health promotion of the preschooler
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What is the most significant lifestyle change fir the preschooler?
- Preschooler is ages 3-5 and they are preparing for school
- Experience brief and prolonged separation
- Use language and mental symbolization
- Increased attention span and memory
What biologic development occurs in the preschooler?
- Physical growth slows and stabilizes
- Average weight gain remains about 5lb/yr
- Average height increases 2.5-3 in/yr
- Body systems mature and stabilize; can adjust to moderate stress and change
What gross and fine motor behavior occurs in the preschooler?
- Gross motor: walking, running, climbing, and jumping well established
- Refinement in eye-hand and muscle coordination: drawing, artwork, skillful manipulation
What psychological development occurs in the preschooler?
- Erikson: Initiative vs GuiltChief psychosocial task of preschool period
- Feelings of guilt, anxiety, and fear may result from thoughts that different from expected behavior
- Development of conscience (superego)
- Learning right from wrong, moral development
What stage of Piaget is the preschooler in?
- Preoperational phase spans 2-7 years and is divided into two stages
- Preconceptual phase: 2-4 yrs
- Intuitive thought phase: 4-7 yrs
- Shifts from egocentric thought to social awareness
- Able to consider other viewpoints
- Egocentricity still evident
What cognitive development occurs in the preschoolers?
- Readiness for school and scholastic learning by age 5-6
- Language continues to develop
- Concept of causality beginning to develop
- Concept of time incompletely understood
- Continued use of "magical thinking"
What moral development occurs in the preschooler?
- Basic level of moral judgement leading to a punishment and obedience orientation
- Naive instrumental orientation- actions to satisfy own needs and less concern of needs of others
- Concrete sense of justice and fairness
What spiritual development occurs in the preschooler?
- Knowledge of faith and religion learned from significant others and religious practices
- Development of conscience strongly linked to spiritual development
- May interpret illness as punishment from God
How does body image develop in the preschooler?
- Increasing comprehension of "desirable" appearance
- Aware of racial identity, differences in appearances, and biases
- Poorly defined body boundaries: fear that if skin is "broken" all the blood and insides will come out
- Frightened by intrusive experiences
How does sexuality develop in the preschooler?
- Form strong attachment to the opposite-sex parent while identifying with the same-sex parent
- Become concerned with modesty
- Sex role imitation, "dressing up like mommy or daddy"
- Sexual exploration more pronounced
- Questions arise about sexual reproduction
What is the social development of a preschooler?
- Individualization-separation process is completed
- Overcome stranger anxiety and fear of separation from parents
- Still need parental security and guidance
- Security from familiar objects
- Play therapy beneficial for working through fears, anxieties, and fantasies
How does language develop in the preschooler?
- Major mode of communication and social interaction
- Vocabulary increases dramatically between ages 2-5 yrs
- Complexity of language uses increases between 2-5 yrs (3-4 yr means 3-4 word sentences, 5+ word sentences by age 5)
What kind of play does the preschooler partake in?
- Associative play (group play with goals and organization)
- Imitative play
- Imaginative play and playmates
- Dramatic play
- *Limit TV and computer time
What is the preschoolers personal-social behavior?
- Willing to please
- Have internalized values and standards of family and culture
- May begin to challenge parental values
How do you determine a child's readiness for school?
Developmental screening tools may be used in preschool and kindergarten, however there is no absolute indicator
How can discuss sex education with a preschooler?
- Find out what the children already know and think
- Be honest
- Avoid over-answering the question
- Sexual exploration and sexual curiosity
What things are preschoolers usually afraid of?
- Being left alone
- Objects or persons associated with pain
- Techniques for desensitization should be used to overcome fears
How do preschoolers deal with stress? How can this be controlled?
- Minimum amounts of stress can be beneficial
- Parental awareness of signs of stress in child;s life
- Prevention of stress
- Schedule adequate rest
- Prepare child for upcoming changes to maximize coping strategies
Why do preschoolers display aggression?
- Aggression is any behavior that attempts to hurt person or destroy property
- May be influences by biologic, sociocultural, and familiar variable
- Factors that increase aggressive behavior include gender, frustration, modeling, and reinforcement
- Positive reinforcement works better than negative reinforcement
What speech problems may occur with the preschooler?
- Stuttering and stammering
- Dyslalia: articulation problems
- Denver Articulation Screening Examination (DASE) tool for assessing speech problems
How can you promote nutrition for the preschooler?
- Caloric requirements are approx 90 kcal/kg wit <30% of diet being fat
- Fluid requirements approx 100 ml/kg depending on activity and climate
- Children like one food (food fads) and have strong tastes
- Consume about 50% of an adult size portion
How can you promote sleep for the preschooler? What are some common sleep problems?
- 12 hrs of sleep per night with infrequent naps
- Consistent bedtime routine
- May have nightmares or sleep terrors (occur in the first few hours of sleep)
How can you promote dental health for the preschooler?
- Eruption of deciduous teeth is complete
- Professional care and prophylaxis to prevent caries
- Nutrition to prevent caries
- Child learning to brush teeth with parent's help
- May need fluoride supplements (controversial)
How can you prevent injury for the preschooler?
- Safety education for the child:
- Stranger danger teaching
- How to interact with animals
- Good touch vs bad touch teaching
- Car and road safety
- Firearm safety
- Bike safety
- Fire safety
- Complete annual physical exams and immunizations
How can you provide anticipatory guidance for the families of preschoolers?
- Childcare focus shifts from protection to education
- Children begin questioning previous teachings of parents
- Children begin to prefer companionship of peers, but still need their patients
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