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NRS 434 Topic 1 DQ 2

DQ 2 Describe the developmental markers a nurse should assess for a 9 month old female infant
Description:

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.

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Replies

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.

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

 

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/

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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 impoRtant, especially with the diverse family set up that we have today.

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James,

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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What questions would you ask the parents?

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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.

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.

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I agree with juice is not a very healthy drink for infants. Fruit juice was recommended by pediatricians as a source of vitamin C and as an extra source of water for healthy infants and young children as their diets expanded to include solid foods with higher renal solute load. It was also sometimes recommended for children with constipation especially prune juice. It is marketed as a healthy, natural source of vitamins and, in some instances, calcium. Because juice tastes good, children readily accept it. Although juice consumption has some benefits, it also has potential detrimental effects. High sugar content in juice contributes to increased calorie consumption and the risk of dental caries. In addition, the lack of protein and fiber in juice can predispose to inappropriate weight gain (too much or too little). Pediatricians need to be knowledgeable about juice to inform parents and patients on its appropriate uses (Heyman & Abrams, 2017).

References

Heyman, M. B., Abrams, S. A., Section of hepatology nutrition, committee on nutrition (2017). Fruit Juice in Infants, Children, and Adolescents: Current Recommendations. Pediatrics139(6), e20170967. https://doi.org/10.1542/peds.2017-0967

Read Also: DQ 1: Describe the effect of extremely low birth weight babies on the family and community

Replies

Hello Stanley, thank you for your submission. I agree that the mother should be advised to use soft finger foods, but the nurse should assess the nutritional patterns of the mother before making the needed recommendations. As a nurse, it is essential to help the mother know the proper complementary nutrition to ensure growth and immunity to fight diseases and avoid delays in her development. Also, being aware of the mother’s cultural background is essential to providing effective education (Saleem et al., 2014).

Reference

Saleem, A. F., Mahmud, S., Baig-Ansari, N., & Zaidi, A. K. M. (2014). Impact of maternal education about complementary feeding on their infants’ nutritional outcomes in low- and middle-income households: a community-based randomized interventional study in Karachi, Pakistan. Journal of Health, Population, and Nutrition32(4), 623–633. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4438693/

NRS 434 Topic 1 DQ 2

NRS 434 Topic 1 DQ 2

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS:DQ 2: Describe the developmental markers a nurse should assess for a 9-month-old female infant

Introduction

Feeding self with finger foods, sitting without support, pulling self to standing position, standing while holding to support and transferring objects from one hand to another are developmental markers for a 9-month-old. They will start poking at objects with a finger, taking objects out of a container, standing alone, cruising along furniture, and potentially taking steps while holding on at 9-month-old. (Green, 2018).

Describe the developmental markers nurses should assess for a 9 -month female infant

For vocalization and socialization assessment, nurse should assess a 9-month-old baby for being able to clap hands, respond to own name, imitates gestures, sounds, and begin to fear strangers. Also, a 9-month-old infant should be able to control lips around a cup and use pincer grasp reflex. Appetite, chewing and swallowing ability should be evaluated by the nurse. In addition, the nurse should assess for the ability of the child to use a cup, hold own bottle, feed self a cracker and pick up objects using pincer grasp reflex during nutritional assessment.

Discuss the recommendations you would give the mother

Small, soft, finger foods that are easily chewed should also be given to the infant. The mother should be advised on what type of food and drink that are age appropriate. Health education will be on child safety issues like car seat safety, preventing falls and preventing drowning.

Explain why these recommendations are based on evidence-based practice

Juice should not be given to infants because it makes them less hungry for healthy foods and may be bad for the new teeth that are forming. The mother should avoid giving groundnuts, grapes, and hot dogs to infants because they pose a big choking hazard.

                                                    Conclusion

The baby`s main drink should still be breastmilk or formula but give the baby a little water in a cup to practice drinking from a cup (Child profile, 2020).

References

Child, P (2020). Nutrition at 9 months. Retrieved from https://cp.dob.wa.gov

Green, S. (2018). Health assessment. Foundations for effective practice. Health assessment of the infant. Grand Canyon University. https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/vl.l#chapter 1

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