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Foundation of personality is established dramatic

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Foundation of personality is establishedDramatic physical growthMoves from reflexive movements to deliberate explorationBegins to experience separation anxiety around 6 months of ageEFFECTS OF HOSPITALIZATIONPRIMARY ISSUE:stimulation and regular routineWithout appropriate stimulation, infant exhibits failure to thriveUnfamiliar environments- strange people, beds, etc.Interruption of mother-child relationship developingExperiences mainly painful stimuli and interruption of sleeping and eating routinesGUIDELINES FOR INTERVENTIONHuman contact is most important when caregiver is not availableEnjoys stimulation such as soothing voices, music, and being rockedHospital environments can be over stimulating- turn TV’s off, dim lights, give one toy or activity at a timeBe sure toys are safe, clean, and large enough so not be ingestedParents must be continually assured of their importance and abilities as caregiversEncourage parents to bring comfort items from home such as favorite toys, blanket, or pacifierCHILD LIFE INTERVENTION EXAMPLESHave family make tapes of voices or familiar soundsSchedules/signs informing staff to be consistent and limit visitors to primary caregiversPosition changes using high chairs, infant swings and infant seatsSpoon toy to promote reaching, grasping, and kickingMirrors to promote exploration of selfInfant Education Texas- multidisciplinary teams coordinate services to meet developmental andpsychosocial needs of children 0-3 years of age; Child Life focuses on the cognitive and social aspect ofthe Hawaii Early Learning Profile (HELP)TODDLERS (1-3 years)DEVELOPMENTPiaget- sensorimotor to preoperational stage:Increased use of symbolic representation (language, dramatic play)Egocentric thinking- unable to take a viewpoint of another personFocuses on the here and nowAbsolute thinking- perceives things as good or bad, right or wrongErickson- autonomy vs. shame and doubt- allow opportunities to explore independentlyDeveloping sense of autonomy, but still dependent on motherStruggle between independence and dependence leads to defiant behavior and temper tantrumsFeels “stranger anxiety” when confronted with unfamiliar facesSeparation anxiety is most intense between 18-24 monthsBowel and bladder controlAcquiring language skillsLearning cause and effectSolitary playDeveloping large motor skillsCannot distinguish between reality and fantasy28
EFFECTS OF HOSPITALIZATIONPRIMARY ISSUE:SeparationInterruption of mother-child relationship- child fears separations and interprets it as a loss of loveFeels loss of control and competenceMay interpret being in hospital or painful procedures as punishment for something he/she did “bad”Restricted ability to exploreRegressive behaviors- thumbsucking, refusal to feed self, return to wetting or soilingGUIDES FOR INTERVENTIONWhen caregivers separate from child, encourage them to assure child of their return and follow through

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Nursing, Nursing of Children and Adolescents

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