What piece of anticipatory guidance would you give to the parents of a toddler preschooler?

Safety in the Home
Key areas of concern for keeping toddlers safe in the home include avoiding exposure to tobacco smoke, preventing injury, and preventing poisoning.

AVOIDING EXPOSURE TO TOBACCO SMOKE
Environmental exposure to tobacco smoke has been associated with increased risk of respiratory disease and infection, decreased lung function, and increased incidence of middle ear effusion and recurrent otitis media. It may also hinder neurodevelopment and may be associated with behavior problems

Parents should avoid cigarette smoking entirely to best protect their children. Even smoking outside of the home is suboptimal because smoke lingers on parents' clothing and children who are often carried (such as younger toddlers) face more exposure. Counsel parents to stop smoking (optimal), but if they continue smoking never to smoke inside the home or car with children present.

PREVENTING INJURY
The toddler is able to open drawers and doors, unlock deadbolts, and climb anywhere he or she wants to go. Toddlers have a limited concept of body boundaries and essentially no fear of danger. Toddlers may fall from any height to which they can climb (e.g., play structures, tables, counters).

They may also fall from wheeled toys such as tricycles. As toddlers gain additional height and hand dexterity they are able to reach potentially dangerous items on the counter or stove, leading to an accidental ingestion, burn, or cut.

The AAP advises against having guns in homes with children. If a gun is kept in the home it should be stored unloaded and locked away.

To prevent injury in the home, stress the following to parents:
Never leave a toddler unsupervised out of doors.
Lock doors to dangerous rooms.
Install safety gates at the top and bottom of staircases.
Ensure that window locks are operable; if windows are left opened, then secure all window screens.
Keep pot handles on the stove turned inward, out of an inquisitive toddler's reach.
Teach the toddler to avoid the oven, stove, and iron.
Keep electrical equipment, cords, and matches out of reach.
Remove firearms from the home, or keep them in a locked cabinet out of the toddler's reach.
Always require the child to wear a helmet approved by the Consumer Products Safety Commission (CPSC) when riding a wheeled toy. This starts the habit of helmet wearing early, so it can be more easily carried over to the bicycle-riding years of the future.
Begin teaching the toddler about watching for cars when crossing the street, but always carry or hold the hand of the toddler when crossing the street.
Teach the toddler to avoid unknown animals.

PREVENTING POISONING
As toddlers become more mobile, they are increasingly able to explore their environment and more easily and efficiently gain access to materials that may be unsafe for them to handle.

Their natural curiosity leads them into situations that may place them in danger. Poor taste discrimination in this age group allows for ingestion of chemicals or other materials that older children would find too unpleasant to swallow. Box 26.2 lists most potentially dangerous ingested poisons.

Discuss poison prevention in the home at each well-child visit. The AAP (2015c) recommends that potentially poisonous substances (e.g., medications, cleaners, hair care products, car care products) be stored out of the toddler's teach, out of the toddler's sight, and in a childproof, locked cabinet.

Store all substances in original containers only.
Never store any liquid other than soda in a soda pop bottle.
Do not allow toddlers access to baby powder, lotion, cream, or other toddler hygiene products.
Ensure all medications have child-safety caps.
Do not leave within the toddler's reach medications such as lozenges or samples that are not packaged in safety bottles.
Be very careful with medications that are provided in transdermal patch form.
Do not refer to medicines as candy, as the toddler may mistake pills for candy and ingest them.
Do not expose toddlers to hazardous vapors such as paints, cleaners, tobacco smoke, and especially street drugs such as crack and marijuana.
Keep "button" batteries secured and away from a toddler's reach.
Keep house plants off the floor, remove them from the home, or hang them or place them on a high shelf

Most dangerous potential poisons
Medicines (especially iron)
Cleaning products
Antifreeze, windshield washer solution
Alcohol
Pesticides
Gasoline, kerosene, lamp oil, furniture polish
Wild mushrooms

Safety in the Water
Drowning is the leading cause of unintentional injury and death in US children, with nearly half of drowning victims being 4 years old and younger

Drowning may occur in very small volumes of water such as a toilet, bucket, or bathtub, as well as the obvious sites such as swimming pools and other bodies of water. Toddlers' large heads in relation to their body size place them at risk for toppling over into a body of water that they are inquisitive about.

Toddlers should be supervised at all times when in or around the water. In general, most children do not have the physical and cognitive capabilities necessary to truly learn how to swim until 4 years of age. Parents who want to enroll a toddler in a swimming class should be aware that a water safety skills class would be most appropriate.

However, even toddlers who have completed a swimming program still need constant supervision in the water

Discipline is a common concern during toddlerhood. The toddler's intense personality and extreme emotional reactions can be difficult for parents to understand and cope with. The toddler needs firm, gentle guidance to learn what the expectations are and how to meet them.

The parent's love and respect for the toddler teach the toddler to care about himself or herself and for others. Affection is as important as the guidance aspect of discipline. Having realistic expectations of what the toddler is capable of learning and understanding can help the parent in the disciplinary process. The toddler's intense push for autonomy can often test a parent's limits. The easygoing infant usually becomes more challenging in toddlerhood.

The toddler's continual quest for new experiences often places the toddler at risk, and his or her negativism very often taxes the parent's patience.

In an effort to prevent the toddler from experiencing harm and in response to his or her continual testing of limits, parents often resort to spanking. Though commonly accepted, the AAP and the NAPNAP recommend against corporal or physical punishment

Recent research points out the dangers inherent in the use of corporal punishment as well as the possibilities for negative effects on the child's future behavior (Box 26.5). Spanking or other forms of corporal punishment lead to a pro-violence attitude, create resentment and anger in some children, and contribute to the cycle of violence

Toddlers younger than 18 months of age should NEVER be spanked, as there is an increased possibility of physical injury in this age group. Also, the infant/young toddler is not capable of linking the spanking with the undesired behavior

Normal toddler development includes natural curiosity, and this curiosity often results in dangerous or problematic activities for the toddler (Lyness, 2013). Toddlers have a difficult time learning the rules and, in general, do not behave badly intentionally. Providing a childproof environment will allow the toddler to participate in safe exploration, which will meet his or her developmental needs and decrease the frequency of intervention needed on the part of the parents.

Discipline should focus on limit setting, negotiation, and techniques to assist the toddler to learn problem solving. Parents should provide consistency and commit to the limits that are set.

Offering realistic choices helps give the toddler a sense of mastery. Rules should be simple and limited in number. Maintaining the toddler's schedule of meals and rest/sleep will help to prevent conflicts that occur as a result of hunger or fatigue. Toddlers should not be made to share, as this is a concept they do not understand.

Parents should encourage simple activities enjoyed by the children involved and avoid confrontation over toys. Parents should offer toddlers appropriate choices to help them develop autonomy, but should not offer a choice when none exists.

Positive reinforcement should be used as much as possible. "Catching" a child being good helps to reinforce appropriate or desirable behaviors. When the toddler is displaying appropriate behavior, the parent should reward the child consistently with praise and physical affection.

"Time-out" can be used effectively at around 2.5 to 3 years of age.

"Extinction" is a particularly useful technique with 2- and 3-year-olds. Extinction involves systematic ignoring of the undesired behavior. Parents sometimes unknowingly contribute to the occurrence of an unwanted behavior simply by the attention they give the toddler (even if it is negative in nature, it is still attention).

Parents who want to extinguish an annoying (nondangerous) behavior should resolve to ignore it every time it occurs. When the child withholds the behavior or performs the opposite (appropriate) behavior, they should use compliments and praise. It may be difficult to ignore a difficult behavior, but the results are well worth the effort.

Spanking is less effective than time-out or other discipline measures to reduce undesired behavior in children.
The toddler younger than 18 months of age
Is not capable of making the appropriate connections between spanking and the undesired behavior
Is at increased risk for physical injury from spanking than older children
Physical punishment
May lead to a pro-violence attitude
May create resentment in the toddlerIs a poor model for learning effective problem solving
May be correlated with antisocial and criminal behavior later in life
Leads to increased aggression in preschoolers, school-age children, and adults
When used frequently, may weaken the parent-child relationship
Childhood corporal punishment increases the probability of depression and substance abuse in adulthood.
Spanking may lead to more severe forms of punishment and to actual child abuse and maltreatment.
The more frequently children are hit or spanked, the more likely they are to hit their own children and to be involved in spouse abuse as adults.

When giving the toddler instructions, tell the child what to do, NOT what not to do. This allows for a positive focus. If you must say "no," "don't," or "stop," then follow with a direction of what to do instead.
Offer limited choices, when a choice is truly available. Say, "Do you want to wear your blue hat or your red hat?" NOT "Do you want to put on your hat?" This gives the toddler some, but not all, control.
Role model appropriate communication, but don't feel like you have to speak nicely all the time. If the situation warrants, use a firm and even tone to get the point across. Avoid yelling.

Pay attention to the inflection in your voice. A statement or direction should not end in a questioning tone or with "Okay?" Be clear. Statements should sound like statements, and only questions should end in a questioning tone.
When a toddler behaves aggressively, label the child's feelings calmly, but be firm and consistent with the expectation. For example, "I know you're mad at your friend, but it is not okay to hit."

Handguns, matches, bodies of water, bicycle riding, and poisons continue to be sources of potential injury during the preschool years. Falls account for the highest percentage of nonfatal injuries among preschoolers. In this age group, motor vehicle accidents are responsible for the most fatal injuries, followed by drowning. A significant number of injuries also occur in or around the home, including burns and poisoning

PREVENTING EXPOSURE TO TOBACCO SMOKE
Parents should protect their preschoolers from second-hand tobacco smoke. Exposure to tobacco smoke is associated with an increased incidence of otitis media and respiratory infections, as well as increased symptoms and medication use in children with asthma. Other effects include decreased lung function and behavioral difficulties (World Health Organization, n.d.). The preschool child should never be in an enclosed space (such as a car) where tobacco smoke is present.

PREVENTING INJURY
The preschool child who runs out into the street is at risk for being struck by a car. Teach preschoolers to stop at the curb and never go into the street without a grown-up. The preschooler may learn to ride a bicycle (with or without training wheels). The child must wear an approved bicycle helmet any time he or she rides the bicycle, even if it is just in the driveway. Requiring helmet use in the early years may lead to the habit of helmet use as the child gets older. Allowing the preschooler to choose his or her own helmet may encourage the child to use the helmet.

Bicycles should be safe for this age group. The size must be correct; the balls of the feet should reach both pedals while the child is sitting on the seat and has both hands on the handlebars. Children younger than 5 years of age have difficulty learning to use hand-operated brakes, so traditional pedal-back brakes are recommended in this age group. Preschoolers are not mature enough to ride a bicycle in the street even if they are riding with adults, so they should always ride on the sidewalk (AAP, 2015b).

It is important to make the inside of the home safe for the preschool child. Parents should install and maintain smoke alarms as well as carbon monoxide detectors in the home. Increased physical dexterity and refinement of motor skills enable the preschooler to strike matches or use a lighter and start a fire. The preschool child is capable of washing his or her hands independently, so the water heater should be set at (49°C) (120°F) or below to prevent scalding (AAP, 2015a).

The preschooler's active imagination and desire to play make-believe may result in a firearm injury. The average preschooler is physically capable of handling and firing a gun, particularly a handgun, which is smaller and lighter. If present in the home, firearms should be kept in a locked cabinet with the ammunition stored elsewhere (AAP, 2015a, AAP, 2015b).

PREVENTING POISONING
Though it is continuing to develop, preschoolers still have unrefined taste discrimination, placing them at risk for accidental ingestion. Parents should never try to coax a child to take a vitamin supplement, tablet, or pill by calling it "candy." Dangerous fluids should be stored in their original containers and should be kept out of reach of preschoolers; they should not be poured into containers that look like ordinary drinking glasses or cups. Potentially dangerous cleaning or personal health and beauty products, gardening and pool chemicals, and automotive materials should be kept out of reach of preschoolers and in a locked cabinet if possible. Medications should have childproof caps and should be kept in a locked cabinet. The Poison Control Center telephone number should be posted on or near the home phone

School-age children become more independent with age. This independence leads to an increased self-confidence and decreased fears, which may contribute to accidents and injuries. School age is a time that the child may walk to school with peers who may influence his or her behavior. Increased independence may also increase exposure to dangerous situations such as the approach of strangers or unsafe streets. Promotion of safe habits during the school-age years is important for parents and nurses

Unintentional injuries are the leading cause of death in children between 1 and 19 years of age (Gilchrist, Ballesteros, & Parker, 2012). Each year, 9.2 million children seek medical attention for nonfatal unintentional injuries

School-age children are very active at home, in the community, and at school. This increased mobility, activity, and time away from parents increase the risk for unintentional injuries. School-age children continue to need supervision and guidance. They need information and rules about car safety, pedestrian safety, bicycle and other sport safety, fire safety, and water safety.

Car Safety:
Seat belt or age- and weight-appropriate booster seat should be used at all times. The lap belt should lie low and flat on the hips and the shoulder belt should lie on the shoulder not the neck or face (usually when the child is about 144.8 cm [57 inches] tall)
Seat belts should be fastened before car is started
Children under 13 years must sit in back seat
Childproof locks should be used in back seat
Rules of conduct for car rides must be established
Motor vehicle accidents are a common cause of injury in the school-age child. While traveling in the car, school-age children should always sit in the rear seat. The front seat is dangerous because of passenger-side airbags in most new-model cars. A school-age child over 18.1 kg (40 lb) (generally 4 to 8 years of age) should use a belt-positioning, forward-facing booster seat using both lap and shoulder belts School-age children who outgrow the convertible restraint can sit in a booster seat until the vehicle seat belt restraint fits properly over the hips and shoulder, typically when they are 144.8 cm (4 feet 9 inches) or taller, usually between 8 and 12 years of age
The seat belt needs to lie low and flat over the hip bones and across the shoulder not the neck or face. Children younger than 13 years of age should not ride in the front seat of a vehicle with an airbag

Pedestrian Safety
Children younger than 10 years of age should not be unsupervised pedestrians
Young school-age children therefore should walk to school or the bus with an older friend, sibling, or parent.
Darting out into the street without looking both ways or from between cars is a common occurrence in the school-age years. Teach children safe street and pedestrian practices.
Child should be instructed to stop at the curb and look right, left, then right again before crossing the street; and crossing only at safe crossings
Older children and adults should provide supervision of younger children
Walking should only be done on sidewalks
In parking lots, children should know to watch for cars backing up and not dart out between parked cars
If children are playing outside, drivers should be aware of their presence before backing up

Bicycle and Sport Safety
Bicycling, riding scooters, skateboarding, and inline skating or roller skating are common activities of school-age children. Laws in some states require helmets for riding bicycles and scooters. In addition, when skating or skateboarding, school-age children should wear a helmet, kneepads, and elbow pads.
Research has shown that head injuries due to bicycle accidents have been reduced by 85% by wearing a well-fitting helmet
It is important for children to wear helmets that fit and that do not obstruct their vision or hearing. Because school-age children have completed most of their skull growth, a helmet can be worn into adolescence. It is important for the child to have a bicycle that is appropriate for his or her size and age.
The child should be able to plant both feet on the ground when sitting on the seat of the bike
It is important to stress to parents the importance of appropriate size and not to get a bike for the child to "grow into." If older school-agers are using the bike for transportation on busy streets, they should be taught to use bike lanes and to give appropriate hand signals for turning. Nonmotorized and motorized scooters also place children at risk for injury, so counsel families about the use of protective gear, including helmets, elbow pads, and kneepads.

Bike Safety: General
Child should know to wear a properly fitted, CPSC (Consumer Product Safety Commission) or Snell-approved helmet every time he/she rides a bike.
Proper fitting helmet should: sit level, not tilted, and firmly and comfortably on the head; have strong wide Y-shaped straps and when you open your mouth should pull down a bit; not move with sudden pulling or twisting; never be worn over anything else (hat, scarf, etc.)
Bikes should be well maintained and appropriately sized.
Child should be oriented to bike and demonstrate ability to ride bike safely before being allowed to ride on street.
Safe areas for bike riding should be established as well as routes to and from area of activities.
Riding bike barefoot, with someone else on bike, or with clothing that might get entangled in the bike should be prohibited.
Child should know to wear sturdy, well-fitting shoes.
Bike should be inspected often to ensure it is in proper working order.
A basket should be used to carry heavy objects.

Bike safety in traffic
All traffic signs and signals must be observed.
If riding at night, the bike should have lights and reflectors and the rider should wear light-colored clothes
Child should know to ride on the side of the road traveling with traffic, and keep close to the side of the road in single file
Child should learn to watch and listen for cars
Headphones should not be used while riding a bike
Never hitch a ride on any vehicles

Sports Safety
Sports should be matched to child's ability and desire
Sports program should have warm-up procedure
Coaches should be trained in CPR and first aid
Appropriate protection devices should be used for individual sport

Skateboarding and inline skating
Child should wear helmet, and protective padding on knees, elbows, and wrists
Child should know not to skate in traffic or on streets or highways
Homemade ramps should be assessed for hazards before skating

All-terrain vehicle
Child should be at least 16 years of age to operate vehicle
Helmets must be worn in addition to protective coverings
No night-time riding
Use should be avoided on public roads
Never stand up in the vehicle or ride in a person's lap

Fire Safety
School-age children are eager to help parents with cooking and ironing. They are curious about fire and are drawn to play with fire, matches, and fireworks.
Serious burns can occur from any exposure to fire.
Educate children about the hazards of fire. In addition, teach children proper behavior around fires at home and outdoors.
Always supervise children in the use of matches. In the home setting, parents should develop a fire safety plan with their children, teach children what to do if their clothes catch on fire, and practice evacuating the house in the event of a fire. In the school setting, children should be aware of the appropriate response to fire drills and fire drills should be conducted on a regular basis.
All homes should have working smoke detectors and fire extinguishers. Change the batteries at least twice a year
Have a fire-escape plan
Practice fire-escape plan routinely
Nobody should smoke in the home especially in bed
Teach what to do in case of a fire: use fire extinguisher, call 911, and how to put out clothing fire
Use stove and other cooking facilities under adult supervision
All flammable materials and liquids should be stored safely
Fireplaces should have protective gratings
Teach children to avoid touching wires they might encounter while playing

Water Safety
Teach school-age children swim and water safety. An adult should always supervise children when they are swimming to prevent water-related accidents.
Teach children how to swim and to never play around or in water without adult supervision
If swimming skill is limited, child must wear life preserver at all times
Child should know never swim alone—if at all possible, swim only where there is a life guard
Understand basic CPR
Teach child to never run or fool around at edge of pool
Drains in pool should be covered with appropriate cover
Life jackets should be worn when on boat
Make sure water is deep enough to support diving

Firearm Safety
Teach child never to touch guns—tell an adult
If have guns in household, need to secure them in a safe place, use gun safety locks, store bullets in a separate place
Never point a gun at a person

Toxin Safety
Teach child the hazards of accepting illegal drugs, alcohol, or dangerous drugs
Store potential dangerous material in a safe place

Unintentional injuries are the leading causes of death in adolescents

Motor vehicle accidents are the leading cause of injury death followed by poisoning, which includes prescription drug overdose

Males are more likely than females to die of any type of injury

Poisoning is the only unintentional injury rate to increase and death from prescription drug misuse is a growing concern

Influencing factors related to the prevalence of adolescent injuries include increased physical growth, insufficient psychomotor coordination for the task, abundance of energy, impulsivity, peer pressure, and inexperience. Impulsivity, inexperience, and peer pressure may place the teen in a vulnerable situation between knowing what is right and wanting to impress peers.

On the other hand, teens have a feeling of invulnerability, which may contribute to negative outcomes.

Alcohol and other drugs are contributing factors in automobile and firearm accidents among adolescents. Most of the serious or fatal injuries in adolescents are preventable

Nurses must educate parents and adolescents on car, gun, and water safety to prevent unintentional injuries.

Motor Vehicle
The largest numbers of adolescent injuries are due to motor vehicle crashes. When the adolescent passes his or her driving test, he or she is able to drive legally. However, driving is complex and requires judgments that the teen is often incapable of making. Also, the typical adolescent is opposed to authority and is interested in showing peers and others his or her independence. It is also normal for teens to take risks.
Teenagers are the least likely age group to wear a seat belt, with males less likely than females.
Crashes involving adolescents are more likely to involve speeding, driving too fast for conditions, or following too close to the car in front of them
More accidents occur when passengers, mostly other teenagers, are present in the car, during driving at night, or driving under the influence of alcohol or drugs
It is essential to promote driver education, to teach about the importance of wearing seat belts, and to explain laws about teen driving and curfews
Many states have enacted a Graduated Driving License (GDL) program, which allows teens to gain driving experience and limits risky circumstances (such as nighttime driving and driving with passengers) by providing a license in three stages (learners' permit, provisional license, and full license)
Wear seat belt at all times.
Do not drive or drive with someone who is impaired.
Take driver-education course.
Establish driving rules between parent and adolescent prior to getting license.
Have all passengers wear seat belts.
Do not use cell phone or text while driving, drink and drive, or drive when tired.
Maintain car in good condition.
Drive with adult supervision for a period of time after receiving license.
Encourage limit on teenage passengers.

Bike: General
Have a well-maintained and appropriate-size bike for adolescent.
Adolescent should demonstrate his or her ability to ride bike safely before being allowed to ride on street.
Safe areas for bike riding should be established as well as routes to and from area of activities.
Should not ride bike barefoot, with someone else on bike, or with clothing that might get entangled in the bike.
Should wear sturdy, well-fitting shoes and CPSC (Consumer Product Safety Commission) or Snell-approved helmets
Proper fitting helmet should: sit level, not tilted, and firmly and comfortably on the head; have strong wide Y-shaped straps and when you open your mouth should pull down a bit; not move with sudden pulling or twisting; never be worn over anything else (hat, scarf, etc.)
Bike should be inspected often to ensure it is in proper working order.
A basket should be used to carry heavy objects.

Bike: In traffic
All traffic signs and signals must be observed.
If adolescent is riding at night, the bike should have lights and reflectors and the rider should wear light-colored clothes.
Should ride on the side of the road traveling with traffic and keep close to the side of the road in single file.
Should watch and listen for cars and never hitch a ride on any vehicle.
Should not wear headphones while riding a bike.

All-terrain vehicles
Should not be operated by an adolescent younger than 16 years of age.
Helmet and protective coverings required.
No nighttime riding.
Not for use on public roads or if teen has been drinking or using drugs.
Do not stand up in the vehicle or ride in a person's lap.

Skateboards/skates
Wear helmet, and protective padding on knees, elbows, and wrists.
Do not skate in traffic or on streets or highways.
Skating on homemade ramps could be dangerous—assess ramps for any hazards before skating.

Water Safety
Learn how to swim; if swimming skill is limited, must wear life preserver at all times.
Never swim alone—should, if at all possible, swim only where there is a life guard.
Learn basic cardiopulmonary resuscitation (CPR).
Do not run or fool around at edge of pool.
Drains in pool should be covered with appropriate cover.
Wear life jacket when on boat.
Make sure there is enough water to support diving.
Do not swim if drinking alcohol or using drugs.
Drowning is a needless cause of death in adolescents. Many drownings are a result of risk-taking behaviors.
With the independence of the adolescent, many times, adult supervision is not prevalent and the teen takes a risk that results in drowning.
Provide water safety education and proper supervision to decrease the incidence of risk taking.
Teach about swimming lessons for nonswimmers

Firearms
If guns are in household, should take firearm safety class, secure guns in safe place, use gun safety locks, and store bullets in separate place.
Never point a gun at a person.
The risk of dying from a firearm injury among 15- to 19-year-olds has been rising. Eighty-three percent of homicides and 45% of suicides in children and adolescents were caused by a firearm
Provide education about gun safety. Guns in the home must be kept and locked in a safe location, with ammunition kept separately.
Parents must teach adolescents about the dangers of playing with firearms.

Fire Safety
All homes should have working smoke detectors and fire extinguishers. Change the batteries at least twice a year.
Have a fire-escape plan and practice the plan routinely.
No smoking in bed.
Teach what to do in case of a fire—use fire extinguisher, call 911, how to put out clothing fire.
All flammable materials and liquids should be stored safely.
Fireplaces should have protective gratings.
Avoid touching any downed power lines.

Machinery
Use safety devices.
Receive training on how to use equipment.
Do not use when alone.

Sports
Match sport to adolescent's ability and desire.
Sports program should have warm-up procedure and hydration policy.
Undergo sports physical before start of activity.
Coaches should be trained in CPR and first aid.
Wear appropriate protection devices for individual sport.

Sun
Use sunscreen with both ultraviolet A (UVA) and ultraviolet B (UVB) protection.
Apply sunscreen prior to going out and reapply sunscreen often.
Limit sun exposure, especially between 10 AM and 2 PM.
Wear hat and sunglasses while outside.

Personal Safety
Never go with a stranger.
Do not enter a car when the driver has been drinking.
Notify an adult where you are when out after dark.
Keep cell phone fully charged.
Never give out personal information over the internet.
Say "no" to drugs, alcohol, or smoking, or to being touched when you do not want to be touched.

Toxins
Teach the hazards of accepting illegal drugs, alcohol, dangerous drugs.
Store potential dangerous material in safe place.

The prevalence of obesity is highest in Hispanic males and African American females between the ages of 12 and 19 years

This increase in obesity in adolescents has led to increases in hypertension, heart disease, and type 2 diabetes. Influential factors causing obesity include poor food choices, unhealthy eating practices, and lack of exercise.

Twenty-nine percent of youth reported drinking sugary beverages at least once a day and 67% reported not attending physical education classes

Most U.S. children and adolescents do not follow or meet the number of daily servings or variety of foods recommended by the dietary guidelines for Americans set out by the HHS and the USDA

Adolescents are busy and eat on the run, with many meals from fast-food facilities. In addition, many schools have decreased or discontinued physical education, which has resulted in a more sedentary lifestyle, leading to weight gain. Interest in computer games, smart phones, and television watching at home has decreased physical activity and exercise and further contributed to weight gain and obesity

Nurses must make parents and adolescents aware of factors leading to obesity. Nurses should recommend:
Proper nutrition and healthy food choices
Good eating habits, including eating a healthy breakfast daily
Decreased fast-food intake
Physical activity for at least 60 minutes daily
Parents/adolescents exercising more at home
Parents living a healthy lifestyle
Decreasing nonactive computer and smartphone use and video, DVD, and television viewing

Television, the internet, and other forms of media, such as cell phones, iPads, and social media sites, are a large force in teens lives today.

Teenagers spend more than 11 hours a day with a variety of different media.

Seventy-five percent of teenagers own a cell phone, with almost all teens (88%) sending text messages

With greater technology and media access comes benefits such as enhancing communication skills, increasing social connections, and improving technical skills, but risks also exists, such as cyberbullying, sexting, exposure to inappropriate content, privacy issues, internet addiction, and sleep deprivation.

Health care providers need to assess media use and advise parents on ways to decrease media risks. Parents should be advised to evaluate websites their adolescent wants to participate in and verify they are age-appropriate.

Parents should talk to their adolescent children daily about online use and activity. They need to discuss the dangers of sharing too much information, posting images or photographs, and the fact that once something is online it is available for others to see and share.

Parents need to be educated on the technology their children are using and encourage the development of a family media use plan that involves establishing reasonable rules about use of cell phones, texting, the internet and social media use, such as no media during meals and regular checking of privacy settings and online profiles for inappropriate content

Three key elements have been proposed by researchers to foster healthy internet habits in teens. These are the right balance between online and offline activities, proper set of online boundaries, and regular communication with a trusted adult about their online experiences

What is important anticipatory guidance for the parents of a 4 month old?

What anticipatory guidance would you give for an infant?

At what age would it be appropriate to start parental anticipatory guidance about teething?

What is anticipatory guidance for adolescent?