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Questions and Answers
At what age is the birth weight quadrupled?
What is the average weight gain per year for a toddler?
At what age does the anterior fontanel close?
How many teeth are expected by the age of 24 months?
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What is the average height of a 2-year-old child?
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Why does the toddler appear 'pot-bellied'?
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What is essential to manage temper tantrums in children?
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What is the primary reason behind a toddler's negativism?
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Why do toddlers often resist having their vital signs taken?
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What is a effective way to reduce negativism in toddlers?
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How can nurses assist parents in understanding negativism in toddlers?
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What is a better way to ask a toddler to take their vital signs?
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What is a common factor that can provoke fears in children?
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At what age is an oral health examination recommended by the American Academy of Pediatric Dentistry?
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Why is plaque removal important in toddlers?
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What is the primary benefit of play in toddlers?
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At what stage of development do toddlers typically achieve voluntary control of the anal and urethral sphincters?
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What is the purpose of anticipatory guidance regarding toilet training?
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What happens if a nurse asks a toddler a question and proceeds with the action despite the toddler's 'no' answer?
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What is regression in the context of child development?
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Why is regression common in toddlers?
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How should a caregiver respond to a toddler's regression?
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What is the primary reason for the high protein requirements in toddlers?
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What is a challenge in meeting the nutritional needs of toddlers?
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What should be placed in front of other sources of heat, such as radiators and fireplaces?
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Why are toddlers at the highest risk for accidental poisoning?
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What is a common hazard to children in this age group when playing outdoors?
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What is a consequence of ingesting harmful substances, such as lye?
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Why are portable electric heaters placed in a high area?
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What is a common type of injury that occurs in playgrounds?
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Study Notes
Fears in Toddlers
- Fears can be provoked by daily stressors such as pressure to toilet train, moves, sibling birth, experiences of loss, or separation from parents.
Dental Health
- The American Academy of Pediatric Dentistry recommends that every child have an oral health examination by a practitioner by 6 months old.
- Initial visit to a dentist or pedodontist (pediatric dentist) should occur by 6 months old or within 6 months of the eruption of the first tooth for high-risk category children.
- Plaque removal by oral hygiene measures should be implemented in toddlers to remove plaque, soft bacterial deposits that adhere to the teeth and cause dental caries (decay or cavities) and periodontal (gum) disease.
Play in Toddlers
- Play magnifies toddlers' physical and psychosocial development.
- Interaction with people becomes increasingly important.
- Solitary play of infancy progresses to parallel play; toddlers play alongside, not with, other children.
Toilet Training
- One of the major tasks of toddlerhood is toilet training.
- Anticipatory guidance and clinical intervention for families surrounding toilet training should begin during routine well-child visits before the child's developmental readiness to toilet train.
- Voluntary control of the anal and urethral sphincters is achieved sometime after the child is walking, probably between 18 and 24 months old.
Normal Toddler Development
- Toddler stage is between 1 to 3 years of age.
- Physical growth slows considerably during this period.
Physical Growth
- Average weight gain is 1.8 to 2.7 kg/year.
- The average weight at 2 years old is 12 kg.
- Birth weight is quadrupled by 2.5 years old.
- Formula to calculate normal weight of children over 1 year of age: Age in years x 2 + 8 =……….Kg
- At 30 months: birth weight quadruples.
Height
- The rate of increase in height also slows, increasing about 10 to 12.5 cm/year.
- 1-2 years increases 1 cm/month.
- The usual increase is an addition of 7.5 cm (3 inches) per year and occurs mainly in elongation of the legs rather than the trunk.
- The average height of a 2-year-old child is 86.6 cm.
- Formula to calculate normal height of children over 1 year of age: Age in years x 5 + 80 =……….cm.
Head and Chest Circumferences
- The brain develops to about 90% of its adult size.
- 1 year to adult head increases 10 cm only.
- Head circumference increases only about 2 cm during the second year.
- Chest circumference continues to increase in size and exceeds head circumference.
- Anterior fontanel closes between 12 – 18 months of age.
Teething
- Primary dentition of 16 teeth by the 24 month and 20 teeth by the 30 month.
Abdomen
- It is protruded and toddler appears “pot-bellied” because of the immature abdominal musculature.
Managing Behavior
- Consistency and developmentally appropriate expectations and rewards can help manage tantrums.
- Ensuring consistency among all caregivers in expectations, prioritizing what rules are important, and developing consequences that are reasonable for the child's level of development help manage the behavior.
Negativism
- Negativism is a normal aspect of toddler development, not an expression of being stubborn or insolent, but a necessary assertion of self-control.
- One method of dealing with negativism is to reduce the opportunities for a “no” answer.
Regression
- Regression is a retreat from one's present pattern of functioning to past levels of behavior.
- It usually occurs in instances of discomfort or stress when one attempts to conserve psychic energy by reverting to patterns of behavior that were successful in earlier stages of development.
- When regression does occur, the best approach is to ignore it while praising existing patterns of appropriate behavior.
Promoting Optimal Health
Nutrition
- During the period from 12 to 18 months old, the growth rate slows, decreasing the child's need for calories, protein, and fluid.
- The protein (13 g/day) and energy requirements are still relatively high to meet the demands for muscle tissue growth and high activity level.
- The need for minerals (such as iron, calcium, and phosphorus) may be difficult to meet, considering the characteristic food habits of children in this age group.
Safety Precautions
- Other sources of heat, such as radiators, fireplaces, accessible furnaces, kerosene heaters, and wood-burning stoves, should have guards placed in front of them.
- Portable electric heaters must be placed in a high area, well out of reach of climbing young children.
- Sunburns are a year-round concern in certain regions.
- Accidental poisoning is a hazard in toddlers due to their innate curiosity and ability to open “childproof” containers.
- Many household products, medications, and plants can be poisonous if swallowed.
- Falls are still a hazard to children in this age group, although by the later part of early childhood, gross and fine motor skills are well developed, decreasing the incidence of falls down stairs and from chairs.
- Playground injuries are common.
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Description
Test your knowledge of physical growth and development in toddlers, including weight gain and height increase. Learn about the average rates and calculations for normal child development. Assess your understanding of this critical stage from 1 to 3 years old.
