NRSE250 preschool child

health and promotion for preschool children

• Curious about their body

• Beginning to understand cause and effect and that they can play a role of their own health

• Still need assistance from adults to understand how health behaviors affect them

preschool age

3-6 years old

preschool growth (weight and height)

2 kg (4 lb) and 7 cm (2 in.) per year

preschool age growth and development

• More developed body suture with more control over themselves

• More mature language- like an adult

preschool: kidneys/ GI

•  full maturity; voluntary control

preschool: heart/lungs

• increased capacity 

• Decreased respiratory rate 22-30

• BP 100/60- HR 80-120 bpm

preschool: ears

• Change shape, less otitis media

immune

• boosted immune response

• Immune continues to develop

musculoskeletal/ neuro

• advances fine/gross motor skills

• Better coordination and ease running, walking, climbing 

dental

• Preschool age all baby teeth should have erupted through gums

• End of preschool (age 6) baby teeth falling out, primary teeth coming in

• Primary teeth erupt sooner in girls 

• Parents help brush their teeth, let kid lead

• Ensure fluoride use, try to start introducing flossing

development landmarks: 3 years

• Open doors, kick balls, runs, jumps 

• Knows their own name, gender, and age 

• Describes action in picture books 

• Able to put on some clothing and shoes, east without assistance 

development landmarks: 4 years

• Climbs ladder, throws a ball overhead, holds pencil

• Ask why, when, how, and the meaning of words

• Washes and duties hands, can brush teeth

• Draws a person with two or three parts 

• Rides with training wheels 

development landmarks: 5 years

• Names four or five colors, can cut and paste, knows address and telephone number, prints some letters

• Draws a person  with head, body, arms, and legs

• Engages in make believe, dress up, role playing

development landmarks: 6 years

• Bounces a ball 4-6 times, can skate and ride a bike, toes shoelaces, understands right from left

• Draws a person with 6 body parts with figure with clothing on

preschool nutrition

1,000-1,600 calories a day

• calcium should be 700-1000 mg/day

• Adults demonstrate good habits with balanced diet: vegetables, grains, proteins, dairy

• Introduce lean meats, seafood, nuts, seeds and beans

• Specific issues impact this age: bone growth, iron deficient anemia, monitor salt/sugar/milk intake

preschool nutrition (what to avoid)

• Avoid: fast food (saturated and trans fats)

• Decrease salt and sugar in diet

• Often refuse to try new foods, important to provide nutritional food choices 

preschool high risk allergens

nuts, eggs, soy, shellfish

• milk, peanuts, tree nuts, soybeans, fish, shellfish, glutens, seeds

lactose intolerance

Lactose intolerance can show up at this age: diarrhea, GI effects, stomach hiring, gas, bloating, cramping (treated by eliminating lactose from diet: dairy, cheese) most common in African Americas, Asian Americans and native Americans 

allergies

• Introduce epinephrine 

• know signs and symptoms and how to use epipen, call 911

• Allergy action plan must be known and understood by peers and teachers

preschool age sleep

• Rituals still important, night terrors (frightening dreams, sleep state may not remember) still an issue, sleep walk

• 8- 12 hours of sleep per night 

• Naps are not needed 

• Pro- longed bedtime routine, may have resistant to bedtime routine, set ritual for them to stick to

vision

• Should approach 20/20 by 6 years of age

• Possibility of developing amblyopia decreases

• Depth and color vision becomes fully established

• Visual capacity can deteriorate rather than improve, however early detection with Snellen Screening tests in school and well- child check-ups

color blindness

can be problematic in school because many cues depend on color recognition (Ishihasa's test is used for color blindness)

hearing

• Hearing develops to the level of an adult

• Can be hindered by recurring otitis media

• If parents notice language delay should consider hearing

• There are several audiometric methods to test hearing – may be done at school screening

language

Develop receptive language: Language that retains information. Children can comprehend the meaning of words and phrases that are not a part of their expressive vocabulary and can make associations between concepts although they are unable to explain these concepts.

• Mimic adult speech

boosters

• DTaP: 4th year

• MMR: between 4 to 6 years old

• Varicella

immunization concerns

 religion, safety of immunizations, importance of accurate information

activity/ exercise

• Play primary activity for this age

• Many activities involve other children

• Begin to cope with limit setting better than toddler stage

• Need to encourage parents to avoid long term use of electronic devices – This limits the child's exposure to interactions with other children and adults – disengages the mind

expanding influences

interactions with peers, siblings, preparation for school, socializing, play, fantasy

preschool initiative

• Encourage child to create and to try new things

• Teach them that mistakes do not make them bad, but this is how we learn

• Miss take= try task again

• Allow and encourage a child's ambitions, new abilities, ideas, and opinions 

• Let them do things on their own

preschool guilt

• Scolding instead of encourage, getting angry over mistakes, discouraging them from risking, focus on failures

coping skills

maturing, fewer tantrums, better ability to problem solve

accidents and injuries

leading cause of death

• Predictable and preventable

• May chase a ball into the street, increased sports related injuries 

• Of all injuries, 2/3 occur in children and adolescents – accidental injury major cause of death 

• Preschoolers: falls, poisonings, thermal injuries

burns

• Scald/direct flame burns are a major hazard for pre school

• Teach danger of matches, open flames, hot objects

drowning

swimming pool risk (lower in bathtub)

• Second highest cause of health in children (following MVA)

• Fencing, flotation device, water survival, supervision

bicycle

• Age-appropriate limits needed

• Helmet: with transition from tricycle to bicycle

lead poisoning (exposure, prevention)

can cause irreversible brain damage

• Developmental delay, learning difficulties, irritability, loss of appetite, weight loss, hearing loss

• Exposure: old paint, old toys, pottery, cosmetics, living in older homes

• Prevention: teach parents about risks, encourage diet low in fat because lead is retained in fat, encourage Vit C, calcium, and iron intake, wash hands and toys, clean dusty surfaces, run cold water

poisoning

• Factors impacting risk exposure 

• Poisonings: More than half occur in children <6 years old

• Poison control number

Forms of poison (solids, liquids, sprays, invisibles)

• Solids: Pills, vitamins, aspirin, lipstick 

• Liquids: Cleaning products, fuel, alcohol

• Sprays: Furniture polish, oven cleaner

• Invisibles: Carbon monoxide, space heater fumes

booster seat

• Booster seat until 4’9” AND are between 8-12 yrs of age

kids in the backseat until what age

13 yeas old (due to airbag dangers)

pedestrian accident potential at home

• Killed/injured in driveway by backing vehicle

Reyes syndrome (rare)

• Occurs in children who were given aspirin(acetyl salicylic acid) when they had chickenpox or the flu

• Causes brain swelling and liver damage – 30% have brain injury and death

• Most often seen in children ages 4 to 12

Reyes syndrome symptoms

• vomiting, irritability, confusion brain swelling, fatty liver and if left untreated coma and death

can ASA transfer via breastmilk

ASA= asprin

yes

Reyes syndrome changes

• Aspirin is no longer recommended for routine use in children but other products ALSO contain salicylates: Pepto Bismol, Alka Seltzer- need to educate parents to avoid these!