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DEVELOPING NURSING CARE PLANS

INFANT

Neonatal is the stage from 0-1month old and will exhibit a range of reflexes such as responding to sudden sounds, sucking and grasping, crying and cooing. According to Jean Piaget's stages of development; Birth to 2 years is referred to as Stage 1 - The Sensorimotor Stage. An infant from 1 month until 12 months, at this stage infants develop and learn about their environment through their 5 senses and reflexes. Can feel, taste, smile, kick, suck, sleep and recognize visual images such as parents, by 3mnths can laugh out loud. Infant 3-6 months - makes eye contact, grasps, rolls over, lifts head, sits with support, starts to cut teeth, can make sounds and vocalize and reacts to strangers with anxiety. Infant 9-12 months - gives cuddles, speaks single words, crawls, climb stands, can walk (toddle), will hold a cup to drink and imitates adults actions, they will also express emotions. (Funnel, Koutoukidis, Lawrence, 2009).

TODDLER

This is the earliest stage of childhood and covers the ages of 1-3years. Toddler 1-2 years - First words (3-24 word vocabulary), first (real) steps, tantrums, moves freely, run's, climbs & explores and can identify some parts of their body. At this stage they like to play with other children. During this time a toddler will learn to become more active and independent through toilet training and trying to feed by his/her self. At 2 years a toddler would have quadrupled the birth mass. By 3 years the body systems have matured. A 3 year old can play constructively and interact with peers, they have a vocabulary of 250 - 800 words and can listen to stories. Stage 2 - Preoperational Stage (2-7years), Piaget's theory. (Funnel, Koutoukidis, Lawrence, 2009).

CHILD

From the ages of 3 - 11 or 12 years of age a child can run, talk and feed themselves. Most know their alphabet and can count to 10. During this time children lose their first set of teeth and grow another set. By 5 years children have a vocabulary of 800 - 1500 words and ask how & why questions, they identify colours and can use scissors. Toward the end of childhood the body systems are matured and can adjust to temperate change and stress. During this stage children strongly identify with parents of the same sex (Funnel, Koutoukidis, Lawrence, 2009, 194). A child grows at a rate of 2 -5cm per year and by 12 years weighs on average about 38kg and is on average 150cm tall. Bones continue to ossify and gains increasing control over fine motor and muscular coordination. They are still dependent on parents. Stage 3 - Concrete Operational Stage (7-11years), Piaget's theory. (Funnel, Koutoukidis, Lawrence, 2009).

Role of play in a child's development

Playtime supports and encourages children to share and become social. Children are able to express their thoughts, feeling and ideas through play. Play requires children use all of their senses; looking, touching, smelling, hearing, feeling and tasting. Playtime endorses the 5 domains of child development; Physical, language, social, creative and cognitive

The impact of Hospitalisation for the child and family.

Hospitalization can impact on a child and his/her family tremendously. Some stressors of hospitalization include separation anxiety, fear, loss of autonomy and daily routines and rituals. These can result in a regression of behaviour, negativity or temper tantrums. Parents and siblings can suffer disbelief, anger, guilt, fear, anxiety, frustration and depression. Family roles are often altered affecting all family members. The emotional needs of the family intensifies. (McCaffery & Pasero, 1999).

ADOLESCENCE

Early, middle and late adolescence is from approximately 13 - 20 years. Adolescence is the transition from childhood into adulthood. Psychological maturity is reached by the end of this adolescent stage. During this stage adolescents go through puberty which is when an individual reaches sexual maturity. Reproduction is possible with the increase of hormonal activity and fertility achievement. Major issues during adolescence are individual and group identity, independence, self image and perhaps eating disorders, substance abuse or suicide, hormonal changes and puberty, sexuality, STD's, relationships and peer pressure. (Funnel, Koutoukidis, Lawrence, 2009).

ADULTHOOD

Adulthood like adolescence can be broken down into three phases, early, middle and late adulthood. Early adulthood generally brings maximum health. These are considered prime reproductive years. Middle adulthood occurs between the ages of 45 - 65 years. Physical degeneration brings decreased skin turgor, loss or grey hair and a decrease in muscle mass and joint motion. Menopause and andropause symptoms begin to occur. (Funnel, Koutoukidis, Lawrence, 2009).

OLD AGE

Otherwise known as late adulthood is the final development stage. At 65 years of age we have the degenerative changes and the pathological changes due to ageing. Physically we have wrinkled skin due to loss of subcutaneous fat and collagen. Everything decreases; reflexes, joint movement, sight, hearing, our sense of smell and taste, liver function, bladder control, breast tissue, sperm count, lung expansion, secretion of saliva and digestive enzymes. The body's systems are generally deteriorating with age and so independence is also decreased. (Funnel, Koutoukidis, Lawrence, 2009).

ADULTHOOD

The impact of infertility can cause social and physical devastation. It is common for infertile couples to go through the 5 stages of grief as infertility may not be something that can be fixed. Some couples may experience denial, anger, bargaining, depression, acceptance and sometimes guilt, couples may go through all or just a few of these stages of grief. Infertility can affect a couple's quality of life, marital adjustment is required and sexual frustration can be experienced. Thompson, M. (2009).

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