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 Review

Concepts Covered:

  • Noninfectious Respiratory Disorder
  • Test Taking Strategies
  • Respiratory Disorders
  • EENT Disorders
  • Prenatal Concepts
  • Studying
  • Prefixes
  • Suffixes
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Integumentary Disorders
  • Oncology Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • Bipolar Disorders
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Community Health Overview
  • Immunological Disorders
  • Renal Disorders
  • Childhood Growth and Development
  • Labor Complications
  • Upper GI Disorders
  • Medication Administration
  • Neurological Emergencies
  • Adulthood Growth and Development
  • Disorders of Pancreas
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Urinary Disorders
  • Vascular Disorders
  • Eating Disorders
  • Learning Pharmacology
  • Anxiety Disorders
  • Basics of NCLEX
  • Factors Influencing Community Health
  • Lower GI Disorders
  • Intraoperative Nursing
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Trauma-Stress Disorders
  • Central Nervous System Disorders – Brain
  • Somatoform Disorders
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Circulatory System
  • Postoperative Nursing
  • Hematologic Disorders
  • Liver & Gallbladder Disorders
  • Infectious Respiratory Disorder
  • Central Nervous System Disorders – Spinal Cord
  • Emergency Care of the Cardiac Patient
  • Concepts of Population Health
  • Peripheral Nervous System Disorders
  • Note Taking
  • Female Reproductive Disorders
  • Oncologic Disorders
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Fetal Development
  • Shock
  • Emergency Care of the Neurological Patient
  • Respiratory Emergencies
  • Labor and Delivery
  • Gastrointestinal Disorders
  • EENT Disorders
  • Postpartum Care
  • Cardiovascular Disorders
  • Newborn Care
  • Renal and Urinary Disorders
  • Newborn Complications
  • Urinary System
  • Musculoskeletal Disorders
  • Infectious Disease Disorders
  • Nervous System
  • Psychotic Disorders

Study Plan Lessons

Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
12 Points to Answering Pharmacology Questions
ABGs Nursing Normal Lab Values
Care of the Pediatric Patient
Glaucoma
Menstrual Cycle
Time Management
X-Ray (Xray)
54 Common Medication Prefixes and Suffixes
ABG (Arterial Blood Gas) Interpretation-The Basics
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Burn Injuries
Cataracts
Computed Tomography (CT)
Family Planning & Contraception
Informed Consent
Lung Sounds
Study Setting
Vitals (VS) and Assessment
Alveoli & Atelectasis
Nursing Care and Pathophysiology for Cushings Syndrome
Goal Setting
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Epidemiology
Essential NCLEX Meds by Class
Gas Exchange
Nursing Care and Pathophysiology of Glomerulonephritis
Growth & Development – Infants
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
6 Rights of Medication Administration
Cerebral Angiography
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Hearing Loss
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Respiratory Acidosis (interpretation and nursing interventions)
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Fractures
Growth & Development – Preschoolers
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Respiratory Alkalosis
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Growth & Development – School Age- Adolescent
Nursing Care and Pathophysiology for Hypothyroidism
Metabolic Acidosis (interpretation and nursing diagnosis)
Performing Cardiac (Heart) Monitoring
Metabolic Alkalosis
The SOCK Method – Overview
Ultrasound
The SOCK Method – S
The SOCK Method – O
Base Excess & Deficit
The SOCK Method – C
The SOCK Method – K
Biopsy
Anxiety
Basics of Calculations
Critical Thinking
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Potassium-K (Hyperkalemia, Hypokalemia)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Asthma
Bloom’s Taxonomy
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Environmental Health
General Anesthesia
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Leukemia
Levels of Consciousness (LOC)
Sodium-Na (Hypernatremia, Hyponatremia)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Routine Neuro Assessments
What is the NCLEX?
Adjunct Neuro Assessments
Anatomy of an NCLEX Question
Burn Injuries
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Fundal Height Assessment for Nurses
Injectable Medications
Moderate Sedation
Oncology Important Points
Somatoform
Technology & Informatics
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
IV Infusions (Solutions)
Malignant Hyperthermia
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Intracranial Pressure ICP
Mood Disorders (Bipolar)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Cerebral Perfusion Pressure CPP
Nursing Care and Pathophysiology for Crohn’s Disease
Depression
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
Post-Anesthesia Recovery
Red Blood Cell (RBC) Lab Values
SATA
Sickle Cell Anemia
Absolute Words
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Discomforts of Pregnancy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Hemoglobin (Hbg) Lab Values
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Antepartum Testing
Hematocrit (Hct) Lab Values
Hemophilia
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Opposites
Sinus Tachycardia
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Nutrition in Pregnancy
Pacemakers
Nursing Care and Pathophysiology of Pneumonia
Same
White Blood Cell (WBC) Lab Values
Atrial Fibrillation (A Fib)
Communicable Diseases
Platelets (PLT) Lab Values
Priority
Coagulation Studies (PT, PTT, INR)
Disasters & Bioterrorism
Nursing Process
Acute vs Chronic
Miscellaneous Nerve Disorders
Premature Ventricular Contraction (PVC)
What do you want me to know?
Duplicate Facts
Ventricular Tachycardia (V-tach)
Repeating Words
Ventricular Fibrillation (V Fib)
Denying Feelings
NCLEX® Question Traps
Albumin Lab Values
Outline Question Method (Note taking)
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Benzodiazepines
Cholesterol (Chol) Lab Values
Drawing Pictures
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of Hypertension (HTN)
Ammonia (NH3) Lab Values
Artificial Airways
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nephroblastoma
Airway Suctioning
Chorioamnionitis
Nursing Care and Pathophysiology for Menopause
Stroke Assessment (CVA)
Nursing Care and Pathophysiology for Cardiomyopathy
Gestational Diabetes (GDM)
Stroke Therapeutic Management (CVA)
Disseminated Intravascular Coagulation (DIC)
Stroke Nursing Care (CVA)
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
Blood Urea Nitrogen (BUN) Lab Values
Fever
Creatinine (Cr) Lab Values
Dehydration
Fetal Development
Nursing Care and Pathophysiology for Hypovolemic Shock
Seizure Causes (Epilepsy, Generalized)
Nursing Care and Pathophysiology for Cardiogenic Shock
Fetal Environment
Seizure Assessment
Chest Tube Management
Nursing Care and Pathophysiology for Distributive Shock
Fetal Circulation
Seizure Therapeutic Management
Urinalysis (UA)
Nursing Care and Pathophysiology for Seizure
Glucose Lab Values
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Hemoglobin A1c (HbA1C)
Mechanisms of Labor
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Nursing Care and Pathophysiology for Meningitis
Appendicitis
Intussusception
Constipation and Encopresis (Incontinence)
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
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
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
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dissociative Disorders
Eczema
Fractures
Hemodynamics
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology for Parkinsons
Asthma
Pediatric Gastrointestinal Dysfunction – Diarrhea
Postpartum Hemorrhage (PPH)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Proton Pump Inhibitors
Schizophrenia
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)