Chapter 30

1. 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.