8. Growth & Development Template BLANK

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NS 132: Pediatrics: Growth & Development Student Name: Sandy Lai Date:10/7/2023 Patient Background & Age: male patient 6 weeks old. Presented with cough and congestion. Subcostal retraction on breathing. Feeding well, no vomiting. Tested positive for RSV at clinic and transferred to kaiser. Suction has been done but didn’t get better. Patient on 1L humidified NC for work of breathing. Average Child My Patient Developmental Stage (Erikson’s) and Developmental Milestones Stage 1: trust vs. mistrust Milestones: can self soothe, hand to mouth, different facial expressions, may smile Care is consistent between mom and grandma although dad isn’t in baby’s life. Mom was at the hospital overnight and the entire shift I was there. Baby is receiving to warmth, love, nurturing he needs to gain trust to his caregivers. Baby can put hand to mouth, no smiling, same facial expressions throughout shift (sleep) except during suctioning (baby squinting, crying and squirming) Physical Development (growth) Length: increase 2.5cm every month for first 6 months. Weight: 1 st week decrease 5- 10% then regain double by 6 months Head circumference: increase 10bm by 12 months Fontanelles : posteriors will close by 2 months and anteriors will close by 9- 18months Length: 51.5cm Weight: 3.405kg current weight, birth weight: 2.45kg, premature 34 weeks GA Head circumference: 32.5cm Fontanelles: posterior and anterior not closed. Cognitive Development (Piaget) 0-2 months: using reflexes such as sucking and Babinski’s reflex Baby has strong sucking reflex and Babinski’s reflex Age-Appropriate Activities Sing, chatting, music. Soft objects to stimulate. Tummy time, rattles, pacifier Classical music was playing in hospital room throughout my shift. Mom purchased rattle toy and soft stuffed

NS 132: Pediatrics: Growth & Development animal at gift shop as well as sang to baby. Has a wabbanub pacifier Immunizations Within first 12 months: Hep b (3 doses), Dtap, Pneumococcus, polio, haemophilus influenza type b Hep b 1 st dose completed. 2 remaining doses are scheduled. Dtap, pnemococcus, polio vaccines are scheduled at 6 months of age Routine Health Screenings weight, head circumference, growth chart, feeding, stool, urine frequency, sleep Weight: 3.405kg. head circumference: 32.5cm, height: 51.5cm. stool: no stool for 2 day. Urine: 3 diapers during my shift. Sleeping whenever not feeding. Growth chart: 25 th percentile in weight and 50 th percentile in length Nutrition Breastmilk or formula. Recommended intake is 100- 120kcal/kg/day Formula exclusive: Neosure 20cals/oz. finished 4oz every 2 hours. Since patient was premature at 34 weeks gestation, he is put on 20cals/oz for formula. Weight is being monitored to ensure he is not losing weight Injury Prevention Infant is at risk for falls and sustain fractures Crib rails up at all times, IV secured with arm board. Baby sleeping on back at all times. Educate mom about not feeding baby or holding baby if she feels sleepy References: Centers for Disease Control and Prevention. (2023, June 6). Important milestones: Your baby by two months . Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones- 2mo.html Common infant and toddler injuries: When to seek medical attention . Children’s Hospital Los Angeles. (2014, December 11). https://www.chla.org/blog/advice-experts/common-infant-and-toddler-injuries-when-seek- medical-attention McCuistion. (n.d.). Obesity, overweight, and Dyslipidemia in children and adolescents . For Children Under Age 2. https://www.utmb.edu/pedi_ed/Obesity/page_23.htm#:~:text=Energy%20requirements%20for %20newborns%20%2D%202,Pediatrics%2C%2021st%20ed.)

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