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Peds Ch18 CCC 105

Peds Exam Ch 18 CCC PN105

What age is the preschool child age 3-5
preschool period is marked by slowing of growth process and mastery and refinement of motor, social, and cognitive abilities
Major tasks of the preschool child Preparation to enter school; Development of cooperative play; Control of body functions; Acceptance of separation; Increase in communication skills, memory, and attention span
Weight __________ from age 1 to age 5 doubles
Marked physical characteristics of preschool children are taller growth and loss of toddler chubbiness; good muscle control and more adept at familiar skills
visual acuity at age 3 20/40
visual acuity at age 4 20/30
age that hand preference develops and primary teeth have erupted age 3
normal pulse rate for preschooler 90-110
average rate of respirations for preschooler 20
average BP of preschooler 85-90/60
Piaget preschool phase preoperational phase
Erickson preschool phase initiative vs. guilt
Kohlberg preschool phase beginning of moral development
Parts of preoperational phase preconceptual, intuitive
Preconceptual stage (ages 2-4) increased development of language and symbolic functioning, including symbolic functioning, egocentrism, animism, and artificialism
symbolic functioning creation of mental image for something that is not there (ex., pretending empty box is a fort)
egocentrism difficulty seeing any point of view other than own
animism tendency to attribute life to inanimate object
artificialism world and everything in it is created by people
Inutitive stage (ages 4-7) prelogical thinking; experience and logic are based on outside appearance; includes centering
centering tendency to concentrate on a single outstanding characteristic of an object while excluding its other features (ex., not eating broccoli because it is green)
effects of cultural practices on preschooler influence development of sense of initiative
who models and influences languange developement parents and older siblings
cause of delays or problems in language development physiological, psychological, or environmental stressors
number of words in preschoolers sentence equals child's age
by age 2.5 can verbalize possessiveness
by age 4 can verbalize past tense
by age 5 can verbalize future tense
development of language includes understanding of language and the expressing of oneself
difficulty in language expression can result in tantrums and acting-out behaviors
play activities in preschoolers increase in complexity
play development, age 2-3 imitation of parents (shaving, vacuuming, etc)
play development, age 4 broader play themes, like trip to zoo or store
play development, age 5 demonstration of imaginary abilities, like flying to moon
role of play in preschooler enables experience of multiple roles and emotional outlets
best approach to communication with preschooler; can distract from pain and establish trust appealing to magical thinking
how to preschoolers learn about religious beliefs and practices observation in the home; abstract concepts are not yet understood
observation of religious practices in hospital can help child deal with stressors
to guide parents in sexual education of preschooler... Assess knoweldge base of child and information requested; Be honest and accurate in information given at child's level; Use correct terminology; Provide education at time questioned; Understand curiousity starts as inquiry to anatomical differences
sexual curiousity in preschooler can be displayed as masturbation
masturbation in preschoolers is normal and harmless if child is outgoing, sociable, and not preoccupied with the activity
specific developments in 3 year olds helpful, assist with chores, less tantrums, able to direct primitive instincts, dress self, eat independently, longer sentences, express thoughts
specific developments in 4 year olds more aggressive, eager to show superiority, prone to pick on friends, boisterous, tattles on others, can use scissors, interested in ages of friends, tie shoes, increased vocab to 1500 words, feats done for purpose
specific developments in 5 year olds more responsible, enjoy doing what is expected, have more patience, like to finish what started, talk constantly, very inquisitive, less fearful, less worrisome
3 year old play type parallel play and associative play, cooperative play for short periods
4 year old play type imaginitive and like to pretend, prefer to play with same sex; prefers simple objects (cardboard box) to ready-made toys
5 year old play type plays games governed by rules, can ride tricycle, can use hammer, encouragement of motor skill development and less parental hovering
3 year old parental relationships loss of interest in mother, gain of interest in father, romantic attachment to parent of opposite sex, identification with parent of same sex
3 year olds have this unique development fear of bodily harm, particularly of body parts
behavior when 3 year old becomes angry when other take his possessions or are disturbed during play egocentrism
age of interest in death and dying age 3-4
preschoolers concept of death realization that others die, but not related to self
parental guidance regarding death encourage questions; reassure that people do not generally die until lived a long and happy life
purpose of preschooler discipline teach and gradually shift control from parents to child
when must discipline be given when incident occurs, adapted to seriousness of infraction
time-out discipline 1 min per year of age, sitting in straight chair facing corner, no interaction or eye contact
rewarding child for good behavior is positive and effective discipline
rewards should not be confused with bribes
modeling (good example) significantly influences children because they identify and imitate adult behavior, verbal and nonverbal
consistency must exist both between parents and within each parent
best method of discipline consistency and modeling
jealousy in preschooler normal response to actual, supposed, or threatened loss of affection
age that new sibling jealousy is strongest age 5
indications of jealousy aggression, biting, pinching, regression
to decrease jealousy of sibling make child feel as if helping with care of infant
thumb-sucking (nonnutritive sucking) normal, instinctual behavior with no detrimental effect as long as discontinued before eruption of permanent teeth
to stop thumb-sucking, give praise and encouragement
enuresis involuntary urination after age that bladder control should have been established
primary enuresis bed wetting in child who has never been dry
secondary enuresis recurrence in child who has been dry for period of 1 year or more
diurnal enuresis day-time wetting
nocturnal enuresis night-time wetting
organic causes of nocturnal enuresis UTI, diabetes, seizures, obstructive uropathy, urinary tract abnormalities, sleep disorders
data collection for enuresis pattern of wetting, number of times/wk, daytime voidings, stream type, dysuria, fluid taken between dinner/bed, family hx, stress, parental reaction, medications, developmental landmarks
enuresis management program includes centered around child, limited liquids after dinner, routinely void prior to bed, bladder training exercises to increase size
preschool programs provide structured activities that foster group cooperation and the development of coping skills; promotes gain in self-confidence and positive self-esteem
daily wash care for preschoolers daily bath and shampoo at least twice a week
preschooler clothing loose enough to not restrict movement but allow for active play; shoes should be sturdy and supportive
preschooler accidents include falls from climbing, car safety, burns from experimentation, poisoning from increased freedom
preschooler accident prevention teach dangers of talking to strangers, playing in lonely places, indirect supervision is required
value of preschool play important to physical, mental, emotional, and social development of both healthy and sick children; develop rapport between child and nurse
nursing plan for play important part of EVERY pediatric nursing care plan
nursing considerations of play patient's state of health, overstimulation, fatigue, medical diagnosis; parents should play for child who cannot play for self
help from preschool play noncompetitive; helps child adjust to an expanding world and increased independence
imaginary playmates common and normal during preschool; serves relief from lonliness, mastery of feats, and provision of a scapegoat
play for mentally impaired child more stimulation required, mental age rather than chronological age considered, must be supervised because of poor judgement, may be aggressive; Repetition is necessary
toys and therapeutic play help retrain muscles, improves eye-hand coordination, and helps crawling and walking
example of postoperative therapeutic play blowing out flashlight as if it were a candle
play therapy used for child under stress; counselor watching child play gives better understanding of struggles, fears, resentments, and feelings towards self and others
art therapy assists children to express their feelings and communicate through drawings, dlay, and other media
highest priority for preschoolers safety
nursing implementations for preschoolers provide parental guidance concerning changing behavior patterns, use of time-out and alternative disciple methods must be stressed
preschoolers and hospitalization may be perceived as punishment because child cannot fully understand cause and effect; may cause separation anxiety
separation anxiety stages protest, despair, detachment, regression
articulation disorder only parent can understand child (I'm the only one who understands what she says)
expressive language delay understand what is told, but will only point and not speak (She'll do what I say, but when she wants something, she just points)
global language delay only says one word and can't play "show me your nose" (He can't play show me your nose and the only word he says is mama)
language disorder never made own words, only repeats what I say (He never made those funny baby sounds or said mama and dada and now he just repeats everything I say)
language loss used to talk, not doesn't talk at all (He used to say things like Joey go bye-bye but now he doesn't talk at all)
Created by: cmp12345