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PEDIATRIC NURSING: TOILET TRAINING

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TOILET TRAINING

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PEDIATRIC NURSING: TOILET TRAINING

  1. 1. TOILET TRAINING PRESENTED BY: MR DINABANDHU BARAD MSC TUTOR, SNC, SOA
  2. 2. INTRODUCTION • The children began to learn independence in self care by the time they reach 3 years of age
  3. 3. INTRODUCTION • Initially the children imitate the actions of the parents and siblings for self care.
  4. 4. INTRODUCTION • Achievement of control of the bodily functions of the defecation and urination is one of the major tasks of the toddler period during growth and development.
  5. 5. AGE FOR TOILET TRAINING • During first three months of the life the infant tends to defecate each feed due to gastrocolic reflex. • The reflex becomes weak by the age of 4 months.
  6. 6. AGE FOR TOILET TRAINING The gastrocolic reflex is a physiological reflex that controls the motility of the lower gastrointestinal tract following a meal. As a result of the gastrocolic reflex, the colon has increased motility in response to the stretch of the stomach with the ingestion of food
  7. 7. AGE FOR TOILET TRAINING • Bowel movement becomes regular without any relation to feed at about 7 months of age. • The infant can be placed on potty chair or toilet seat at the age of 10 months, as sitting without support usually achieved within this age.
  8. 8. DEVELOPMENTAL MILESTONE
  9. 9. AGE FOR TOILET TRAINING • By the age of 15-18 months toddler can walk to toilet and ready for starting toilet training and should be encouraged to go to the toilet. • At 2 years the child is trainable. • By the age of 3 years the child can withhold and postpone bowel movement.
  10. 10. AGE FOR TOILET TRAINING • For bladder control the child is able to indicate wet pant by the age of 18 months. • At 2 years, the child is generally toilet trained in the day time and remains dry by day. • The 2.5 years old child may have begun to master night time bladder control and usually by the age of 3 years becomes dry by night. • Bladder control may not be completed until the child is 4 to 5 years of age.
  11. 11. INDICATIONS OF READINESS • An important responsibility of the nurse is to help the parents to determine the readiness of their toddler for toilet training. • The actual age of readiness can be determined on the evidences of • Physiological • psychological • intellectual level of maturity.
  12. 12. PHYSIOLOGIC READINESS Children are physiologically ready for toilet training in the following situations • When neuromuscular systems are sufficiently matured (when myelination of the nerves has occurred to the urinary and the anal sphincter and the child is able to walk.
  13. 13. NEURAL CIRCUIT FROM BRAIN TO BLADDER
  14. 14. PHYSIOLOGIC READINESS • When bladder size has increased sufficiently so that the child can hold the urine for two hours or awaken from to keep the napkin dry.
  15. 15. PSYCHOLOGICAL READINESS The toddlers psychological readiness is indicated in the following situation: • When the child can distinguish between sensation of holding on and letting go and can communicate this difference to the mother or primary care giver. • When the child is attempting to imitate the parent or the sibling of the same sex in the act of urination.
  16. 16. INTELLECTUAL READINESS The toddlers who have normal intelligence and able to communicate verbally are generally ready for the toilet training by the middle of the second year of life. But those who are intellectually impaired may not be ready for a variable period after the time.
  17. 17. PROCESS OF TOILET TRAINING Bowel training is easier than the bladder training due to less number of stools in a day than number of times of urination. Parents should be made aware about the following aspects during toilet training. • Comfortable child size toilet seat or potty chair to be provided at suitable area as the child like. • Feeding at the same time each day and night
  18. 18. PROCESS OF TOILET TRAINING • Parents should stay with the child and explain in simple language about what to be done during urination and defecation. • The child should not be permitted to play with toys during toilet training to avoid distraction of the attention. • Wiping immediately and drying the child after toilet to promote comfort.
  19. 19. PROCESS OF TOILET TRAINING • Rewarding the child with praise and cuddling on desired behaviour to get cooperation . • Punishment and negative approaches by forcing on potty may lead to unsuccessful training. • Patience and persistence behaviour are necessary in helping the child during toilet training
  20. 20. PROBLEMS OF TOILET TRAINING • Delay in achieving the bladder and bowel control is common problem. • Childs illness, accidents and hospitalization during toilet training may cause regression and ineffective training. • Unsuccessful training may also occur in new home, broken family and parental divorce etc.
  21. 21. THANK YOU
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TOILET TRAINING

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