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Concepts Of Maternal-Child (NUR 4130) Chapter 26 Peds - Growth And Development

John Marsh
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Chapter 26 peds – growth and development

Nova Southeastern University

Concepts Of Maternal-Child Nursing And Families (NUR 4130)

Chapter 26 toddlers
Physical Growth of the Toddler
Toddler 1-3 years of age.
• Height and weight increase steadily in spurts at a slower rate than the infant
– Generally reach half adult height by age 2
– Average weight gain is 3 to 5 lb per year
– Height increases an average of 3 in per year
• Anterior Fontanels close by 18 months
• Head size more proportional to body by age 3
Toddlers do not need as many calories-physiological anorexia.
Organ System Maturation
• Neurologic system
– Brain reaches about 90% of size by age 2
– Myelination of the brain and spinal cord continues to progress and is complete
around 24 months of age. Myelination results in improved coordination and
equilibrium as well as the ability to exercise sphinter control, which is important
for bowel and bladder mastery.
– Protective reflexes
• The forward or downward parachute reflex is particulary helpful when
child starts to toddle.
• Respiratory system
– Alveoli increase in number until age 7; trachea and airways small compared to
– Eustchain tubes are relatively short and straight
– Tongue is relatively large in comparison to mouth.
• Cardiovascular system
– Heart rate decreases; blood pressure increases
Organ System Maturation (cont.)
• Gastrointestinal system
– Stomach increases in size; small intestine grows in length; stool passage
decreases. ( one or more per day)
– Stool may be yellow brown or green
– Bowel control achieved by end of toddlerhood.
– 3 meals per day
– pepsin production matures by 2
• Genitourinary system
– Bladder and kidney reach adult function by 16 to 24 months; bladder capacity
increases; urethra remains short (UTIS)
– Urine output should be 1 mL/kg/hr
• Musculoskeletal system
– Bones increase in length; muscle matures; swayback and pot belly appear due to
weak muscles until 3 years old.
Growth Theories
 Erikson’s theory focuses on achievement of autonomy and self-control.
o the toddler is struggling for self-mastery, to learn to do for himself or herself
what others have been doing for him.
o Toddler saying “no”.
o Achieves self control
o Imitates adults and playmates
o Spontaneously shows affection
o Withstands delayed gratification
o Cannot take turns in games until about 3
Motor Skill Development (Toddler)
• Gross motor skills
– Include running, climbing, jumping, pushing or pulling a toy, throwing a ball, and
pedaling a tricycle
– Toddler gait-charactestic of new walkers. Legs are wide apart, toes pointed
forward, the toddler sways from side to side.
– Toddler may fall often, but will use outstretched arms (parachute reflex) to catch
him or herself.
– By 3 years, the toddler walks in a heel to toe fashion similar to that of adults
– Toddlers often use physical actions such as running, jumping, and hitting to
express their emotions because they are only just learning to express their
thoughts verbally.
• Fine motor skills
– Progress from holding and pinching to the ability to manage utensils, hold a
crayon, string a bead, and use a computer
– Adequate vision is neseccary for the refinement of fine motor skills because
hand-eye coordination is crucial for directing the fingers, hand and wrist to
accomplish small muscle tasks.



Concepts Of Maternal-Child (NUR 4130) Chapter 26 Peds - Growth And Development

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