TODELER GROWTH AND DEVELOPMEN
(AGE 1 TO 3 YEARS)
1.physical growth and development
A. general characteristics
A toddler's characteristic protruding abdomen result
from underdevelopment abdominal muscles.
B. Height and weight changes
1. normal height changes include:
a) Growth of about 3-4 inches(7.5 to 10 cms)per year.
b) Reaching about half of expected adult height at age
2 years
2. normal weight changes include:
considerably slower rate of gain than in infancy ,about 4
1/2 to 6 1/2 lb(2 to3kgs)per year.
C. Head circumference and fontanel changes
1. Head circumference normally increases about 1inch
(2.6cm) between age 1 and 2 years.
2. The anterior fontanel closes between ages 12 and 18
months.
D . Socialization
A toddler's social interaction is dominated by ritualism
,negativism ,and independence .
E .communication
When preparing a toddler for a stressful event, such as a
surgical procedure ,caregivers should provide simple
explanations immediately before the event .
1
HEALTH PROTECTION
Injury prevention
1 . Toddlers are prone to the same injuries as infants ,
including :
a) falls
b) aspiration
c) poisoning
d) burns
e) motor vehicle accidents
f) other accidental injury
2 . Nursing considerations associated with accident
include: prevention
a) falls : instruct parents to keep crib rails up , place gates
across stairways , keep screen secure on all windows ,
and super the toddler at play .
b) A aspiration poisoning :teach parents to place all toxic
substances up height and locked (child can now climb
and open ); secure safety caps on medications ;and
remove all small ,easily aspirate objects from the child's
environment .Urge them to keep the phone number of
poison control center by the telephone at all time .
c) burns : Instruct parent to avoid using table clothes (a
curios toddler may pull the cloth to see what is on the
table , possibly spilling hot food or liquids on himself or
herself ); to teach the toddler what "hot " means ; to store
matches and cigarette lighters in a locked cabinet out of
reach ;and to secure safety plugs in all unused electrical
outlets.
d) motor vehicle accidents: instruct parents to continue using
an appropriate –sized car seat at all times .
2
e) other accident injury :teach parents to lock cabinets and
drawers that contain hazardous items , such as knives
,firearms , and ammunition ; encourage parents to teach the
toddler to avoid playing in the street an how to cross the
street safely ;and urge parents to supervise tricycle riding
and outdoor play .
3
HEALTH PROMOTION OF TRADDLERS
Sleeping patterns
1. Toddlers' sleep need average 12 hours per day
2. a toddler typically sleeps through the night and has one
daytime nap.
3. A child typically discontinues daytime naps round age 3.
4. a consistent bedtime ritual helps prepare a toddler for
sleep(e.g .,same bedtime , a light snack ,reading , and
tucking in to bed ). A security object ,such as a blanket or
stuffed toy may aid the transition to sleep .
SELECTED HEALTH PROBLEMS OF TODDLERS
A. fears
1. common fears of toddlers include :
a) loss of parents-separation anxiety.
b) stranger anxiety .
c) loud noises (e.g. vacuum cleaner)
d) going to sleep
2. Emotional support , comfort , and simple explanations may
help allay a toddler's fears .
B .sibling rivalry
1. A toddler commonly develops feelings of sibling rivalry
after a new baby is born ,stemming from a sense of
"dethronement" since he or she no longer is the sole focus
of his parents' attention .
2 . Caregivers may help reduce a toddler's sense of sibling
rivalry by beginning preparation 1 month before the new
baby's scheduled birth ;discussing the baby's feeding
,diapering ,and sleeping needs ; and reassuring the toddler
4
that his or routine will stay much the same (e.g. ,meals ,
bedtime rituals).
3 . After the baby's birth , parents should allow and and
encourage the toddler to help care for the new baby
whenever possible so that the toddler feels included and
important .
C. Bowel and bladder control
1. signals indicating that toddler is ready for toilet training
include:
a) walks well(muscle co-ordination indicates that sphincter
control can be gained).
b) communicates with parents
c) has awareness of a wet or soiled diaper
d) can hold urine for 2 hours
e) is interested in pleasing parents
2. Bowel control develops before bladder control ; the toddler
may stay dry during the day but need diaper at night until
age 4.
D. child abuse and neglect
1. Description :acts of commission or omission by caregivers
that prevent a child from actualizing his or her potential for
growth and development .
2. Etiology
a) A n estimated 25% of fractures in children under 3
years stem old from child abuse .
b) parental characteristics linked to child abuse include a
history of being abused themselves , low self-esteem
,and difficulty controlling aggressive impulses .
5
C) factors that may predispose a child to abuse include the
child's temperament ,birth order ,and sex ; in addition ,
an illegitimate or "imperfect" (i.e .,mentally or
physically impaired) child is of ten at risk for abuse .
d) family characteristics that may continue to child abuse
include chronic stress , financial or emotional crises
,and major life changes .
.
6