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Toilet Teaching When myelination of the spinal cord is achieved around age 2 years, the toddler is capable of exercising voluntary control over the sphincters. Girls may be ready for toilet teaching earlier than boys. Toddlers are ready for toilet teaching when: Bowel movements occur on a fairly regular schedule. The toddler expresses knowledge of the need to defecate or urinate. This may be through verbalization, change in activity, or gestures such as: Looks into or grabs diaper Squats Crosses legs Grimaces and/or grunts Hides behind a door or the couch when defecating The diaper is not always wet (this indicates the ability to hold the urine for a period of time). The toddler is willing to follow instructions. The toddler walks well alone and is able to pull down his or her pants. The toddler follows caregivers to the bathroom. The toddler climbs onto the potty chair or toilet (AAP, 2019d). Parents should approach toilet teaching with a calm, positive, and nonthreatening manner. Initially it may be helpful to allow the toddler to observe a same-sex family member using the toilet. Start with the toddler fully clothed on the potty chair or toilet while the parent or caregiver talks about what the toilet is used for and when. The toddler will feel most comfortable with a toddler potty chair that sits on the floor. If a potty chair is unavailable, facing toward the toilet tank may make the toddler feel more secure, as the buttocks remain on the front of the seat rather than sinking through the toilet seat opening. After a week or longer, remove a dirty diaper and place the contents in the toilet. Next, try having the toddler sit on the potty chair or toilet without pants or diaper on. The toddler may benefit from watching a caregiver or friend use the toilet. It may also be beneficial to demonstrate using the potty chair with a baby doll that wets. Parents should always use gentle praise and no reproaches. Usually the best time to achieve success with defecation on the toilet is following a meal. When the toddler has achieved success with bowel control, bladder control will come next. It may be many months before nighttime bladder control is achieved, and the toddler may still require a diaper at night. Parents should use appropriate words for body parts, urination, and defecation, then use those words consistently so the toddler understands what to say and do (AAP, 2019a). After a couple of weeks of successful toileting, the toddler may start wearing training pants. When toddlers have an accident and do not make it to the toilet, gently remind them about toileting and let them help clean up. Toddlers should never be punished for bowel or bladder “accidents.” With so much attention focused on the genitalia during toilet teaching and the frequency of being without a diaper, it is natural for toddlers to become more focused on their own genitalia. Boys and girls both will explore their genitalia and discover the resulting pleasurable sensation. Masturbation in the toddler often causes a great deal of discomfort in the parent. The parent should not draw attention to the activity, as that may increase its frequency. The parent should calmly explain to the toddler that this is an activity that may only be done in private (Carter & Feigelman, 2020b). If the toddler is masturbating excessively or refuses to stop when in public, then there may be additional stressors in the toddler’s life that should be explored. after reading the above text answer the follwing questions 1. Implications for nursing and your management plan 2.Teaching information for parents and/or the patient 3. Relevant assessment data such as pathophysiology, medications, pertinent laboratory values, growth and development considerations, etc.Images and charts of relevant data 4.A nursing journal related to your topic with discussion.
SCIENCE
HEALTH SCIENCE
NURSING
NURSING PEDIATRIC

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