Chapter 12: Preschooler Health Problems & Family Care

Preschooler Health Problems & Family Care from Wong’s Essentials of Pediatric Nursing provides a comprehensive overview of the health promotion and developmental milestones for the preschooler, spanning ages three to five years. Biologic development is characterized by a stabilization of physical growth, resulting in a slender, erect physique and significant refinement of gross and fine motor skills, such as balancing, skipping, and drawing shapes. Psychosocially, the child enters Erikson’s stage of initiative versus guilt, where energetic learning and the development of a conscience (superego) take place; however, children may experience guilt when their independent actions overstep limits or when they misinterpret causality due to magical thinking. Cognitive development is framed by Piaget’s preoperational phase, divided into the preconceptual and intuitive thought stages, where children transition from absolute egocentrism toward social awareness, yet remain bound by literal interpretations of language and transductive reasoning. Moral development operates at Kohlberg’s preconventional level, shifting from a punishment and obedience orientation to a naive instrumental orientation driven by self-satisfaction. The text details social development, noting the completion of the separation-individuation process and the emergence of associative play, where children interact in similar activities without rigid rules. Significant attention is given to the development of body image, sexuality, and gender identity, characterizing sexual curiosity and exploration as normal developmental behaviors. The chapter also addresses common parental concerns including the management of fears (such as fear of the dark or bodily mutilation), aggression, speech dysfluency (stuttering), and the role of imaginary playmates. Finally, it outlines strategies for promoting optimal health, covering nutritional requirements to prevent obesity, sleep hygiene to manage nightmares, dental care for primary teeth, and critical injury prevention measures regarding pedestrian safety, poisoning, and the use of protective equipment like helmets.