Nurs 207 - Development

Question 1

Define development

Answer 1

The sequence of physical, psychosocial, and cognitive developmental changes that take place over the human lifespan

Question 2

Scope of Development

Answer 2

The extent to which development influences an individual spans the entire life course - from birth to death.

Normal human development is organized and progressive and usually occurs in a predictable sequence

Delayed ————— Expected ————— Advanced

Question 3

Attributes and Criteria

Answer 3

Developmental Level
Developmental Delay
Developmental Milestone
Developmental Regression
Developmental Arrest

Question 4

Developmental Level

Answer 4

an individuals stage of development or ability to independently achieve an outcome

Question 5

Developmental Delay

Answer 5

an essential element of neurological and/or cognitive maturation has not occurred within an age range and should be investigated

Question 6

Developmental Milestone

Answer 6

an ability or specific skill that most individuals can accomplish in a certain age range

Question 7

Developmental Regression

Answer 7

the loss of developmental milestones

Question 8

Developmental Arrest

Answer 8

plateau of developmental change in some category and is noted when chronologic age continues to progress but developmental change does not

Question 9

Physical/Physiological Development

Answer 9

• refers to the growth and changes in body tissues and organ systems and the resultant changes in body functions and proportions

Includes cellular proliferation, differentiation, and maturation that occurs in each organ and system that allows integrated human functioning necessary for life and health

Physiological growth and development occur in a bilateral and symmetrical way, progressing in a cephalocaudal (head-to-toe) direction and proximodistally (from midline to periphery)

Question 10

Motoric Development

Answer 10

• separated into 2 major categories: gross and fine motor.

Generally, motoric development progresses from the achievement of gross motor to fine motor skills - known as refinement.

Question 11

Gross motor skills

Answer 11

Gross motor skills - involve the use of large muscles to move about in the environment

(ie. sitting, standing, maintaining balance, cruising, walking, running, walking up stairs without assistance, and more complex physical tasks such as playing soccer

Question 12

Fine motor skills

Answer 12

Fine motor skills - involve the use of small muscles in an increasingly coordinated and precise manner

(ie. batting at an object, reaching and holding an object, transferring an object from hand to hand, holding a pencil in a refined grasp, making marks with a pencil, writing letters, writing words, creating artwork, using hands and fingers to eat, draw, dress, and play)

Fine motor development is contingent upon cognitive and neurological development

Question 13

Social /Emotional Development

Answer 13

• includes the development of self-understanding, understanding others, and understanding social interactions.

Usually occur in this order → self, others, and social interaction

Knowledge of social and emotional skills is critical because it directs effective communication with an individual(s) and may impact suggested environmental strategies for an individual to obtain optimal functioning.

Question 14

Cognitive Development

Answer 14

• relates to working memory capacity, cognitive self-regulation, and the processing and use of information about the environment and objects in the environment.

Individuals have an increasing understanding between self and information over time

Development of critical thinking skills and executive functioning, which includes learning, forming concepts, understanding, problem-solving, reasoning, remembering, and thinking abstractly

Combination of cognitive and advanced social/behavioural development enable moral and spiritual development

Question 15

Communication Development

Answer 15

• language involves a set of rules shared by a group of people that allows the communication of thoughts, ideas, and emotions
  3 components of speech: Articulation, Voice, Fluency

Question 16

Articulation

Answer 16

pronunciation of sounds

Question 17

Voice

Answer 17

production of sound by vocal cords

Question 18

Fluency

Answer 18

rhythm of speech

Question 19

Adaptive Development

Answer 19

• refers to the acquisition of a range of skills that enable independence at home and in the community
• Adaptive skills are learned
• Include self-care activities such as dressing/undressing, eating/feeding, toileting, grooming, management of one’s immediate environment, functional behaviour within the community such as crossing the street safely, going to the store, and following the rules of politeness when interacting with others
• Requires advanced and complex skills in each of the other developmental domains and efficient sensory integration processes
• Examples include: cooperation, a level of moral and ethical decision making, abilities to follow social and cultural folkways, mores, taboos, rules, and laws

Question 20

Piaget’s Theory of Cognitive Development

Answer 20

• addresses the development of children’s intellectual organization and how they think, reason, perceive and make meaning of the physical world
• Recognized people move through these specific periods at different rates but in the same sequence or order

Period 1 - Sensorimotor (birth to 2 years)
Period 2 - Preoperational (2 to 7 years)
Period 3 - Concrete Operations (7 to 11 years)
Period 4 - Formal Operations (11 to adulthood)

Question 21

Period 1 Sensorimotor

Answer 21

Birth to 2 years

• Infant develops the action pattern for dealing with the environment (include mouthing, looking, vocalizing, grasping, or hitting

Question 22

Period 2 Pre-operational

Answer 22

2 to 7 years

• Children learn to think with the use of symbols and mental images
• Parallel play
• Child starts to use other language
• understanding who they are as a person (may not understand beyond themselves)
• iimitate the behaviour of another person

Question 23

Period 3 Concrete Operations

Answer 23

7 to 11 years

• able to apply logic to a situation
• can describe a process without actually performing it
• understanding processes on how to do things (critical thinking starting)

Question 24

Period 4 Formal Operations

Answer 24

(11 to adulthood)

• ethics, morality, politics, and/or religion start to become understandable
• thinking moves to abstract and theoretical subjects
• organize thoughts
• reason possibilities

Question 25

Kohlberg’s Moral Development Theory

Answer 25

Identified 6 stages of moral development occurring at three levels Theorized that a child’s moral development does not advance if the child’s cognitive development does not also mature Level 1 - Pre-conventional Level 2 - Conventional Level 3 - Post-conventional

Question 26

Kohlberg's Level 1 - Pre-conventional

Answer 26

up to 9 right or wrong based on punishment vs reward

Question 27

Kohlberg's Level 2 - Conventional

Answer 27

10 - 18 (adolescence) sees moral reasoning based on his/her own personal internalization of societal and others expectations wants to please others/doing things for others (less egocentrism)

Question 28

Kohlberg's Level 3 - Post-conventional

Answer 28

> 19 higher level ethical thinking determined by personal values finds a balance between basic human rights and obligations and societal rules and regulations start to envision an ideal society

Question 29

Erikson’s Theory of Eight Stages of life

Answer 29

- each person goes through 8 stages of development, each person needs to accomplish a particular task before moving to the next stage

Question 30

Erikson Stage 1

Answer 30

Infancy - Birth to age 1 year Trust vs Mistrust Infant learns to trust others

Question 31

Erikson Stage 2

Answer 31

Toddler - 1 to 3 years Autonomy vs Sense of shame and doubt Toddler learns to be independent and develops self confidence

Question 32

Erikson Stage 3

Answer 32

Pre-school - 3 to 6 years Initiative vs Guilt Child learns to initiate his or her activities (use fantasy and imagination)

Question 33

Erikson Stage 4

Answer 33

Middle Childhood - 6 to 11 years (puberty) Industry vs Inferiority Child learns new skills (increased competence in physical, cognitive, and social areas)

Question 34

Erikson Stage 5

Answer 34

Adolescence - 12 to 18 years Identity vs Role confusion Acquiring a sense of identity

Question 35

Erikson Stage 6

Answer 35

Young Adulthood - 18 to 35 years Intimacy vs Isolation Form close, personal relationships

Question 36

Erikson Stage 7

Answer 36

Middle Adulthood - 35 to 65 years (True adulthood) Generativity vs Self-absorption and stagnation See beyond personal needs and accomplishments and view the needs of society (help younger people) Dissatisfaction with one's achievements often leads to self-absorption stagnation

Question 37

Erikson Stage 8

Answer 37

Old Age - Age 65 years and older Integrity vs Despair Reflect on life and either feel satisfaction or disappointment

Question 38

How does growth and development influence approaches to nursing care

Answer 38

Risk Recognition Developmental Assessment Influences Care Delivery The ability to provide patient-centred, quality care requires nurses to understand and assess the different aspects of an individual’s development and appropriately adjust the care they provide. It is also important for nurses to recognize when expected developmental progression in any area is not occurring so that collaborative interventions can be initiated. Times during which development is rapidly occurring (ie. infancy, childhood, and older adulthood) deserve special attention and in-depth knowledge because nursing care will need to responsively adjust and nurses will need to adapt to the developmental changes of the patient more frequently and on an individual basis.

Question 39

Infancy

Answer 39

Period from 1 month to 1 year = dramatic physical growth

Question 40

Infancy physical changes

Answer 40

size increases rapidly during the first year; birth weight doubles in approx. 5 months and triples in 12 months patterns of body function stabilize as evidenced by predictable sleep, elimination, and feeding routines

Question 41

Infants psychosocial changes

Answer 41

Separation – by the first year infants begin to differentiate themselves from other people, understanding they are separate beings capable of acting on their own Initially, infants are unaware of the boundaries to self, but through repeated experiences with the environment, they learn where self ends and where the external world begins At 2 or 3 months of age, infants begin to smile responsively rather than reflexively They can recognize differences in people when their sensory and cognitive capabilities improve By 8 months, most infants can differentiate a stranger from a familiar person and respond differently between the two Close attachment to the primary care provider (commonly parents) is usually established by this age By age 9 months, children play simple social games such as patty-cake and peekaboo’s More complex interactive games such as hiding seek, involving objects, are possible by 1 year of age

Question 42

Infant main cause of death for babies between 1 and 12 months of age)

Answer 42

Sudden Infant Death Syndrome (SIDS)

Question 43

Infant main cause of death between 6 and 12 months of age

Answer 43

Injury

Question 44

Toddler

Answer 44

1 - 3 years

Question 45

Toddler physical changes

Answer 45

rapid development of motor skills allows toddlers to participate in self-care activities, such as feeding, dressing, and toileting Locomotion skills eventually include running, jumping, standing on one foot for several seconds, and kicking a ball Most can ride tricycles, climb ladders, and run well by their 3rd birthday By 3, children draw simple stick people and can usually stack a tower of small blocks Children usually show a willingness to please parents and take pride in their accomplishments

Question 46

Toddler cognitive changes

Answer 46

By 2 years, toddlers complete the development of object permanence, the ability to remember events, beginning ability to put thoughts into words Toddlers recognize they are separate beings from their mothers, but they are unable to assume another person’s point of view They use symbols to represent objects, places, and people – imitate other people, pretend one object is another An 18 month old uses approx. 50 words A 2 year old has a vocab up to 200 words and is generally able to speak in two-word sentences Word most often used is “No” until well into the 3rd year Moral development is only beginning and is also egocentric

Question 47

Toddler health risks

Answer 47

Injury Drowning Poisoning Car safety

Question 48

Pre-schooler

Answer 48

3-5

Question 49

Pre-schooler physical changes

Answer 49

Large and fine muscle coordination improves Run well, walk up and down steps with ease, learn to hop By age 5, they can usually skip on alternate feet, can jump rope, and begin to skate and swim Learn to copy crosses and squares. Triangles and Diamonds are usually mastered between ages 5 and 6.

Question 50

Preschooler cognitive changes

Answer 50

Children judge people, objects, and events by their outward appearance or what seems to be true Thinking is hindered by their limited attention and attending skills Artificialism – the misconception that everything in the world has been created by humanity may result in children asking questions such as “Who build the mountains?” Animism – the attribution of animal life to inanimate objects, often results in statements such as “Trees cry when they get their branches broken”. At about the age of 4, the intuitive phase of preoperational though develops Children’s ability to think more complexly is demonstrated by their ability to classify objects according to their size or colours. Egocentricity persists, but during these 3 years, it begins to be replaced with social interaction As children near the age of 5, they begin to use or can be taught to use rules to understand causation. Knowledge of the world remains closely linked to concrete (perceived by the senses) experiences Moral development expands – beginning understanding of behaviours considered socially right or wrong continue to be motivated, by the wish to avoid punishment and desire to obtain a reward Vocabularies continue to increase rapidly By the age of 6, children know more than 2100 words and can construct sentences using 5 or 6 words

Question 51

Preschool psychosocial changes

Answer 51

Curiosity and developing initiative lead to the active exploration of the environment, development of new skills, and the making of new friends Children become more social after their 3rd birthday as they shift from parallel play to associative play Most able to play together in a cooperative manner 4 years – groups of 2/3. 5 years- group has a temporary leader for each activity Pretending allows children to understand others points of view, develop skills in solving social problems, and become more creative

Question 52

Toddler psychosocial changes

Answer 52

Children strive for their independence Their strong wills are frequently exhibited in negative behaviour when caregivers attempt to direct their actions socially, toddlers remain strongly attached to their parents and fear separation from them begin to participate in parallel play, which is playing beside rather than with another child They learn the joy of sharing

Question 53

Preschool health risk

Answer 53

Unintentional injury

Question 54

School age

Answer 54

6 to 12

Question 55

School age physical changes

Answer 55

Slower rate of growth but steady Most children practice the basic gross motor skills of running, jumping, balancing, throwing, and catching during play which results in refinement of neuromuscular function and skills Fine motor skills improve and as control is gained over fingers and wrists children become proficient in a wide range of activities Independent in bathing, dressing, and taking care of other personal needs

Question 56

School age cognitive changes

Answer 56

Able to think in a logical manner and to understand the relationship between things and ideas thoughts are no longer dominated by their perceptions, their ability to understand the world Considerably less egocentric Develop the ability to concentrate on more than one aspect of a situation More capable of understanding another person’s view/feelings

Question 57

School age psychosocial changes

Answer 57

Erikson - Industry vs Inferiority - Positively recognized for success feel a sense of worth Strive to acquire competence and skills necessary for them to function as adult 12 year old children are able to Consider what society would be like without rules because of their ability to reason logically and their experiences with group play

Question 58

True or false. Forgetfulness is NOT a part of ageing

Answer 58

TRUE

Question 59

Health Concern across the lifespan

Answer 59

Failure to Thrive | - a loss of weight and a subsequent loss of linear growth

Question 60

Failure to thrive may be due to: | 3 reasons

Answer 60

Organic Causes – arising from something happening inside the body – physiological condition (celiac disease, cystic fibrosis) Exogenous or non-organic – (Outside source) – poor nutrition, food scarcity, neglect, abuse, parental mental illness, anemia (could be organic) Mixed – combination of both

Question 61

Failure to thrive is common in:

Answer 61

Common in Old-Old (Alzheimer’s) Frequently diagnosed in infants under age of 1 Can happen at any age Direct impact to growth and development – particularly physical growth