g&d of school-age child
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Growth and Development of
the School-Age ChildAreas of dramatic change between 6 and 10 years
First day of school Thinking process Social skills Activities Attitudes Use of language
Industry vs. inferiority-if unsuccessful in completing activities during this
stage, children develop a feeling of inferiority-success with completing the activities in this stage
provides the child with self-confidence
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Growth and Development of
the School-Age Child (cont.)
Health becomes community concern Starting school
Physical exam
Immunizations
Usually healthy time of childs life Accidents still pose serious hazard
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Physical Development
Weight and height Growth is slow and steady Gains about 5 lbs. annually
Annual height increase about 2.5 (6 cm) Period ends in the preadolescent growth spurt
Changes in dentition Starts to lose deciduous (baby) teeth at about 6 years
Eruption of permanent teeth, 6 year molars (directlybehind the deciduous molars) These are important: key or pivot teeth-help shape the
jaw and affect the alignment of the permanent teeth
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Physical Development (cont.)
Changes in skeletal growth
Spine is straighter
Abdomen is flatter Body is generally more slender and long-legged
Bone growth in long bones
Cartilage is being replaced by bone at the epiphyses
(growth centers at the end of long bones and atwrists)
Skeletal maturation is more rapid in girls than in boys
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SKELETAL GROWTH
6 YEAR OLD
10YEAR OLD
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Psychosocial Development
Displays a sense of duty and accomplishment
Engages in meaningful projects and sees them through
to completionApplies the energies earlier put into play to
accomplishing tasks
Refines motor, cognitive, and social skills
Develops a positive sense of self
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Psychosocial Development (cont.)
Not all children are ready for this stage due toenvironmental deprivation, a dysfunctional family,insecure attachment to parents, and immaturity Unrealistic or excessive goals can cause problems later inlife
When environmental support is adequate child shouldcomplete several personality development tasks at thisage:
Developing coping mechanisms Developing a sense of right and wrongAccomplishing a feeling of self-esteem Displaying ability to care for oneself
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Psychosocial Development (cont.)
Each child is product of Personal heredity Environment
Cognitive ability Physical health
Every child needs love and acceptance
Understanding, support and concern when mistakes
are made Thrive on praise and recognition
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Psychosocial Development (cont.)
Factors affecting self-confidence
Consistent rules
Positive attention
Clear expectations
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Psychosocial Development (cont.)
Development from ages 6 to 7
Still employs magical thinking
Can sit still for short periods of time Understands taking turns
Enjoys group activities
Begins to enjoy participating in real-life activities
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Psychosocial Development (cont.)
Development from ages 7 to 10
Questions parental standards as the ultimate authority
Becomes more impressed by the behavior of peers Is increasingly interested in group activities
Moves from preoperational, egocentric thinking toconcrete, operational, decentered thought
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Psychosocial Development (cont.)
Development from ages 7 to 10
Concepts displayed by the 7- to 10-year-old child
Decentration Being able to see several aspects of a problem at the
same time and to understand the relation of variousparts to the whole situation
Cause-and-effect relations become clear Magical thinking begins to disappear
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Psychosocial Development (cont.)
Concepts displayed by the 7- to 10-year-old child (cont.) Reversibility
Conservation of continuous quantity
The ability to think in either direction Classification
The ability to group objects into a hierarchicalarrangement
Collections
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QuestionA school-age child aged 7-10 years moves from
preoperational, egocentric thinking to what?
a. Concrete, operational, centered thought
b. Concrete, operational, decentered thought
c. Cognitive, operational, centered thought
d. Cognitive, operational, decentered thought
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Answerb. Concrete, operational, decentered thought
Rationale: Important changes occur in a childs thinkingprocesses at about age 7 when there is movement frompreoperational, egocentric thinking to concrete,
operational, decentered thought.
Q#2
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Nutrition
As coordination improves, the child becomesincreasingly active Requires more food to supply necessary energy
The nutritional needs of the school-age child shouldbe met by choosing foods from all the food groups Increased appetite and a tendency to go on food jags
are typical Offer choices Supervise snacking habits Matter-of-fact attitude about food by caregivers Provide a positive mealtime atmosphere
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Nutrition (cont.)
Obesity can be a concern Causes
Genetic, environmental, or sedentary lifestyle factors
Interventions Appropriate physical activity (moderately active for 60
minutes every day, or most days) Limiting fat intake (no more than 35% of total
calories) Positive caregiver support
-avoid nagging-avoid clean your plate rule-limit fast food meals
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Nutrition (cont.)
Health teaching at school
Reinforce proper diet
Subsidized breakfast and lunch programs Provide well-balanced meals (often children only eat part)
Old enough to be partially responsible for packing ownlunch
Post school lunch menus
Q#3
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H l h P i d M i
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Health Promotion and Maintenance
(cont.)
Health education (cont.)
Sex education-time and place for formal educationremains controversial
Includes
Helping children develop positive attitudes abouttheir own bodies
Their own sex
Their own sexual role to achieve optimumsatisfaction in being a boy or a girl
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Health Promotion and Maintenance
(cont.) Sex education (cont.)
At various places in curriculum-often limited to 1 class,usually 5thgrade
Covers different topics in different school systems-watchfilms about menstruation and developing bodies;separate classes for boys and girls
Caregivers may want to use printed materials
Teach about HIV
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Health Promotion and Maintenance
(cont.) Health education (cont.)
Substance abuse education Just say no programs
Teach unhealthy aspects of tobacco, alcohol and druguse Children may experiment with inhalants
May contain deliriants Can cause death
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HEALTH PROMOTION AND
MAINTANENCE CONTD
Common Products Inhaled as Deliriants-Box 26-1
Model glue Varnish
Rubber cement Shellac Cleaning fluids Hair Spray
Kerosene vapors Nail polish remover
Gasoline vapors Liquid typing correction fluid
Butane lighter fluid Propellant (whipped cream)
Paint sprays Aerosol paint cans
Paint thinner Solvents
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Health Promotion and Maintenance
(cont.)
Substance abuse education
Family caregivers should Teach familys values
Teach difference between right and wrong
Set and enforce rules of acceptable behavior
Learn facts about drugs and alcoholActively listen to the children in the family
Q#4
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Health Promotion and Maintenance
(cont.)
Accident prevention-remains leading cause of death Children must learn safety rules and practice them until
they are routine Children should know
Their full name Caregivers names
Home address Telephone number How to call 911
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Health Promotion and Maintenance
(cont.)
Safety topics for school-age group-page 598
Traffic signals and safe pedestrian practices
Safety belt use for car passengers Bicycle safety
Skateboard and skating safety
Swimming safety
Danger of projectile toys
Danger of all terrain vehicles
Use of life jacket when boating
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QuestionHealth promotion and maintenance is important in this
age group. What is one topic that is important for thecaregiver to teach the child?
a. Positive body image
b. How to use the stove
c. How to call the health care providerd. Basic hygiene
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Answerd. Basic hygiene
Rationale: Caregivers have a responsibility to teach thechild about basic hygiene, sexual functioning,substance abuse, and accident prevention.
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The School-Age Child in the Health Care Facility
CONCEPT 6-8 YEARS 8-12 YEARS IMPLICATIONS FOR
NURSING
Birth See babies as aresult of 3 factors:social and sexualintercourse and
biological fusion
Begin to put 3components together;sperm and egg cometogether not sure why
Cultural & educationalfactors play a part indevelopment of wherebabies come from
Tend to see babyas emerging fromfemale only; fromoutside force-created whole
Fewer discrepancies inknowledge based on sexdifferences
Nurse should assess childsidea about birth; can theyunderstand where babiescome from and how beforeteaching
Boys know lessthan girls aboutbaby information
Explain roles of both parents,but the idea of sperm andegg union may not beunderstood until 8 or 9 yearsold
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CONCEPT 6-8 YEARS 8-12 YEARS IMPLICATIONS FOR
NURSINGDeath May be viewed as
reversibleConsidered irreversible Change from vague view
of death as reversibleand caused by externalforces to awareness ofirreversibility and bodilycauses
Animism (attributionof life) may be seen insome children; deathis viewed as result of
outside force
Ideas about what happensafter death unclear;related to concreteness ofthinking and socio-
religious upbringing
Fears about death morecommon @ 8; adultsshould alert to this
Experiences withdeath facilitateconcept development
Explanations aboutdeath, the fact theirthoughts will not causea death, they will notdie (if illness is notfatal) are needed
The School-Age Child in the Health Care Facility
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The School-Age Child in the Health Care Facility
CONCEPT 6-8 YEARS 8-12 YEARS IMPLICATIONS FORNURSING
HumanBody
Know body holdseverything inside
Can understandphysiology
Cultural factors mayplay a part in abilityand willingness todiscuss bodilyfunctions
Use outside world toexplain
Use generalprinciples to explainbody functions
Educational programscan be very effectivebecause of naturalinterest
Aware of major organs Interested ininvisible functions ofthe body
Assess knowledge ofbody by using diagramsbefore teaching
Interested in visiblefunctions of body
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The School-Age Child in the Health Care Facility
CONCEPT 6-8 YEARS 8-12 YEARS IMPLICATIONS FORNURSING
Health See heath as doingdesired activities
See health as doingdesired activities
Need assistance inseeing cause and effect
List concretepractices ascomponents ofhealth
Understand cause andeffect Capitalize onpositiveness of concept;health lets you do whatyou really want to do
Many do not see
sickness as related tohealth; may notconsider cause andeffect
Believe it is possible to
be part healthy and partnot at the same time;can reverse from healthto sickness and back tohealth
Young children who are
sick may feel they willnever get well again
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The School-Age Child in the Health Care Facility
CONCEPT 6-8 YEARS 8-12 YEARS IMPLICATIONS FORNURSING
Illness Sick children may seeillness aspunishment;evidence suggests
that healthy childrendo not see illness aspunishment
Same as 6-8 years ofage; can identifyillness states, reportbodily discomfort,
recognize that illnessis caused by specificfactors
Social factors play a part inillness concept
Highly anxiouschildren more likely
to view illness asdisruptive
Recognize that some seeillness as punishment
Sickness is a diffusestate; rely on othersto tell them when
they are ill
Encourage self-care andself-help behavior,especially in older children
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The School-Age Child in the Health
Care Facility (cont.)
Anxious about looking different than others their age May be uncomfortable with nurse of the opposite sex
Inform families and children of rules as part ofadmission process
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Nursing Care for the School-Age
Child in a Health Care Facility
Explain all procedures to children and their families
Show equipment and material to be used Outline realistic expectations of procedures and
treatments
Answer childrens questions truthfully
Give children an opportunity to verbalize anxieties
Respect desire for privacy