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Pediatrics Ch 17
The Toddler
| Question | Answer |
|---|---|
| What is the age of a toddler | 1 – 3 years |
| What is Erikson’s stage for a toddler | Autonomy vs. Shame and Doubt |
| What are some tasks for the toddler to master | Toilet training, self feeding, self dressing, speech development |
| What must a parent do while allowing the toddler an opportunity for social and physical independence | Maintain safety and a positive self and body image |
| How do toddlers test their power | Saying No |
| What is negativism | Toddlers testing their power by saying No |
| What is ritualism | Making compulsive routines of simple tasks |
| Why do toddlers use ritualism | To increase their sense of security |
| How do toddler’s legs and arms lengthen | Through ossification and growth in the epipehyseal areas of the long bones |
| How much weight does the toddler gain per year | 4 to 6 pounds |
| How much does the toddler weigh by 2 ½ years old | Quadruple the birth weight |
| What is the rate of increase for a toddler’s height | 4 inches/year |
| How might a parent determine how tall their child will become | Double the height at 2 years |
| Does the brain grow more during the toddler years or infancy | Toddler years |
| What is the rate of increase in head circumference during the second year of life | 1 inch |
| What is the rate of increase in head circumference during the first year of life | 4 inches |
| When does a toddler appear to become leaner, and why | After 2 years - Chest circumference begins to exceed abdominal circumference |
| What causes the abdomen to flatten | Muscle fibers increase in size and strength |
| When does myelination of the spinal cord allow for control of anal and urethral sphincters | By age 2 |
| When is bowel and bladder control usually complete | 2 ½ - 3 years |
| When do respirations shift from abdominal to thoracic | As the child approaches school age |
| What change does skin undergo during the toddler years | Becomes tough as the epidermis and dermis bond more tightly |
| How do the lymphatic tissues of the adenoids and tonsils change during the toddler years | They enlarge |
| What are common problems related to the Eustachian tubes, and why do they occur | Tonsillitis, otitis media, and upper respiratory infections – short, straight Eustachian tubes |
| When is the eruption of deciduous teeth complete | 2 ½ years |
| What is the average blood pressure of a toddler | 90/56 mm Hg |
| What is the average respiratory rate of a toddler | 25 breaths/min |
| What is the average pulse of a toddler | 70 to 110 bpm |
| How do toddlers assimilate information | Through trial, error, and repetition |
| When is binocular vision established | 15 months |
| What is the visual acuity of a 2 year old | 20/40 |
| What are the stages of separation anxiety | Protest, despair, detachment |
| What might cause a toddler to think that all paper bags contain toys | Cause and effect – if one does, they all must |
| What causes toddlers to be able to place a round peg into a round hole | The concept of spatial relationships develop |
| What is object permanence | Understanding that something exists even if it is out of sight |
| What evidence is there that toddlers begin to internalize standards of behavior | Saying no-no when reaching for forbidden objects |
| When is there a recognition of sexual differences | By 2 years |
| Why can flushing the toilet be upsetting to toddlers | They feel they are flushing a part of themselves away |
| What might impair a toddler’s body image and self-esteem | Being scolded in a way that makes them feel they are bad rather than their behavior |
| What is a child’s vocabulary at 3 years | 900 words |
| When does a child begin to say ma-ma and da-da | At the end of the 1st year |
| What causes toddlers to repeat noises/words | A happy response |
| How do children first refer to animals | By the sounds they make |
| What makes the abdomen protrude in the toddler | Exaggerated lumbar lordosis |
| How might a toddler react if an adult sounds threatening | Saying No, then saying it louder |
| What should a parent do if they are concerned about a child’s delayed speech | Discuss it with the health care provider during a routine exam |
| What are the screening signs for autism | No pointing or gesturing by 12 months, no single words by 16 months, no spontaneous two word phrases by 24 months, loss of language or social skills |
| What should be ruled out if the screening signs for autism are noted | Lead poisoning, hearing deficits |
| What common household items might contain lead | Vertical window blinds, metal decorative vases |
| What is the goal of discipline for the toddler | To teach, not punish |
| What should the response be to a toddler that scribbles on the wall | Give paper |
| What is an uncontrolled anger reaction common to toddlers | Temper tantrum |
| What should limit setting include | Praise for desired behavior as well as disapproval for undesired behavior |
| What does a time out period in a safe place accomplish | Helps the child develop the ability to tolerate delayed gratification and self regulation |
| When should a time out begin | When the child has settled down |
| What should the parent do when the child becomes calm during a time out | Praise |
| How long should a time out last | 1 minute per year of age |
| What affects the extent of a child reaction at the time of fear | Physical and mental health |
| What are self consoling behaviors for the toddler | Clinging to favorite possessions and repetitive rituals |
| When are self consoling behaviors most common | Bedtime and during separation from parents |
| What increases the fear of separation in a toddler | Stress |
| What attitude should be shown to toddlers who are afraid | Respect and understanding |
| Who should the toddler seek out during stressful situations | The parent |
| If a toddler does not seek the parent during a stressful situation, what is needed | A closer evaluation of the parent-child relationship |
| When is negativistic behavior predominant | During the terrible two’s |
| What does regular spanking reflect | A desperate effort by the parents to gain control over a toddler beginning autonomy and developing negativism |
| What are some noncorporal techniques of discipline | Time out, limit setting, clear communication, frequent rewards/approval for positive behavior |
| What are the keys to effective discipline | Communicating love and respect with a clear message that it is the behavior and not the child that is disapproved of |
| Why should an adult make an effort to be at a toddler’s eye level when talking | The adult seems less overwhelming |
| What should be the characteristics of a toddler’s clothing | Simple, easy on and off, loose, protective from sun |
| Why does a toddler wear shoes | Protection |
| How should a toddler’s shoes fit | The shape of the foot, ½ inch longer, ¼ inch wider, secure heels |
| What shoes should a toddler wear to the doctor | The usual shoes |
| Why should a toddler wear their usual shoes to the doctor | It shows how the shoes have been worn and indicates how the child is using the body |
| When should the toddler be barefoot | Whenever it is safe and possible |
| Why should a toddler be barefoot whenever it is safe and possible | It strengthens the foot muscles |
| How should a toddler’s socks fit | Should not flex the toes |
| What should a toddler be taught to do with socks | Pull them free from the toes before putting on shoes |
| What contributes to posture | Nutrition, fresh air, exercise, rest, the posture of other family members |
| What does a toddler who is happy and allowed gradually increasing independence develop | Sense of security |
| When a toddler slouches, what might it indicate | Lack of self confidence and insecurity |
| What does the nurse assess when instructing parents about toilet training | Parent’s expectations, family and cultural preferences, developmental readiness of the child |
| When does voluntary control of the anal and urethral sphincters begin | 18 to 24 months |
| What are indications of readiness for toilet training | Waking up dry, ability to communicate they are wet or need to go, willing to sit on the potty for several minutes, curiosity about bathroom activities |
| How should a child be placed on a standard toilet | Facing the tank or with a bench to support the feet |
| What should be the characteristics of a potty chair | Support the back and arms of the child with feet touching the floor |
| What type of toilet training is usually attempted first | Bowel training |
| Why might some children become bladder trained during the day | They enjoy the sound |
| What may help a child become bowel trained quickly | A pattern of having bowel movements at the same time |
| What could sitting on the potty for too long without supervision result it | Bathroom playtime |
| When is bladder training begun | When the toddler stays dry for 2 hours at a time |
| When do children typically stop having toilet training accidents | 4 years |
| What reaction should the parents have to toilet training accidents | Accepting, matter of fact, change the clothes |
| What word should toddlers be taught to use to signal the need to use the toilet | One that can be recognized by other than the immediate family |
| How many calories per day do infants need | 110 per kilogram |
| How many calories per day do toddlers need | 100 per kilogram |
| How much milk do toddlers need per day | No more than 24 ounces |
| What dietary deficiency can too few solid foods lead to | Iron |
| What is a common diet related illness in children between 1 and 3 | Anemia |
| What can be noticed about a well nourished toddler | Steady proportional gains on height and weight charts, good bone and tooth development |
| When can meal specific nutritious food be eaten during the toddler years | Any time |
| Why are large servings discouraged for toddlers | They can overwhelm the child and/or lead to overeating problems |
| What is a measurement guide to use for toddler serving size | 1 tablespoon of solid food per year of age |
| Why might a toddler refuse to eat | Fatigue, not hungry, manipulate parents |
| How should a parent handle ritualistic behavior at mealtimes | Go along with it as long as it does not become too pronounced |
| When should a toddler’s attention be allowed to wander from mealtimes | When they have eaten a fair amount |
| What should a toddler in a high chair wear | Safety restraint |
| What kind of food do 2 year olds like | Finger foods |
| What state regulations are licensed day cares subject to | Physical layout, number of children per caretaker, education of personnel |
| What do successful alternate child care arrangements depend on | Specific guidelines in selection, frequent visits, communication with staff |
| Why does toddler day care differ from preschool | Short attention span, tendency for parallel play, need for closer supervision |
| What is the leading cause of death in childhood | Accidents |
| What is the best prevention for accidents in the toddler years | Knowledge of age appropriate risks, anticipatory guidance |
| What normal characteristics of a toddler make them injury prone | Curiosity, mobility, negativity |
| When does car seat use begin | With the ride home from the hospital after birth |
| When is a child large enough for a car safety belt to fit correctly | Above 80 pounds, above 57 inches |
| How are the most serious injuries from a toy box/chest caused | Lid falling on a child or being trapped inside |
| How do toddlers learn to manipulate, understand their environment, socialize, and explore their world | Play |
| What are some preferred toddler toys | Pots and pans, water, music, crayons, finger paint, paper |
| What are the keys to a positive play experience | Supervision and maintenance of safety |
| What kind of thinking is predominant in a toddler | Egocentric |
| What kind of play do toddlers engage in | Parallel gradually becoming cooperative |
| Why does the infant car seat face the rear | To prevent the head form falling forward when the car stops suddenly or during an accident |
| What behavioral characteristics of a toddler can cause traffic and automobile hazards | Impulsive, unable to delay gratification, increased mobility, egocentric |
| What behavioral characteristics of a toddler can cause burns | fascination for fire, can reach articles by climbing, pokes fingers in holes and openings, can open doors and drawers, unaware of cause and effect |
| What behavioral characteristics of a toddler can cause falls | likes to explore, can open doors and lean out windows, immature depth perception, changing capabilities, seeming grown up |
| What behavioral characteristics of a toddler can cause suffocation and choking | explores with senses, likes to bite and taste things, eats on the run |
Created by:
futurenurse
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