Chapter 16: The Preschool Child: Growth & Nursing Care

The Preschool Child: Growth & Nursing Care examines physical milestones, such as the doubling of one-year weight by age five, the complete eruption of primary teeth, and the establishment of hand preference, alongside the improvement of visual acuity. Cognitive development is explored through Piaget's preoperational phase, subdivided into the preconceptual and intuitive thought stages, where children demonstrate symbolic functioning yet remain limited by egocentrism, animism, artificialism, and centring. The text details the critical expansion of language skills, noting that sentence length typically corresponds to age, and addresses common speech concerns like stuttering. Psychosocial maturation is framed by Erikson’s stage of initiative versus guilt, while moral development is viewed through Kohlberg’s early preconventional theories. A significant portion of the chapter is dedicated to the evolution of play, describing the transition from parallel and associative activities to cooperative play, and highlights the utility of therapeutic play and play therapy for managing stress or neurodevelopmental disorders. The summary also outlines essential parental guidance topics, including the management of sexual curiosity and masturbation, the establishment of sleep rituals to mitigate nightmares and night terrors, and the implementation of constructive discipline techniques like time-outs and consistency instead of corporal punishment. Furthermore, it addresses common behavioral issues such as sibling rivalry, jealousy, thumb sucking, and enuresis (bed-wetting), providing nursing interventions for both primary and secondary enuresis ranging from conditioning alarms to pharmacological treatments like desmopressin. Finally, the chapter underscores the importance of accident prevention regarding burns, poisoning, and stranger danger, and discusses the specific emotional needs of hospitalized preschoolers who may experience separation anxiety, regression, and fears of bodily harm due to their magical thinking.