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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Concepts Covered:

  • Cardiac Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of Pancreas
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Pregnancy Risks
  • Postpartum Complications
  • Gastrointestinal Disorders
  • Musculoskeletal Trauma
  • Hematologic Disorders
  • Respiratory Disorders
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Basic
  • Factors Influencing Community Health
  • Fundamentals of Emergency Nursing
  • Integumentary Disorders
  • Emotions and Motivation
  • Delegation
  • Prioritization
  • Test Taking Strategies
  • Basics of NCLEX
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Renal Disorders
  • Newborn Care
  • Upper GI Disorders
  • Substance Abuse Disorders
  • Prenatal Concepts
  • Fetal Development
  • Labor and Delivery
  • Labor Complications
  • Postpartum Care
  • Newborn Complications
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Hematologic Disorders
  • Oncologic Disorders
  • Endocrine and Metabolic Disorders
  • EENT Disorders
  • Cardiovascular Disorders
  • Renal and Urinary Disorders
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Infectious Disease Disorders
  • Eating Disorders
  • Oncology Disorders
  • Vascular Disorders
  • Intraoperative Nursing
  • Postoperative Nursing
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock

Study Plan Lessons

Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Postpartum Hemorrhage (PPH)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Fractures
Nursing Care and Pathophysiology for Anemia
Asthma
Advance Directives
Legal Considerations
HIPAA
Brief CPR (Cardiopulmonary Resuscitation) Overview
Fire and Electrical Safety
Fall and Injury Prevention
Isolation Precaution Types (PPE)
Maslow’s Hierarchy of Needs in Nursing
Delegation
Prioritization
Triage
Overview of the Nursing Process
Therapeutic Communication
Defense Mechanisms
Abuse
Patient Positioning
Complications of Immobility
Urinary Elimination
Bowel Elimination
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Intake and Output (I&O)
Blood Glucose Monitoring
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Head to Toe Nursing Assessment (Physical Exam)
Menstrual Cycle
Family Planning & Contraception
Gestation & Nägele’s Rule: Estimating Due Dates
Gravidity and Parity (G&Ps, GTPAL)
Fundal Height Assessment for Nurses
Maternal Risk Factors
Physiological Changes
Discomforts of Pregnancy
Antepartum Testing
Nutrition in Pregnancy
Chorioamnionitis
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Mechanisms of Labor
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Prolapsed Umbilical Cord
Placenta Previa
Abruptio Placentae (Placental abruption)
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Discomforts
Breastfeeding
Mastitis
Initial Care of the Newborn (APGAR)
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Meconium Aspiration
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Newborn of HIV+ Mother
Care of the Pediatric Patient
Vitals (VS) and Assessment
Growth & Development – Infants
Growth & Development – Toddlers
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Eczema
Impetigo
Pediculosis Capitis
Burn Injuries
Sickle Cell Anemia
Hemophilia
Nephroblastoma
Fever
Dehydration
Vomiting
Celiac Disease
Appendicitis
Intussusception
Constipation and Encopresis (Incontinence)
Conjunctivitis
Acute Otitis Media (AOM)
Tonsillitis
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cystic Fibrosis (CF)
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Nephrotic Syndrome
Enuresis
Cerebral Palsy (CP)
Meningitis
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Scoliosis
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Base Excess & Deficit
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Hematocrit (Hct) Lab Values
White Blood Cell (WBC) Lab Values
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Albumin Lab Values
Cholesterol (Chol) Lab Values
Ammonia (NH3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Urinalysis (UA)
Glucose Lab Values
Hemoglobin A1c (HbA1C)
X-Ray (Xray)
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Cerebral Angiography
Cardiovascular Angiography
Echocardiogram (Cardiac Echo)
Ultrasound
Biopsy
Informed Consent
Preoperative (Preop)Assessment
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
General Anesthesia
Local Anesthesia
Moderate Sedation
Malignant Hyperthermia
Post-Anesthesia Recovery
Postoperative (Postop) Complications
Discharge (DC) Teaching After Surgery
Hemodynamics
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Normal Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Pacemakers
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock