Skip to content
Class Notes

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.

Preview 6 of 17 pages

See the first 6 pages exactly as they appear in the document.

  1. Page 1
    Read page 1 as text

    Saunders' NCLEX Pediatrics Review Growth and Development across the Life Span I. Terms 1. Abuse: The willful infliction of pain, injury, mental anguish, or unreasonable confinement. Abuse can include verbal assaults, the demand to perform demeaning tasks, theft, or mismanagement of personal belongings. Abuse inflicted can be physical, emotional, or sexual. 2. Accommodation: The ability to change a schema (an individual's cognitive structure or framework of thought) to introduce new ideas, objects, or experiences. 3. Aging: The biopsychos octal process of change occurring between birth and death. 4. Assimilation: The ability to incorporate new ideas, objects, and experiences into the framework of one's thoughts. 5. Conscious: All experiences that are part of an individual's awareness and that the individual is able to control. 6. Dementia: An organic syndrome identified by gradual and progressive deterioration in intellectual functioning. Long- and short-term memory loss occur with impairment in judgment, abstract thinking, problem-solving ability, and behavior, resulting in a self-care deficit. A common type of dementia is Alzheimer's disease. 7. Depression: A mood disorder that can be identified by feelings of sadness, hopelessness, and worthlessness, and a decreased interest in activities. 8. Ego: One's 'sense of self'; provides functions such as problem solving, mobilization of defense mechanisms, reality testing, and the capability of functioning independently; the mediator between the id and the superego. 9. Exploitation: Illegal or improper us e of the individual' s res ource s. 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 psychic energy. 12. Neglect: The lack of providing services necessary for physical or mental health; includes failure 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 understand the world. 16. Self-neglect: The choice to avoid medical care or other services that could improve optimal function. Unless declared legally incompetent, an individual has the right to refuse care. 17. Subconscious: Often called the preconscious; includes experiences, thoughts, feelings, or desires that might not be in immediate awareness but can be recalled to consciousness: helps repress 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 available to the conscious mind. n. The Pyramid to Success 1. 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 in identifying appropriate and expected human behavior. 3. The Pyramid to Success focuses on Sigmund Freuds theory of psychosexual development, Jean Piaget's theory of cognitive development, Erik Eriksons psychosocial theory, and Lawrence Kohlberg's theory of moral development.

  2. Page 2
    Read page 2 as text

    4. 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 age group that will ensure a safe and hazard-free environment. 5. When a question is presented on the NCLEX examination, if an age is identified in the question, note the age and think about the associated growth and developmental concepts. 6. The Integrated Processes addressed in this unit include Caring, Communication and Documentation, Nursing Process, and Teaching/Leaming. III. Client Needs 1. Safe and Effective Care Environment • Acting as a client advocate • Consulting with members of the health care team • Establishing priorities • Maintaining confidentiality • Preventing accidents • Providing care following ethical and legal standards • Respecting client and family needs based on their preferences • Upholding chent's rights 2. Health Promotion and Maintenance • Assisting with family planning • Discussing lifestyle choices • Identifying changes that occur as a result of the aging process • Identifying developmental stages and transitions • Identifying expected body image changes • Maintaining health and wellness • Monitoring growth and development • Providing client and family education • Respecting health care behefs and preferences 3. Psychosocial Integrity • Assessing for abuse and neglect • Considering grief and loss issues with the older client • Identifying coping mechanisms • Identifying loss of quantity and quality of relationships with the older chent Identifying support systems » Monitoring for adjustment to potential deterioration in physical and mental health and well-being in the older chent • Monitoring for changes and adjustment in role function in the older client (threat to independent functioning). • Monitoring for sensory and perceptual alterations • Providing resources for the chent and family 4. Physiological Integrity • Administering 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 health ■ care beliefs, education level, and language.

  3. Page 3
    Read page 3 as text

    IV. Psychosocial Development and Erik Erikson 1. The theory • Eriksen s theory of psychosocial development describes the human hfe cycle as a series of eight 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) later in life. • The theory focuses on psychosocial tasks that are accomplished throughout the hfe cycle 2. Psychosocial development • Occurs through a lifelong series of conflicts affected by social and cultural factors. E • Each 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 Piaget 1. The theory • Piaget's theory of cognitive development defines cognitive acts as ways in which the mind organizes 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 and understand the world. —> A young child has only a few schemata with which to understand the world, and gradually 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 the framework of one's thoughts. —> The growing child will perceive and give meaning to new information according to what is already known and understood. • Accommodation —> Accommodation is the ability to change a schema to introduce new ideas, objects, or experiences. —> Accommodation changes the mental structure so that new experiences can be added. 2. Stages of cognitive development • Sensorimotor stage —> Birth to 2 years _> Development proceeds from reflex activity to imagining and solving problems through the 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, even if out of their visual field. • Preoperational stage —> 2 to 7 years —> The child leams to think in terms of past, present, and future. —> The child moves from knowing the world through sensation and movement to prelogical thinking and finding solutions to problems. —> The child is egocentric. —> The child is unable to conceptualize and requires concrete examples.

  4. Page 4
    Read page 4 as text

    • Concrete 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 Kohlbeig 1. Moral development • Moral development is a comphcated process involving the acceptance of the values and rules 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 or level to the next as they mature. • Stages or levels of moral development cannot be skipped. 2. Levels of moral development VII. Psychosocial Development and Sigmund Freud 1. Components of the theory 2. Levels of awareness • Conscious 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 and that the individual is able to control. —> Consciousness includes all infonnation that is remembered easily and is immediately available to an individual. • Preconscious level of awareness —> The preconscious is called the subconscious. —> The preconscious includes experiences, thoughts, feehngs, or desires that might not be in immediate awareness but can be recalled to consciousness. -> The subconscious can help repress unpleasant thoughts or feelings and can examine and censor certain wishes and thinking. • Unconscious level of awareness —> The unconscious is not logical and is governed by the Pleasure Principle, which refers to seeking immediate tension reduction. —> Memories, feehngs, thoughts, or wishes are repressed and are not available to the conscious mind. —> These repressed memories, thoughts, or feehngs, if made prematurely conscious, can cause anxiety. 2. Agencies of the mind • Id, 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 the leadership of the ego.

  5. Page 5
    Read page 5 as text

    The 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 return to a more comfortable, constant level of energy. —> Acts immediately in an impulsive, irrational way and pays no attention to the consequences of its actions; therefore, often behaves in ways harmful to self and others. —> The primary process is a psychological activity in which the id attempts to reduce tension. —> The primary process can include hallucinating or forming an image of the object that will satisfy its needs and remove the tension. —> The primary process by itself is not capable of reducing tension; therefore, a secondary psychological 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 external world. —> Emerges because the needs, wishes, and demands of the id require appropriate exchanges 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 ego follows the Reality Principle and operates by means of the secondary process—that is, realistic thinking. —> The aim of the Reality Principle is to satisfy the id's impulses in the external world with an object that is suitable; the Reality Principle determines whether an experience is 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 will work. The superego —> Necessary part of sociahzation that develops during the phallic stage at 3 to 6 years of age. —> Develops from interactions with the child's parents during the extended period of childhood 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 instilling guilt. —> What parents approve of and what they reward the child for doing become incorporated as the ego ideal by the mechanism of introjecticn. —> The superego strives for perfection rather than pleasure and represents the ideal rather than the real. —> Living up to one's ego ideal results in the individual feeling proud and increases self- esteem.

  6. Page 6
    Read page 6 as text

    3. Anxiety and defense mechanisms • The ego develops defenses or defense mechanisms to fight off anxiety. • Defense mechanisms operate on an unconscious level, except for suppression, so the individual 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 too extreme in distorting reality, then interference in healthy adjustment and personal growth may occur. 4. Psychosexual stages of development • Human 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 and seek pleasure. • Each stage is associated with a particular conflict that must be resolved before the child can move successfully to the next stage. • Experiences during the early stages determine an individuals adjustment patterns and the personality traits that the individual has as an adult. VIII. The Hospitalized Infant and Toddler 1. Separation anxiety • Protest —> Crying, screaming, searching for a parent; avoidance and rejection of contact with strangers —> Verbal attacks on others —> Physical fighting; kicking, fighting, biting, hitting, pinching • Despair —> Withdrawn, depressed, uninterested in the environment —> Loss of newly learned skills • Detachment —> 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 of resignation and is not a sign of contentment. —> The toddler detaches from the parents in an effort to escape the emotional pain of desiring the parents presence. —> e. The toddler copes by forming shallow relationships with others, becoming increasingly self-centered, and attaching primary importance to material objects. —> f. This is the most serious phase because reversal of the potential adverse effects is less likely to occur once detachment is established. In most situations, the temporary separation imposed by hospitalization, does not cause such prolonged parental absence that the toddler enters into detachment. 2. Fear of injury and pain: Affected by previous experiences, separation from parents, and preparation for the experience. 3. Loss of control • Hospitalization, with its own set of rituals and routines, can severely disrupt the life of a toddler. • The lack of control often is exhibited in behaviors related to feeding, toileting, playing, and bedtime. • The toddler may demonstrate regression.

11 more pages in the full document

Unlock it once and it stays in your library, ready to chat with or turn into flashcards.

Unlock the full document

More National Council Licensure Examination study materials

See all

Study this document with CramX

Once it is in your library, every tool can work from it.