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

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

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

5. Developmental milestones
Language
Emotional
Autonomy
Socialisation
Play behaviour

6. Milestones

7. Developmental milestones
Cognitive development
Deferred imitation
Preoperational thought
Assimilation

8. Health promotion
Toddler safety
Lead screening
Sources
Testing
Effects

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

10. Health promotion
Daily activities
Dressing
Sleep
Bathing
Care of teeth

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

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

13. Tantrums

14. 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.

15. 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.

16. 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.

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

18. 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.

19. 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.