toddlers and preschoolers- 8 Flashcards

Question

preconventional

Answer 1

As described for toddlers, this level of moral reasoning (age 2 to 7) involves an obedience/punishment mentality.

Answer 2

A child should be given feedback in relationship to his or her behavior. The child should be told “good job” instead of “good boy/good girl.” Preschoolers cannot understand the process of disease transmission. The child may feel that an illness is a punishment for “being bad” (magical thinking).

Answer 3

Dress and undress self with assistance at age 3 years (later without assistance) Go up and down the stairs without assistance at age 3 years Draw squares, circles, and later triangles at age 3 years Begin learning to use utensils and drinking from a cup at age 3 years

Answer 4

Hop and stand on one foot for 5 to 10 seconds at age 4 years Throw objects overhand at age 4 years Catch a bounced ball at age 4 years Draw stick figures with more than two body parts at age 4 years (later draws people with bodies) Use scissors at age 4 years

Answer 5

Brush own teeth and go to the toilet without assistance at age 5 Learn to skip, ride a bicycle, and swim at age 5

Answer 6

Speak clearly enough for strangers to understand (by age 5 years) Speak in three- to four-word sentences at age 3 years Speak in four- to five-word sentences at age 4 years Speak in sentences of five or more words at age 5 years Tell stories Use future tense Comprehend rhyming State full name and address (later in stage) Have concrete or literal interpretation of language

Answer 7

``` Recall parts of a story Count to 10, but no concept of numbers Correctly identify at least four colors Begin to understand the concept of time Know the meaning of same and different Begin to use imagination and creativity Ask “why” questions ```

Answer 8

Be more independent Be proud of their abilities Show interest in new things Want to do things by themselves Obey rules Engage in role-play Play well with others; this is known as associative play Want to please and be like friends Try to negotiate problem solving Have trouble in differentiating between reality and fantasy (later preschoolers can tell the difference) Believe in monsters or be afraid of the dark Begin to understand gender and racial differences Begin to explore their genitalia through masturbation Can be demanding or eager to help Can be jealous over the arrival of a new sibling Place importance on body integrity

Answer 9

Many preschoolers are afraid of the dark and may be afraid to sleep in a dark room. It is helpful to have a night-light that sheds minimal light to reduce fear. Providing a bedtime routine will decrease anxiety and provide a relaxing environment.

Answer 10

``` chief complaint family medical history medical history medications allergies review of systems social history ```

Answer 11

Conduct head-to-toe assessment from least to most invasive/intrusive, leaving painful areas for last. The child will be more cooperative with the examination when performed in this order.

Answer 12

height weight head circumference vital signs

Answer 13

heart rate, respiratory rate, temperature, pulse oximetry, and blood pressure (BP) within normal range (Table 8–1). Use an appropriate-size cuff to measure the BP

Answer 14

measured for all children younger than 2 years. May be assessed after 2 years of age if difficulty with bone growth or issues identified that impact the growth of the head.

Answer 15

minimal clothing, diaper, or underwear only preferred for accuracy. Include body mass index for children older than 2 years.

Answer 16

standing when able to stand. Recumbent for young toddler, because lordosis is common in this age group.

Answer 17

BP: 70 + 2 × age in years = lower end of systolic BP; 90 + 2 × age in years = upper end of systolic BP

Answer 18

``` Appearance general nutrition status head torso extremities PAMS BM ```

Answer 19

Proportionately larger heads as compared with bodies Greater ratio of body surface area to total weight Larger tongues and greater proportion of soft tissue in and around the airway Shorter, more narrow airway that is more elastic and collapsible More pliable chest Weaker abdominal muscles, creating the look of distention Belly breathers Higher metabolic rates Higher fluid requirements Higher total blood volumes

Answer 20

Allow the child to select which digit to put the pulse oximeter on. May demonstrate use on the caregiver’s finger to show that it is a painless procedure. Allow child to select which arm to use for BP check when appropriate. Talk to the child and tell of the tight “hug” feeling to expect on the arm with BP check. Allow child to stay with caregiver so that respiratory rate and BP will not be falsely increased because of anxiety. Assess toddlers in their comfort zone, usually in a parent’s lap. Remember to protect a preschooler’s modesty. Approach children and get down to their eye level. Give praise whenever it is appropriate.

Answer 21

Note the child’s overall appearance. Look at the chest for labored respirations, accessory muscle use, and irregularity of breathing. Note the position of comfort the child places themselves when having difficulty breathing. Check skin for abnormal bruising, rash, or lesions.

Answer 22

Lung sounds for clarity, wheezing, rhonchi, or crackles Neck sounds for stridor or snoring Heart sounds for regularity and murmur (listen apically for a full minute to assess thoroughly) Bowel sounds for abnormalities (absent, hypoactive, or hyperactive)

Answer 23

Abdomen for masses, organomegaly, and tenderness Pulses for quality; should be equal bilaterally and equal in upper and lower extremities Scalp for fontanels, which typically close by age 2 years

Answer 24

drowning, motor vehicle accidents, homicide, suffocation, and fires and/or burns

Answer 25

alls, struck by/against an object, and bites/stings

Answer 26

remain highest amongst children between 1 and 4 years of age

Answer 27

Minimize falls risk Remind caregivers to never leave the crib side Check equipment regularly Check temperature of water, food, and drinks Explore any signs or symptoms that potentially may require a referral to child protective services. Educate caregiver on basic safety Install smoke and carbon monoxide detectors,

Answer 28

kids hide in emergency make plan

Answer 29

child ingesting any more than a taste of hand sanitizer could be at risk for alcohol poisoning”`

Answer 30

Never tell a child medication is candy.

Answer 31

childproof swimming areas playgrounds dangerous because they are unfamiliar teach crosswalk safety wear a helmet always use a safety/booster seat in the backseat

Answer 32

Furrowed brow and open-mouth-type grimace, or lack of expression Restlessness or sleeping and withdrawal (ways to cope with pain) Wariness/fear of movement Irritability/agitation No vocalization to harsh/high-pitched cry

Answer 33

- ask for caregiver opinion without them influencing the child’s response - ask preschool-age children questions about the quality of their pain, and avoid making assumptions on the level of pain the child “should” be experiencing - Assess for causes of pain such as infection, injury, surgical/procedural, or disease, as well as for elevated heart rate, BP, and respiratory rate - Observe specific behaviors children display in reaction to pain, such as facial expression, movement, and vocalization - Choose the appropriate pain scale - When in doubt, assume pain is present and treat accordingly

Answer 34

Young toddlers do not have the cognitive ability to convey the pain they are feeling, but this capability begins at about age 2 years.

Answer 35

- Use medical play to explain and prepare for medical procedures - The medical play items prepare the child for how equipment may feel and sound. - allow child to keep comfort items

Answer 36

Never give children the choice of taking a medication or not. Instead, give them a choice in medication form, such as liquid or chewable, or a choice in what to take the medication with, such as water, juice, or applesauce.

Answer 37

Some pain scales may not be reliable for children of different cultures because of cultural influence on pain response Oucher scale is used

Answer 38

face legs activity cry consolability

Answer 39

Ability to have dry diaper for a few hours at a time or during a nap Regularly timed bowel movements Interest in the potty or going to the potty with others Physical ability to get to potty and pull up/down pants Ability to follow simple directions Unhappiness with the feeling of a wet or dirty diaper Ability to vocalize when they went and/or if they have to go

Answer 40

likely not ready. | Parents should avoid potty training during stressful times

Answer 41

- practice sitting on potty - practice hand washing - proper use of hand sanitizer - front to back wiping - boys sit first then stand - encouragement through praise and celebration - do not be severe or punitive when accidents happen

Answer 42

Distract the child, say goodbye, and leave quickly. The quicker you leave, the quicker the episode will end. Practice leaving at home by going to another room and saying you will be back soon. Stay calm, be consistent, and give reassurance that you will be back.

Answer 43

``` Hunger Tiredness Being uncomfortable/sick Being overstressed Attention seeking Other problems (mental, physical, or emotional) ```

Answer 44

Whining and crying to screaming Hitting and kicking to scratching and biting Breath holding -stay calm and collected

Answer 45

Separate the children to their own spaces. Set rules, such as no name calling, no pushing, and no slamming things. Avoid choosing sides. Assist with proper expression of feelings of anger and frustration. Teach them to be kind to each other by encouraging apologizing, sharing, and comforting each other when hurt.

Answer 46

includes jealousy, competition, and fighting among siblings, often to gain attention from parents or to show dominance over one’s brother or sister.

Answer 47

13 g/day for age 1 to 3 years and 19 g/day for age 4 to 8 years

Answer 48

three meals a day with quite a few snacks throughout the day.

Answer 49

seven times a day, consuming more meals than snacks.

Answer 50

Serving larger portions than recommended and/or pressuring a child to eat or clean his or her plate can lead to overeating and increased risk for childhood obesity.

Answer 51

drink two servings of skim or low-fat milk or other milk product

Answer 52

two to three servings of whole milk or milk products

Answer 53

appropriate serving size for a child who is 2 to 3 years of age is half of an adult serving or 1,000 to 1,200 calories per day.

Answer 54

- Difficulty decreasing amount of intake of juice and sweet drinks 4-6oz - Difficulty fostering healthy eating habits - Difficulty consuming enough iron and zinc.

Answer 55

Drinking from a bottle throughout the day or at night increases the risk for dental caries. It may also decrease appetite for solid food, and thus increase risk for malnutrition. The American Dental Association recommends that a child see the dentist from first tooth to age 1, then every 6 months throughout life.

Answer 56

- For children 1 to 3 years old, use a smear of toothpaste the size of a grain of rice, and for 3 to 6 years old, use a pea-size amount of fluoride toothpaste in the morning and at night. - Start flossing once a day when child has two teeth that touch together.

Answer 57

- cause pain and infection - increased cost associated with multiple visits - There is also a relationship between dental caries and child mistreatment and/or neglect at the family level

Answer 58

- Rules and responsibilities - How to be safe - How to be a good friend by sharing, being kind, and not hitting others - How to establish and keep routines so they can begin to do these routine things on their own - age appropriate chores - taking time to listen - encourage kids to bathe and dress themselves or assist

Answer 59

Fever accompanied by Moist, productive cough Green or blood-tinged nasal discharge Pulling at ears

Answer 60

- Have a thermometer at home. - Give medication with dosage appropriate to the weight of the child - Use patient cooling techniques - Promote dehydration prevention - Small, frequent sips of fluids - Electrolyte-replacement beverages - Broths - Popsicles ``` - Diet advancement (as tolerated) Clear liquids May begin with a BRAT diet Soft/bland foods Solids: when able ```

Answer 61

Bruises in areas that are not typically bruised during play Symmetry of bruises Bruising that looks like an object Bruises in different stages of healing History of multiple broken bones Caregiver speaks up when nurse asks how a bruise occurred Caregiver’s story does not fit the identified injury or developmental ability of the child Multiple hospitalizations and child does not have a chronic health problem

Answer 62

``` Tachypnea Retractions Nasal flaring Accessory muscle use Tripod positioning Stridor, wheezing, and sonorous respirations ```

Answer 63

- Call if there has been a negative change from what the primary care provider (PCP) has first assessed. - whenever there is immediate information that the provider needs to know. - Bring to the PCP if the child is no longer able to perform a skill that he or she was once able to perform. - Bring to PCP whenever the caregiver believes the child is ill or his or her behavior has changed and there is suspicion that something is wrong.

Answer 64

Call 911 for all emergencies. Child is not breathing properly or adequately. Child’s face is blue or extremities are blue. Child has decreased responsiveness Child becomes injured and has excessive bleeding Call for all perceived emergencies.

toddlers and preschoolers- 8 Flashcards

(88 cards)