developmental problems will continue to develop and improve these fundamental skills. Throughout life, the child will, through training and practice, develop specialized skills. • Sleep and rest: Sleep is required by all humans for normal health and development. Newborns require the most sleep and will spend most of the day either eating or sleeping. As the child gets older, the need for sleep tends to decline. Through early childhood, most children will need one or two naps during the day. By age four, many children will not need naps. Night time sleep requirements will normally decrease between the ages of 4-10. During adolescence, the need for sleep increases again and may last until young adulthood. • Metabolism: Metabolism refers to the physical and chemical processes in the body that convert or use energy. Breathing, contracting muscles, digesting food, and eliminating waste are some of the processes controlled by our metabolism. Metabolic needs varywidely among individuals and are defined as the basal metabolic rate (BMR). BMR is the rate of metabolism when the body is at rest. BMR is highest for infants and may be slightly higher for males. The BMR will determine the individual's caloric requirements throughout life. • Temperament: Just as children are born with certain physical characteristics, they are also born with certain patterns of behavior (temperament) that make the child unique. The nurse can use knowledge about temperament to promote normal growth and development. Temperament is typically defined in terms of nine characteristics: o Activity level, or the amount of motion the child exhibits

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