2. Health Promotion for the Toddler Flashcards
Growth & Development During Early Childhood
The toddler: __-__ months
> Struggles for autonomy
> Develops a sense of self separate from parents
> Increased motor skills and lack of experience increase the risk for injury
> Egocentric and demanding behaviors
* Temper tantrums
* Negativism
* “terrible two’s”
12-36
Physical Growth & Development
> Birth weight quadrupled by 2-3 years
> Half of adult height between ages 2 and 3 years
> Brain growth slows
> Immature abdominal musculature: “pot-bellied” appearance
> Muscle tissue gradually replaces most adipose tissue (baby fat)
Healthy People 2030 Goals for Toddlers
* Increase proportion of parents who use positive parenting and communicate with their healthcare provider about positive parenting
* Achieve and maintain effective vaccination coverage levels for recommended vaccines
* Prevent an increase in the rate of poisoning deaths
* Increase age-appropriate vehicle restraint system use
* Prevent an increase in the rate of fall-related deaths
* Reduce drowning deaths
* Prevent inappropriate weight gain in children ages 2-5 years
* Reduce the proportion of children ages 3-11 years exposed to secondhand smoke
Motor Development
> Learns to walk well
* Regular beds may replace cribs
> Perfects fine-motor skills
> Hand-eye coordination improves
> Can feed themselves with a spoon, although it’s messy
> Can dress simple items of clothing but can’t differentiate front from back
> Can zip large zippers, put on shoes, wash and dry hands
> Can brush own teeth
Cognitive & Sensory Development
> Consumed with curiosity and boundless energy
> Tremendous cognitive growth
> Piaget’s ___ period
* Learning by trial and error
> ___ stage of cognitive development
> ___ is firmly established
> Uses symbols and words when referring to absent people or objects
> Mimics same-sex parent performing household tasks - ___
> Imitates the parent putting on make-up or shaving after parents leave for work - ___
> Enjoys opening doors and drawers
sensorimotor
Preoperational
Object permanence
domestic mimicry
deferred imitation
> Preoperational stage of cognitive development starts around age 2 and is characterized by
___ - unable to consider other’s point of view
> Takes toy away from another child
___ - believes inert objects are alive
> When tripping over toy scolds toy for “hurting” them
Egocentrism
Animism
___ - cannot process in reverse
> Takes toy apart and cannot put back together
___ - wishes comes true
> Believes wishes come true
___ - focuses on only one aspect of an experience
> Cannot follow more than one direction at a time
Irreversibility
Magical thought
Centration
Language Development
> Most children can communicate verbally by their second birthday
> Between 15- and 24-months language develops rapidly
> Toddlers can understand more than they can say
> By age ___, 60-70% of speech should be understandable
> By 24 months toddler knows 300 or more words
> Encouraged to express needs rather than parents anticipating and providing what they want before they ask
2
Psychosocial Development
> Characterized by the struggle for autonomy
> Develops a sense of self separate from the parent
> __ __ __ __ __ (Erikson)
* Realize they have a will and that they can control others even though they don’t often get what they want
* Learn which behaviors gain approval as opposed to those that lead to censure and discipline
* Right and wrong determined by consequences of actions
* Universal behaviors
> ___ - favorite word “no”
> ___ - routines are important
Autonomy versus shame and doubt
Negativism
Ritualism
* Separation anxiety peaks again
> May use transition objects (favorite blankie) to help with anxiety
> Spends most of the time at play - it is the child’s work
* ___ - play alongside others but not “with” others
* ___ - acting out scenes of everyday life
Paralell play
Symbolic play
Age-Related Activities and Toys for Toddlers
General Activities
> Fills and empties containers
> Begins dramatic play
> Increased use of motor skills
> Enjoys feeling different textures
> Explores the home environment
> Imitates orders
> Likes to be read to
> Looks at books and television programs that are age appropriate
Toys and Specific Types of Play
> Continued exploring of the body part of self and others; mechanical toys; objects with different textures, such as sand and clay and finger paints, large puzzles, trucks, dolls
> Therapeutic play begins
Psychosexual Development
* Gender identity and body image are developing
* Model people important to them
* Sexual curiosity, anatomic exploration, and masturbation are common
* Encourage parents to answer questions simply and honestly
* Children should not be shamed or punished for self-comforting behaviors
Health Promotion - Nutrition
Nutritional Requirements
> Solid foods
* 3 meals and 2 snacks each day
> Age-related challenges
* Limit sugar
* Offer a choice between healthy foods only
* Allow child to participate in shopping
* Be a role model
> Food jags
* Volume varies each day
* One day they like a food and the next day they reject it
> Physiologic anorexia
* Related to growth rate slowing down and appetite decreases
* Limit snacks, milk (16-24 oz/day), and juices
* Focus on weekly intake rather than daily
Nutritious Snacks
* Fresh fruit
* Celery sticks with cheese spread
* Yogurt
* Bagels
* Carrot sticks
* Graham crackers
* Pretzels
* Puddings
Increasing Nutritional Intake
* Limit to 2 nutritious snacks per day and give only at toddler request
* Limit to 4-6 ounces of juice per day
* Introduce finger foods at 8-10 months
* Limit to 16-24 ounces of milk per day
* Keep mealtimes pleasant
* Do not force feed
* Do not feed children who can feed themselves
Health Promotion - Dental Care
* All __ deciduous teeth are present by age 30 mos
* Proper care of these teeth is crucial for the child’s general health and alignment of permanent teeth
* Nurses should teach
> Good oral hygiene
> Adequate fluoride intake
→ 6 mos - 3 years - 0.25 mg daily fluoride supplement
> Regular dental checkups
20
Health Promotion: Sleep & Rest
> 12-14 hours of sleep per day
> Still takes one nap per day
> Often resist causing temper tantrums
* Set firm consistent limits
* Wind down 30 minutes prior to bedtime with quiet activity
* Warm bath
* Bedtime rituals
* Transition objects
* Avoid high carbohydrate snacks before bedtime
Health Promotion: Discipline
> Need and want discipline to feel secure
> Unaware of the consequences of their actions so vigilance and limits are needed for safety
> Firm, consistent discipline helps toddlers learn self-control
> Ignore temper tantrums once safety has been assured
> Positive reinforcement of acceptable behavior
> Use diversion or timeouts (one minute per year of age)
> Discipline must be immediate, realistic, age appropriate
