Pediatric Growth, Development, and Health Promotion

Flashcards covering growth, development, milestones, safety, and nursing interventions for infants, toddlers, and preschoolers.

14-Month-Old Discipline Strategy

Disciplining a $14\text{-month-old}$ involves setting limits to ensure safety and redirecting negative behavior toward a preferred positive action.

2-Year-Old Feeding Skill Milestone

An expected developmental eating skill observed in a $2\text{-year-old}$ is using a cup to drink independently.

Parallel Play

A form of play characteristic of toddlers where two children sit near each other playing with separate toys (e.g., separate dolls) without direct interaction or sharing.

Temper Tantrum Prevention in Preschoolers

An effective nursing strategy to prevent temper tantrums in a $3\text{-year-old}$ is setting consistent limits on the child's behavior.

Appropriate Toy for an 18-Month-Old

Non-toxic finger paints, which allow creative expression without presenting a severe choking risk.

Language Development at 12 Months

An infant at $12\text{ months}$ of age typically says $3\text{ to }5$ words with meaning in addition to "momma" and "dada".

Communicating Time to Young Children

Relating time to concrete daily events or routines (e.g., "when lunch time begins for everyone") rather than clock units or minutes.

Preschooler Post-Procedure Reaction Management

Applying a band-aid to a $3\text{-year-old}$ who is distressed after a procedure, directly addressing their cognitive fear of skin mutilation and loss of body integrity.

Toilet Training Readiness Age

Toddlers typically begin showing interest in and awareness of bowel and bladder elimination around $18\text{ months}$ of age.

Safe Toddler Snack

Soft foods like bananas; hard, round, or sticky foods such as grapes, popcorn, and peanuts pose high choking hazards.

Oral Liquid Antibiotic Administration (Toddler)

Inserting the syringe into the child's inner cheek and slowly depressing the plunger to administer liquid oral medication safely.

Autonomy vs. Shame and Doubt

Erikson's psychosocial stage for toddlers, where children relinquish dependence on caregivers to perform small tasks independently and gain self-worth.

Overcoming Dependency in Toddlers

If parents keep a toddler dependent in areas where the child is capable of using skills, the toddler will develop a sense of shame.

Toddler Choice Strategy

Offering two simple, acceptable options in the moment to reduce toddler resistance, shift negativism, and successfully complete a task.

Managing Toddler Negativism

Avoiding the use of the word "NO" in directives and refraining from framing questions in a manner that allows a "NO" response.

Toddler Ritualism

Maintaining consistent routines (such as bedtime and naptime habits) to provide comfort and emotional security, especially during hospitalization.

Separation Anxiety Completion Age

Separation anxiety is typically complete by $18\text{ months}$ of age.

Piaget Preoperational Stage

The cognitive development stage characteristic of toddlers and preschoolers, marked by animism, egocentrism, irreversibility, lack of conservation, and magical thinking.

Animism

Attributing lifelike qualities, feelings, or intentions to inanimate objects (e.g., believing a medical machine might bite).

Irreversibility

The cognitive inability of young children in the preoperational stage to mentally or physically reverse an initiated action.

Egocentrism

The cognitive inability to envision situations or viewpoints from any perspective other than one's own.

Conservation (Piaget)

The understanding that physical properties (mass, volume, shape, length) remain constant despite changes in physical appearance or container shape; absent in preoperational children.

Magical Thinking

The preschooler's cognitive belief that thoughts can influence external events or that whatever adults tell them is literally true.

Initiative vs. Guilt

Erikson's psychosocial stage for preschoolers, where children develop initiative through active exploration and creativity, but risk feeling guilt if behaviors conflict with expectations.

Preschooler Self-Esteem Evaluation

Preschoolers evaluate their own behaviors based on external feedback from others and require positive reinforcement (PRIDE skills) to foster self-worth.

Preschooler Behavioral Parameters

Establishing reasonable rules prior to new experiences and reinforcing them during high-energy or stressful situations.

Signs of Stress in Preschoolers

Behavioral and physical manifestations of stress including developmental regression, somatic complaints (belly aches, headaches), and withdrawal.

Preschooler Stress Prevention

Scheduling adequate rest and preparing the child for upcoming events in advance (e.g., reading a book about the dentist prior to a visit).

Imaginary Playmates

Pretend companions created by preschoolers to manage major life changes (relocation, new sibling) or acquire new skills; should be acknowledged as real to the child without allowing blame assignment.

Common Preschooler Fears

Fears including darkness, being left alone, animals (snakes, large dogs), ghosts, body mutilation/castration, and objects or persons associated with pain.

Medical Play and Desensitization

Using a stuffed animal or doll to demonstrate a procedure (e.g., trying a nebulizer mask on a teddy bear first) to reduce anxiety and gain cooperation.

Choice-Based Vital Signs Intervention

Offering a resistant toddler a choice between two positive activities (e.g., playing with bubbles or playdough) while taking vital signs to promote autonomy.

Midday Task Resistance Management

Inquiring about the child's home sleep schedule and routine when a toddler routinely becomes uncooperative during the middle of the day.

1-Year Weight Calculation

An infant's birth weight typically triples by $1\text{ year}$ of age (e.g., a term neonate born at $7\,\text{lb}\,8\,\text{oz}$ should weigh approximately $22.5\,\text{lb}$ at $12\text{ months}$).

Gross Motor Milestone: Head Control & Rolling (4 Months)

By $4\text{ months}$ of age, an infant exhibits no head lag and rolls from belly to back.

Gross Motor Milestone: Rolling & Assisted Sitting (5-6 Months)

By $5\text{ to }6\text{ months}$ of age, an infant rolls from back to belly and sits with assistance.

Gross Motor Milestone: Unassisted Sitting (8 Months)

An infant achieves the gross motor skill of sitting unassisted at $8\text{ months}$ of age.

Gross Motor Milestone: Creeping/Crawling (9-10 Months)

An infant creeps and crawls (often backwards at first) at $9\text{ to }10\text{ months}$ of age.

Gross Motor Milestone: Cruising (11-12 Months)

An infant cruises well along furniture between $11\text{ and }12\text{ months}$ of age.

Gross Motor Milestone: Independent Walking (12 Months)

An infant walks a few steps independently at $12\text{ months}$ of age.

Fine Motor Milestone: Hands Open & Toy Shaking (2-4 Months)

An infant opens and closes hands and shakes toys between $2\text{ and }4\text{ months}$ of age.

Fine Motor Milestone: Hand-to-Hand Object Transfer (7 Months)

An infant transfers objects between hands at $7\text{ months}$ of age.

Fine Motor Milestone: Pincer Grasp (9-10 Months)

An infant develops the pincer grasp to feed self and drinks from a cup with assistance at $9\text{ to }10\text{ months}$ of age.

Activity to Improve Pincer Grasp

Turning the pages of a hard cover book is an activity recommended to help refine a $12\text{-month-old's}$ pincer grasp.

Fine Motor Milestone: Utensil Use & Hand Dominance (12 Months)

By $12\text{ months}$ and into toddlerhood, an infant begins holding a spoon, holds a crayon to mark paper, and develops hand dominance.

Language Milestone: Cooing & Laughing (2-4 Months)

Coos and laughs out loud develop between $2\text{ and }4\text{ months}$ of age.

Language Milestone: Babbling (6 Months)

An infant typically begins babbling at $6\text{ months}$ of age.

Language Milestone: Meaningful Words & Commands (9-10 Months)

An infant says "dada" and "mama" with specific meaning and follows simple verbal commands at $9\text{ to }10\text{ months}$ of age.

Primitive Reflex Disappearance Age

The majority of an infant's primitive reflexes should disappear by $4\text{ months}$ of age.

Infant Pacifier Guidance

Pacifiers provide comfort and satisfy an infant's non-nutritive sucking needs when they do not need to eat.

Establishment of Infant Dental Provider

Parents should establish a dental provider for their child by $1\text{ year}$ of age.

Infant Teething Relief

Teething pain can be managed using a frozen teething ring or appropriately dosed Tylenol.

Fluoride Toothpaste Guidelines for Infants

Brushing with a smear of fluoride toothpaste should begin as soon as the first tooth erupts; delaying fluoride toothpaste until $2\text{ years}$ of age requires further teaching.

Sequential Order of Infant Nutrition Introduction

1. Breastmilk/formula only, 2. Add rice cereal, 3. Add fruits/veggies, 4. Add proteins, 5. Child may have honey (after $1\text{ year}$).

Top Cause of Infant Fatal Injury (CDC)

Unintentional suffocation ranks as the number one cause of injury-related death in infants under $1\text{ year}$ of age.

Top Cause of Non-Fatal Infant Injury (CDC)

Falls rank as the leading cause of non-fatal injuries in infants.

SIDS (Sudden Infant Death Syndrome)

An unexplained infant death resulting from an unknown medical abnormality or vulnerability, classified as a natural death.

Accidental Suffocation (SUID)

A sleep-related infant death resulting from full or partial airway obstruction causing oxygen deprivation and carbon dioxide buildup, classified as accidental.

ABCs of Safe Sleep

Evidence-based sleep guidelines dictating that babies should sleep: Alone, on their Backs, in a safe Crib.

Room Sharing Guideline

The American Academy of Pediatrics recommends keeping the crib in the parents' room (room sharing) until the infant is $12\text{ months}$ old.

Swaddling Safety Limit

Swaddling with arms in or out is safe until the infant shows signs of attempting to roll over, which typically occurs at $4\text{ months}$ of age.

Environmental Risk Factors for SUID/SIDS

Prone or side sleep positions, soft bedding, co-sleeping/bed sharing, tobacco smoke exposure, overheating, and caregiver alcohol or drug use.

Crib Environment Hazards

Pillows, heavy blankets, stuffed animals, bumper pads, propped bottles, and hanging cords or strings near the crib.

Rear-Facing Car Seat Recommendation

All infants and toddlers should ride in a rear-facing car seat with a 5-point harness until at least $2\text{ years}$ of age or until reaching maximum manufacturer weight/height limits.

Car Seat Chest Clip Placement

The car seat chest clip must be securely buckled and positioned level with the child's nipple line.

Car Seat Outerwear Safety Rule

Bulky coats or winter jackets must not be worn underneath car seat harness straps because they create slack and prevent proper strap tightness.

Vehicle Heat Stroke Risk

Leaving a child unattended in a motor vehicle can result in fatal heat stroke, as dangerous internal vehicle temperatures occur within $15\text{ to }30\text{ minutes}$.

Back Seat Age Requirement

All children younger than $13\text{ years}$ of age should ride secured in the back seat of a vehicle.

Infant Fall Risk Factors

Cephalocaudal physical development (disproportionately large/heavy head) combined with developing motor skills without cognitive awareness of hazards.

Infant Drowning Risks

Infants can drown in small amounts of standing water (bathtubs, mop buckets, toilets) because they cannot swim and lack understanding of cause and effect.

Infant Sunscreen Application Age

SPF sunscreen is only recommended for infants $6\text{ months}$ of age or older; infants under $6\text{ months}$ must be kept in the shade and covered.

Button Battery Ingestion Danger

Ingestion of flat lithium cell button batteries (e.g., CR2032) causes rapid chemical burns and severe tissue necrosis within hours.

Medication Storage Safety

Over-the-counter and prescription medications must be stored securely out of reach because young children frequently mistake colorful pills for candy.

Primary Bedside Nursing Principle

"BABY FIRST, NURSING TASK SECOND" — prioritizing emotional connection, play, singing, and rapport before performing clinical tasks.

Hospital Crib Safety Standards

Keeping all four crib side rails completely raised and ensuring no loose medication wrappers, caps, or equipment remain inside the bed.

Cephalocaudal Development Pattern

The physical growth and developmental progression extending from head to tail, where head control is mastered before trunk and leg movement.

Child Abuse Fatality Ranking in Kentucky

Kentucky consistently ranks between $1\text{st and }3\text{rd}$ nationally per year in child fatalities resulting from abuse.

Tummy Time Developmental Practice

Placing a $2\text{-month-old}$ infant on their stomach on a firm blanket on the floor with a high-contrast toy nearby to build neck muscle strength and eliminate head lag.