Care of Mother, Child, and Adolescent Reviewer

GROWTH AND DEVELOPMENT - Allow education/ teaching on social rules, sharing and playing in
Preschooler Stage (3- 6 years) small groups, simple games and rules.
A. Weight - The cooperative games of preschoolers stimulate curiosity and
- Gains 5 lbs. or 2.25 kg per year exploration.
- Average weight is 40 lbs. or 18 kg at age of 5 growth - Imaginative provide friends and understand child because
- Appears thinner than the toddler imaginary friends are normal at this stage.
B. Height - Requires regular socialization with mates of similar age.
- Average height is 37 inches or 94 cm at age of 3 - The 5 years old is interested in group games or reciting songs they
- 40 ½ inches (103 cm) at age of 4 have learned in kinder garten or preschool.
- 43 inches or 110 cm at age of 5 - The preschooler’s play and game may be dramatic, creative,
- Grows 2 ½ to 3 inches or 6.5 to 7.5 cm per year imitative and imaginative.
- Has erect posture; looks tall but thin a. Toys
- Increase in size is seen in elongated of legs vs. trunk  Creative sand bags, cutting and pasting tools, water
Sleep colors, coloring books, play clay.
- The preschooler requires about 12 hours of sleep each day  Dramatic play house, dolls, puppets
- A security object and a nightlight help with sleeping  Imitative housekeeping toys, nurse set, doctor’s set
C. Teething  Active wagons, playground equipments, skates
- At the beginning of the preschool period, the eruption of the deciduous (primary) teeth I. Health Maintenance in the Preschool Age
is complete  Nutrition
- Regular dental care is essential, and the preschooler may require assistance with  Calories 1700 per day; 90 cal. per kg. body wt. per day
brushing and flossing of teeth; fluoride supplements may be necessary if the water is  With food likes and dislikes
not fluoridated  Self-feeder, less picky; feeds self at 4 years; can pour from pitcher
- Late preschool – may brag “ dancing teeth” loss primary teeth may start by 5-7 years  Safety and Accidents
D. Development Milestone  Teach safety on the street
3 years a. Look on both ways before crossing; don’t chase ball on the street
 Catches ball with some misses observe traffic rules and lights; don’t play in the street
 Undress self-dresses with help  Motor vehicle safety use seat belts
 Imitates cross  Parents should set good example; they learn best by imitation.
 Builds tower of 9 – 10 blocks  Other causes of injuries;
 Asks many “why’s” a. Burns - don’t let them play with matches or lights
4 years b. Drowning- teach swimming, supervise near pools
 Walks down stairs with alternating feet like adult  General Safety -child should know his own name, address,
 Catches ball without missing telephone number and to seek help when loss; not to talk to
 Laces shoe without bow strangers and not to accept candies or foods from them
 Copies a square; draws a man with three parts  Sleep Patterns
 Brushes teeth  Have the most amounts of sleep disturbance because of real or
 Draws two geometric shapes imaginative or illogical fears.
 4-5 word sentences  May have fears of the dark, ghost or inanimate objects
 Asks questions; very inquisitive; has sexual curiosity ( start of sex education)  Requires 9-12 hours of night sleep; may give up nap
 Counts to 5  Masturbation is common and normal at this stage
5 years Management – give substitute toy to play with
 Skips; hops alternating feet -do not punish or verbally reprimand
 Jumps rope; throws and catches ball well -explanation of privacy of the act and its meaning
 Dress self totally without assistance should be done by parents
 Ties shoe laces  Guidance for Parents and Caregivers
 Copies rectangles and triangles a. Assess what the child really knows when he asks questions
 Prints letter, numbers, words, first name b. Give answers simply, honestly, matter of fact
 Last year for normal “ stuttering” (dysfluency) -without emotions, without delay and use
 Counts to 10 correct terminologies
E. Psychosocial Skills School Age Child (6 to 12 years old)
- Decreasing egocentrically with sharing A. Weight
- Pretends in play; develops imaginary friends - doubles over this period
- Imitates others; likes to play “ dress up” games B. Height
- With gender specific behavior at 5 years - grows about two inches per year
- Aggressiveness and impatience peak at 4 years, then eager to please - at 9 years, boys and girls are the same in size
Parents should praise behavior of all types and encourage creativity - at 12 years, girls are bigger than boys
- Derives satisfaction from accomplishment; loves to create Teething -loss of deciduous teeth at 5-7 years.
- Needs opportunities to explore different people, things and events. - Average 6 years, this is the time of eruption of permanent teeth,
Initiative vs. Guilt including first and second molars, at 12, all permanent teeth
- Once children reach the preschool stage (ages 3–6 years), they are capable of initiating except final molars have erupted.
activities and asserting control over their world through social interactions and play - This is the age of the dental caries major problem of this stage
- By learning to plan and achieve goals while interacting with others, preschool children Causes:
can master this task  Poor nutrition
- Initiative a sense of ambition and responsibility occurs when parents allow a child to  Inadequate hygiene
explore within limits and then support the child’s choice  Increased intake of carbohydrates and sweets
- These children will develop self-confidence and feel a sense of purpose Prevention
- Those who are unsuccessful at this stage—with their initiative misfiring or stifled by  Good brushing and flossing
over-controlling parents—may develop feelings of guilt  Good nutrition
F. Psychosexual Development  Fluorinated water
Phallic Stage (3 -6 years )  Regular dental check up
- The child experiences pleasurable and conflicting feelings associated with the genital C. Psychosocial Skills
organs. Industry vs. Inferiority
- The pleasures of masturbation and the fantasy life of children set the stage for Oedipus - Children begin to compare themselves with their peers to see how they measure
complex – a strong emotional attachment of a preschooler boy towards his mother. up.
- Electra complex is the attachment of preschool girl to her father. - They either develop a sense of pride and accomplishment in their schoolwork,
G. Cognitive Skills sports, social activities, and family life, or they feel inferior and inadequate
- Concentration focuses on parts not whole; focuses on one thing at a time because they feel that they don’t measure up.
- Magical and fantasy thinking continues - If children do not learn to get along with others or have negative experiences at
- Increasing concept of time and space; time correlates with events( i.e. after breakfast; home or with peers, an inferiority complex might develop into adolescence and
afternoon, after nap) adulthood.
H. Play D. Gross Motor Skills
1. Cooperative Play 1. There is increased strength and physical activity, very energetic, develops greater
coordination and stamina.
 Care of Mother, Child, and Adolescent Reviewer
2. Bone growth is faster than muscular and ligament growth; more susceptible to I. Morality
bone fractures Morality develops in the school before age 9
6 years -Jumps, skips, hops prints, ties shoe laces well  with strict superego
7 years -Rides a bicycle, can swim, vision mature, hand  after age 9, autonomous morality develops; recognizes different points of
coordination developed completely Vision 20/20 view
J. Health maintenance
-The numerator indicates the distance (in feet) from the
1. Nutrition
chart which the subject can read the line.
 Calories needs 2100 to 2400 per day
-The denominator indicates the distance at which a  Breakfast is the most important meal
normal eye can read the line  More likely to eat junk foods and soft drinks (zero – caloric foods)
8 years -Writes rather than prints; more graceful movement  Snacks should be well planned to make the child take the needed
-With increased smoothness and speed calories.
-Since arms and legs begin to grow may stumble on  Tends to choose own foods, influenced by mass media; needs
furniture or spill his milk on the table
nutritional education nutritious snacks, cooking, meal planning.
9 years -“On the go” constantly
 Displays good table manners.
-Fully developed hand eye coordination to enjoy basketball
and baseball Adolescence (12-18 years old)
10 years -Begins to show secondary sex characteristic changes A. Weight
- With pubertal growth spurt
Changes Occurring in Girls: - Females: 38lbs. Mean weight gain between 10-14 years
a. Increase in the transverse diameter of the pelvis - Males: 52lbs. Mean weight gain between 12-16 years
b. Breast development B. Height
c. Vaginal secretions  Pubertal growth spurt
d. Growth of axillary and pubic hair Females: 95% of mature height achieved by the onset of menarche
Menstruation usually begins between the times she develops axillary hair Males: 95% of mature height achieved by the skeletal age of 15 years
- Girls are usually taller than boys C. Definition of Terms
- Some 10 year olds girls menstruate, they become more feminine, and thus there is a 1. Pubescence – time span during which reproductive functions begin to mature:
decline in motor activity. ends with attainment of full maturity or reproductive capacity and is
Changes Occurring in Boys: characterized by:
a. Increase in the size of the genitalia a. Rapid growth of the body
b. Hypertrophy of breast tissue b. Full genital development
c. Growth of pubic, axillary, facial and chest hair c. Sexual awareness
d. Deepening of voice 2. Puberty – period of full reproductive maturity.
e. Production of spermatozoa, may begin nocturnal emission (loss of seminal fluid during a. Girls: before, this period was believed to be heralded by the first mens
sleep) menarche, Studies, however, have shown that most young girls are NOT
11 years old more active; always constant motion – FERTILE for about 1 – 2 years after menarche
drumming fingers, tapping pencils or feet b. Boys: puberty approaches at or near the first ejaculation. True
(nervous energy) reproductive maturity is attained when viable sperm appear in the
semen.
E. Fine Motor Skills Pubescence and Puberty deal with the physical biological aspects of development of the
With smoothness and speed young boy or girl.
6 years -can print, cuts and paste well 3. Adolescence- social and behavioral maturation from the beginning of
-can easily tie shoes laces pubescence to beyond the time of reproductive maturity.
7 years -with fully developed eyes; can read regular D. Teething
-size letters enjoys reading-a pleasure 13 years- eruption of the second molars
8 years -writes rather than prints 14- 15 years -eruption of the third molars; may erupt at 18-24 years (wisdom teeth)
9 years -writing begin to look more mature and less awkward E. Physical Growth
10-11 years with smoothness and speed in fine motor skills In addition to the rapid increase in weight and height, there are some alterations in the
body shape:
F. Language Development Boys - leaner; pelvic girth does not change so much but his chest and shoulders are
o With rapidly expanding vocabulary broader.
o Likes name calling and word games Girls- pelvis broadens; form becomes smoother because of fat deposition in the thighs,
o With passwords (secret language) hips and breasts.
o With sense of humor; giggles a lot; laughs a great deal; enjoys a dirty In girls, breast development is the first overt sign of beginning reproductive maturation
jokes The earliest secondary characteristics to appear in boys are an increase in the size of the
G. Psychosocial Skills testes and scrotum and later the penis.
1. School occupies half of his waking hours F. Psychosocial Patterns
a. Friends, classmates are more important than the family. 1. Early Adolescence (12 – 14)
b. Teacher becomes the parent substitute. - Physical body changes can result to alter self – concept fears and
c. School phobia difficulty coping up with demands that may rejection
result to psychosomatic disorders or complaints. - May have mood swings; with fantasy and daydreaming.
d. There is increasing social sensitivity - Needs consistent discipline; needs limit in behavior
e. More cooperative, more improved manners - This is the period of rebellion and uncertainty
f. Capable of good deal of responsibility - Movies and music provide enjoyable diversions to most
g. Modest; enjoys privacy (starting at age 10) adolescents
h. With hero-worshipping - Boys enjoy sports and girls are engrossed in self – improvement
H. Cognitive Skills and hobbies.
 Period of industry; likes to explore, produce, accomplish, to have adventure. 2. Middle Adolescence (Girls: 13 – 16; Boys: 13 – 17)
 Purposes of Play - Emancipated from parents except financially. Increased time is
 to develop mental abilities learn nature of competition spent with peer group creating changes that cause tension with
 to learn to bargain, cooperative and compromise parents.
 to increase social activities - Identifies own values.
 to increase motor abilities - Finds increasing interest in heterosexual relationship; may find a
 to develop logical thinking, reasoning abilities mate or form “love” relationship
 In the beginning of school years, boys and girls play together but gradually separate into - With peer group:
sex – oriented type of activities.  One of the strongest motivating forces of behavior
 Team Play rules and rituals dominate play: individuality not tolerated by peers.  Finds importance to be a part of a group and be like
 Types of Play/Games everyone else int eh group conforms to values/fads of the
o Quiet games painting, collections, reading, TV, radio group.
o Athletic activities swimming, hiking, cycling, basketball - Sex education complete at this point
o 6 to 9 years old housekeeping toys, doll accessories, needle work; Physical 3. Late Adolescence (Girls: 16 – 21; Boys: 17 – 21)
games, tree climbing, jumping rope, cycling. - Physically and financially dependent from parents
o 9 to 12 years handicrafts, science toys, magic sets, chess, scrabble, model kits, - Finds identity; finds a mate; develops morality
video games, radio/records, comic books. - Increasing social and moral interest; participate in society
 Care of Mother, Child, and Adolescent Reviewer
- Completes physical and emotional maturity
4. Adolescence and Independence
- By 15 – 16 years, adolescents feel they should be treated as adults
- Ambivalence – adolescents want freedom but are not happy with
corresponding responsibilities that come with it.
- Parental ambivalence is also present they try to give the
adolescent freedom but continue to offer constructive guidance
and enforce discipline
5. The radius of significant others is the peer group
G. Cognitive Development/Skills
1. The stage of Format Operations means he is capable of:
a. Abstract thinking
b. Scientific reasoning and formal logic
c. Viewing problems comprehensively
d. Increasing intellectual abilities
2. In the genital stage, which extends from about 12 to 20, an adolescent focuses
on the genitals as an erogenous zone and engages in masturbation and sexual
relations with others.
3. During this period of renewed sexual drive, an adolescent experiences conflict
between his or her own needs for sexual satisfaction and society’s expectations
for control of sexual expression.
4. Core concerns include body image development and acceptance by the opposite
sex.
H. Health problems1
1. Fears
a. Relationships with the opposite sex
b. Homosexual tendencies
c. Ability to assume adult roles.
2. Problems or Challenges
a. Drug abuse
b. Alcoholism
c. Smoking
d. Health problems – HPN, Posture, Acne
3. Communication
a. An adolescent has the capacity for hypothetical thinking and logical
reasoning and can understand factors related to health status, illness and
other situations.
b. He/She is typically interested in discussing his or her health problems and
schedules procedures.
4. Safety/ Accidents
a. Accidents are the leading causes of deaths; motor accident, sports
injuries.
b. Drugs and alcohol may be serious problems; suicide may also be a cause
of death.
c. Drowning may also cause injuries and deaths.
- Counseling against swimming alone and taking risk
- Teach CPR and first aid
I. Discipline
 Firm but reasonable limit setting is necessary and appreciated
 A supportive, yet non – interfering family is essential
 Privileges and responsibilities should be balanced in accordance with his/her
maturity
J. Sleep and Rest
- Rapid growth, over – exertion in activities and a tendency to stay
late commonly interfere with sleep and rest requirements.
- In an attempt to catch up on missed sleep, many adolescents
sleep late at every opportunity.
K. Sex Education
- Teaching about sexual function should expand to cover more in
depth information on the physical, hormonal and emotional changes of puberty.
Common Health Problems
1. Teenage pregnancy – pregnancy before age 19, usually unplanned and out of
wedlock.
2. Suicide – suicidal behavior refers to destructive, self – inflicted behaviors that
result in harm.
-Suicide is the intentional taking of one’s own life.
Causes:
 Stress
 Family dysfunction and low self - esteem
3. Obesity – excessive accumulation of adipose tissue in the body.
Causes:
 Results from over eating
 Family influences on eating patterns, attitude towards food