Health Promotion of Toddlers PDF

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Summary

M. Milner...

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Health Promotion of Toddlers (1 to 3 years) Physical Development  

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Fontanel: o Anterior fontanels close by 18 months of age. Weight: o At 30 months of age toddlers should weight four times their birth weight. Toddlers gain approximately 1.8 to 2.7 kg (4 to 6 lb) per year. Height: o Toddlers grow about 7.5 cm (3 in) per year. Head circumference: o Head circumference and chest circumference are usually equal by 1 to 2 years of age.

Cognitive Development 

Piaget: o Sensorimotor phase transitions to the preoperational phase around 2 years of age. o The concept of object permanence increases. o Toddlers have and demonstrate memoires of events that they relate to. o Domestic mimicry is evident. o Preoperational though does not allow for toddlers to understand other viewpoints but it does not allow them to symbolize objects and people to imitate previously seen activities.

Language Development   

Language increases to between 50 and 300 words by the age of 2 years. 1 year: has a three to five word vocabulary and understands simple commands. 2 to 3 years: using multiword sentences by combining two to three words, language increases to about 300 words, imitates animal sounds, refers to self by name, and begins to use verbs in past tense.

Psychosocial Development 

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Erikson: o Autonomy vs. shame and doubt. o Independence is paramount for toddlers who are attempting to do everything for themselves. o Toddlers often use negativism or negative responds as they begin to express their independence.

o Ritualism or maintaining routines and reliability provided a sense of comfort for toddlers as they begin to explore the environment beyond those most familiar to them.

Social Development 

Toddlers begin to develop feelings of concern for others and progressively see themselves as separate from their guardians and increase their explorations away from them.

Body-Image Changes  

Toddlers appreciate the usefulness of various body parts. Toddlers develop gender identify and recognize gender differences by 3 years of age.

Age Appropriate Activities  

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Solitary play evolves into parallel play in which toddlers observe other children and then might engage in activities nearby. Appropriate activities: o Filling and emptying containers. o Water toys and clay. o Playing with blocks. o Looking at books. o Push-pull toys. o Tossing balls. o Finger paints. o Large piece puzzles. o Thick crayons. Temper tantrums result when toddlers are frustrated with restrictions on independence. Providing consistent age appropriate expectations helps toddlers to work through frustration. Toilet training can begin when toddlers have the sensation of needing to urinate or defecate. Guardians should demonstrate patience and consistency in toilet training. Nighttime control might develop last. Discipline should be consistent with well defined boundaries that are established to develop acceptable social and emotional behavior. Time out, redirection, and positive reinforcement are effective methods for toddlers.

Nutrition 

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Children might establish lifetime eating habits during early childhood.

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Toddlers begin developing taste preferences and are generally picky eaters who repeatedly request their favorite foods. Physiologic anorexia occurs resulting in toddlers becoming fussy eaters because of a decreased appetite. Toddlers should consume 24 to 28 oz od milk per day and can switch from drinking whole milk to drinking low-fat milk after 2 years of age. Juice consumption should be limited to 4 to 6 oz per day. Trans fatty acids and saturated fats should be avoided. Diet should include 1 cup of fruit daily. Food serving size should be 1 tbsp for each year of age. Toddlers generally prefer finger foods because of increasing autonomy. Regular mealtimes and nutritious snacks are best meet nutrition needs. Snacks or desserts that are high in sugar, fat, or sodium should be avoided. Foods that are potential choking hazards should be avoided. Adult supervision should always be provided during snack and mealtimes. Foods should be cut into small bite size pieces to make them easier to swallow and to prevent choking. Toddlers should not be allowed to engage in drinking or eating during play activities or while lying down.

Sleep and Rest    

Toddlers typically average 11 to 12 hours of sleep per day including one nap. Naps often are eliminated in older toddlerhood. Resistance to bedtime and expression of fears are common in this age group. Maintaining a regular bedtime and bedtime routine helpful to promote sleep.

Injury Prevention 

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Aspiration of foreign objects: o Small objects that can become lodged in the throat should be avoided. o Toys that have small parts should be kept out of reach. o Age appropriate toys should be provided. o Clothing should be checked for safety hazards. o Balloons should be kept away from toddlers. o Guardians should know emergency procedures for choking. Bodily harm: o Sharp objects should be kept out of reach. o Firearms should be kept in locked boxes or cabinets. o Toddlers should be kept away from toddlers. o Guardians should know emergency procedure for choking. Burns:

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o The temperature of bath water should be checked. o Thermostats on hot water heaters should be turned down to less than 120  F. o Working smoke detectors should be kept in the home. o Pot handles should be turned toward the back of the stove. o Electrical outlets should be covered. o Toddlers should wear sunscreen when outside. Drowning: o Toddlers should not be left unattended in bathtubs. o Toilet lids should be kept closed. o Toddlers should be closely supervised when near pools or any other body of water. o Toddlers should be taught to swim. Falls: o Doors and windows should be kept locked. o Crib mattresses should be kept in the lowest position with the rails all the way up. o Safety gates should be used across the top and bottom of stairs. Motor vehicle injuries: o Infants and toddlers remain in a rear facing safety seat until the age of 2 years or until they exceed the height and weight recommended by the manufacturer. o Toddlers over the age of 2 years or who exceed the height and weight recommendations for rear facing safety seats are moved to a forward facing safety seat with a harness. o Safest area for infants and children is the backseat of the car. o Do not place rear facing safety seats in the front seat of vehicles with deployable passenger airbags. Poisoning: o Exposure to lead paint should be avoided. o Safety locks should be placed on cabinets that contain cleaners and other chemicals. o The phone number for a poison control center should be kept near the phone. o Medications should be kept in childproof containers away from the reach of toddlers. o A working carbon monoxide detector should be placed in the home. Suffocation: o Plastic bags should be avoided. o Crib mattresses should fit snugly. o Crib slats should be no farther apart than 6 cm. o Pillows should be kept out of the crib. o Drawstrings should be removed from jackets and other clothing....