Ch. 4 Health Promotion-Toddler (1-3)

*Injury Prevention* sharp objects, firearms, unattended animals, strangers

...

*Nutrition* Food serving size should be _______ for each year of age.

1 tbsp

A nurse is caring for several children. List the immunizations the nurse should give for children in each of the age groups listed below. 12 to 15 months 12 to 23 months 15 to 18 months 12 to 36 months

12 to 15 months - IPV (6 to 18 months), Hib, PCV, MMR, and varicella 12 to 23 months - Hep A, given in two doses at least 6 months apart 15 to 18 months - DTaP 12 to 36 months - Yearly seasonal TIV

*FINE MOTOR SKILLS* Uses a cup well & builds a tower of 2 blocks by...

15 months

*GROSS MOTOR SKILLS* Walks w/o help & creeps up stairs by...

15 months

At ____months toddlers should weigh 4 times their birth weight.

30 months

*Nutrition* Juice consumption should be limited to _____ oz per day.

4-6

*Cognitive development* Language increases to about ____ words w. toddlers speaking in two- to three-word phrases.

400

Toddlers grow about ____cm (__in) per year.

7.5 cm (3in)

*Nutrition* Exposure to a new food may need to occur ___-___times before toddlers develop an acceptance of it.

8-15

*Psychosocial development* Toddlers are in what Erikson stage?

Autonomy vs. shame & doubt *Independence is paramount for toddlers, who are attempting to do everything for themselves.

. The father of a 17-month-old toddler is frustrated with the toddler's behavior. The father tells the nurse that the toddler is "bad," but he doesn't know how to make the toddler behave better. Which of the following responses is appropriate? A. "Allow your child to learn by trial and error." B. "Consistently enforce well-defined limits." C. "Reward your child's good behavior, but ignore the bad behaviors." D. "Punish your child when he behaves badly."

B * Toddlers need to have consistent boundaries enforced for discipline to be effective. Behavior should not be enforced with only rewards or only punishments. Trial and error lacks consistent boundaries and may allow the toddler to experience unhealthy consequences.

*Immunizations* At 15- 18 mnths

DTap

*Immunizations* At 12 to 23 months...

Hep A (2 doses at least 6mnths apart)

*Immunizations* At 12-15 months CDC recommends..

IPV, Hib, PCV, MMR, & varicella

*Injury Prevention* Falls

Lock doors & windows Crib mattress lowest & rails up safety gates across stairs

*Cognitive development* Does preoperational thought allow toddlers to understand other viewpoints?

NO *but it does allow them to symbolize objects & people to imitate previously seen activities.

*Injury Prevention* Suffocation

Plastic bags Crib mattresses (should be a tight fit) Pillows kept out of crib remove draw strings form jackets etc.

*Age-Appropriate Activities* T or F Temper tantrums result from frustration with restrictions on independence.

TRUE * Providing consistent, age appropriate expectations helps toddlers to work through frustration.

*Nutrition* T or F Toddlers are generally picky eaters.

True

*Psychosocial development* T or F Toddlers progressively see themselves as separate from their parents and increase their explorations away from them.

True

*Psychosocial development* Moral development is closely associated w/ ______________________.

cognitive development

*Nutrition* Toddlers generally prefer ______ foods because of increasing autonomy.

finger

*Injury Prevention* Poisoning

lead paint lock cabinets w/ chemicals poison control # Child proof medication containers carbon monoxide detector in home

*Nutrition* Foods that are potential choking hazards include..

nuts grapes hot dogs peanut butter raw carrots tough meats popcorn coins candy *avoid these foods

*Age-Appropriate Activities* Solitary play evolves into ______________, in which toddlers observe other children and then engage in activities nearby.

parellel play

*Injury Prevention* Drowning

supervised in bathtubs & pools (& other water) toilet lid closed teach toddlers to swim

*Nutrition* Should adult supervision always be provided while toddlers are eating?

yes

*GROSS MOTOR SKILLS* Assumes a standing position by

18 mnths

*FINE MOTOR SKILLS* Manages a spoon w/o rotation & turns pages in a book, 2 or 3 at a time by...

18 months

Anterior fontanels close by

18mnths

*GROSS MOTOR SKILLS* Walks up and down stairs by

2 years

*FINE MOTOR SKILLS* Builds a tower of 6 or 7 blocks by

2 years old

*FINE MOTOR SKILLS* Draws circles & has good hand-finger coordination by...

2.5 years

*GROSS MOTOR SKILLS* Jumps in place w/ both feet & stands on one foot momentarily by...

2.5 years

*Psychosocial development* Toddlers develop gender identity by...

3 years

*Injury Prevention* Motor-vehicle

Approved car seat in back seat (away from air bags) Rear facing car seat until 9.1 kg (20 Ibs) & then still put in the back seat. Toddlers use car seats until 4 years

*Age-Appropriate Activities* Appropriate activities include

Filling & emptying containers playing w/ blocks looking at books playing with toys that can be pushed and pulled tossing balls

A 13-month-old toddler is being discharged from the hospital. Which of the following potential health risks should the nurse address with the parents? (Select all that apply.) Elevated cholesterol levels Poisoning Peer pressure Burns Falls

Poisoning Burns Falls * Poisoning, burns, and falls are all potential risks for this age group because the child is gaining independence and becoming more curious. Elevated cholesterol levels may become an issue during adolescence. Peer pressure usually begins during the school-age years, becoming more of a risk during adolescence.

*Immunizations* At 12-36 months

TIV (yearly seasonal trivalent inactivated 'flu' vaccine) LAIV (live, attenuated influenza vaccine) by nasal spray (at 2 years of age)

*Cognitive development* T or F Domestic mimicry (playing house) is evident.

TRUE

*Cognitive development* T or F Toddlers have and demonstrate memories of events that relate to them.

TRUE

*Nutrition* T or F Regular meal times & nutritious snacks best meet nutrient needs.

TRUE

*Nutrition* T or F Toddlers should consume 24-30 oz of milk per day, and they may switch from drinking whole milk to drinking low-fat milk (2% fat) at 2 years.

TRUE (Ryan Barr calls bullshit)

A parent of a 20-month-old toddler is concerned about how often the toddler gets hurt. The nurse should inform the parent that toddlers are prone to accidents for what reasons?

Toddlers are still developing their fine and gross motor skills, while at the same time trying to exert their independence through movement. Developmental tasks include developing autonomy, wanting to try things alone, wanting to explore more of the world away from parents, walking well, and beginning to run and climb.

*Age-Appropriate Activities* T or F Discipline should be consistent with well-defined boundaries that are established to develop appropriate social behavior.

True

*Nutrition* T or F If there is a family history of allergy, then cows' milk, chocolate, citrus fruits, egg whites, seafood, and nut butters may be gradually introduced while monitoring for reactions.

True

*Psychosocial development* T or F Punishment & obedience orientation begin in toddlers with a sense that good behavior is rewarded & bad behavior is punished.

True

*Nutrition* T or F High sugar, fat, or sodium should be avoided.

True (depends on the type of fat in my opinion- ryan barr)

The parents of a 14-month-old toddler want to know why their daughter has not been responsive to toilet training. The toddler is standing by herself but still crawls for locomotion. Her vocabulary is developing, but she does not seem to understand what it means to "go potty." The nurse should inform the parents that the toddler needs to develop what skills before she is able to achieve toilet training?

Voluntary control of anal and urethral sphincters Gross motor skills of sitting, walking, and squatting Fine motor skills for removing clothing Communication skills to indicate toileting need Cognitive skills to follow directions The ability to recognize the urge for toileting

*Cognitive Development* Toddlers transfer into preoperational stage (Piaget). The concept of __________ permanence is full developed.

object

*Age-Appropriate Activities* Toilet training can begin when....

toddlers recognize sensation of needing to urinate or defecate. *Parents should be patient and consistent in toilet training. Nighttime control may develop last.

*Injury Prevention* t or f Keep toys with small parts out of reach

true *age appropriate toys √ clothes for safety hazards (loose buttons) *keep balloons away from toddlers

*Psychosocial development* Do toddlers appreciate the usefulness of various body parts?

yes

*Psychosocial development* Do toddlers experience separation anxiety?

yes

*Psychosocial development* Are toddlers egocentric?

yes, they are unable to see things from the perspectives of others

*Injury Prevention* Burn prevention

√ bath T. lower hot water heater T. Smoke detectors Pot handles in cover outlets sunscreen