Discussion: A mother comes in with 9-month-old girl

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Discussion: A mother comes in with 9-month-old girl

Re: Topic 1 DQ 2

One assessment used to determine and measure growth and milestone in infants is anthropometric. Fundamental anthropometry involves measuring weight, length, and head circumference and plotting the figures in a chart to compare the growth of the baby with national and international standards (World Health Organization, 2006). The WHO represents these measures in percentiles which can be used over time to chart growth and act early in case of deviation. A low Weight for length percentile indicates wasting and is a sign of acute malnutrition. Low weight for age percentile may indicate stunting in growth.

Developmental delays can also be assessed through milestones. At 9 months an infant should have attained some social, cognitive, motor, and language milestones. Socially the baby should have a fear of unfamiliar people and be more attached to familiar adults. The infant should have a basic understanding of “no”, copy sounds, and point at objects of interest. Cognitive wise, the infant should be able to look for things hidden from them, play peek-a-boo and move objects between hands. Motor milestones at this age include sitting without support, crawling, pulling to a standing position, and standing with support (CDC, 2021). Major delays in these markers could point to serious issues especially neurologic deficits, learning deficiencies, and nutrition. Breastmilk provides the energy requirements and boost their immune system. Complementary feeding should be introduced if not already started as breastmilk is inadequate in sustaining the infant’s nutritional needs at 9 months (Dewey, 2013). Solid foods should be introduced slowly and increased as the baby tolerate. Also, food variety and consistency should be gradually increased. Adherence to these nutritional guidelines is important for the wellness and health of the baby (Black et al., 2008).

Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., De Onis, M., Ezzati, M., … & Maternal and Child Undernutrition Study Group. (2008). Maternal and child undernutrition: global and regional exposures and health consequences. The Lancet, 371(9608), 243-260.

Centers for Disease Control and Prevention. (2021). CDC’s Developmental Milestones. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-2yr.html

Dewey, K. G. (2013). The challenge of meeting nutrient needs of infants and young children during the period of complementary feeding: an evolutionary perspective. The Journal of nutrition, 143(12), 2050-2054.

World Health Organization. (2006). WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. World Health Organization

Consider the following patient scenario:

A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).

Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion: A mother comes in with 9-month-old girl

Re: Topic 1 DQ 2: Discussion: A mother comes in with 9-month-old girl

Developmental markers are milestones an infant achieves during their growth and development in the first couple of months of their lives. As the infant grows, the infant should achieve certain milestones, take for example, an infant between the age of 0-2 months, the infant is expected to be able to hold up their own head and to push up when they are laying on their stomach. As for the scenario in the assignment question, the mother’s child is 9-months-old, therefore, the nurse should assess the infant for the ability to achieve the milestones for the age range of the 6-9 months and start to see some attempt in activities in the age group between 9 and 12 months. The 6 to 9 month age range includes activities such as crawling, sitting without support, pulling herself up into a standing position, and/or standing while holding onto something supportive such as chairs, sofas, etc.

During the assessment, it is important as a health care professional to understand that not every child will present the same and therefore a detailed assessment is vital. For example, a young infant may not be comfortable and be experiencing shyness or fear around strangers, so it is necessary to have the caregiver in the room at all times otherwise the nurse may not obtain substantial information from the assessment in order to provide quality care. Also, the nurse should utilize screening tools like that of the Denver Developmental Screening Test II, which is useful in assessing an infant’s language and motor skills. If any developmental delays are assessed, then the nurse should notify the primary physician and the family in order to treat appropriately and provide appropriate resources.

References:

Green, S. Z. (2018).  Health assessment: Foundations for effective practice. Chapter 1: Health assessment of the infant. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/1

Health Assessment: Discussion: A mother comes in with 9-month-old girl

After assessing the infant’s growth and identifying where the infant is on the growth chart, it is important to gain information on the nutritional status of the infant. According to the WHO, infants at 9 months old should be receiving complementary foods 3-4 times/day while still receiving breastmilk and/or formula. It is important for nurses to assess the nutritional intake of the infant.

According to the CDC, milestones that should be present at 9 months include: being afraid of strangers, understanding the word “no”, copies gestures, making different sounds such as “babababa”, looks for things that he/she see you hide, puts things in mouth, plays peek-a-boo, can get to a sitting position, pulls to stand, crawls, and stands when holding on (2018).

It is important to identify developmental milestones in order to identify infants who are at risk for developmental delay. There are a variety of evidence-based screening tools that allow healthcare professionals to identify infants that are at risk for developmental delays. Some of these assessment tools include: Ages and Stage Questionnaire, Child Development Inventory, and the Parent’s Evaluation of Developmental Status (2018). According to the CDC, it is also important to educate parents on developmental milestones, that way they can inform healthcare providers regarding any concerns (2018).

References

CDC (2018). Developmental Monitoring and Screening for Health Professionals. Retrieved from: https://www.cdc.gov/ncbddd/childdevelopment/screening-hcp.html

CDC. (2018). Important Milestones: Your Baby by Nine Months. Retrieved from: https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html

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