Growth and Development of the Toddler

1. Bill and Ted are a domestic couple that have brought in their 30-month-old daughter, Victoria, complaining of a runny nose, cough, and low-grade fever. Bill and Ted adopted Victoria at birth. The biological mother was a teenager who chose to give her child up for adoption and Bill and Ted provided financial support to ensure that she received the appropriate prenatal care. Her pregnancy and delivery were unremarkable. She has had no contact with Victoria or her fathers since the birth. The nurse practitioner determined that the symptoms are attributed to an upper respiratory tract infection (URI) or common cold and recommended that it be treated symptomatically. While in the office, Bill and Ted have some questions regarding Victoria’s behavior. They explain that she has become more defiant, repeatedly responding to their questions or commands with “no” or temper tantrums. Neither Bill nor Ted has been a parent before adopting Victoria and they are concerned that they are to blame for her behavior.  (Learning Objectives 1, 5, and 12)

a. What can the nurse teach Bill and Ted about the psychosocial or cognitive development of a toddler that would help them understand Victoria’s behavior?

b. What can the nurse teach Bill and Ted regarding promoting appropriate discipline for  Victoria?

c. What is “temperament” and how would it influence Victoria’s behavior?

2. Tenzin and Dechen have brought in their 24-month-old son, Kim, for his wellness examination and immunizations. Kim is the first child for Tenzin and Dechen, but Dechen is 6 months pregnant with their second child. Tenzin and Dechen are Tibetan refugees who have moved to the United States from India. Kim was born in the United States. Tenzin and Dechen are very focused on Kim’s physical abilities (i.e., motor skills, communication, and sensory skills). They express their desire for Kim to do well in school and be successful in business. (Learning Objectives 3, 4, 7, 11, and 13)

a. What could the nurse share with Kim’s parents regarding the normal motor, communication, and sensory development of a 24-month-old?

b. What can the nurse teach Tenzin and Dechen regarding promoting healthy growth and development in Kim?

c. Kim’s parents are curious about toilet training. How can the nurse teach Kim’s parents about toilet training with a toddler?