Toddler Growth and Development PDF

TODDLER EDWIN DEL ROSARIO, CCRN, ACNP, AGNP TODDLER: GROWTH AND DEVELOPMENT LESSON 1 TODDLER  GROWTH AND DEVELOPMENT Speaks in two-word sentences 20 deciduous teeth present @ 2.5 years Chest circu...

TODDLER EDWIN DEL ROSARIO, CCRN, ACNP, AGNP TODDLER: GROWTH AND DEVELOPMENT LESSON 1 TODDLER  GROWTH AND DEVELOPMENT Speaks in two-word sentences 20 deciduous teeth present @ 2.5 years Chest circumference > head @ 2 years Heart rate : 90-110 Pouchy abdomen: weak abdominal muscles Baby fats begin to lordosis disappear Wide based gait  ANTHROPOMETRICS Physical Body Weight Height Head Growth contour standard quadrupled gains 5 Chest > Lordosis growth chart his birth inches (12 Head waddle measure weight cm) /year Anterior with wide height with gains only estimated fontanelle stance child lying adult down about 5-6 closes lbs. (2 kg) height: doubles @ 2 years  PHYSIOLOGIC CHANGES HR slows down 110 to 90 Cardiovascular BP increases to 99/64 mmHg RR slows down, remains abdominal Respiratory Respiratory tract lumen increases = less respiratory illnesses brains develops to 90% of adult size Nervous system complete myelination of spinal cord  PHYSIOLOGIC CHANGES - stomach capacity increases to the point that the child GI SYSTEM can eat 3 meals a day - stomach secretions become more acid → GI infections are less common - IgG and IgM antibody production becomes mature @ IMMUNE SYSTEM 2 years of age- the passive immunity effects from intrauterine life are no longer operative - 8 new teeth the canines and the first molars erupt during the 2nd year DENTITION - all 20 deciduous teeth are generally present by 2 1/2 to 3 years at age  PSYCHOSEXUAL DEVELOPMENT FREUD’S Anal stage - TOILET training  PSYCHOSOCIAL DEVELOPMENT ERICKSON’S shame and Autonomy doubt VS.  PSYCHOSOCIAL TASK Differentiate Ability to Increase Vocabulary Assert self from withstand independence increases ownership caregiver delayed gratification Less likely to Help with Temper Hoarding Possessiveness fear stranger dressing tantrums  COGNITIVE DEVELOPMENT PIAGET’S Cognitive development Acquisition of Mental Preoperational language symbolism thoughts  LANGUAGE DEVELOPMENT 12 mos. 18 mos. 18 mos. – 2 2 years 24 months 3 years knows Y. follows gives remembe identify r and own geometric Begins to simple first repeat 3 name forms use short directions name numbers Refer to sentences gives full self name  MAGICAL SYMBOLISM Object permanence Transitional Magical objects thinking Ritualistic behavior PREOPERATIONAL THINKING  MORAL DEVELOPMENT KOHLBERG’S Preconventional Phase punishment No sense of obedience morality  SPIRITUAL DEVELOPMENT FOWLER’S Spiritual development learn about God Assimilate Vague idea of Routine: saying through behavior related God prayers Caregivers to divinity TODDLER: DEVELOPMENTAL MILESTONES LESSON 2  DEVELOPMENTAL MILESTONES Physical gain about three to five pounds grow three to five inches between ages one and two, Symbolic thought. Cognitive deferred imitation able to recall recent events autonomy vs. independence Emotional Balance with consistently sound rules Terrible two  GRADED INDEPENDENCE/NEGATIVISM Graded independence/negativism Give opportunity to make Avoid use of pain, ridicule Provide Safe environment choices = punishment  DEVELOPMENTAL MILESTONES 15 mos.: interacting with other people Socialization 18 mos. : imitates caregiver 2 years: aware of gender Parallel play Play 18 mos.: enjoys pull toys 2 yrs.: imitate adult action: cooking Favorite word: NO 15-18 mos.: knows 10x more words than they can verbally communicate Language 2 years: 50-100 words. Use 2 or more word in combination 3.5-4 yrs.: uses I, me, her, him 5 yrs.: uses thousands of words, speaks in sentences,  PLAY Parallel play Physical and social development Purpose Therapeutic value educational moral formation free, spontaneous, active Characteristics no rules, constructive Based on preference Selection no sharps objects  AGE FINE MOTOR GROSS MOTOR LANGUANGE PLAY MONTHS 15 Puts small pellets into bottles Walks alone 4-6 words Can stack 2 blocks Scribbles with pen/crayons Can seat self in a Enjoys being read Hold spoon well (may still chair to turn it upside down) Can creep upstairs Drops toys for adult to recover (explore sense of permanence) 18 No longer rotate spoon to Can run and jump in 7-20 words, uses Imitates household his mouth place jargoning chores Walk up/down stairs Names one body Begins PARALLEL (hold on railings) parts play 24 Opens doors by turning Walks upstairs alone 50 words (two-word Parallel play doorknobs (both feet on same sentence) Can unscrew lids level) (noun, pronoun, verb 30 Makes simple lines/strokes Jumps down from Verbal language Spend time playing for crosses with pencil chair increases house, imitate Knows full name parents action Names one color Play is roughhousing  TOYS Car and trucks Balls Building blocks Stuff toys (security objects) Play telephone Paly hammer, drums, pots (outlet of aggression) Push/pull toys Simple puzzles Crayon Special Needs , Health Promotion, and Application of the Nursing Process LESSON 3  PROMOTING SAFETY Falls Burns Poisoning Car safety Drowning Cuts/stabs Make your Keep all potential rear-facing Do not unattended house child- children hazards car seat near water/bath Lock guns proof away from should be in until 2 years tub appliances locked cabinet Childproof: Keep sharps out swimming pools of reach Lead poisoning  NUTRITION Nutrition Requirement Special needs less appetite sedentary: 1000 meals: 3x/day than infant kcal/d High CHON, weaning from active: 1400 CHO, moderate breastfeeding kcal/d fats Offers finger Adequate foods, allows a Calcium and choice Phos, Iron Prefers to eat same type of food  HYGIENE Dental Dressing Sleep Bathing care Encourage Encourage to Seeping Enjoys bath healthy snacks, dress 8hrs./night time not high CHO, themselves napping 2x/d, sweet foods Need shoes for sleeping 12 drink protection as Not to leave hrs./night, fluorinated soon as they unsupervised napping 1x/d drinks walk can put on their socks and underpants  TOILET TRAINING Bowel training should be started before bladder training Principles Training should not be accomplished during illness of toilet Consistency Positive maternal attitude training Child must feel secure when seated on toilet bowl No distractions during training TOILET TRAINING : REQUIREMENTS Physiologic Sphincter control Psychologic Understands act of Desire to please the elimination mother Can verbally communicate need to defecate  HEALTH CONCERNS: TODDLER Delayed Child begins to speak by 15 mos. of age speech Ritualic Acceptance Do not interference behavior Allows toddler to complete: prevent anxiety Toddler’s “NO” Intervention Negativism limiting number of questions asked of a child making statement rather than question Allow to choose  SPECIAL NEEDS OF A TODDLER begins at about 7 months, persists throughout Separation preschool Intervention anxiety say goodbye firmly, repeat explanation, then leave Assure that you will return Toddlers are independent enough but do not have Tamper vocabulary to express frustration Intervention tantrum Tell the toddler that behavior is unacceptable Ignore  SPECIAL NEEDS OF A TODDLER slowness in carrying out request Cannot decide which of the two action to take Dawdling Intervention Give specific instruction Allow child to learn by experience Refers to natural jealousy and resentment of a child Sibling Dethronement issue Interventions Discuss pregnancy and coming of a new child Rivalry Role playing: using dolls Use “pet” as a training Do not leave with an infant/newborn  SPECIAL NEEDS OF A TODDLER Retreat from a present pattern of functioning to past level of behavior Causes: stress (hospitalization) Intervention Regression Ignore it Praising existing pattern of appropriate behavior No new areas learning during stress  SPECIAL NEEDS OF A TODDLER Separation anxiety Learning to tolerate Understands object Acknowledge the and master brief permanence behavior but do not periods of concepts tolerate separation is a task THANK YOU HAVE FAITH