Chapter 24: Growth & Development Of The Toddler 1-3 Years

Question 1

What does autonomy mean?

Answer 1

Independence

Question 2

Toddlerhood is a time of _____________ and ______________

Answer 2

Slowed growth
Rapid development

Question 3

How many pounds does each toddler gain?

Answer 3

4.5 to 6.0 pounds

Question 4

How many inches does the toddler grow?

Answer 4

3 inches

Question 5

What are the
1. Personal-Social
2. Fine motor
3. Gross Motor
4. Language
5. Cognitive Development
Of a 12-15 month old (1year and 3months)

Answer 5

1. Begins Erikson’s stage of autonomy vs shame and doubt. Seeks novel way to pursue new experiences. Imitation of people are more advanced
2. Builds with blocks; finger paints, able to reach out with hands and bring food to mouth, holds a spoon, drinks for a cup
3. Movements become more voluntary, Postural control improves; able to stand and may take a few independent steps
4. First words are not generally classified as true language, they are generally associated with the concrete and are usually activity-oriented
5. Begins to accommodate to the environment and the adaptive process evolves

Question 6

What are the
1. Personal-Social
2. Fine motor
3. Gross Motor
4. Language
5. Cognitive Development
Of a 18 month old (1year and 6months)

Answer 6

1. Extremely curious, Becomes a communicative social being, Parallel play, Fleeting contacts with other children, Make-believe play begins
2. Better control of spoon; good control when drinking from cup
   Turns pages of a book
   Places objects in holes or slots
3. Walks alone; gait may still be a bit unsteady
   Begins to walk sideways and backward
4. Begins to use language in a symbolic form to represent images or ideas that reflect the thinking process
   Uses some meaningful words such as hi, bye-bye, and all gone
   Comprehension is significantly greater
5. Demonstrates foresight and can discover solutions to problems without excessive trial-and-error procedures
   Can imitate without the presence of a model (deferred imitation)

Question 7

What are the
1. Personal-Social
2. Fine motor
3. Gross Motor
4. Language
5. Cognitive Development
Of a 24 month old (2 year old)

Answer 7

1. Language facilitates autonomy
   Sense of power from saying no and mine
   Increased independence from mother
2. Turns pages of a book singly
   Adept at building a tower of six or seven cubes
   When drawing, attempts to enclose a space
3. Runs well with little falling
   Throws and kicks a ball
   Walks up and down stairs one step at a time
4. Begins to use words to explain past events or to discuss objects not observably present
   Rapidly expands vocabulary to about 300 words; uses plurals
5. Enters preconceptual phase of cognitive development
   State of continuous investigations
   Primary focus is egocentric

Question 8

What are the
1. Personal-Social
2. Fine motor
3. Gross Motor
4. Language
5. Cognitive Development
Of a 36 month old (3 year old)

Answer 8

1. Basic concepts of sexuality are established
   Separates from mother more easily
   Attends to toilet needs
2. Copies a circle and a straight line
   Grasps the spoon between the thumb and index finger
   Holds cup by handle
3. Balances on one foot; jumps in place; pedals tricycle
4. Quest for information furthered by questions like why, when, where, and how
   Has acquired the language that will be used in the course of simple conversation during adult years
5. Preconceptual phase continues; can think of only one idea at a time; cannot think of all parts in terms of the whole

Question 9

What are the behavioral characteristics?

Answer 9

Negativism, ritualism, dawdling, and temper tantrums

Question 10

What is Negativism?

Answer 10

This age has been called an age of negativism. Certainly, the toddler’s response to nearly everything is a firm no, but this is more an assertion of individuality than of an intention to disobey. Limiting the number of questions asked of the toddler and making a statement, rather than asking a question, is helpful in decreasing the number of negative responses from the child.

** Limit the number of questions asked and offer a choice will help decrease the number of no responses**

Question 11

What is Ritualism?

Answer 11

employed by the young child to help develop security, involves following routines that make rituals of even simple tasks.

Question 12

What is dawdling?

Answer 12

Wasting time or being idle, serves the purpose of asserting independence.

Question 13

What is Temper Tantrums?

Answer 13

aggressive displays of temper during which the child reacts with rebellion to the wishes of the family caregiver, spring from the many frustrations that are natural results of a child’s urge to be independent.

Question 14

What is useless during a temper tantrum?

Answer 14

reasoning, scolding or punishing during a tantrum

Question 15

Tantrums are accompanied by….

Answer 15

head banging and breath holding.

Question 16

The family caregiver should…

Answer 16

remain calm when dealing with a toddler having a tantrum

Question 17

Toddlers use what kind of play?

Answer 17

Parallel Play - toddler plays alongside other children but not with them

Question 18

What toys involve the toddlers new gross motor skills?

Answer 18

push-pull toys, rocking horses, large blocks, and balls

Question 19

What motor skills develop through thick crayons, play dough, finger paints, wooden puzzles with large pieces, toys that fit pieces into shaped holes, and cloth books.

Answer 19

fine motor skills

Question 20

Discipline is

Answer 20

means to train or instruct in order to produce a particular behavior pattern, especially moral or mental improvement, and self-control.

Question 21

Punishment is

Answer 21

penalizing someone for wrongdoing.

Question 22

What happens to the toddle when a newborn comes along?

Answer 22

The toddler regresses to more infantile behavior.
ex: may need or want a bottle and may start wetting themselves again after the new baby is born

Question 23

What preparations is needed before the new baby arrives?

Answer 23

Moving the older child to a larger bed.

Question 24

___ to ____ calorie diet for a toddler

Answer 24

1,000 to 1,400

Question 25

How many cups of fruits should a toddler eat?

Answer 25

1-1.5 cups

Question 26

How many cups of vegetables should a toddler eat?

Answer 26

1-1.5 cups

Question 27

How many oz of grains should a toddler eat?

Answer 27

3-5 oz

Question 28

How many oz of protein foods should a toddler eat?

Answer 28

2-4 oz

Question 29

How many cups of dairy should a toddler eat?

Answer 29

2-2.5 cups

Question 30

What are common eating problems between the ages 1 and 3 years old.

Answer 30

1. The child’s growth rate has slowed; therefore, they may want and need less food than before. Family caregivers need to know that this is normal.
2. The child’s strong drive for independence and autonomy compels an assertion of will to prove their individuality, both to self and to others.
3. A child’s appetite varies. Food jags, the desire for only one kind of food for a while, are common.

Question 31

What are tips for reinforcing family teaching?

Answer 31

1. Messiness is to be expected and prepared for when learning begins; it gradually diminishes as the child gains skill in self-feeding.
2. At 15months, the toddler can sit through meals, prefers finger feeding, and wants to self-feed. They try to use a spoon but has difficulty with scooping and spilling.
3. The 15-month-old grasps the cup with the thumb and forefinger but tilts the cup instead of the head.
4. By 18months, the toddler’s appetite decreases.
5. The 18-month-old has improved control of the spoon, puts spilled food back on the spoon, holds the cup with both hands, spills less often, and may throw the cup when finished if no one is there to take it.
6. At 24months, the toddler’s appetite is fair to moderate.
7. The toddler at this age has clearly defined likes and dislikes and food jags.
8. The 24-month-old grasps the spoon between the thumb and forefinger, can put food on the spoon with one hand, continues to spill, and accepts no help (“Me do!”).
9. By 30months, refusals and preferences are less evident. Some toddlers at this age hold the spoon like an adult, with the palm turned inward. The cup, too, may be handled in an adult manner.
10. The 30-month-old tilts their head back to get the very last drop.

Question 32

Tips for reinforcing family teaching when feeding toddlers

Answer 32

1. serve small portions and provide a 2nd serving when the first has been eaten.
2. Allow substitution for a disliked food. ex: if the child refuses milk sub with pudding, cheese, yogurt and cottage cheese
3. Toddlers like foods served warm or cool
4. Provide a social atmosphere at mealtimes
5. Toddlers prefer foods that they can pick up with their fingers; however, they should be allowed to use a spoon or fork when they want to try.
6. Try to plan regular mealtimes with small nutritious snacks between meals. Do not attach too much importance to food by urging the child to choose what to eat.
7. Dawdling at mealtime is common with this age group and can be ignored unless it stretches to unreasonable lengths or becomes a play for power. Mealtime for the toddler should not exceed 20 minutes. Calmly remove food without comment.
8. Do not make desserts a reward for good eating habits. It gives unfair value to the dessert and makes vegetables or other foods seem less desirable.
9. Offer regularly planned nutritious snacks such as milk, crackers and peanut butter, cheese cubes, and pieces of fruit. Plan snacks midway between meals and at bedtime.
10. Remember that the total amount eaten each day is more important than the amount eaten at a specific meal.

Question 33

What do routine physical checkups include?

Answer 33

assessment of growth and development
oral hygiene
toilet training
daily healthcare
the family caregiver–toddler relationship
parenting skills.

Question 34

Reinforcing family teaching about Bathing

Answer 34

1. set a regular time for the bath
2. never leave the toddler alone
3. bath toys
4. avoid using bubble bath for girls bc of bladder infections
5. a bath is relaxing and can help the child quiet down

Question 35

Reinforcing family teaching about dressing

Answer 35

1. active interest in helping to put on their clothes
2. by 18 months by removing their socks and shoes whenever they please
3. by age 2-3 the toddler can begin by putting on underpants, shirts, or socks.
4. Encourage the family caregiver to take a relaxed attitude as the toddler learns to dress themselves.
5. Roomy clothing with easy buttons; large, smooth-running zippers; and Velcro are easier for the toddler to handle.
6. late infancy, shoes need to be worn primarily to protect the toddler’s feet from harsh surfaces. Sneakers are still a good choice. Avoid hard-soled shoes. High-topped shoes are unnecessary.

Question 36

Reinforcing family teaching about dental care

Answer 36

1. dental caries are a major health problem
2. The development of dental caries is linked to the effect the diet has on the oral environment.
3. When the child is about 2years of age, they should learn to brush the teeth or at least to rinse the mouth after each meal or snack.
4. Plain water should be used until the child has learned how to spit out toothpaste.
5. One good method is to stand behind the child in front of a mirror and brush the child’s teeth
6. The use of fluoride toothpaste strengthens tooth enamel and helps prevent tooth decay, particularly in communities with unfluoridated water.

Question 37

What is a fluoride supplement?

Answer 37

A fluoride supplement is a medication and should be treated and stored as such. Fluoride can also be applied during regular visits to the dentist, but the greatest benefit to the tooth enamel occurs before the eruption of the teeth.

Question 38

When should the toddler go to the dentist?

Answer 38

dentist is recommended to occur soon after the child’s first birthday so the child gets acquainted with the dentist, staff, and office.

Question 39

What happens at the 2nd visit to the dentist?

Answer 39

the child has a preliminary examination and is evaluated for any dental risks. The family caregivers are given anticipatory guidance regarding dental hygiene, diet and dietary habits, and the use of fluoride.

Question 40

How many visits are recommended in a year?

Answer 40

two

Question 41

Children of low-income families often have ___ dental hygiene and _____.

Answer 41

poor and care because of the cost of care and lack of knowledge of the family caregiver about proper care and nutrition.

Question 42

Some family caregivers may believe it is unnecessary to take proper care of baby teeth… why?

Answer 42

“they fall out anyway.” However, the care and condition of the baby teeth affect the normal growth of permanent teeth, which are forming in the jaw under the baby teeth.

Question 43

Reinforcing family teaching about toilet training

Answer 43

Toilet training can be started when the child’s sphincter muscles have developed enough so the child can control them; this usually occurs at age 18 to 24months. Perfection should not be expected. To aid in training, the caregiver leaves the child on the potty chair for only a short time. If the child has a bowel movement or urinates after leaving the potty, this is ignored. The child should not be teased, and the potty chair should not be emptied until the child has gone back to playing or other activities.

Question 44

Reinforcing family teaching about sleep

Answer 44

1. 12-14 hours of sleep is to be expected in the first year of toddlerhood
2. decreasing to 10-12 hours by 3 years old
3. The toddler soon gives up a morning nap, but most continue to need an afternoon nap until sometime near the third birthday
4. Bedtime rituals provide structure and a feeling of security because the toddler knows what to expect and what is expected of them
5. The separation anxiety common in the toddler may contribute to some of the toddler’s reluctance to go to bed.
6. Family caregivers must be careful that the toddler does not use this to manipulate them and delay bedtime.
7. Gentle, firm consistency by caregivers is ultimately reassuring to the toddler.
8. Regular schedules with set bedtimes are important.

Question 45

Tips for reinforcing family teaching preventing motor vehicle accidents

Answer 45

1. Never start the car until the child is securely in the car seat.
2. If the child manages to get out of the car seat or unfasten it, pull over to the curb or side of the road as soon as possible, turn off the car, and tell the child that the car will not go until they are safely in the seat. Children love to go in the car, and they will comply if they learn that they cannot go unless in the car seat.
3. Never permit a child to stand in a car that is in motion.
4. Remind the toddler to stop at a curb and wait for an adult escort to cross the street. An older child should be taught to look both ways for traffic. Start this as a game with toddlers, and continually reinforce it.
5. Remind the child to cross only at corners.
6. Begin in toddlerhood to instill awareness of traffic signals and their meanings. As soon as the child recognizes color, they can tell you when it is all right to cross.
7. Never let a child run into the street after a ball.
8. Remind the child to never to walk between parked cars.
9. As a driver, always be on the alert for children running into the street when in a residential area or running in a parking lot.

Question 46

How to prevent drowning

Answer 46

never leave a mobile infant or toddler unattended

Question 47

How to burns occur?

Answer 47

Burn accidents occur most often as scalds from immersions and spills and from exposure to uninsulated electrical wires or live extension cord plugs.

Question 48

Tips for reinforcing family teaching for preventing burns

Answer 48

1. Do not let electrical cords dangle over a counter or a table. Repair frayed cords. Newer small appliances have shorter cords to prevent dangling.
2. Cover electrical wall outlets with safety caps.
3. Turn handles of pans on the stove toward the back of the stove. If possible, place pans on back burners out of the toddler’s reach.
4. Place cups of hot liquid out of reach. Do not use overhanging tablecloths that toddlers can pull.
5. Use caution when serving foods heated in the microwave; they can be hotter than is apparent.
6. Supervise small children at all times in the bathtub so they cannot turn on the hot water tap.
7. Turn thermostat on home water heater down so that the water temperature is no higher than 120°F.
8. Place matches in metal containers and out of reach of small children. Keep lighters out of reach of children.
9. Never leave small children unattended by an adult or a responsible adolescent.

Question 49

What are the types of substances a toddler would want to sample?

Answer 49

cosmetics, personal care products, household cleaners, prescription or over-the-counter drugs, kerosene, gasoline, peeling lead-based paint chips or dust particles, or nicotine (electronic cigarettes, gum, patches).

Question 50

__________ is still the most common medical emergency in children with the highest incidence between the ages of 1 and 4years.

Answer 50

Poisoning

Question 51

What medications are most commonly involved in cases of childhood poisoning?

Answer 51

Acetaminophen
Salicylates (aspirin)
Laxatives
Sedatives
Tranquilizers
Analgesics, such as ibuprofen, opioids
Antihistamines
Cardiac medications
Cough/cold medicines
Birth control pills

Question 52

TIPS FOR REINFORCING FAMILY TEACHING for Preventing Poisoning

Answer 52

1. Keep harmful products and household cleaning products (laundry and dishwashing detergent pods) locked up and out of a child’s sight and reach.
2. Use safety latches or locks on drawers and cabinets.
3. Read labels with care before using any product.
4. Replace child-resistant closures and safety caps immediately after using product.
5. Never leave alcohol or electronic cigarettes/nicotine refill cartridges, gum, patches within a child’s reach.
6. Keep products in their original containers; never put nonfood products in food or drink containers.
7. Remind children not to drink or eat anything unless it is given to them by a trusted adult.
8. Do not take medicine in front of small children; children tend to copy adult behavior.
9. Do not refer to medicine as candy; call medicine by its correct name.
10. Check your home often for old medications and get rid of them following the U.S. FDA drug disposal guidelines (U.S. FDA, 2019).
11. Keep button battery compartments on household products taped and secured, store batteries out of reach and sight of children, and do not allow children to play with batteries.
12. Keep plants off floor and out of children’s reach.
13. Keep lotion, cream, powder, cosmetics, insect repellent out of children’s reach.
14. Post the Poison Help Line (formerly called the Poison Control Center) number near each telephone: (800) 222-1222.
15. Program the Poison Help Line number into your cell phones and into your home phone.

Question 53

What does the social assessment cover?

Answer 53

eating habits and food preferences, toileting habits and terms used for toileting, family members and the names the child calls them, the name the child is called by family members, pets and their names, favorite toys, sleeping or napping patterns and rituals, and other significant information that helps the staff better plan care for the toddler

Question 54

As the nurse you may become a ________ while caring for the child

Answer 54

surrogate parent

Question 55

The nurse should maintain….

Answer 55

as much as possible the pattern, schedule, and rituals that the toddler is used to helps to provide some measure of security to the child. This is a time when the toddler needs the security of a beloved thumb or other lovey, a favorite stuffed animal or blanket. It is important to recognize that the toddler uses this to provide self-comfort

Question 56

The toddler transitions from sensorimotor phase to

Answer 56

Preoperational phase around 2 years of age
1. increased object permanence
2. Tertiary circular reactions
3. Domestic mimicry
4. Begin to problem solve through trial and error
5. Have memories of events they relate to

Question 57

What is object permanence in the sensorimotor stage?

Answer 57

1. Peek-a-boo: this is done by covering the face with hands, blanket, or other available materials
2. Container Play: as children explore the sensorimotor stage they would enjoy having container play. This play helps them develop object permanence and cause-and-effect thinking
3. Stacking Play: playing building blocks and stacking them contribute to the development of motor activities and turn-taking opportunity.
4. Sensorimotor activities: parents can begin providing their children with sensory bottles, sensory bags, sensory sticks, and sensory boards to make them acquire object permanence.