NCLEX Review Guide: Growth & Development, Stages of Life, and Immunizations

Key Developmental Concepts

• Growth refers to physical changes in size, weight, and height, while development encompasses cognitive, emotional, and social maturation processes.
• Development follows predictable patterns: cephalocaudal (head to toe) and proximodistal (center to periphery).
• Critical periods exist where specific developmental tasks must be mastered for optimal functioning in later stages.

Infancy (0-12 months)

• Trust vs. Mistrust (Erikson): Infants develop trust through consistent, responsive caregiving and meeting basic needs.
• Major milestones: social smile (2 months), sits without support (6 months), walks independently (12 months).
• Nutrition: Exclusive breastfeeding recommended for first 6 months, introduce solids at 4-6 months starting with iron-fortified cereals.

Toddlerhood (1-3 years)

• Autonomy vs. Shame and Doubt: Toddlers assert independence while learning self-control and developing confidence in abilities.
• Language explosion occurs with vocabulary increasing from 10 words at 18 months to 1000+ words by age 3.
• Safety Priority: Toddlers are at high risk for accidents due to increased mobility and curiosity without understanding consequences.

Preschool (3-6 years)

• Initiative vs. Guilt: Children develop leadership skills and begin planning activities while learning moral boundaries.
• Magical thinking and animism are normal cognitive characteristics where objects are given human qualities.
• Parallel and associative play transitions to cooperative play with peers.

School Age (6-12 years)

• Industry vs. Inferiority: Children develop competence through mastering new skills and academic achievements.
• Concrete operational thinking emerges with ability to understand cause and effect relationships.
• Peer relationships become increasingly important for social development and self-esteem.

Routine Childhood Immunizations

1. Verify immunization history and contraindications before administration
2. Obtain informed consent and assess for allergies
3. Use appropriate injection sites based on age and muscle mass
4. Document vaccine lot number, site, and date in permanent record
5. Provide Vaccine Information Statement (VIS) to parents/guardians

Contraindications: Severe illness with fever, immunocompromised state for live vaccines, previous severe allergic reaction to vaccine components.