Chapter_033.pdf

Perry: Maternal Child Nursing Care, 7th Edition Chapter 33: The Preschooler and Family Key Points Biologic development in the preschool period is characterized by mature body systems and refinement in gross and fine motor behavior, as evidenced by activities such as running, jumping, riding a tricyc...

Perry: Maternal Child Nursing Care, 7th Edition Chapter 33: The Preschooler and Family Key Points Biologic development in the preschool period is characterized by mature body systems and refinement in gross and fine motor behavior, as evidenced by activities such as running, jumping, riding a tricycle, catching a ball reliably, and balancing on one foot. According to Erikson, acquiring a sense of initiative is the chief psychosocial task of the preschooler. Development of the superego occurs during this period, as conscience begins to emerge. According to Piaget, the preschool age is characterized by intuitive (or prelogical) thinking and a move toward logical thought processes through advanced and complex learning, language, and understanding of causality. The seeds of moral development are planted during the preschool period. According to Kohlberg, children move from punishment and obedience orientation in which they learn to judge actions as good or bad, to the stage of naive instrumental orientation, in which they are concerned with satisfying their own needs and, less frequently, the needs of others. Young children’s understanding of spirituality is influenced by their cognitive level. Social development includes further separation-individuation, more sophisticated language, greater independence, and more imitative, imaginative, and dramatic play. Various types of play are typical of this period, but preschoolers especially enjoy associative play—group play in similar or identical activities but without rigid organization or rules. The appearance of imaginary companions usually occurs between ages 2 ½ and 3 years, and for the most part, such playmates are relinquished when the child enters school. Imaginary companions serve many purposes: They become friends in times of loneliness, they accomplish what the child is still attempting, and they experience what the child wants to forget or remember. Areas of special concern for parents related to growth and development are the preschool and kindergarten experience, sex education, fears, stress, aggression, and speech problems. In selecting an early learning program, parents should inquire about the Copyright © 2023, Elsevier, Inc. All Rights Reserved. facility’s daily program, teacher qualifications, staff-to-student ratio, discipline policy, environmental safety precautions, provision of meals, sanitary conditions, adequate indoor and outdoor space per child, fee schedule, and accreditation. Two rules that govern how parents answer questions about sex and other sensitive issues are to find out what the child knows and thinks and to be honest. Fears constitute a great part of the preschool period; fear of objects or potential annihilation are common. Factors that tend to increase aggressive behavior in preschoolers are gender, frustration, behavior modeling, and reinforcement. Hesitancy or dysfluency in speech patterns is common during language development in children 2 to 5 years old. Health promotion continues to be directed toward proper nutrition, adequate sleep, proper dental care, and injury prevention. Sleep patterns vary widely, but the average preschooler sleeps about 12 hours a night and infrequently takes daytime naps. An appropriate and consistent bedtime, nap schedule, more active play during waking hours, and consistent bedtime routine can help prevent and treat common sleep problems and night wakings experienced by young children. Children are at risk for multiple infections; teaching parents prevention methods is one of the main roles of the nurse. Child maltreatment may take the form of physical abuse or neglect, emotional abuse or neglect, or sexual abuse. Parental, child, and environmental characteristics are criteria that may predispose children to physical abuse. Identification of abuse entails securing evidence of maltreatment, taking a history pertaining to the incident, and assessing parental and child behaviors. The reported incidence of sexual abuse has increased in the past decade; common forms are incest, molestation, rape, exhibitionism, child pornography, child prostitution, and pedophilia. The nurse’s role in caring for children of abuse includes protecting the child from further abuse, supporting the child and family, planning for discharge, and partnering in prevention programs. Copyright © 2023, Elsevier, Inc. All Rights Reserved.