Peds: PrepU Ch. 5
The caregiver of a 6-year-old expresses concern that the child cannot yet print the first and last name. The caregiver is wondering if this is normal. Which response by the nurse would be most appropriate? -"By the age of 6, most children can print some letters and maybe their first name." -"Usually by the age of 6, most children can write numbers up to nine, but no letters." -"Some children this age cannot hold a pencil or crayon well enough to write legibly." -"It is not unusual for children of this age to be writing their first name in cursive."
"By the age of 6, most children can print some letters and maybe their first name." By 3 years of age, a child should be able to hold a pencil in the writing position. By age 4, the child can draw circles and squares and a body with four parts. At age 5, the child can print letters, copy a triangle and a picture of a person with six parts and cut with scissors. The 6-year-old child can print letters or numbers and may be able to print his or her own name. Children do not write in cursive until school age.
The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency? -"He loves milk and drinks it every time he is thirsty." -"He eats a well-balanced diet." -"He enjoys eggs and fortified cereal for breakfast." -"He does not like spinach, but he does like chicken and beef."
"He loves milk and drinks it every time he is thirsty." This is likely to result in a very high intake of milk. Excess milk drinking may lead to iron deficiency since the calcium in milk blocks iron absorption. The nurse needs to emphasize this fact and suggest an appropriate daily milk intake. The other statements all include iron-rich foods and would not point to a risk for iron deficiency.
The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching? -"I put him in time-out when the problem occurs." -"He is allowed out of time-out when he is calm." -"The time-out doesn't just have to be in his room." -"I usually have him in time-out for about 10 minutes."
"I usually have him in time-out for about 10 minutes." A time-out should be timed appropriately. The time-out should occur at the time the offense occurred, to ensure the child relates the offense (the behavioral problem) to the time-out period. Brief time-outs are more effective than very long ones, because a long time-out enables the child to redirect attention from calming down to being resentful. The maximum time-out duration should be 1 minute for each year of age, but it may be necessary to start with much shorter time-outs. A time-out should end as soon as the child is calm. Time-outs do not have to occur in the child's room; any location where the child is removed from activity and has an opportunity to become calm will do.
The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family? -"Stop the car any time the preschooler unbuckles the restraints." -"Explain that wearing a seat belt is a law and the police officer will give a ticket if the seat belt is not buckled." -"Set a good example. Wear your own seat belt every time you drive." -"Reward the child with candy or some other treat each time the child keeps the seat belt on."
"Set a good example. Wear your own seat belt every time you drive." A preschooler wants to please, and if the caregiver consistently wears the seatbelt, that will become the standard for riding in the car. All states have laws that define safety seat and restraint requirements for children. Adults must teach and reinforce these rules. One primary responsibility of adults is always to wear seat belts themselves and to make certain that the child always is in a safety seat or has a seat belt on when in a motor vehicle. A child can also be calmly taught that the vehicle "won't go" unless everyone in it is properly restrained. The child should be taught respect of rules and laws, but making threats or giving rewards is not appropriate.
The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement by the mother indicates a need for further teaching? -"The balls of her feet should reach both pedals while sitting." -"Pedal back brakes are better for her age group." -"She should always ride on the sidewalk." -"She can ride on the street if I am riding with her."
"She can ride on the street if I am riding with her." The preschooler is not mature enough to ride a bicycle in the street even if riding with adults, so the nurse should emphasize that the girl should always ride on the sidewalk even if the mother is riding with her daughter. The other statements are correct.
During an assessment, a preschool-aged child tells the nurse about having 12 siblings. The nurse is aware that the child has two older brothers. What would be the nurse's best response? -"I guess you don't know much about counting yet." -"Don't lie to me. That's never a nice thing to do to someone." -"Does it make you feel more important when you add on brothers?" -"That is a good pretend answer but tell me the names of the brothers you really have."
"That is a good pretend answer but tell me the names of the brothers you really have." Explanation: Stretching stories to make them seem more interesting is a phenomenon frequently encountered in preschoolers. This kind of storytelling should not be encouraged. The child should be helped to separate fact from fiction. The nurse should ask the child to say the names of the brothers the child really has. The nurse should not insult the child's counting ability. The nurse should not accuse the child of lying or making the child seem more important by having more brothers.
The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention? -"The school has a looser environment, which is a good match for his temperament." -"The school requires processed foods and high sugar foods be avoided." -"The school is quite structured and advocates corporal punishment." -"There is a very low student-teacher ratio, and they do a lot of hands-on projects."
"The school is quite structured and advocates corporal punishment." The nurse needs to emphasize that there are number of reasons that a parent should not choose a preschool that utilizes corporal punishment. It may negatively affect a child's self-esteem as well as ability to achieve in school. It may also lead to disruptive and violent behavior in the classroom and should be discouraged. The other statements would not warrant further discussion or intervention.
The mother of a 3-year-old tells the nurse that she is concerned that her child is not developing motor skills quickly enough. She states that, "My son can't skip and cannot stand on one foot for any length of time while playing." How should the nurse respond? -"Your child is not expected to be able to perform those activities at 3 years of age." -"I wouldn't be too concerned since he seems fine during my assessment." -"Maybe practicing these activities with him would help him improve these motor skills." -"I am sure he will become more proficient in these activities soon."
"Your child is not expected to be able to perform those activities at 3 years of age." Skipping and standing on one foot for up to 10 seconds are motor skills that are expected from a 5-year-old, not a 3-year-old; therefore, the best response is letting the mother know that her child is not behind in motor development.
Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply. -"Try using a night light in the child's room." -"Set up some familiar bedtime rituals for your child." -"Keep the door closed and the lights off so that your child can fall asleep faster." -"Avoid having your child watch frightening shows on TV before bedtime." -"Try reading a favorite story before bedtime."
-"Try using a night light in the child's room." -"Set up some familiar bedtime rituals for your child." -"Avoid having your child watch frightening shows on TV before bedtime." -"Try reading a favorite story before bedtime." Preschoolers may refuse to go to sleep because of fear of the dark. A night light, screening out frightening stories or TV shows, and using familiar bedtime routines, including reading a favorite story, can help. Keeping the door closed and the lights off would only help to promote the child's fear.
Language development is rapid in the preschool years. At the age of 2 most children use about 50 to 100 words. By the time the child is 5 years of age, how many words do most children use? -1,000 words -1,500 words -2,000 words -3,000 words
2,000 words A 2 year old verbalizes about 50 to 100 words. By the age of 3 the child is using telegraphic speech. This means they can speak in short sentences containing only essential information. By the age of 5 preschoolers know and use about 2,000 words. By age 6 the child is making sentences that are adult-like in structure.
A nurse is preparing a presentation for a health fair discussing various aspects of toddlers. Which example should the nurse use to best illustrate dramatic play? -Playing apart from others without being part of a group -Acting out a troubling or stressful situation -Playing a video game with several other children -Watching television or videos
Acting out a troubling or stressful situation Dramatic play allows a child to act out a troubling or stressful situation. Solitary independent play means playing apart from others without making an effort to be part of the group or group activity. During cooperative play, children play in an organized group with each other as in team sports or video games. Onlooker play occurs when there is observation without participation, such as watching television or videos.
A nurse is caring for a 4-year-old child that will be undergoing a procedure to remove a mass from the abdomen. In order to help the child remain calm in preparation for getting an IV catheter placed, what intervention might the nurse implement? -Allow the child to play with a procedure doll. -Not discuss the procedure in front of the child. -Distract the child with games and candy. -Take the child to the playroom for coloring.
Allow the child to play with a procedure doll. The nurse can allow the child to play with a procedure doll that will simulate the procedure for the child.
A nurse is developing a plan of care for a 4-year-old client with cystic fibrosis who has frequent hospitalizations related to his illness. Which would be the most appropriate nursing diagnosis for this client? -Health-seeking behaviors -Risk for imbalance nutrition, more than body requirements -Parental anxiety related to lack of understanding -Delayed growth and development related to frequent illness
Delayed growth and development related to frequent illness This client has frequent hospitalizations and is at risk for delayed growth and development. For a client at this age, play, socialization, exploring, and imagination are all important parts of normal growth and development.
The mother of a 4-year-old boy reports her son has voiced curiosity about her breasts. She asks the nurse what she should do. Which information is best for the nurse to give the parent? -Advise the parent that sexual curiosity is unusual at this age. -Encourage the parent to provide a detailed discussion about human sexuality with the child. -Encourage the parent to determine what the child's specific questions are and answer them briefly. -Advise the parent to explain to the child that he is too young to discuss such things.
Encourage the parent to determine what the child's specific questions are and answer them briefly. Sexual curiosity is normal in the preschool-aged child. The parents should be encouraged to provide brief, honest answers to the child. The parents must also determine the type of curiosity the child has. Explanations should be within the level of understanding of the child.
The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish? -Hop on one foot -Walk backwards with heel to toe -Throw and catch a ball -Jump rope
Hop on one foot The 4-year-old should be able to hop on one foot and can control movements of the hands. By the age of 5 the child can walk backwards heel to toe, throw and catch a ball well, and jump rope.
The nursing instructor is illustrating the various types of play. The instructor determines the class is successful when the students correctly choose which example as best representing onlooker play? -Playing apart from others without being part of a group -Acting out a troubling situation -Playing in an organized group with each other -Observing without participating
Observing without participating Onlooker play occurs when there is observation without participation such as watching television. Solitary independent play means playing apart from others without making an effort to be part of the group or group activity. Dramatic play allows a child to act out a troubling situation. During cooperative play, children play in an organized group with each other as in team sports.
The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium? -Orange -Banana -Apple -Peach
Orange A medium orange contains 50 mg of calcium and is a good nondairy choice. The other fruits are healthy choices but do not contain as much calcium.
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in? -Pretending to be mommies and daddies in the playhouse -Playing a board game -Painting pictures in the art corner of the room -Watching a movie with other children their age
Pretending to be mommies and daddies in the playhouse Preschool children have imitative play, pretending to be the mommy, the daddy, a policeman, a cowboy, or other familiar characters. The school-aged child enjoys group activities, such as board games, and making things, such as drawings, paintings, and craft projects. The adolescent enjoys activities he or she can participate in with their peers.
A parent brings the 4-year-old child for a check-up. Which finding would concern the nurse? -Resting pulse rate of 120 -Ectomorphic body type -No increase in appetite compared with that in toddler years -Weight gain of 5 lb (2.27 kg) in the past year
Resting pulse rate of 120 Pulse rate in preschool children decreases to about 85 bpm typically, so the nurse should be concerned about a pulse rate of 120 in a 4-year-old. Contour changes in preschool children are so definite that future body type—ectomorphic (slim body build) or endomorphic (large body build)—becomes apparent. Neither of these body types is a reason for concern. During these years, appetite remains the same as it was during the toddler years, a level perhaps considerably less than some parents would like or expect. Weight gain is slight during the preschool years as the average child gains only about 4.5 lb (2 kg) a year.
A 4-year-old is going to finger paint for the first time. What is the best action for the adult supervisor of this activity? -Draw a picture first for the child to see how to do it. -Tell the child that it will be fun but that he or she should not make a mess. -Support whatever the child paints. -Make a model for the child to follow so it will be easy to copy.
Support whatever the child paints. Preschoolers have a vivid imagination and need little direction for free-form play, such as finger painting. If a person draws a tree and tells the child to draw one, the child may no longer have fun, because the child believes that his or her tree will not look as good. The preschooler is not ready for competition and will drop out of the activity. Finger painting is a messy activity, so telling the child not to be messy takes the fun and the creative part out of the activity. The adult should provide aprons or clothing to protect the child's clothing and allow the painting in an area that can be cleaned easily.
Which gross motor skill would the 4-year-old child have most recently attained? -The child can hop on one foot. -The child can tie his/her shoelaces. -The child can cut his/her food. -The child can button his/her clothes.
The child can hop on one foot. Gross and fine motor skills continue to develop rapidly in the preschool-age child. Gross motor skills have to do with the development of large muscles. Balance improves and around the age of 4, thus the child can hop on one foot and stand on one foot for 5 seconds. A 3-year-old child does not have the ability to accomplish these tasks. A 5-year-old child can button his/her own clothes, tie their shoes, and cut his/her food.
Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize: -having the child wear a personal flotation device whenever near or on the water. -enrolling the child in swimming lessons. -adults learning infant/child cardiopulmonary resuscitation (CPR). -using and renewing sunscreen regularly.
having the child wear a personal flotation device whenever near or on the water. Preschool children are safe around water only when adult supervision is constant. Wearing a personal flotation device adds additional protection and should be as routine as "buckling up" in the car. At 5 years old, most preschoolers are mature enough to become swimmers; yet knowing how to swim does not make the preschooler safe without supervision. CPR is a life-saving skill and using sunscreen will protect the skin, but neither will be a factor in preventing drowning.
When planning how to respond to a 3-year-old child about telling stories ("tall tales"), the nurse would base the statement on the fact that: -imagination in a 3-year-old is at its peak. -a 3-year-old knows the word two but not the concept of two. -a preschooler is in an insecure period. -preschoolers have a limited vocabulary.
imagination in a 3-year-old is at its peak. Preschoolers have vivid imaginations and love to play "make believe." They are inquisitive learners. It is not unusual for their imaginations to create "tall tales" and be in a world of make-believe. Preschoolers have a vocabulary of between 1,500 and 2,100 words, depending upon their age. They can count to 10 and know at least 4 colors. Their communication is concrete. At this age they are not capable of abstract thought. During the preschool years, the child develops a sense of identity. They know who they are and to the family in which they belong. They develop the knowledge of right and wrong. The preschool years help develop the child's sense of belonging and their place in the world.
The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of: -transduction. -magical thinking. -animism. -beginning empathy.
transduction. The nurse identifies transduction. Because the 4-year-old recently received an injection from a nurse in a flowered uniform, the girl believes that all nurses who wear flowered uniforms give shots. Transduction is reasoning by viewing one situation as the basis for another situation even though the two may or may not be causally linked. Magical thinking involves believing that one's thoughts are all-powerful. Animism is attributing life-like characteristics to inanimate objects. Empathy is the understanding of others' feelings.
A first-time father calls the pediatric nurse stating he is concerned that his 4-year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate? -"Disciplining is not likely to be effective, but if the child keeps wetting the bed it may be necessary." -"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration." -"Setting rules is a parent's job to help the child have acceptable social behavior, so take away a privilege each time she wets the bed." -"Nightly bedwetting up to age 12 is developmentally typical, so you will need to practice patience with your daughter."
"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration." Occasional bedwetting is not uncommon for young preschoolers and is not a concern unless it continues past the age of 7. When the child does have an accident, treating it in a matter-of-fact way and providing the child with clean, dry clothing is best. The child should not be disciplined or made to feel he or she is socially unacceptable when bedwetting occurs.
The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching? -"I will need to find an appropriate punishment for him if this continues." -"I have heard that both boys and girls often touch themselves at this age." -"I should teach him certain rules about this activity." -"This is probably a good time to talk about safety and who can touch him."
"I will need to find an appropriate punishment for him if this continues. The nurse should remind the father that overreaction to this behavior may cause it to occur more frequently. Masturbation at this age should be treated matter-of-factly. The other statements are correct.
During an extended stay in a hospital the nurse has observed a 5-year-old having several temper tantrums. How should the nurse address this behavior with the parents? -"I think we need to plan how to discipline your child when acting out this way." -"We don't allow children of this age to throw tantrums so you will need to manage your child's behavior." -"Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here." -"I am concerned that your child may have a developmental delay since most children of this age don't throw temper tantrums."
"Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here." Typically temper tantrums are few or absent in occurrence by the time the child is of preschool age. Asking if this is typical behavior at home is appropriate in determining if this is just aggressive behavior or if this is a sign of a developmental delay. It is generally not necessary to discipline a child for temper tantrums and disciplining is not in the nurse's scope of practice.
A father tells the nurse that his son has been asking questions about his genitals. The father states that he is unsure how to answer the questions of a 4-year-old. How should the nurse respond? -"That is a difficult subject to address. I'm not sure what is the best way to answer that question." -"You should answer his questions by whatever feels most comfortable to you." -"It's best to answer his questions using accurate anatomical names and keep your answers simple." -"I would suggest getting books with pictures to help explain the differences between male and female genitalia."
"It's best to answer his questions using accurate anatomical names and keep your answers simple." It is suggested to keep answers brief and use correct anatomical names of body parts. Offering this advice to the father will help guide him in how to address questions. It is not necessary to go into the detail of using books with pictures for children of this age.
The nurse realizes that the 5-year-old's growth chart and BMI indicate the child is at risk for obesity. What other findings reinforce this risk? Select all that apply. -A father who is overweight -Food used as reward or punishment -Television on during meals -Expectations to eat everything on plate -Mealtimes organized and regular -Fast food eaten once a month
-A father who is overweight -Food used as reward or punishment -Television on during meals -Expectations to eat everything on plate Overweight parents, food used as reward or punishment, TV viewing during meals, and the "clean plate club" all are factors that contribute to weight gain. The frequency the family eats fast food is not excessive. Regular, structured meals result in less snacking and more nutritious meals. Family eating together is bonding.
The parents of a preschool-aged child are investigating child care centers to enroll the child. What would the nurse review with the parents prior to them making a decision? Select all that apply. -Ask about the child-staff ratio. -Ask about the center's payment plan. -Find out if parents can visit at any time. -Find out how long the center has been in operation. -Ask about the center's licenses and compliance with regulations.
-Ask about the child-staff ratio. -Find out if parents can visit at any time. -Find out how long the center has been in operation. -Ask about the center's licenses and compliance with regulations. When investigating child care centers, the nurse should counsel the parents to find out about the child-staff ratio, parental visiting hours, the time the center has been in operation, and compliance with licenses and regulations. The payment plan might be important to the parents; however, it should not be the sole factor in making a decision about a child care center.
The parents of a 5-year-old tell the nurse that it "seems like our child is afraid of everything from fireworks to butterflies." What actions should the nurse take? Select all that apply. -Ask the parents if they can identify anything that may be causing their child be be fearful. -Encourage the parents to just ignore the fears since this is common behavior with the preschool-aged child. -Suggest to the parents to talk with their child about his fears. -Work with the parents and child to devise strategies to help deal with the fears. -Advise the parents to help the child understand that the fears are irrational.
-Ask the parents if they can identify anything that may be causing their child be be fearful. -Suggest to the parents to talk with their child about his fears. -Work with the parents and child to devise strategies to help deal with the fears. Preschoolers have a vivid imagination, which often leads to a variety of fears. The best way to deal with the child's fears is to address them and work together to determine ways to help minimize the fears. The preschooler is not emotionally equipped to understand why fears are irrational.
The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize? -Allow the child to touch and play with the nebulizer for a few minutes before the treatment. -Show the child how to use the nebulizer and tell the child how much easier it is to breathe afterward. -Explain that the child will feel better after the treatment and allow the child to ask questions. -Use a poster or brochure to illustrate to the child how the machine works.
Allow the child to touch and play with the nebulizer for a few minutes before the treatment. Children are often less anxious about procedures if they are allowed to handle equipment beforehand— and perhaps "use" it on a doll or another toy. Play is an effective way to let children act out their anxieties and to learn what to expect from the hospital situation. Explaining how the treatment will help him or her feel better, using posters, and encouraging the child to ask questions would be appropriate for the older child, not the preschool-aged child.
Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue? -Allowing the preschooler to fall asleep wherever and whenever the child is tired enough -Eliminating caffeine sources beginning late afternoon -Providing a nightlight -Taking the TV set out of the child's room -Planning for the child to get 12 hours of sleep daily
Allowing the preschooler to fall asleep wherever and whenever the child is tired enough Consistent bedtimes and places for sleep promote good sleep habits. Caffeine (soft drinks) interferes with sleep. A nightlight can reduce fear of the dark common in preschoolers. Removing the TV from the child's room prevents viewing and screen light from keeping her awake. Twelve hours of sleep daily is an average amount for preschoolers.
A parent brings her 3-year-old child in for a sick visit for the third time this year. The child, who attends a preschool program, continues to develop upper respiratory infections. The parent is frustrated with the situation and asks the nurse for advice. What would be the best recommendation for the nurse to give to the parent in this situation? -Make sure that frequent handwashing is being stressed at the preschool -Withdraw the child from preschool and keep at home -Send the child to preschool with a healthy snack each day -Teach the child to cover the mouth when sneezing
Make sure that frequent handwashing is being stressed at the preschool Even though the number of major illnesses is few in this age group, the number of minor illnesses, such as common colds and ear infections are high. Children who attend childcare or preschool programs have an increased incidence of gastrointestinal disturbances (vomiting and diarrhea) and upper respiratory infections from the exposure to other children unless frequent handwashing is stressed at the setting. Withdrawing the child from preschool likely is not a viable option for the parent. Sending the child to preschool with a healthy snack, although a good recommendation, will not help prevent upper respiratory infections. Teaching the child to cover the mouth when sneezing is helpful in preventing transmission of infections to other children but not in preventing the child from becoming infected.
Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget? -Primary circular reaction -Coordination of secondary schema -Tertiary circular reaction -Preoperational thought
Preoperational thought A 3-year-old is in the preoperational stage according to Piaget. Primary circular reaction is seen in infants of 3 months. Coordination of secondary schema is seen in infants at age 10 months. Tertiary circular reaction is seen in toddlers between 12 and 15 months.
A parent tells a nurse that the child has recently established some friendships for the first time. In which age group do you expect this child to be? -Toddler -Preschool -School age -Adolescence
Preschool During the preschool years the preschooler learns to cooperate with other children. Learning how to make a friend is an important part of social development. Preschoolers need a special friend they can talk to, care about, and play with. The toddler is aware of other children but plays parallel to other toddlers, they do not interact or form friendships at their developmental level. School age children have developed friendships and often have close relationships with one or two friends, but have multiple friends in school. Friendships are very important to the adolescent child.They have established friendships throughout their lives.
The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation? -Presence of 20 deciduous teeth -Presence of 10 deciduous teeth -Absence of dental caries -Presence of 19 deciduous teeth
Presence of 10 deciduous teeth The presence of only 10 deciduous teeth would warrant further investigation. The preschooler should have 20 deciduous teeth present. The absence of dental caries or presence of 19 teeth does not warrant further investigation.
The nurse is caring for a preschool child in the hospital with severe developmental delays. The parents have 3 other younger children at home and both parents work full-time outside the home. The family has just moved to this area. Which nursing diagnosis would be the highest priority in regard to the parents at this time? -Imbalanced nutrition, less than body requirements -Interrupted family processes -Readiness for enhanced parenting -Risk for caregiver role strain
Risk for caregiver role strain Given that the parents are trying to care for 4 children with a severely developmentally delayed preschooler in the hospital, and they are new to the area (making it unlikely that they have a strong support system), the highest priority nursing diagnosis would be caregiver role strain. Family processes are likely altered, but with the hospitalization, strain on the parents is a higher priority nursing diagnosis.
What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler's mother? -A ratio of 10 children to 1 teacher is adequate. -Specific program goals to be accomplished should be available. -The longer the center has been in operation, the better it is. -Research local newspapers to see if there are any complaints against the center.
Specific program goals to be accomplished should be available. Preschool is used for toddlers to foster social skills and to accustom them to the group environment. When a parent is searching for a preschool they should check the school's accreditation, the teacher's qualifications, and seek the recommendations of other parents. They should visit the school to see the teacher's interact with the children, the focus of the activities and hygiene practices. Parents should look at the school's daily schedule and the types of activities offered. Are the activities structured or loose? Preschoolers need planned activities. They are very ready to learn, but the activities should be planned to focus on their short attention spans.
At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to: -testing and identification of group role. -playing in an even-number group of children (four). -preschoolers having a harder time sharing than toddlers. -regression.
testing and identification of group role. Although 4-year-olds continue to enjoy play groups, they may become involved in arguments more than they did at age 3, especially as they become more certain of their role in the group. This development, like so many others, may make parents worry a child is regressing. However, it is really forward movement, involving some testing and identification of their group role. Because 3-year-olds are capable of sharing, they play with other children their age much more agreeably than do toddlers, which makes the preschool period become a sensitive and critical time for socialization. The elementary rule that an odd number of children will have difficulty playing well together generally pertains to children at this age: two or four will play, but three or five will quarrel.
