Preschooler (3-5 Years)

1 | Page

E. A. Dinoy BSN II-D

Preschooler

(3-5 Years) 20 of all their deciduous teeth are present at 3 years of age

Assessment:  Physical Growth and Development

 Cognitive

Slimmer, taller and much more childlike Learns extended language Lymphatic tissues begin to increase in size e.g. tonsils IgG and IgA levels increase Physiologic splitting of heart sounds may be present Anteroposterior and transverse diameters of the chest reach adult proportions Pulse rate decreases to about 85 bpm Blood pressure: 100/60 mmHg

Exhibits genu valgus(knock-knees) Weight gain: slight at 4.5 lbs (2 kg) a year as

it

was

during

Height gain: minimal at 2 - 3.5 inches (6-8 cm) a year in average

stage

They have intuitional thought but they lack insight to view themselves as others see them or put themselves in another’s place Vocabulary is about 900 words Imaginations are keener than they will be at any other time in their lives The child with a well-developed sense of initiative discovers that learning about new things is fun Developmental Guilt

Muscles are noticeably stronger

Appetite remains toddlerhood

Falls to the preoperational according to Piaget

task:

Initiative

versus

To gain a sense of initiative, they need exposure to a wide variety of experiences and play materials They are interested in seeing new places and enjoy going with the family on vacationthese activities lead to increased vocabulary and learn words which they transfer from abstract

2 | Page concepts to the objects to which they relate

E. A. Dinoy BSN II-D Frequently asks how and why questions that needs simple answers

They have such active imaginations that they need little guidance

Words with multiple confounding to them

Imitation: they need free rein to imitate the roles of the people around them

Enjoys participating in mealtime conversation and describes something from their day in great detail

Fantasy: they believe that thoughts and wishes come true

their

Oedipus Complex: strong emotional attachment of a preschool boy to his mother

If children are criticized or punished for attempts at initiative, they develop a sense of guilt for wanting to try new activities or have new experiences

Electra Complex: attachment preschool girl to his mother

They need exposure to an adult of the opposite sex so they can become familiar with opposite gender roles

 Communication

are

They have a great deal in their ability to understand the world and how they relate to people

Egocentric-defines something in relation to themselves

They can determine right from wrong based on their parent’s rules

s

 Emotional

 Personality-Temperament

Because 3-years olds are capable of sharing, they play with other children agreeably than do toddlers , which is why preschool age is sensitive and critical time for socialization

meaning

of

a

Each child competes with the same-sex parent for the love and attention of the other parent  Play Do not need many toys They enjoy games that use IMITATION e.g. playing house They imitate what they see their parents are doing

3 | Page

E. A. Dinoy BSN II-D Many have imaginary friends as a normal part of having active imagination 4 and 5 years old divide their time between rough housing and imitative plays Also interested in group games

Diagnosis:  Wellness oriented: related

to

Health

 Preschooler safety As preschoolers broaden their horizons, safety issues increase

They still need supervision to be certain they do not injure themselves or other children and to ensure they do not stray too far from home They must be reminded repeatedly of automobile safety

 Other Nursing Diagnosis: Risk for injury related to increased independence outside the home Delayed growth and development related to frequent illnesses Risk for poisoning related to maturational age of child Risk for injury to teeth related developmental age and play activities

for

By age 4, they may project an attitude of independence and the ability to take care of their own needs(PSEUDOINDEPENDENCE)

Begin to develop best-friendships

Health-seeking behaviors developmental expectations

Planning/Implementation Promotion:

to

Risk for Impaired Urinary Elimination related to parental knowledge deficit of toilet-training techniques

They may imitate taking medicine so adults should never take them in front of children Warn a child never to talk with or accept gifts from strangers Teach a child how to call for emergency Describe what police officers look like Explain the importance of telling secrets to adult when they feel uncomfortable Explain not to tolerate bullying behaviors from other children

4 | Page Make sure that parents buckle preschoolers in into car seats in the backseat Promote bicycle safety  Nutritional Health The preschool years are not a time of fast growth so the child is less likely to have a ravenous appetite Offering small servings of food is still a good idea Most children are hungry after preschool and enjoy a snack when they arrive home Teach parents to make mealtime a happy and enjoyable part of the day for everyone Initiative or learning how to do new things can be strengthened by allowing a child to prepare simple foods e.g. sandwiches or spreading jelly on toast Parents should select foods based on the food pyramid, making sure to offer a variety Caution parents not to give vitamins more than recommended amount Vitamins should be out of reach A vegetarian diet should appear colorful

E. A. Dinoy BSN II-D  Preschooler development on daily activities Preschoolers have often mastered the basic skills needed for most self-care activities including feeding, dressing, washing and tooth brushing DRESSING: mot of them can dress themselves except for difficult buttons, although there may be a conflict with what the child would wear SLEEP: they are aware of their heeds, when they are tired, they often curl up on the sofa or bed and fall asleep EXERCISE: this period is an active phase so they make a great deal of exercise BATHING: they can wash and dry their hands perfectly adequately if the faucet is regulated for them CARE OF TEETH: the child should continue drinking fluorinated water or receive a prescribed oral fluoride supplement if fluoride is not provided in the water supply; one good tooth brushing session a day is more often effective than more frequent half-hearted brushings  Healthy Family functioning Parents should development

encourage

vocabulary

5 | Page Answering a preschooler’s question is often difficult because the questions are philosophical It is important for parents to guide a child through struggles without discouraging the child’s right to have an opinion Time-out is a good technique to correct behaviors for parents to continue through the preschool years

Parental Concerns development:

r/t

normal

E. A. Dinoy BSN II-D … sense of time is still distorted so that they are not comforted by assurances … sense of limited

distance

is

also

still

 Behavioral Variations A combination of keen imagination and immature reasoning results in common behavior variations in preschooler TELLING TALL TALES: stretching stories to make them seem more interesting is a phenomenon frequently encountered IMAGINARY FRIENDS: many have imaginary friend that plays with them

 Fears Because preschoolers imagination is so active, it can lead to a number of fears FEAR OF THE DARK: an example of fear heightened by a child’s vivid imagination: a stuffed toy by daylight becomes a threatening monster in the dark … They may be reluctant to go to bed or to go back to sleep by themselves unless a light is left on FEAR OF SEPARATION OR ABANDONMENT: their keen imagination allows them to believe that they are being deserted when they are not

DIFFICULTY SHARING: sharing is a concept that first comes to be understood around the age of 3 years then around three years of age, children begin to think understand that some things are theirs, some belong to others and some belong to both … They must have property rights

experience in

REGRESSION: some, generally in relation to stress, revert to behavior they previously outgrew such as thumb sucking, negativism, loss of bladder control and inability to separate from their parents

6 | Page SIBLING RIVALRY: jealousy f a brother or sister may first become evident during this period, partly because they have enough vocabulary to express how they feel  Preparing for a new sibling Introduction of a new sibling is a major happening that parents need to take special steps to be certain their preschooler will be prepared. There is no rule when to begin, but it should be before the time when the child begins to feel the difference the new baby will make  Sex education Children in this period become accurately aware of the difference between boys and girls possibly because this may be the first time in their lives they are exposed to genitalia of the opposite sex  Choosing a Preschool/Child Care Center The main purpose of a childcare center is to provide childcare while parents work or are otherwise occupied These centers are dedicated to stimulating the children’s sense of creativity and initiative and introducing them to new experiences and social contacts they would not ordinarily receive at home

E. A. Dinoy BSN II-D  Preparing Child for School Essential to this preparation is the parent’s attitude. If school is always discussed as something to look forward to, as an adventure that will be satisfying and rewarding, then the child view it from early on as a positive experience  Broken fluency Developing language is such a complicated process that children from 26 years of age are typically having speech difficulty that parents may interpret as stuttering  Bathroom Language Many preschoolers imitate the vocabularies of their parents or older children in the family so well during this time that they incorporate swear words into their vocabularies. Parents may have to be reminded that a child does not understand what the words mean; he/she has simply heard them, just as he or she has decided to use them. Correction should be unemotional; for example, “That’s not a word we like to hear you use. When you’re angry, why don’t you say ‘fudge’ (or whatever)? The correcting is no different from that involvement when a child uses poor grammar.

7 | Page

E. A. Dinoy BSN II-D If parents become emotional, a child realizes the value of such words and may continue using them for the attention they create.

Source: Pilitterri, A., 2003. Maternal and Child Health Nursing: Care of the Childbearing and Childrearing family. Philippines: Lippicott Williams and Wilkins.