Pediatric nursing immunization 800 words due 1/18/2020

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N371PPT_Chapter_27.pptx

Chapter 27 Growth and Development of the Preschooler

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Physical Growth Developments of the Preschooler

Average growth of 2.5 to 3 in per year

Average weight gain around 5 lb per year

Loss of baby fat and growth of muscle

Length of skull increases slightly; lower jaw more pronounced; upper jaw widens

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Motor Skill Development

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Question #1

The nurse is assessing a 4-year-old for gross motor skill development. Which would the nurse expect this preschooler to have accomplished?

a. hopping on one foot

b. standing on one foot for 10 seconds

c. skipping

d. swimming

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Answer to Question #1

a. hopping on one foot

The 4-year-old should be able to hop on one foot.

At age 4, the preschooler hops on one foot and stands on one foot up to 5 seconds. At 5 years old the preschooler stands on one foot for 10 seconds, may skip, and may learn to skate and swim.

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Maturation of the Organ System (Preschooler)

Myelination of the spinal cord allows for bowel and bladder control to be complete; small intestine grows in length.

Respiratory structures continue to grow in size; number of alveoli increase.

Eustachian tubes remain short and straight.

Heart rate decreases; blood pressure increases slightly; innocent heart murmur may be heard.

20 deciduous teeth should be present.

Urethra remains short in children, making them susceptible to urinary tract infections.

Bones increase in length and muscles strengthen and mature.

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Psychosocial Development of the Preschooler

In Erikson’s stage of development: initiative versus guilt

Preschooler is an inquisitive and enthusiastic learner

Feels sense of accomplishment by succeeding in activities

Feeling pride in accomplishment stimulates initiative

Overextending self can result in sense of guilt

Superego (conscious development) is completed and is basis for moral development

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Social Skills Developed by the Preschooler

Cooperation

Sharing (of things and feelings)

Kindness

Generosity

Affection display

Conversation

Expression of feelings

Helping others

Making friends

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Emotional and Social Development of the Preschooler

Friendships

Preschoolers learn how to make and keep a friend

Temperament

Indicator of parent’s expectation of child’s behavior

Determines child’s task orientation, social flexibility, and reactivity

Fears

Preschoolers exhibit variety of fears

Parents should acknowledge child’s fears

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Cognitive Development of the Preschooler

Piaget’s theory

Preoperational stage

Magical thinking

Believes thoughts are all-powerful

Imaginary friend

Creative way to sample activities and behaviors and practice conversation skills

Transduction

Extrapolates from one situation to another

Animism

Attributes life-like qualities to inanimate objects

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Psychosocial Preschool-Aged Child

Kohlberg’s theory

Preconventional stage

Punishment and obedience orientation

Religion

Diet

Mode of discipline

View of children

Prayer or meditation

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Language Development

Symbolic thought

Do not understand the concept of death

Acquisition of language allows for child to express thoughts and creativity

Transition in this period from the use of telegraphic speech at age 3 years to the adult-like structure of sentences at age 5 years

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Sample Nursing Diagnoses for Issues Related to Growth and Development

Delayed growth and development

Imbalanced nutrition, less than body requirements

Interrupted family processes

Readiness for enhanced parenting

Risk for caregiver role strain

Risk for delayed development

Risk for disproportionate growth

Risk for injury

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Issues Involved in Promoting Growth and Development of the Preschooler

Building self-esteem

Maintaining routine and ritual

Setting limits and remaining consistent with them

Knowing signs of developmental delay

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Question #2

The nurse is assessing a 5-year-old child for signs of developmental delay. Which would alert the nurse to a potential problem?

a. the child can build a tower of six blocks

b. the child does not play with other children

c. the child engages in fantasy play

d. the child separates from parent easily

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Answer to Question #2

b. the child does not play with other children

This is a sign of a potential developmental delay.

Signs of developmental delay in preschool-aged children include not playing with other children, not being able to build a block tower of six to eight blocks, not engaging in fantasy play, and not separating from the parent without major protest.

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Focus of Nursing Care Plan to Promote Growth and Development of Preschooler

Promoting growth through play

Promoting early learning

Promoting language development

Choosing a preschool/starting kindergarten

Promoting safety

Promoting nutrition

Promoting healthy sleep and rest

Promoting appropriate discipline

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Question #3

Is the following statement True or False?

The nurse should recommend that parents of a 3- to 5-year-old receive 500- to 800-mg calcium and 10-mg iron daily.

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Answer to Question #3

True.

The preschool child needs 500- to 800-mg calcium and 10-mg iron daily.

Preschool children need 500- to 800-mg calcium and 10-mg iron daily. Parents should be aware that drinking excess amounts of milk may lead to iron deficiency as the calcium in milk blocks iron absorption.

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Daily Nutritional Requirements of the Preschooler

500- to 800-mg calcium

10-mg iron

19-mg fiber

Fat intake no less than 20% and no more than 30% daily calories

Saturated fats less than 10%

Diet high in nutrient-rich foods

Limited amounts of poor, high-calorie foods

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Risks of Overweight and Obesity

Hypertension

Hyperlipidemia

Insulin resistance

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Developmental Issues for Preschoolers

Lying

Sex education

Masturbation

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Question #4

Tell whether the following statement is True or False.

The nurse is counseling parents of a 5-year-old who are concerned that their child is masturbating. The recommended intervention for this situation is to advise parents to discourage their child from this practice using firm discipline.

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Answer to Question #4

False.

The recommended intervention for a 5-year-old child who is masturbating is to treat it in a matter-of-fact way, making sure the child knows nudity and masturbation are not acceptable in public.

If parents overreact to this behavior, it may occur more frequently. The child should also be taught that no other person can touch his or her private parts.

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Focus of Health Care Visits Throughout Childhood

Expected growth and development

Anticipatory guidance

Preparation for school entry

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Hospitalization

Explore the environment

Engage in make-believe play

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