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Zorluk: Çok zorDevelopmental Stages and Transitions

A practical nurse (PN) is collecting data on a 9-month-old infant during a well-child visit. The infant was born prematurely at 32 weeks of gestation. The caregiver expresses significant anxiety, stating, "My baby is not pulling up to stand or saying 'mama' and 'dada' yet, but my friend's 9-month-old does both." Data collection reveals the infant sits unsupported, smoothly transfers objects from hand to hand, and exhibits a downward parachute reflex. Based on these findings, which action is the most appropriate for the PN to take?

  1. Reinforce teaching with the caregiver that the infant's current milestones are expected when adjusting for gestational age.Cevap
  2. B
    Document the findings and report the delayed gross motor and language milestones to the registered nurse.
  3. C
    Reassure the caregiver by stating, "Every baby develops at their own pace, so there is no reason to worry about missing these milestones."
  4. D
    Advise the caregiver to introduce hard solid foods, such as crackers, to rapidly develop the oral-motor muscles required for speech.

Cevap

The most appropriate action is to reinforce teaching with the caregiver that the infant's current milestones are entirely expected when adjusting for their premature birth.
The correct action demonstrates an understanding of how to assess premature infants. Because the infant was born 8 weeks (2 months) early, their 9-month chronological age must be adjusted to a 7-month developmental age. Sitting unsupported, transferring objects between hands, and demonstrating the parachute reflex are normal, expected milestones for a 7-month-old infant. Therefore, reinforcing teaching about adjusted age is the correct, scope-appropriate action to alleviate parental anxiety.

Adım Adım Çözüm

1
Determine the degree of prematurity.
A full-term pregnancy is 40 weeks. The infant was born at 32 weeks, meaning the infant was born 8 weeks (or 2 months) early.
Premature infants must have their developmental milestones assessed based on their adjusted age rather than chronological age until they are about 2 years old.
2
Calculate the infant's adjusted developmental age.
Chronological age (9 months) minus degree of prematurity (2 months) equals an adjusted age of 7 months.
This calculation provides the accurate baseline for evaluating the infant's expected neurological and physical capabilities.
3
Evaluate the current assessment data against the adjusted age.
At an adjusted age of 7 months, expected milestones include sitting unsupported, transferring objects from hand to hand, and the appearance of the parachute reflex. Pulling to stand and saying specific words like 'mama' are 9-10 month milestones.
Comparing the findings confirms the infant is developmentally on track and not experiencing a delay.
4
Select the appropriate nursing intervention within the PN scope of practice.
The PN should reinforce teaching regarding adjusted age expectations to alleviate the caregiver's anxiety.
Reinforcing previously established education falls squarely within the scope of practice for a practical nurse and directly addresses the clinical scenario.

Anahtar Kavram

Calculating Adjusted Developmental Age for Premature Infants
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Konular

Developmental Stages and Transitions

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