Week 3: Growth & Development

WEEK 3: GROWTH & DEVELOPMENT (PART 2) All images are for educational purposes only, not for further dissemination. NURS 123 LEARNING OBJECTIVES ▪Define the concept(s) of growth and development. ▪Identify and describe the basic principles of growth and development. ▪Discuss relevant theories related to growth and development from a strengthbased perspective. ▪Discuss human physical, cognitive, psychosocial, and psychosexual growth and development across the lifespan. ▪Consider implications for health assessment across the lifespan. What we know about G&D… ● ● ● ● physical growth vs psychosocial/cognitive/moral development there are predictable patterns of growth and development, but pace will vary growth and development can be influenced by a multitude of factors: ○ ○ ○ ○ SDOH Environment Genetic Factors “Nature vs Nurture” developmental theories and milestones can help us to anticipate what is expected at various stages of development across the lifespan. Impact of Culture on G & D May influence beliefs and values related to growth and development ● Role expectations related to developmental age ● ○ What value is placed on independence, self-motivation, skill and knowledge acquisition, etc? ○ What is the appropriate age for an individual to complete school, get a job, pursue an intimate relationship? ○ Are there real or symbolic rites of passage recognized within a culture? Adolescence may be thought to extend into early 20s ● Consider: Language is a way to pass on cultural knowledge and loss of language can contribute to loss of cultural identity. How might this impact development across the lifespan? (Myllykoski, 2020) ● A closer look at growth & motor development Expected Patterns of Growth: ● ● ● Periods of accelerated growth such as infancy & toddlerhood as well as adolescent growth spurts ○ Most infants will double their birth weight by 6 months and triple their birth weight by 12 months. ○ Females typically experience prepubescent/pubescent growth spurt and physical changes earlier than males Anthropometric measurements ○ Growth charts and percentiles ○ What does it mean if an infant is in the 5th percentile vs the 95th percentile? Other examples: ○ Fontanels in infant skull to permit brain growth ○ Head disproportionately large in infancy and early childhood Image: McKinney, E. S., Smith Murray, S., James, S. R., et al. [2017]. Maternal child nursing [5th ed.]. St Louis: Saunder A closer look at growth & motor development Expected Patterns of Motor Development: ● General milestones act as a guide for assessing anticipated development ● Motor control progresses from gross to fine ○ Example: ability to pull self to standing by 10 months, ability to throw a ball by 24 months Fine motor skills initially ruled by reflexes and become more controlled and precise over time. ● Nurses also need to be aware of “expected” sensorimotor development and language development ● ○ Receptive language development tends to exceed expressive/productive vocabulary throughout the lifespan Reflecting on the Role of the Nurse 1. Risk recognition- all populations are at risk for impaired development, with pediatric populations being at increased risk 2. Developmental Assessments- occur throughout the lifespan with the goal of early identification of developmental challenges; requires an understanding of developmental milestones for age groups a. Infants and children- well child visits; screening for developmental problems, tracking physical growth (using growth charts) b. Adolescents- monitoring of physical development and sexual development, assessing for high risk behaviors c. Adults and older adults- monitor for age appropriate changes in physical function, focus on functional assessments, stress and coping, and others 3. Care Delivery How does anticipated G&D influence health assessment? ● Nurses must be aware of what is “expected” development across the lifespan in order to identify variations and concerns during assessments. ■ ● Example: What is the expected heart rate for a newborn as compared to an adult? (Hint: refer to Table 6 -2 in health assessment text) How will your approach to assessment differ when the patient is a toddler or an adolescent or an older adult? ○ what are the focus areas for assessment and screening? (See Table 28.4 - Fundamentals text p. 765) ○ age-appropriate assessment tools (example: pain assessment tools) ○ sources of health history information ○ impact on communication and development of therapeutic relationships ● Impacts ability to differentiate between physiological changes and pathological changes Example of Age-Appropriate Assessment Tools (for information only, will not be tested on specific tools) Other perspectives on G & D: What is epigenetics? ➔ “Epigenetics links genetics, the environment, and their influences on human development and disease.” (LeTourneau, 2020, p. 355) ➔ Watch this video: What is Epigenetics? “Growth and development are complex, inter-related processes that are influenced by and, in turn, influence the health of the individual. The nurse who understands this relationship is aware of the need for age-specific health assessment, health-protection, and healthpromotion strategies” (Peachy, 2021, p. 204) References LeTourneau, N. (2020). Developmental theories. In B. J. Astle and W. Duggleby (Eds.). Canadian Fundamentals of Nursing (6th ed.). Elsevier. ● Myllykoski, M. H. (2020). Psychosocial and cognitive development. In T.C. Stephen & D.L. Skillen (Eds). Canadian nursing health assessment: a best practice approach (2nd ed, pp. 191-209). Wolters Kluwer Health. ● Peachy, L. (2021). Overview of growth and development framework. In S. Dames, M. Luctkar-Flude, & J. Tyerman (Eds.). Edelman and Kudzma Canadian Health Promotion Throughout the Life Span (1st ed, pp. 193-210). Elsevier. Rousseau, K. & Raymond, C. (2020). Addressing developmental needs across the lifespan. In D. Gregory, C. Raymond, L. Patrick, T. Stephen (Eds.) Fundamentals: Perspective on the Art and Science of Canadian Nursing (2nd ed., pp. 751-790). Wolters-Kluwer. ● ●