CH 19: Preschool Child (Health Promo)
The nurse is teaching parents about strategies concerning injury prevention for preschoolers. Instructions for parents would include which of the following? Select all that apply. Dress child only in flame-retardant clothing Administer ipecac syrup immediately in event of any poison ingestion. Use heat mist humidifier on sturdy tables. Practice emergency escape plan from the home. Obtain training in CPR and abdominal thrusts.
Dress child only in flame-retardant clothing Practice emergency escape plan from the home. Obtain training in CPR and abdominal thrusts. Preschoolers should only wear flame-retardant clothing, esp at night. For safety, use only cool mist humidifiers to treat upper respiratory tract infections. Ipecac syrup is not universally used for all poison ingestion. It is appropriate for some substances and not for others. The poison control contact will advise the caller when to administer ipecac syrup. The phone number for the poison control center should be within easy access. Parents need to recognize burns or blister around the mouth, odor of poisons, empty containers around the child, stomach distress or changes in normal activity level which might indicate poison ingestion.Parents should implement practice sessions concerning an escape plan from the home in event of emergency. Post 911 on all phones and teach child how to report the child's name and address over the phone. Additionally, parents should be trained in cardiopulmonary resuscitation and the use of abdominal thrusts. Monitor the use of balloons and eating habits of preschoolers. Additional precautions include closing the doors of the dishwasher, oven, washer, and dryer; mark all glass doors with decals to delineate doors; use gates at the top and bottom of stairs for the younger child; set water heater temperature at a maximum of 120°F to avoid burns; store all poisonous substances out of the reach of children; discourage running in the house; avoid throw rugs on bare floors.
Which play activity would the nurse plan for a 4-year-old girl 2 days after undergoing an appendectomy? Playing a game of Monopoly Dressing up in a Cinderella gown Participating in a game of hopscotch Drawing pictures of her mother and father
Drawing pictures of her mother and father Most 4-year-old children play simple interactive games, dress themselves, copy a number of basic geometric figures well, and draw recognizable people. Preschoolers enjoy using language skills in telling stories and asking questions, and they can balance on one foot, jump, and run well. Because the child is 2 days postappendectomy, the activity selected would have to be one that is appropriate for her condition and recovery. Dressing up in fairy tale clothing would be an activity of a healthy 4-year-old child but not one recovering from surgery. The game of hopscotch is too vigorous. Playing a game of Monopoly is at a higher level than her intellectual development. Drawing pictures of her family would be the best choice for a play activity.
The school nurse assesses preschoolers for genetic conditions such as: Down syndrome. congenital hypothyroidism. sickle cell disease. Duchenne muscular dystrophy.
Duchenne muscular dystrophy. During the preschool years, the genetic conditions that are most likely to appear are cystic fibrosis, Duchenne muscular dystrophy, fragile X syndrome, and Williams syndrome and autism which is generally considered a genetic disorder with a high degree (90%) of heritability. These disorders, characterized by aberrant social interaction, communication, and stereotyped patterns of behavior, affect 0.5% to 1.0% of the population and often are diagnosed or suspected in the preschool years when social interaction plays a larger role in development. Down syndrome is usually diagnosed soon after birth because the infant exhibits physical characteristics that warrant evaluation for the chromosome karyotype. Congenital hypothyroidism and sickle cell disease are determined during the neonatal period through the newborn screening test.
The preoperative stage of thinking is displayed by the child as: transductive reasoning. the trait of irreversibility. understanding the perspectives of others. an ability to consider more than one factor when solving simple problems.
transductive reasoning. Piaget describes the preoperative stage of thinking as transductive reasoning. The child cannot proceed from general to particular (deduction) or from particular to general (induction); rather, the child moves only from particular to particular in making associations and solving problems. At this stage of development, the child is unable to consider more than one factor at a time when solving simple problems. For example, a child can be given two identical cups containing equal amounts of water and asked which cup contains the greater amount of water. During the preoperational stage, the child responds that they contain the same amount of water. The child is then asked to pour the water from each cup into two different containers (one flat and wide, the other tall and narrow). When asked which container has more water, the child always identifies one. The child usually selects the taller, narrower container with water at the higher height. When the water is again transferred to the identical cups and the experiment repeated, the child returns to the original conclusion that the amounts are equal.This experiment also illustrates the trait of irreversibility. The child is unable to connect the reversible operation, the transfer of the water back into the original cup, to reach the logical conclusion that the differently shaped containers may hold the same amount of water. The child cannot mentally associate that the transformation from one state to another relates to the shape of the container, not the amount of the water. The preschooler is not able to demonstrate the concept of irreversibility. The child is not able to connect the reverse operation to reach a logical conclusion.
The nurse is teaching parents about typical sleep disturbances of the preschooler. Which recommendation would the nurse make to the parents? Bedtime rituals of 1 hour or more should decrease sleep disturbances. Nighttime wakening, frequently seen in toddlers, is uncommon in preschool years. Parents should help the child differentiate between "pretend" and "real" occurrences. When the child has night wakening events, reassurance occurs when the child is taken to the parent's bed.
Parents should help the child differentiate between "pretend" and "real" occurrences. Night terrors and nightmares characterize the nighttime wakening problems that generally occur during the preschool years. Night terrors manifest as frightening dreams that cause the child to sit up in bed, scream, stare at an imaginary object, breathe heavily, perspire, and appear in obvious distress. The child, not fully awake, may be inconsolable for 10 minutes or more, before he or she relaxes and returns to a deep sleep. In most cases the child does not recall the dream and in the morning does not remember the incident.Nightmares (anxiety dreams) are a more common cause of night wakening. After age 3, nightmares occur frequently. Dreams frighten preschoolers as they connect to the larger world with their active imaginations and fantastic ideas. These children can waken fully and feel fearful and helpless. Usually they provide vivid descriptions at the time, and they frequently remember the event the following morning. Consolation can be given by a parent who sits with the child, listens to descriptions and fears about the dream, and reminds the child that dreaming is natural and sleep will soon return.Parents of preschoolers can benefit from the following recommendations: Bedtime rituals of 30 to 45 minutes are common. Night wakening events are common in the preschool years. The child who wakes up at night should be reassured and encouraged to return to his or her own bed. Parents should have clear rules about children sleeping with them if children will not stay in their own beds. Restricting frightening television shows and stories and discussing "real" vs "pretend" ideas and stories can help lessen the incidence of nightmares.
The nurse working with the preschool age group educates parents about which of the following nutritional guidelines? Select all that apply. Preschool children should eat at least five servings of fruits and vegetables per day. Children aged 3 to 5 should receive 1000 to 1200 calories per day. Preschool children should consume approximately half of their diet in carbohydrates. Fat requirements in preschool children are higher than those for older children. Cholesterol is not an issue at for this age group.
Preschool children should eat at least five servings of fruits and vegetables per day. Preschool children should consume approximately half of their diet in carbohydrates. Fat requirements in preschool children are higher than those for older children. Establishing healthful nutritional and physical activity behaviors begins during childhood. Children should eat a variety of foods with at least five servings of fruits and vegetables per day. Children age 3 to 5 years old should receive 1200 to 1600 calories per day depending on their activity level and sex. Preschool children should consume approximately half of their diet in carbohydrates, with the other half consisting of protein (≈5% to 20%) and fat (≈20% to 35%).With more than half of the preschool diet consisting of carbohydrates, whole grains and other complex carbohydrates should be plentiful in order to attain a total fiber intake of 20 to 25 g per day. Fat requirements in preschool children are higher than those for older children, but fat consumption should consist primarily of unsaturated fat, with saturated fat, trans fatty acids, and cholesterol intake as low as possible. Guidance for these recommendations along with types and amounts of foods is depicted in the systems called MyPyramid and Choose MyPlate (www.choosemyplate.gov/). A child-friendly version of MyPyramid addresses the special needs of children 6 to 11 years old. Preschoolers need approximately 90 kcal/kg of body weight per day for health maintenance, activity, and growth. Good eating habits including low cholesterol food choices and avoiding trans fatty acids are important for this age group as it is for all subsequent developmental stages as the child progresses through life.
Which of the following physical activities are most appropriate for the preschool age group? Select all that apply. Ring around the Rosy Watching television Electronic video games Tee ball (nonpitching vs of softball) Paintball
Ring around the Rosy Tee ball The preschooler regulates body activities with more purpose and copes with limit setting better than the toddler, but has much energy and requires outlets for this energy during their day. The young child requires physical activity for energy expenditure. Physical activity, for the developing child, may be more appropriately described as either locomotor play or active play. Active play increases from the toddler to the preschool period, and then declines approximately 10% for each advancing year of age. Hinkley and colleagues concluded that efforts to promote children's physical activity should seek to influence children's preference for physical activity, parent rules, and sex-specific strategies. Nurses should encourage parents to engage the preschool child in active, locomotor, and rough-and-tumble play.Although this age group needs physical activity, many preschoolers spend long periods each day watching television, videos, and playing electronic games. Occasionally parents use the electronic diversions inappropriately to entertain the child. Although some excellent television, video, and electronic game programming is available for preschoolers, many electronic entertainment options focus on adult themes and violence. Many experts agree that television, videos, and electronic games disengage the child's mind and support less learning. Parents should remember that preschoolers who rely on television, videos, and electronic games do not have enough life experiences to interpret many of the issues presented in adult shows. Additionally, they might be missing opportunities for interacting with other children or adults, hindering the development of an active healthy lifestyle.Tee ball is intended for children age 4 to 8 and develops skills needed for later playing of softball and baseball. It is an excellent activity for the preschool age group. Similarly ring around the Rosie is a simple game, involving singing and walking. It utilizes motor skills which are developmentally appropriate for the preschooler. By contrast paintball is not appropriate for this age-group. It requires skills and abilities not yet developmentally achieved.
The nurse assesses the preschooler's coping mechanisms as being developmentally appropriate through observation of: temper tantrums. fantasy play. separation anxiety. flexible bedtime rituals.
fantasy play. Preschoolers use many of the coping mechanisms developed during their toddler years; however, the preschooler generally shows greater ability to verbalize frustration, fewer temper tantrums, and more patience in experimentation to resolve difficulty than the typical toddler. Preschoolers refine their problem-solving skills. Through fantasy play, preschoolers investigate solutions or responses to stressful events and find inner control for challenging situations.Occasionally projection and fantasy lead parents to consider their child dishonest. When faced with the question, "Did you break this dish?" the preschooler might respond, "No, Teddy did it." The child might even relate a detailed story of the toy bear mishap. Preschoolers tend to project blame. Active fantasies help tell the story. Parents should not accuse the preschooler of lying, but rather the adult should help the child decide whether the story is pretend or real. The concepts of pretend and real help encourage children to discuss nightmares, television shows, stories, and their own active imaginations. Strict adherence to rituals or game rules controls situations for the preschooler. The preschooler has longer and more rigid bedtime rituals than the toddler.
The hallmark of the first substage of Piaget's preoperational stage is the ability of the preschooler to function using: abstract thinking. concrete thinking. auditory cues. language.
language. The older toddler enters the first substage of the preoperational stage described by Jean Piaget. The hallmark of this preconceptual substage includes the ability to function symbolically using language. The preschool child demonstrates increased symbolic functioning during the intuitive substage, from age 4 to 7 years. The predominant feature of this and the following period is the concrete thought process, as compared with adult abstract thinking. As they experience symbolic mental representations, preschoolers process mental symbols as though they were actually participating in the event. Adults analyze and synthesize symbolic information without concrete connections between the mental process and the actual event. At this stage, mental abstraction, such as skipping from one part of an operation to another, reversing the operation mentally, or thinking of the whole in relation to the parts, is not feasible.
When evaluating the health perception of a preschooler, the nurse understands that this age-group views pain or illness as: punishment. separation anxiety. a result of their actions. painful regardless of the intervention.
punishment. By age 4 or 5, children possess their own beliefs about health from their family. They begin to understand that they play a role in their own health. The preschooler often becomes upset over minor injuries. Pain or illness may be frequently viewed as punishment. The preschooler's declaration, "If you don't put your seat belt on you will get in an accident" is a statement that reflects the idea of expected immediate and absolute cause and effect. The preschooler cannot conceive that the purpose of the seat belt is to prevent injury in the event of an accident, not prevention of the accident itself.The infant and toddler from 6 to 30 months will demonstrate signs of separation anxiety. The school-age child views illness as related to their lack of following parents' instructions for wearing warm clothes, eating nutritious meals, and getting enough rest. The toddler responds to all interventions as if they were going to be painful because they view pain concretely.
