Pediatric Nursing Demystified

Lower jaw trembling is noted constantly, even when not crying or

excited.

Response to loud sounds is absent or minimal.

Signs of Poor Parent–Child Bonding

Parent touches child minimally (i.e., only when feeding or providing care).

Minimal eye contact noted between parent and child (unless culture

related).

Possible signs of abuse noted: bruising, poor hygiene, malnourishment.

Infant older than 6 months of age shows minimal attachment to parent.

Potential Illness or Injury

Congenital conditions (see maternal-child text) may manifest through

developmental delays or distress.

Respiratory distress may be noted secondary to decreased surfactant or

as in later months due to airway obstruction, particularly due to foreign

body insertion.

Accidents and falls (after 4 months) may occur due to unanticipated

mobility and unsecured elevated surface or insufficient hold on body

part.

Infection risk factor due to immature immune system.

Hypothermia due to diminished temperature control.

Malnutrition secondary to poverty or failure to thrive.

CHAPTER 2/ Growth and Development^17

Chronological Developmental Stage or Defining Key Impact on

Age Range Theory Phase Characteristics Nursing Care

TABLE 2–1•Developmental Characteristics: Birth to 24 Months

Birth to 18

months

First year

Birth to 2 years

Sigmund Freud

Personality

Id, ego, superego

Psychoanalytical

Eric Erikson

Life-span stages

Psychoanalytical

Jean Piaget

Social/cognitive

Oral stage

Trust vs. mistrust

Sensorimotor

stage

Pleasure centers

on mouth

Dependence on

significant other

for comfort and

support to build

trust

Coordinates

sensory

experiences with

physical action

Encourage

self-feeding,

avoid foreign

object ingestion

Support bonding

and maintenance

of family

relationships

Plan tactile

experiences and

colorful materials,

to stimulate senses

3