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Peds Exam 1
Toddler & Preschooler Child Development And Health Promotion pt 1
| Question | Answer |
|---|---|
| SIDS Protective Factors | Breastfeeding Pacifier use at naps and bedtime Back to sleep at naps and bedtime Room share, don’t bed share: separate sleeping surface for 6 mo Safe sleeping environment |
| ABC of safe sleep | Alone, Back, Crib |
| safe sleep environment | Supine position- ‘back to sleep” Firm, non-inclined sleep surface Room sharing without bed sharing Avoid soft bedding and overheating No toys in crib/bassinet |
| bundle baby under their neck until | they can roll |
| Healthy People 2030 Safe Sleep | Increase the proportion of infants who are put down to sleep on their backs |
| Common Developmental Concerns Infancy | Separation and Stranger Anxiety Colic Thumb sucking, pacifiers, security items Spitting up Teething |
| early childhood development ages | toddlers 1-3 years preschoolers 3-6 years so there is some overlap |
| toddlers age | 1-3 years |
| toddlers want to be | independent |
| toddlers anterior fontanel | closes 12-18 months, diamond on top of their head |
| physical growth - toddlers physical growth | Slower but steady increase in height and weight |
| by 2, toddlers are | half of their adult |
| toddlers weight | 4x their birth weight at 30 months 3x at 12 months 2x at 4-5 months |
| at 3, head is more | proportioned to body |
| at 1 year, head is | equal to chest |
| at 2 years, head is | bigger than chest |
| toddlers have a | pot belly look trunk heavy with bowed legs, growing occurs in spurts |
| physical growth toddlers - sensory changes | Visual acuity 20/40- acceptable Depth perception still developing Taste- lack of discrimination- at risk for poisoning |
| toddler vision | binocular vision, should no longer have cross eyes |
| since depth perception in toddlers is still developing, | they are at risk for falls |
| toddler taste lack of discrimination | if we drink something bad, we know it's bad but kids do not |
| physical growth toddlers - neurological | 75% complete brain growth at 2 years, 90% at 3 years Myelinization of spinal cord nearly complete at 2 years |
| since the brain growth is 90% at 3 years, | we stop measuring head circumference at 3 |
| Myelinization of spinal cord nearly complete at 2 years which means | kids now have control over their rectal and urinary sphincters so can start potty training |
| physical growth toddlers - improved immunity because | they are being exposed to more at daycare |
| physical growth toddlers - respiratory | Tongue, tonsils and adenoids large Eustachian tubes short and straight |
| Tongue, tonsils and adenoids large in toddlers because | developing more alveoli |
| Eustachian tubes short and straight so toddlers are prone to | ear infections |
| physical growth toddlers - cardiovascular | HR decreased, BP increases Blood vessels easily compressed when palpated |
| since blood vessels easily compressed when palpated, | you must use light touch for pulse |
| what age is primary dentition (full set of teeth) complete by | 30 months |
| physical growth toddlers - GI | Enlarging stomach size Slowed growth requirements reduce intake so don't need as many calories Voluntary control of elimination so potty train |
| physical growth toddlers - GU | Bladder capacity increases Control of urethral sphincter Short urethra = inc risk of UTI |
| gross motor skills at 15 months | Takes a few steps alone |
| fine motor skills at 15 months | Feeds self finger foods (pincer grab) |
| gross motor skills at 18 months | Walks independently Climbs on and off furniture Climbs stairs with help Seats self in a chair |
| fine motor skills at 18 months | Scribbles Tries to use a spoon Throws a ball Stacks 3–4 blocks |
| gross motor skills at 24 months | Runs Kicks a ball Walks up and down stairs with help |
| fine motor skills at 24 months | Eats with a spoon Stacks 6–7 blocks STARTS to turn doorknobs, unscrew lids Points to named pictures and objects |
| gross motor skills at 30 months | Jumps off the ground with both feet |
| fine motor skills at 30 months | CAN turn knobs Turns book pages one at a time Takes off some clothing |
| gross motor skills at 36 months | Pedals a tricycle Climbs well, runs easily Bends over without falling |
| fine motor skills at 36 months | Uses a fork Strings items together Puts on some clothes by self Copies a circle |
| anticipatory education with rolling | when rolling, don't leave unattended on changing table |
| Cognitive Development Toddler | Piaget-Sensorimotor transitions to Preoperational around 2 yrs and goes until 7yrs Object permanence fully developed Have memories that relate to them Unable to understand other viewpoints- Egocentric Mental representation (18-24mo) Reading daily |
| since toddlers are egocentric, | they don't want to share but it is normal |
| Mental representation (18-24mo) | don't see something but remember it and use another object to mimic it |
| reading daily AND | having normal conversations! |
| language development for toddler | Comprehension (receptive language) out-paces communication (expressive language) |
| 12 months language milestone | understands “no”, imitates gestures (waving goodbye) |
| 15 months language milestone | uses finger to point, follows command with gesture |
| 18 months language milestone | > 3 words other than “mama,” “dada”, most 10-15 words, follows command without gesture |
| if 18 months and doesn't know name or follow commands without gesture, then | autism |
| 24 months language milestone | 2-word sentence |
| 2-word sentences is | "me up" telegraphic speech - cutting out necessary words |
| echolalia | resolves by age 3 repeat over and over again something they heard someone else say |
| 30 months language milestone | 50 words |
| 36 months language milestone | understood by most people outside family |
| it is important to do what during language development | parental reading and talking aloud |
| Body Image | Exploration away from caregivers Begin naming body parts Unclear body boundaries |
| Unclear body boundaries as toddler so | pooping can be difficult and cause them stress |
| Gender Identity | Aware of their gender and expected set of behaviors comes from their environment, based on clothing/toys |
| Psychosocial Development — Toddler | Toddler (1–3 yr): Autonomy vs. Shame and Doubt |
| autonomy | I can do it myself — let me choose. "me do" |
| Shame & Doubt | Assertiveness considered unacceptable = I doubt myself; my efforts are wrong. |
| what to do when toddlers are in autonomy vs shame and doubt | give them choices but not yes or no choices praise attempts not just results |
| Psychosocial Development Toddler | Increasing independence & self-control Learning socially acceptable behaviors & language Individuation/separation allows for emerging sense of others Transitional/security objects- helps with stress Temperament |
| parents are correcting and teaching toddlers which is how they have and learn... | Increasing independence & self-control Learning socially acceptable behaviors & language |
| stranger anxiety - early toddler | Peaks 15-18 months Resolves ~ 30 months and by 3 because daycare starts |
| Individuation/separation allows for emerging sense of others which leads to | building peer relationships and they begin to play with others |
| Transitional/security objects | Favorite toy, blanket - beneficial in hospital!! Helps to self- soothe, dev autonomy |
| temperament is | inherited |
| psychosocial development toddlers - Ritualism and Negativism | Transitional objects for security, LOVE routine and rituals |
| difficult thing with toddlers is | you can not reason with them! keep them safe, stay in the area but ignore (extinction) |
| psychosocial development toddlers - temper tantrums | totally normal!! it is their inability to control environment |
| sibling rivalry during toddler age | jealous of sibling |
| toddler regression | NORMAL to regress, educate to just ignore! |
| Sociocultural Influences on the Toddler | Four forces shaping growth, nutrition and daily routines — assess every one |
| Homelessness and poverty affecting toddler | Food insecurity and unstable housing Missed well-child visits and immunizations |
| Food customs affecting toddler | Which foods are offered, and when Shapes intake and growth patterns |
| Family values affecting toddler | Who makes health decisions Expectations for discipline and independence |
| Culture affecting toddler | Beliefs about illness and treatment Language and health literacy needs **get interpreter |
| Moral Development Toddler | Egocentric- unable to see things from other’s perspective, can only see from their perspective |
| moral development in toddler: punishment and obedience | Believe good behavior is rewarded and bad behavior is punished, comes with consistency!! |
| toddler play is | parallel play |
| parallel play is | when 2 children play alongside each other but never play together |
| activities for toddler | KNOW: fill and empty containers, play with blocks, books, push-pull toys, tossing balls, finger paints, large-piece puzzles, thick crayons, outdoor and physical play |
| Health Promotion and Common Concerns Toddler | Nutrition Sleep and Activity Dental health- see infancy section Appropriate Discipline Toilet training Temper Tantrums Injury prevention |
| toddlers establish lifelong eating habits by what age | 3 |
| what kind of eaters are toddlers | picky eaters |
| toddlers experience | physiological anorexia |
| a typical spaced out diet for a day for a toddler | 3 meals and 2 snacks- smaller portions |
| what should toddlers be eating | Well balanced fruits, veggies, whole grains Like finger foods, different colors and shapes Easy to chew and swallow, avoid hard, round foods |
| ritualism | toddlers like the same foods (food jag), cup and plate |
| what should you not do with toddlers and food | use food as a reward |
| children should be watched eating | mastication is still developing make sure they're eating in a chair and not running choking is silent!! |
| Healthy People 2030 - Nutrition | Reduce the proportion of children and adolescents aged 2–19 years who have higher weight |
| sleep for toddlers | Bedtime resistance Frequent night waking Nightmares Encourage bedtime routine!!!! Night light since they're afraid of dark Transitional object |
| toddlers and safe sleep | don't need to worry about that so toddlers can have a blanket or stuffy if that makes them feel better |
| activity and bedtime for toddlers | decreased activity before bed starting at 4mo |
| toddlers activity | high level, risk for obesity, want at least 1hr physical activity a day |
| toilet training for toddlers - nurse job | help parent recognize readiness |
| what does readiness for potty training look like | Awareness Interest in and/or motivation Being dry for at least 2 hours during day Being able to sit, pull pants down, follow directions |
| tips for toddler potty training | master bowel control first and night control last |
| temper tantrums in toddlers are more likely if | hungry and tired |
| temper tantrums in toddlers are | age appropriate lack of self control inability to control their environment and attempt to regain control |
| what to do if your toddler is having a temper tantrum | Remain present- keep safe Ignore behavior Provide ways to express frustration - find something else to be upset with |
| sibling rivalry in toddlers | Keep routine Individual time daily Involve in care of sibling Encourage 1 on 1 time with parent |
| discipline in toddlers | Catching- positive reinforcement Extinction Time out - 2.5-3 years old Physical punishment- inadvisable |
Created by:
leh195