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Separation Anxiety As toddlers become increasingly skilled at mobility, they realize that if they have the capability of leaving, then so does the parent. As self-awareness develops and conflicts over closeness versus exploration occur, separation anxiety may re-emerge in the 18- to 24-month period (Lieberman, 2018). Power struggles may escalate and distress at separating from the parent may increase. Again, a predictable routine with appropriate limit setting may help toddlers to feel safer and more secure during this period. From the age of 24 to 36 months, separation anxiety again eases. The older toddler begins to have a concept of object constancy: he or she has an internal representation of the parent or caregiver and is better able to tolerate separation, knowing that a reunion will occur. Temperament Temperament is the biologic basis for personality. It is our emotional and motivational core, around which the personality develops over time (Child Development Institute, 2018). Temperament affects how the toddler interacts with the environment. The easygoing toddler may adapt more easily and not mind changes in routine as much as other toddlers. The easygoing toddler usually sleeps and eats well and has more predictable and regular behaviors. However, the toddler may still express frustration by having a temper tantrum. The “difficult” toddler is more likely to have intense reactions, negative or positive, with temper tantrums being more likely, more frequent, and more intense than in other toddlers. The structure and routine that toddlers need to feel secure are essential for the difficult toddler; otherwise, the child feels insecure and as a result is more likely to behave inappropriately. The difficult toddler is also the most active of the three temperament types. The slow-to-warm-up toddler is more of a loner and may be very shy. He or she may experience more difficulty with separation anxiety. The behavior of the slow-to-warm-up toddler is more passive; the toddler may be very watchful and withdrawn and may take longer to mature. Changes in routine usually do not result in as much upset, since the toddler’s natural reaction is one of passivity (Lieberman, 2018). Based on the toddler’s temperament, make suggestions to the parents for interacting with the toddler in various situations. For example, to avoid temper tantrums in the difficult toddler, suggest that the parent should be especially diligent about maintaining structure and routine as well as avoiding tantrum triggers such as fatigue and hunger. Explain to parents that they may need to exercise additional patience with new activities to which the slow-to-warm-up toddler may need extra time becoming accustomed. Fears Common fears of toddlers include loss of parents (which contributes to separation anxiety) and fear of strangers. Some toddlers may be very slow to warm up to people they do not know. The nurse caring for a toddler in the outpatient or hospital setting should take the time to establish a relationship with the toddler in order to allay the toddler’s fears. Toddlers may be afraid of loud noises and large or unfamiliar animals. Going to sleep may be a scary time for toddlers as they may be afraid of the dark. A nightlight in the toddler’s room may be very helpful 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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