PRESCHOOLER

From 3-5 years old

Nursing Process (Preschooler)

Nursing process overview

Assessment Obtain health history Perform physical and developmental evaluation Assess weight and height Assess for general appearance.

Nursing diagnosis:

developmental expectations Risk for injury related to increased independence outside the home Delayed growth and development related to frequent illness. Risk for poisoning related to maturational age of the child Parental anxiety due to lack of knowledge of understanding of childhood development.

Health seeking behaviours related to

Implementation
Role playing Role Modelling Let them participate during the assessment.

Growth and Development

Physical Growth

Physical Growth
Preschooler becomes slimmer, taller and much more child like proportion Contour changes become apparent can be ectomorphic (slim body build) endomorphic (large body build) Lymphatic tissues increase in size. IgG and IgA antibodies increases. innocent heart murmurs.

PULSE RATE: 85 bpm BLOOD PRESSURE: 100/60 mmHg RESPIRATORY RATE: 20-30cpm
Frequent Voiding (9-10x a day) Has well-formed arch of the foot Genu Valgus (Knock Knees)

Genu Valgus

condition where the

knees angle in and touch one another when the legs are straightened

GENU VALGUS

Normal phase of development Between ages 2-5 y/o straightens at 6-7 years Girls have more genu valgus compared to young boys

Weight and Height

WEIGHT GAIN : 4.5lb or 2kg a year. HEIGHT: 2 3.5 inches (68cm) a year Less appetite (same as toddler)

Teeth
Preschoolers generally have all the 20 deciduous teeth Rarely that a new teeth erupts at this stage.

Developmental Milestone

Language Development
3 y/o child has 900 vocabulary words Used to ask questions. (up to 400 a day) Mostly how and why questions. Imitates language exactly Egocentric
Child becomes inquisitive during preschool

Play
Imitates what they`re parents are doing. (imitative play) Pretends to be teachers, cowboys, doctor etc. Have imaginary friends. Interested in group games and songs (5y/o) Child imitates her mom

Child pretends being a doctor

Emotional Development

Developmental Task
Initiative vs Guilt (Erikson)
be able to achieve
Child is punished or
criticized upon initiative

Initiative is the developmental task that a child should

Child develops guilt for wanting to try new activities.

A child with well-developed sense of initiative discovers that learning something new is fun.

Imitation Children generally imitate what they`re parents

are doing.
pretends feeding a doll do chores (helping to mop the floor) a girl might wear large shoes

Fantasy Learns to differentiate fantasy and reality

- become afraid that they might lost their identity and become stuck in their fantasies.

Oedipus and Electra Complex

Sigmund Freud Oedipus Complex- refers to the strong emotional attachment of a preschool boy to his mother. Electra Complex- attachment of a preschool girl to her father.
Nursing responsibility: Parents who are not prepared for this behaviour may feel hurt/ rejected it is important to reassure them that this phenomena of competition is normal

Gender Roles
Preschoolers need exposure to an adult of the opposite gender so they can become familiar with opposite gender roles.

Socialization

Preschoolers become more involve in play groups thus arguments would be often They develop having best buds or best friends.

Motor Development

Motor Development
Fine Motor
3 years old - undresses self - Stacks tower of blocks - Can draw a cross
3 year old child stacks blocks

4 years old- can do simple buttons 5 years old- draws a 6-part man - can lace shoes

4 year old child buttoning shirt

Gross Motor
3 years old Runs - Alternate feet on stairs -stands on one foot 4 years old- jumps and skips 5 years old- throws overhand

5 year old child throws a ball

Psychosexual Development

Phallic stage (Freud

Stages

of

Childhood Det.)
-Child learns sexual identity through awareness of genital area

Nursing Implication

Accept child`s sexual interest such as fondling his/ her own . Genitals as a normal area of exploration. Help parents answer child`s questions about birth or sexual differences.

Cognitive Development

Cognitive Development (Piaget)

Preoperational Thought Centering : looks at an object and focuses only to one of
its characteristics

Intuitional Thought: refers to lack of insight to put

themselves in someone`s situation. believes they are 100% correct. they cannot see your kind of situation Lack of Conservation: meaning they cannot see that only the form not the amt. has changed. Lack of Reversibility- they cannot retrace steps.

Moral Development

Pre-conventional Level (Level 1)

2-3 years old- punishment or obedience orientation. Child does right to avoid punishment.

4-7 years old- Individualism. Carries out action to satisfy own needs rather than the society`s.

Promoting Preschool Safety

Promoting Preschool Safety

Keeping Children Safe Strong and Free
1. 2. 3. 4. Warning them not to talk or accept a ride from strangers Teaching a child how to call for help Describe how police officer look like Explain that if children/ adults ask them to keep a secret and made them uncomfortable they should tell their parents or another trusted adult 5. Explain that bullying behaviour from other children is not to be tolerated but should be reported so they can receive help in managing it.

Promoting Motor Vehicle and Bicycle Safety

Parents should stress the importance of seat belts. Parents should provide they`re child with helmet when riding on their bicycle.

Promoting Nutritional Health

Offer small amt. of servings so the child wouldn`t be overwhelmed by the amount of food on the plate. Don`t give sugary foods before meal as they decrease child`s appetite. Teach parents to make mealtime happy and enjoyable. Encourage to help prepare meal

Promoting Devt. of preschool in Daily Activites

Dressing Preschooler prefer bright colors or prints and may select clothes that mismatched. Sleep Refuse to go to sleep at night because of fear of dark and nightmares. switching on the night light. screen out frightening stories.

Bathing

Do not leave child unattended in the bath tub.

Care of Teeth

Child should continue drinking fluoridated water to keep teeth strong. After preschooler brushed their teeth parents should check that all tooth surfaces are cleaned. Encourage children to eat healthy snacks like apple, banana, carrots instead of sweets to prevent tooth decay.

Night Grinding or Bruxism

Refers to grinding the teeth at night (usually at sleep children do this for a short time each night to release tension which allows them to fall asleep. Children who grinds teeth extensively has greater than normal anxiety

Promoting Healthy Functioning Family

Major parental role- develop
vocabulary devt. Discipline time out as a discipline technique.

Time-out is a discipline technique that involves placing children in a very boring place for several minutes following unacceptable behaviours. Time-out means time out from any attention.

Common Health Problems

Major Cause of Death
1. Automobile Accidents 2. Poisoning 3. And Falls

Minor Illnesses

1. Colds 2. Ear Infections 3. Flu

Keep away medicine and other substances that can cause poisoning

Common Fears of The Preschool

Fear of the dark. Fear of mutilation. Fear of separation or abandonment.
Toys become monsters under childs imagination

Behaviour Variations
1.Telling Tales means stretching stories to make them more interesting. (common in preschoolers) 2. Imaginary Friends- although this is normal in preschooler parents should help child to separate fact from fantasy.

3. Difficulty Sharing
4. Regression 5. Sibling Rivalry

Broken Fluency
Broken Fluency -repetition and prolongation of
sounds, syllables and words. - often referred to us secondary stuttering. -It is part of the normal devt. and as such will pass.

Encourage a Sense of Initiative on a Physically Challenged Child

Nutrition: respect child preferences
: serve toast or sandwiches cut into animal shapes taking oral medicine.

Medicine: Allow a child to choose a chaser such as juice after

Rest: Provide adequate light in childs room. Hygiene: Allow child to choose bath tub toys, clothing.
: Allow child to wash himself Pain: Encourage the child to express pain

Stimulation :Guessing games encourage sense

of initiative. : Provide manipulative toys (finger paint, clay) : encourage use of play rooms for socialization. : encourage child to interact with family. (drawing pictures for siblings or telephoning home.)

End of Slide