Conception through Adolescence: Key Points

Conception and Pregnancy: Second Trimester

• Most Important Data to Assess: Detection of fetal movement.
  • Fetal movement felt between 16-20 weeks.
  • Other options explained:
    • Uterus position: Should be above the pubis in the second trimester.
    • Breast or bottle feeding: Decision typically made in the third trimester.
    • Morning sickness: Common in the first trimester.

Newborn Reflexes

• Babinski Reflex: Should be present at six months.
  • Moro and Startle Reflex: Present in newborns, disappear by 6 months.
  • Extrusion Reflex: Present at birth, disappears by 4 months.
  • Importance for NCLEX: Know timing and expected presence of reflexes.

Infant Development

• Expected Physical Growth:

  • Birth weight doubles by 6 months, triples by 12 months.
  • Anterior fontanelle closes by 12-18 months, not 4-8 weeks.
  • Chest and head circumference equal at 12 months.
  • Birth height increases 1 inch per month for the first 6 months.

• Developmental Milestones at 6 Months: Able to completely roll over.

  • Pulling to stand, creeping, and sitting independently expected by 9 months.

Toddler Development (1-3 Years)

• Parallel Play: Predominant developmental characteristic at 18 months.
  • Other stages:
    • Peer pressure: School-age children (6-9 years).
    • Mutilation anxiety: Preschool children (2-5 years).
    • Imaginary playmates: Preschool age.

Pre-Operative Care for Toddlers and Preschoolers

• Allow Handling Equipment: For familiarization and comfort.
  • Incorrect options explained:
    • Performing own hygienic care: Not suitable for a five-year-old.
    • Alone time: Increases anxiety.
    • Age-appropriate magazines: Not suitable for a five-year-old.

Pain Management in Young Children

• Most Appropriate Response (4.5-Year-Old): Offer comfort and distraction by allowing to cry and providing a favorite toy.
  • Wrong responses:
    • Mentioning shots increases anxiety.
    • Telling them not to move offers no comfort.

Infant Safety

• Key Safety Measure (3-Month-Old): Remove feeding bibs at bedtime to prevent suffocation.
  • Other safety tips (8-12 months): Gate stairways, close bathroom doors.
  • Avoid large, hard teething biscuits: Risk of choking.

Behavioral Expectations by Age

• 3-Month-Old: Able to smile responsively.
  • Other behaviors:
    • Saying 'dada': Around 12 months.
    • Differentiating strangers: Around 8 months.
    • Playing peek-a-boo: Around 9 months.

Nutritional Information for School-Age Children

• Appropriate Snack (9-Year-Old): Plain popcorn, not milkshakes, potato chips, or candy.

Physical Development During School-Age Years

• Expected Growth: 1-2 inches per year.
  • Other details:
    • Weight almost doubles, not triples.
    • Many physical differences among children.
    • Body fat decreases, tends to redistribute.

Appropriate Activity for Hospitalized Six-Year-Old

• Best Activity: Crayons and coloring book.
  • Other options unsuitable due to complexity or lack of interest.

Pre-Adolescent Developmental Stage

• Developmental Sign: Secondary sex characteristics.
  • Girls: Breast buds.
  • Boys: Facial hair, deepening voice.
  • Other points:
    • Appears earlier in girls than boys.
    • Confide in friends, not parents.
    • Start showing interest in the opposite sex.

Discussing Sexual Health with Adolescents

• Best Question (14-Year-Old Seeking Birth Control): Open-ended question about past sexual activities.
  • Other questions too restrictive or irrelevant.
  • Importance of open-ended questions in gathering information.

Conclusion

• Stay tuned for more stages.
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