A community health nurse is conducting a home visit for a family that recently welcomed a newborn. The parents express frustration regarding sudden behavioral changes in their older children. The 2-year-old has begun throwing daily temper tantrums and refusing to eat previously favored foods. The 6-year-old has developed frequent stomach aches before school, though recent pediatric physical examinations were normal. Based on the principles of developmental stages and family transitions, which of the following nursing interpretations and corresponding anticipatory guidance is most appropriate?
- The 2-year-old is exhibiting autonomy-seeking behaviors amplified by the transition, and the 6-year-old is demonstrating somatic manifestations of stress; advise offering the toddler limited choices and scheduling dedicated, uninterrupted daily time with each older child.Cevap
- BThe 2-year-old is showing signs of insecure attachment, and the 6-year-old is exhibiting classical developmental regression; recommend integrating both older children into all aspects of the newborn's daily care to foster sibling bonding.
- CThe children's behaviors indicate maladaptive coping in response to impaired role transitions; instruct the parents to implement strict disciplinary boundaries to re-establish household structure and request a behavioral therapy referral for the 6-year-old.
- DThe 6-year-old is struggling with the initiative versus guilt stage, while the 2-year-old's food refusal indicates a new sensory processing issue; suggest allowing the children to temporarily set their own daily routines to promote a sense of environmental control.
Cevap
The interpretation that the 2-year-old is exhibiting autonomy-seeking behaviors and the 6-year-old is demonstrating somatic manifestations of stress, with guidance to offer limited choices and dedicated time.
The correct response accurately applies Erikson's psychosocial theory to both children. The 2-year-old is in the 'Autonomy vs. Shame and Doubt' stage, where tantrums and food refusal are normal expressions of seeking independence, often exacerbated by the stress of a new sibling. The 6-year-old is in the 'Industry vs. Inferiority' stage; school-age children commonly express emotional stress or anxiety through somatic complaints (like stomach aches) when physical causes have been ruled out. The anticipatory guidance is evidence-based: providing limited choices gives the toddler a safe sense of control, and dedicating uninterrupted daily time reassures both children of their secure place in the family during a major transition.
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Anahtar Kavram
Developmental and Psychosocial Transitions in the Expanding Family