Nursing Care of a Family with a Preschooler-

Nursing Care of a Family
with a Preschool Child

<<
PRESCHOOL PERIOD
● Preschool period is traditionally includes the years 3, 4, and 5.
● Physical growth slows considerably during this period, personality and

cognitive growth continue at a rapid rate.
● Most children of this age want to

do things for themselves.
APPEARANCE OF THE AVERAGE
PRESCHOOLER
Nursing Assessment of a
Preschooler’s Growth and
Development
PHYSICAL GROWTH
A definite change in body contour occurs during the preschool years. The wide-legged gait,
prominent lordosis and protuberant abdomen of the toddler change to slimmer, taller, and
much more childlike proportions. Here are the body types:
Ectomorphic Body Build (slim body build)
Endomorphic Body Build (large body build)

PHYSICAL GROWTH
• Handedness also begins to be obvious. A major step forward is a child’s ability to learn
extended language, which is achieved not only by motor development but also by
cognitive development.
• Children of this age who are exposed to more than one language or who live in a bilingual
family have a unique opportunity to master two languages with relative ease because of
this increased cognitive ability.
PHYSICAL GROWTH
• Lymphatic tissue begins to increase in size, particularly the tonsils; levels of immune
globulin IgG and IgA antibodies increase.
• Physiologic splitting of heart sounds may be present for the first time on auscultation;
innocent hearts murmurs may also be heard for the first time.
• Pulse rate decreases to about 85 beats/min, and blood pressure holds at about 100/60
mmHg.
PHYSICAL GROWTH
• The bladder is easily palpable above the symphysis pubis; voiding
is frequent enough (9 or 10 times a day) that play must be
interrupted, and voiding accidents may occur if a child becomes
absorbed in an activity.
• Muscles are noticeably stronger, so activities such as gymnastics

becomes possible. Many children at the beginning of the period
exhibit genu valgus (knock-knees); this disappears with
increased skeletal growth at the end of the preschool period.
PHYSICAL GROWTH
Weight, Height, Body Mass Index, and Head Circumference
• Weight gain is slight during the preschool years; the average child gains only about 4.5
lbs. (2 kg) a year.
• Height gain is also minimal during this period: only 2 to 3.5 in. (6-8 cm) a year on
average.
• Head circumference is not routinely measured at physical assessments on children over 2

years of age because it changes little after this time.
PHYSICAL GROWTH
Teeth
• Children generally have all 20 of their deciduous teeth by 3 years of age; permanent teeth
don’t replace these until school age. Preserving these teeth is important because they hold
the position for the permanent teeth as the child’s jaw grows larger.
2
DEVELOPMENTAL
MILESTONES
SUMMARY OF PRESCHOOL GROWTH AND
DEVELOPMENT
LANGUAGE DEVELOPMENT
● The extent of a 3-year-old child’s vocabulary varies depending on how much the child has been
encouraged to ask questions or participate in conversations.
● A child typically, however, has a vocabulary of about 900 words and uses it to ask questions
constantly, up to 400 a day, such as “Why is snow cold?” “How do worms hear?” and “What
does your tongue do?”
EGOCENTRISM
● Perceiving that one’s thoughts and needs are better or more important than those of others, is also
strong during the preschool period.
● As part of egocentrism, preschoolers define objects mainly in relation to themselves, so a spoon

is “what I eat with” not a curved metal object; a crayon is “ what I write with” not an orange wax
object.
PLAY
● Preschoolers do not need many toys because, with an imagination keener than it will be at any
other time in life, they enjoy games that uses imitation such as pretending they are a teacher,
cowboy or cowgirl, fire fighter or store clerk.
EMOTIONAL DEVELOPMENT
Initiative
● sense of initiative versus guilt.
● Children with a well-developed sense of initiative like to explore because they have discovered that
learning new things is fun.
● If children are criticized or punished for attempts at initiative, they can develop a sense of guilt for
wanting to try new activities or to have new experiences. Those who leave the preschool period with a
sense of guilt can carry it with them into school situations.
Initiative
● To gain a sense of initiative, preschoolers need exposure to a wide variety of experiences and play
materials so they can learn as much about how things work as possible.
● Urge parents to provide play materials that encourage creative play.
oFinger Paints
oSoapy Water to splash or blow into bubbles
oSand to build castles
oModeling clay or homemade dough to mold into figures or make into
pretend cookies
Imitiation
● Imitating the actions of the people around them

peaks during this stage.
● Role modeling this way should be fun and does

not have to be accurate.
● Children generally imitate those activities best

that they see their parents performing at home.
Fantasy
● Preschoolers begin to make a differentiation between

fantasy and reality; they may become so engrossed in a
fantasy role that they fear they are “stuck” in the fantasy
and are no longer themselves.
● Such intense involvement in play is part of “magical

thinking,” which is active at this age (i.e., believing
thoughts and wishes can come true).
Oedipus Complex & Electra Complex
● Occurs in Phallic Stage of Psychosexual Development
● Oedipus Complex refers to the strong emotional attachment a preschool boy demonstrates toward
his mother
● Electra complex is the attachment of a preschool girl to her father
● Parents who are not prepared for this behavior may feel hurt and cut off from family interaction.
Parents can be assured this phenomenon of competition and romance in preschoolers is a normal
part of maturing.
Gender Roles
● Preschoolers begin to be aware of the difference between

sexes and so need to be introduced to both gender roles.
● Encourage single parents to plan opportunities for their

children to spend some time with adults other than
themselves such as grandparents, or a relative of the
opposite sex, for this experience.
Socialization
● Preschoolers play with other children their age much more agreeably than do toddlers, which makes
the preschool period a sensitive and critical time for socialization.
● They may become involved in arguments more than they did at 3 years of age, especially as they
become more certain of their role in the group.
● Five-year-olds begin to develop “best” friendships, perhaps on the basis of who they walk to school
with or who lives closest to them.
Socialization
● The elementary rule that an odd number of

children will have difficulty playing well
together generally pertains to children at
this age: two or four will play, but three or
five will quarrel.
Cognitive Development
● According to Piaget (1969), cognitive development is still preoperational by 3 years of age,

although children during this period also enter a second phase called intuitional thought.
● During this second phase of development, children learn by asking questions such as “How come?”
and “Why?”.
● Piaget named this stage “intuitive thought” because he believed that children tend to be so certain
of their knowledge and understanding that they are unaware of how they gained this knowledge
initially.
CENTRATION
● This is showed as a style of thinking by intuitive children
● These children typically are focused on the characteristic of an object or person, and they base their
decisions or judgment on that one characteristic (as opposed to considering multiple
characteristics).
● Centration also means that preschoolers cannot make mental substitutions and often feel they are
always right.
CONSERVATION
● Preschoolers are not yet aware of the property of conservation.
● This inability to appreciate conservation has implications for nursing care because it means
preschoolers are not able to comprehend that a procedure performed two separate ways is the same
procedure.
● They cannot see that only the form, not the amount, has changed.
DECENTERING
● Combined with the concept of conservation, appear prior to more sophisticated logical thinking
abilities.
Moral & Spiritual Development
● Children of preschool age determine right from wrong based on their parents’ rules because they have
little understanding of the rationale for these rules or even whether the rules are consistent.
● If preschoolers depend on their parents to supply rules for them, when faced with a new situation,
they may have difficulty understanding the rules they know.
Moral & Spiritual Development
● They begin to have an elemental concept of spirituality if they

have been provided some form of religious training.
● Children at this age enjoy the security of religious holidays and

religious rituals such as prayer before meals because these rituals
offer them the same reassurance and security as a familiar
nursery rhyme read over and over.
3
PARENTAL CONCERNS
ASSOCIATED WITH THE
PRESCHOOL PERIOD
PROMOTING PRESCHOOL SAFETY
By age 4 years, children may project an attitude of independence and the ability to take care of their own
needs. However, they still need supervision to be certain they do not injure themselves.
Examples:
- exploring the blades of a lawn mower or an electric saw
- may imitate taking medicine if they see family members doing so
- automobile safety
Possible
Unintentional Prevention Measure
Injury
Motor Vehicles Teach safety with tricycles (e.g., look before crossing driveways, do not cross streets).
Teach the child to always hold hands with an adult before crossing a street.
Teach parking lot safety (e.g., hold hands with an adult, do not run behind cars that could be backing up).
Teach children to consistently wear helmets when beginning bicycle riding.
Falls Always supervise a preschooler at a playground.

Remove drawstrings from hooded clothing.
Help the child to judge safe distances for jumping or safe heights for climbing
Drowning Teach beginning swimming.
Animal bites Do not allow the child to approach strange dogs.

Supervise the child’s play with family pets.
Possible
Injury
Poisoning Never present medication as a candy.
Never take medication in front of a child.
Never store food or substances in containers other than their own.
Post the telephone number of the poison control center by the telephone or as a cell phone contact number (1-800-
222-1222).
Teach the child that medications are a serious substance and not for play
Burns Store matches in closed containers.
Do not allow the preschooler to help light birthday candles or fireplaces; fire is not fun or a treat.
Community safety Teach the preschooler that not all people are friends (e.g., “Do not talk to strangers or take candy from strangers”).
Define a stranger as someone the child does not know, not someone odd looking.
Teach the child to say “no” to people whose touching he or she does not enjoy, including family members. (When a
child is sexually maltreated, the offender is usually a family member or close family friend.)
Possible
Injury
General Know the whereabouts of the preschooler at all times.
Be aware the frequency of unintentional injuries increases when parents are under stress.
Special precautions must be taken at these times.
Some children are more active, curious, and impulsive and therefore more vulnerable to unintentional injuries than
others.
Keeping Children Safe, Strong, and Free
The preschool years are not too early a time to educate children about the potential threat of harm
from strangers or how to address bullying behaviour (from children to adults) at preschool or at
play through such measures as:
• Cautioning a child never to talk with or accept a ride from a stranger

• Teaching a child how to call for help in an emergency (yelling or running to a designated
neighbor’s house if outside, or dialing 911 if near a phone)
Keeping Children Safe, Strong, and Free
• Explaining that if children or adults ask them to keep secrets about anything that has made
them uncomfortable, they should tell their parents or another trusted adult, even if they
have promised to keep the secret •
• Explaining that bullying behavior from other children is not to be tolerated and should be
reported so they can receive help managing it
Motor Vehicle and Bicycle Safety
• Preschoolers need to be buckled into car or booster seats in the back seat
• Remind parents to check the position of the shoulder harness in both types of
seat so the belt doesn’t cross a child’s face or throat.
PROMOTING THE NUTRITIONAL HEALTH OF A PRESCHOOLER
Nutrition Requirement
• Foods selected for preschoolers should include variety (U.S. Department of Agriculture, 2012) and be
based on MyPlate recommendations
• Preschoolers may not eat a great deal of meat because it can be hard to chew.
• Additional vitamins are probably unnecessary if a child is eating foods from all five food groups and
meets the criteria for a healthy child such as being alert and active with height and weight within
normal averages
PROMOTING THE NUTRITIONAL HEALTH OF A PRESCHOOLER
Vegetarian Diet
• This is usually colorful and therefore appeals to preschoolers.

• If vegetarian diets are deficient in any aspects, it is usually in calcium, vitamin B12 , and
vitamin D.
Calcium: important for bone growth; sources are green

leafy vegetables, milk products
Vit. B12: found in fortified cereals and milk
Vit. D: found almost exclusively in animal products

PROMOTING THE DEVELOPMENT OF THE PRESCHOOLER IN
DAILY ACTIVITIES
Dressing
• Most 4-year-olds can dress themselves except for difficult buttons,
• Preschoolers prefer bright colors or prints and so may select items that are appealing in color
rather than matching. One way for parents to solve the problem of mismatching is to fold
together matching shirts and slacks so a child sees them as a set rather than individual pieces.
DAILY ACTIVITIES
Sleep
• Preschoolers are more aware of their needs than toddlers; when they are tired, they often curl
up on a couch or soft chair and fall asleep.
• Children in this age group may refuse to go to sleep because of fear of the dark and may wake
at night terrified by a bad dream. This means that preschoolers may need a night-light turned
on, although they did not need one before.
DAILY ACTIVITIES
Exercise
• The preschool period is an active phase, so preschool play
tends to be vigorous.
• Roughhousing helps relieve tension and participating time-

honored games such as ring-around-the-rosy, London Bridge,
or other more structured games they were not ready for as
toddlers.
DAILY ACTIVITIES
Exercise
• Promoting these types of active games and reducing television watching can be steps toward
helping children develop motor skills as well as prevent childhood obesity.
DAILY ACTIVITIES
Hygiene
• Children this age are not paragons of neatness and may not clean their hands thoroughly. Preschoolers do
not clean their fingernails or ears well, either, so these areas often need “touching up” by a parent or older
sibling.
• Parents should turn down the temperature of the water heater in their home to under 120°F to help
prevent scalds.
• Some girls develop vulvar irritation (and perhaps bladder infections) from exposure to bubble bath so
parents shouldn’t add such products to the water
DAILY ACTIVITIES
Care of Teeth
• Independent toothbrushing should be started during preschool.
• One good toothbrushing period a day is often more effective than more frequent half-hearted
attempts.
• Dental services can be performed at 3 years of age e for an evaluation of tooth formation because
deciduous (baby) teeth must be preserved to protect the dental arch.
DAILY ACTIVITIES
Care of Teeth
• If a tooth has to be pulled for any reason, this can cause the permanent teeth to drift out of
position or the jaw not to grow enough to accommodate them
• Teeth grinding (Bruxism) may begin at this age as a way of “letting go,” similar to body
rocking. Children who grind their teeth extensively may have greater than average anxiety.
PROMOTING HEALTHY FAMILY FUNCTIONING
• An important role of preschooler parents is to respect creativity
Discipline
• A “time-out” is a useful technique for parents to correct behavior throughout the preschool
years.
• It allows parents to discipline without using physical punishment and allows a child to learn a
new way of behavior without extreme stress
• 3 to 5 minutes is appropriate for preschoolers.

4 PARENTAL CONCERNS
ASSOCIATED WITH THE
PRESCHOOL PERIOD
COMMON HEALTH PROBLEMS OF THE PRESCHOOLER
• The mortality of children during the preschool years is low and becoming lower every year as more
infectious diseases are preventable. However, the number of minor illnesses, such as common colds
and ear infections, are high.
• Children who live in homes in which parents smoke have a higher incidence of ear (otitis media) and
respiratory infections than others
• Children who attend child care or preschool programs also have an increased incidence of
gastrointestinal disturbances (vomiting and diarrhea) and upper respiratory infections from the
exposure to other children unless frequent hand washing is stressed at the setting
AREA OF FOCUS METHODS FREQUENCY

Assessment
• Health History Health interview Every Visit

• Physical health Physical examination Every Visit
• Developmental milestones History, observation Every Visit
Formal Denver Developmental Screening Test Before start of school

(DDST-II)
• Growth milestones Height and weight plotted on standard growth Every Visit
chart; body mass index (BMI)
Blood pressure Every Visit
• Hypertension History, observation; height and weight Every Visit
• Nutrition information
History and observation Every Visit
• Parent–child relationship History and observation Every Visit
• Social behavior
Assessment
• Vision and hearing defects History and observation Every Visit
Preschool E stereo and audiometer testing Before start of school

History and observation
• Autism spectrum disorder
screening History, physical examination At 18 and 24 months
• Dental health Dental visit
Fluoride varnish Every Visit
Cholesterol, triglycerides Every 6 months
• Dyslipidemia Lead Blood analysis (depending on risk in area) Recommended each visit
If indicated by risk
Purified protein derivative (PPD) test (if there If indicated by risk
• Tuberculosis are high-risk factors)
If indicated by risk
Immunization
• Diphtheria, pertussis, and tetanus DTaP 5 Before start of school
• Measles, mumps, and rubella

(MMR) MMR #2 Before start of school
• Poliomyelitis (inactivated)
IPV #4 Before start of school
• Varicella
VAR #2 Before start of school
• Influenza
IIV Yearly
• Pneumococcal
Pneumococcal conjugate vaccine (PCV) May be indicated before school
in susceptible children
COMMON FEARS OF THE PRESCHOOLER
Fear of the Dark
It is an example of a fear heightened by a child’s vivid

imagination: a stuffed toy by daylight becomes a threatening
monster at night. Children awaken screaming because of
nightmares. They may be reluctant to go to bed or go back to
sleep by themselves unless a light is left turned on or a parent
sits nearby
Fear of Mutilation
• This is also significant during the preschool age, as revealed by the intense reaction of a preschooler
to even a simple injury such as falling and scraping a knee or having a needle inserted for an
immunization.
• According to Freud, boys develop a fear of castration because, developmentally, they are more in
tune with their body parts and are starting to identify with the same-sex parent as they go through the
Oedipal phase
Fear of Separation or Abandonment
• Their sense of time is still so distorted that they cannot be comforted by assurances such as “Mommy
will pick you up from preschool at noon.”
• Their sense of distance is also limited, so making a statement such as “I work only a block away” is
not reassuring. Relating time and space to something a child knows better, such as meals, television
shows, or a friend’s house, is more effective.
BEHAVIOR VARIATIONS
A combination of a keen imagination and immature reasoning results in a number of other common
behavior variations in preschoolers.
Telling Table Tales
• Stretching stories to make them seem more interesting is a phenomenon frequently encountered in
preschoolers.
• The child perceive something exciting that have happened.
• Parents may be concerned that tall tales of this nature can lead to chronic lying if supported.
• Conveys the idea that the child has not told the truth, yet does not squash imagination or initiative.
BEHAVIOR VARIATIONS
Imaginary Friends
• Creative part of the preschool years and can be invented

by children who are surrounded by real playmates as
well as by those who have few friends, parents may find
them disconcerting.
• Pretend friends can encourage language development

may provide an outlet for a child to express innermost
feelings, or serve as handy scapegoat for behavior about
which a child has some conflict.
BEHAVIOR VARIATIONS
Difficulty Sharing
• Sharing is a concept that first comes to be understood around the age of 3 years.
• Children engage in parallel play (two children need two toys spaces to play because they
cannot pass one toy back and forth or play together).
• Children begin to understand some things are theirs, some belong to others, and some can
belong to both.
• Assure parents that sharing is a difficult concept to grasp, and, as with most skills,
preschoolers need practice to understand and learn it.
BEHAVIOR VARIATIONS
Sibling Rivalry
• Jealousy of a brother or sister may first become

evident during the preschool period because this is the
first time children have enough vocabulary to express
how they feel and partly because preschoolers are
more aware of family roles and how responsibilities at
home are divided.
BEHAVIOR VARIATIONS
Sibling Rivalry
• The parents are untried, unsure of how far they should let a first child venture or what
level of responsibility a child could accept, allowing the firstborn to serve as the
“trial run” for all children who come after.
• To help preschoolers feel secure and to promote self-esteem during this time,
reminding them that there are things they can do that a younger sibling is not allowed
to do.
PREPARING FOR A NEW SIBLING
• There is no rule as to when this preparation should begin, but it should be before the time the child
begins to feel the difference the new baby will make.
• The unknown is always more fearful than a definite event because those can be faced and conquered.
• Help parents not to underestimate the significance of a bed to a preschool child because it is security,
consistency, and “home.”
• If the mother will be hospitalized for the birth, parents should be certain their child is prepared for this
separation
• Some preschoolers may react very coldly to their mothers, turning their head away and refusing to
come to them after even a few days of separation when they return home.
PREPARING FOR A NEW SIBLING
• Allow the child to visit in the hospital to help

relieve this type of separation anxiety.
• Most parents find the problem of jealousy is

bigger than they anticipated and welcome a few
suggestions about how to provide more time for
their preschooler during the day or which
activities a preschooler would especially enjoy.
SEX EDUCATION
• Possibly, this is a normal progression in development, and, possibly, this may be the first time they are exposed to the
genitalia of the opposite sex as they watch while a new brother or sister has a diaper changed, they see other children
using the bathroom at a preschool, or they see a parent nude.
• It is important that parents do not convey that these body parts are never to be talked about so they leave an open line
of communication for sexual questions.
• It is common for preschoolers to engage in masturbation while watching TV or before they fall asleep at night. The
frequency of this may increase under stress, as does thumb-sucking.
• Calling unnecessary attention to the act can increase anxiety and cause increased, not decreased, activity.
SEX EDUCATION
• Preschool children have the beginnings of sexual awareness and are interested in learning where babies grow.
• A parent could introduce the subject by visiting a new baby in the neighborhood with the child or pointing out a
neighbor who is pregnant.
• Encourage parents to prepare children thoroughly for this experience, or else the sight of their mother in pain and the
wonder of birth can become an overwhelming and negative experience rather than a positive one for them.
• Correct terminology should be used when providing an explanation to a child.
• Teach the preschoolers to avoid sexual maltreatment, such as allowing anyone to touch their body unless they and their
parents agree that it is all right.
CHOOSING A PRESCHOOL OR CHILD CARE CENTER
• The terms “child care center” and “preschool” are often used interchangeably, so parents cannot depend on
the name of a school to define its structure.
• Traditionally, the main purpose of a child care center is to provide child care while parents work or are
otherwise occupied.
• A preschool is dedicated to stimulating children’s sense of creativity and initiative and introducing them to
new experiences and social contacts that they would not ordinarily receive at home.
PREPARING A CHILD FOR SCHOOL
• School involves a great deal of children’s time and influences their future greatly, it’s important for parents to
take time to prepare preschoolers not only physically, by being certain their immunizations are up-to-date,
but also emotionally.
• Identifying colors should be established by this age, but some children are not coordinated enough at 4 to 5
years of age to tie their shoes or to print
• If school is discussed as something to look forward to, as an adventure that will be satisfying and rewarding,
a child comes to look forward to it as a positive experience. If school is presented as a punishment there can
be little delight in anticipating it.
PREPARING A CHILD FOR SCHOOL
• If a child is to ride a bus to school, a parent might take a child on a municipal bus as an introduction to this
form of transportation.
• If a child is to walk to school, a trial walk is in order.
• If a child will be required to take a lunch to school, a parent can introduce this new experience by preparing a
bagged lunch at home.
• If a child was not attending preschool, some parents may have to change their child’s daily routine a few
months in advance of beginning school to accustom the child 1862 to waking earlier or going to bed earlier.
BROKEN FLUENCY
Broken Fluency
• repetition and prolongation of sounds, syllables, and words
• It is often referred to as secondary stuttering because the child began to speak without
this problem and then, during the preschool years, develops it.
• For example: A child may begin to repeat words or syllables, saying, “I-I-I want a n-n-
new spoon-spoon-spoon.”
BROKEN FLUENCY
Here are the rules:
• Do not discuss in the child’s presence that he or she is having difficulty with speech.
• Listen with patience rather than interrupt or ask the child to speak more slowly or to
start over.
• Always talk to the child in a calm, simple way to role model slow speech.
• Protect space for the child to talk if there are other children in the family
• Do not force a child to speak if he or she does not want to.
• Do not reward a child for fluent speech or punish for nonfluent speech.
BATHROOM LANGUAGE
Bathroom Language
• Parents may have to be reminded that children do not necessarily understand what the
word they are using means; they have simply heard it, just as they have heard hundreds
of other words and have decided to use it.
• If parents become emotional, a child realizes the value of such a word and may continue
using it for the attention it creates.
CONCERNS OF THE FAMILY WITH A PRESCHOOLER WITH UNIQUE NEEDS
• A preschooler with a disability has a greater need for problem-solving skills

than the average child because even simple procedures such as eating or
getting dressed can be difficult if their physical challenge limits the options.
• Physically challenged or chronically ill preschoolers should attend a

preschool program if at all possible because of the socialization benefits.

Nursing Care of a Family with a Preschooler-

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Nursing Care of a Family

with a Preschool Child

● Physical growth slows considerably during this period, personality and

● Most children of this age want to

Ectomorphic Body Build (slim body build)

Endomorphic Body Build (large body build)

• Muscles are noticeably stronger, so activities such as gymnastics

Weight, Height, Body Mass Index, and Head Circumference

• Head circumference is not routinely measured at physical assessments on children over 2

● As part of egocentrism, preschoolers define objects mainly in relation to themselves, so a spoon

● sense of initiative versus guilt.

● Urge parents to provide play materials that encourage creative play.

● Imitating the actions of the people around them

● Role modeling this way should be fun and does

● Children generally imitate those activities best

● Preschoolers begin to make a differentiation between

● Such intense involvement in play is part of “magical

Oedipus Complex & Electra Complex

● Occurs in Phallic Stage of Psychosexual Development

● Electra complex is the attachment of a preschool girl to her father

● Preschoolers begin to be aware of the difference between

● Encourage single parents to plan opportunities for their

● The elementary rule that an odd number of

● According to Piaget (1969), cognitive development is still preoperational by 3 years of age,

● This is showed as a style of thinking by intuitive children

● Preschoolers are not yet aware of the property of conservation.

Moral & Spiritual Development

Moral & Spiritual Development

● They begin to have an elemental concept of spirituality if they

● Children at this age enjoy the security of religious holidays and

Falls Always supervise a preschooler at a playground.

Drowning Teach beginning swimming.

Animal bites Do not allow the child to approach strange dogs.

Keeping Children Safe, Strong, and Free

• Cautioning a child never to talk with or accept a ride from a stranger

Keeping Children Safe, Strong, and Free

Motor Vehicle and Bicycle Safety

• This is usually colorful and therefore appeals to preschoolers.

Calcium: important for bone growth; sources are green

Vit. B12: found in fortified cereals and milk

Vit. D: found almost exclusively in animal products

• Most 4-year-olds can dress themselves except for difficult buttons,

• Roughhousing helps relieve tension and participating time-

• Independent toothbrushing should be started during preschool.

• An important role of preschooler parents is to respect creativity

• 3 to 5 minutes is appropriate for preschoolers.

AREA OF FOCUS METHODS FREQUENCY

• Health History Health interview Every Visit

Formal Denver Developmental Screening Test Before start of school

Preschool E stereo and audiometer testing Before start of school

• Diphtheria, pertussis, and tetanus DTaP 5 Before start of school

• Measles, mumps, and rubella

Fear of the Dark

It is an example of a fear heightened by a child’s vivid

Fear of Separation or Abandonment

Telling Table Tales

• Creative part of the preschool years and can be invented

• Pretend friends can encourage language development

• Jealousy of a brother or sister may first become

• Allow the child to visit in the hospital to help

• Most parents find the problem of jealousy is

• Correct terminology should be used when providing an explanation to a child.

• If a child is to walk to school, a trial walk is in order.

• repetition and prolongation of sounds, syllables, and words