NCLEX Review Guide: Growth & Development and Preventive Pediatric Health Care

Key Definitions

• Growth refers to quantitative changes in size, weight, and height that can be measured objectively.
• Development involves qualitative changes in function, skills, and abilities including cognitive, social, and emotional progress.
• Growth and development occur simultaneously but at different rates throughout childhood.

Infant (0-12 months)

• Motor skills: Rolls over by 4-6 months, sits without support by 6-8 months, walks by 12-15 months.
• Cognitive: Object permanence develops around 8-10 months; stranger anxiety peaks at 8-9 months.
• Language: First words typically emerge by 10-12 months; babbling begins around 6 months.

Toddler (1-3 years)

• Autonomy vs. Shame (Erikson): Toddlers develop independence while learning self-control and confidence.
• Language explosion: Vocabulary increases from 50 words at 18 months to 1000+ words by age 3.
• Toilet training: Usually begins between 18-24 months when child shows readiness signs.

Preschooler (3-6 years)

• Initiative vs. Guilt (Erikson): Children learn to plan activities and tackle new challenges.
• Magical thinking: Believes thoughts can cause events; may feel responsible for illness or divorce.
• Cooperative play: Begins to play with others and follow simple rules.

School-age (6-12 years)

• Industry vs. Inferiority (Erikson): Focus on developing competence in academic and social skills.
• Concrete operational thinking (Piaget): Can think logically about concrete objects and situations.
• Peer relationships: Same-sex friendships become increasingly important.

Well-Child Visit Schedule

1. Newborn to 6 months: Visits at birth, 3-5 days, 1, 2, 4, and 6 months
2. 6 months to 2 years: Visits at 9, 12, 15, 18, and 24 months
3. 2-6 years: Annual visits at 2, 3, 4, 5, and 6 years
4. School-age and beyond: Annual visits with additional visits as needed

Immunization Schedule Highlights

• Birth: Hepatitis B vaccine (first dose within 24 hours)
• 2, 4, 6 months: DTaP, IPV, Hib, PCV13, RV (rotavirus)
• 12-15 months: MMR, Varicella, Hib, PCV13
• 4-6 years: DTaP, IPV, MMR, Varicella boosters

Screening and Assessment

• Growth parameters: Plot height, weight, and head circumference on standardized growth charts at each visit.
• Developmental screening: Use standardized tools like DDST-II or ASQ to assess milestones.
• Vision and hearing: Formal screening begins at age 3-4 years, with ongoing assessment at all visits.