Toddlers believe rules are absolute and behave out of fear of punishment.
The toddler will respond with good behavior for positive feedback. These values and beliefs are learned. Preschoolers frequently express their values by stating who or what they like or what they want to be when they grow up.
Preschoolers receive modeling of values from involved adults, peers, as they develop their morality. School-Age children’s values come from religion, cultural, and parental values influences. These factors shape a child’s moral development, and concept of right and wrong.
School-age children are able to make decisions related to moral and ethical issues.
Parents may cater to their toddler when they are misbehaving, giving them more attention when they are bad than when they are good. This make the toddler believe that behaving badly gets their parents attention. Parents need to remember to reward good behavior, and to emphasize rewards for acceptable behavior and minimizing attention for unwanted behavior.
Parents may not have firm and established rules, making it confusing for the toddler to distinguish right from wrong. Peers or inappropriate content on television can negatively influence preschooler’s values and beliefs.
Parents may have a poor morals and value system themselves, inadvertently teaching their preschoolers the same behaviors. School-age children may bend to peer pressure to gain the acceptance of their peers.
School-Age children may cheat due a desire to win, or pressure from their parents and peers to be great.
Short Answer Questions
Address the following based on the above assessment findings. Expected answers will be 1-2 paragraphs in length. Cite and reference outside sources used.
1) Compare and contrast identified similarities as well as differences in expected assessment across the childhood age groups.
Across the stages of development from toddler up to school age children there is a significant difference in the amount of guidance needed and the amount independence required. The differences are evident when examining how each developmental phase interacts and responds within each health assessment pattern. Toddler and preschool children need more structure and routine, whether it’s brushing their teeth or bedtime rituals. School-aged children, on the other hand, require more independence and trust in decisions while still being guided and reassured as the develop their own sense of identity. There are similarities as amongst the age groups as well, such as all of the children moving towards a state of autonomy and the ability to express themselves adequately and be heard by either their parents, their peers, or both. Additionally, all of the different age groups have the need for a structured and healthy home environment in order to grow and develop.
2) Summarize how a nurse would handle physical assessments, examinations, education, and communication differently with children versus adults. Consider spirituality and cultural differences in your answer.
When the nurse is caring for a child, the nurse must remember that they are essentially caring for the child and the parent (Jarvis, 2012). For a nurse, the assessment, examination and interaction with a child patient offers its own set of challenges and requires a different approach from that of an adult. When dealing the toddler and preschooler, the nurse should visit with the parent first, letting the child size the nurse up. The nurse can assess child on how they interact and react to the parent and the nurse. This allows the child to see that the caregiver has accepted and trusts the nurse. For the toddler and the preschooler, the parent will be providing most, if not all of the health history. When beginning the physical assessment on the child, move slow and approach them slowly while seeming happy and unthreatening.
The nurse should allow the child to hold instruments, like a stethoscope, during the physical exam to help them feel like they are involved in their own care. Having parents there add security and support for children, and also can help with the ease of assessing the child without them realizing that they are being assessed. With children of each stage of development, the nurse must be cognizant of verbal and non-verbal cues provided by the child. The nurse should be mindful that there could be cultural and/or spiritual considerations to take into account, like when undressing a child of the opposite sex.
The nurse needs to ensure that the caregiver and the child feel comfortable. With both children and adults, assessment should start with least invasive and progress leaving most invasive last. School-Age children should be assed like either children or adults depending on their developmental age. Adult assessment can be more direct than that of a child. Ask adults open ended questions, listen to their complaints, and educate as needed.
Current Nursing. (2012). Theory of Psychosocial Development: Erik H. Erikson. Retrieved From http://currentnursing.com/nursing_theory/theory_of_psychosocial_development.html
Edelman, C., Kudzma, E., Mandle, C. (2010). Health Promotion throughout the Life Span [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books /9780323056625
Jarvis, C. (2012). Physical Examination and Health Assessment [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-1-4377-0151-7