Exam 2 Flashcards
(43 cards)
Immunizations during toddlerhood:
vaccines begin to slow down
Last round is at 18 months
does not start back up until 4
What age is toddlerhood?
18 months - 3 years
Erikson: toddlerhood
Autonomy vs doubt/shame
Autonomy: being own person
less dependent on parents
lack confidence because of not being able to do things
Growth: toddlerhood
Height: 2- 4 inches per year
Weight: 4 -6 pounds
toddler height at 2 is 50% of adult height
” big Belly”
Lumbar Lordosis: curving inward of lower back that put pressure on entire back
anterior fontanelle closes at 18 months
overall growth slows down
start to shed baby fat
posture straightens
Milestones for toddlers:
large range of milestones
mobility = trouble
climbing stairs
tricycles
running
kicking
throwing
hold spoon + fork
scribble
copy a circle
Examination of Toddlers:
need to have some level of control
hold equipment
blow out otoscope light
let them listen to heart w stethocope
distraction
jokes
Exam done on parents lap
No head- to-toe assessment: get creative
painful things should be last
establish trust
Poisoning: toddlerhood
greatest risk from 1-2 years
explore the world with mouth
Medication, household products, plants, cigarettes, alchol, cosmetics
If suspected call posion control
Child Abuse Signs:
Parental delay in seeking help and reluctance to provide information
Bare spots and broken hair
Inconsistences in story + old fracture
Pattern injuries
Burn marks
Bruises (especially on back of body)
Lack of guilt
Vision: toddlerhood
About 20/40 (worse than adults)
EOMS can be an issue (strabismus)(cross eyed)
Kids may need glasses or surgery to correct
If untreated: result in amblyopia (lazy eye)(permanent issues) (visual acuity)
Diminished or loss of vison in one eye
Brain favors normal eye
Management focused on making child use one eye to reduce vision (lazy eye)
Use a patch
Tantrums: Toddlerhood
more common
Say No because they can
Big temper tantrum
Ignore the behavior
Set limits and stick to them
Routine simple and predictable
Trick them into thinking they have control
Waking hours are at play
Do not have verbal skills to communicate needs
Not good at sharing (parallel plays) play side by side; not together
Potty Training: Toddlerhood
Usually starts with bowel then urine training
18-24 months; start when psychological able to: before leads to frustration
Skill needed: walking, stooping down to sit on the potty, have to stay dry for at least 2 hours;
Need to Sit for 2-3 minutes intermittently
Incentive charts (get treat when they go on the potty)
Daytime dryness starts before nighttime dryness
Major parental concern
Nurse Role:
Provide anticipatory guidance
Assist with toileting program
Discuss with parents their understanding of children attitude and readiness
Allergies: toddlerhood
Toddlerhood is when they begin
Show as hives (red wheals)
High risk foods (TEST QUESTIONS)
Nuts
Shellfish
Dairy (eggs + milk)
Gluten
Soy
Sleeping: toddlerhood
Need for sleep decreases: 12 hours a day; 1-2 naps a day
Schedules are helpful to avoid overfatigue
Bedtime rituals are very important; brush teeth, story, bath, need predictable
Night terrors:
Can develop
Recall a frightening dream
Often not awake completely
Usually falls back to sleep in 5- 10 minutes
Avoid awakening: speak softly
Will eventually grow out of night terror
Dental: toddler
All 20 baby teeth erupt by the end of toddlerhood
Brushing teeth is very important
Start visiting the dentist
Fluoride supplement if not in the water (controversial)
Prevent dental caries: bedtime bottle should be water only; no juice
Car Seats:
Proper installation of safety seat- best to have a certified care seat technician.
Laws vary from state to state
Rear facing until AT LEAST 2 yrs old, then forward facing with 5 point harness. Stay in seat with 5 point harness until as long as possible according to manufacturers guidelines for height and weight.
Transition to booster seat when outgrow manufacturers rec in terms of height and weight
Then Booster seat until 8-12 yrs AND 4’9”
Kids in back seat of car until at least age 13!! (airbag dangers!!)
Autism:
1 in 37 boys: 1 in 151 girls
Boys are 4x more likely to have autism
Most children are being diagnosed after 4; can be diagnosed starting at 2
Autism affects all ethnic and socioeconomic groups
Minority groups tend to be diagnosed later and less often
Early intervention affords best opportunity to support healthy development and deliver benefits throughout the lifetime
No medical detection for autism
Diagnosis:
Behavioral: inappropriate social interaction, poor eye contact, compulsive behavior, impulsivity, repetitive movement, self-harm, persistent repetitive of words/ actions
Developmental: learning disability or speech delay
Cognitive: intense interest of limited number of things or problem paying attention
Psychological: unaware of other emotions or depression
Lack of social smile
What is the most common way for a toddler to get injuried?
Climbing is most common
What temp should the water heater be set to for toddlers?
120- 125 degrees
Reyes Syndrome:
Rare: can be extremely deadly
ASA can transfer vis breast milk
Aspirin no longer recommended for routine use in children: watch Pepto Bismol, Alka Seltzer: education parent to avoid this
Aspirin usage/ product that contain aspirin (acetyl salicylic acid) + a viral infection
Brain swelling + liver damage
Most often seen in children 4-12
Symptoms: vomiting irritablity, confusion, brain swelling, fatty liver and if untreated coma and death
Immunizations: Pre school children
getting boosters
Dtap: 4th year
MMR: 4-6
Varicella: if they did not get
Concerns:
relgious
safety
importance of accurate information
Erikson: Pre school Age:
Initiative vs guilt
encourage child to create and try new things
teach them to make mistakes do not make them bad,
allow childs ambition, abilites, idea, opinion
let them do things on own
Lead posioning:
can cause irreversible brain damage
old paint, old toys, pottery
Prevention- teach parents about risks, encourage diet low in fat because
lead is retained in fat, encourage Vit C, calcium, and iron intake
Can cause neurological delays
Affects blood brain barrier
Cosmetic imports
Absorption is a lot easier
Developmental delays
Prevention: Handwashing, wash toys, see where toys are imported from, Run Cold Water: Older plumbing,
Poisoning:
No number is safe: 0 is what we want
Special Diet:
encourage diet low in fat because lead is retained in fat, encourage Vit C, calcium, and iron intake
Vison: pre school aged:
Should approach 20/20 by 6 years of age
Possibility of developing amblyopia decreases
Depth and color vision becomes fully established
Visual capacity can deteriorate rather than improve, however
Early detection with Snellen Screening tests in school and well-child check-ups
Can use the Snellen now
Color blind:
Can be problematic in school because many cues depend on color recognition
Ishihara Test: used to test for color blindness
Food allergies: Pre school
With increase in food choices, food allergies also emerge
Up to 8% of children have food allergies
I million preschoolers are affected and approx. 1/3 of these are life threatening allergies
High-risk allergens: milk, eggs, peanuts, tree nuts, soybeans, fish, shellfish, glutens, seeds
