By:-

Shalini joshi
M.Sc. Nsg 1
st
year
BASIC HUMAN NEEDS


GROWTH AND DEVELOPMENT
Development of fertilized ovum
Growth and development of
embryo and fetus
Growth and Development Of The
New Born, infant, Toddler and
preschooler school age children
Growth and development of
adolescence
Adulthood growth and
developmental
Freud theory (sexual development)
Piaget theory (cognitive
development)
Erikson theory

Basic human need definition
Maslows Hierarchy of Human
Need
Basic human needs and related
nursing action
Implication of human needs in
nursing practice
Growth and development
Characteristics of growth and
development
Stages or period of growth
Stages of prenatal development

Outline of the content

A basic human need is want of something or
requirement for biological, social or spiritual
functioning experienced by a person without
which a person cannot survive

HIERARCHY

Hierarchy means that in any list of items some
items are classed as more important than
others.

Maslows Hierarchy of Human Needs

Abraham Maslow identified in 1968 five basic level of
basic human needs that are arranged in the order of
priority for satisfaction.

They are the lower level needs. They have the highest priority
overall the other needs because they are essential to life. They
include the needs for
Air,
Food,
Water,
Temperature maintenance,
Rest or sleep,
Elimination,
Sexuality
Avoidance of pain
PHYSIOLOGICAL NEEDS

A primary nursing
function is to meet
these needs as they
are vital to the
survival of patients



SAFETY AND SECURITY NEEDS:-
Adequate shelter and
protection
Physical safety
Psychological
safety
Understanding,
Group acceptance,
Affection,
Mutual trust,


The feeling of the belonging to other
LOVE AND BELONGING NEEDS
Every individual either sick or well
desires the companionship and
recognition of his family or
friends.

The nurse should always consider
love and belonging needs of
the patients by way of care and
by establishing a nurse client
relationship based on mutual
understanding and trust.

It is necessary to feel pride, to feel a sense of
accomplishment, in what one does, and to believe that others
also share this regard.
Self esteem gives the importance

Self esteem needs
individual
confidenc
e
worth
independence
strength
adequacy
usefulness
Lack of self esteem gives

A feeling of inferiority feeling of self dislike
Inadequacy
weakness helplessness





frustration and sense of failure.

Nurses can meet
patients self esteem
needs by accepting
their values and beliefs,
encourages them to set
attainable goals and
facilitating support by
family or friends.


Self actualization is the highest level of human needs. When
the need for self esteem is satisfied the individual strives
for self actualization, of ones potential through full
development of ones unique capabilities.

SELF ACTUALIZATION NEED
The nurse must focus on the
strength and capabilities
rather than on problem to
meet patients self
actualization needs. She
must aim at caring the total
individual need (holistic
care), and must provide a
sense of hope to maximize
his potentials.

Knowledge of human needs helps nurses to:-
Understand themselves, so that they can meet their personal
needs outside the health care setting,
Eg:- maintenance of body temperature.
Set priorities as in giving care.
Eg:- working and playing will assume a low priority
during a period of critical illness.
Better to understand patients behavior so that they can
respond therapeutically rather than emotionally.

Implication of HUMAN NEEDS in nursing
practice:-
Relieve the distress of patients,
eg:- helping a patient to meet his unmet need of
love and affection.
To get used to all ages and in all health care setting both at
health and illness. It is an approach for holistic nursing care.

Help client to develop and grow,
eg:- nurse can help clients to move towards self
actualization by helping them to find meaning on their
illness experience.
Provide a framework and be applied the nursing process at
the individual and family level.


GROWTH AND DEVELOPMENT
The term growth and development both refer to
dynamic processes often used interchangeably, these
term have different meaning. The period of growth and
development extends throughout the life cycle; however,
the period in which the principle changes occur is from
conception to the end of adolescence.

Growth refers to the increase in physical size of the whole
or any of its parts and can be measured in inches or
centimeter and in pounds or kilograms. Growth results
because of cell division and the synthesis of proteins. It
causes a quantitative change in the childs body.
Dorothy Marlow,

GROWTH
Growth refers to the changes that can be measured and
compared, for example- taking the height and weight of a
pediatric client and comparing the measurements to the
standardized growth charts.
Potter and Perry,
GROWTH
It is an increase in the complexity of function and skill
progression.

It is a capacity and skill of a person to adapt to the
environment.

Development is the behavioral aspect of growth. Eg:- a
person develops the ability to walk, to talk and to run.

Development takes place from birth to death.

DEVELOPMENT
Growth and Development are independent,
interrelated processes. For eg:-an infant
muscle, bones and nervous system must grow to
a certain point before the infant is able to sit up
or walk.

Individual differences:- each child has an individual rate of
growth, but the pattern of growth shows less variability.

Readiness for certain tasks:- the critical periods; measurable
period lasting from a few days to few weeks, during which the
learning of certain behaviours occur, are termed as critical
periods.

Rate of development:- during the period of growth and
development of the total body and its subsystems, growth is
sometimes rapid and at times it slows down.





Characteristics of Growth and Development :-

Stages of Growth and Development
Prenatal
- Embryonic (conception- 8 w)
- Fetal stage (8-40 or 42 w)
Infancy
- Neonate
- Birth to end of 1 month
- Infancy
- 1 month to end of 1 year
Early Childhood
- Toddler
- 1-3 years
- Preschool
- 3-6 years
Middle Childhood
- School age
- 6 to 12 years

Late Childhood

- Adolescent
- 13 years to approximately
18 years
DEVELOPMENT OF FERTILIZED OVUM

The trophoplast is developing into the placenta,
which will nourish the fetus, the inner cell mass is
forming the fetus itself. The cells differentiate
into three layers, each of which will form
particular parts of the fetus.

THE INNER CELL MASS
The Ectoderm
mainly forms
the skin and
nervous system.
The
Endoderm
forms mucous
membranes and
glands,
The
Mesoderm
forms bones
and muscles
and also the
heart and
blood vessels,
including those
which are in
the placenta.
Certain
internal
organs also
originate in
the mesoderm.
The developing offspring after implantation and until 8
weeks after conception. During the embryonic period
all the organs and system of the body are laid down
in rudimentary form so that at its completion they
have simply to grow and mature for a further 7
month. The conceptus is known as a fetus during this
time.
THE EMBRYO
Growth and Development of Embryo and
fetus
04-8 weeks
Very rapid cell division
Head and facial feature
develop.
All major organs are laid
down in primitive form
External genitalia develop
but sex not distinguishable.
Early movements.
Visible on ultrasound on 6
weeks
0-4 weeks after conception
Rapid growth
Formation of embryonic
plate
Primitive central nervous
system forms
Heart develops and begins
to beat.
Limb buds form


Growth and Development of Embryo and fetus

12-16 weeks
Rapid skeletal development
visible on x-ray.
Meconium present in gut.
Lenugo appears.
Nasal septum and palate
fuse.

08-12 weeks
Eye lids fuse
Kidneys begin to function and
fetus passes urine from 10
weeks
Fetal circulation functioning
properly
Sucking and swallowing begin
Sex apparent
Fetus moves freely
Some primitive reflexes
present


Growth and Development of Embryo and
fetus
20-24 weeks
Most organ become
capable of functioning
Periods of sleep and
activity
Respond to sound
Skin red and wrinkled

16- 20 weeks
Quickening- mother felts
fetal movement
Fetal heart beat heard
on auscultation
Vernix caseosa appears
Finger nails can be seen
Skin cells begin to be
renewed

Growth and Development of Embryo and
fetus
28-32 weeks
Begins to store fat and
iron
Estes descend into
scrotum
Lenugo disappears from
face
Skin becomes paler and
less wrinkled

24-28 weeks
Survival may be
expected if born
Eyelids reopen
Respiratory movements.

Growth and Development of Embryo and
fetus
36-40 weeks
Term is reached and
birth is due
Contours rounded
Skull firm


32-36 weeks
Increased fat makes the
body more rounded
Lenugo disappears from
the body
Head hairs lengthens
Nails reach tips of the
fingers
Ear cartilage soft
Planter creases visible
Growth and Development of Embryo and
fetus
New born refers to the baby ages from birth to
four weeks. First week of age is known as early
neonate period. Late neonate period ranges
from 7-28 days of life.

Growth and Development Of The New
Born

Adjustment to extra uterine life to all system
Respiratory system:- the most critical immediate physiologic
changes required of the new born is the onset of breathing The
stimuli that help to initiate respiration are primary.
a) Chemical stimuli- chemical factor in the blood (low oxygen,
high carbondioxide and low ph ), which initiate impulses that
excite the respiratory centre in the medulla.
b) Thermal stimuli- it is the sudden chilling of the infant who
leaves warm environment and enters a relatively cooler
atmosphere. This abrupt change in temperature excites sensory
impulses in the skin that are transmitted to the respiratory
centre.

Once the lungs are expanded the inspired oxygen dilates the
[pulmonary vessel which decreases the pulmonary vascular resistance
and consequently increases the pulmonary blood flow
CIRCULATORY SYSTEM
As the lungs receive blood, the pressure in the right atrium,
right ventricle and pulmonary artery decrease

At the same time there is progressive rise in systemic vascular
resistance from the increased volume of blood through the placenta
at cord clamping
This increases the pressure in the
left side of the heart.


Since blood flows from an area of
high pressure to that of low
pressure, the circulation of blood
through fetal shunts is reversed
Structure Before birth After birth
Umbilical vein Bring arterial blood to the
heart
Obliterate: becomes round
ligament of the liver
Foramen Ovale Connects right and left
auricles
Obliterated usually.
Lungs Contain no air and very little
blood; filled with fluid,
Filled with air and well
supplied with blood
Pulmonary arteries Bring little blood to lungs Bring much blood to lungs
Ductus Arteriosus Shunts arterial and some
venous blood from the
pulmonary artery to aorta
Obliterated; becomes
ligamentum arteriosum.
Umbilical Arteries Bring arterio venous blood to
placenta
Obliterated; becomes vesical
ligame on anterior abdominal
wall.
Ductus venousus hunts bring arterial blood into
inferior vena cava
Obliterated; becomes
ligamentum venosum.
Large surface area
Radiation
Non shivering thermogenesis;- produces cellular
respiration
A unique thermogenic source to a full term newborn is brown
adipose tissue (BAT)or brown fat. It has greater capacity for
heat production through intensified metabolic activity than does
ordinary adipose tissue
Thermoregulation

The blood volume of the newborn depends upon the
amount of placental transfer of blood. The blood
volume of the full term infant is about 80-85
ml/kg of body weight.
After birth the total blood volume averages
300ml,
Hemopoetic Systems
Physical growth:- newborn loses some weight shortly after birth.
This weight usually is regained within 10 to 12 days. Most
newborns gain about 4 oz (113 g) to 8 oz (227 g) a week and grow
about 1 in. (2.5 cm) to1.5 in. (3.5 cm) in the first month.

Cognitive development. Cognition is the ability to think, learn, and
remember. Newborn's brain is developing rapidly. To promote
healthy brain growth every time mother need to interact in a
positive way with baby.

DEVELOPMENT OF THE NEW BORN
Emotional and social development. Newborns quickly learn to
communicate. They seek interaction with you and express how
they feel with sounds and facial expressions. At first,
instinctual behaviors, such as crying when uncomfortable, are
the baby's ways to signal his or her needs.

For example, baby's eyes will track mothers movements. And his
or her face will brighten when mother cuddle and talk
soothingly. Even at a few days old, baby may try to mimic by
sticking out tongue.

Language development:- newborn is listening to and absorbing
the basic and distinct sounds of language. This process forms
the foundation for speech.

Language development:- newborn is listening to and
absorbing the basic and distinct sounds of language. This
process forms the foundation for speech.

Sensory and motor skills development. Newborns have all
five senses. Newborn quickly learns to recognize face, the
sound of voice, and how you smell. Newborn's sense of touch
is especially developed, particularly around the mouth. Baby
also has a strong sense of smell,

Motor skills develop as baby's muscles and nerves work
together. Movements are mostly controlled by reflexes
Growth and Development Of The infant
A baby's growth is dramatic during this first year.
Babies grow taller, and their heads get bigger.
The first year is characterized by rapid physical growth.
A normal baby doubles its birth weight in six months and triples it in a
year.
During that time, there is great expansion of the head and chest, thus
permitting development of the brain, heart, and lungs, the organs most
vital to survival.
The bones, which are relatively soft at birth, begin to harden, and the
fontanelles, the soft parts of the newborn skull, begin to calcify
Brain weight also increases rapidly during infancy : by the end of the
second year, the brain has already reached 75% of its adult weight.

Physical growth
Cognitive development. Babies make great advances in being
able to learn and remember.
Emotional and social development. Babies start to show their
emotions and how they feel about other people.
Language development. Babies quickly learn language by what
is spoken around them.
Sensory and motor development. Babies become strong
enough to sit. Some will stand, and others will begin to take
their first steps.

Growth and Development Of The Toddler

Toddler ranges from the time when children begin to
walk independently until they walk and run with ease
which is form 12 to 36 months.
Physical growth of the toddler
Biological growth:- the rate of biological growth slows down
compared with that during infancy.
Weight and height:- the toddler rate of weight gain markedly
differ in comparison with the infant. The toddler gains about
1.8 to 2.7 kg a year.
The average weight at 2 years of age is 12 kg. at 2

years of
age the childs weight is about four times that at birth.
The gain in height is greater than that of weight during the
toddler period. Height increases about 10 to 12.5 Cms per
year and is largely a result of growth in the length of the legs.
The height of 2 years of age is about 85 cms. Boys tend to be
slightly taller than girls, although this difference is slight.

Body proportion:- the young toddler has a relatively
large head in comparison with the size of the rest of
the body. The head circumference in the second year
increases by 25cm. by 2 years of age the hest
circumference exceeds that of the head.
Dentition:- at 2 years, the toddler has about 16 teeth,
and 2
1/5
years the full set of 20 temporary teeth
have erupted

Ages 2 through 6 are the early childhood years, or
preschool years. Like infants and toddlers,
preschoolers grow quicklyboth physically and
cognitively

Growth of the preschooler
Children begin to lose their baby fat, or chubbiness,
around age 3.
Toddlers soon acquire the leaner, more athletic look
associated with childhood.
The child's trunk and limbs grow longer, and the
abdominal muscles form, tightening the appearance
of the stomach
Threeyearold preschoolers may grow to be about 38
inches tall and weigh about 32 pounds
Development of the toddler up to
preschooler
Physical development. In these years, a child becomes
stronger and starts to look longer and leaner.
Cognitive development. A child this age makes great
strides in being able to think and reason. In these years,
children learn their letters, counting, and colors.

Emotional and social development. Between
the ages of 2 and 5, children gradually learn
how to manage their feelings. By age 5,
friends become important.

Language. By age 2, most children can say at
least 50 words. By age 5, a child may know
thousands of words and be able to carry on
conversations and tell stories.
Sensory and motor development. By age 2,
most children can walk up stairs one at a
time, kick a ball, and draw simple strokes
with a pencil. By age 5, most can dress and
undress themselves and write some lowercase
and capital letters.


HANDOUTS
School-age period is between the age of 6 to
12 years. The child's growth and development
is characterized by gradual growth
Growth and development of school age
children
Age 8-9:Male/female
Weight:- 19.6-39.6 kg
Height:- 117-141.8 cm
Age 10-12: Male/female
Weight:- 24.3-58 kg
Height:- 127.5-162.3 cm

Age 6: Male/female
Weight:- 16-23.5 kg
Height:- 106.6-123.5 cm
Age 7: Male/female
Weight:- 17.7-30 kg
Height:- 111.8-129.7 cm

Biological changes
Growth in height and weight assumes a slower but steady pace as
compared with the earlier years. Between ages 6 to 12, children will grow
an average of 5cm per year to gain 30-60 cm in height and will almost
double their weight, increasing 2 to 3 per year.

Physical maturation is evidenced by other body tissues and
organs.
Bladder capacity, greater in girls than boys.
Heart grows slowly in the middle years and small in size when
compared with the size in the other age period. Heart rate and
respiratory rates steadily decreases and blood pressure
increases during this age period
Immune system becomes more competent in its ability to
localize infection and produce an antibody-antigen response.
Bones continue to grow and musculoskeletal system continues to
mature, in size and coordination.

Physiological changes
At the age of 7 years
Repeats the performance to
master them
More caution in performing new
things
Uses brush and combs the hair

At the age of 6 year
Aware of hand as a tool
Returns to finger feedings
Likes to draw and print
Color vision reaches
maturity
Uses knife to spread butter
or jam on bread.

At the age of 10-12 years
Mostly children will have the normal
characteristics similar to adults.

At the age of 8-9 years
Often graceful
Always on the go; jumps skip.
Increased smoothness and speed in fine motor
control
Develop the concepts of number
Counts 13 coins
Knows the time as morning and afternoon.
Knows right from left hand
Does simple calculation
Perform bed time activities
Takes bath alone
More independent in doing things
Occasional temper tantrum can be seen.

Developmental tasks of school age children


At 7-11 years, the child now is in the concrete
operational stage of cognitive development. He
is able to function on a higher level in his
mental ability.

Greater ability to concentrate and participate
in self-initiating quiet activities that challenge
cognitive skills, such as reading, playing
computer and board games.
Emotional development
The schoolage child:
Fears injury to body and fear of dark.

Jealous of siblings (especially 68 years old child)
.
Curious about everything.

Has short bursts of anger by age of 10 years but able
to control anger by 12 years.
Social development
The schoolage child is :
Continues to be egocentric.
Wants other children to play with him.
Insists on being first in every thing
Becomes peer oriented.
Improves relationship with siblings.
Has greater selfcontrol, confident, sincere.
Respects parents and their role.
Joints group (formal and informal).
Engage in tasks in the real world.
ADOLESCENT
ADOLESCENT

Adolescence is a transition period from childhood
to adulthood. Its is based on childhood
experiences and accomplishments.

It begins with the appearance of secondary sex
characteristics and ends when somatic growth is
completed and the individual is psychological
mature.
Height:
By the age of 13, the
adolescent triples his birth
length.
Males gains 10 to 30cm in
height.
Females gains less height
than males as they gain 5
to 20cm.
Growth in height ceases at
16 or 17 years in females
and 18 to 20in males

Weight:
Growth spurt begins
earlier in girls (1014
years, while it is 1216 in
boys).
Males gains 7 to 30kg,
while female gains 7 to
25kg.

PHYSICAL GROWTH:
Appearance of secondary sex characteristics

Secondary sex characteristics in girls
Increase in transverse diameter of the pelvis.

Development of the breasts.

Change in the vaginal secretions.

Growth of pubic and axillary hair.

Menstruation (first menstruation is called menarche, which
occurs between 12 to 13 years).
Secondary sex characteristics in boys:
Increase in size of genitalia.

Swelling of the breast.

Growth of pubic, axillary, facial and chest hair.

Change in voice.

Rapid growth of shoulder breadth.

Production of spermatozoa (which is sign of puberty).
Cognitive development:
Through formal operational thinking, adolescent can deal with a problem.

Emotional development:
This period is accompanied usually by changes in emotional control.
Adolescent exhibits alternating and recurrent episodes of disturbed behavior
with periods of quite one. He may become hostile or ready to fight, complain
or resist every thing.

Social development:
He needs to know "who he is" in relation to family and society, i.e., he
develops a sense of identity. If the adolescent is unable to formulate a
satisfactory identity from the multi-identifications, sense of self-confusion will
be developed according to Erikson:-
Adolescent shows interest in other sex.
He looks for close friendships.
Age frame is from about late teens to thirty (20-40
years)
Peak of physical health and fitness (occurs on average at
approximately age 30)
Height of cognitive abilities
Healthy, vigorous, energetic

EARLY ADULTHOOD GROWTH AND
DEVELOPMENTAL

In 20 years
May still gain height
Gain in muscle, fat
Brain still increasing in size and weight
(although no new neurons are being formed)
Senses optimal

Physical growth:-

Establish personal and economic independence
Forming a support group of friends and others
Developing work skills/career
Making a commitment in a relationship
Establishing a family
Managing optimal healthy lifestyles

DEVELOPMENTAL TASK
Age frame from about the thirties to the mid sixties
Expand personal and social involvement and
responsibility
Adjusting to physiological and emotion changes
Reaching and maintaining job satisfaction/ preparing
for retirement
Observing maturation of children
Managing chronic health conditions

Middle Adulthood development
Age time frame from mid sixties to death.
Aging is influenced by heredity, nutrition,
exercise, lifestyle choices such as smoking,
and lifelong adjustments to change.

Late Adulthood development
Age frame 65-74 years
If healthy may not experience ages from middle years
Beginning social and emotional adjustments to
decreasing physical strengths and changes in body such
as vision and hearing limitations
Adjusting to retirement with loss of job related
activities
Adjusting to changing family roles with children, spouse
and grandchildren.

Young-Old development
Middle old, 75-84
Adjusting to more chronic conditions, such as arthritis
Adjusting to losses of abilities to drive car
Losses of friends and siblings
Need to accept lifes experiences

Middle Old and Old- Old development task
Accept physical limitations and dependence on others
Acceptance of losses (deaths and activities).
Acceptance to alternate living conditions, such as
assisted living or long term care

Old-Old, 85 and older


Jean Piaget (1896-1980)
A Swiss developmental
psychologist
Gave cognitive
developmental theory
It is a comprehensive
theory about the
nature & development
of human intelligence
COGNITIVE DEVELOPMENTAL THEORY
Piaget theory
(cognitive development
ERIKSON STAGE THEORY
PSYCHOSOCIAL THEORY
(1963)
SUMMARY