Chapter 26: Growth and Development Toddler

Question 1

Toddlerhood

Answer 1

From 1 to 3 years of age. Refinement of motor skills, cognitive development, and language skills

Question 2

Growth

Answer 2

Growth occurs in Spurts. Weight gain is 3 to 5 pounds per year. Height increases about 3 inches per year. By two years old they are half their adult height. Head increases 1” by 2 years and half inch a year until five. Anterior fontanel closed by 18 months

Question 3

organ systems

Answer 3

Brain: 80% adult size by 3… myelinization complete around 24 months.

Respiratory: Alveoli increase until age 7

Heart rate decreases BP increases

Bladder and kidney adult function by 16-24 months. Short urethra leads to UTIs

Question 4

Erikson

Answer 4

autonomy vs shame and doubt

Question 5

Piaget

Answer 5

Sensorimotor
Substage 5: tertiary circular object permanence 12-18
Substage 6: mental combinations. 18-24, imitation
Preoperational: 2-7 yrs. imitation and animism

Question 6

Gross Motor skills

Answer 6

12 to 15 walks independently
18 months climbs stairs with assistance, pulls toys
24 months runs kicks ball, tiptoe, several toys while walking, up-and-down furniture
36 month climbs, pedals tricycle, runs easily, up-and-down stairs alternate feet, bend over without falling.

Question 7

Fine motor skills

Answer 7

12 to 15 feeds self finger foods,
18 month reaches, grasps, releases, turns book pages, remove shoes, stacks 4 cubes
24 month tower of 6 to 7, right or left-handed, imitates circular and vertical strokes, scribbles, turn knobs, pegs in holes
36 months undresses self, draw circle, 9 to 10 cubes stack, pencil in the correct position, screw and unscrew, turn book pages one at a time

Question 8

Language development

Answer 8

Receptive language is the ability to understand what is being said. It is more advanced than expressive language. 50 words by two years, echolalia. Why and what. At three years old telegraphic speech which contains the essential words to get the point across. Stuttering start between two and four years and usually resolve within a couple years

Question 9

Separation anxiety

Answer 9

Usually reemerges from 18 to 24 months. It should ease up in between 2 to 3 years.

Question 10

The hospitalized Toddler

Answer 10

The primary task is establishing autonomy, and the toddlers focus is mobility and language development. You must try to promote continued development during this time.

Question 11

Possible nursing diagnoses

Answer 11

Delayed growth and development. Imbalanced nutrition. Interrupted family processes. Readiness for enhanced parenting. Risk for caregiver role strain. Risk for delayed development. Risk for disproportionate growth. Risk for injury

Question 12

Findings of developmental delay

Answer 12

Continued tiptoed walking or failure to develop a walking pattern. By 18 months not walking, not speaking 15 words, not understanding function of household items.
By two years does not use two word sentences, does not imitate, does not follow basic instructions, cannot push a toy with Will.
By three years difficulty with stairs, frequent falling, Cannot build a tower of more than four, difficulty manipulating small objects, extreme separation anxiety, can’t copy circle, no make-believe play, cannot communicate in short phrases, doesn’t understand instructions, no interest in other kids, unclear speech, drooling

Question 13

Toddler play

Answer 13

At least 30 minutes of structured physical activity and at least one up to several hours of unstructured activity per day.

Question 14

Safety

Answer 14

Drowning is the leading cause of unintentional injury and death in US children. The highest rate occurs in 1 to 2-year-old

Question 15

Nutrition

Answer 15

At least 500 mg of calcium per day. One cup of milk provides 300 mg of calcium. Broccoli, oranges, sweet potatoes, tofu, beans are also a good source. Spinach is not a good source of calcium.

Iron deficiency anemia in the first two years is associated with development and psychomotor delays. Give iron fortified cereals and other foods along with vitamin C.

A vegan diet is lacking in vitamin D, vitamin B12, and iron.
Fiber 19 g. Fat intake between 20 to 30% of total calories. Milk Limited to 16 to 24 ounces.

Fiber: applesauce, carrots, corn, green beans, mangoes, pears folates: avocados, broccoli, peas, oranges, dark greens, strawberries
vitamin K: apricots, cantaloupe, carrots, mangoes, dark green, Sweet potatoes
vitamin C broccoli, cantaloupe, peas, oranges, potatoes, strawberries, tomatoes

Three full meals about one fourth the size of an adult portion and two snacks

Obesity risk factors are having a parent that is overweight or obese, and an increase in juice intake

Question 16

Sleep and rest

Answer 16

18 month: 13.5 hours
24 month: 13 hours
three-year-old: 12 hours.
You should sleep through the night and take one daytime nap. Most napping is stopped around three years old

Question 17

Teeth

Answer 17

Full set by 30 months. Use pea size amount of fluoride toothpaste beginning at two years. Weaned from bottle no later than 15 months.

Question 18

Discipline

Answer 18

Spanking before 18 months of age could increase possibility of physical injury. The toddler cannot link the Spanking to the behavior.

Focus on limit setting, negotiation, and techniques to learn problem-solving. Be consistent. They do not understand the concept of sharing. Reward for good behavior. Timeouts can be used starting at 2.5 to 3 years. Extinction is ignoring the behavior and is effective.

Question 19

Developmental concerns

Answer 19

Toilet teaching, temper tantrums, thumbsucking or pacifier, sibling rivalry, regression