Pediatric Nursing: Developmental Milestones Across Age Groups

Importance of Age-Specific Nursing Care in Pediatrics

B: Body Changes
- Anterior fontanels: close at 18 months
- Posterior fontanels: close around 2 months
- Weight: double by 6 months, triple by 12 months
- Length: grows about 0.5-1 inch/month
- Teeth: lower central incisors at around 10 months
A: Achieving Milestones (Motor and Cognitive)
- 2 months: head moves side to side, tracks faces/objects, makes verbal noises, smiles
- 4 months: enjoys play, babbles, holds toys, reaches for objects, rolls over
- 6 months: sits up with support, stranger anxiety, early vowel sounds
- 8-9 months: sits without support, crawls, uses pincer grasp, object permanence
- 10-12 months: begins walking, follows simple commands, says simple words, separation anxiety starts
B: Baby Safety
- SIDS: preventive measures (back sleeping, no smoking, etc.)
- Shaken Baby Syndrome: never shake a baby, lay baby down if stressed
- Choking: precautions with breast milk, mucus, foods
- Car Seat Safety: rear-facing in back seat
- Burns: avoid hot surfaces, electrical outlets, and hot water
I: Interventions
- Trust vs Mistrust stage (Erickson)
- Soothe cries promptly, ensure caregiver presence for older infants
E: Eating Plan
- Breastfeeding: exclusive for 6 months, supplement with vitamin D if needed
- Formula: iron-fortified if not breastfeeding
S: Social Stimulation
- Independent play: progresses from observation to interaction over first year
- Infants love faces, high-contrast items, and auditory stimuli

T: Temper Tantrums
- Normal, calm handling, ignore tantrum but stay close
- Distracting and avoiding triggers, giving choices
O: On the Move (Safety)
- High risk of hazards: drowning, falls, burns, choking, etc.
D: Diaper to Potty Transition
- Signs of readiness: dry periods, interest in potty, regular bowel movements
D: Developmental Stage Theory
- Piaget: Sensory motor/Pre-operational
- Erickson: Autonomy vs Shame
- Parallel Play: plays alongside other children but not with them
L: Loves to Say No (Negativism)
- Avoid direct questions, offer choices
E: Eating Plan
- Healthy finger foods, avoid sugary and fatty foods, supervise dental hygiene
R: Ritualism, Rivalry, and Regression
- Importance of maintaining routines, include toddlers in the care of new siblings, handle regression without stress
Physical Changes
- Continues growth in height and weight

P: Physical Changes
- Slower growth rate, weight and height increases steadily, refined motor skills
R: Reduced Separation Anxiety
- Less intense but needs reassurance
E: Erickson and Piaget Theories
- Initiative vs Guilt (Erickson): developing sense of purpose
- Pre-operational stage (Piaget): magical thinking and literal interpretations
S: Scared of Things
- Fears of harm or hospitalization, magical thinking needs reassurance
C: Child Safety
- Gun safety, swimming, protective gear for physical activities
H: Healthy Eating
- Less picky than toddlers, full set of baby teeth by end of preschool
O: Others (Play)
- Transition to associative and cooperative play
O: Outline Behavior Expectations
- Anticipate reduction in tantrums, possible nightmares
L: Language Explosion
- Rapid development, possible temporary stuttering

S: Skills
- Fine motor: writing, drawing with greater detail
- Gross motor: riding bikes, swimming, competitive sports
- Cognitive: math, reading, problem-solving
- Social: forming friendships based on peers' approval
C: Changes (Physical)
- Steady growth, onset of puberty by end of stage for girls
- Dental transitions: losing baby teeth
H: Harmful Risks
- Safety in physical activities, stranger awareness, fire and gun safety
O: Obstacles
- Self-concept development and challenges
- Bullying: recognizing signs and interventions
- Nutrition: preventing childhood obesity
- Exposure to drugs and inappropriate content
O: Outcome of Hospitalization
- Fears of pain, death, loss of routine
- Nurse’s role: addressing fears, maintaining routines
L: Learning Developmental Theories
- Industry vs Inferiority (Erickson): developing sense of competency
- Concrete Operations (Piaget): understanding conservation and classification
- Moral Development (Kohlberg): understanding rules and laws

T: The Big Changes (Puberty)
- Tanner stages, physical changes, social relationships, teeth maturation
E: Education
- Safety: driving, substance abuse, suicide risks
- Health: sex education, nutritional needs, sleep importance
E: Erickson, Piaget, and Kohlberg
- Identity vs Role Confusion (Erickson): forming identity
- Formal Operational (Piaget): abstract thinking
- Social Contract Orientation (Kohlberg): understanding laws
N: Nurses Role
- Addressing fears of peer separation, loss of control, privacy concerns
- Promoting honesty, involvement in decisions, social activity encouragement