NUR 505 Homework Assignment for Unit 7 Readings-Answer key

1. Physical Changes and Maturation of Systems: Please describe the biological maturations that are happening in each body system (focus on what is changing instead of what is staying the same, and make sure to include the changes of prepubescence):

SystemBiological Maturations

NeuroSkull and brain grow very slowly during this time period.

GI/GUGains an average of 5cm and 2-3 kg per year. Fat gradually diminishes and its distribution pattern changes. GI system matures, leading to a decrease in upset stomach, better maintenance of blood sugar levels. Stomach capacity continues to increase, which allows for longer periods in between feedings. All deciduous teeth are lost during this time period.

RespiratoryRR decreases (normal is 14-22).

CardiacHR decreases (normal is 70-110 until age 10 then 55-90 from ages 10-12, or the range of 60-95 for all school-age is acceptable as well). BP increases (normal avg. is 90-110 for SBP and 55-65 for DBP).

ImmuneImmune system becomes more competent in localizing infections and producing a coordinated antibody-antigen response.

MusculoskeletalPosture improves, skeletal lengthening occurs, increase in % of body weight represented by muscle tissue, leading to an increase in strength and physical capabilities although muscles are still immature when compared to adolescents and adults (higher risk for overuse injury compared to adolescents). Head and waist circumference are decreased in relation to height; leg length is increased in relation to height. Bones continue to ossify throughout childhood.

2. Please summarize the nutritional needs of school-age children. Caloric needs are diminished in r/t body size. Should have a balanced diet with all the food groups, with an emphasis on nutrient-dense foods such as grain products, vegetables, and fruits; lean proteins; calcium-rich food; and foods that are low in fat, saturated fat, sugar, salt and cholesterol. The National school lunch and school breakfast programs can help children meet their nutritional needs if not able to be met at home. These programs are helpful but are not perfect by any means. 3. Please detail the sleep needs of school-age children.

Highly individualized. Depends on the age, activity level, and other factors such as health status. Growth rate has slowed; therefore less energy is expended in growth than during the preceding periods. Sleep requirements decrease during school-age years, going from 11 hours at 5 years of age to 9 hours of sleep at 12-13 years of age.

4. Please detail dental health needs of school-age children.

Go from having 20 deciduous teeth to having 28 secondary teeth during this time period. The first deciduous tooth is usually shed around 5-6 years of age. The first molar appears b/w ages 6-7 and the second molar b/w ages 11-13 on average. Continue to need supervision with brushing and assistance with flossing until later in the school-age period. Are not as restricted on amount of toothpaste as they can spit it out at these ages. Other dental health care needs are similar to toddlers/preschoolers in terms of avoiding cariogenic food, type of brush used (soft nylon), timing for brushing (after any food ingestion and before bed), and dental visits (usually every 6 months).

5. Please list the injuries that are most common in the school-age period, along with nursing interventions that could help prevent each of them (some could be copied from your other lists, but please make sure your interventions are specific to this growth and development stagei.e. take out nursing interventions that no longer apply and add the nursing interventions that now do apply).

MVA- Should be in a booster seat until they are 4ft 9in in height. Should wear a seat belt at all times. Should not ride in the bed of a truck. Should use passenger door/window locks if equipped (newer cars all have this). Should not ride in the front seat with an airbag prior to age 13.

Emphasize pedestrian safety (crossing at crosswalks, waiting for the walk signal, looking both ways before crossing the street, walking against the flow of traffic if no sidewalks are available). Children are playing in the street more at this age, need to educate on watching for cars while playing if a safer area is not available.

Bikes are also being ridden more in this age group, as are other wheeled activities such as skateboards, rollerblades, etc. Need to educate on helmet use with proper fit (helmets should have a seal of approval from the U.S Consumer Product Safety Commission and be replaced if the child crashes); bike safety such as use of reflectors and proper hand signals, proper fit of bike to childs height (balls of the feet should touch when on the seat and the feet should be able to be placed on the ground when straddling the center bar). Other safety equipment may be appropriate depending on the sport (knee pads, elbow pads).

Should caution against the operation of other power vehicles such as ATVs, rider lawnmowers, and snowmobiles.

Drowning-Many children can swim in this age-group, so the risk of drowning is less but is still present. The child should be taught how to swim if they have not already learned, taught the basic rules of water safety such as only swimming in safe and supervised places and never swimming alone. Should use approved floatation devices if needed when swimming and at all times when in a boat. Fencing should still be around pools.

Burns- Similar to previous ages, although now the child might be helping cook so safety while cooking/grilling should be taught. The child can now be taught what to do in case of a fire (fire drills, stop/drop/roll). Children should always be supervised when around things that can cause burns (firecrackers, bonfires or barbecues, when around chemicals in school).

Poisoning- Similar to previous ages in that child-safety lids should be present on all medications and substances that can cause poisoning should be kept out of reach of all children. Teaching should now extend to illicit drug use and alcohol consumption (towards the middle of school-age period).

Bodily Damage- Similar to previous ages, but should now incorporate sports/play safety and also cautioning against risk-taking behaviors. See table 17-2 for specific interventions to protect against bodily harm.