Preschooler

3-5 years of age

Physical growth slows considerably during this period, personality and cognitive growth are substantial.

Important period growth for parents

This age want to do things for themselves

Physical Growth

Preschooler becomes slimmer, taller and much more childlike proportions

Contour changes become apparent

can be Ectomorphic (slim body build)

Endomorphic (large body build)

Lymphatic tissue increase in size

IgG and IgA antibodies increases

Innocent heart murmurs

Bladder is easily palpable above the symphysis pubis ;Void frequently (9 or 10 times a day)

Genus Valgus

Pulse Rate: 85 bpm

Blood Pressure: 100-160

Respiratory Rate: 20-30 cpm

Frequent voiding(9-10x a day)

Has well formed arch of the foot.

Genus Valgus

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

Normal phase of development

Between ages 2-5 years old

Girls have more genu valgus compared to young boys

Height and Weight

Height:

Growth in height averages

(6.25 to 7.5cm)per year.

Average height at 5 years 110cm, or double the birth length.

Height and Weight

Weight:

The average weight gain during preschool age is 2.3kg/year.

Average weight at 5 years 18.7kg. ordouble the weight of one year of age.

Head Circumference

Head circumference is not routinely measured at physical assessments on children over 2 years of age.

Teeth

Preschoolers generally have all the 20 deciduous teeth

Rarely that a new teeth erupts at this stage

Developmental Milestone

Language Development

3 years old child has 900 vocabulary words

Used to ask question (up to 400 a day)

Mostly how and why questions

Imitates language exactly

Egocentric

Play

Imitates what theyre parents are doing (imitative play)

Pretend to be a nurse, doctor, teacher etc.

Have imaginary friends

Interested in group games and songs (5y/o)

Developmental Task

Initiative vs Guilt (Erickson)

Initiative is the developmental task that a child should be able to achieve.

Child is punished Child develops guilt

or criticizedupon for wanting to try

Initiative new activities.

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

Imitation children generally imitate what theyre parents are doing

pretends feeding a dolldo chores (helping to mop the floor)

a girl might wear a large shoesFantasy learns to differentiate

fantasy and reality- become afraid that they might lost their identify and become stuck in

their fantasies

Oedipus and Electra Complex

Oedipus 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 behaviourmay feel hurt/rejected it is important to reassure them that this phenomena of competition is normal.

Gender RolesPreschoolers need exposure to an

adult of the opposite gender so they can become familiar with opposite

gender rolesSocialization

Preschoolers become more involve in play groups thus arguments would be

often.They develop having best buds or best

friends

Motor Development

Motor Development of Preschool child

At 3 Years: Can wash hands.

Can feed himself well.

Build a tower of 9-10 blocks.

Can go to toilet.

Begins to use a scissor.

Can ride a tricycle.

Go up stairs.

Stand on one foot for a few seconds.

Motor Development of Preschool child (cont.)

At 4 Years: Can jump well, goes up and down stairs. Can brush his teeth, lace

his shoes. Can copy a square.

Motor Development of Preschool child (cont.)

At 5 Years: Can use scissor well. Drew a recognizable picture of a man. Can dress himself without assistance. Can wash himself without wetting his

clothes. Can balance on one foot for about 8 seconds.

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

PhyschosexualDevelopment

Phallic stage child learns sexual identity through awareness of genital area

Nursing Implications

Accepts childs sexual interest such as fondinghis/her own

Genirals as a normal area of exploration. Help parents answer childs question about birth or sexual differences

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 someones situation

o Believes they are 100% correct

o They cannot see your kind of situation

Lack of Conservation- meaning they cannpotsee that only the form not the amount has changed

Lack of Reversibility they cannopt retrace steps

Moral Development

Pre-conventional Level (Level 1)

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

4-7 years old individualism. Carries out action to satisfy own needs rather than the societys

Promoting Preschool Safety

Keeping children Safe, Strong and Free

1. Warning them not to talk or accept a ride from strangers

2. Teaching a child how to call for help

3. Describe how police officer look like

4. Explain that if children/adults ask them to keep a secret and made them uncomfortable they should tell their parents or another trusted adults

5. Explain that bul;lying 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 theyre child with helmet when riding on their bicycle.

Promoting Nutritional Health

Offer small amount of servings so the children wouldnt be overwhelmed by the amount of food on the plate.

Dont give sugary foods before meal as they decrease childs appetite.

Teach parents to make mealtime happy and enjoyable.

Promoting Developmentof preschool in Daily Activities

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 unattended in the bath tub

Care of the Teeth

- Child should continue drinking fluoridated wter to keep strong

- After preschooler brushed their teetyhparents 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 parntal role develop vocabulary development

Discipline Time out as discipline technique

-Time out is a discipline technique that invovlesplacing children in a very boring place for several minutes following unacceptable behaviours.Timeout means time out fro 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

Common Fears of the Preschool

Fear of the dark

Fear of mutilation

Fear of separation or abandonment

Behaviour Variations

Telling Tales- means stretching stories to make them more interesting (common in Preschool)

Imaginary Friends although this is normal in preschooler parents should help child to separate fact from fantasy

Difficulty Sharing

Regression

Sibling Rivalry

Effect of birth of a sibling

Any environmental changes may have traumatic effect on the child, the birth of sibling is a change and deprives the older child of some parents attention.

The child feels loss of affection.

He feels also rejected and may become jealous. continue

He usually shows his hostility to the new baby openly and directly.

He shown his hostility toward his mother in different ways

The mother should accept such temporary behavior and must discuss with him the difference between his needs and those of the infant.

Effect of birth of a sibling

Early Sexual Development

Purposefully touching private parts (masturbation), occasionally in the presence of others

Attempting to see other people when they are naked or undressing

Mimicking dating behavior (such as kissing, or holding hands)

Early Sexual Development

Talking about private parts and using naughty words, even when they dont understand the meaning

Exploring private parts with children their own age (such as playing doctor, Ill show you mine if you show me yours, etc.)

Child Care Center

A school or childcare experience is helpful for preschoolers, as peer exposures appears to have a positive effect on social development.

The terms childcare center preschool and nursery school are often used interchangeably, so parents cannot depend on the name of school to define its structure.

Broken Fluency

Broken Fluency Repetition and prolongation of sonds , syllables and words

often referred to us (secondary stuttering )

It is part of the normal development and as such will pass

Encourage a Sense of Initiative on a Physically Challenged Child

Nutrition respect child preferences

- serve toast ior sandwiches cut into animal shapes

Medicine Allow child to choose a chaser such as juice after taking oral medicine

Rest Provide adequate light in childs room

Hygiene allow child to choose bath tub toys, clothing

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 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 )