Parenting Development Presentation

Nursing Care of a
Family With a
Toddler
Objectives:
• Describe normal growth and development of a
toddler as well as common parental concerns
• Assess a toddler for normal growth and

development milestones.
• Formulate nursing diagnoses related to toddler

growth and development or parental concerns
regarding growth and development.
• Identify expected outcomes for nursing care of a

toddler as well as help parents manage seamless
transitions across differing health care settings.
• Implement nursing care to promote normal growth

and development of a toddler, such as discussing
toddler developmental milestones with parents.
Physical
Development
While toddlers are making great strides
developmentally, their physical growth begins to slow.
Weight, Height, Head Circumference, and Body

Mass Index
• A child gains only about 5 to 6 lb (2.5 kg) and 5 in. (12
cm) a year during the toddler period, much less than the
rate of growth during the infant year.
• Head circumference increases only about 2 cm during
the second year compared to about 12 cm during the
first year.
⚬ Head circumference equals chest circumference at 6
months to 1 year of age.
⚬ By 2 years, chest circumference should have grown
greater than that of the head.
• Body mass index (BMI) is usually calculated beginning
with the toddler age to identify toddlers who are
overweight or underweight.
⚬ Calculate at: http://apps.nccd.cdc.gov/dnpabmi/
Body Contour
• Toddlers typically have a prominent • They also have a forward curve of the spine
abdomen. at the sacral area (lordosis).
⚬ Although they are walking well, their ⚬ As they become more experienced at
abdominal muscles are not yet walking, this will correct itself naturally.
strong enough to support abdominal ⚬ Many toddlers waddle or walk with a
contents as well as they will be able wide stance
Body Systems
• Respirations slow slightly but continue to • Stomach secretions become more acid;
be mainly abdominal. therefore, gastrointestinal infections also
become less common.
• Heart rate slows from 110 to 90 beats/min.
• Stomach capacity increases to the point a
• Blood pressure increases to about 99/64 child can eat three meals a day.
mmHg.
• Control of the urinary and anal sphincters
• The brain develops to about 90% of its becomes possible with complete
adult size. myelination of the spinal cord so toilet
training is possible.
• In the respiratory system, the lumens of
• Immune globulin (Ig)G and IgM antibody
vessels enlarge progressively so the threat
production becomes mature at 2 years of
of lower respiratory infection lessens.
age. The passive immunity obtained during
intrauterine life is no longer operative.
Teeth
• Teeth Eight new teeth (the canines and the fi
rst molars) erupt during the second year.
• All 20 deciduous teeth are generally present

by 2.5 to 3 years of age
Parental Difficulties in Evaluating Illness in Toddlers
Language
Development
Toddlerhood is a critical time for
language development
A child who is 2 years old and does not talk in

two-word, noun–verb simple sentences needs a
careful assessment to determine the cause
because this implies underdevelopment.
“No,” is used frequently by toddlers and a

manifestation of their developing autonomy
Language
Development
Develops quickest if parents respect what toddlers have to say so
children grasp the use and purpose of language.
The AAP (2012) recommends television viewing should be severely limited

until at least 2 years of age.
Urge parents to encourage language development by naming objects as

they play with their child or when they give the toddler something. It
helps children grasp the fact that words are not meaningless sounds, but
that they apply to people and objects and have uses.
Language
Development
Children should not be made to name an object before they can have it
because their vocabulary is so limited, but parents can reinforce
language by voicing the request (e.g., “You want the ball?”).
Reading aloud and describing pictures in a book is another effective way

to strengthen vocabulary. This is an additional benefit of strengthening
parent–child bonds and offering respite for parents who are tired of more
active games
Language
Development
Very active children may use fewer words than children who are less active
because they are too busy doing things to describe what it is they are
doing.
If they are spoken to in baby talk, their enunciation of words can be poor; if
they hear examples of bad grammar, they will not use good grammar.
Remind parents that pronouns are difficult for children to use correctly;
many children are 3.5 or 4 years of age before they can separate the
different uses of “I,” “me,” “him,” and “her.”
Language
Development
Cognitive
Development
Cognitive Development
(Jean Piaget)
SENSORY MOTOR STAGE

Substage 5 (12 to18 months) tertiary circular reaction - child develops
variations of old responses in approaching a new object. (trial & error
method)
Substage 6 (18 months to 2yrs) - the inventions of new means through

mental combinations. Deferred imitations and invisible displacement
occurs at this stage.
Preoperational stage (2 to 7yrs) - the childs thinking is based on concrete

perceptions and actions on immediate environment. Child uses one word
to several rather similar persons or objects.
Building Strong Parent-
Child Relationships
Open Communication: Always be

approachable and ready to listen.
Quality Time: Spending undistracted
time with children strengthens the
bond.
Affection and Support: Show physical
and verbal affection to create
emotional security.
Positive Parenting
Techniques
Encouragement over Criticism: Focus on

positive reinforcement rather than
punishment.
Setting Clear Expectations:
Communicate rules and boundaries
clearly.
Active Listening: Take time to
understand the child's perspective
without interrupting.
Effective Discipline
Strategies
Consistent consequences help

children learn accountability.
Reward good behavior to encourage
repetition.
Explain why certain behaviors are
wrong instead of using harsh
punishments.
Emotional Development
in Children
Allow children to express

emotions without judgment.
Children learn from how parents handle
emotions like anger and stress.
Teach children to understand others'

feelings by setting an example.
Socialization
• Once toddlers are walking well, they become

resistant to sitting in laps and being cuddled.
• At 15 months, children are still enthusiastic about

interacting with people, providing those people are
willing to follow them where they want to go.
• By 18 months, toddlers imitate the things they see a

parent doing, such as “study” or “sweep,” so they
seek out parents to observe and imitate.
• By 2 or more years of age, children become aware

of gender differences and may point to other
children and identify them as “boy” or “girl.”
The Role of
Parenting Styles
Authoritative: Combines warmth with
boundaries, encouraging
independence while providing
support.
Permissive: Loving but with few rules,
which may lead to lack of structure.
Authoritarian: Strict and controlling,

which can impact a child's emotional
growth.
Appropriate Toys for
Toddlers
• Things for solving problems: wood puzzles (with 4 to 12

pieces), blocks that snap together, objects to sort (by size,
shape, color, smell), and things with hooks, buttons, buckles,
and snaps
• Things for pretending and building: blocks, smaller (and
sturdy) transportation toys, construction sets, child-sized
furniture (kitchen sets, chairs, play food), dress-up clothes,
dolls with accessories, puppets, and sand and water play toys
• Things to create with: large non-toxic, washable crayons and
markers, large paintbrushes and fingerpaint, large paper for
drawing and painting, colored construction paper, toddler-
sized scissors with blunt tips, chalkboard and large chalk, and
rhythm instruments
Appropriate Toys for
Toddlers
• Picture books with more details than books for
younger children
• CD and DVD players with a variety of music (of course,
phonograph players and cassette recorders work too!)
• Things for using their large and small muscles—large
and small balls for kicking and throwing, ride-on
equipment (but probably not tricycles until children
are 3), tunnels, low climbers with soft material
underneath, and pounding and hammering toys
Discipline
• Setting rules or road signs so

children know what is expected
ofthem
• Punishment is a consequence that

result from a breakdown in
discipline or the child’s disregard of
the rules that were learned
Temper Tantrums
• The child may kick, scream, stomp

feet, shout, “No,no,no”, flail arms
and legs, bite or bang his or her
head against the floor
Separation Anxiety
• Say goodbye firmly, repeat the
explanation
Thank You

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Nursing Care of a

• Assess a toddler for normal growth and

• Formulate nursing diagnoses related to toddler

• Identify expected outcomes for nursing care of a

• Implement nursing care to promote normal growth

Weight, Height, Head Circumference, and Body

• All 20 deciduous teeth are generally present

A child who is 2 years old and does not talk in

“No,” is used frequently by toddlers and a

The AAP (2012) recommends television viewing should be severely limited

Urge parents to encourage language development by naming objects as

Reading aloud and describing pictures in a book is another effective way

SENSORY MOTOR STAGE

Substage 6 (18 months to 2yrs) - the inventions of new means through

Preoperational stage (2 to 7yrs) - the childs thinking is based on concrete

Open Communication: Always be

Encouragement over Criticism: Focus on

Consistent consequences help

Allow children to express

Teach children to understand others'

• Once toddlers are walking well, they become

• At 15 months, children are still enthusiastic about

• By 18 months, toddlers imitate the things they see a

• By 2 or more years of age, children become aware

Authoritarian: Strict and controlling,

• Things for solving problems: wood puzzles (with 4 to 12

• Setting rules or road signs so

• Punishment is a consequence that

• The child may kick, scream, stomp

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