Summary

Growth and development start at conception and continue through adolescence. During conception and the prenatal stage, the genetic makeup and the basic physical structure of the child are determined. Immediately after birth, in the neonatal stage, the child learns to bond with their caregiver and develop a sense of trust. As they continue to develop through infancy, children experience rapid physical growth. When children enter the toddler years, their physical growth starts to slow down, and they rapidly develop gross motor and language skills. The toddler years are also characterized by the child’s need for autonomy. As children enter the preschool years, they develop more fine motor skills and start to learn how to function in a group setting. During the school-age period, children tend to form strong friendships and enjoy being active. Their growth continues at a slow, steady pace. Once children enter adolescence, they go through a growth spurt and develop sexual characteristics. This final stage of child development is characterized by the child establishing a unique identity separate from their family.

There are three theories of growth and development that are frequently discussed in pediatric nursing: Freud, Erikson, and Havighurst. Freud’s theory is referred to as a psychosexual theory. It examines human development through the lens of sexual desire. According to Freud, sexual is a general term that refers to any pleasurable action or thought. Freud’s theory is sequential, meaning children pass through a series of stages based on their age. If there is not appropriate resolution of the conflict in each stage, the individual could develop psychosocial problems later in life. Erikson’s theory is similar to Freud’s theory in that it is based on a series of stages that each child passes through, and there is a conflict that must be resolved in each stage. Not resolving each conflict could result in an unhealthy or maladaptive personality. Havighurst’s theory of development is also sequential but does not have a conflict in each stage that needs to be resolved. In Havighurst’s theory, there are specific tasks that need to be completed in each age group. Successful completion of these tasks leads to a healthy, happy individual.

Health risks are different for different population groups. Health risk for women of childbearing age who are considering having a family revolve around the ability to get pregnant, stay pregnant, and have a healthy pregnancy. A woman’s general state of health impacts her fertility, but there are other genetic and physiological factors that must be addressed if she has had a hard time conceiving. Once a woman is pregnant, she needs lots of education about appropriate diet and self-care activities during pregnancy.

In terms of the health risks for children, they change as children progress through infancy and childhood. Newborns are at-risk for complications from exposure to toxins in utero, birth trauma, and congenital malformations. Infants are completely dependent on their caregiver and are at risk for child abuse and neglect that could result in FTT or accidental injuries. They are also at risk for SIDS. Parents must be educated on appropriate sleeping conditions to help prevent this.

As children enter the toddler years, they gain independence and mobility. This increase in mobility places them at risk for accidental trauma. Also, their quest for independence can be very frustrating for parents. The typical personality of a toddler combined with the milestones of this age group, like toilet training, make them at-risk of child abuse. Sometimes parents get frustrated and lash out at their toddler. This age group is also at risk for malnutrition. This is especially true when they transition from breast milk or formula to cow’s milk at age 1 year. Parents need to be educated about providing a well-balanced diet and limiting consumption of milk.

When children enter preschool, their health risks continue to change. Most children in this age group are frequently in large groups with other children, which places them at risk for accidents and exposure to communicable diseases. As they enter school, they may be exposed to bullying or school violence. Also, previously undiagnosed learning disabilities could surface. Finally, the adolescent years bring a lot of changes that affect teens’ health risks. This age group struggles with identity formation and frequently relies on their peer group for guidance and support. This can lead to risk-taking behavior, mental health issues, and problems adapting to a new adult role.

Nursing considerations for the conception/prenatal stage, the neonate stage, and the infant stage focus on education related to family planning, pregnancy, and care of the neonate and infant. These stages are the foundation of development from infancy and beyond. Family planning education helps a person time when and if they have children. Prenatal education focuses on having a healthy pregnancy and minimizing the risk of congenital malformations and birth trauma. In the neonate and infant stages, parents need a considerable amount of support regarding bonding, feeding, and meeting the basic needs of the child.

The emphasis of nursing considerations changes as children enter the toddler years. Toddlers are quite a bit more independent than infants, but they still need constant supervision. The focus of nursing care is providing anticipatory guidance to help parents manage fostering independence while still constantly supervising their children. During this age group, parents should also be reminded about the importance of fostering language development.

Nursing considerations for preschool-age children focus on keeping them safe outside the home. During this age group, most children spend a significant part of their day with other children. Parents need guidance on promoting early learning and keeping children safe as they interact with others outside the home. Once children enter the school-age years, they are significantly more independent from their parents but still need guidance, especially if conflicts arise. Parents should have open conversations with their children about school violence and bullying. If children are being bullied, parents should involve the school administration to make it stop. This is also the time in life when children may be diagnosed with learning disabilities. Both nurses and parents should be aware of the signs of learning disabilities so that they can intervene early if there are concerns.

During the adolescent stage of development, nursing care focuses on helping teens develop a strong personal identity. This is a challenging time of development, and many teens experience anxiety and depression. Having an open mind and engaging teens may help them discuss their feelings. It may also be necessary to refer them to a therapist for help. This age group is also known to exhibit risk-taking behavior, especially if their peer group is engaged in risky behavior. Preparing parents for this possibility and providing them with resources may make this development period easier.