The parent of a preschool-age client voices concerns about ...

[DyllonKazuo]

The parent of a preschool-age client voices concerns about potential developmental delays stating that the older sibling reached milestones significantly ahead of the younger child.
 
  An assessment reveals the child is able to assist with dressing and can play catch. Based on this assessment finding, which response by the nurse is the most appropriate?
  1. Your child appears to be on target with the expected milestones for age.
  2. Your older child may simply be smarter than your 3 year old.
  3. I would recommend extensive testing to determine the source of the delays.
  4. Have you spoken with the health care provider about these delays?

Question 2

During a health maintenance visit, the nurse measures the height and weight of an infant and plots the measurements on the growth chart. The nurse notes a slowed growth pattern.
 
  Which action by the nurse is the most appropriate at this time?
  1. Obtaining an endocrinologist referral.
  2. Performing a nutritional assessment.
  3. Waiting until the next visit to intervene.
  4. Assessing for circulatory problems.

[Animal_Goddess]

Answer to Question 1

Correct Answer: 1
The developmental tasks of the child are on track for age. Advising the parent one child is smarter than another is potentially damaging, as well as inappropriate. Testing is not warranted at this time, the child is within the norms of development. There are not evident delays to review with the healthcare provider.

Answer to Question 2

Correct Answer: 2

The nurse should perform a nutritional assessment because slowed growth is an early indicator of inadequate nutrition. It is expected that the rate of growth will remain consistent throughout infancy. Referring the baby to an endocrinologist would be done by the health care provider, not the nurse, as this is outside the nurse's scope of practice. The nurse should not wait until the next visit to intervene as early intervention, which commonly involves parent education and support, can often resolve problems. Before looking for other causes of slowed growth, the nurse should first assess the baby's nutritional status. Assessing for circulatory problems might follow if adequate nutrition has already been established.