1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 31 Nursing Care of a Family With a Preschool Child

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Healthy Development of the Preschooler Assessment-HR=85; innocent heart murmur; BP=100/60 Body contour more childlike No new teeth; tonsils appear enlarged Vocabulary of 900-2100 words Increased coordination-running, riding a bike

3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Preschooler Physical growth –Height, weight, head circumference –Teeth

4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Preschooler (cont’d) Developmental milestones –Language development –Play

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Preschooler (cont’d) [Insert Table 31.1 – Summary of Preschool Growth and Developent]

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Preschooler (cont’d) Emotional development –Developmental tasks Initiative Imitation Fantasy

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Preschooler (cont’d) Emotional development –Oedipus, Electra complexes –Gender roles –Socialization

8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Preschooler (cont’d) Cognitive development Moral, spiritual development

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion Safety –Keeping children safe, strong, free –Motor vehicle, bicycle safety –Health Maintenance schedule-873

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Nutritional health –Recommended dietary reference intakes –Nutritional health with vegetarian diet

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Daily activities –Dressing –Sleep –Exercise –Bathing –Teeth Night grinding

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Healthy family functioning –Discipline Parental concerns –Health problems –Fears Dark Mutilation Separation or abandonment

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Parental concerns –Behavior variations Telling tall tales Imaginary friends Sharing Regression Sibling rivalry

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Parental concerns –New sibling –Sex education –Choosing preschool or child care center –Preparing child for school –Broken fluency –Bathroom language

15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Concerns with physically challenged or chronically ill preschooler –Nutrition and physically challenged or chronically ill preschooler

16. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question A previously toilet trained 4-year-old child has many episodes of urinary incontinence while in the hospital for a fractured femur. Which of the following actions should the nurse implement? A.Awaken the child every 2 hours through the night to try to use the bedpan. B.Explain that children will usually quickly regain control over a previously mastered skill once home again. C.Send a urine specimen for analysis. D.Limit consumption of fluids between meals.

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. Explain that children will usually quickly regain control over a previously mastered skill once home again. Rationale: Stressful events may cause a child to regress back from a previously mastered task. Hospitalization, trauma, and separation from parents are all examples of what may induce this.

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question A 4-year-old boy will not stop throwing sand at his sister. Which of the following punishments would be most effective with this child? A.Send him to his room for 30 minutes. B.Restrict television viewing for a day. C.Sit him in “timeout” for 15 minutes. D.Spank him on his bottom.

19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer C. Sit him in “timeout” for 15 minutes. Rationale: Trying to correct behavior while allowing the child the right to his or her opinion works best without use of physical punishment.

20. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question To encourage fluency, you would advise a preschooler’s mother to A.encourage the preschooler to recite in front of friends. B.allow the preschooler to have time to talk. C.encourage the preschooler to speak slowly. D.stop the preschooler and tell him or her to start over.

21. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. Allow the preschooler to have time to talk. Rationale: Children who do not feel rushed to speak have less broken fluency.