Pediatric health promotion project.

INFANT AGE: Birth – 1 year

Ericksons stage: Trust vs. Mistrust

MILESTONES

Gross Motor | age of development

lifts head off a mattress when prone|2 month

rolls from back to side|4 month

rolls from back to front|6 months

sits unsupported |8 months

Changing from a prone to a sitting position|10 months

sits down from a standing position without assistance|12 months

Fine Motor | age of development

Holds hands in an open position Grasp reflex fading|2 months

Grasps objects with both hands | 4 months

Holds bottle| 6 months

Begins using pincer grasp| 8 months

Grasps rattle by its handle|10 months

tries to build a two-block tower without success Can turn pages in a book|12 months

Vaccines given:

Name of vaccine | times it is given | SQ or IM?

Hepatitis B (HepB) | birth | 3 doses

This is to prevent infection from the hepatitis B virus, which causes diseases such as liver problems.

Rotavirus (RV) | 6 weeks | 2 or 3 doses

To protect against rotavirus, which causes severe watery diarrhea, vomiting, fever, and abdominal pain

Diphtheria, tetanus, and acellular pertussis | 6 weeks | 5 doses

To protect infants against infections caused by diphtheria, tetanus, and pertussis.

Haemophilus influenzae type b (Hib)| 6 or 12 weeks | 3 or 4 doses

To prevent against meningitis, pneumonia, and epiglottitis.

Pneumococcal conjugate (PCV13)| 6 weeks | 4 doses

To protect from pneumococcal disease, which can cause severe disease of the lungs, blood, and brain.

Inactivated poliovirus (IPV)| 6 weeks | 4 doses

To produce antigens in the body to prevent poliovirus

Inactivated influenza vaccine (IIV)| 6 months | yearly

To improve body immunity to protect against influenza.

Measles, mumps, rubella (MMR)|12 months | 2 doses

MMR vaccine is given to infants protect against measles, mumps, and rubella

Varicella (VAR)|12 months | 2 doses

To protect against chickenpox.

Develop a nutritional plan for the first year of life

Breast milk is the best food for a baby during the first few months of birth. Infants should be fed with Breast milk or iron-fortified until the infant is 12 months old. Breast milk helps to build a child's immune system against many diseases.

During the first four months of birth, breast milk and infant formula could be given. From the fourth to the sixth month, infant cereal could be introduced in addition to the breast milk and formula.

Also, from the sixth to the eight-month, juice, water, vegetables, fruits, beans could be introduced to the infant.

Furthermore, from the eight to the twelfth month, eggs, cheese, meats could be introduced to the infant.

Describe language development during the first year of life

Crying is the first form of verbal communication. Crying decreases by 12 weeks of age. Infants vocalize with cooing noises by 3 to 4 months and turn head to the sound of a rattle by 3 months. Makes single vowel sounds by 2 months, by 3 to 4 months the consonants are added. The child begins speaking two-word phrases, then three to five words by the age of 1 year.

progresses to speaking three-word phrases

Discuss sensory development during the first year of life

Infants progress from reflexes to repetitive movements to imitating activities.

Sight

In the first few month's babies have uncoordinated eye movements and may appear cross-eyed at times.

Hearing

Babies with normal hearing should startle in response to noise

Smell

Infants have a strong sense of smell and prefer the smell of their mother.

Taste

Babies prefer sweet taste over the sour, bitter taste

Touch

Babies are comforted by touch

Safety in the home

During the newborn-infant phase, parents have to prevent children from putting objects in their mouths. Infants should also be kept from objects that could cause bodily harm. Anchor heavy objects and furniture so they cannot be overturned on top of the infant.

Furthermore, Infants should be prevented from drowning. The door to the kitchen should be closed; infants should not be left unattended in bathtubs or any water sources. Also, infants should be placed in positions that would prevent falls. Infants should not be placed on elevated surfaces. Plastic bags, balloons, pillows should be kept away from infants to prevent suffocation.

Case study:

The 6-month-old in the photo you chose was brought to the clinic by parents for a 6-month old check up. They are new parents and have many questions and concerns.

1. They ask “what can we do to encourage our baby’s development?”

Respond here using rationale from reputable sources, cite per APA

2. One of the parent's states in high School he remembers in his psychology class there are different developmental theories. He asks how those relate to his child right now?

Respond here using rationale from reputable sources cite per APA

3. During your assessment, the parents ask what findings would concern you. Discuss specific developmental warning signs you are assessing.

Respond here using rationale from reputable sources cite per APA

TODDLER AGE: 1 to 3 years

Ericksons stage: Autonomy vs. Shame

MILESTONES

Gross Motor | age of development

Walks without help, Creeps up stairs | age of development | 15 months

Runs clumsily; falls often Throws a ball overhand, Jumps in place with both feet Pulls and pushes toys|18 months

Walks up and downstairs by placing both feet on each step | 2 years

Fine Motor | age of development

Uses a cup well Builds a tower of two blocks | 15 months

Manages a spoon without rotation Turns pages in a book, two or three at a time Builds tower of three or four blocks| 18 months

Builds a tower of six or seven blocks turns pages of books one at a time| 2 years

Vaccines given:

Name of vaccine | times it is given | SQ or IM?

Inactivated poliovirus | 12 to 15 month | third dose

To produce antigens in the body to prevent poliovirus

Hepatitis A (Hep A )| 12 to 23 months | 2 doses

It is used to prevent hepatitis A, a type of liver disease that is caused by the hepatitis A virus.

Diphtheria, tetanus, and acellular pertussis | 15 to 18 months

To protect against infections caused by diphtheria, tetanus, and pertussis (whooping cough).

Inactivated influenza vaccine | 12 to 36 months | Yearly

To improve body immunity to protect against influenza.

Develop a nutritional plan for the Toddler:

Gear this in a way that a parent or caregiver with an 8th-grade education could understand it.

There is an increased risk for choking in infants until the age of 4 years, foods that are potential choking hazards should be avoided. The toddler should be served more iron-rich foods such as meat, poultry, fish, enriched grains, beans, etc. Milk intake should be limited to about 2 to 3 cups a day.

Foods that contain vitamin C like tomatoes, broccoli, oranges, etc. which improve the body's iron absorption should be given to the toddler. Also, snacks could be introduced to the toddler but with parent supervision.

Describe information regarding emotional/social and moral /spiritual development during toddlerhood.

Moral development is closely associated with cognitive development. Toddlers are unable to see things from the perspectives of others; they can only view things from their points of view. Toddlers begin to have a sense that good behavior is rewarded and bad behavior is punished.

Discuss sensory development of the toddler

Toddlers examine new objects by feeling, shaking, and putting them in their mouths. Smell matures, toddler's vision, and depth perception progress. The concept of object permanence becomes fully developed.

The toddler develops taste preferences and dislikes. Some dependent behavior on a caregiver, but clinginess is decreased.

Safety in the home & Community

Get information from your book or CDC.gov reference according to APA that you would be important to teach those caring for toddlers.

Keep small objects (i.e. candy, grapes, coins) away to prevent choking.

Age-appropriate toys should be provided

Toddlers should not be left alone in unattended bathtubs or any body of water.

Doors and windows should be kept locked.

Crib mattresses should be kept in the lowest position to avoid falls.

Safety locks should be put on cabinets to avoid the risk of poisoning.

Case study:

The 2-year-old in the photo you chose was brought to the clinic by his mother for a 2-year-old check-up. The following questions will refer to a child this age.

1. The mother states “we do not speak English to our child at home, because it is not our first language, and are working so our child will be bilingual.” What do you need to consider when assessing language development in this child?

Respond here using rationale from reputable sources, cite per APA

2. The mother asks what they can do to encourage their child’s language development.

Respond here using rationale from reputable sources cite per APA

3. The parent reports that the child’s favorite word is “No.” She asks if this is normal at this age. How would you respond?

Respond here, being sure to include discussion on Erikson’s stage of development and suggestions for dealing with this- use rationale from reputable sources cite per APA.

PRESCHOOL AGE: 3 to 6 years

Ericksons stage: Initiative vs. Guilt

MILESTONES

Gross Motor | age of development

rides a tricycle|3 year old

Jumps off bottom step|3 year old

skips and hops on one foot |4 year old

throws ball overhead|4 year old

Jumps rope|5 year old

Walks backwards with the heel to toe|5 year old

Fine Motor | age of development

Turn pages in a book | 3 year old

Wash their hands | 3 years old

Complete a puzzle|4 year old

Tie their shoes|5 year old

Vaccines given:

Diphtheria and tetanus toxoids and pertussis (DTaP)| 4 to 6 years

To protect preschoolers against infections caused by diphtheria, tetanus (lockjaw), and pertussis (whooping cough).

measles, mumps, and rubella (MMR) | 4 to 6 years

MMR vaccine is given to preschooler to protect against measles, mumps, and rubella

inactivated poliovirus| 4 to 6 years

To produce antigens in the body to prevent poliovirus

varicella| 4 to 6 years

To protect against chickenpox

influenza vaccine| 3 to 6 years | yearly

To improve body immunity to protect against influenza.

Develop a nutritional plan for the preschool aged child:

The preschool-aged child should be fed healthy foods, such as lean meats, poultry, seafood, eggs, legumes, dairy foods, fresh or lightly processed fruits and vegetables.

Parents should avoid feeding preschool-aged children with high-fat and high-sugar snacks. Also overfeeding should be avoided.

Describe language development during the preschool period.

The vocabulary of preschoolers increases to more than 2,100 words by the end of their fifth year. Preschoolers speak in sentences of three to five words between the ages of 3 to 5 years. Preschoolers enjoy talking, and language becomes their primary method of communication.

Identify normal cognitive and psychosocial changes occurring in the preschool-aged child.

The preschooler moves from totally egocentric thoughts to social awareness and the ability to consider the viewpoints of others. Preschoolers become energetic learners, despite not having all of the physical abilities necessary to be successful at everything. Preschoolers feel good about themselves in regard to mastering skills that allow independence such as dressing, feeding, etc. During stress, insecurity, or illness, preschoolers can regress to previous immature behaviors such as nose-picking, bed-wetting, etc.

Safety in the home & Community

Preschoolers should be prevented from causing bodily harm to themselves. Dangerous equipment such as knives, Firearms should be kept in locked cabinets or containers.

Preschoolers should not be left unattended to in bathtubs. Preschoolers should be closely supervised when near any pool or a body of water.

Preschoolers should be taught stranger safety. Parents should teach preschoolers how to protect themselves from strangers.

Also, preschoolers should be prevented from burns. Preschoolers should be kept away from fire and hot equipment such as hot electric iron, gas cooker, etc. Working smoke detectors should be made available in the home.

Case study:

The newly turned 5-year-old was brought in for a school check up.

1. The parent states “My child really loves to play make-believe and is constantly playing in a fantasy world. I am worried that this is not healthy behavior.” How would you address the parent’s concerns?

Respond here using rationale from reputable sources, cite per APA.

2. The parent expresses concern about the transition to Kindergarten. What guidance can you give regarding this?

Respond here using rationale from reputable sources cite per APA

3. During your assessment, the parents ask what findings would concern you. Discuss specific developmental warning signs you are assessing for.

Respond here using rationale from reputable sources cite per APA

School Age

AGE: 6-12 years

Ericksons stage: Industry vs. Inferiority

MILESTONES

Identify the developmental milestones of the school-age child and label if gross or fine motor.

School-age children will gain about 2 to 3 kg in weight and 2 inches per year in height. They will begin to see an improvement in their motor skills and have better control, coordination and balance.

Gross Motor Skills

Balance and rhythm improve

Ride a two-wheel bike

Jumps rope

Swim

Fine Motor Skills

Writing

Molding objects

Complete a puzzle

Typing on a computer

---------------------------------------------------------------

Vaccines given:

Influenza vaccine| Yearly

To improve body immunity to protect against influenza.

Tetanus and diphtheria toxoids and pertussis vaccine (Tdap)| 11 to 12 years| SQ or IM?

To protect against infections caused by diphtheria, tetanus, and pertussis.

Human papillomavirus vaccine| 11 to 12 years

This vaccine can prevent cervical cancer

Meningococcal (MCV4) | 11 to 12 years

This vaccine prevents Meningococcal diseases.

nutritional plan for the school aged Child

In a school-aged child appetite increases while the calories (energy needed for food) are reduced. The consumption of fatty meats, high-fat dairy products, eggs should be limited while the consumption of fish should be encouraged. The consumption of excess food in school-aged children leads to obesity which should be avoided.

The School-aged child should be encouraged to take more water. Consumption of soda or other sugar-sweetened beverages should be limited as they cause a higher risk for various health problems such as weaker bones.

The School-aged Child should be fed with fruits, vegetables, fish, cooked lean meats, low-fat milk, etc. Beef, pork, liver, dried beans are a good source of zinc and should be fed to these children as it improves their memory and school performance.

Identify normal physiologic, cognitive, and moral changes occurring in the school-aged child.

A sense of industry is achieved, and a sense of accomplishment is gained. There is a transition from perceptual to conceptual thinking. The child can see the perspective of others and also solve problems. At the early school age, the child does not understand the reasoning behind rules and expectations for behavior. They believe what they think is wrong, and what others tell them is right. At the later school age, they can judge the intentions of an act rather than just its consequences.

Describe the role of peers and schools in the development and socialization of the School-aged child.

Peer groups play an important role in social development. Children prefer the company of same-gender companions, bad peer relationships in childhood results in later social unacceptable behaviors. Schools are the medium through which these peer relationships can be formed. Most peer relationships come from school association.

Promoting safety for the School aged Child

Children should be prevented from causing bodily harm to themselves by keeping dangerous and hazardous materials away from their reach. Firearms should be kept in locked cabinets. School-aged children should also be taught stranger safety. Children should be taught to wear a helmet or other protective equipment when performing activities like bicycling.

Furthermore, a safe play area should be created for these children in the home. Children should be taught safety precautions to guide during cooking to avoid burns.

Also, children should be supervised when swimming or near a body of water to prevent drowning. Swimming pool depth in homes should not be too deep. Children could also be taught how to swim.

Case study:

The child in the above photo is brought to the clinic by her caregiver.

1. During the assessment, you note the interaction between the caregiver and the child. While you are asking the child about friends at school, the caregiver responds the child "does not have many friends. I told her that if she cared more about her appearance, the other children would want to spend time with her." How would you respond to the caregiver?

Respond here using rationale from reputable sources, cite per APA

2. The caregiver expresses concerns regarding discipline and how best to approach this. How would you respond?

Respond here using rationale from reputable sources cite per APA

3. During your assessment, you discover that the child spends most of her time watching television and playing video games. What guidance can you give to the child and her caregiver regarding this?

Respond here using rationale from reputable sources cite per APA

Adolescent AGE: 12 – 20 years

Ericksons stage: Identity vs. Role Confusion

Identify normal physiologic changes, including puberty occurring during the adolescent period. What factors influence the growth of teens? How has growth of teens changed over the past few decades?

Normal physiologic changes, including puberty occurring during the adolescent period, are changes in the individual’s height, weight, body composition, circulatory and respiratory systems.

Pubertal changes that occur are in two phases, adrenarche and gonadarche. During adrenarche, there is increased production of adrenal androgens that contribute to changes like skeletal growth while in gonadarche, physical and sexual maturation is reached. Sexual maturation occurs with breast development, pubic hair growth, menstruation, Testicular enlargement, Pubic hair growth, Penile enlargement, etc.

Factors that influence the growth of teens include; diet, exercise, and hereditary. Over the past three decades, adolescents have become taller and heavier than their ancestors, and the beginning of puberty is earlier.

---------------------------------------------------------------

Vaccines given:

influenza vaccine | Yearly

To improve body immunity to protect against influenza.

Meningococcal (MCV4)| 16 to 18 years

This vaccine prevents Meningococcal diseases.

Develop a nutritional plan for the Adolescent

Adolescents should take foods high in calcium such as milk, white beans, broccoli, cheese, and yogurt. They should also take food high in protein are meats, fish, poultry, beans, and dairy products.

The adolescent food should consist of cereals, fruits, vegetables, fruits, dairy, protein foods. The Adolescent nutritional plan could consist of 10 ounces grain, 3 ½ cup vegetables, 2 ½ cups fruits, 3 cups diary, 7 ounces protein food for a day.

Describe psychosocial, cognitive, and moral changes occurring in the adolescent.

These include; Ability to think through more than two categories of variables concurrently, highly imaginative, and idealistic. Adolescents develop a sense of personal identity and view themselves, unique individuals. They are able to solve moral dilemmas using internalized moral principles and question the relevance of existing moral values to society and individuals.

Promoting Safety

The adolescent should be taught fire safety to avoid burns. Also, adolescents should learn to swim, and also, they should not swim alone to avoid drowning. Adolescents should be taught to say “no” to harmful substances and alcohol.

Furthermore, firearms should be unloaded and kept in a locked cabinet. Proper use of sporting equipment and protective equipment if they would engage in any sporting activity.

Parents should be aware of changes in mood such as social isolation, expression of suicidal thoughts. This is to know the adolescent at risk of self-harm. They should also take driving education.

Case study:

A 15 year old girl, Kali, is brought into the clinic by her mother for an annual school check up.

1. During the assessment Kali states she wants to pierce her belly button but her parents say no. She says “They just don’t get it, there is no risk to this—I have at least 19 friends who have one and no one has had problems.” How would you address this?

Respond here using rationale from reputable sources, cite per APA.

2. During your assessment, Kali says her boyfriend is very protective of her. He often tells her what to wear and doesn't like many of her friends. He also gets angry when she doesn't respond quickly to his calls or texts. What thoughts do you have on hearing these things from Kali?

Respond here using rationale from reputable sources cite per APA

3. After the exam is complete, Kali’s mom says she has concerns about communication with her daughter. How would you respond?

Respond here using rationale from reputable sources cite per APA