chapter 27 growth and development of the preschooler

Issues Involved in Promoting Growth and Development of the Preschooler

-Building self-esteem -Maintaining routine and ritual -Setting limits and remaining consistent with them -Knowing signs of developmental delay

social skills development by the preschooler

-Cooperation -Sharing (of things and feelings) -Kindness -Generosity Affection display -Conversation -Expression of feelings -Helping others -Making friends

temperament

-Indicator of parent's expectation of child's behavior -Determines child's task orientation, social flexibility, and reactivity

cognitive development of the preschoolers

-Magical thinking Believes thoughts are all-powerful Imaginary friend -Creative way to sample activities and behaviors and practice conversation skills -Transduction Extrapolates from one situation to another -Animism Attributes life-like qualities to inanimate objects

iron intake for preschooler

10 mg

fiber intake for preschooler

19mg

average growth preschooler

2.5 to 3 inches per year

how teeth should be present?

20 deciduous teeth should be present

preschool RR

22-25

Ca intake for preschooler

500 - 800mg

average weight gain for preschooler

5lbs per year -loss of baby fat and growth of muscle -length of skill increase slightly, lower jaw more pronounced; upper jaw widens

preschool HR

65-110

2. The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? A) Hesitancy and dysfluency are normal during this period of development. B) Reading to the child will help model appropriate speech. C) Expressive language concerns warrant a developmental evaluation. D) The mother should ask her child's physician for a speech therapy evaluation.

A) Hesitancy and dysfluency are normal during this period of development. Preschoolers often have a period of dysfluency and hesitancy in their language development, but it usually resolves by about age 4 years.

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother? A) If spanking is not working, then time-out is not likely to be helpful either. B) Place the child in time-out for 4 minutes. C) Use time-out only if removing privileges is unsuccessful. D) The child should stay in time-out until crying ceases.

B) Place the child in time-out for 4 minutes. The generally accepted guidelines recommend keeping the child in time-out for 1 minute per year of age.

1. The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as: A) Problematic; the child is old enough to begin to have a basis in reality. B) Normal, because the child is hospitalized and out of her routine. C) Normal for this stage of growth and development. D) Problematic, as it interferes with needed nursing care.

C) Normal for this stage of growth and development. Imaginary friends help the preschooler cope with stress in his or her life.

The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? A) lack of fully developed hearing. B) A less discriminating sense of touch. C) Visual acuity that has not fully developed. D) A less discriminating sense of taste.

D) A Less discriminating sense of taste Less

4. A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse? A) Allow the child unlimited access to the sippy cup to ensure adequate hydration. B) Encourage sweets for the extra caloric content. C) Teach the mother about nutritional needs of the preschooler. D) Assess the child's usual intake pattern at home.

D) Assess the child's usual intake pattern at home.

Preschooler cardiovascular

Heart rate decreases; blood pressure increases slightly; innocent heart murmur may be heard.

Risks of Overweight and Obesity

Hypertension Hyperlipidemia Insulin resistance

Erkisons stages of development preschooler

Initiative vs. Guilt -Preschooler is an inquisitive and enthusiastic learner. -Feels sense of accomplishment by succeeding in activities -Feeling pride in accomplishment stimulates initiative -Overextending self can result in sense of guilt

Fears

Preschoolers exhibit variety of fears Parents should acknowledge child's fears.

friendships

Preschoolers learn how to make and keep a friend.

conscious development for preschooler

Superego (conscious development) is completed and is basis for moral development.

Is the following statement true or false? The nurse should recommend that parents of a 3- to 5-year-old receive 500 to 800 mg calcium and 10 mg iron daily.

True. The preschool child needs 500 to 800 mg calcium and 10 mg iron daily. Rationale: Preschool children need 500 to 800 mg calcium and 10 mg iron daily. Parents should be aware that drinking excess amounts of milk may lead to iron deficiency as the calcium in milk blocks iron absorption.

The nurse is assessing a 4-year-old for gross motor skill development. Which of the following would the nurse expect this preschooler to have accomplished? a. hopping on one foot b. standing on one foot for 10 seconds c. skipping d. swimming

a. hopping on one foot. The 4-year-old should be able to hop on one foot. Rationale: At age 4, the preschooler hops on one foot and stands on one foot up to 5 seconds. At 5 years old the preschooler stands on one foot for 10 seconds, may skip, and may learn to skate and swim.

what should you limit for preschoolers

amounts of poor, high-calorie ffoods

The nurse is assessing a 5-year-old child for signs of developmental delay. Which of the following would alert the nurse to a potential problem? a. the child can build a tower of six blocks b. the child does not play with other children c. the child engages in fantasy play d. the child separates from parent easily

b. the child does not play with other children. This is a sign of a potential developmental delay. Rationale: Signs of developmental delay in preschool-age children include not playing with other children, not being able to build a block tower of six to eight blocks, not engaging in fantasy play, and not separating from the parent without major protest.

myelination of the spinal cord allows for what?

bowel and bladder control to be complete; small intestine grows in length.

respiratory system of a preschool is ?

espiratory structures continue to grow in size; number of alveoli increase.

saturated fats for preschooler

less than 10%

fat intake for preschooler

no less than 20% and no more than 30% daily calories

diet high in what for a preschooler?

nutrient-rich foods

how is the uretha in a preschooler?

remains short in children, making them susceptible to urinary tract infections.

how do Eustachian tubes remain as a preschooler?

short and straight

4 years old signs of development delay

• Cannot jump in place or ride a tricycle • Cannot stack four blocks • Cannot throw ball overhand • Does not grasp crayon with thumb and fingers • Has difficulty with scribbling • Cannot copy a circle • Does not use sentences with three or more words • Cannot use the words "me" and "you" appropriately • Ignores other children or does not show interest in interactive games • Will not respond to people outside the family; still clings or cries if parents leave • Resists using toilet, dressing, sleeping • Does not engage in fantasy play

5 years developmental delay

• Is unhappy or sad often • Has little interest in playing with other children • Is unable to separate from parent without major protest • Is extremely aggressive • Is extremely fearful or timid, or unusually passive • Cannot build tower of six to eight blocks • Is easily distracted; cannot concentrate on single activity for 5 minutes • Rarely engages in fantasy play • Has trouble with eating, sleeping, or using the toilet • Cannot use plurals or past tense • Cannot brush teeth, wash and dry hands, or undress efficiently

5 years old communication

• Persons outside of the family can understand most of the child's speech • Explains how an item is used • Participates in long, detailed conversations • Talks about past, future, and imaginary events • Answers questions that use "why" and "when" • Can count to 10 • Recalls part of a story • Speech should be completely intelligible, even if the child has articulation difficulties • Speech is generally grammatically correct • Vocabulary of 2,100 words • Says name and address

5 years old fine motor skills

• Prints some letters • Draws person with body and at least six parts • Dresses/undresses without assistance • Can learn to tie laces • Uses fork, spoon, and knife (supervised) well • Copies triangle and other geometric patterns • Mostly cares for own toileting needs

4 years old communication skills

• Speaks in complete sentences using adult-like grammar • Tells a story that is easy to follow • 75% of speech understood by others outside of family • Asks questions with "who," "how," "how many" • Stays on topic in a conversation • Understands the concepts of "same" and "different" • Asks many questions • Knows names of familiar animals • Names common objects in books and magazines • Knows at least one color • Uses language to engage in make-believe • Follows a three-part command • Can count a few numbers • Vocabulary of 1,500 words

5 years old cross motor skills

• Stands on one foot 10 seconds or longer • Swings and climbs well • May skip • Somersaults • May learn to skate and swim

4-years old expected motor skills

• Throws ball overhand • Kicks ball forward • Catches bounced ball • Hops on one foot • Stands on one foot up to 5 seconds • Alternates feet going up and down steps • Moves backward and forward with agility

4 years old expected fine motor skills

• Uses scissors successfully • Copies capital letters • Draws circles and squares • Traces a cross or diamond • Draws a person with two to four body parts • Laces shoes