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Difficulty: HardDevelopmental Stages and Transitions

A pediatric clinic nurse is providing anticipatory guidance to the parents of a 30-month-old toddler. The parents are expecting their second child in two months. Which of the following instructions should the nurse include to support the toddler's developmental transition and promote a safe environment? Select all that apply.

  1. Transition the toddler from a crib to a youth bed at least one month before the newborn's arrival.Answer
  2. Delay the initiation of toilet training until the family routine has stabilized after the birth.Answer
  3. Provide the toddler with a baby doll to practice caregiving and role-playing activities.Answer
  4. D
    Explain to the toddler that the new baby will be an active playmate as soon as they come home.
  5. E
    Implement a structured punishment system to immediately correct any regressive behaviors, such as bedwetting.
  6. F
    Expect the toddler to safely hold the newborn's bottle during feedings to foster sibling attachment.

Answer

The correct interventions are transitioning to a youth bed a month early, delaying toilet training, and providing a baby doll for role-playing.
Supporting a toddler through the arrival of a sibling requires minimizing concurrent stressors and fostering developmentally appropriate coping mechanisms. Transitioning the toddler to a youth bed well before the birth prevents feelings of displacement. Delaying toilet training is recommended because major transitions often cause stress and regression, making it an inappropriate time to introduce a new, demanding skill. Providing a baby doll encourages symbolic play, which aligns with Piaget's preoperational stage and allows the toddler to safely process the transition through imitation.

Step-by-Step Solution

1
Analyze the client's developmental stage.
The 30-month-old client is in Erikson's Autonomy vs. Shame and Doubt stage and Piaget's early Preoperational stage.
Understanding baseline developmental milestones is required to formulate an appropriate care plan.
2
Evaluate the impact of the upcoming family transition.
The arrival of a newborn introduces significant stress, often leading to feelings of displacement and regressive behaviors in toddlers.
Anticipatory guidance must address the psychological impact of sibling arrival.
3
Review each option against developmental safety and psychosocial principles.
Interventions that introduce changes gradually, utilize symbolic play, and minimize concurrent stressors are appropriate. Punitive measures or unrealistic expectations are incorrect.
Nursing interventions must be developmentally safe and promote healthy coping mechanisms.

Key Concept

Toddler Psychosocial Development and Sibling Adaptation
Estimated Time:1m 30s
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Topics

Developmental Stages and Transitions

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