Nursing care of a family with a toddler Chapter 30 Nursing care of a family with a toddler

Nursing process: Healthy Development of the toddler Assessment Ability in relation to ADLs Parents’ source of information Anticipatory guidance Realistic goals setting

Growth and development of a toddler Physical growth Height, weight, head circumference Body contour Body systems Teeth

Developmental milestones Language Emotional Autonomy Socialisation Play behaviour

Milestones

Developmental milestones Cognitive development Deferred imitation Preoperational thought Assimilation

Health promotion Toddler safety Lead screening Sources Testing Effects

Health promotion Nutritional health Toddler nutrition Promoting adequate intake with vegetarian diet

Health promotion Daily activities Dressing Sleep Bathing Care of teeth

Health promotion Healthy family functioning Parental concerns Toilet training Ritualistic behaviour Negativism Discipline Separation anxiety

Health promotion Parental concerns Temper tantrums Sibling rivalry Concerns with physically challenged or chronically ill toddler Nutrition and physically challenged or chronically ill toddler

Tantrums

Question A toddler seems unable to remain dry despite toilet training. When planning care for him, it would be important to counsel his mother that he: probably is not yet physically ready for toilet training. is reacting to her emotional outbursts, responsible for delaying toilet training. may need to be examined by a child psychologist to solve this problem. must be under undue stress to be behaving this way.

Answer A. Is probably not yet physically ready for toilet training Rationale: Children must have both physical and mental maturity for toilet training. For many children, this point is not reached until they are 2½ or 3 years old.

Question A toddler’s mother is concerned because her toddler takes her blanket everywhere. Which advice would be most appropriate for her regarding this? Have her daughter evaluated by a child psychologist. Understand that this is probably a normal event. Make subtle efforts to remove the blanket. Destroy the blanket by cutting off a strip from it every day.

Answer B. Understand that this is probably a normal event. Rationale: Blankets or favourite toys serve as transitional objects or security objects.

Question The parents of a 2-year-old child are concerned because their child’s back seems curved. The nurse’s best response would be: the child needs to be screened for scoliosis. the child needs referral for a spine radiograph. this is normal for this age. to perform a full neurological assessment.

Answer C. This in normal for this age. Rationale: Toddlers have a natural lordosis (forward curvature of the spine) that resolves as they grow. It is not within the nurse’s scope of care to order radiographs.