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NRS 434 Describe the developmental markers a nurse should assess for a 9-month-old female infant

NRS 434 Describe the developmental markers a nurse should assess for a 9-month-old female infant

NRS 434 Describe the developmental markers a nurse should assess for a 9-month-old female infant

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).

According to the CDC (2020) a 9-month-old baby should be able to do a few things that is important and will indicate how the baby progress for her age. Social and Emotional: Baby may be afraid of strangers and attached with those familiar with them. Language/Communication: Understands “no” and make different sounds that seems like “mama”, Cognitive: plays peek-a-boo, can hold cereal between pointer finger and thumb. Physical development: sits by themselves without support, crawls. (Green, 2018) These are` some of the developmental markers for a 9-month-old baby.

Various assessments are done to ensure that the baby is on the right track developmental wise. It is important for parents to be part of the assessments so they can understand what to look for. Before any recommendations can be given to the mother, assessment will be done in order to give appropriate information. I would talk to the mother and enquire about the baby’s feed regiment. I would also have to know if the mother was breast feeding. We will discuss feeding schedules and if the mother was breast feeding. It is important to know if she produces enough milk to satisfy the baby and how often. Once all the information is collected, we can recommend food that is nutritious for the baby, draw up a schedule to ensure that the baby eat, and drink as scheduled.

NRS 434 Describe the developmental markers a nurse should assess for a 9-month-old female infant

References

Center for Disease Control and Prevention

(CDC). (2020). Important milestone: Your baby by nine months. Retrieved from https://www.cdc.gov/ncbddd/actearly/milestone/milestone-9mo.html

The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to caregivers.

Create a 10-12 slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end.

In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored.

Green,S.Z. (2018). Health assessment: Foundation for effective practice. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundation-for-effective-practice/v1.1/

Hello Valencia, it is true that feeding program of the baby are among the factors that ne must consider. For the case of breastfeeding mothers, we must understand the amount of milk the mother was producing since its fundamental in the development process of the child. I am impressed you have discussed an important factor that most people don’t think s impotant, especially with the diverse family set up that we have today.

Thank you. When babies or children present with underweight the first thing that comes to mind is feeding although they maybe underlying medical conditions,it is important to rule out those. For the breastfeeding mothers to be able to produce breast milk they should take themselves balanced meals , be well hydrated and have they their minds relaxed. Stress affects milk production so education on that should be given.

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As per the CDC growth chart, a 9-month-old girl who weighs 6.75 kg represents 5th percentile on CDC growth chart. The head circumference of 43 cm and length of 68.5 cm for 9month-old represents 25th percentile per CDC growth chart which is normal and nothing to be concerned about. A 9-month-old should have several fine motor skills such as banging objects on the table, transfer objects from one hand to another and feeds self-finger food. They should also have gross motor skills such as able to crawl, sit without support, able to get into sitting position, pulls self to standing position, stands while holding onto a support and making stepping movement (Green, 2018). If this 9-month-old girl has developed age-appropriate milestones then it is not that concerning.  I will recommend to the mother to continue breastfeeding, monitor her food intake and introduce some solid food as in fruits such as a banana. I will encourage the mother to keep her immunization up to date to prevent infection. Mother should be advised to seek early medical help if she runs fever, vomiting or any other sickness that can cause baby to lose further weight.

Failure to thrive is a condition commonly seen by primary care physicians. Prompt diagnosis and intervention are important for preventing malnutrition and developmental sequelae. Medical and social factors often contribute to failure to thrive. Either extreme of parental attention (neglect or hypervigilance) can lead to failure to thrive. About 25 percent of normal infants will shift to a lower growth percentile in the first two years of life and then follow that percentile; this should not be diagnosed as failure to thrive. Many infants with failure to thrive are not identified unless careful attention is paid to plotting growth parameters at routine checkups. A thorough history is the best guide to establishing the etiology of the failure to thrive and directing further evaluation and management. All children with failure to thrive need additional calories for catch-up growth Krugman, 2003). In this scenario mother should be encouraged to make a calorie chart for the infant to ensure proper growth and development.

ALSO READ: NRS 434 Environmental Factors and Health Promotion Presentation

NRS 434 Describe the developmental markers a nurse should assess for a 9-month-old female infant

References

Green, S. Z. (2018). Grand Canyon University (E.D). Foundations for Effective Practice.  https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/1

Krugman, S. D., & Dubowitz, H. (2003). Failure to thrive. American family physician68(5), 879–884.

When thinking of failure to thrive most of us would immediately jump to an older adult that is small and fragile. Personally, I never thought about infants and babies having this same presentation. Though we learn about it in nursing school, failure to thrive for children gets pushed to the back of our minds, but like you said is more common than we’d think. I agree, these findings are not terribly concerning if other developmental milestones are being met. I did not know hypervigilance could also cause failure to thrive. Great work!

NRS 434 Describe the developmental markers a nurse should assess for a 9-month-old female infant

What questions would you ask the parents?

Thank you for your question. I would ask parents if they have any concern about baby is fine and display good motor skills. If the infant is able to sit without support, able to get into sitting position, and self-feed finger food, then I will request the parents to continue monitor infant’s feeding pattern. In addition, I would also inquire if the baby is free of diseases, how much food intake and what kind of solid food they offer to their infants. I will encourage parents to make a diet log for their infant so they can make sure their child is getting sufficient calories for their proper growth and development.

Good post. Often times, when a child presents with underweight the first thing we think of is nutrition. Evaluating the child`s eating habits and overall health is of utmost importance. Medical problems that that may have contributed to weight loss or poor weight gain need to be ruled out. It`s important to ask about the baby`s diet so as to pinpoint deficiencies. Information is given to parents to refer to the food pyramid so they can see what is lacking in the child`s diet.

NRS 434 Describe the developmental markers a nurse should assess for a 9-month-old female infant

Ref

Helping a child who is underweight

https://www.babycenter.com/child/food-and-nutrion/helping-a-child-who-is-underweight_64368

Thanks for your post. I love the points you raised regarding failure to thrive and causative factors. I completely agree with you that poverty and poor socioeconomic factors has a great role to play. However, there are some programs like Women, Infant and Children (WIC) that the nurse can recommend for such mothers as it will greatly benefit the child. This is because WIC gives free food to the baby and the mother. till the baby is 5 years old.

Read also on: https://nursingassignmentgurus.com/nrs-434-describe-the-effect-of-extremely-low-birth-weight-babies-on-the-family-and-community/

Developmental milestones are a set of goals or markers that a child is expected to achieve during maturation. They are categorized into 5 domains: gross motor, fine motor, language, cognitive, and social-emotional and behavioral. Understanding and identifying the developmental milestones can help the provider more adeptly recognize delayed development, facilitating earlier interventions and improving outcomes (Boehning, A.P, et al, 2023). At 9 months the child should be able to do perform the following: Fine motor skills: bangs on table, transfers object from one hand to the and self feeds. Gross motor skills: crawls, sits without support, able to get into sitting position, pulls self to standing position, stands while holding onto a support and males stepping movements, Language: yes, no, mama, dada, imitates sounds, cognitive development: object permanence is often learned by playing peekaboo (Falkner, A, 2022) and social-emotional and behavioral: development of stranger anxiety is manifested by crying when unfamiliar people approach the child. It is linked to infants’ developmental task of distinguishing the familiar and unfamiliar.

Given the scenario with this 9 month-old infant female the weight, height and head circumference are below the 50th percentile on the CDC growth chart represents the possibility of the premature birth or severe failure to thrive. A 9 month-old infants average weight is 9 pounds 2 ounces, height 27 1/2 inches and head circumference should measure 43 centimeters (Brusie, C, 2020). Surveillance and screenings are part of every well-child care visit. These developmental assessments are performed according to an age-appropriate milestone checklist. The purpose of these assessments allows the provider the necessary information to closely monitor a child at risk or with developmental delays. It important that the provider adjusts assessments according to the child’s chronological age and gestational age for comparison. One example, is if a child was born at 30 weeks gestation and went in for a 9-month-old well-child visit the child would be behind approximately 10 weeks on milestones due to premature birth. If there are delays noted in an exam, it is important to schedule routine follow ups to assist in early child interventions. Some interventions could include physical therapy, occupational therapy and speech therapy. The earlier delays are identified the better the prognosis for the child.

If I was the clients nurse I would start off with a detailed H&P on mother and her pregnancy, pre-existing conditions, substance abuse, complications during pregnancy or preterm delivery. In addition, I would ask for the mother about the clients nutritional intake, living environment and current situation, housing, family support or assistance, is mom employed etcetera because these could be key factors that are affecting the growth and development of the infant. After gathering this information I would be able to make a nursing diagnosis for this client to best assist their current needs. Information I could offer the mother are nutritional information for the childs age, milestones appropriate for age, age appropriate toys, household safety and hazards, sleeping safety to prevent SIDS and discuss possible referral to agencies in the community if child fails to meet future developmental milestones for early intervention to prevent further delay.

References:

Boehning, A. P., Misirliyan, S. S., & Shah, M. (2023, March 16). Development milestones – statpearls – NCBI bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557518/

Brusie, C. (n.d.). 9-month-old Baby: Development, milestones & growth. BabyCenter. (2021, Sep 21). https://www.babycenter.com/baby/month-by-month/9-month-old-baby-milestones-and-development_713

Falkner, A. (2022). 1. Health assessment of the infant. In S. Z. Green (Ed.), Health Assessment: Foundations for effective practice (second, pp. 9–19). essay, Grand Canyon University. Retrieved June 9, 2023,.