Pediatric nursing immunization 800 words due 1/18/2020

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N371PPT_Chapter_26.pptx

Chapter 26 Growth and Development of the Toddler

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Physical Growth of the Toddler

Height and weight increase steadily in spurts at a slower rate than the infant

Generally reach half adult height by age 2

Average weight gain is 3 to 5 lb per year

Height increases an average of 3 in per year

Fontanels close by 18 months

Head size more proportional to body by age 3

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Organ System Maturation #1

Neurologic system

Brain reaches about 90% of size by age 2

Respiratory system

Alveoli increase in number until age 7; trachea and airways small compared to adult

Cardiovascular system

Heart rate decreases; blood pressure increases

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Organ System Maturation #2

Gastrointestinal system

Stomach increases in size; small intestine grows in length; stool passage decreases.

Genitourinary system

Bladder and kidney reach adult function by 16 to 24 months; bladder capacity increases; urethra remains short.

Musculoskeletal system

Bones increase in length; muscle matures; swayback and pot belly appear due to weak muscles until 3 years old.

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Growth Theories

Freud’s theory focuses on the satisfaction and/or frustration of expelling feces (anal stage).

Piaget’s theory focuses on development of the senses of the toddler.

Erikson’s theory focuses on achievement of autonomy and self-control.

Kohlberg’s theory focuses on the moral development of the toddler.

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Question #1

The nurse praises a 3-year-old child for using the potty. Which of the following theorists focuses on the satisfaction/frustration of expelling feces?

a. Piaget

b. Freud

c. Erikson

d. Kohlberg

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Answer to Question #1

b. Freud

Freud’s theory focuses on the satisfaction and/or frustration of expelling feces (anal stage).

Piaget’s theory focuses on development of the senses of the toddler; Erikson’s theory focuses on achievement of autonomy and self-control; Kohlberg’s theory focuses on the moral development of the toddler.

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Motor Skill Development (Toddler)

Gross motor skills

Include running, climbing, jumping, pushing or pulling a toy, throwing a ball, and pedaling a tricycle

Fine motor skills

Progress from holding and pinching to the ability to manage utensils, hold a crayon, string a bead, and use a computer

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Speech Development (Toddler)

Receptive language development: the ability to understand what is being said or asked

Typically far more advanced than expressive language development (ability to communicate desires and feelings)

Common occurrences

Echolalia: repetition of words and phrases without understanding

Telegraphic speech: speech that contains only the essential words to get the point across

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Sensory Development

Use all senses to explore the world

Vision progresses

Depth perception matures

Hearing at adult level

Sense of smell matures

Taste discrimination not completely developed

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Emotional and Social Development of the Toddler

Focus

Separation

Seeing oneself as separate from the parent

Individuation

Forming a sense of self and learning to control one’s environment lead to emotional lability.

Egocentrism

Focus on self

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Typical Behaviors of the Toddler

May rely on a security item

Becomes aware of gender differences

May display aggressive behaviors

May show fear of loss of parents and of strangers

Becomes more self-aware; does not have clear body boundaries

Separation anxiety may reoccur

May resist invasive procedures

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Promoting Growth and Development of the Toddler Through Play

Play is the major socializing medium for toddlers.

Toddlers need 30 minutes of structured physical activity and 1 to 3 hours of unstructured physical activity per day.

Parents should limit television and encourage creative and physical play instead.

Toddlers engage in parallel play (playing alongside another child) instead of cooperative play.

Toddlers are egocentric and do not like to share.

The short attention span of toddlers will make them change toys frequently.

Toddlers do not need expensive toys.

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Question #2

Is the following statement True or False?

The best type of toys for toddlers is store-bought interactive electronic toys.

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Answer to Question #2

False.

Toddlers do not need store-bought expensive toys.

The best toys for toddlers are familiar household items, child-sized household items, blocks, cars, plastic figures, stuffed animals, dolls, doll beds, and carriages. Manipulative toys with knobs and buttons that make things happen, shapes to insert into matching holes, puzzles, chalk, buckets and shovels, and floating toys are also recommended. Appropriate gross motor toys include gyms, tricycles, pull toys, and wagons.

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Promoting Safety for the Toddler

Provide a childproof environment

Use a safe car seat in back of car

Provide a safe home environment

Avoid exposure to tobacco smoke

Prevent injury

Prevent poisoning

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Sleep and Dental Health Requirements for the Toddler

18-month-old: 13.5 hours of sleep per day

24-month-old: 13 hours of sleep per day

3-year-old: 12 hours of sleep per day

A typical toddler should sleep through the night and take one daytime nap

Most children discontinue daytime napping at around 3 years of age

30 months toddler has full set of primary teeth

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Nutritional Plan

Lay foundation

High in nutrient-rich foods

Toddlers who consume a strictly vegan diet (no food from animal sources) are at risk for deficiencies in vitamin D, vitamin B12, and iron. Supplementation with these nutrients should occur to promote adequate nutrition and growth.

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Question #3

The nurse is planning a diet for a toddler that is rich in vitamin A. Which of the following foods might the nurse include?

a. avocados

b. corn

c. strawberries

d. spinach

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Answer to Question #3

d. spinach

Spinach is rich in vitamin A.

Avocados are rich in folate, corn is rich in fiber, and strawberries are rich in vitamin C. Other foods rich in vitamin A include apricots, cantaloupe, carrots, mangoes, dark greens, and sweet potatoes.

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Promoting Self-Feeding in Toddlers

Use a child-sized spoon and fork with dull tines

Seat the toddler in a high chair or at a comfortable height in a secure chair

Never leave the toddler unattended while eating

Minimize distractions during mealtime

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Common Developmental Concerns of the Toddler

Toilet teaching

Negativism

Temper tantrums

Thumb sucking and pacifiers

Sibling rivalry

Aggression

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Signs a Toddler Is Ready for Toilet Teaching

Regular bowel movement

Expresses knowledge of need to defecate or urinate

The diaper is not always wet

The toddler is willing to follow instructions

The toddler walks well alone and can pull down pants

The toddler follows caregiver to bathroom

The toddler climbs onto potty chair or toilet

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Teaching Strategies to Minimize Issues With Sibling Rivalry

Attempt to keep the toddler’s routine as close to normal as possible

Spend individual time with the toddler on a daily basis

Involve the toddler in the care of the baby

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Focus of Discipline for the Toddler

Limit setting

Negotiation

Techniques to assist the toddler to learn problem solving

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Role of Parent

Talk and sing to child to encourage conversation and promote language development

Read to toddler every day

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Guidelines for Choosing a Preschool for a Toddler

Parents agree with goals and an overall philosophy.

Teachers and assistants are trained in early childhood development as well as CPR.

Classes are small with an appropriate adult-to-child ratio.

Disciplinary procedures are consistent with the parents’ values.

Parents are able to visit at any time.

School is childproofed inside and out.

Appropriate hygiene procedures are in place.

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