Chapter
Chapter 31
31
Nursing
Nursing Care
Care of
of a
a Family
Family With
With a
a
Preschool
Preschool Child
Child (3-5
(3-5 yrs)
yrs)
OBJECTIVES
• Describe normal growth and development as well as common parental concerns of the
preschool period.
• Identify 2020 National Health Goals related to the preschool period that nurses can help
the nation achieve.
• Assess a preschooler for normal growth and developmental milestones.
• Formulate nursing diagnoses related to preschool growth and development or common
parental concerns.
• Identify expected outcomes for nursing care of a preschooler as well as help parents
manage seamless transitions across differing healthcare settings.
• Using the nursing process, plan nursing care that includes the six competencies of Quality
& Safety Education for Nurses (QSEN): Patient-Centered Care, Teamwork & Collaboration,
Evidence-Based Practice (EBP), Quality Improvement (QI), Safety, and Informatics.
• Implement nursing care related to normal growth and development of a preschooler, such
as preparing a preschooler for an invasive procedure.
• Evaluate expected outcomes for achievement and effectiveness of care.
• Integrate knowledge of preschool growth and development with the interplay of nursing
process, the six competencies of QSEN, and Family Nursing to promote quality maternal
and child health nursing care.
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Key Terms
• broken fluency
• bruxism
• conservation
• ectomorphic body build
• egocentrism
• Electra complex
• endomorphic body build
• genu valgus
• intuitional thought
• Oedipus complex
• secondary stuttering
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2020 National Health Goals Related to
Preschoolers
• Increase the number of states and the District of Columbia with
laws requiring helmets for bicycle riders under 15 years of age,
from 19 states to 27 states.
• Decrease acute middle ear infections (otitis media) among
children from 246 out of 1,000 to 221 out of 1,000.
• Increase the proportion of children aged 19 to 35 months who
receive the recommended doses of diphtheria, tetanus, and
pertussis (DTaP); polio; MMR; Hib; hepatitis B; varicella; and
PCV vaccines from 44.3% to 90%.
• Increase the rate of use of forward-facing child car seats
among children age 1 to 3 years from a baseline of 72% to
79%.
• Reduce the proportion of children 3 to 11 years exposed to
secondhand smoke from 52.2% to 47%.
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Nursing Diagnoses for Preschoolers
• Health-seeking behaviors related to developmental
expectations
• Risk for injury related to increased independence outside the
home
• Delayed growth and development related to frequent illness
• Risk for imbalanced nutrition, more than body requirements,
related to fast food choices
• Risk for poisoning related to maturational age of child
• Parental anxiety related to lack of understanding of childhood
development
–
Parents may not understand that their child has an
imaginary friend
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Assessing Growth and Development in the
Preschooler
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Growth and Development of a Preschooler
• Physical growth
–
Height, weight, body mass index, and head circumference
–
Teeth – X20 deciduous teeth by 3 yrs
• Body Types
–
Ectomorph (slim), Endomorph (large), Mesomorph
• Developmental milestones
–
Language development
–
Play: Imitation, imaginary friends
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Growth and Development of a Preschooler
—(cont.)
• Emotional development
–
Developmental tasks
• Initiative vs. guilt
• Imitation
• Role modeling
• Fantasy
• Magical Thinking
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Growth and Development of a Preschooler
—(cont.)
• Emotional development
–
Oedipus and Electra complexes
–
Gender roles
–
Socialization
• Cognitive development
–
Preoperational
–
Have not yet developed the property of conservation
• Moral and spiritual development
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Health Promotion: Safety
• Keeping children safe, strong, and free
• Motor vehicle and bicycle safety
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Health Promotion: Safety—(cont.)
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Health Promotion: Daily Activities
• Dressing
• Sleep
• Exercise
• Bathing
• Teeth
–
Night grinding (Bruxism)
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Parental Concerns During the Preschool
Years
• Health problems
• Fears
–
Dark
–
Mutilation – Boys develop a fear of castration
–
Separation or abandonment
• Behavior variations
–
Telling tall tales
–
Imaginary friends
–
Sharing
–
Regression
–
Sibling rivalry
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Parental Concerns During the Preschool
Years—(cont.)
• New sibling – Refer to Box 31.7
• Sex education
• Choosing preschool or childcare center
• Preparing child for school
• Broken fluency
• Bathroom language
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Health Promotion: Family Functioning—
(cont.)
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Health Promotion: Family Functioning
• Discipline
–
Time-outs
• As many minutes as the child’s age
• Preparing a child for school
–
Child readiness
–
Parental attitude
–
Practice
• Transportation
• Following instructions
• Lunch protocols
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