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Nursing Care for Preschool Children

Chapter 31 discusses nursing care for families with preschool children, focusing on physical growth, cognitive development, and safety measures. Key developmental milestones include language acquisition, emotional development, and the importance of play in learning. The chapter also addresses health concerns, nutritional needs, and strategies for effective discipline and preparation for school.

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0% found this document useful (0 votes)
9 views4 pages

Nursing Care for Preschool Children

Chapter 31 discusses nursing care for families with preschool children, focusing on physical growth, cognitive development, and safety measures. Key developmental milestones include language acquisition, emotional development, and the importance of play in learning. The chapter also addresses health concerns, nutritional needs, and strategies for effective discipline and preparation for school.

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hvo9
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Chapter 31 - Nursing CARE OF A Family WITH A Preschool


Child
Theoretical Frameworks of Nursing (University of Cebu)

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CARE OF MOTHER, CHILD AT RISK | NCM 109


CHAPTER 31: NURSING CARE OF A FAMILY WITH A PRESCHOOL CHILD

PHYSICAL GROWTH COGNITIVE DEVELOPMENT


BODY CONTOUR PIAGET: Preconceptual (Preoperational) and Intuitive Thought
• Thinner & taller Stages
• Exhibits genu valgus (knock-knees) • Increased sense of time and space (tomorrow, afternoon, next
HEIGHT week)
• 2 – 3 ½ inches (6 – 8 cm)/year • Egocentrism
o They feel they are always right
WEIGHT
• Not aware of the PROPERTY OF CONSERVATION
• 4 ½ lbs (2 kg)/year
• They cannot see that only the form, not the amount, has
TEETH changed.
• Have all the 20 deciduous teeth by 3 y.o. • Perception dominates reasoning
LYMPHATIC TISSUE MORAL AND SPIRITUAL DEVELOPMENT
• ↑ in size, particularly the tonsils
1. Kohlberg’s Pre-Moral Stage
• ↑ IgG and IgA antibodies levels
• Believes right and wrong are determined by rewards and
PULSE RATE AND BLOOD PRESSURE punishments
• PR = 85 bpm • Based on their parents’ rules
• BP = 100/60 mmHg • May not understand why something is right or wrong
VOIDING 2. Believes God has physical characteristics
• 9 – 10x/ day
• Night-time bladder control is achieved. 3. Participates in some religious rituals, but may not
DEVELOPMENTAL MILESTONES understand their significance
LANGUAGE DEVELOPMENT SAFETY
• 3 years old POSSIBLE
o Vocabulary of 900 words PREVENTIVE MEASURES
ACCIDENTS
o Constantly asks “HOW?” and “WHY?” ‐ Keep child in car seat
• 4 – 5 years old ‐ Do not allow to play outside
o Continue to ask many questions unsupervised
o Enjoy participating in mealtime conversation ‐ Teach safety with tricycles
o Can describe something from their day in great detail 1. MOTOR
‐ Teach to always hold hands with a
o Imitate language exactly what they hear VEHICLES
grownup before crossing the street
o STUTTERING (DISFLUENCY) is common ‐ Teach parking lot safety
PLAY ‐ Should wear helmets when riding
• COOPERATIVE bicycles
o Purpose: ‐ Supervise at playgrounds
▪ To help the child learn to share and play in small 2. FALLS ‐ Judge safe distances for jumping or
groups. heights for climbing
▪ To learn simple games and rules, language concepts, ‐ Do not leave child alone in bathtub or
and social rules. 3. DROWNING near water
• Play may be: ‐ Teach beginning swimming
o Dramatic ‐ Do not allow child to approach strange
4. ANIMAL
o Imitative dogs
BITES
o Creative ‐ Supervise play with family pets.
• Expresses self through play ‐ Never present medication as candy.
• Imitate what they see parents are doing ‐ Never take medicines in front of
• Have IMAGINARY FRIENDS children
‐ Never store food or substances in
EMOTIONAL DEVELOPMENT
containers other than their own
DEVELOPMENTAL TASKS ‐ Post telephone number of local poison
ERIKSON: Initiative vs. Guilt 5. POISONING control center by the telephone
• Learns to do things, derives satisfaction from activities ‐ Stock each first‐aid box with syrup of
• Needs exposure to variety of experiences and play materials ipecac, with proper instructions for
that encourage creative play administration
• IMITATES role models ‐ Teach child that medication is a
• ACTIVE IMAGINATION serious substance and not for play
• Cannot differentiate between reality and fantasy ‐ Store vitamins out of reach
‐ Buy flame-retardant clothing
‐ Turn handles of saucepan towards
6. BURNS back of stove
‐ Store matches/ lighters in closed
containers

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CARE OF MOTHER, CHILD AT RISK | NCM 109


CHAPTER 31: NURSING CARE OF A FAMILY WITH A PRESCHOOL CHILD

‐ Do not allow child to help light 4. BATHING


birthday candles, fireplace, etc. • Supervise bath
‐ Keep screen in front of a fireplace or • Avoid use of bubble bath
heater o It is associated with incidents of UTIs
‐ Teach “not to talk with strangers” or 5. TEETH
accept anything from a stranger
7. COMMUNITY • Night grinding (Bruxism)
‐ Teach child to say “NO” to people
SAFETY o A way of letting go to release tension
whose touching he does not enjoy,
including family members HEALTHY FAMILY FUNCTIONING
‐ Child should know own name, DISCIPLINE
address, telephone number, and how • TIME‐OUT
to seek help if lost o A technique of helping children learn that actions have
‐ Teach how to call for help in an consequences
emergency. o Parents must be certain their children understand the rule
‐ Warn a child not to accept rides from they are trying to enforce.
strangers o Parents should give 1st warning; if the child repeats the
‐ Explain that if children or adults ask behaviour, parents select an area that is nonstimulating,
8. GENERAL
them to keep secrets about anything such as a corner of a room (TIME OUT space) and direct
SAFETY
that has made them uncomfortable, the child to go there. (1 min. per year of age)
they should tell their parents or PARENTAL CONCERNS
another trusted adult, even if they
have promised to keep the secret HEALTH PROBLEMS
‐ Explain that bullying behaviour from • Ear (otitis media) and respiratory infections
other children is not to be tolerated • Gastrointestinal disturbances (vomiting & diarrhea)
but to be reported so they can receive • IMMUNIZATIONS:
help managing it. o 2nd dose of MMR
▪ given between 4 – 6 y.o.
NUTRITIONAL HEALTH
o 4th booster dose of IPV and DTaP (Diphtheria, tetanus, and
1. RECOMMENDED DIETARY REFERENCE INTAKES acellular pertussis)
• Select foods based on the food pyramid ▪ given between 4 – 6 y.o.
• Caloric need = 1,700 kcal/ day • Fears:
2. NUTRITIONAL HEALTH WITH A VEGETARIAN DIET o Dark
• A child may need vit. B12 supplement because it is only found o Mutilation
in animal products o Separation or abandonment
DAILY ACTIVITIES BEHAVIOR VARIATIONS
1. Telling tall tales
1. DRESSING
2. Imaginary friends
• 3 – 4 y.o. 3. Sharing
o Can dress themselves, except for difficult buttons ‐ begins to have best friends
o Prefers bright colors or prints and often do not match 4. Regression
• 5 y.o. ‐ thumb sucking, negativism, loss of bladder control
o Can lace shoes 5. Sibling rivalry
2. SLEEP NEW SIBLING
• Needs 12 hrs. of sleep SEX EDUCATION
• May have FEAR OF THE DARK (very common) • 3 y.o.
• Interventions: o Knows sex differences
1) Use night-light • 6 y.o.
2) Have open discussion o Imitates masculine/feminine behaviors
3) Parents need to comfort and reassure the child that o Gender identity well-established
nightmares are not real o Sexual curiosity and exploration:
4) Help the child remain in bed until he falls back to sleep ▪ Masturbation
• Bedtime rituals: ‐ May increase in frequency when the child is
1) Bath under stress
2) Bedtime stories ‐ Redirect child’s attention without punishing or
3) Listening to soothing music reprimanding
4) Have chat with the caregiver ‐ Teach child that touching genitals is not
3. EXERCISE appropriate in public
• Games such as: ▪ Curious about anatomical differences and seeks to
1) Ring –around-the-rosy “investigate” them
2) London bridge PREPARING A CHILD FOR SCHOOL
• Instill in their children that learning is fun.

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CARE OF MOTHER, CHILD AT RISK | NCM 109


CHAPTER 31: NURSING CARE OF A FAMILY WITH A PRESCHOOL CHILD

BROKEN FLUENCY
• STUTTERING
o repetition and prolongation of sounds, syllables & words

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Common questions

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Preschool children aged 3 have a vocabulary of approximately 900 words, often asking "how" and "why" questions. By ages 4 to 5, children continue to ask many questions and enjoy engaging in mealtime conversations. They can describe events from their day in detail, imitate language they've heard, and stuttering is common during this stage .

Common behavior variations include telling tall tales, having imaginary friends, and exhibiting regressive behaviors such as thumb-sucking or bladder control issues. To manage these behaviors, parents should provide reassurance without reinforcing the behavior (e.g., ignoring tall tales while encouraging honesty), guide children in making friends, and maintain routines to prevent stress-induced regression. Open communication and setting a consistent example are key strategies in managing these behaviors .

Preschool children are typically in Piaget's Preconceptual and Intuitive Thought Stages, where egocentrism and perception dominate their reasoning. The concept of the 'property of conservation' is challenging because they cannot understand that an object's quantity does not change despite a change in its form or appearance. This affects their learning process as they focus more on visual aspects rather than underlying principles, which can limit their ability to grasp abstract concepts .

Time-out is effective because it helps children learn that their actions have consequences in a non-physical way. Key steps for implementing it include ensuring the child understands the rule, giving a first warning, and if the behavior is repeated, directing the child to a non-stimulating area for time-out (one minute per year of age). This method requires consistency and should be followed by discussing the misbehavior to reinforce learning .

Erikson's stage of Initiative vs. Guilt involves children learning to undertake activities independently and deriving satisfaction from these activities. Implications for emotional development include the need for a variety of experiences and materials that encourage creative play. During this stage, children imitate role models and have an active imagination, although they often cannot distinguish between reality and fantasy, which can lead to feelings of guilt if their actions are discouraged or reprimanded .

Imaginary friends are indicative of a preschool child's active imagination and their inability to differentiate completely between reality and fantasy. These friends often fulfill a role in cognitive and social development by enabling children to practice language skills, manage emotions, and explore social scenarios in a risk-free environment. They can also serve as a tool for children to express their thoughts and feelings in ways they might not be comfortable doing with real peers or adults .

Preschool children following a vegetarian diet may require a Vitamin B12 supplement, which is typically found in animal products. Their diet should still follow general dietary guidelines like those in the food pyramid with a caloric intake of around 1,700 kcal per day. Ensuring that their nutritional needs are met is especially important to support their growth and developmental milestones during this critical stage .

Cooperative play helps preschool children learn to share, play within small groups, and understand simple games, rules, and social norms. This type of play benefits cognitive development by promoting problem-solving and language skills. Socially, it helps children understand the importance of cooperation, empathy, and communication in interactions with others, contributing to their ability to function as part of a group and boosting self-confidence .

To prevent poisoning, parents should never present medication as candy, avoid taking medicines in front of children, and ensure that food and substances are stored in their proper containers. It is also critical to post the local poison control center’s number by the phone, stock first-aid kits with syrup of ipecac, and teach children that medication is not for play. These measures are critical because preschool children are curious and might accidentally consume harmful substances if safety precautions are not in place .

Parents can address the fear of the dark by using a night-light, having open discussions with the child about their fears, and reassuring them that nightmares are not real. They should also help the child remain in bed until they fall back to sleep. Establishing a comforting bedtime ritual involving a bath, bedtime stories, or listening to soothing music can also help alleviate nighttime anxiety .

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