Growth & Development – Preschoolers

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Included In This Lesson

Study Tools For Growth & Development – Preschoolers

Theories of Development (Cheatsheet)
Eriksons Stages (Cheatsheet)
Pediatric Growth Charts (Cheatsheet)
Age 5 Years – Developmental Milestones (Picmonic)
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Outline

Overview

  1. Developmental categories

    1. Growth
    2. Motor
    3. Language
    4. Psychosocial/Cognitive
  2. Impact of development

    1. Patient interactions
    2. Common issues

      1. Patient safety
      2. Patient education

Nursing Points

General

  1. 3-5 years
  2. Can communicate their needs and become more social.  
  3. Coordination and fine motor skills improve
  4. Preparing to go to school.

Assessment

  1. Growth

    1. Gains 5 pounds per yr
    2. Grows 2-3 inches per yr
  2. Motor Development

    1. Gross motor

      1. Hops on 1 foot by 4 yrs
      2. Rides tricycle around 3 yrs
      3. Rides bike without training wheels by 5-6 yrs
    2. Fine motor

      1. Copies square by 3-4 yrs
      2. Copies triangle by 5 yrs
      3. Draws a person by 5 yrs
  3. Language Development

    1. Vocabulary of 2,100 words by age 5
    2. Uses fantasy in stories
    3. Know name and address
    4. Red flag – language still unintelligible
  4. Psychosocial/Cognitive

    1. Initiative vs Guilt
    2. Cooperative  play
    3. Magical thinking
    4. Poor concept of time
    5. Fairly proficient with self-care

      1. Brushes teeth
      2. Uses spoon and fork
      3. Dresses self

Therapeutic Management

  1. Patient Interactions

    1. Language becomes very important

      1. Use non-threatening words
    2. Timing of procedures

      1. Avoid delays if possible
    3. Magical thinking surrounding cause of illness

      1. May think it’s a punishment
    4. Strong fear of bodily harm

      1. Use bandages to help feel secure
  2. Safety & Patient Education

    1. Injury – burns, drowning
    2. Preparation for School

      1. Traffic Safety
      2. Prevention of sexual abuse

        1. Right to say “no!”
        2. Encourage communication
        3. Seek out trusted caregivers and safe environments
        4. Red flags

          1. Inappropriate sexual knowledge
          2. Regressions

Nursing Concepts

  1. Human Development
  2. Patient Centered Care
  3. Health Promotion

Patient Education

  1. Preparing a preschooler for an intervention or procedure

    1. Use simple terms
    2. Demonstrate equipment
    3. Use a doll to explain and clarify
    4. Use neutral words

      1. Take your temperature = see how warm you are
      2. Catheter = tube
      3. Electrodes = stickers
      4. Shot = medicine under the skin
      5. Incision = special opening
    5. Clarify that the procedure is not a punishment

      1. Magical thinking
    6. Always apply bandage over puncture site

      1. Fear of bodily harm
    7. Avoid excessive delays

      1. Poor concept of time
    8. Involve the child when possible.  Give options.

      1. Developing initiative 

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Transcript

Hey guys! We are moving on to Preschoolers and I have to say I love this age group. Just like lessons on toddlers and infants, we are going to cover what milestones to be looking for, how this affects your interactions with them and then look at common problems and patient education topics.

Preschoolers are 3-5 years old. In these 3 years they really transition from chubby, baby-like kids who still need a lot of help to more slim, very agile kids who can very nearly get themselves ready in the morning. At the same time they are becoming a lot more social, still a little egocentric, but starting to be able to look outside of themselves a bit.

Growth is pretty consistent and stable for preschoolers. They gain about 5 lbs per year and grow 2-3 inches per year. Rather than seeing trunk get longer, the growth will probably come from the legs.

So we said toddlers were still pretty clumsy, well preschoolers become much more graceful- with fewer falls and episodes of toppling over. Coordination and eye hand coordination improve by leaps and bounds.

Just a reminder that by this point you aren’t likely to pick up on motor delays. What you need to be on the lookout for are regressions. We talked about these some in the growth and development overview lesson.

Language for a preschooler is pretty comprehensive. They are pretty hilarious and can spin a story out of nothing and come up with the craziest ideas. Sometimes this can make getting a good understanding of what happened or what hurts a little difficult, but if you ask them really direct questions they can usually give you helpful information about how they are feeling.

A red flag to note here – by age 3 their speech should be clear. It’s pretty normal for toddlers to have their own cute little baby talk that only their parents understand, but by preschool years this should change and people who don’t already know the child should be able to understand them.

Preschoolers are in the initiative vs guilt phase. They are so eager to try new things and are so proud of themselves when they accomplish them. Equally they can get very upset and feel guilty when they don’t.

So much of what is happening during these years prepares kids to attend school- one of the shifts that happens around 3 years is a change in their play. All of the sudden play becomes very involved with a lot of coordinating and cooperating. Where before this everything was all about the family, preschoolers start to really enjoy playing with other people their own age. We call this cooperative play. If a child displays no interest in cooperative play and seems to always prefer being alone, this can be considered a red flag for social development.

Three things that can make caring for preschoolers a little difficult are their magical thinking, their poor concept of time and having an extreme fear of injury. With magical thinking the preschooler may think that their illness is a punishment for something they thought or did, so it’s important to reassure them it’s not a punishment! With a poor concept of time you have to be careful of causing anxiety in the hospital by preparing them for a procedure too far in advance. Ideally, you just tell them shortly or immediately before the procedure. This is true for toddlers as well. They are extremely worried about things like having holes in their body so always come prepared with a bandage to help them feel secure.

So- you can tell the preschool years are kind of a more stable time developmentally- the same is true for school-age. While there are still a lot of important things happening developmentally, the risks are decreasing so there isn’t as much going on in terms prevention and education. Most problems for preschoolers are either just common illnesses or injury related. So for this age group most of education is still around that common theme of safety and prevention.

One thing we do add to the picture now though is the kid having a slightly wider social experience. So we are now educating the kid and parents on topics like traffic safety, sexual abuse prevention, dental health and other important self-care topics. Take a look at the outline for more details on these topics.

Your priority nursing concepts for this content are human development, patient centered care and health promotion

Okay guys, that wraps up our chat about kids ages 3-5. Your key learning points for this age group are 1) To remember that the driving force is their energy and enthusiasm for trying new things, so they are constantly taking the initiative to master new skills. Number 2) their social experiences are really expanding. So we want to see a transition from a preference for playing solo to a preference for playing with other kids. Number 3) their unique way of thinking means we have to be extra careful about what we say, how we say it and when we say it. And lastly, number 4) Their development at this age has the end goal of being ready to go to school. Parents may be worried about this so education topics will tend to be aimed at supporting this transition.

That’s it for our lesson on growth and development during preschool years. Make sure you checkout all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing

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NCLEX Prep A

Concepts Covered:

  • Test Taking Strategies
  • Respiratory Disorders
  • Prenatal Concepts
  • Prefixes
  • Suffixes
  • Disorders of the Adrenal Gland
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Bipolar Disorders
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Immunological Disorders
  • Childhood Growth and Development
  • Medication Administration
  • Adulthood Growth and Development
  • Labor Complications
  • Disorders of the Thyroid & Parathyroid Glands
  • Pregnancy Risks
  • Cardiac Disorders
  • Learning Pharmacology
  • Anxiety Disorders
  • Basic
  • Disorders of Pancreas
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Trauma-Stress Disorders
  • Oncology Disorders
  • Somatoform Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Eating Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Circulatory System
  • Hematologic Disorders
  • Emergency Care of the Cardiac Patient
  • Emotions and Motivation
  • Delegation
  • Vascular Disorders
  • Oncologic Disorders
  • Prioritization
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Basics of NCLEX
  • Fetal Development
  • Shock
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Musculoskeletal Trauma
  • EENT Disorders
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Postpartum Care
  • Cardiovascular Disorders
  • Renal Disorders
  • Newborn Care
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Female Reproductive Disorders
  • Infectious Disease Disorders
  • Nervous System
  • Psychotic Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Menstrual Cycle
54 Common Medication Prefixes and Suffixes
Addisons Disease
Advance Directives
Family Planning & Contraception
Vitals (VS) and Assessment
Nursing Care and Pathophysiology for Cushings Syndrome
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Essential NCLEX Meds by Class
Growth & Development – Infants
6 Rights of Medication Administration
Growth & Development – Toddlers
Thrombocytopenia
Blood Transfusions (Administration)
Growth & Development – Preschoolers
Nursing Care and Pathophysiology for Hyperthyroidism
Preload and Afterload
Growth & Development – School Age- Adolescent
Nursing Care and Pathophysiology for Hypothyroidism
Legal Considerations
Performing Cardiac (Heart) Monitoring
HIPAA
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Gestation & Nägele’s Rule: Estimating Due Dates
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Fire and Electrical Safety
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Leukemia
Diabetes Management
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Burn Injuries
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Fundal Height Assessment for Nurses
Injectable Medications
Oncology Important Points
Somatoform
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Fall and Injury Prevention
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
IV Infusions (Solutions)
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Normal Sinus Rhythm
Physiological Changes
Sickle Cell Anemia
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Discomforts of Pregnancy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Antepartum Testing
Hemophilia
Sinus Tachycardia
Nutrition in Pregnancy
Pacemakers
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Maslow’s Hierarchy of Needs in Nursing
Benzodiazepines
Delegation
Nursing Care and Pathophysiology of Hypertension (HTN)
Nephroblastoma
Prioritization
Chorioamnionitis
Triage
Nursing Care and Pathophysiology for Cardiomyopathy
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Fever
Overview of the Nursing Process
Dehydration
Fetal Development
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Fetal Environment
Nursing Care and Pathophysiology for Distributive Shock
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Therapeutic Communication
Defense Mechanisms
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Abuse
Constipation and Encopresis (Incontinence)
Patient Positioning
Complications of Immobility
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Urinary Elimination
Bowel Elimination
Precipitous Labor
Dystocia
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Intake and Output (I&O)
Defects of Increased Pulmonary Blood Flow
Blood Glucose Monitoring
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Scoliosis
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Eczema
Hemodynamics
Proton Pump Inhibitors
Schizophrenia
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)