Caring for Infants and Children
Objectives:
After you take this class, you will be able to:
- Discuss infants, toddler, pre-school children, school age children and teenagers in terms of their physical and mental state.
- Change the way you care for infants and children, as based on their own age group.
- Maintain safety and comfort for infants and children.
INTRODUCTION
Nursing assistants and other health care workers must know how to care for babies and children. This care must meet the special needs of these age groups.
Nursing assistants, nurses and many others get a lot of joy as they care for children but there are also a lot of challenges.
Infants, toddlers, pre-school children, school age children and teenagers all have their own age related needs. These needs are best met when nursing assistants, nurses and many other health care providers know about the normal growth and development process that children go through. We must know how the needs of these age groups affect the care we give.
THE AGE GROUPS
Infants and children have many age related needs. These patients belong to one of these are groups:
- INFANTS- Birth to 1 year
- TODDLER- 1 to 3 years
- PRE-SCHOOL CHILD- 3 to 5 years
- SCHOOL CHILD- 5 to 12 years
- ADOLESCENT (TEENAGER)- 12 to 18 years
A new baby is an infant from the minute they are born until they have their 1st birthday. They are a toddler after their 1st birthday and until they are 3 years of age. These young children begin to walk and toddle around the house.
From the age of 3 until 5, a child is in the pre-school age group. The young child has not yet started the first grade of school. From 5 to 12 years of age, the child is considered a school age child.
The last stage of childhood is adolescence. A boy or girl is a teenager, or adolescent, from 12 to 18 years of age. After the age of 18, the child is considered a young adult and able to make legal decisions of their own.
This class will teach you about infants, toddlers, pre-school children, school age children, adolescents and their needs. If you would like to learn about the elderly, take the class called Caring for the Elderly.
HOW INFANTS & CHILDREN DEVELOP AND GROW
Erik Erikson, a psychologist, taught us about the 8 major developmental stages that human beings go through during their life. Each one of these stages has some tasks, or things, that every person must do when they are in each age group.
Nursing assistants and other health care providers must know about the major tasks for each of the age groups. For example, nursing assistants who take care of adolescents must know that teenagers have to form their own identity. They have to form their own sense of self and who they are.
A teenager's sense of self must be encouraged when they are in the hospital or home ill for a long period of time. When this age group is in the hospital they are not with their friends. Their group of friends helps them define who they are. Friends have become much more important to the teenager than their own family.
Things that each age group must do are listed below for the infant, toddler, pre-school child, school age child and adolescent.
- Infants- learn how to trust others. They are not yet able to do anything for themselves. They depend on others to feed them and to keep them safe. They need to be loved. They need others to keep them clean and dry. They must feel that their needs will be met as soon as they begin to cry.
- Toddlers- begin to take care of themselves and do things on their own. They learn to control themselves and what they do. They learn how to walk around, feed themselves, use the toilet and control their own behavior. This age group does not like to be frustrated. They also want to be with their parents. They do not like people that they do not know.
- Pre-School Children- start to act with a purpose and a goal. They begin to feel happy about what they can do. This age group is afraid of being punished and rejected.
- School Age Children- want to be confident. They want to do well in school. They try very hard to please their teachers and their parents. School age children want to feel that they are competent and able to do things on their own.
- Adolescents, or Teenagers- want to be a part of a group. They need to have a sense of self and know who they are. They form their own identity when they belong to a group. Also, they often rebel against their parents.
HOW INFANTS & CHILDREN LEARN AND UNDERSTAND
Jean Piaget, another psychologist, is a well-known expert on how human beings learn from birth until the age of about 15. Usually, children by the age of 15 have fully developed their ability to learn in a complete adult way.
Teenagers at 15 years of age no longer have to see a picture of a beach ball in a book in order to read and understand the word "ball" in the book. They can read the word "ball" and have a picture of a ball in their mind without seeing an actual ball on their desk or in a book. Children that are 12 to 15 years of age are also able to subtract numbers on paper without having to use concrete objects like pennies to add, subtract, multiply and divide.
Below are the stages of learning and thinking ability that begin immediately after birth and continue to grow until the child reaches the age of about 15.
Pre-Operations. During the pre-operational stage, the young child is not yet able to do concrete operations like adding and subtracting even if they are using marbles or other concrete objects.
Concrete Operations. The child in this stage is not able to think or learn in an abstract way. They can, however, add simple numbers when they have concrete objects, such as marbles or pennies, to use. For example, they are able to learn that 2 pennies and 3 pennies adds up to be 5 pennies with they move and count the pennies. These young children also begin to understand the meaning of written numbers and words.
Formal Operations. During this stage the child is able to see the numbers 3 and 2 on paper and understand that adding these two numbers together will be 5. They can now add, subtract, multiply and divide in an abstract way, that is, they no longer need concrete objects to do it. They also understand the meaning of words as they read. They no longer need picture books or concrete objects to understand the meaning of a word.
Nursing assistants should know about how children learn. Knowing about the learning stage of the child helps us to speak with them and to instruct them in a way that they understand.
From birth until about the age of 2, young children learn how to separate themselves from the things and people around them. They begin to touch and control some objects.
During the Preoperational Stage, toddlers and pre-school children begin to speak and communicate with others using words. They learn how to count. They begin to understand the meaning of each number and word. They test things and they try new things. They are very curious. They like to discover new things.
Children at this age ask a lot of "why" questions. They ask, "Why is the sky blue?" "How do trains run down the track?"
At about 7, the child begins to reason and think things out logically. Between the ages of 12 and 15, the child finally thinks and learns in an adult way. Their thinking growth is complete. They are ready for the life that is ahead of them.
Keeping Children Safe
Safety is one of the most basic human needs. Children and old adults have the GREATEST safety needs. For example, infants will put almost anything in their mouth, including poison and small things that they can choke on. We must, therefore, prevent poisoning and choking by keeping dangerous things away from infants and small children. Old adults may also put harmful things in their mouth. Some times older adults may over dose on their own medications or drink dangerous home cleaners when they are confused. They also have to be kept safe.
In addition to putting strange things in their mouth, infants and young children also do NOT know the difference between things that are safe and those that are not. They are very curious and they will try just about anything. They have little or no fear about getting hurt. It is our job to watch them very closely so they do not injure themselves while we are taking care of them in the home or in the hospital.
Nutrition & Hydration for Infants and Children
Nutritional and hydration needs also change as a person ages. Infants, teenagers, pregnant women and women who are breastfeeding their child need more calories than the other age groups.
Infants need extra iron and the fats from whole milk, formula or breast milk. Infants get baby foods at about 4 to 6 months of age starting with cereal. New foods should be added slowly and ONE at a time so that new foods that cause problems can be identified right away.
Toddlers like to eat foods that they can pick up with their hands and eat. They start to use cups instead of bottles. They may even begin to use a spoon to feed themself. Pre-school children start to decide what foods they like and dislike. They use a fork, knife and spoon to eat.
School age children like "fast food" and eating with friends.
Teenagers need extra calories, protein, calcium, iron, iodine and B complex vitamins for their growth. They often do not get a good diet. They eat a lot of snacks and "fast food". They also do not stick to regular meal times. Many teenagers develop eating disorders that can lead to poor health and even death.
Special Care for Infants and Children
Nursing assistants and other healthcare providers must change the way they provide care, as based on the age group of the patient. For example, an infant is not able to learn about the care they are getting. We must, therefore, tell the family or care giver about the care the patient is getting.
The Special Needs of Infants
Infants need frequent small feedings. They have to be kept warm with a blanket and proper clothing because their body is not yet able to control its own temperature. Infants can also become dehydrated very quickly, especially if they have diarrhea or vomiting. They have to be kept safe and away from infections because their body is not able to fight off infections as older children and adults can.
The vital signs of the infant are also different from those of the adult. The usual vital signs are as follows:
- Pulse- 100 to 160 per minute
- Respirations- 30 to 60 per minute
- Blood Pressure- 50 to 100/25 to 70
Infants must be held, cuddled and touched. It is important to let the parents have close contact with the infant so that the baby bonds and gets attached to the parents. The mother, father, sisters and brothers are the most important people to them. They do NOT want to be separated from them. They often cry when the parents are not seen. We should encourage the family members to stay with the infant and young child whenever this is possible. We should also help the family to care for the sick infant or child.
Infants have to learn how to trust others. We must meet their needs immediately so that this trust can be developed.
Infants must NEVER be left alone unless they are in a safe crib with the side rails up. They should be placed on their back and WITHOUT any pillows when they sleep. Medications, small objects and other items that are not safe MUST be kept out of their reach. When the infant or young child leaves the hospital, a safe and approved car seat must be used.
The Special Needs of Toddlers
Toddlers learn how to walk, run and climb. They have a lot of energy. They must be protected from injuries. They begin to play with blocks and color with large crayons. They like to sit side by side with another child as they play. This age group starts to communicate their needs to others using words instead of crying.
Toddlers begin to ask the nursing assistant questions about their care and their illness. We must answer these questions in a way that the toddler, or young child, can understand. Since the toddler and the young child have a very short attention span, we should explain things to these patients in a very simple and short way. It is good to use dolls, puppets and story books as you talk to the young child.
This age group will also cry when they are separated from their parents. Parents are the most important people to them. They want the love and approval of the parents.
They do not like people that they do not know, including nursing assistants. We should, therefore, let the parents stay with the child as much as possible.
The Special Needs of Pre-School Children
During this stage of life, the child can better deal with being away from their parents. They are able to speak to others and tell them what they want or need.
These young children ask a lot of "Why" questions. They like to learn new things. Nursing assistants should answer their questions in an honest way and in a way that the child can understand.
The preschool child learns their name, address and phone number. They, too, have a lot of energy and must be watched closely. They often get hurt and injured. They need a safe place to live, play and sleep.
At times, these young children are afraid of the dark. Some have nightmares. The care giver should comfort them when they are afraid.
Preschool children have food likes and dislikes. They can feed themselves. They also start to take care of some of their basic needs. For example, they are able to get dressed on their own.
The Special Needs of School Age Children
This age group likes to do well in school. They also like to please others. They can help around the house and take care of themselves. Friends are important to them.
This age group has a little knowledge about the human body and how it works. They are able to understand their illness if we explain the illness and their care in clear words that they can understand. They can also do some of their own personal care.
The Special Needs of Teens
Teens (adolescents) like to be their own person. They often rebel against their parents and other people in their life, like their school teachers. They often show anger. Sometimes, they break rules and laws.
Their friends are the most important group to them. They are not happy when they are not with their friends. This age group wants to look and dress nicely. They want to be liked by their group of friends. This gives them a sense of self. They also like the opposite sex. Healthcare providers must give them privacy and time with their friends. We also have to watch them so that they do not use alcohol, cigarettes and illegal drugs.
Some teens become sad and depressed. Suicide rates are high in this age group.
Teenagers like to eat "fast foods" with loud music and friends rather than good meals at home with their family. Their diet is very often NOT good.
Summary
Infants, toddlers, pre-school children, school age children and teenagers all have their own age related needs. These needs are best met when nursing assistants, nurses and many other health care providers know about their special needs and know how to take care of them.
References
Alspach JG. (1996). A Framework for Assessing Age Related Competency: Distinguishing Attributes of Various Age Groups.Pensacola, Florida: National Nursing Staff Development Organization.
Berman, Audrey, Shirlee Snyder, Barbara Kozier and Glenora Erb. (2010). Kozier & Erb's Fundamentals of Nursing: Concepts, Process, and Practice. 8th Edition. Pearson Prentice Hall.
Erikson E. (1963). Childhood and Society 2nd Edition. New York: WW Norton.
Hockenberry, Marilyn J. and David Wilson. (2010).Wong's Essentials of Pediatric Nursing. 8th Edition. Elsevier Mosby.
Kee, Joyce LeFever and Evelyn Hayes. (2009). Pharmacology: A Nursing Process Approach 6th Edition. Saunders Elsevier
Monahan, Frances Donovan and Wilma J. Phipps (2007). Phipps’ Medical-Surgical Nursing: Health and Illness Perspectives. 8th Edition. Elsevier Mosby.
Nettina, Sandra M. (2009). The Lippincott Manual of Nursing Practice. 7th Ed. Lippincott, Williams and Wilkins.
Schuster C and Ashburn S. (1992). The Process of Human Development: A Holistic Life Span Approach. Boston: Lippincott, Williams and Wilkins.
Sheehy Gail. (1995). New Passages: Mapping Your Life across Time. New York: Ballantine Books.
Copyright © 2010 Alene Burke