Principle of growth and development

Children may vary among each othe i their rate of growth and dvelopment. But stil all of them follow certain principles as follow.

• Growth and development is a continuos prcess from conception to adolescence. The rate of growth varie at different ags. During prnatal d infancy period the eate of growth is very rapid. This growth rat gradully declines during early childhood During te middle hilhood the growth rate is slo. the growth rate again becomes rapid durn puberly. Thus infancy and puberty ar two specific periods of rapid growth.
• The development takes place:

a.  In the cephalo-caudal directin.That means development proceeds from head to toe. For example the first step towards walking  is head control then sitting abilility.

b. Fom general to specific: That means general development takes place before special development. For example during skill development the gross motor skills will be developed before fine motor skills.

Developmental Tasks

In the process of physical growth and the development of abilities and skills the children are expected to carry out certain responsibilities or tasks at certain stages of dvelopment. These tasks are called developmental tasks. Havighurst, a psychologist, has defined the developmental task as "the task which arieses at certain periods in the life of an individual, the successful accomplishment of which leads to satisfaction and success with later tasks while the failure leads to dissatisfaction and difficulty with later life."  Some of these developmental tasks arise out of physical maturation e.g. learnng to sit, stand or walk. Wereas other developmental taks arise from social pressure e.g. learning to play , speak, read etc. and some developmental tasks arise out of personal values and desires e.g. preparing for a vocation.

Purposes of developmental tasks

•  Developmental taks serve as guidelines to know what the chiild is expected to do at different ages.
• Developmental tasks enable the parents to motivate children to do what is expected of them.

Developmental taks enable the parents to know what lie ahead and what the child is expected to do in the successive stages.

Growth and Development

Growth and develpoment are two improtant characteristics of human begings. The term growth and development generally refers to the process by which the fertilised ovum develops into a mature adult. This maturation occurs through successive changes in both physical structure and functional abilities.

Growth is an essential feature of childhood. Growth refers to physical matureation. In other words, its is the increase in size of the body resulting from increase in the number and size of the cells of body. The increase in body size leads the child to be taller, broader and heavier. These changes in height and breadth (eg. head circumference) can be measured in terms of centimetres or inches and the heaviness or weight in terms of kilogram or pounds. Thus growth is a quantitative change and can be measured easily.

In general the rate of growth is more important than the actual size of the child . so to assess the growth rate, the measurement of height and weight shuld be done at regular intervals.

Development is defined as th functional or physiological maturation that follows physical maturation. In ohter words it is the acquisition of skills and the ability to adopt to environment. It is measured in terms of various behavioural achievemetns or abilities known as milestones. Development is complex qualitative change. Hence it is difficult to measure.

Characteristics of a Child

A child is not a miniature adult but a unique individual wih special needs and qualities. An Adult is a mature being in terms of body structure and functions whereas a child is at a varying stage f rowth and development from birth to adolescence. That means he is an immature inividual in erms of his body structure and functions necessitating a different kind of care. The characteristics of children can be discussed under the follwoing heaidngs.

1. 
   
   body structure
2. 
   
   physiological processess
3. 
   
   intellectual abilites
4. 
   
   emotional responses.

Body structure

In relation to body structure, the proportional size of the body parts is an important feature. For example an infant has a heavier and bigger head in comparison to his body size and weight. It makes handling of infants different from older children and adults. The infants head must  be supported while holding or lifting him. Injury to head can occur more commonly in infants than in the older children.

In neonates the skull bones are joined by membranous spaces called sutures and fontanelle. So any increase in the intracranial pressure in infant causes the suture lines to be widened and fontanelle to be bulged out, thereby increasing the size of the head. But in older children and adults increase in intracranial pressure does not increase the size of the head.

Physiological processes

The difference in the physiological characteristics of childrean at different ages makes it necessary to provide different kinds of care to children at the different ages.

In terms of unit body weight, younger children need more nutritious food than older children because of their rapid growth rate, increased level of body activity and high basal metabolic rate. If young children do not get adequate food, they develop nutritionla deficiencies such as marasums, kwashiorkor, rickets, xerophthalmia etc. much more rapidly that in the older children.

Child care in early civilization

Value of children changed gradually as people started settling in the fertile lands. Some cultures valued physical beauty as an essential characteristics of person. These people cared for children well so that the children would have well formed bodies.

Some cultures valued large families as a blessing of god. Children in these cultures were considered as the gifts of god and so were taken care of well. Some cultures valued cleanliness and food as essential in life. These practices influenced greatly on the health of mother and child.

Historical overview of  child care
The knowledge of historical trend in child care helps to understand the present care in the light of the past and it enables one to determine the fututre direction for better care.
Care of the child at any period is believed to be influenced by the people's way of living, their belief about health and their values for their children.

Child health status

Health is a complex phenomena. According to World Health Organization, health is not merely the absence of disease of infirmity but is a stateof complete physical, mental and social well being. From this definition child health means a state of physical, mental and social harmony of the child which pro,otes his ottimum growth and development. However in estimating the health status of children in a country, the commonly used indicators are the absence commonly used indicators are the absence of disease (ie morbidity ) a death ( mortality)

The IMR can be divided into neonatal mortality rate (NMR) and post neonatal mortality rate ( PNMR). The NMR includes death of children less that 28 days of age and PNMR includes death of children from 28 days until 1 year of age.

Role of the paediatric nurse

Nursing care of children aims at achieving the highest possible health in children and promoting their optimum growth and development. In rder to achieve this aim, the paediatric nurse should play multiple roles as depicted in the following.

Care Provider

As a care provider , the nurese is responsible to care for the sick children in meeting their physical and emotionl needs. The responsibility to administer the prescribed medicines and treatments also falls on her. She is held accountalbe for all her nursing actions. So she must carry out her responsibilites with knowledge and dedication.

To demonstrate her sense of accountablity,she should use nursing process in her care. The use of nursing process enables her:

• to assess each child's need through nistory taking and physical examination.
• to identify the health needs of the child
• to plan and implement nursing ations
• to evaluate the outcome of nursing actions

A child specially the young one, is totally dependent on his parents or care givers to fulfill his basic needs such as food, toileting and clothing. So the parents should be included in the care of their children as far as possible.This enhances their responsibility as parents and help to build their confidence in child care at home.

Health Educator

Health education is oneof the important roles of the nurse. health education of children aims at giving essentail health information to the parents and guardians for the promotion and maintenance of the health of children. health education arouses awareness of the parents regarding child care and influences their child care practive . Some of the important topics of health education are:

• child's nutrition
• immunisation
• prevention of accidents
• personal adn environmental hygiene
• oral rehydration therapy
• child spacing

Introduction to child care

Child is a young human being who has not reache the age of discretion or maturation. This literally childhood is the period from the birth until the achieves full maturation: physically, mentally and socially. the period of childhood ends with the initiation o adulthood period.
The branch of medicine dealing with children is called paediatrics. The term paediatrics is derived from the Greek words "paidos", "iatrike" and "ics". The word "paidos" means a child, iatrike" means treatment and "ics" means science. The paediatrics means the science of child care and treatment of childhood diseases. Since the intrauterine health of child greatly affects his extrauterine health, the intrauterine period of the child is also included in paediatrics. thus, broadly speaking the term paediatrics would mean the study of the child from conception to adolescence.

The specialist doctor who treats children is called paediatrician. The intra uterine health of the child is usually taken care by the obstetrician andmidwife through regular antenatal care.
Paediatric nursing is the branch of nursing that is concerned with the care of children not only during illness but also during health by providng preventive care to them.