NSG 6430 Aquifer Case Study – Developmental Evaluation and Screening

NSG 6430 Aquifer Case Study – Developmental Evaluation and Screening

NSG 6430 Aquifer Case Study – Developmental Evaluation and Screening

Nursing: Aquifer Case Study for Pediatrics

            Aquifer Pediatrics are highly interactive and dynamic ways that help students to develop clinical reasoning skills for future successful practice. Besides, a nurse uses Aquifer Pediatrics to assess, diagnose and develop patient care plans that are based on the latest evidence-based practice as well as follow the recommended clinical guidelines. The following description is based on a response to questions from the Aquifer Case titled Pediatrics 02. It seeks to analyze nursing skills in the assessment, diagnosis, and formulation of a care plan for a patient named Asia.

History to Be Taken From Asia in Preparation for a Well-Child Visit

            Interval history is one of the pertinent questions to be concerned with as a health care provider. This entails probing the guardian about a detailed birth history and asking if the child has ever had any health problems. In case the mother has medical records, laboratory investigation results and review visits, such information is used to assess the past medical history of the child (Burns et al., 2016). The interval history also provides information on growth and development of the child. This can be achieved through the use of developmental screening tools suitable for Asia.

            Diet history serves to offer information on the feeding practices of the child. The history also provides a profile of the tolerable and intolerable foods for the child, which can help health providers recommend alternative feeding practices (Quitadamo, Ummarino, & Staiano, 2015). Family history is an essential component of the well-baby visit as it unravels the genetic and behavioral as well as environmental vulnerabilities that might cause potential illness to the child. Nonetheless, social history also serves as an important aspect in the preparation for the well-baby visits. It delves into the livelihoods of the primary caretakers and the environmental risks that might influence the health status of the child. However, questions regarding growth and development of the child appropriate to her age include the following:

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  • What was Asia’s weight and height in the previous visit?
  • Do you notice a change in the child’s growth?
  • Does the child feed properly?

The Developmental Tool to be used for Asia

            The Ages and Stages Parent Report Questionnaire (ASQ) is the most suitable tool to assess the developmental score for the child. ASQ is a developmental as well as a social-emotional screening device that yields results that are highly reliable and valid for every stage of growth of the child. The parents can readily monitor and report the growth of the child at every developmental stage. According to Burns et al. (2016), the tool is important in assessing stunting in children since it looks at the strengths as well as the trouble spots as children achieve growth. With this, it monitors height developmental of the child and compares it with reference standards to ensure that the growth of Asia is in line with her recommended age. In this assessment, parents are informed about Asia’s developmental milestones for a healthy living (De Onis, 2015). Expert opinion on the growth schedule of the child is also provided based on primary screening. Guided by the argument, the ASQ tool increases specificity in child screening and therefore can be used to provide a targeted intervention as per the diagnosis of the child.

NSG 6430 Aquifer Case Study - Developmental Evaluation and Screening
NSG 6430 Aquifer Case Study – Developmental Evaluation and Screening

            As at 9 months, Asia’s developmental stages was appropriate for her age. In the ASQ tool, several developmental scores were identified. Her gross motor scores were normal since she could stand alone and attempt walking. Most specifically, Asia crawled on the exam table, sat well and could pull herself (Susman, Feagans, & Ray, 2014). Her fine motor was also developing well since she could attempt pincer grasp. Her language indicates frequent babbles but not specific to particular words which affirms a recommended developmental age as per the ASQ tool (Moeschler & Shevell, 2014). She is also social and adaptive as she could quietly sleep on the exam table to allow the doctor to make a diagnosis. These scores affirm that Asia was developing based on the requirement of her age.

Immunization Schedules, Patient Education and Follow-up for Asia

            On the first visit, Asia should receive DTaP for diphtheria, tetanus, and pertussis. IPV should be administered against polio. Moreover, Asia needs to receive the Hib vaccine for Haemophilus influenza type B and PCV13 for pneumococcus (13 strains). MMR should be administered against measles, mumps, and rubella while varicella needs to be used against the immunization of varicella. Asia should receive Rotav vaccines against the rotavirus on the first visit. HepA and HepB should be administered to Asia to protect her against Hepatitis A and B respectively.

            Patient education focuses on encouraging the mother to continue providing complementary feeds to the child. De Onis (2015) illustrates that attention should be given to blunt diets and provide soluble fiber diets to avoid the irritation of the gastrointestinal tube. The mother also needs to identify foods preferred by the child to improve oral intake. Food service to the child should also be done with love to encourage recommended intake. Follow-ups should be done after one month for the baby to receive her immunization schedules, complete blood count tests and for further examination on her condition. However, in case the mother recognizes negative changes in her health before one month elapses, then the child should be presented to a health facility immediately for medical assessment.

References

Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Maaks, D. L. G. (2016). Pediatric Primary Care-E-Book. Elsevier Health Sciences.

De Onis, M. (2015). World Health Organization Reference Curves. The ECOG’s eBook on Child and Adolescent Obesity, 19.

Moeschler, J. B., & Shevell, M. (2014). Comprehensive evaluation of the child with intellectual disability or global developmental delays. Pediatrics134(3), e903-e918.

Quitadamo, P., Ummarino, D., & Staiano, A. (2015). GER and GERD in children: to treat or not to treat?. Minerva pediatrica67(2), 187-197.

Susman, E. J., Feagans, L. V., & Ray, W. J. (2014). Emotion, Cognition, Health, and Development in Children and Adolescents (PLE: Emotion). London, UK: Psychology Press.