Ch. 27 Growth and Development of the Preschooler

R/f for lack of social and emotional reediness for school includes

- insecure attachment to the early years - maternal depression - parental substance abuse - low socioeconomic status ** nurses should screen for this and make referals

communication abilities of the 5 yr old

- outside family can understand speech - explain how an item is used - participate in long detailed convo - talk about past, future, and imaginary events - asks questions using why and when - can count to 10 - recalls part of a story - speech should be intelligible - grammatically correct - vocab 2100 words - says name and adress

Fine motor skills by age 5

- prints some letters - draws person with 6 body parts - dress/undress w/o assistance - learn to tie laces - use utensils well - copies geometric patterns - mostly cares for own toileting needs

Piaget age 4-7

- classify and relate objects - knows right or wrong but not why - tolerates others differences - curious - accepts cultural rules - uses words appropriately but doesn't know meaning - question parents values

Gross motor skills by age 3

- climbs well - pedals tricycle - runs easily - walks up and down stairs alternating feet - bends over easily without falling

Piaget age 2-4

- egocentric - short attention span - learns through observing - animism - not logical - active imagination

communication abilities of the 4 yr old

- speak in complete sentences - use adult like grammar - 75% understood by others outside family - asks questions of who, how, how many? - stays on topic - understands "same" and "different" - asks questions - knows names of familiar animals - name common objects in books - knows at least one color - use language to engage in make believe - follows a three part command - can count a few numbers - vocab of 1500

Gross motor skills by age 5

- stands on one foot for 10 sec - swings and climbs well - skips - somersaults - may learn to skate and swim

Gross motor skills by age 4

- throws ball overhead - kicks ball forward - catches bounce ball - hops on one foot - stands on one foot 5 sec. - alternates feet going up and down stairs - moves backwards and forwards with agility

Fine motor skills by age 3

- undress self - copies circle - builds tower of 9-10 cubes - holds a pencil in writing position - screws/unscrews lids - turn book pages one at a time

what is important for the preschooler in regards to safety in the care

- use forward facing car seat up to 4 yr old if the height permits - after reaching car seat hight requirement the child should sit in a booster seat that uses lap and shoulder straps

Fine motor skills by age 4

- uses scissors successfully - copies capital letters - draws circles and squares - traces a cross or diamond - draw a person w/ 2-4 body parts - laces shoes

preschoolers should have how many hours of sleep?

11-12 hr each day ***important to continue bedtime routine and ritual

preschoolers should consume about ________ mg of dietary fiber every day

19 mg - benifiber is helpful for those that wont eat

the preschooler should have ___________ deciduous teeth present

20

at 5 yr of age the child uses ______________ words

2000 words

Preschool age

3-6 years of age

The average 3 year old is __________ lb increasing to an average weight of ___________ by 5 years

32 lb; 41 lb

The average weight gain in the preschool years is how much per year?

4-5 lb

Bowel and bladder control is complete by what age?

4-5 yr. but they may still have accidents - myelination of the spinal cord has occurred

Average 4 year old is how tall?

40.5 inches

Average 5 year old is how tall?

43 inches

at 2 yr of age the child uses ____________ words

50-100 words

the upper jaw line widens in the preschool years in preparation for permanent teeth, usually starting around ________ years old

6

The average preschool child will grow how much in one year

6.5-7.5 cm (2.5-3 inches)

the respiratory system reaches full growth by age

7 yr

3-5 yr old requires ___________ amount of calcium

700-1000 mg

Average 3 year old is how tall?

96.2 cm (37 inches)

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

Assess the child's usual pattern at home The nurse must first assess the child's current intake to determine if there is a deficiency.

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? Hesitancy and dysfluency are normal during this period of development. Reading to the child will help model appropriate speech. Expressive language concerns warrant a developmental evaluation. The mother should ask her child's physician for a speech therapy evaluation.

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? If spanking is not working, then time-out is not likely to be helpful either. Place the child in time-out for 4 minutes. Use time-out only if removing privileges is unsuccessful. The child should stay in time-out until crying ceases.

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.

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. A less discriminating sense of touch. Visual acuity that has not fully developed. A less discriminating sense of taste.

Less discriminating sense of taste

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: Problematic; the child is old enough to begin to have a basis in reality. Normal, because the child is hospitalized and out of her routine. Normal for this stage of growth and development. Problematic, as it interferes with needed nursing care.

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

Freud age 3-7

Phallic stage (genetallia is center)

preoperational thought

based on a self-centered understanding of the world - egocentric and only has a one way view

what sounds are usually mastered by 5 yr

f, v, s, z

Animism

gives life like qualities to inanimate objects

erikson age 3-6

initiative vs guilt

drinking excessive amounts of milk may lead to

iron deficiency as the calcium in milk blocks iron absorption

Preschool eating habits

it is normal for the preschooler to eat erratically- very well one day and very little the next day

Calcium rich foods

low fat milk, low fat yogurt, cheddar cheese, dried white beans, tofu, raw broccoli

magical thinking

normal in preschool development - believes that his or her thoughts are all powerful - helps the child satisfy their curiosity and make room for the real world

Imaginary friend

normal in the preschooler - creative way to sample different activities and behaviors - can easily switch between fantasy and real

Stool passage in the preschooler usually occurs how many times a day?

once or twice

night terrors

partial arousal from deep sleep with screaming and thrashing during the episode awakening the parent. Usually occurs one hour after sleep and child is unaware of the parents presence and is not broken out of terror. The child will rapidly return to sleep without fully awakening and have no memory of the event

Kohlberg age 2-7

punishment and obedience

3 year old exhibits __________ speech using short sentences containing only essential info

telegraphic

what sounds are mastered at 6 yr

th, r

Preschoolers are susceptible to injury because

the musculoskeletal system has not completely developed

stuttering

usually presents in the preschool years and resolves itself by age 8

Transduction

when preschooler correlated subjects and things that are unrelated