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Preschooler
3-5 years of age
Physical growth slows considerably during this period, personality and cognitive growth are substantial.
Important period growth for parents
This age want to do things for themselves
Physical Growth
Preschooler becomes slimmer, taller and much more childlike proportions
Contour changes become apparent
can be Ectomorphic (slim body build)
Endomorphic (large body build)
Lymphatic tissue increase in size
IgG and IgA antibodies increases
Innocent heart murmurs
Bladder is easily palpable above the symphysis pubis ;Void frequently (9 or 10 times a day)
Genus Valgus
Pulse Rate: 85 bpm
Blood Pressure: 100-160
Respiratory Rate: 20-30 cpm
Frequent voiding(9-10x a day)
Has well formed arch of the foot.
Genus Valgus
condition where the knees and angle in and touch one another when the legs are straightened.
Normal phase of development
Between ages 2-5 years old
Girls have more genu valgus compared to young boys
Height and Weight
Height:
Growth in height averages
(6.25 to 7.5cm)per year.
Average height at 5 years 110cm, or double the birth length.
Height and Weight
Weight:
The average weight gain during preschool age is 2.3kg/year.
Average weight at 5 years 18.7kg. ordouble the weight of one year of age.
Head Circumference
Head circumference is not routinely measured at physical assessments on children over 2 years of age.
Teeth
Preschoolers generally have all the 20 deciduous teeth
Rarely that a new teeth erupts at this stage
Developmental Milestone
Language Development
3 years old child has 900 vocabulary words
Used to ask question (up to 400 a day)
Mostly how and why questions
Imitates language exactly
Egocentric
Play
Imitates what theyre parents are doing (imitative play)
Pretend to be a nurse, doctor, teacher etc.
Have imaginary friends
Interested in group games and songs (5y/o)
Developmental Task
Initiative vs Guilt (Erickson)
Initiative is the developmental task that a child should be able to achieve.
Child is punished Child develops guilt
or criticizedupon for wanting to try
Initiative new activities.
* A child with well developed sense of initiative discovers that learning something new is fun.
Imitation children generally imitate what theyre parents are doing
pretends feeding a dolldo chores (helping to mop the floor)
a girl might wear a large shoesFantasy learns to differentiate
fantasy and reality- become afraid that they might lost their identify and become stuck in
their fantasies
Oedipus and Electra Complex
Oedipus refers to the strong emotional attachment of a preschool boy to his mother
Electra Complex attachment of a preschool girl to her father
Nursing Responsibility:
Parents who are not prepared for this behaviourmay feel hurt/rejected it is important to reassure them that this phenomena of competition is normal.
Gender RolesPreschoolers need exposure to an
adult of the opposite gender so they can become familiar with opposite
gender rolesSocialization
Preschoolers become more involve in play groups thus arguments would be
often.They develop having best buds or best
friends
Motor Development
Motor Development of Preschool child
At 3 Years: Can wash hands.
Can feed himself well.
Build a tower of 9-10 blocks.
Can go to toilet.
Begins to use a scissor.
Can ride a tricycle.
Go up stairs.
Stand on one foot for a few seconds.
Motor Development of Preschool child (cont.)
At 4 Years: Can jump well, goes up and down stairs. Can brush his teeth, lace
his shoes. Can copy a square.
Motor Development of Preschool child (cont.)
At 5 Years: Can use scissor well. Drew a recognizable picture of a man. Can dress himself without assistance. Can wash himself without wetting his
clothes. Can balance on one foot for about 8 seconds.
Gross motor
3 years old runs
- alternate feet on stairs
- stands on one foot
4 years old jumps and skips
5 years old Throws overhand
PhyschosexualDevelopment
Phallic stage child learns sexual identity through awareness of genital area
Nursing Implications
Accepts childs sexual interest such as fondinghis/her own
Genirals as a normal area of exploration. Help parents answer childs question about birth or sexual differences
Cognitive Development (Piaget)
Preoperational Thought
Centering looks at an object and focuses only to one of its characteristics
Intuitional Thought refers to lack of insight to put themselves in someones situation
o Believes they are 100% correct
o They cannot see your kind of situation
Lack of Conservation- meaning they cannpotsee that only the form not the amount has changed
Lack of Reversibility they cannopt retrace steps
Moral Development
Pre-conventional Level (Level 1)
2-3 years old punishment or obedience orientation. Child does right to avoid punishmet
4-7 years old individualism. Carries out action to satisfy own needs rather than the societys
Promoting Preschool Safety
Keeping children Safe, Strong and Free
1. Warning them not to talk or accept a ride from strangers
2. Teaching a child how to call for help
3. Describe how police officer look like
4. Explain that if children/adults ask them to keep a secret and made them uncomfortable they should tell their parents or another trusted adults
5. Explain that bul;lying behaviour from other children is not to be tolerated but should be reported so they can receive help in managing it.
Promoting Motor Vehicle and Bicycle Safety
Parents should stress the importance of seat belts.
Parents should provide theyre child with helmet when riding on their bicycle.
Promoting Nutritional Health
Offer small amount of servings so the children wouldnt be overwhelmed by the amount of food on the plate.
Dont give sugary foods before meal as they decrease childs appetite.
Teach parents to make mealtime happy and enjoyable.
Promoting Developmentof preschool in Daily Activities
Dressing
- Preschooler prefer bright colors or prints and may select clothes that mismatched
Sleep
- Refuse to go to sleep at night because of fear of dark and nightmares
*switching on the night light
*screen out frightening stories
Bathing
- Do not leave unattended in the bath tub
Care of the Teeth
- Child should continue drinking fluoridated wter to keep strong
- After preschooler brushed their teetyhparents should check that all tooth surfaces are cleaned.
- Encourage children to eat healthy snacks like apple, banana, carrots instead of sweets to prevent tooth decay.
Night Grinding or Bruxism
- Refers to grinding the teeth at night (usually at sleep )
- children do this for a short time each night to release tension which allows them to fall asleep
- children who grinds teeth extensively has greater than normal anxiety
Promoting Healthy Functioning Family
Major parntal role develop vocabulary development
Discipline Time out as discipline technique
-Time out is a discipline technique that invovlesplacing children in a very boring place for several minutes following unacceptable behaviours.Timeout means time out fro any attention.
Common Health Problems
Major Cause of Death
1. Automobile Accidents
2. Poisoning
3. And Falls
Minor Illnesses
1. Colds
2. Ear Infections
3. Flu
Common Fears of the Preschool
Fear of the dark
Fear of mutilation
Fear of separation or abandonment
Behaviour Variations
Telling Tales- means stretching stories to make them more interesting (common in Preschool)
Imaginary Friends although this is normal in preschooler parents should help child to separate fact from fantasy
Difficulty Sharing
Regression
Sibling Rivalry
Effect of birth of a sibling
Any environmental changes may have traumatic effect on the child, the birth of sibling is a change and deprives the older child of some parents attention.
The child feels loss of affection.
He feels also rejected and may become jealous. continue
He usually shows his hostility to the new baby openly and directly.
He shown his hostility toward his mother in different ways
The mother should accept such temporary behavior and must discuss with him the difference between his needs and those of the infant.
Effect of birth of a sibling
Early Sexual Development
Purposefully touching private parts (masturbation), occasionally in the presence of others
Attempting to see other people when they are naked or undressing
Mimicking dating behavior (such as kissing, or holding hands)
Early Sexual Development
Talking about private parts and using naughty words, even when they dont understand the meaning
Exploring private parts with children their own age (such as playing doctor, Ill show you mine if you show me yours, etc.)
Child Care Center
A school or childcare experience is helpful for preschoolers, as peer exposures appears to have a positive effect on social development.
The terms childcare center preschool and nursery school are often used interchangeably, so parents cannot depend on the name of school to define its structure.
Broken Fluency
Broken Fluency Repetition and prolongation of sonds , syllables and words
often referred to us (secondary stuttering )
It is part of the normal development and as such will pass
Encourage a Sense of Initiative on a Physically Challenged Child
Nutrition respect child preferences
- serve toast ior sandwiches cut into animal shapes
Medicine Allow child to choose a chaser such as juice after taking oral medicine
Rest Provide adequate light in childs room
Hygiene allow child to choose bath tub toys, clothing
Hygiene allow child to choose bath tub toys, clothing
- allow child to wash himself
Pain Encourage the child to express pain
Stimulation
Guessing games encourage sense of initiative
Provide Provide manipulative toys(finger paint , clay )
Encourage use of play rooms for socialization
Encourage child to interact with family (drawing pictures for siblings or telephoning home )