Health promotion of the School age Child
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When is the beginning and end of the school age years?
- 6-12 years
- Begins with the shedding of first deciduous teeth and ends at puberty with acquisition of final permanent teeth (28-32)
What biological development occurs during the school age years?
- Height increase 2in/yr
- Weight increase 2-3 kg/yr
- Males and females begin to differ in size, with females maturing faster
How do the different body systems mature during the school age years?
- Bladder capacity increases (larger in females)
- heart smaller in relation to the rest of body
- Immune system increasingly effective
- Bones increase in ossification
- Physical maturity not necessarily correlated with emotional and social maturity
What is prepubescence?
- Defined as the 2yrs preceding puberty
- Typically occurs during preadolescence
- Varies from ages 9-12 (female about 2 yrs earlier than body)
What Freudian period is the school age child in?
- Relationships center around same-sex peers
- Freud describes this time as the latency period of psychosexual development
What Erikson stage is the school age child in?
- Industry v. Inferiority
- Eager to develop skills and participate in meaningful and socially useful work
- Acquire sense of personal and interpersonal competence
- Growing sense of independence
- Peer approval is a strong motivator, but family is still the strongest motivator of values
- Inferiority may derive from self or scoil environment
- Inferiority may occur is incapable or unprepared to succeed at task
- All children will feel some degree of inferiority for a skill they cannot master
What Piaget stage is the school age child in?
- Concrete Operations
- Use thought processes to experience events and actions
- Develop understanding of relationships between things and ideas
- Able to make judgments based on reason (conceptual thinking)
- Able to solve problems, able to master conservation
- Able to see other's viewpoints
How does the school age child develop morally?
- Development of conscience and moral standards
- Age 6-7: reward and punishment guide choices
- Older School Age: able to judge an act by the intentions that prompted it
- Rules and judgements become more founded on the needs and desires of others
- Can treat others how they want to be treated
How does the school age child develop spiritually?
- Children think in concrete terms
- Children expect punishment for misbehavior
- May view illness or injury as punishment for a real or imagined misdeed
- May not understand the concept of death until 9-10 yrs of age
What social development occurs in the school age child?
- Shift to the importance of the peer group
- Identification with peers is a strong influence in child gaining independence from parents
- Sex roles strongly influenced by peer relationships
How does the school age child's relationships with family change?
- Parents are primary influence in shaping the child's personality, behavior, and value system
- Increasing independence from parent is primary goal of middle childhood
- Children are not ready to abandon parental control
What kind of play does the school age child partake in?
- Competitive and Cooperative play (also onlooker play)
- Involves physical skill, intellectual ability, and fantasy
- Form groups, cliques, secret societies
- Rules and ritual
- Quiet games and activities as well as group/competitive sports
- Ego mastery
How does the school age child develop a self-concept?
- A conscience awareness of a variety of self-perceptions (abilities, values, appearance, etc)
- Importance of significant adults in shaping child's self concept
- Positive self-concept leads to feelings of self-respect, self-confidence, and happiness
How does the school age child develop their body image?
- Generally children like physical selves less as they grow older
- Body image influenced by significant others
- Increased awareness of difference may influence feelings of inferiority
- Even more modest than preschoolers
How does the school experience influence the school age child?
- School experience is second to family as a socializing agent
- Transmission go values of the society occurs in school
- Peer relationships become increasingly important
How can you promote nutrition for the school age child?
- A balanced diet is required for adequate growth
- Quality of diet is directly r/t family's pattern of eating
- Fast food and obesity become a concern
- Child should be eating adult size portions by the end of school age
How can you promote sleep and rest for the school age child?
- School age children should be 9.5 hrs of sleep per night (but this is highly individualized)
- May resist bed time during ages 8-11
- 12 years and older are less resistent to bed time
How can you promote exercise and activity in the school age child?
- Kids generally enjoy competition and may participate in competitive sports
- Helps in learning and acquiring skill sets
How can you promote dental health in the school age child?
- Eruption of all permanent teeth by the end of school age
- Needs good dental hygiene and prevention of caries
- Malocclusion may lead to the need for braces or retainer
- If dental avulsion occurs, replace tooth or put in milk and go to DR ASAP
How can promote sexual education in the school age child?
- Sex play is normal part of curiosity during preadolescence
- Middle childhood is the ideal time for sexual education
- Information on sexual maturity and reproduction my be presented
- Establish effective communication with parents
What is the nurse's role in sexual education for school aged children?
- The nurse should treat sex as a normal part of growth and development
- Encourage questions and answers
- Differentiate between sex and sexuality
- Be open for communication with parents
What is the purpose of school health?
- Ongoing assessments, referrals, screenings
- Routine services, emergency care safety and infection control
- Increases knowledge of health and health habits
- Opportunity for teaching both students and parents
How can you prevent injury in the school aged child?
- MVA is the most common cause of severe injury and death
- Teaching on the importance of bike helmets
- Appropriate safety equipment for all sports
- Teach about gun safety
What anticipatory guidance can you provide for families of school aged children?
- Assist parents in adjusting to child's increasing independence
- Parents should provide support as unobtrusively as possible
- The child will move from narrow family relationships to broader world of relationships
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