Care of the Toddler Overview
What is the key fine motor milestone for 15 months?
use a cup well
What is RItualism?
routine; feel safe in environment so they can continue to branch out
The pediatric nurse is presenting basic safety tips at a local health fair for families. The nurse should point out the majority of hospital visits for toddlers can be prevented by exercising which precaution?
safely store all chemical substances
The nurse suspects that a child may be in pain and is preparing to perform a pain assessment. At what age would the nurse begin the pain assessment by asking the parents, "What word does the child use to explain that they are in pain?"
1 to 2 years
When should toddlers wean from bottlefeeding?
12-15 months
How much whole milk or fat and cholesterol should a toddler be getting?
16-24 oz. a day
The parents of an overweight 2-year-old boy admit that their child is a bit "chubby," but argue that he is a picky eater who will eat only junk food. Which response by the nurse is best to facilitate a healthier diet?
"Give him more healthy choices with less junk food available."
What is the key communication milestone for 2 years?
2-3 word sentences, follow 2-3 step instructions
What should a toddler's play schedule look like?
30 minutes of structured physical play and 1-3 hours of unstructured play
What is the key communication milestone for 18 months?
50-word vocab
A nurse is presenting a class on discipline for a group of parents of toddlers. What information would be important for the nurse to teach this group? Select all that apply.
Consistency in the rules is important so the child understands what is expected. If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. Even at this young age, children need boundaries.
How should parents maintain skin integrity and prevent infection?
Cut fingernails avoid tight clothing/heat 100% cotton Antihistamines
What is atopic dermatitis (eczema)?
Inflamed, dry skin in response to allergens or environmental triggers
What is symbolic thought?
some things can be other things
Which statement(s) by the parent of a toddler with special needs indicates more nursing education is needed? Select all that apply.
"Our toddler scoots around on the floor so we keep our toddler in a playpen for safety." "Our toddler teethed late, and the teeth are still coming in, so we have not looked for a dentist." "We encourage our toddler to enjoy playing alone to keep our toddler protected from other children."
The nurse is assigned to care for a 15-month-old toddler. When developing a care plan addressing the nutritional needs of the toddler, which client goal(s) demonstrate the nurse's understanding of these needs? Select all that apply.
"The child will learn to drink from a cup within the next month." "The child will stop drinking from a bottle while in bed within the next 2 weeks." "The child will drink specified amounts of milk and other fluids on a daily basis, as suggested by the pediatrician."
How should parents treat eczema?
*Promote skin hydration* Avoid hot water avoid perfumes, dyes, fragrances Don't leave child completely dry after bath Medications
What are the key symptoms for otitis media?
*Pulling at ears* *TM bulging, red/opaque, drainage* *hearing difficulties
The nurse is caring for a toddler who was just diagnosed with a hearing impairment. What would the nurse expect to assess in the child?
A delay or lack of clear, understandable speech pattern
Which is the best way for parents to aid a toddler in achieving the developmental task?
Allow the toddler to make simple decisions
What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums?
Appear to ignore the toddler
Which of Erikson's developmental theories do toddlers fall under? (Start gain control -> independence0
Autonomy v. Shame and Doubt
What is the key fine motor milestone for 2.5 years?
Draws circle, turn a doorknob
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erikson's theory of development, what would be an appropriate intervention for this child?
Encourage the child to pick out his own clothes.
The nurse is assessing the language development of a 3-year-old girl. Which finding would suggest a problem?
speaks in 2- to 3-word sentences
The nurse is assessing 2-year-old twins. The parent states, "My twins will not play together, only alongside each other." Which action will the nurse take first?
Explain that this is normal behavior for toddlers.
The parent of a toddler is frustrated because the toddler insists on brushing his own teeth and being left alone in the bathtub. What advice should the nurse provide to the parent about these expectations?
Helping with teeth brushing encourages autonomy.
A nurse is assisting the parents of 2-year-old who is having temper tantrums. What would the nurse encourage the parents to do once temper tantrums have started?
Move objects out of the way or move the child to prevent injury.
The nurse is assessing a toddler's language development. What finding would the nurse interpret as reflecting expected development for a 2-year-old?
speaks in two-word sentences using a noun and a verb
The nurse is teaching the parents of a 3-year-old child how to help the child complete the developmental task of initiative versus guilt. Which nursing example is the appropriate task and instruction?
Praise the child when demonstrating correct dressing, eating, and toileting independently.
Which Piaget developmental stage are toddlers in? (experiment with their behavior)
Preoperational
The nurse is administering otic medication to a 22-month-old with a diagnosis of otitis media. Which nursing action ensures that the medication is distributed appropriately?
Pull the pinna down and back.
What are some early signs of autism?
Reduced response to name Abnormal communication *Fixation* *Bigger tantrums* *Not meeting milestones*
What is the key gross motor milestone for 18 months?
Run clumsily
The father of a toddler reports his son says "no" every time he attempts to correct him. What is the best advice the nurse can offer to the parent?
Saying no is your son's way of trying to exert his independence and is expected.
The nurse is preparing a female toddler for the repair of an eyebrow laceration. The girl is most likely to demonstrate which response in anticipation of the procedure?
Scream and cling tightly to her parent.
What are some risks of otitis media?
Seasonal Other children noncompliance with vaccines Down syndrome rare breastfeeding
Describe the eustachian tubes in a toddler.
Short and straight
When should parents start toilet teaching?
Sometime after 2
The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly?
Telling the child firmly that we don't scream in the office
The 18-month-old toddler has most likely attained which gross motor skill?
The ability to walk independently.
What is the key gross motor milestone for 2.5 years?
tiptoe
The home health nurse is visiting a 2-year-old client's home. Which finding will cause the nurse to intervene?
The family's medications are located in a kitchen drawer.
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior?
The need for separation and control
The nurse has brought a 3-year-old's oral medications into the room for administration. Upon approaching the child, the nurse said, "I have your medication. Would you rather have me hand it to you or Mommy?" In critiquing the nurse's actions, which is most accurate?
The nurse's behavior is correct. The nurse provided the child a choice between two acceptable options with the outcome of taking the medication.
A nurse, who is also a mother of a 2-year-old child, attends a party at a friend's house and notes some safety concerns that she would like to share with the other mother privately. Which observations during the party would be considered a safety concern that should be addressed privately when appropriate? Select all that apply.
The nurse/mother notes that the toddler's car seat is located in the passenger front seat. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.
What is parallel play?
Toddlers play alongside another child
What is negativism?
Toddlers want to say "no"
What is the key fine motor milestone for 2 years?
Turn pages, one at a time
The nurse is completing a physical assessment of a 24-month-old child who was born at 33 weeks' gestation. Which objective data provide the basis for documenting that this child has progressed from the 15-month-old to the 18-month-old developmental level? Select all that apply.
Uses an 8-word vocabulary. Follows simple commands such as "sit down." Uses a spoon to feed self.
What is the key gross motor milestone for 15 months?
Walks alone
What is the key gross motor milestone for 2 years?
Walks up and down stairs with both feet
When should mothers wean from breastfeeding?
around 12 months
A nurse is assessing a 3-year-old's fluid and electrolyte status. When obtaining the child's history, which of the following would be most important?
asking the parents how often the child has been urinating
The mother of a 2-year-old child tells the nurse that she is constantly scolding the child for having wet pants. The child was toilet trained at 12 months, but since walking, the child wets all of the time. Which nursing diagnosis should the nurse use to guide instruction for the mother?
deficient parental knowledge related to inappropriate method for toilet training
What are food jags?
focused on one food for an extended period of time
A parent tells the nurse that no matter what is asked of the toddler, the toddler says, "No." What suggestion might the nurse make to help the parent handle this situation?
give the toddler secondary, not primary, choices
What is animism?
giving life-like qualities to inanimate objects
The nurse is observing a 3-year-old boy in a day care center. Which behavior might suggest an emotional problem?
has persistent separation anxiety
What is egocentrism?
inability to see another's perspective
The nurse is caring for a toddler in the pediatric unit and notes the child is responding according to expected developmental stages. Which characteristic will the nurse predict this toddler to exhibit while in the hospital?
insists on doing a new skill and then asking for help
The nurse is caring for an 18-month-old child. The nurse is aware that the child is which stage according to Erikson?
Autonomy versus shame and doubt
When do toddlers reach half of their height?
By 2
What is the key fine motor milestone for 18 months?
manage a spoon, turn 2-3 pages in a book
What foods should toddlers AVOID?
nuts, popcorn, etc. can have grapes, hot dogs, cherry tomatoes, etc. but they need to be cut up
Parents share that their toddler often needs a snack in between meals. Which snack choice is nutritious enough to give the toddler energy but also may help prevent dental caries? Select all that apply.
orange slices cheese slices yogurt
Which way should the car seat face for toddlers?
rear-facing until at least 2
