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Nursing School

The Toddler
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from class notes

The Toddler (1-3 yrs)


- Psychosocial Growth & Development: Erikson’s Autonomy vs. Shame & Doubt; they will have temper tantrums - DON”T GIVE IN (it’s the same for adolescents, as well), frequent mood swings, really need discipline, the lessons learned at this stage will shape future behavior, they need adults to set limits, they need to learn rules, this is the “no” stage where they want to be in control (give them simple either or choices, don’t give them a chance to say no), still very egocentric, need consistency & an established routine provides a sense of security


- Cognitive Developemnt:

- Piaget’s Sensorimotor Stage:      

            - 5th phase: Tertiary Circular Reactions - 12-18 months

                        - experiment w/new ways to reach desired outcome, they do things just to see what happens

                        - turn cups upside down to make it empty instead of drinking it

                        - become aware of relationship between 2 events but can’t transfer knowledge to new situations

                        - more aware of object permanence & existence of unseen objects

            - 6th phase: Invention of New Means Through Mental Combination - 19-24 months

                        - search for objects in potential hiding places, will actively search for things

                        - imitation displays a greater meaning & understanding

                        - they will repeat swear words & gestures

                        - limited & exaggerated concept of time so be concrete in explanations of time

                        - use their frame of reference for time: “we’ll go to lunch when the show is over”


- Pre-Operational Phase:

            - Pre-Conceptual Stage: 2-4 years, behavior very egocentric, imagination @ its peak

                        - not logical or deductive in reasoning

                        - “magical thinking” they feel that if they think something it will come true

                        - “animism” giving life like qualities to inanimate objects


- Spiritual Development:

            - Stage 1 - Intuitive Projective: learn through imitating main role models, religious teachings come from family

                        - emulate practices of role models

                        - assimilate behavior of role models (prayers @ dinner...)


- Physical Development:

- Growth: 4-6 pounds/year - birthweight quadrouples by 2 years, pot bellied, belly & head large, short legs

- Neuro: brain cells continue to increase in size & brain growth 75% complete, VERY short attention span, the 5 senses are becoming well coordinated

- Cardio-Pulmonary: internal structures of ear/throat are short & straight which puts them at risk for ear/respiratory infections; age 6-7 structures elongate & curve (less ear infections), resps still abdominal 25/min, HR 90-100, BP 70-100/50-60

- GI: salivary glands matured & functioning well, gastric acidity increases & food is broken down, stomach capacity increases & peristalsis decreases so they have fewer BM’s

- Musculoskeletal: bone growth continues & bones in arches develop giving them adult looking feet (1 yr olds have flat feet), these kids only really need shoes when going outside for protection

- Toilet education: is a PROCESS, does not happen overnight, age 2 for girls, 2 for boys, child must be ready & have a desire, boys are later d/t mom doing all of the teaching & mom isn’t a good role model for peeing standing up, child needs muscle control, desire (most important), & must be able to communicate the need to go

- Teething: 5-6 months - 1 yr may have 5 or 6 teeth but by 2 all primary teeth should be present (20), go to the dentist to teach them it’s not scary, teach to brush teeth, may not work well


- Fine Motor Development: sort shapes, hold crayon w/fist “coloring,” no staying inside the lines (a 5 yr old should be able to stay inside the lines), learn to dress selves & button large buttons & unbutton smaller buttons (it’s easier), engage in play w/large piece puzzles, parallel play: next to each other but not playing together

no concept of sharing d/t egocentrism


- Gross Motor Development: acquisition of locomotion

- 15 months walk w/assist

- 18 months try to run & fall

- 2 years walk & run well


- Language Development: 1500 words in 2-3 word sentences, comprehension is greater than speech ability, can recall & pronounce words when provided w/stimulus (picture in a book), learns by repitition


-Social Development:

- Play - parallel

- Sibling Rivalry - dethroned & tend to regress for a brief period (return to infant behavior)

- Regression - very common, often d/t sibling, doesn’t last long

- Sexuality - finding their genitals, masturbation, nothing wrong w/it, will do it when stressed, age of 2 should be able to identify boys & girls based on outward appearance, can tell you what role each sex has “mommy cooks & daddy watches tv,” use correct medical terminology (penis & vagina), take the opportunity to teach good touch, bad touch


- Nutritional Needs: 1300-1500 calories/day

- physiologic anorexia: periods of eating less between periods of growth

- probably prefer small portions & small plates & cups & the same plates/cups all the time

- only give a small serving size, according to age - don’t put a lot on their plates they won’t eat it all


- Sleep/Rest: need 10-12 hrs/day, take afternoon naps, REM is 20-30% of sleep, may/should sleep through the night, normal sleep pattern emerges by 2-3 years


- Health Maintenence:

- Immunizations-

- Yearly Checkups - to ensure growth

- Safety - bike helmet, seatbelts/carseats, etc...

NOTHING on this website is to take the place of a physician's advice. Everything in this site is meant to be only a helpful tool for me and my nursing student friends.

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