MN 580 Unit 1 Discussion Growth and Development

The patient who has been selected for this research paper is John, an eleven-year old child, admitted to the pediatric ward due to dehydration secondary to gastroenteritis. The patient had been in the unit for one day. However, the nurses were having difficulties in administering medications to him. According to them, John is afraid of needles. He cries loudly whenever a nurse with a needle approaches him. He also ran out of the unit when he was informed that he was to receive due medications. The nurses also reported that he is highly anxious whenever he sees any healthcare staff in his room. John’s behavior has affected the care he is receiving since he missed intravenous medications in the morning due to his fear of needles alongside healthcare providers dressed in hospital attire.

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

Needle phobia is one of the problems that are witnessed among children and adolescents visiting institutions of healthcare. According to Orenius et al. (2018), needle phobia is the fear of transfusions and injections. Statistics shows that approximately 3.5 to 10% of the population is affected by it. Needle phobia decreases with increase in age. However, it remains the most diagnosed problem among children (19% in those aged between 4 and 6 years and 11% among those aged between 10 and 11 years) (Orenius et al., 2018). Needle phobia presents a significant dilemma to the healthcare providers since it violates the principle of doing no harm or suffering to the patient (Karlsson et al., 214). Therefore, it increases the need for the adoption of interventions that would minimize or eliminate the phobia, hence, the selection of this child.

Growth and Development Stage of the Patient

According to Erickson’s theory of development, individuals go through eight stages of development. They include trust versus mistrust (birth to 12 months), autonomy versus shame and doubt (1-3 years), initiative versus guilt (3-6 years) and industry versus inferiority (6-12 years). It also includes identity versus role confusion (12-18 years), intimacy versus isolation (20-40 years), generativity versus stagnation (40-60 years), and integrity versus despair (above 60 years) (Dunkel & Harbke, 2017). John is in the industry vs. inferiority stage of Erickson’s theory. According to Erickson, this stage of child development is characterized by the child comparing himself with their friends or peers and sees how he measures up. The child can either be self-confident and have pride or feel inferior to others if they do not measure up to their expectations. The child develops pride as he accomplishes most of their aspirations such as sports, family life, and academics. The child will develop low self-esteem if he perceives that he does not measure up to the level of the peers. Therefore, inferiority complex might arise if the child continues to have repetitive negative experiences as they interact with the peers.

Social interactions play an important role in this stage. A child learns to interact with others and feels proud of his accomplishments. He develops a strong self-concept if he/she develops the needed competencies in undertaking their expected roles. Specific aspects should be considered in the child’s learning environment to facilitate successful transition in this stage. One of them is praising the child on small accomplishments and giving the attention he needs in undertaking activities such as reading, solving problems, and drawing. Teachers and parents should also not equate acceptance as well as love to achievement. Instead, unconditional support should be offered to children who experience the challenge of inferiority complex.

Compare and Contrast Patient’s Behavior with Those Cited in Literature

Erickson identified in his theory that the first stage of one’s development is referred as trust versus mistrust. This period begins at the time of birth and ends when a child reaches 1 year. The children interact with their environment and learn to trust their parents. Trust develops when his or her fundamental needs of survival are met. This stage demands that the caregivers demonstrate significant sensitivity and responsiveness to the needs of the infants, as a way of developing their trust. Erickson discovered that mistrust arises when the caregivers become insensitive and unresponsive to the needs of the infants. Such behaviors make the infants become anxious and fear the adults they interact with in their environment (Kropf & Greene, 2017). John appears to have mistrust issues based on the behavior he shows towards the nurses. He does not trust in the care that they provide him in the institution. The lack of trust implies that his early childhood stage might have failed to build his trust towards adults. The type of play activities that a child should engage in during this stage include talking and singing to him, responding to his vocal expressions, and offering colored age-appropriate toys for play.

The second stage of child’s development according to Erickson’s theory is autonomy versus shame and doubt. This stage begins when the child is one year old and ends at three years. The child learns to achieve independence. H/she struggles to do most of the activities for him/herself. Children develop confidence if they navigate this stage successfully. However, self-doubt arises when the child fails to develop the needed independence in becoming initiative. Parents should promote successful navigation of this stage through encouraging the child to engage in activities such as toilet training and enabling them to have control over toy preferences, selection of clothes, and food choices. They should also demonstrate faith in the abilities of their children as a way of building their sense of confidence and autonomy (Kropf & Greene, 2017). It can be seen from the case study that John demonstrates shame and doubt towards the nurses. He doubts them, and is therefore, not only fearful of the needle but also to the nurses too. Some of the play activities that the children can engage in this stage include toilet training, garden activities, and games that develop their imaginative abilities. It is important that parents communicate with the children in a non-judgmental manner to show that they understand their feelings. Children should also be encouraged to express feelings and assisted in the selection of choice of words that demonstrate respect and cultural awareness.

The other stage according to Erickson’s theory is initiative versus guilt. This stage begins at three years and ends at six years. A child develops a sense of control over their world in this stage. Play and social interactions influences the child’s abilities of being assertive in this phase. Children should have the abilities to plan as well as achieve goals in their social interactions in the school. Children who demonstrate self-planning activities navigate this stage successfully and become initiative, ambitious, and responsible. They also become self-confident and have a better understanding of the sense of purpose in their lives. However, children who become unsuccessful develop feelings of guilt (Greene, 2017). John appears to have unsuccessfully navigated this stage. He fears the needles and healthcare providers, which demonstrate a lack of self-confidence, mistrust and guilt. Some of the play activities the child can engage in this stage include sensory exploration with sand and engaging in creative arts such as painting for the development of fine motor skills. Parents should be non-judgmental in their communication. They should help the children understand their abilities. They should also acknowledge the progresses their children make.

Industry versus inferiority is the other stage of Erickson’s theory of development (6-12 years). The child compares their abilities with those of their friends in their learning environment. The self-comparison determines whether the child becomes proud of his/her accomplishments or feels inadequate and inferior to others. Inferiority complex might develop due to continuous or repetitive exposure to negative experiences. The consequences of such exposure include feelings of shame, fear, guilt, and mistrust towards others (Greene, 2017). John appears to experience inferiority issues. He does not trust the healthcare providers. Therefore, it is essential that play activities such as exposure therapy to the things he fears is provided. Social interactions should aim at building the child’s self-worth and esteem. Non-judgmental communication should be used at home and schools to foster feelings of pride and accomplishments. Lastly, social interactions should focus on competency development rather than competition among the peers.

The other stages of development according to Erickson’s theory are identity vs. role confusion, intimacy vs. isolation, generativity vs. isolation, and integrity vs. despair. The identity vs. role confusion stage is characterized by the child trying to develop a feeling of self. Intimacy vs. isolation stage mainly focuses on forming successful relationships. Generativity vs. stagnation entails the adults finding the purpose in the society and contributing to others’ development. Integrity vs. despair is the last phase where adults reflect their lives and either become proud of their accomplishments or regret them. Therefore, it determines the manner in which one ends his or her life. One is likely to end life a bitter person if the life goals were not achieved.

Nursing Diagnosis

Fear of the unknown as evidenced by patient’s nervousness on seeing nurses and tearing on seeing needles.

Goal

To help alleviate patient’s fear towards the nurses and needles within three days of the child’s stay in the unit

Interventions Planned

The interventions that were planned included role-playing, distraction, and desensitization

Actual implementation of Interventions

Role-playing- I role-played with the child on the roles of a nurse in administering injections and handling of toy needles. I used this approach to reduce the child’s anxiety during the actual administration of medications.
Distraction- I engaged the child in activities that diverted his attention while the medication was being administered. This included asking questions such as those related to their favorite food, songs, and teachers.

Desensitization- the use of this approach entailed assisting the child to understand the situations leading to his anxiety, training him on relaxation during injection, and desensitizing the previous experiences by reinforcing positive behaviors.

Patient’s Response to Play

The patient was highly involved in role-playing. He expressed significant interest in holding the toy needles and demonstrating how the nurses have been injecting him. He also participated in injecting some of the nurses in the unit using the needle toys. The patient was happy to engage in the play and it helped him in managing his fear towards the needle and nurses. The use of distraction was also effective. The child was participative in singing his favorite songs during the administration of medications. This helped him in diverting his attention away from the injections and the nurse. The use of desensitization was not effective. The patient was not ready to engage in reflection and using it to address his fear. The ineffectiveness of this approach could have been due to his age.

Evaluation

The patient was able to tolerate needle injections and nurses by the end of three days. He was able to communicate with the nurses without fear. His level of anxiety during the administration of medications was also reduced. The nurses reported that they were finding it easy for them to administer medications since parental involvement was minimal. Therefore, I believe the interventions were effective. The use of desensitization as a play of managing needle fear should explored in relation to use in pediatrics.

References

Dunkel, C. S., & Harbke, C. (2017). A review of measures of Erikson’s stages of psychosocial development: Evidence for a general factor. Journal of Adult Development, 24(1), 58-76.

Greene, R. R. (2017). Eriksonian theory: A developmental approach to ego mastery. In Human behavior theory and social work practice (pp. 107-136). Abingdon, UK: Routledge.

Karlsson, K., Rydström, I., Enskär, K., & Dalheim Englund, A. C. (2014). Nurses’ perspectives on supporting children during needle-related medical procedures. International journal of qualitative studies on health and well-being, 9(1), 23063.

Kropf, N. P., & Greene, R. R. (2017). Erikson’s eight stages of development: Different lenses. In Human Behavior Theory (pp. 75-92). Abingdon, UK: Routledge.

Orenius, T., LicPsych, Säilä, H., Mikola, K., & Ristolainen, L. (2018). Fear of injections and needle phobia among children and adolescents: an overview of psychological, behavioral, and contextual factors. SAGE Open Nursing, 4, 2377960818759442.

This week’s Discussion will address the growth and development of the child from neonate to adolescents, cultural considerations, and the importance of communication with the child and family in respect to age and developmental considerations. This will build a solid knowledge base for the provider when caring for the child.

Your professor will assign you a case to present and, in return, you will reply to your classmates in the other cases in order to promote a robust discussion.

Please complete each initial post in APA format following the Discussion Board grading rubric to include, but not limited to the following:

Apply a principle of human growth and development related to appropriate age group

Apply developmental theory related to age group

Discuss developmental milestones related to the age

Discuss developmental assessment tool related to the age

Apply cultural consideration and cultural assessment to presentation

Case 1: A 6-month-old Haitian male, both parents present at the appointment and the third child for both parents. Child was born at 40 weeks, last seen at 4-month visit and no concerns at that time. Child is smiling, babbling, rolls both from abdomen to back and back to abdomen and sits with support.

Case 2: A 2-year-old Hispanic female, mother and grandmother present at the appointment, first child for mother, sixth grandchild for grandmother. Mother speaks English as primary language; grandmother speaks Spanish as primary language. Last well visit was at 18 months of age and was speaking 20 words total, about 10 in English and 10 in Spanish. Now, mother states that child has about 50 words, with some in English and some in Spanish.

Case 3: A 4-year-old African American male, with mother, father, and paternal grandmother present. Child is here for well check for school entry. Child speaks approximately 100 words and only 50% intelligible.

Case 4: A 7-year-old Mexican American male with mother and maternal grandmother present. Mother has no concerns except grandmother feels the child is “too skinny.”

Case 5: A 14-year-old Caucasian female from single-parent family with father present. Father states that “she has always been healthy but I am worried that something is wrong because she doesn’t talk to me anymore.”

MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments

Unit 2 assignment

Anticipatory Guidance for Neonates to Adolescents Table

MN 580 Unit 1 Discussion Growth and Development

Anticipatory guidance helps family, caregivers, and others know what to expect according to the childâ€™s growth and development. The guidance is done through collaboration between the healthcare provider and the caregiver. It is sometimes thought of as a type of counseling. Nurse practitioners working in pediatric primary care need to be experts on anticipatory guidance. There are excellent resources available and these are being updated as technologies and environments change. MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments.

This Assignment will demonstrate your ability to describe age-specific anticipatory guidance for the child and the family. Additionally, you will then have a reference table for quick glance created by you for future encounters with pediatric individuals and their families.

This assignment has a template that you will use to fill in the relevant elements of the anticipatory guidance per age group. The columns provide guidance to the specific areas such as safety and immunizations. If there is an area that is not applicable, such as oral health in infancy-newborn group, then place N/A in the box.

Check Out Also: NURS 6053 Week 11 Assignment Change Implementation and Management Plan

Submit your assignment to the Unit 2 Dropbox.

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MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments

AGE GROUP	PHYSICAL DEVELOPMENT AND MENTAL HEALTH	NUTRITION AND PHYSICAL ACTIVITY	ORAL HEALTH	SAFETY CONCERNS	IMMUNIZATIONS
Infancy- Newborn Visit
Infancy-First Week Visit
Infancy-1 Month Visit
Infancy-2 Month Visit
Infancy-4 Month Visit
Infancy-6 Month Visit
Infancy-9 Month Visit
Early Childhood-12 Month Visit
Early Childhood-15 Month Visit

Early Childhood-18 Month Visit
Early Childhood-2 Year Visit
Early Childhood-2.5 Year Visit
Early Childhood-3 Year Visit
Early Childhood-4 Year Visit
Middle Childhood-5 and 6 Year Visits
Middle Childhood-7 and 8 Year Visits
Middle Childhood-9 and 10 Year Visits
Early Adolescence-11 to 14 Year Visits
Middle Adolescence-15 to 17 Year Visits
Late Adolescence-18 to 21 Year Visits

Assignment Requirements:

Before finalizing your work, you should:

be sure to read the Assignment description carefully;

consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and

utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);

be well ordered, logical, and unified, as well as original and insightful;

display superior content, organization, style, and mechanics; and

use APA 6th Edition format.

MN 580 FNP II – Primary Care of Children and Adolescents Health

Unit 3 assignment

The i-HumanÂ® scenario below is designed to help you move through a simulated clinical patient scenario. Your work will be scored by i-HUMAN rubric below and transferred to a grade in the gradebook by faculty. This assignment is worth 100 points. MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments.

Grading criteria for assignment are:

History = 30

Physical Exam = 30

Differential Diagnosis = 15

Rank Diff Dx = 5

Must not Miss Diagnoses = 5

Test Selection = 15

The follow up review i-Human Seminar will be held in Unit 4 and is mandatory either by live attendance or review of recording and alternative assignment. This is worth 20 points.

For this activity, you will need to login to your i-Human account. Instructions for logging-in are as follows:

Go to https://ih2.i-human.com/.

Select â€œAssignmentsâ€ from the menu options on the top left of the screen.

Press the green play button next to the I Human Testing Mode Ryan for the case study.

The case study will open; click Start to begin.

Complete all elements of the case study (history, physical exam, assessment, etc.)

Once you have successfully completed the Assignment, take a screenshot of the last screen of the activity, paste it into a Microsoft Word document, save your document, and Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

For help creating a screenshot, visit the website below.

Take a Screenshot. Retrieved from http://www.take-a-screenshot.org

ORDER NOW FOR AN ORIGINAL PAPER

MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments

Unit 5 assignment

i-Human Case

Grading criteria for assignment are:

History = 30

Physical Exam = 30

Differential Diagnosis = 15

Rank Differential Diagnosis = 5

Rank Differential Diagnosis (must not miss) = 5

Lab Tests Ordered = 15

The follow up review i-Human Seminar will be held in Unit 6 and is mandatory either by live attendance or review of recording and alternative assignment. These Seminar is worth 20 points.

For this activity, you will need to login to your i-Human account. Instructions for logging-in are as follows:

Go to https://ih2.i-human.com/.

Select â€œAssignmentsâ€ from the menu options on the top left of the screen.

Press the green play button next to the Johnson for University case study.

The case study will open; click Start to begin. MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments.

Complete all elements of the case study (history, physical exam, assessment, etc.)

For help creating a screenshot, visit the website below.

Take a Screenshot. Retrieved from http://www.take-a-screenshot.org

MN 580 FNP II – Primary Care of Children and Adolescents Health

Unit 6 assignment

Applying Current Evidence Based Practice Guidelines for the Diagnosis and Treatment of Acute Bacterial Sinusitis in Pediatric Patients Using Healthcare Informatics.

This assignment will demonstrate your ability to use healthcare informatics to apply current evidence-based practice guidelines to the management of a pediatric patient diagnosed with acute bacterial sinusitis.

The guidelines that you are to use are in the following article available in the online Purdue Global library.

Hauk, L. (2014). AAP releases guideline on diagnosis and management of acute bacterial sinusitis in children one to 18 years of age. American Family Physician, 89(8), 676-681.

This assignment has a template that you will use to fill in the requested information. MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments.

Please submit to the Dropbox when you have completed your assignment.

	Pediatric Client with Acute Bacterial Sinusitis
List the clinical criteria that must be present to support this diagnosis in pediatric patients from newborn to 21 years of age. Categorize clinical signs and symptoms by: Persistent Symptoms, Severe Onset, or Worsening Symptoms.	List Criteria for Persistent Symptoms.	List Criteria for Severe Onset of Symptoms.	List Criteria for Worsening Symptoms.
When would imaging studies be indicated?
What is the recommended Antibiotic for Child with No Known Allergies? Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).
What is the second line Recommended Antibiotic for Child with allergy to PCN Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).
When is Referral indicated?
What additional medications and or treatment strategies are recommended for treatment or symptomatic control
What is the treatment change in a child with worsening symptoms at 72 hours after initiation of antibiotic
When is outpatient 72 hour â€œobservationâ€ acceptable?
What modifications would be needed for the following children: Four year old who is otherwise healthy
Child with immune deficiency
Child with two prior sinus infections
Child with cystic fibrosis
What other conditions would modify these treatment recommendations?

MN 580 FNP II – Primary Care of Children and Adolescents Health

Unit 7 assignment

Collaboration Paper

This assignment is a formal paper. This includes: APA format, title page, headings, literature review, proper citation per APA, logical sequence, conclusions, clarity, understanding of the topic, and reference list. The paper should be 3-5 pages in length excluding the title page and reference page. The paper must demonstrate independent ideas and conclusions. At a minimum, the following topics must be well articulated in the paper. Remember that discussion of each topic requires citations that are current (less than 5 years old) and relevant. Please refer to the grading rubric for how your paper will be graded. MN 580 FNP II – Primary Care of Children and Adolescents Health Assignments.

Explain how multidisciplinary collaboration can affect clinical decision making.

Discuss how collaboration can lead to improved patient outcomes.

Discuss how lack of collaboration can lead to poor patient outcomes.

Identify three barriers to professional collaboration among healthcare professionals and patients?

What are the five best ways to promote professional collaboration in pediatric primary care?

How can the nurse practitioner encourage and support collaboration among the patient, family, caregivers, and healthcare professionals?

Assignment Requirements:

Before finalizing your work, you should:

be sure to read the Assignment description carefully (as displayed above);

consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and

utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);

be well ordered, logical, and unified, as well as original and insightful;

display superior content, organization, style, and mechanics; and

use APA 6th Edition format.

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.