NR602 Week 3: Homework- MyEvaluations Log
NR602 Week 3: Homework- MyEvaluations Log
Perform clinical activities under the guidance of a clinical preceptor and document all your patient encounters and practicum hours on the clinical documentation log and submit before the end of Week 3.
Week 3 References
Burns, C.E. (2020). Pediatric Primary Care (7th ed.). Saunders Elsevier
Centers for Disease Control and Prevention (CDC). (2019). Growth charts.
Savage, M. N., & Bouck, E. C. (2017). Predictors of Risky Behavior and Offending for Adolescents with Mild Intellectual Disability. Intellectual & Developmental Disabilities, 55 (3), 154-166
ORDER COMPREHSIVE SOLUTION PAPERS
Family Assessment by the Nurse Practitioner: Assessment of the Infant, Child and Adolescent Review of Pediatric Development
The fundamental objective of pediatric patient care is to optimize growth and development in order to enhance quality of life and minimize injury, illness, and death. The nurse practitioner (NP) must comprehend and frequently apply basic growth and development theories and concepts to the treatment of children and their families. The following are some fundamental human growth and development concepts.
- Human growth is cephalocaudal (head to tail) and from the center of the body to the periphery.
- Human growth is linear and should follow established patterns for physical, cognitive, and motor growth and development.
- Physical growth during childhood should follow a smooth curve if measured every 6 to 12 months.
- Growth or height velocity per year can and should be calculated when there are concerns in linear growth. The formula for growth velocity = change in height since last visit times 12 months divided by months since last visit.
- The process of physical growth and development takes almost 2 decades to complete.
- Development depends on psychosocial maturation and cognitive learning.
- Cognitive development occurs from simple to complex (concrete to abstract).
- Each child is unique, with different environments, history, exposures, and genetic make-up that will affect growth and development.
- No single measure should be a concern for growth, but serial measures for at least 6 to 12 months should be recorded.
This week’s readings will cover growth and management in pediatric primary care, including newborns, toddlers/preschoolers, school-age children, and adolescents. Developmental milestones are divided into several areas, including social, emotional, linguistic, and cognitive growth. As a nurse practitioner, it is critical to be aware and experienced in screening for red flags in children.
Review (Burns et al., 2020)
- Table 10.4 Developmental Red Flags: Newborns and Infants
- Table 11.12 Red Flags of Early Childhood Development
For more information on developmental milestones, review American Academy of Pediatrics’ Bright Futures website. Also download the Centers for Disease Control and Prevention’s (CDC) Milestones Tracker app from the CDC website.
Normal Growth and Development (NR602 Week 3: Homework- MyEvaluations Log)
Routine measurement and tracking of growth and development cannot be emphasized enough. In the primary care setting, not only should charts and graphs be kept of children’s weight and height gains, but also of BMI and head circumferences. Children should always be measured more than once to confirm results when there are concerns about accelerated or delayed growth. Shoes and extra clothing, such as coats and accessories should be taken off during weighing and measuring children. Office personnel should be trained in proper weighing and measurement of children. A diagnosis of growth problems should not be made on a single measure at a single visit. When children are referred for delay or acceleration in height or weight to the pediatric specialist best suited based on associated symptoms, then all measures of height and weight along with plotted growth charts of several visits should be sent to the specialist.
The growth curve is more than just a chart that compares a child’s height, weight, head circumference, and/or BMI to population norms; it also helps the primary care practitioner to anticipate development trajectories. For example, a patient with premature puberty may be taller than others at a younger age, but may cease developing shortly after puberty, making him or her shorter than expected. One rationale for medically interfering and postponing puberty is to reach maximum potential height.
To accurately assess growth at each visit, key principles must always be employed.
- Each child must be weighed and measured at each visit.
- For infants, clothing must be removed.
- Recumbent height measurement (when the child is lying down) is utilized until 2 years of age.
- Head circumference should be measured until age 3.
- Infants should be weighed with no clothes or diaper.
- In older children, height must be with shoes off, against a wall, and with heels to the wall at every visit.
- Height and head circumference should be measured three times for congruence and the highest number used.
- Physical growth parameters should be plotted at each visit and an ongoing record kept.
- For premature infants born at less than 36 weeks’ gestation, height and weight documentation should be corrected for by a documented gestational age assessment, completed in the first 24 hours.
Review growth charts within your Burn’s Pediatric Primary Care textbook. The same age appropriate growth charts are also available at the Centers for Disease Control and Prevention’s (CDC) website, under National Center for Health Statistics.
Review the Growth Curves video at: https://www.youtube.com/watch?v=lNE8jSL7WQk