1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 30 Nursing Care of a Family With a Toddler

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Healthy Development of the Toddler Assessment-HR=90-110; BP=99/64 Chest circumference>head circumference Lordosis Wide based gait “Pouchy” abdomen Two-word sentences

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

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

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Toddler (cont’d)

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Toddler (cont’d) Developmental milestones –Cognitive development Deferred imitation Preoperational thought Assimilation

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of a Toddler (cont’d)

8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion Toddler safety –Lead screening Sources Testing Effects

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Nutritional health –Toddler nutrition –Promoting adequate intake with vegetarian diet

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Daily activities –Dressing –Sleep –Bathing –Care of teeth

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Healthy family functioning Parental concerns –Toilet training –Ritualistic behavior –Negativism –Discipline –Separation anxiety

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d) Parental concerns –Temper tantrums –Sibling rivalry Concerns with physically challenged or chronically ill toddler –Nutrition and physically challenged or chronically ill toddler

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion (cont’d)

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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 A.probably is not yet physically ready for toilet training. B.is reacting to her emotional outbursts, responsible for delaying toilet training. C.may need to be examined by a child psychologist to solve this problem. D.must be under undue stress to be behaving this way.

15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question A toddler’s mother is concerned because her toddler takes her blanket everywhere. Which advice would be most appropriate for her regarding this? A.Have her daughter evaluated by a child psychologist. B.Understand that this is probably a normal event. C.Make subtle efforts to remove the blanket. D.Destroy the blanket by cutting off a strip from it every day.

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question A 13 month old toddler is being discharged from the hospital. Which of the following potential health risks should the nurse address with the parents? (Select all that apply) Elevated cholesterol levels; poisoning: peer pressure; burns; falls

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. Understand that this is probably a normal event. Rationale: Blankets or favorite toys serve as transitional objects or security objects.

19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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 A.the child needs to be screened for scoliosis. B.the child needs referral for a spine radiograph. C.that this in normal for this age. D.to perform a full neurologic assessment.

20. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer C. Explain that 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 a nurse’s scope of care to order radiographs.