Toddlers and Family: period of intense exploration

Question 1

What are some characteristics of toddlers? (12-36 months)

Answer 1

• Temper tantrums & obstinacy occur frequently
• Increased understanding & use of language
• Formation of reciprocal relationships
• Understand parents will return
• Master locomotion & eye-hand coordination -Acquisition of fine & gross motor skills

Question 2

What are specific psychosocial tasks that occur during toddlerhood? Autonomy vs. shame/doubt (Erikson)

Answer 2

differentiating self from others,
separation from parent,
delayed gratification,
communication.

Question 3

Describe Piaget’s sensorimotor and preoperational stage

Answer 3

Toddler experiments by integrating older learning with new skills ‘Assimilation & Accommodation’
Applies this knowledge in new situations
Beginning of rational judgment
Understanding awareness of causal relationships
Discovery of objects as objects
Learns spatial relationships
Transition between self-satisfying behavior & socialized relationships

Question 4

When are physiological systems mature by?

Answer 4

end of toddlerhood

Question 5

When do they gain voluntary sphincter control?

Answer 5

18-24 months

Question 6

What is their visual acuity?

Answer 6

20/40

Question 7

What are aspects of psychosocial development?

Answer 7

• Differentiating self from others
• Coping with delayed gratification
• Controlling bodily functions
• Acquiring socially acceptable behavior
• Communicating verbally
• Interacting in less egocentric manner
• Imitation of behaviors
• Domestic mimicry
• Concept of time still embryonic

Question 8

What are signs that toddlers are ready for toilet training?

Answer 8

Voluntary sphincter control 
Able to stay dry for 2 hours 
Fine motor skills to remove clothing
Willingness to please parents
Curiosity about adult’s or sibling’s toilet habits
Impatient with wet or soiled diapers

Question 9

When is coordination improved?

Answer 9

between 2-3 years

Question 10

When is manual dexterity established? When are they able to trow a ball?

Answer 10

12-15 months; 18 months

Question 11

What is the greatest cognitive achievement?

Answer 11

Language

Question 12

How does language change in toddlerhood?

Answer 12

Increased symbols & language skills
Striking increased ability to understand & increased level of comprehension
Comprehension is much greater than number of words a toddler can say
At age 1 uses 1 word sentence
By age 2 uses multiword sentences

Question 13

How do toddlers develop: body image?

Answer 13

Refer to body parts by name
Avoid negative labels about physical appearance
Recognize sexual differences by age 2

Question 14

How do they develop gender identity?

Answer 14

Exploration of genitalia is common
Gender roles understood by toddler
Playing “house”

Question 15

What is parallel play?

Answer 15

Imagination

form of play in which children play adjacent to each other, but do not try to influence one another’s behavior.

Question 16

How do toddlers change in weight and height?

Answer 16

Weight gain slows to 4 to 6 lb/year
Birth weight should be quadrupled by 2½
Height increases about 3 inches/year
Growth is step-like rather than linear

Question 17

What are normal vital signs in toddlers?

Answer 17

1st check respirations: 20-30/min
2nd apical heart rate: 80-110/min
Temperature: 37

Question 18

What are the sleep patterns of a toddler?

Answer 18

Decrease slightly in 2nd year
Averages 12 hours including 1 nap
Activity level is high so tired
Sleep problems common: Fears of separation
Bedtime rituals helpful & transitional objects

Question 19

When does stranger anxiety and temper tantrums dissipate?

Answer 19

by age 2 1/2 to 3

Question 20

What are some issues in parenting toddlers?

Answer 20

Separation anxiety 
Temper tantrums
Sibling rivalry 
Regression
Thumb sucking 
Toilet training
Limit setting & discipline
Effective discipline
Reward
Ignoring or Time out

Question 21

Describe the G&D of a preschooler (3-5)

Answer 21

• Develops sense of initiative to find out about self & others
• Developmental task to acquire a sense of purpose
• Refinement in gross & fine motor skills
• Increased attention span & memory
• Critical period for emotional & psychological development
• Preparing for significant lifestyle change of going to school

Question 22

What are the two stages in Piaget’s preoperational stage? (preschooler)

Answer 22

Preconceptual phase: ages 2 to 4
Intuitive thought phase: ages 4 to 7

characterized by intuitive (or pre-logical) thinking then move towards logical thought processes through advanced, complex learning, language & understanding of causality

Question 23

Thought process shifts from ‘egocentrism’ to ______ (preschoolers)

Answer 23

social awareness & ability to consider other viewpoints

Question 24

According to Piaget’s how do pre-schoolers develop intellectually?

Answer 24

Increasing curiosity & explorative behavior
Language & cognitive development occur simultaneously & complement each other
Symbolic thought & language are prominent

Question 25

Describe Initiative vs. Guilt (Erikson)

Answer 25

3-6 years

• Initiative moderated by guilt as child realizes initiative may place them in conflict with others
• Guilt, anxiety, fear may result from actions & thoughts of differing from expected behaviour
• Develops a sense of initiative ‘energetic learning’ child wants to learn what to do for himself &others
• Conscience ‘superego’ begins to emerge (sense of guilt)
• Child learns to initiate play activities on own

Question 26

388: How do nurses address Initiative vs. Guilt?

Answer 26

encourage child to explore environment with senses, promote imagination, role modeling, anticipatory guidance to parents

Question 27

What are examples of fine motor and cognitive abilities of pre-schoolers?

Answer 27

Buttoning clothing
Holding a  pencil
Building with small blocks
Using scissors
Playing a board game
Able to draw picture of self

Question 28

How do preschoolers develop biologically?

Answer 28

Physical growth slows & stabilizes
Body systems mature & stabilize
Muscle development & bone growth are still not mature
Child can adjust to moderate stress & change
Physical proportions change
Males & females similar in size & proportion

Question 29

What gross motor skills do preschoolers have?

Answer 29

walking, running, climbing, & jumping well established by 36 months

Refinement in eye–hand & muscle coordination
Drawing, artwork, buttons

Question 30

How do preschoolers develop cognitively?

Answer 30

Language continues to develop.
Concept of causality begins to develop.
Concept of time is incompletely understood.
Use of “magical thinking” is frequent.
Awareness of racial identity, differences in appearances, & biases.

Question 31

Describe the development of sexuality in preschoolers

Answer 31

Strong attachment to opposite-sex parent while identifying with same sex parent.
Modesty becomes a concern.
Sex-typing & sex role limitation occurs, with child “dressing up like Mommy or Daddy.”
Sexual exploration is more pronounced & questions may arise.

Question 32

How does a toddler develop socially?

Answer 32

Separation & individuation process are completed
Overcoming stranger anxiety & fear of separation from parents
Still need parental security, guidance, boundary setting
Security from familiar objects

Question 33

Describe language for preschoolers

Answer 33

Major mode of communication & social interaction
Interpret words literally
Define simple things
Ages 4 to 5: four & five-word sentences
Age 6: use & understand all parts of speech correctly
Identifies opposites

Question 34

Play is important for:

Answer 34

Sensorimotor development
Socialization
Creativity
Self-awareness
Therapeutic value

Question 35

388: What is the nurse’s role during preschooler age?

Answer 35

• observe child interact with parents & others
• Base your nursing interventions & approaches on age appropriate developmental level
• Explain procedures according to senses
• Setting stage critical as imagination is active so may see procedures as a consequence for misbehavior

Question 36

What are the guidelines for a physical exam for preschoolers?

Answer 36

Non-threatening environment
Place frightening equipment out of sight
Provide privacy
Provide time for play
Observe for behaviors re: child’s readiness to cooperate
Begin with least intrusive examination (observation)

Question 37

What are normal vital signs of a preschooler?

Answer 37

Pulse: 80–120 beat/min. (average 100/min).
Respiration: 20–30 min.
Blood Pressure: 100/67+24/25
Temperature 37 C

Question 38

How do preschoolers develop emotionally?

Answer 38

Tends to be impatient & selfish
Expresses aggression through physical & verbal behaviours.
Shows signs of jealousy of siblings.
Sexual exploration & sexual curiosity common
Fears the dark

Question 39

What are the sleep patterns of a preschooler?

Answer 39

Nightmares & sleep terrors common
12 hours of sleep per night, infrequent naps
Sleep rituals important

Question 40

Describe primary prevention of disease

Answer 40

Hand washing
Preschool Immunization
Infection control policies
Anticipatory guidance

Question 41

Child care focus shifts from _______ to _______

Answer 41

Protection to Education

Question 42

What are some red-flags that are cause for concern at the preschool age?

Answer 42

Inability to perform self-care tasks, hand washing, simple dressing, daytime toileting
Lack of socialization
Unable to play with other children
Unable to follow directions