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Pediatrics NCLEX Review Saunders

Saunders' NCLEX Pediatrics Review: Key terms on growth, development, and mental health across the lifespan. Covers abuse, aging, cognition, and mood disorders—essential for NCLEX prep.

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Pediatrics NCLEX Review Saunders - Page 1 preview imageSaunders' NCLEX Pediatrics ReviewGrowthand Development acrosstheLifeSpanI.Terms1.Abuse: The willful infliction of pain, injury, mental anguish, or unreasonable confinement.Abuse caninclude verbalassaults,thedemand toperform demeaningtasks, theft,ormismanagement of personal belongings. Abuse inflicted can be physical, emotional, or sexual.2.Accommodation: The ability to changea schema (an individual's cognitive structure orframework of thought) to introduce new ideas, objects, or experiences.3.Aging: The biopsychosoctal process of change occurring between birth and death.4.Assimilation: Theabilitytoincorporatenewideas,objects,andexperiencesintotheframework of one's thoughts.5.Conscious: All experiences that are part of an individual's awareness and that the individual isable to control.6.Dementia: An organic syndrome identifiedby gradual andprogressive deterioration inintellectual functioning.Long- andshort-termmemory lossoccur withimpairmentinjudgment, abstract thinking, problem-solving ability, and behavior, resulting in a self-caredeficit. A common type of dementia is Alzheimer's disease.7.Depression: A mood disorder that can be identified by feelings of sadness, hopelessness, andworthlessness, and a decreased interest in activities.8.Ego: One's 'sense of self'; provides functions such as problem solving, mobilization of defensemechanisms, reality testing, and the capability of functioning independently; the mediatorbetween the id and the superego.9.Exploitation: Illegal or improper use of the individual's resources.10. Gerontology: The study of the process of aging.11. id: Source of all primitive drives and instincts; considered to be the reservoir of all psychicenergy.12. Neglect: The lack of providing services necessary for physical or mental health; includesfailure to prevent injury.13. Polypharmacy: Taking multiple prescription and / or over-the-counter medications together.14. Schema: An individual's cognitive structure or framework of thought.15. Schemata: Categories that an individual forms in his or her mind to organize and understandthe world.16. Self-neglect: The choice to avoid medical care or other services that could improve optimalfunction. Unless declared legally incompetent, an individual has the right to refuse care.17. Subconscious: Often called thepreconscious; includes experiences, thoughts, feelings, ordesires that might not be in immediate awareness but can be recalled to consciousness: helpsrepress unpleasant thoughts or feehngs.18. Superego: The moral component of personality, including internalization of the values, ideals,and moral standards of society.19. Unconscious: Memories, feelings, thoughts, or wishes that are repressed and are not availableto the conscious mind.n.The Pyramid to Success1.Nonnal growth and development proceed in an orderly, systematic, and predictable pattern,which provides a basis for identifying and assessing an individual's abilities.2.Understanding the path of growth and development across the life span assists the nurse inidentifying appropriate and expected human behavior.3.The Pyramid to Success focuses on Sigmund Freuds theory of psychosexual development,JeanPiaget's theory of cognitive development,Erik Eriksonspsychosocial theory, andLawrence Kohlberg's theory of moral development.
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Pediatrics NCLEX Review Saunders - Page 2 preview image4.Growth and development concepts focus on the aging process and on physical characteristics,nutritional behaviors, skills, play, and specific safety measures relevant to a particular agegroup that will ensure a safe and hazard-free environment.5.When a question is presented on theNCLEX examination, if an age is identified in thequestion, note the age and think about the associated growth and developmental concepts.6.TheIntegratedProcessesaddressedinthisunitincludeCaring,CommunicationandDocumentation, Nursing Process, and Teaching/Leaming.III. Client Needs1.Safe and Effective Care EnvironmentActing as a client advocateConsulting with members of the health care teamEstablishing prioritiesMaintaining confidentialityPreventing accidentsProviding care following ethical and legal standardsRespecting client and family needs based on their preferencesUpholding chent's rights2.Health Promotion and MaintenanceAssisting with family planningDiscussing lifestyle choicesIdentifying changes that occur as a result of the aging processIdentifying developmental stages and transitionsIdentifying expected body image changesMaintaining health and wellnessMonitoring growth and developmentProviding client and family educationRespecting health care behefs and preferences3.Psychosocial IntegrityAssessing for abuse and neglectConsidering grief and loss issues with the older clientIdentifying coping mechanismsIdentifying loss of quantity and quality of relationships with the older chent Identifyingsupport systems»Monitoring for adjustment to potential deterioration in physical and mental health andwell-being in the older chentMonitoring for changes andadjustment in role function in the older client (threat toindependent functioning).Monitoring for sensory and perceptual alterationsProviding resources for the chent and family4.Physiological IntegrityAdministering medication safely.Identifying health care preferences.Identifying practices or restrictions related to procedures and treatments.Monitoring for alterations in body systems and the related risks ftom the aging process.Providing basic care and comfort needs.Providing care using a nonjudgmental approach.Providing interventions compatible with the client's age, cultural, religious, and healthcare beliefs, education level, and language.
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Pediatrics NCLEX Review Saunders - Page 3 preview imageIV. Psychosocial Development and Erik Erikson1.The theoryEriksen s theory of psychosocial development describes the human hfe cycle as a series ofeight ego developmental stages from birth to death.Each stage presents a psychosocial crisis, the goal of which is to integrate physical,maturation, and societal demands.The result of one stage may not be permanent, but can be changed by experience(s) laterin life.The theory focuses on psychosocial tasks that are accomplished throughout the hfe cycle2.Psychosocial developmentOccurs through a lifelong series of conflicts affected by social and cultural factors. EEach conflict must be resolved for the child or adult to progress emotionally.Unsuccessful resolution leaves the individual emotionally handicapped.3.Stages of psychosocial development.V.Cognitive and Jean Piaget1.The theoryPiaget's theory of cognitive development defines cognitive acts as ways in which the mindorganizes and adapts to its environment (i.e., "mental mapping").Schema refers to an individual's cognitive structure or framework of thought.Schemata—> Schemata are categories that an individual forms in his or her mind to organize andunderstand the world.—> Ayoung child has only a few schemata with which to understand the world, andgradually these are increased.—> Adults use a wide variety of schemata to understand the world.Assimilation—> Assimilation is the ability to incorporate new ideas, objects, and experiences into theframework of one's thoughts.—> The growing child will perceive and give meaning to new information according towhat is already known and understood.Accommodation—> Accommodation is the ability to change a schema to introduce new ideas, objects, orexperiences.—> Accommodation changes the mental structure so that new experiences can be added.2.Stages of cognitive developmentSensorimotor stage—> Birth to 2 years_> Development proceeds from reflex activity to imagining and solving problems throughthe senses and movement.—> The infant or toddler leams about reality and how it works.—> The infant or toddler does not recognize that objects continue to be in existence, evenif out of their visual field.Preoperational stage—> 2 to 7 years—> The child leams to think in terms of past, present, and future.—> Thechild moves from knowingtheworld throughsensationandmovement toprelogical thinking and finding solutions to problems.—> The child is egocentric.—> The child is unable to conceptualize and requires concrete examples.
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Pediatrics NCLEX Review Saunders - Page 4 preview imageConcrete operational—> 7 to 11 years—> The child is able to classify, order, and sort facts.—> The child moves horn prelogical thought to solving concrete problems through logic.—> The child begins to develop abstract thinking.Formal operations—> 11 years to adulthood—> The person is able to think abstractly and logically.—> Logical thinking is expanded to include solving abstract and concrete problems.VI. Moral Development and Lawrence Kohlbeig1.Moral developmentMoral development is a comphcated process involving the acceptance of the values andrules of society in a way that shapes behavior.Moral development is classified in a series of levels and behaviors.Moral development is sequential but people do not automatically go from one stage orlevel to the next as they mature.Stages or levels of moral development cannot be skipped.2.Levels of moral developmentVII.Psychosocial Development and Sigmund Freud1.Components of the theory2.Levels of awarenessConscious level of awareness->The conscious mind is logical and is regulated by the Reality Principle.—> Consciousness includes all experiences that are within an individual's awareness andthat the individual is able to control.—> Consciousness includes all infonnation that is remembered easily and is immediatelyavailable to an individual.Preconscious level of awareness—> The preconscious is called the subconscious.—> The preconscious includes experiences, thoughts, feehngs, or desires that might notbe in immediate awareness but can be recalled to consciousness.->The subconscious can help repress unpleasant thoughts or feelings and can examineand censor certain wishes and thinking.Unconscious level of awareness—> The unconscious is not logical and is governed by the Pleasure Principle, which refersto seeking immediate tension reduction.—> Memories, feehngs, thoughts, or wishes are repressed and are not available to theconscious mind.—> These repressed memories, thoughts, or feehngs, if made prematurely conscious, cancause anxiety.2.Agencies of the mindId, ego, and superego—> The id, ego, and superego are the three systems of personality.—> These psychological processes follow different operating principles.—> In a mature and well-adjusted personality, they work together as a team under theleadership of the ego.
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Pediatrics NCLEX Review Saunders - Page 5 preview imageThe id—> Source of all drives—> Present at birth—> Includes genetic inheritance, reflexes, capacities to respond, instincts, basic drives,needs, and wishes that motivate an individual.—> Operates according to the Pleasure Principle.—> Does not- tolerate uncomfortable states and seeks to discharge the tension and returnto a more comfortable, constant level of energy.—> Actsimmediately in animpulsive,irrationalwayandpaysnoattention to theconsequences of its actions; therefore, often behaves in ways harmful to self andothers.—> The primary process is a psychological activity in which the id attempts to reducetension.—> The primary process can include hallucinating or forming an image of the object thatwill satisfy its needs and remove the tension.—> The primary process by itself is not capable of reducing tension; therefore, a secondarypsychological process must develop if the individual is to survive. When this occurs,the structure of the second system of the personality, the ego, begins to take form.The ego—*Functions include reality testing and problem solving.—> Begins its development during the fourth or fifth month of life.—> Emerges out of the id and acts as an intermediary between the id and the externalworld.—> Emerges because the needs, wishes, anddemands of the id require appropriateexchanges with the outside world of reality.—> The ego distinguishes between things in the mind and things in the external world.—> Reality testing is a function of the ego. and the ego uses realistic thinking.—> The egofollowstheReality Principle andoperatesbymeansof thesecondaryprocess—that is, realistic thinking.—> The aim of the Reality Principle is to satisfy the id's impulses in the external worldwith an object that is suitable; the Reality Principle determines whether an experienceis true or false and whether it has external existence.—> The ego devises a plan and tests the plan by some type of action to see whether it willwork.The superego—> Necessary part of sociahzation that develops during the phallic stage at 3 to 6 years ofage.—> Develops from interactions with the child's parents during the extended period ofchildhood dependency.—> Includes internalization of the values, ideals, and moral standards of society.—> Child internalizes moral standards of parents and society.—> Superego consists of the conscience and the ego ideal.—> Conscience refers to capacity for self-evaluation and criticism.—> When moral codes are violated, the conscience punishes the individual by instillingguilt.—> Whatparentsapproveof andwhattheyrewardthechildfordoingbecomeincorporated as the ego ideal by the mechanism of introjecticn.—> The superego strives for perfection rather than pleasure and represents the idealrather than the real.—> Living up to one's ego ideal results in the individual feeling proud and increases self-esteem.
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Pediatrics NCLEX Review Saunders - Page 6 preview image3.Anxiety and defense mechanismsThe ego develops defenses or defense mechanisms to fight off anxiety.Defense mechanisms operate on an unconscious level, except for suppression, so theindividual is not aware of their operation.Defense mechanisms deny, falsify, or distort reality to make it less threatening.An individual cannot survive without defense mechanisms; however, if they become tooextreme in distorting reality, then interference in healthy adjustment and personal growthmay occur.4.Psychosexual stages of developmentHuman development proceeds through a series of stages from infancy to adulthood.Each stage is characterized by the inborn tendency of all individuals to reduce tension andseek pleasure.Each stage is associated with a particular conflict that must be resolved before the childcan move successfully to the next stage.Experiences during the early stages determine an individuals adjustment patterns andthe personality traits that the individual has as an adult.VIII.The Hospitalized Infant and Toddler1.Separation anxietyProtest—> Crying, screaming, searching for a parent; avoidance and rejection of contact withstrangers—> Verbal attacks on others—> Physical fighting; kicking, fighting, biting, hitting, pinchingDespair—> Withdrawn, depressed, uninterested in the environment—> Loss of newly learned skillsDetachment—> Detachment is uncommon and occurs only after lengthy separations from the parent.—> Superficially, the toddler appears to have adjusted to the loss.—> During this phase, the toddler again becomes more interested in the environment,plays with others, and seems to form new relationships; this behavior is a form ofresignation and is not a sign of contentment.—> The toddler detaches from the parents in an effort to escape the emotional pain ofdesiring the parents presence.—> e.Thetoddlercopesbyforming shallowrelationshipswithothers,becomingincreasingly self-centered, and attaching primary importance to material objects.—> f. This is the most serious phase because reversal of the potential adverse effects isless likely to occur once detachment is established. In most situations, the temporaryseparationimposedby hospitalization, doesnotcausesuchprolongedparentalabsence that the toddler enters into detachment.2.Fear of injury and pain: Affected by previous experiences, separation from parents, andpreparation for the experience.3.Loss of controlHospitalization, with its own set of rituals and routines, can severely disrupt the life of atoddler.The lack of control often is exhibited in behaviors related to feeding, toileting, playing, andbedtime.The toddler may demonstrate regression.
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