Normal Pediatric Nursing (Growth and Development) ▪ Mama – 8 months
▪ Mama/Dada – 12 months
• Growth: inc. size and structure ▪ Bubbling – 4 months
• Normal range of Weight: 5.5lbs to 9.5lbs / 2 = kg ▪ Pincer grasp – 9 months
o 6mo x 2 o Pinagbabawal na technique:
o 12mo x 3 ▪ 2 months: hearing (most sensitive sense), vision, cooing
o 2½x4 (first attempt to talk), social smile, crying with tears,
Ex. headlag (cannot carry the weight of head), sit upright to
• BW: 8lbs avoid abdominal polyp
• 6mo x 2 = 16lbs • Sleep: supine
• 12mo x 3 = 24lbs • Awake: supine
• 2 ½ x 4 = 32lbs o High risk of SIDS
o Shaken baby syndrome
• Breast feeding inc. proteins and antibodies (passive immunity) o Bawal ugain, gulatin
o Formula milk: Has no antibodies • Toys: mobiles(contrasting colors), music box (soft
music – cranial 8)
• Height: 18” to 21” x 2.54 = cm • Wrong practices by filipinos: duyan (kumot)= naka
o 1st 6 months: in 1 inch/month curve ang likod, may lubid na hinihila (increase
o 1st year: (+) 50% risk of spinal injury), sinasara din ang top of the
o Milk contains: Tryptophan -> melatonin -> deep sleep -> Growth duya (no stimulation of the eyes) – magiging bobo
Hormone (lengthens the bone, lessen fats, tones the muscle) ang bata
o Sleeping before puberty makes you tall
▪ 4 months: babbling, Laughing out loud, gurgling (drooling),
• Development: maturation/skills disappearance of headlag
• Parameters to check skills of child: • S: supine
o Physiologic: body parts • A: prone to strengthen upper extremities (tummy
o Psychosocial: behavior+society time), also widens perspective
o Cognitive: mental o Wrong practice: nakacarga but nakaharap
• Milestone: benchmark of child’s achievement, if at par with the age sa mommy, ang nakikita ay chest ng
o Criteria: mommy
▪ language ▪ 6 months: vowel sounds, roll over from back to abdomen,
▪ Interaction “strangers’ anxiety” (normal, but needs to be managed by
▪ Gross & Fine: motor (fingers) giving to others, but when they cry, get them back right
• away, do not let them stay)
o Phil: Metro Manila Developmental Screening Test (MMDST) ▪ 8 months: mama, sits without support
o US: Denver Developmental Screening Test (DDST) ▪ 10 months: bye-bye (John William Piaget), creeping (bed to
o Ex: crib, gapang), inc. risk of fall, object permanence,
“separation anxiety” -
(normal but needs to be managed; leave the baby in the o Jean Piaget
morning going to work when awake, to say goodbye: “I will ▪ Cognitive - “intelligence” is important for human survival
be back by dinner-use meals for time & do not delay ▪ Operational
goodbye, be firm Phases of abandonment: protest(crying), o Lawrence Kohlberg
despair (hopeless), denial (ignoring mommy when she gets ▪ Moral “right” – conventional
home)
▪ 12 months: mama-dada, standing, attempts his first • Stages of Growth and Development
independent step o Age bracket by Sigmund Freud
▪ 13-15: walking with ease ▪ Birth to 18 months (infant) – oral – mouth, feed, pacifier,
• Gross and Fine Motor Skills – “voluntary”/conscious thumbsucking (expression of enjoyment, happiness,
o 0 months: close, clenched, fist release tension) If preschoolers thumbsuck, it is
o 3 months: open, palmar (gross), reflex regression; to eliminate- identify and eliminate stressor; if
o 6 months: hold, palmar grasp (gross) – intentionally hold and fixation is not managed, ex. Overfeed: oral dependent,
release object underfed- oral sadistic “sarcastic”
o 9 months: pincer grasp (fine) – high risk for choking and aspiration; ▪ 18m-3 years old (Toddler) – anal – toilet training, readiness
oral stage(freud) ▪ 3-6 (preschooler) – phallic – masturbation “curiosity”;
o 12 months: throwing object, can control fingers. complexes – Elektra (daughter to father due to penis envy),
o (+) 1 month rule, additional skill Oedipal (son to mother)
o (-) 1 month rule, attempts ▪ 6-12 (schooler) – latency (dormant) – homosexuality
• Patterns of Growth and Development phase; girls are always with girls; boy are always with boys;
o Cephalocaudal: head to toe same sex groupings
o Proximodistal: central to peripheral ▪ 12-18 (adolescence) – genitals – secondary sexual
o Symmetrical: same rate and direction characteristics; boy-girl relationships
o Mass to specific: simple to complex, gross to fine o Age bracket by Erik Erikson
• Theorists ▪ Birth to 18 months (infant) – trust vs. mistrust
o Sigmund Freud • on time, cuddle, talk to, play soft music
▪ Id, Ego, Superego ▪ 18m-3 years old (Toddler) – autonomy vs shame and doubt
▪ Psychosexual • independence, ritualistic (bed time stories, fave
• Libido=sexual drive things for security blanket)
• Oral – anal • temper tantrums (they cannot communicate well,
o Erik Erikson when you explain something, they cannot
▪ Psychosocial: understand- do not explain to the child-ignore, set
• Trust vs. Mistrust limits, time out- face the wall (3 mins): non-
• Personality is influenced by the Culture + Society stimulating environment)
• provide options to promote independence
▪ 3yrs-6yrs (preschooler) - initiative vs guilt
• Initiative-initiate their own activity
o Ex: using kumot for bahay-bahayan, using • Value cause and effect: high grades=tuwa si
leaves for luto-lutuan mama
• Answer back to child properly as not to feel guilt ▪ 12-18 (adolescence) – formal operational
▪ 6-12 (schooler) – industry vs inferiority • Hypothetical
• Minimal growing • Solve problems
• Plus, minus • Able to find solutions
• Use time o Age bracket by Lawrence Kohlberg (walang infant and toddler kasi
• Competitive, exact tool for what is needed; di ma matuturuan ng moral values)
positive reinforcement; buy what they need (ex. ▪ Birth to 18 months (infant) – pre-religious
Boy scout uniform needed for school to avoid • Tell them they are nice, good, amazing, they are
inferiority) perfect
▪ 12-18 (adolescence) – identity vs role confusion • If you say bad, they become bad
• Friends have more influence on them than parents ▪ 18m-3 years old (Toddler) – pre-religious
o Age bracket by Jean Piaget • Tell them they are nice, good, amazing
▪ Birth to 18 months (infant) – sensory motor ▪ 3yrs to 6yrs (preschooler) – preconventional
• Reflexes • Punishment, obedient, orientation
▪ 18m-3 years old (Toddler) – sensory motor • Individualism
• Imaginary playmate • Instrumentation – better system than P.O.O
• management: support but present reality ▪ 6-12 (schooler) –
▪ 3yrs to 6yrs (preschooler) – pre-operational • Social conformity – they submit to standards of
• Simple thoughts society
• generalize things • Law conformity – takot sa people in authoruty
• if they like it, like all ▪ 12-18 (adolescence) – formal operational
• if don’t like; they don’t like all • Social contract: respect the majority decision
• conservation: idea about wight, mass (kung ano • Ethical principle: know what is right and wrong
marami, ayun ang mataas na value) o
o ex: 100 coins vs. 1000 bill
o tablespoon of meds vs. cup
• no sense of reversibility: no sense of direction,
nawawala lagi
▪ 6-12 (schooler) –concrete operational
• Systematic thoughts
• Able to classify things
• Ex: I like veggies like eggplant but I don’t like
lettuce
• Already have sense of conversation and
reversibility
