lOMoARcPSD|26582732
CONCEPTS OF MATERNAL-CHILD NURSING AND
FAMILIES EXAM 2 PEDIATRICS 2025-2026
Growth & dev of toddlers pg. 992
• Both physical growth and acquisition of new motor skills slow somewhat during toddler yrs
• Height and weight continue to ↑ steadily but slower than infancy growth happens in
spurts rather than linearly step-like growth
• Averages weight at 2 y/o is 26lbs and height is 34 inches
• Dentition primary teeth in place (start to get teeth at 6 months) teach them to brush their
teeth and maybe floss, you’ll have to help them pg. 1010 read more
• Avg toddler weight gain 1.36 to 2.27kg (3 to 5lbs)/year length/height ↑ an avg of 7.62 cm
(3 inches)/year head circumference ↑ about 2.54 cm (1 in) and then ↑an avg of of 1.27
cm (0.5 in)/year until 5 y/o head size becomes more proportional to rest of body near 3
y/o
• Toddlers generally reach half their adult height by 2 y/o
Major toddler tasks
• Differentiation of self from significant others
• Tolerates separation from parent
• Ability to withstand delayed gratification
• Control over bodily functions
• Acquisition of socially acceptable behavior
• Verbal means of communication
• Ability to interact w/others in a less egocentric manner
• Speak 100-200 words
Physiological systems
• Myelination of the brain and spinal cord is usually complete around 24 months improved
coordination and ability to exercise sphincter control for bladder and bowel mastery
• Hr ↓ and bp ↑ in toddlerhood
• Urine output should be 1 ml/kg/hr urethra
still remains short making them for susceptible
to utis than adults (male and female)
• ↑ ability to maintain body temp body is becoming more proportional
• They start to produce antibodies against infections
Psychosocial development pg. 994
• Erickson defines the toddler period as a time of autonomy versus shame and doubt it’s a
time of exerting independence
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• The toddler is struggling for self-mastery and to do for themselves what others have been
doing for them
• They may quickly chg from happy and pleasant to crying and screaming
• Exertion of independence results in toddler’s fav response “no” will answer “no” even if
they mean “yes”
• Separation anxiety in a place can cope w/brief separation leave something important to
you w/the child “watch my sweater, don’t let anyone take it and i’ll be back”
• Coping mechanisms o regression returns to prev behavior
o Ritualism maintains sameness will watch the same show over and over. Will cry
until you play the same one. It’s important to do things on a schedule, dinner
Time, bed time, do things at the same time everyday
Motor skill development pg. 995
• Walking progresses to running, climbing, and jumping
• Pushing or pulling a toy, throwing a ball, and pedaling a tricycle are accomplished in
toddlerhood
• Fine motor progress from holding and pinching to the ability to manage utensils dev of
hand-eye coordination
• As toddler’s master a new task, they have the confidence to conquer the next one
↑selfesteem
• The toddler who is eager to face challenges will dev more quickly than a reluctant one
• Gross motor walks well, climbs stairs
• Fine motor ↑ coordination, grasp and release
Gross motor skills
• Large muscle groups are starting to strengthen
• “toddler gait” doesn’t walk smoothly legs are planted wide apart, toes are pointed
forward, and toddler sways from side to side after 6 months, gait is smoother by 3 y/o
toddler walks in heel-to-toe fashion
• Toddler may fall often but will try to catch themselves parachute reflex
• Since they are just learning thoughts and feeling verbally, they will use physical actions to
express themselves running, jumping, hitting
Age Expected gross motor skill Expected fine motor skill
12-15 months Walks independently Feeds self finger foods
Uses index finger to point
18 months Climbs stairs w/assistance Masters reaching, grasping and releasing:
pulls toys while walking stacks blocks, puts things in slots
Turns book pages
Removes shoes and socks (single if board
book, multiple if paper)
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Stacks four cubes
24 months Runs Build tower of 6-7 cubes
Kicks ball Right or left handed
Can stand on tiptoe carries Imitates circular and vertical strokes
several toys, or a large toy Scribbles and paints
while walking climbs onto Starting to turn knobs
and down from furniture Puts round pegs into holes
w/o assistance
36 months Climbs wall Undresses self
Pedals tricycle Copies circle
Runs easily Builds tower of 9-10 cubes
Walks up and down stairs Holds pencil in writing position
w/alternate feet Screws/unscrews lids, nuts, bolts
Bends over easily w/o Turns book pages one at a time
falling
Adaptive behaviors pg. 997
• Language young toddler begins to use short sentences and will progress to a vocab of 50
words by 2 y/o and understands over 200 words o echolalia repetition of words and
phrases w/o understanding o telegraphic speech by 3 y/o speech that only contains
essential words
• Personal-social ↑independence
• Play parallel play 2 kids sitting in a sandbox scooping sand into their buckets, not talking to
each other. Not playing together, but doing the same thing they like toys that make noise
as toddlers
Nutrition pg. 1006
• Forming healthy eating habits early is impt bc the child will continue these choices later in
life
• Breastfeeding for at least 12 months then for as long as mutually agreeable btwn child and
mother breastfeeding into toddlerhood is beneficial nutritional, immunological, and
emotional benefits
• Weaning from bottle should occur by 12-15 months prolonged use = dental caries
• Physiologic anorexia due to slowed growth growth slows so they don’t eat as much, the
baby is fine. A fat baby is not a healthy baby
• Will experience food jags may only prefer one particular food for several days, then not
want it again for weeks
• Praise toddler for trying something new but never punish them for not wanting to try
something
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, lOMoARcPSD|26582732
• Juice intake can lead to obesity in children, since they like the sweet taste, they drink
excessive amounts it also causes them to get full and they don’t eat their food
• ↓ calorie and protein needs
• Picky, fussy eater
• Use nutritious snacks, small portions, finger foods and a variety of food groups
• Safety poisoning they see colorful cleaning products and want to get into them. Also,
don’t call medicine candy bc they’ll want to get into it
• Adequate calcium intake and appropriate exercise lay the foundation for proper bone
mineralization avg of 500mg ca/day dairy products are primary source of dietary ca
• Iron deficiency anemia in 1st 2 yrs of life is assoc w/dev and psychomotor delays child stops
getting nutrients needed from breast milk bc it’s replaced w/cow milk give iron fortified
cereals and other foods rich in iron and vitamin c
• Fat and cholesterol should not be restricted in children younger than 2 y/o growing rapidly
• Encourage toddlers to drink water limit juice 4-6 oz/day and milk 16-24 oz/day serve
milk/juice w/meals or snacks
• Offer 3 full meals and 2 snacks/day ¼ of what an adult would eat
• Parent provides food and toddler decides on how much to eat mouthing, and spitting out
food and eating it again is normal, don’t scold child
Downloaded by NELSON KIIRU ()
CONCEPTS OF MATERNAL-CHILD NURSING AND
FAMILIES EXAM 2 PEDIATRICS 2025-2026
Growth & dev of toddlers pg. 992
• Both physical growth and acquisition of new motor skills slow somewhat during toddler yrs
• Height and weight continue to ↑ steadily but slower than infancy growth happens in
spurts rather than linearly step-like growth
• Averages weight at 2 y/o is 26lbs and height is 34 inches
• Dentition primary teeth in place (start to get teeth at 6 months) teach them to brush their
teeth and maybe floss, you’ll have to help them pg. 1010 read more
• Avg toddler weight gain 1.36 to 2.27kg (3 to 5lbs)/year length/height ↑ an avg of 7.62 cm
(3 inches)/year head circumference ↑ about 2.54 cm (1 in) and then ↑an avg of of 1.27
cm (0.5 in)/year until 5 y/o head size becomes more proportional to rest of body near 3
y/o
• Toddlers generally reach half their adult height by 2 y/o
Major toddler tasks
• Differentiation of self from significant others
• Tolerates separation from parent
• Ability to withstand delayed gratification
• Control over bodily functions
• Acquisition of socially acceptable behavior
• Verbal means of communication
• Ability to interact w/others in a less egocentric manner
• Speak 100-200 words
Physiological systems
• Myelination of the brain and spinal cord is usually complete around 24 months improved
coordination and ability to exercise sphincter control for bladder and bowel mastery
• Hr ↓ and bp ↑ in toddlerhood
• Urine output should be 1 ml/kg/hr urethra
still remains short making them for susceptible
to utis than adults (male and female)
• ↑ ability to maintain body temp body is becoming more proportional
• They start to produce antibodies against infections
Psychosocial development pg. 994
• Erickson defines the toddler period as a time of autonomy versus shame and doubt it’s a
time of exerting independence
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
• The toddler is struggling for self-mastery and to do for themselves what others have been
doing for them
• They may quickly chg from happy and pleasant to crying and screaming
• Exertion of independence results in toddler’s fav response “no” will answer “no” even if
they mean “yes”
• Separation anxiety in a place can cope w/brief separation leave something important to
you w/the child “watch my sweater, don’t let anyone take it and i’ll be back”
• Coping mechanisms o regression returns to prev behavior
o Ritualism maintains sameness will watch the same show over and over. Will cry
until you play the same one. It’s important to do things on a schedule, dinner
Time, bed time, do things at the same time everyday
Motor skill development pg. 995
• Walking progresses to running, climbing, and jumping
• Pushing or pulling a toy, throwing a ball, and pedaling a tricycle are accomplished in
toddlerhood
• Fine motor progress from holding and pinching to the ability to manage utensils dev of
hand-eye coordination
• As toddler’s master a new task, they have the confidence to conquer the next one
↑selfesteem
• The toddler who is eager to face challenges will dev more quickly than a reluctant one
• Gross motor walks well, climbs stairs
• Fine motor ↑ coordination, grasp and release
Gross motor skills
• Large muscle groups are starting to strengthen
• “toddler gait” doesn’t walk smoothly legs are planted wide apart, toes are pointed
forward, and toddler sways from side to side after 6 months, gait is smoother by 3 y/o
toddler walks in heel-to-toe fashion
• Toddler may fall often but will try to catch themselves parachute reflex
• Since they are just learning thoughts and feeling verbally, they will use physical actions to
express themselves running, jumping, hitting
Age Expected gross motor skill Expected fine motor skill
12-15 months Walks independently Feeds self finger foods
Uses index finger to point
18 months Climbs stairs w/assistance Masters reaching, grasping and releasing:
pulls toys while walking stacks blocks, puts things in slots
Turns book pages
Removes shoes and socks (single if board
book, multiple if paper)
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Stacks four cubes
24 months Runs Build tower of 6-7 cubes
Kicks ball Right or left handed
Can stand on tiptoe carries Imitates circular and vertical strokes
several toys, or a large toy Scribbles and paints
while walking climbs onto Starting to turn knobs
and down from furniture Puts round pegs into holes
w/o assistance
36 months Climbs wall Undresses self
Pedals tricycle Copies circle
Runs easily Builds tower of 9-10 cubes
Walks up and down stairs Holds pencil in writing position
w/alternate feet Screws/unscrews lids, nuts, bolts
Bends over easily w/o Turns book pages one at a time
falling
Adaptive behaviors pg. 997
• Language young toddler begins to use short sentences and will progress to a vocab of 50
words by 2 y/o and understands over 200 words o echolalia repetition of words and
phrases w/o understanding o telegraphic speech by 3 y/o speech that only contains
essential words
• Personal-social ↑independence
• Play parallel play 2 kids sitting in a sandbox scooping sand into their buckets, not talking to
each other. Not playing together, but doing the same thing they like toys that make noise
as toddlers
Nutrition pg. 1006
• Forming healthy eating habits early is impt bc the child will continue these choices later in
life
• Breastfeeding for at least 12 months then for as long as mutually agreeable btwn child and
mother breastfeeding into toddlerhood is beneficial nutritional, immunological, and
emotional benefits
• Weaning from bottle should occur by 12-15 months prolonged use = dental caries
• Physiologic anorexia due to slowed growth growth slows so they don’t eat as much, the
baby is fine. A fat baby is not a healthy baby
• Will experience food jags may only prefer one particular food for several days, then not
want it again for weeks
• Praise toddler for trying something new but never punish them for not wanting to try
something
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
• Juice intake can lead to obesity in children, since they like the sweet taste, they drink
excessive amounts it also causes them to get full and they don’t eat their food
• ↓ calorie and protein needs
• Picky, fussy eater
• Use nutritious snacks, small portions, finger foods and a variety of food groups
• Safety poisoning they see colorful cleaning products and want to get into them. Also,
don’t call medicine candy bc they’ll want to get into it
• Adequate calcium intake and appropriate exercise lay the foundation for proper bone
mineralization avg of 500mg ca/day dairy products are primary source of dietary ca
• Iron deficiency anemia in 1st 2 yrs of life is assoc w/dev and psychomotor delays child stops
getting nutrients needed from breast milk bc it’s replaced w/cow milk give iron fortified
cereals and other foods rich in iron and vitamin c
• Fat and cholesterol should not be restricted in children younger than 2 y/o growing rapidly
• Encourage toddlers to drink water limit juice 4-6 oz/day and milk 16-24 oz/day serve
milk/juice w/meals or snacks
• Offer 3 full meals and 2 snacks/day ¼ of what an adult would eat
• Parent provides food and toddler decides on how much to eat mouthing, and spitting out
food and eating it again is normal, don’t scold child
Downloaded by NELSON KIIRU ()
