Toddler Growth and Development (Chapter 11)
Because of negativism in toddlers, how should the nurse go about listening to the toddlers heart?
"I'm now going to listen to your heart!" instead of "can I listen to your heart?" bc they will say no
What should language be like at 18 months?
10 words and should put together at least 2 words
When should birth weight be quadrupled in toddlers?
2 1⁄2 years
How long should a child ride in a rear facing car seat?
2 years old ride in rear-facing car safety seat until the child has outgrown the manufacturer's weight and height recommendation
How much do toddlers grow a year?
3 in per year
What should language be like at 30 months?
30 mo. = plural words (we, bottles, colors)
What should language be like at 24 months?
300 words and can do 2-3 word sentences
What does weight gain look like in toddlers?
4-6 lb/yr
How much should drawstrings be shortened for safety?
6 inches or less
What psychosocial stage are toddlers in?
Autonomy vs. shame and doubt (Erickson)
Because of their small size they cannot reach poisons placed in the highest cabinet in the kitchen. A) True B) False
B) False
Teaching swimming to children under age four years provides the child with "drown proofing" A) True B) False
B) False
Toddlers are too young to be taught to obey traffic regulations. A) True B) False
B) False
One of the major tasks of toddlerhood is toilet training. Which of the following statements is true? A. Nighttime bladder control develops first B. Bowel control is accomplished before bladder control C. Toddlers must first have gross motor skills sufficient to climb up to the adult toilet. D. The universal age for initiating toilet training is age 2 years.
B. Bowel control is accomplished before bladder control
What type of play is primarily seen in toddlers?
PARALLEL! they play side by side but not necessarily together
What happens with toddlers and independence?
Toddlers develop skills of independence—they want to do everything themself • Skills of independence may result in tyrannical, strong-willed, volatile behaviors • Skills include feeding, playing, dressing, and undressing self
Toddlers are often known to be finicky eaters and may exhibit abnormal eating patterns that may concern parents. Which of the following actions for feeding toddlers should be suggested so that adequate amounts of nutrients for growth and development are consumed? Select all that apply. a. Avoid placing large food portions on the toddler's plate. b. Allow the child to graze on nutritious (not "junk" food) snacks during the day. c. Insist that the child sit at the table until all persons have completed their meals. d. Allow the child to make certain food choices (within reasonable limits)—for example, would you like a half peanut butter or ham sandwich? e. Provide meals at the same time of day as much as possible so that the toddler has a sense of consistency.
a. Avoid placing large food portions on the toddler's plate. b. Allow the child to graze on nutritious (not "junk" food) snacks during the day. d. Allow the child to make certain food choices (within reasonable limits)—for example, would you like a half peanut butter or ham sandwich?
One indication that the toddler is ready to begin toilet training is: a. Child recognizes urge to let go and hold on and is able to communicate this sensation to the parent b. Child is able to stay dry all night c. Child demonstrates mastery of dressing and undressing self d. Child asks parent to have wet or soiled diaper changed
a. Child recognizes urge to let go and hold on and is able to communicate this sensation to the parent
A common cause of accidental death in children 1 to 19 years old involves motor vehicle crashes. Evidence from test crashes indicates that the safest action to prevent accidental deaths in toddlers includes: a. Placing the child in a rear-facing weight-appropriate car restraint seat until 24 months old b. Allowing the child to ride in the front seat with a lap-shoulder seat restraint to avoid emotional outbursts c. Allowing the child to ride in a forward-facing booster restraint seat after 12 months old d. Placing the child in the regular seat using the lap-shoulder belt as long as the child weighs at least 45 pounds
a. Placing the child in a rear-facing weight-appropriate car restraint seat until 24 months old
The typical play activity in which toddlers engage is called: a. Solitary b. Parallel c. Associative d. Cooperative
b. Parallel
What is essential when toddlers are near any source of water?
close adult supervision
What happens to coordination between two and three years?
coordination improves! should be able to walk up alternate steps!
How do you know if a child is getting the nutrients that they need?
if they have steady growth, then yes!
What is the major cause of toddler poisoning?
improper storage! Only a locked cabinet is safe.
When are children ready for potty training?
may show readiness around 12 months, if they can go all night dry they are ready
What is Ritualization in toddlers?
need to maintain sameness and reliability
What cognitive stages are toddlers in?
sensorimotor and preconceptual phase (Piaget)
How should we explain time to toddlers?
something like "we are going to go to your appointment after lunch"
What do toddlers need for dental health?
• Regular dental examinations—every 6 months • Removal of plaque • Fluoride • Low-cariogenic diet • brush teeth themselves with adult supervision
What is toddler behavior like?
• domestic mimicry • imitation • concept of time embryonic with some understanding
What happens with fine motor development in toddlers?
• improved dexterity: 12-15 months (drawing, pincer grasp) • can throw a ball at 18 months
What are common illnesses in toddlers?
• respiratory tract infections • otitis media • tonsillitis
How do parents avoid crib injury?
•crib rails should be fully raised • the mattress should be kept at the lowest position •toys or bumper pads that may be used as steps to climb out should be removed •the floor under the crib should be carpeted or have a throw rug
When should children be walking?
12 months
When is the toddler period?
12 to 36 months old "the terrible twos"
When do children have sphincter control?
18-24 months
What is visual acuity in toddlers?
20/40 is acceptable 20/20 is preffered
Unrestricted freedom achieved through locomotion makes toddlers at great risk for injury. A) True B) False Toddlers are too young to be taught to obey traffic regulations. A) True B) False Because of their small size they cannot reach poisons placed in the highest cabinet in the kitchen. A) True B) False Teaching swimming to children under age four years provides the child with "drown proofing" A) True B) False One of the major tasks of toddlerhood is toilet training. Which of the following statements is true? a. Nighttime bladder control develops first 10 PEDS EXAM ONE Bowel control is accomplished before bladder control Toddlers must first have gross motor skills sufficient to climb up to the adult toilet. The universal age for initiating toilet training is age 2 years.
A) True
What is physiologic anemia?
At approximately 18 months old, decreased nutritional need with a decreased appetite • toddlers become fussy eaters • may eat tons one day and nothing the next
What is a common thing that caregivers accidentally OD toddlers on?
acetaminophen! Its found in many combo over the counter products so caregivers give two things and don't realize its in both
When do toddlers recognize sexual differences?
by two years old
A mother brings her 3-year-old daughter to the well-child clinic and expresses concern that the child's behavior is worrisome and possibly requires therapy or medication at minimum. The mother further explains that the child constantly responds to the mother's simple requests with a "no" answer even though the activity has been a favorite in the recent past. Furthermore, the child has had an increase in the number of temper tantrums at bedtime and refuses to go to bed. The mother is afraid her daughter will hurt herself during a temper tantrum because she holds her breath until the mother picks her up and gives in to her request. The nurse's best response to the mother is that: a. The child probably would benefit from some counseling with a trained therapist. b. The mother and father should evaluate their childrearing practices. c. The child's behavior is normal for a toddler and may represent frustration with control of her emotions; further exploration of events surrounding temper tantrums and possible interventions should be explored. d. The child's behavior is typical of toddlers, and the parents should just wait for the child to finish this phase because this will end soon as well.
c. The child's behavior is normal for a toddler and may represent frustration with control of her emotions; further exploration of events surrounding temper tantrums and possible interventions should be explored.
What is negativism in toddlers?
saying no or I do, part of the quest for autonomy
What is the most common kind of thermal injury in children?
scald burns!
Why do temper tantrums occur in toddlers so frequently?
they know what they want (either you said no or they can't communicate) and they just get frustrated!
What happens in social development of toddlers?
they separate from parents and want to be themselves!
What is the leading cause of death in children?
unintentional injuries
What is a major factor of injury increases in early childhood?
unrestricted freedom achieved through locomotion combined with an unawareness of danger within the environment
When should children sleep in a bed instead of a crib?
when they reach a height of 89 cm (35 inches
How much sleep do toddlers need?
10 hours per night May take one nap per day or relinquish this around 2-3
What is the toddler period characterized by?
• Intense period of exploration •Temper tantrums, obstinacy occur frequently • Play
What are some concerns related to toddler growth and development?
• Toilet training • Sibling rivalry • Temper tantrums • Negativism • Regressive behavior
How do we assess if a toddler is ready for toilet training?
• Voluntary sphincter control • Ability 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 • Impatience with wet or soiled diapers
What are common household objects that can cause aspiration harm?
• balloons • coins • paper clips • pins • bells • buttons • batteries • pull-tabs on cans • thumbtacks • nails • screws • jewelry (especially pierced earrings) • pins
What develops cognitively for toddlers?
• casual relationships between events • appearance of objects indicate function (aka a crayon is always going to be red because they have a red crayon) • learns spatial awareness • object permanence advances
What do we need to keep in mind for toddlers and body image/sexuality?
• do not make negative comments about physical appearance • genital exploration is common • refer to body parts by correct name • gender roles are understood by toddler-may play house
