Pediatric Nursing Demystified

CHAPTER 2/ Growth and Development^15

OVERVIEW

Every developmental stage comes with a particular set of challenges and

accomplishments. Care of the client in a particular stage of development

requires an understanding of the particular physical and psychosocial reactions

that typically takes place with the client in that stage. Although concepts are

stated as being typical for an age group, the nurse should be flexible and

expect that some clients may overlap developmental stages. The nurse must

recognize the presence of expected developmental characteristics or signs of

developmental delays that may result from prolonged or chronic illness when

planning age-appropriate care for the client and family.

THEORETICAL FOUNDATIONS FOR GROWTH AND DEVELOPMENT

Growth and development can be categorized from various perspectives:

physical, language, cognitive, social, and emotional. All areas must be

assessed and progression in each area supported. Biological agerefers to

child’s age based on biological health and functional capabilities, whereas

chronological ageis the number of years that have elapsed since birth. Social

agerefers to the social roles and expectations related to the child’s age, and

psychological ageis the adaptive capacities compared to another child of the

same chronological age. Developmental stages and ages may overlap depending

on the reference used. Psychosocial theorists Freud, Erikson, and Piaget propose

behaviors that may be anticipated as a child develops.

NEWBORN/INFANT

Age range: birth to 12 months (up to 24 months)

Physical Milestones

Makes jerky, quivering arm thrusts

Brings hands within range of eyes and mouth

Moves head from side to side while lying on stomach

Head flops backward if unsupported

Keeps hands in tight fists

Strong reflex movements

Progresses from five to eight feedings per day to three meals and two

snacks by 12 months

Progresses from sleeping 20 hours per day to 12 hours and two naps by

12 months

Sensory Milestones

Focuses 8 to 12 inches (20.3 to 30.4 cm) away

Eyes wander and occasionally cross

Prefers black-and-white or high-contrast patterns

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