Physical and Biological Movement and Cognitive Development of a Child - Report Example

Child Health Child Health Child Health Physical and biological movement Developmental characteristics A normally developed child would have an average weight of 18.7 kg. and a height of 43.25 inches (Price and Gwin, 2008, p.221). Deciduous teeth would begin to be lost and eruption of permanent teeth would occur. Handedness would be established. 90% of children would be right-handed. They start to play games which have rules. Their fear is lost and they become more confident among authorities as in school. Gathering friends and playing with them in gay abandon becomes a habit. Playing and chattering with a best friend is developed. Using the play equipment is another achievement. Apart from walking, running, jumping and hopping, they can also take about three or four jumps together (Price and Gwin, 2008, p.225). They like games with numbers and letters. The days of the week can be named and they usually print their first name. Children could be showing tantrums, crying frequently or being excited or persistent or aggressive or shy or react to failure depending on the situation. Observation Susan, 5 years old, is in the intuitive thought stage of the preoperational phase by Piaget. Egocentrism is evident in her and she believes that her toys and Barbie doll are going to come alive soon (animism). Being quarrelsome is not a habit for Susan. Susan is a normal child by the concepts of physical and mental development. Walking, running, jumping and using the play equipment at school come naturally to her. She seems to be fairly well-developed physically and biologically, weight being 17 kg. and height 41 inches, just below the normal standards. Eruption of permanent teeth has begun. The lower incisors are missing and the upper two have started growing: these are permanent teeth. She uses her right hand mostly. Shy about class discussions but not shy to tell when she is uncomfortable, Susan is an interesting child. Cognitive development Developmental characteristics Vocabulary will be developed to around 2100 words (Price and Gwin, 2008, p.221). Sentences would be used containing around 6-8 words each which is a progress from the 3-4 worded sentences of the four year old. Coins and 4 or more colors would be named. Names of the days of the week and months and seasons would be known by them. Other time-associated words would be spoken by them. Usually the children relax during rest periods. Ardently listening to stories is another form of relaxation (Price and Gwin, 2008, p.231). Occasionally they are restless and keep fidgeting. Sleeping habits could vary. Children may refuse to take the afternoon nap in class. Even night sleep may be delayed. Observation Susan’s vocabulary comes to around 1700 words. She can make a few sentences with 6-8 words each. Recognizing the various colors, she easily distinguishes them but her favorite is pink. Her doll’s dress is pink and she is in a pink frock now. The days, months and seasons are known to her. The numbers up to 20 and the alphabets are another region of her knowledge but she cannot “chant” these out in chronological order. Sleeping during the class is encouraged for the afternoons and Susan usually obliges. She appears to love listening to the stories that her teacher tells. Concentrating on each word that is told, she does not fidget at all. Psychosocial development Developmental characteristics The child will be less rebellious and quarrelsome. It would be more composed and eager to start off with some activity. Being more independent, and responsible, it settles down to respecting authority (Price and Gwin, 2008, p.225). Less fear enables it to speak and behave frankly with others including elders. The desire to please others by conforming to the rules and sporting the best of manners makes it a pleasant child. Caring for itself, it needs occasional assistance. Associative play is the difference seen as it grows. It tries to follow rules but hates to lose. This may make it indulge in a little cheating to avoid losing. The ability to share and take due turns while playing is a development in the psychosocial area. Jealousy and sibling rivalry are possibilities but usually at the age of 5 these tendencies disappear. Finger sucking is a habit which is usually lost by the time the pre-school child reaches school. Bedwetting could be another worrying habit (Price and Gwin, 2008,p.228). Observation Susan possesses a calm demeanor. She settles down quickly and responds pleasantly to the teacher. Exhibiting independence in her meals, sleeping habits and toiletry, she accepts authority and desires to do things by the teacher’s instructions. Eagerness to do things right must be her thought. Favorite food consists of broccoli, chicken, grapes, strawberry, chocolate chip cookies and chocolates. She hates celery and carrots. Concerning toileting, she washes her hands well with soap and believes in privacy when she goes about it. She can read some words but cannot write. The two sexes and the male organ are recognised. Her favorite cartoons are Dora the Explorer and Spongebob Squarepants. Enjoying the company of her younger siblings, she plays and watches television with them. She is able to wear shoes herself but needs help to tie her shoe laces. Her frock is worn by herself but if a jacket is needed, she needs assistance. Being the eldest of three siblings, she sleeps with them and her mom in the basement of the house. She is able to say her name, age and birthday but cannot spell out her name yet. Spending a lot of time in the nursery, she waits patiently for her mom to collect her. Her play activities include imagining that her Barbie doll is her baby. Bathing, dressing and feeding her seems to be a main activity. Joining with the boys for boisterous games where she attempts to be a leader and tri-cycling around the compound have been her other activities. When the teacher puts on some music, she switches to dancing her own steps to the tune. Once in awhile she calls “ teacher, teacher” when she feels that some authority is needed to help her out in arguments. Susan used to exhibit jealousy and sibling rivalry earlier when the first of her siblings were born. However with the birth of her second sibling, she seems to have reconciled to the situation. Susan did not thumb-suck but has enuresis. Interventions by nurses 1. Nutritional advice to parents: Simple nourishing meals including the basic food groups are the best for Susan, a pre-school child, who has a height and weight just short of the normal standards. Foods should preferably not be mixed together (Price and Gwin, 2008, p.229). Her appetites may vary frequently. Preschool children need 1600 kilocalories per day by the US Department of Agriculture (2006). Proteins, calcium, iron and plenty of vitamins A and C should be included. Juice intake must be limited to 4-6 ounces per day. The fluctuating appetite must not be countered by advice or scolding or coaxing or bribing. Foods that were disliked earlier can be tried again. Focusing positively should be the attitude. Mealtimes should be pleasant experiences. Table manners may be initiated. Using an unbreakable milk glass may tide over some situations (Price and Gwin, 2008, p.229). Children must be included in the conversations but should never be allowed to dominate. The authority figure should be the father or the mother. The table cloth if waterproof, meals would not be disturbed for the cleaning process. A tasty and nourishing dessert at the end would be advisable. 2. Treatment and nursing care for enuresis: Detailed history of the enuresis needs to be taken: about frequency, daytime voids, amount of fluid after dinner, family history, stress and reactions of the parents and child, and any medications being taken (Price and Gwin, 2008, p.228). Whether the social life of the child is inhibited because of this habit and what extent of toilet training Susan had must be enquired into. Any organic cause has to be eliminated. Though this problem of bed-wetting usually resolves by itself, it may cause emotional strains in the family and the child. Reassurance to the parents is the major intervention of the nurse. Parents should be told that power struggles or guilt or shame are unnecessary. Counseling, hypnosis, behavior modification and pharmacotherapy with Imipramine can decrease enuresis. Imipramine has side effects of mood and sleep disturbances (Price and Gwin, 2008, p.228). Life-threatening cardiac problems have been known to occur. Dosage should be well adjusted.Practical hints may be given to the parents by the nurses: moisture-activated conditioning devices may be used. Bladder training exercises may be given. The bedroom must be as close to the bathroom as possible. The child may help to clean up the wet bed. More fluids may be consumed during the daylight hours and avoided after dinner. A child should never be punished for the habit. Rationales 1. Susan’ height of 41 inches and weight of 17 kg. are slightly below the normals of 43.25 inches and 18.7kg. Nutritional advice to the parents would help the child grow and attain the normal levels prescribed. Simple meals would be better accepted by Susan. She can be explained to or informed as to what formed the food on her plate. Changes to the dishes prepared may make the child interested. They may like the foods that they disliked earlier as their tastes keep differing. Mealtime experiences go to form a strong bonding relationship with the concept of family. These would be remembered all through life. The sharing of pleasantries, the boosting of each other’s morale and the general bonhomie catches onto the child. It too should be made part of the conversation and encouraged to talk. The unbreakable glass is advised so that the child does not feel guilty of damaging something even if the milk is spilt accidentally. Some children could even make the breaking of glass a habit if they are not happy with a situation. They may make this a manner of protest. Allowing them to take over the conversation may lead them to forget about the authority of the parents. Helping them to try new foods may change the fluctuating patterns of appetites. The dessert would make up for whatever was lost earlier during the meals. 2. The aim of the advice is to help the family cope with the situation and change the behavior of the child through various strategies. Practical efforts to stop the habit are essential. Detailed history helps the nurse to understand the situation better and allows her to ensure or rule out organic causes. Susan or her parents should not have reason to end up being emotionally upset and taking psychiatric treatment. References: Price, D., L. & Gwin, J. F. (2008). Pediatric Nursing - An Introductory Text. 10th edition, St. Louis:  Saunders/Elsevier: Read More