Growth and Development of the Preschooler

1. Donnie has brought his 4-year-old son, Isaac, to the pediatric free clinic for a kindergarten physical. Isaac is the older of two children of Donnie and Mary Smith. Donnie is employed as a farrier but his work does not provide insurance and he has come to a nurse-operated free clinic. Donnie shares that Isaac enjoys spending time with his father when he is working with the horses, but he is concerned that Isaac has an imaginary friend named “Tackle.” On physical examination, Isaac is 39 inches tall and weighs 35 lbs. Donnie is a man of average height (5’9” with a slim build). Donnie is concerned that Isaac may be too small for his age. (Learning Objectives 1)

a. What can the nurse communicate to Isaac’s father about his physical growth?

b. What can the nurse teach Isaac’s father about his cognitive and psychosocial development?

c. What can the nurse teach Isaac’s father about his moral development?

2. Nina is the 5-year-old adopted daughter of Sarah and Tim Johnson. Nina is the Johnsons’ only child. They adopted Nina before her first birthday. The Johnsons have brought Nina to the clinic today to discuss some concerns they have about her development. Nina is attending a public kindergarten. Since beginning school, the Johnsons have noticed that they are catching Nina lying more. They are concerned that this may be a result of attending school. In addition, they are concerned about her verbal development and note that her teacher reported that Nina seems to be stuttering or repeating the term “um” when speaking. She also has some difficulty with “sh” and “th” sounds. When the Johnsons try to discuss these issues with Nina she becomes “very emotional” and retreats to her room. (Learning Objectives 2 and 6)

a. What can the nurse teach the Johnsons about lying in preschool children?

b. What can the nurse teach the Johnsons regarding stuttering and speech development with Nina?

c. What can the nurse teach the Johnsons regarding emotional development in preschool children?