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NR328 Pediatrics Erikson Stage Trust-Mistrust Chamberlain University

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Chamberlain University

NR328 Pediatrics Erikson Stage Trust-Mistrust Chamberlain University

Erikson stage Trust-Mistrust -Separation anxiety -Object permanence by 8- 9mon (looking for hidden things) Autonomy Vs. Shame -Strong attachment to mom/dad -Ritualistic -Egocentric -Time for toilet training Initiative Vs. Guilt -Gender role identity: love to be the with same sex parents Industry V.s Inferiority -Love school Identity Vs. Role confusion Developmental approach -Provide cuddling, touch and talk softly -Response immediately when cries -Firm & positive- give choice when possible -Do not expect cooperation -Do not argue -Concrete & poor concept of time -Routines make them comfortable -Strong imagination -Fear of body mutilation so Band-Aid is magic -Better understating of cause and effect -Likes to be with same gender -Likes competition -Appreciates tangible rewards -Likes independence and autonomy -Capable of abstracting thinking -Peer relationships very important Play Play solitary -Sensory stimulationmusic, mirrors, black& white pictures Parallel play -Begins as imaginative and make believe play -Love to be on the go -Love to play dress up -Games- Follow their RULE – Likes to play in a team -Enjoys building & constructing things -Limit screen time -Friends -Sports -School actives, dances, movies, dating Nutrition -Breast feed or bottle feed -Give Vit D at 2 months – Solid food at 6 months -Whole milk @ 1 years -Skim milk @ 2 years -Continue to wean if not complete -Milk 2-3 cups/day -Finger goods -Limit sugar, fat, salt -Give mini meals -Similar to toddler – -Decreased parental control -Decrease activity -Increase risk for obesity and anorexia, bulimia Safely -Car seat on the back seat of the car -Continue to use car seat -Supervise indoor and outdoor activities -Edu toward sex, drugs, ETOH, risky behaviors Mile stones -Toilet training -Huge language development -Temperament is normal -By 3 years old should be able to ride a three wheel bike -Concrete thinking -Better understanding concept of time -Interested in friends and school -Peer and body image is very important Anticipatory guidance -About 4-6 months adding solid food by adding least allergic to most allergenic -Add one a time Rice cerealfruit& veggiesmeatseggs Toilet training -Must exhibit, physical, mental, psychological, parental readiness Temperament -Ignore bad behavior and praise good one Used play for understanding and coping*** – World is a make belief – Medical play to help alleviate fear of procedure -Like to know what going on with them, procedures – Like written, graphics explanation -Gives full explanations -Respect confidentiality -Keep confidentially useless harm to self and others -Restrictions -Impose few restrictions but do not set limits -Use adult pain assessment Downloaded by Homework Score ([email protected]) lOMoARcPSD|5960618Hospital affect -Separation anxiety at 6 months onwards, greatest at 1 year Fear of abandonment -Parents leave something behind Fear of loss of control -Let them touch equipment and let them do procedure on the doll Poor understating of body boundaries -Will scream and cry Fear -Physical harm -Separation form friends and school Procedures -Explain more fully -Use Diagrams and books Coping -Reports pain (use # scale) -Open to learn distraction techniques Verbal skills -Excellent ability to verbalize Fears -Fears loss of control -Give information and provide privacy Coping -Will appreciate& participate in coping methods Hydration Sign Mild Moderate Severe Fluid volume loss <50ml/Kg 50-99ml/kg >100ml/kg Skin color Pale Gray Mottled Skin turgor Decreased Poor Very poor Mucous membranes Dry Very dry Parched Urine output Decreased Oliguria Marked oliguria and azotemia BP Normal Normal or lowered Lowered Pulses/cap refill time Normal or increased/<2 secs Increase/ 2-3 secs Rapid and thread/ >3 secs Vital Signs Calculate how much they lost** 1g= 1ml Pre-illness weight in gram – illness weight in gram Pre-illness in Kg Daily caloric requirement for children High risk Neonate 120-150 cal/kg NB 100-200 cal/kg 1-2 y.o 90-100 cal/kg 2-6 y.o 80-90 cal/kg 7-9 y.o 70-80 cal/kg 10-12 y.o 50-60 cal/kg Female 14-18 yrs 2000-2400 cal/day Male 14-18 yrs 2400-3200 cal/day

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