Exam 1- Health Promotion in the Toddler, Preschooler, School Aged Child, and Adolescent Flashcards Preview

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Flashcards in Exam 1- Health Promotion in the Toddler, Preschooler, School Aged Child, and Adolescent Deck (116)
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1

toddler age range

12 months through 36 months

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Toddler -- Physical Development


Physical growth – 5 lb./yr weight 3 in/yr Ht

Physiologic anorexia

Anterior fontanel closes 12 to 18 months

Achieves 50% of adult height by 2 years

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Toddler – Gross Motor

Walking by 15 months

Climbing on anything

Removing clothing

Stoops and recovers

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Toddler – Gross Motor

By 18 months

Runs clumsily, falls often

Walks up stairs with hand held

Jumps in place with both feet

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Toddler – 24 mo – Gross Motor

Throws ball over hand. Kicks ball.

Goes up and down stairs with 2 feet on each step

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Toddler – Gross Motor

By 30 months –
Jumps from chair, steps, anything
Stands on one foot momentarily

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Fine Motor

Scribbles
Can use a spoon and toothbrush, but messy
2 yr. wash and dry hands

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Toddler- Negativism and Ritualism


Really want to be an adult

Ask them to do something and they will say “no”

Ask them to help you the adult do something they are doing, and you will get a Big Yes

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Critical Tasks of Toddler Period

Recognition of self as a separate person with own will

Control of impulses and acquisition of socially acceptable ways to communicate wants and needs

Control of elimination

Toleration of separation from parent

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Preoperational Thinking



Egocentrism – views everything in relation to self and is unable to consider another’s point of view

Animism– Believes that inert objects are alive and have wills of their own

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Preoperational

Irreversibility – Cannot see a process in reverse order. Can not follow a line of reasoning back to its beginning.


Magical thought – wishing something will make it happen

Believe that their thoughts are all powerful

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Preoperational

Centration – Tends to focus on one aspect of an experience. May have difficulty putting together a puzzle. Focuses on dominant characteristics of an object

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Moral and Spiritual

Kohlberg
Preconventional or Premoral phase
Whether an action is good or bad depends on whether it is rewarded or punished

Fowler
Spirituality is based on images and imagination

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Language/communication

15 – 18 mo – Putting two words together (25% intelligible)

Understands simple directions

2 – 3 word phrases by 2 years (50% intelligible)

3 – 4 word sentences by 3 years (75% intelligible)

Own first and last name can be stated by 2 ½ to 3 years

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Communicating with the Toddler

Ask parents what his words for things like urination are

Tell exactly what you are going to do just before you are going to do it

A combination of words and gestures for expressing wants--Holographic speech

Are learning to name body parts

Concerned about body
Boo boos
Male vs. female

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Well-Child Visit

Blood Lead Level at 1 year & 2 year visit
Hgb/Hct
Vision – cover, uncover test

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Parenting Issues – Toddler years

Discipline
Toilet Training
Temper Tantrums

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Discipline

Consistent limits

Positive reinforcement

Immediate consequences

Redirection or distractions

Time outs: 1 minute per year of age

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Readiness for toilet training

Can remove own clothing

Is willing to let go of a toy when asked

Has been walking well for one year

Notices when diaper is wet

Communicates need to go to bathroom

Wants to please parent by staying dry

Family not under major stressors

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Temper Tantrums

Limited language leads to frustration

Anticipate

Inconsistent parental practices increase frequency of tantrums

Isolate safely and ignore

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Anticipatory Teaching

Regular meal times with utensils that fit, with family

Soft toothbrush, non-fluoride toothpaste

Sleep about 12 – 14 hr/day, 1 nap

Limit TV viewing to < 1 hr day

Bedtime routine

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Nutrition

Toddlers have the highest number of taste buds and the higher degree of taste sensitivity.

Eating jags

1 Tbsp of solid food per year of age

Ritualism = regular meal times

Whole milk at 1 year – 24 – 30 oz/day

100% juice – 4 – 6 oz/day – Cup only

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Domestic mimicry --Symbolic Play

Imitating parent of same sex in household tasks – domestic mimicry

Deferred imitation is imitating the parent after they have left their sight

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Toddler – Age Appropriate Toys

Noise-making, push-pull toys, riding toys, work bench, toy hammers, musical anything, drums, pots and pans

blocks, puzzles with very few large pieces

finger paints, crayons, clay

dolls/stuffed animals

Toy telephones

Storybooks with pictures

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Acetaminophen Poisoning

Most common accidental drug poisoning in children

Toxic dose is 150mg/kg or greater in children

Multiple formulation and concentrations make chronic acetaminophen toxicity a significant problem

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Acetaminophen Poisoning

Treatment:
Antidote N-acetylcysteine (Mucomyst) can usually be given orally

Dilute with fruit juice or soda

Give loading dose, then 17 maintenance doses

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“The US Food and Drug Administration (FDA) issued an important warning related to the safety of acetaminophen. The FDA recommended that healthcare professionals discontinue prescribing and dispensing prescription combination drug products that contain more than 325 mg of acetaminophen per tablet, capsule, or other dosing formulations.”

true

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Lead Blood Levels

Blood test done if infant is at risk at any time

Universal Lead Serum Test is done at 1 year and 2 years

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Lead Poisoning

Children who are iron deficient absorb lead more readily than those with sufficient iron stores

Lead interferes with the binding of iron onto the heme molecule

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Long-term neurocognitive signs of lead poisoning

Developmental delays

Lowered IQ (intelligence quotient)

Reading skill deficits

Visual-spatial problems

Visual-motor problems

Learning disabilities