Peds Exam Ch 18 CCC PN105
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| What age is the preschool child | age 3-5
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| preschool period is marked by | slowing of growth process and mastery and refinement of motor, social, and cognitive abilities
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| 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
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| Weight __________ from age 1 to age 5 | doubles
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| Marked physical characteristics of preschool children are | taller growth and loss of toddler chubbiness; good muscle control and more adept at familiar skills
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| visual acuity at age 3 | 20/40
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| visual acuity at age 4 | 20/30
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| age that hand preference develops and primary teeth have erupted | age 3
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| normal pulse rate for preschooler | 90-110
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| average rate of respirations for preschooler | 20
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| average BP of preschooler | 85-90/60
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| Piaget preschool phase | preoperational phase
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| Erickson preschool phase | initiative vs. guilt
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| Kohlberg preschool phase | beginning of moral development
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| Parts of preoperational phase | preconceptual, intuitive
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| Preconceptual stage (ages 2-4) | increased development of language and symbolic functioning, including symbolic functioning, egocentrism, animism, and artificialism
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| symbolic functioning | creation of mental image for something that is not there (ex., pretending empty box is a fort)
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| egocentrism | difficulty seeing any point of view other than own
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| animism | tendency to attribute life to inanimate object
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| artificialism | world and everything in it is created by people
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| Inutitive stage (ages 4-7) | prelogical thinking; experience and logic are based on outside appearance; includes centering
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| 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)
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| effects of cultural practices on preschooler | influence development of sense of initiative
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| who models and influences languange developement | parents and older siblings
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| cause of delays or problems in language development | physiological, psychological, or environmental stressors
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| number of words in preschoolers sentence equals | child's age
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| by age 2.5 can verbalize | possessiveness
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| by age 4 can verbalize | past tense
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| by age 5 can verbalize | future tense
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| development of language includes | understanding of language and the expressing of oneself
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| difficulty in language expression can result in | tantrums and acting-out behaviors
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| play activities in preschoolers | increase in complexity
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| play development, age 2-3 | imitation of parents (shaving, vacuuming, etc)
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| play development, age 4 | broader play themes, like trip to zoo or store
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| play development, age 5 | demonstration of imaginary abilities, like flying to moon
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| role of play in preschooler | enables experience of multiple roles and emotional outlets
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| best approach to communication with preschooler; can distract from pain and establish trust | appealing to magical thinking
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| how to preschoolers learn about religious beliefs and practices | observation in the home; abstract concepts are not yet understood
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| observation of religious practices in hospital | can help child deal with stressors
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| 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
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| sexual curiousity in preschooler can be displayed as | masturbation
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| masturbation in preschoolers | is normal and harmless if child is outgoing, sociable, and not preoccupied with the activity
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| 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
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| 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
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| 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
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| 3 year old play type | parallel play and associative play, cooperative play for short periods
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| 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
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| 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
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| 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
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| 3 year olds have this unique development | fear of bodily harm, particularly of body parts
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| behavior when 3 year old becomes angry when other take his possessions or are disturbed during play | egocentrism
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| age of interest in death and dying | age 3-4
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| preschoolers concept of death | realization that others die, but not related to self
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| parental guidance regarding death | encourage questions; reassure that people do not generally die until lived a long and happy life
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| purpose of preschooler discipline | teach and gradually shift control from parents to child
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| when must discipline be given | when incident occurs, adapted to seriousness of infraction
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| time-out discipline | 1 min per year of age, sitting in straight chair facing corner, no interaction or eye contact
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| rewarding child for good behavior is | positive and effective discipline
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| rewards should not be confused with | bribes
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| modeling (good example) | significantly influences children because they identify and imitate adult behavior, verbal and nonverbal
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| consistency | must exist both between parents and within each parent
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| best method of discipline | consistency and modeling
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| jealousy in preschooler | normal response to actual, supposed, or threatened loss of affection
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| age that new sibling jealousy is strongest | age 5
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| indications of jealousy | aggression, biting, pinching, regression
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| to decrease jealousy of sibling | make child feel as if helping with care of infant
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| thumb-sucking (nonnutritive sucking) | normal, instinctual behavior with no detrimental effect as long as discontinued before eruption of permanent teeth
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| to stop thumb-sucking, give | praise and encouragement
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| enuresis | involuntary urination after age that bladder control should have been established
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| primary enuresis | bed wetting in child who has never been dry
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| secondary enuresis | recurrence in child who has been dry for period of 1 year or more
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| diurnal enuresis | day-time wetting
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| nocturnal enuresis | night-time wetting
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| organic causes of nocturnal enuresis | UTI, diabetes, seizures, obstructive uropathy, urinary tract abnormalities, sleep disorders
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| 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
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| enuresis management program includes | centered around child, limited liquids after dinner, routinely void prior to bed, bladder training exercises to increase size
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| preschool programs | provide structured activities that foster group cooperation and the development of coping skills; promotes gain in self-confidence and positive self-esteem
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| daily wash care for preschoolers | daily bath and shampoo at least twice a week
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| preschooler clothing | loose enough to not restrict movement but allow for active play; shoes should be sturdy and supportive
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| preschooler accidents include | falls from climbing, car safety, burns from experimentation, poisoning from increased freedom
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| preschooler accident prevention | teach dangers of talking to strangers, playing in lonely places, indirect supervision is required
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| value of preschool play | important to physical, mental, emotional, and social development of both healthy and sick children; develop rapport between child and nurse
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| nursing plan for play | important part of EVERY pediatric nursing care plan
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| nursing considerations of play | patient's state of health, overstimulation, fatigue, medical diagnosis; parents should play for child who cannot play for self
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| help from preschool play | noncompetitive; helps child adjust to an expanding world and increased independence
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| imaginary playmates | common and normal during preschool; serves relief from lonliness, mastery of feats, and provision of a scapegoat
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| 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
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| toys and therapeutic play | help retrain muscles, improves eye-hand coordination, and helps crawling and walking
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| example of postoperative therapeutic play | blowing out flashlight as if it were a candle
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| play therapy | used for child under stress; counselor watching child play gives better understanding of struggles, fears, resentments, and feelings towards self and others
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| art therapy | assists children to express their feelings and communicate through drawings, dlay, and other media
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| highest priority for preschoolers | safety
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| nursing implementations for preschoolers | provide parental guidance concerning changing behavior patterns, use of time-out and alternative disciple methods must be stressed
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| preschoolers and hospitalization | may be perceived as punishment because child cannot fully understand cause and effect; may cause separation anxiety
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| separation anxiety stages | protest, despair, detachment, regression
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| articulation disorder | only parent can understand child (I'm the only one who understands what she says)
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| 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)
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| 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)
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| 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)
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| 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)
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