• Subject Name : Nursing

The Importance of Play During Hospitalization of Children

Ans 2: The growth and development for preschool children in the age of 4-6 years is defined as per the developmental milestones. The normal growth and developmental physiology varies among different children as per their genetic inheritance patterns and parental combinations. The growth in preschool, children is differentiated into motor development, cognitive development and physiological development.

Physical and Motor Development

The preschool children show a significant gain in weight which is recorded as 6 grams on an average per day. Thus overall change in Body mass index is known with average weight 40 pounds and height is 40 inches (Doi et al., 2018). The normal vision is 20/20. The sleep patterns also show a change with progression in age for 11-13 hours and night and daytimes nap are mostly not present. A lot of research studies show that the preschool children show a growth in height which accounts to double their birth length.

  • The balance improves and needs no support for walking. Also the eye and hand coordination improves and the child can throw a ball overhand with coordination. But bed wetting may be prevalent in this age too.

Sensory and Cognitive Development

  • The vocabulary increases in this age with an approximation of more than 1,000 words. In addition to this, the child can easily put up 4-5 words in a sentence which sounds meaningful. The past memory and its subsequent narration improves and memory recognition improves.
  • The child learns counting and develops a curiosity for the world and its working by asking a lot of questions. They may learn vulgar words by observing adults and also start learn and reciting songs. A major developmental milestone is the development of a feeling of getting independent and tries to do all things by themselves and take charge of their daily activities like bathing and eating whether they perform it in a right way or not.
  • The mental attitude becomes aggressive if parents stop them and aggression levels increase. A humorous and ironic point is that they start discussing about their family matters to others which may be shameful sometimes for parents as they disclose their personal and family fights to strangers and relatives.
  • The child becomes aware of the day night schedule as well as time patterns.an increased understanding of shape and size of things and their differentiation on basis of heavy, long etc.

Behavioural Changes

The transformation of calm child into an energy package with bossiness, increased intelligence to explain needs.

This age is the time when there is huge spurt of development of imaginative ideas which they communicate to their adults and friends.

Feet and Hand Movement

Development of improved movement which includes standing on one foot for ten seconds without falling. Children can easily do hops, somersaults and able to do skipping.

Some developmental milestones for hands and fingers include the copying of triangle and other geometric patterns with fingers. The children can dress up without any assistance and as per wish and choice.

Language Milestones

The language milestones include recalling past story, and presents needs for the future, says the names of parents and home locality address(Doi et al.,2018).. The major cognitive milestones include increase in counting up to ten objects and colour recognition of basic colors.

The most important growth and development milestone is social and emotional intelligence which includes making friends to people they like and imitate their habits and actions. Also they understand the importance of rules like no TV or less usage of mobile, no breaking of things and become aware of their gender and speak as per their gender like him, her. They began to differentiate between imaginary dream world and the real world

But these are just general growth and development milestones. They may change due to change in socioeconomic status, family atmosphere, parenting skills and the sedentary lifestyle habits. The children may grow less than other children of their age due to malnutrition or due to genetic reasons. They may have less eyesight if they use electronic gadgets more. So different factors will influence the growth and development of preschool children and they imitate what they observe their parent’s actions, thus frequent fights between parents may result in timid and fearful behavior of child. Thus parents need to be aware of their child’s developmental milestones and consult a pediatric in case of abnormal growth and behavior.

Ans 4: Nursing Interventions for Promoting Health and Wellness in Preschoolers

  • The most important intervention for promoting health and wellness in pre-schoolers for their growth and development is child health surveillance (Pate et al., 2016) which is important for their growth in terms of motor development and other behavioural milestones such as presence of autism. This surveillance is important to diagnose any abnormality in motor skills and mental wellbeing that can have a bad impact on child’s life. This surveillance is based upon specific activities which anticipate damages or injuries as well as promotion, prevention. The interventions include continuous monitoring of interrelated attention towards childhood illnesses. These include basic questionnaires for children and asking them if their development is normal and also what disease if any is affecting their growth.
  • Another major intervention is the nutritionist approach in nursing (Koukourikos et al., 2015) the nurse will prepare a diet chart in consultation with a paediatrician. The nurse will follow the person centred care approach as per the nutritional deficiencies and body requirements of a child. The daily calorie intake and calorie needs must be balanced which is1400-2,200 calories for normal pre-schoolers but care plan must be designed as per physical activity status and socioeconomic factors (Doi et al., 2018). This intervention is important as diet has a major role in growth and development of children and imbalanced diet can cause obesity, prevalent in children in United States. But weak and lean children may have an extra fast metabolism that can hamper
  • Children with developmental disabilities must be handles in way so that there is no progression in disease and also their growth is nor hindered (Mistry et al., 2012). Family interactions must be improved in order to improve their social interactions and development. Special supplementation must be provided as per the ailment and the problem with vitamin A supplementation being the major. Also nurses must use friendly interventions to enhance their emotional intelligence and social development. Pleasure activities such as music therapy which is soothing and reduces the anxiety and stress in the hospital environment , touch is a proven for effective improvement in health condition in children and generous touch and hug results in miraculous positive improvements in health conditions. So these pleasure activities and cognitive behavioural therapies must be used in coordination with medical treatment to improve the health of child.

References for Increase Physical Activity in Children

Doi, L., Wason, D., Malden, S., & Jepson, R. (2018). Supporting the health and well-being of school-aged children through a school nurse programme: a realist evaluation. BMC health services research, 18(1), 664. https://doi.org/10.1186/s12913-018-3480-4.

Pate, R. R., Brown, W. H., Pfeiffer, K. A., Howie, E. K., Saunders, R. P., Addy, C. L., & Dowda, M. (2016). An Intervention to Increase Physical Activity in Children: A Randomized Controlled Trial With 4-Year-Olds in Preschools. American journal of preventive medicine, 51(1), 12–22. https://doi.org/10.1016/j.amepre.2015.12.003

Koukourikos, K., Tzeha, L., Pantelidou, P., & Tsaloglidou, A. (2015). THE IMPORTANCE OF PLAY DURING HOSPITALIZATION OF CHILDREN. Materia socio-medica, 27(6), 438–441. https://doi.org/10.5455/msm.2015.27.438-441

Mistry, K. B., Minkovitz, C. S., Riley, A. W., Johnson, S. B., Grason, H. A., Dubay, L. C., & Guyer, B. (2012). A new framework for childhood health promotion: the role of policies and programs in building capacity and foundations of early childhood health. American journal of public health, 102(9), 1688–1696. https://doi.org/10.2105/AJPH.2012.300687

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