[Exam 3] Chapter 26 – Growth and Development of the Toddler Flashcards
Normal age here?
1-3 year old child
Physical Growth: How is growth here?
In spurts.
Physical Growth: Average weight gain a year?
1.36-2.26 (3-5 lbs) per year
Physical Growth: Length increase here?
7.62 cm (3 inches) per year
Physical Growth: When do they reaach half of their adult size?
By age 2
Physical Growth: Head circumference change?
Increase by 2.54 cm (1 inch) between 1-2, and then half a inch per year until 5
Physical Growth: When does anterior fontanel close?
At 18 months
Organ System Maturation - Neurologic System: Size of brain by 2 years?
HAs reached 90% of its adult size
Organ System Maturation - Neurologic System: When does myelination of brain and spinal cord stop?
Complete around 24 months of age
Organ System Maturation - Neurologic System: What changes does myelineation cause?
Improved coordination and equilibrium as well as ability to exercise sphincter control
Organ System Maturation - Respiraotry System: When does this reach maturity?
At 7 years of age.
Organ System Maturation - Cardiovascular System: What happens to heart rate and blood prssure?
HR decreases, and blood pressure increases.
Organ System Maturation - GI System: What changes occur here?
Pepsin production mature by 2.
Small intestine grows until adulthood.
Stools decrease to 1 per day.
Stool may change color.
Organ System Maturation - Urinary System: When does bladder/kidney reach adult levels?
By 16-24 months of age, allowing 1 mL/kg/hour
Organ System Maturation - Musculoskeletal System: What happens by 3 years of age?
Musculature strengthens and the abdomen is flatter
Psychosocial Development: Erikson theory that toddler develops?
Autonomy vs Shame and Doubt. Time to exert independence meaning their favorite response is no.
Cognitive Development: What does Jean Piaget believe here?
Toddlers move through last two substages of first stage, the sensorimotor stage between 12-24 months.
Cognitive Development: What behaviors is the toddler expressing by 2 years of age?
Capable of using symbols to allow for imitation, allowing then to imitiate household tasks
Cognitive Development: Piaget identified the second stage of cognotive development as?
The preoperational stage. Occurs between 2-7 years.
Toddlers begin to become more sophisticated with symbolic thought
Cognitive Development: How do they view objects in preoperational stage?
Begin to have characteristics that make them unique from one another. Considered small or large, have particular color, or unique texture
Cognitive Development: They may do animism , which is what?
Human feelings and characteristics that is attributed to objects
Cognitive Development: Activities to promote Eriksons Autonomy vs Shame and Doubt?
Achieves autonomy and self control. Separates from parent/caregiver. Withstands delayed gratification.
Cognitive Development: Freuds stage , and activites here?
Anal Stage
Focus is on achieving anal sphincter control. Satisfaction and/or frustration may occur as toddler lears to withhold and expel stool
Motor Skill Development: Fine motor skills progress from holding and pinching to what
ability to manage utensils, hold a crayon, string a bead and use a computer
Gross Motor Skills: What is the toddler gait?
Toddler does not walk smoothly and maturely. Instead, legs are planted widely apart, toes pointed forward, and the toddler seems to sway from side-to-side .
Gross Motor Skills: What is the parachute reflex?
When they outstretch their arms to catch themselves when they fall.
Fine Motor Skills: What skills are learned here?
Holding utensils require more control and agility, and is needed for buttoning and zipping. Are able to fit a puzzle piece or sring a bead.
Sensory Development: How is their eyes by the time they are toddler?
Reaches 20/50 to 20/40 in both eyes.
Communication and Language Development: What is receptive language?
The ability to understand what is being said or asked.
Communication and Language Development: What is expressive language?
ability to communicate one’s desires and feelings
Communication and Language Development: What does it mean they receptive language is learned before expressive?
Toddler understands language and is able to follow commands far sooner than they can actually use the words themselves.
Communication and Language Development: How will the toddler begin to use expressive language?
Young toddler begins to use short sentences and will have vocab of 50 words by 2 years
Communication and Language Development: What is Echolalia?
Repetition of words and phrases without understanding, normally in those younger than 30 months of age.
Communication and Language Development: What is Telegraphic speech?
Common for 3 year olds. Refers to speech that contains only the essesntial words to get the point across.
Communication and Language Development: Example of Telegraphic Speech?
Instead of “I want a cookie and milk”, they will say “Want cookie milk”
Emotional and Social Development: Emotional development focused on what?
Separation and individuation. See themselves as separate from parents and form a sense of self and exert control over their environment
Emotional and Social Development: What is egocentrism?
They begin to focus on themselves. Want to control results that may result in being very happy one second, and overreacting the next moment
Emotional and Social Development: When do power struggles occur?
During the toddler stage. Important to develop rituals and routines that will provide stability and security for toddler
Emotional and Social Development: How can adults help control aggressive behaviors?
Building empathy by pointing out when someone is hurt and explaining what happened. Toddlers should not be blamed for their impulsive behavior. Should be guided toward socially acceptable acction instead
Emotional and Social Development - Separation Anxiety: What problem arises due to realization that if they have ability to leave, so does parent
Develops as conflicts over closeness versus xploration occur
Emotional and Social Development - Separation Anxiety: When may separation anxiety re-emerge?
In 18-24 month period and will ease by 24-36 months
Emotional and Social Development - Temperament: Easygoing toddler may act how?
Apapt more easily and not mind changes in routine as much as other todlers. Usually sleeps and eats well.
How will a difficult toddler be more likely to act?
More intense reactions, negative or positive, with temper tantrums being more likely and more frequent and more intense.
Emotional and Social Development - Temperament: How will a slow-to-warm-up toddler act?
Is more of a loner and may be very shy. May experience more difficulty with separation anxietyu.
Emotional and Social Development - Fears: Common fears here include?
Loss of parents, and fear of strangers.
Promoting Healthy Growth/Development: How can foundation for self-esteem be developed?
Those who give their toddle rlove and respect regardless of a child’s gender, behavior, or capabilities . Built through familiarity with daily routine
Promoting Healthy Growth/Development: What happens when routine and limits are absent?
Toddler develops feelings of uncertainty and anxiety
Promoting Healthy Growth/Development: Signs of developmental baby after walking for several months?
Persistent tiptoe walking. Failure to develop a mature walking pattern
Promoting Healthy Growth/Development: signs of developmental delay by 18 months?
Not walking, not speaking 15 words, and does not understand function
Promoting Healthy Growth/Development: signs of developmental delay by 2 years?
Does not use two-word sentences, and does not imitate actions
Promoting Healthy Growth/Development: Signs of developmental delays by 3 years?
Difficulty with stairs, frequent falling, and cannot build tower more han four blocks
Promoting Growth/Development W/ Play: How much play do they need?
At least 30 minutes of structured physical activity , and anywhere from 1 to several hours of unstrucured physical activity
Promoting Early Learning - Promoting Language Development: How should the parents give the child the opportunity to use the word “no”?
By asking silly questions like “can a cat drive a car?
Promoting Early Learning - Encourage Reading: What does reading everyday do?
Best way to promote language and cognitive development
Promoting Early Learning - Choosing Preschool: What does preschool help toddler with?
Become more mature and independent and give the toddler a different source for sense of accomplishment.
Promoting Early Learning - Choosing Preschool: What environment should parents look for?
Goals and overall philosopy work wel
Teachers trained in early childhood development
Small class size
Parents can visit at any tim
Promoting Early Learning - Choosing Preschool: How can you ease toddler into going here?
Talk about preschool and visit the school a couple of times. Should tell infant that they will pick them up.
Promoting Safety - Safety in Car: What seat should they use until 2 years?
Rear-facing car seat with harness straps and a clip until 2 years
Promoting Safety - Safety in Car: what seat can be used at 2 years?
Forward-facing seat may be used.
Promoting Safety - Safety in Home and Avoiding Tobacco Smoke: What problems can smoking cause?
Increased risk of respiratory disease and infection, decreased lung function, and increased incidence of middle ear effusion
Promoting Safety - Safety in Home and Prevent Injury: How to prevent injury in home?
Never leave toddler unsupervised.
Lock doors to dangerous rooms
Install safety gates. Keep pot handles turned inward.
Keep electrical equipment out of reach.
Promoting Safety - Safety in Home and Prevent Poison: What does poor tase discrimination result in?
Allows for ingestion of chemicals or other materials that older children find too unplesant to follow.
Promoting Safety - Safety in Home and Prevent Poison: What safety measures can be taken?
Store all substances in original containers
Do not allow access to baby pwoders
DO not leave within medication
Do not expose to hazardous vapors
Promoting Safety - Safety in Water: When are children able to learn how to swim?
Not until 4 years of age
Promoting Nutrition - Weaning: How long is breastfeeding recommended for?
At least 1 year.
Promoting Nutrition - Weaning: Weaning should occur by what age?
By 12-15 months of age.
Promoting Nutrition - Weaning: Prolonged bottle-feeding associated with?
Development of dental carries.
Promoting Nutrition - Txing about Nutritional Needs: How much calcium needed? And where to get from?
500 mg per day
Get from dairy productions. Such as one-cup of low-fat whole milk , 8 oz yogurt or cheddar cheese .
Promoting Nutrition - Txing about Nutritional Needs: Iron deficiency anemia in first 2 years of life may be associated with?
Developmental and psychomotor delays
Promoting Nutrition - Txing about Nutritional Needs: Where to get iron once breast-feeding ends?
REplaced with iron-poor cow’s milk.
Promoting Nutrition - Txing about Nutritional Needs: What should not be restricted for those younger than 2?
Fat or cholesterol intake. Fat should be 20-30% of total calories.
Promoting Nutrition - Txing about Nutritional Needs: Daily intake recommendation of fiber for 1-3 year old?
19 g
Promoting Nutrition - Txing about Nutritional Needs: Juice intake should be limited to how much?
4-6 oz per day.
Promoting Nutrition - Txing about Nutritional Needs: Milk intake should be limited to how much per day?
16-24 oz per day
Promoting Nutrition - Advancing Solid Foods: How many meals should be offered?
3 full meals and two snacks daily. Portions should be 1/4 the size of adults
Promoting Nutrition - Advancing Solid Foods: What should parent do when deciding what foods to eat?
Parent must decide which foods to eat, to resist a power struggle.
Promoting Nutrition - Promoting Self-Feeding: Suggestions for parents?
Use child-sized spoon. Set toddler in high chair. And never leave unattended.
Promoting Nutrition - Promoting Healthy Eating Habits: What is physiologic anorexia?
Toddlers do not require as much food intake for their size as they did in infancy
Promoting Nutrition - Promoting Healthy Eating Habits: What are food jags?
Toddler may prefer only one particular food for several days, then not want it for weeks
Promoting Nutrition - Preventing Overweight/Obesity: For those younger than 3, greatest RF for this is?
Having a parent with a high body mass index
Promoting Nutrition - Preventing Overweight/Obesity: How can nurse screen for overweight?
By calculating BMI and plotting the BMI on the standardized age-and gender approriate growth charts
Promoting Nutrition - Preventing Overweight/Obesity: What part does juice intake play in obesity?
They may drink excessive amounts of it since it is sweet.
Promoting Healthy Sleep/Rest: How much sleep does a 18, 24, and 3 year odl require?
13.5, 13, and 12 hours
Promoting Healthy Sleep/Rest: When does daytime napping end?
At around 3 years of age
Promoting Healthy Sleep/Rest: What rituals can be done at bed to prepare for sleep?
Choose a bedtime and stock to it. May include reading a story and routine should be a calm period with minimal outside distractions
Promoting Healthy Teeth/Gums: What contirbutes to development of dental caries?
Poor oral hygieine, prolonged use of a bottle, lack of fluoride intake and delayed dental care
Promoting Healthy Teeth/Gums: How should cleaning of toddlers teeth progress?
From brushing with simply water to using a small amount of fluoridadted toothpaste.
Promoting Healthy Teeth/Gums: Carbohydrate-containing foods combined with oral bacteria create what?
Decreased oral pH that is optimal for development of dental caries
Promoting Healthy Teeth/Gums: If too much fluoride inggested, flurosis occurs which is what?
Mottling of the enamel.
Promoting Healthy Teeth/Gums: Risk factors for flurosis is?
High fluoride levels, use of fluride containing toothpaste prior to 2 years, adn excessive ingestion of fluoride
Proting Appropriate Discipline: Why should those younger than 18 months never be spanked?
Ther is an increased possibility of physical injury
Proting Appropriate Discipline: Discipline should focus on what?
Limit setting, negotiation, and techniques to assist the toddler to learn problem solving
Proting Appropriate Discipline: Why is positive reinforcement good?
Helps to reinforce appropriate or desirable behaviors. SHould be rewarded with praise and physical affection
Proting Appropriate Discipline: When can time-out be used?
At 2.5 - 3 years of age.
Proting Appropriate Discipline: Extinction is useful at 2-3 years of age. What is this
Involves systematic ignoring of the undesired behahvior. Ignore the behavior every time it occurs. When opposite behavior occurs, give them praise
Addressing Common Developmental Concerns - Toilet Teaching: What happens when myelination of spinal cord is achieved at 2 years old?
Toddler capable of exercising voluntary control over sphincters.
Addressing Common Developmental Concerns - Toilet Teaching: Toddlers ready for toilet teaching when?
BMs occur regularly.
Expresses knowledge of need to defecate.
Diaper is not always wet
Toddler is willing to follow instructions
Addressing Common Developmental Concerns - Toilet Teaching: Best time to achieve success with pooping?
Following a meal
Addressing Common Developmental Concerns - Negativism: How do you deal with this?
Avoid asking yes-or-no questions. Instead, offer simple choices that will give toddler sense of control. Such as “Do you want a red or blue cup?” instead of “do you want milk”
Addressing Common Developmental Concerns - Temper Tantrums: May be manifested how?
As a screaming and crying fit or a full-blown episode in which toddler throws himself on floor kicking, screaming, or pounding.
Addressing Common Developmental Concerns - Temper Tantrums: What should parent do when temper tantrum occurs?
To ignore the behavior and ensure that the child is safe during the tantrum. Physical punishment will prolong the tantrum
Addressing Common Developmental Concerns - Temper Tantrums: How to handle this in public?
Give the child a bear-hug and sooth them with a calm voice
Addressing Common Developmental Concerns - Thumb Sucking and Pacifiers: No need to worry about sucking habit until when?
Until it is time for permanent teeth to erupt.
Addressing Common Developmental Concerns - Thumb Sucking and Pacifiers: Prolonged and frequent sucking in withdrawn child is more likely to cause what?
Changes in tooth and jaw structures than sucking that is primarily used for self soothing
Addressing Common Developmental Concerns - Sibling Rivarly: How to minimize issues here?
Attempt to keep the toddler routine as close to normal as possible. Spend individual time with toddler on daily basis and involve toddler in care of baby
Addressing Common Developmental Concerns - Regression: What may happen with regression?
Occurs during stressful event like birth of sibling. May want to go back to an earlier stage such as bottle or pacifier use.
The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells “no” all the time. The nurse identifies this toddler’s behavior as
problematic, as it interferes with needed nursing care. normal for this stage of growth and development. normal because the child is hospitalized and out of his routine.
normal for this stage of growth and development.
The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse’s best response to this information?
The toddler should have a developmental evaluation as soon as possible. If the mother would read to the child, then speech would develop faster. Receptive language normally develops earlier than expressive language. The mother should ask her child’s physician for a speech therapy evaluation.
Receptive language normally develops earlier than expressive language.
A 2-year-old is having a temper tantrum. What advice should the nurse give the mother?
For safety reasons, the toddler should be restrained during the tantrum. Punishment should be initiated, as tantrums should be controlled. The mother should promise the toddler a reward if the tantrum stops. The tantrum should be ignored as long as the toddler is safe.
The tantrum should be ignored as long as the toddler is safe.
What is the best advice about nutrition for the toddler?
Encourage cup drinking and give water between meals and snacks. Encourage unlimited milk intake, because toddlers need the protein for growth. Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.
Encourage cup drinking and give water between meals and snacks.
To gain cooperation from a toddler, what is the best approach by the nurse?
Immediately pick the toddler up from the mother’s lap. Kneel in front of the toddler while he or she is on the mother’s lap. Do the nursing tasks quickly so the toddler can play. Ask the toddler if it is okay if you begin the needed task.
Kneel in front of the toddler while he or she is on the mother’s lap.
