NUR 203 Pediatric Rotation
Explanation of Growth and Development Evaluation
Child’s Initials: Child’s Age: Gender: Medical Diagnosis:
Brief Summary of Child. Admission/hospital course/medical diagnosis with a nursing plan.
Example: 14 y/o children admitted to hospital 3 days ago with complaints of leg and back pain.
History of SCA. Third admission this year for sickle cell crisis. Plan to treat the underlying cause
(infection), hydrate and relieve pain. Teaching for prevention of crisis reviewed.
1. Biological growth: Textbook
a. Height for 14 y/o child b/t ____kg and ____kg (3%-97%)
b. Weight for 14 y/o
c. Head circumference N/A
d. Blood pressure, heart rate, and respiration for 14 y/o
Biological growth: Child
a. Height 62″, 50%
b. Weight 60 kg, 75%
c. VS: B/P 114/76; AP 72; R 18, Temp 36.6
Impression: Child WNL for an age yet appears a bit small and chubby because of the slight discrepancy of the percentiles.
2. Communications: Textbook (at least 3 examples)
a. The 14 y/o child communicates with well-thought-out sentences; is able to analyze and infer. Learning complex material. Includes parents and peers in conversations yet beginning to separate away from parents more. Expressed likes and dislikes. Able to verbalize pain on a 1-10 scale. Non-verbal communication may include withdrawal, sleeping, and avoidance.
Communications: Child (3 examples)
a. My child was very verbal. Spoke with the mother at the bedside about lunch selection. Stated, “I hate this food. Can you bring me some Taco Bell tomorrow?” Described his medical condition, saying “This is my third time in the hospital this year. I just can’t seem to stay healthy this year”. Nonverbal included grimacing while getting out of bed and stating my pain is a 6 on the pain scale.
Remember that communication in the hospital is not always the norm at home. You need to be able to assess this. The child may be talking with the mother, but usually, the mother may state, he’s usually too busy to talk to me at home.
b. Personal/Social: What is the normal social interaction your 14 y/o (or 3 month old, whatever age)? What is the social interaction of your child? Use hospital and at-home examples
Impression: My child is WNL or above the normal limits for communication for his age.
3. Nutritional requirements:
a. The 14-year-old has greater nutritional needs because of the anticipated growth spurt.
An increase in protein, iron, and calcium is needed and could be found in meat and milk.
Using the food pyramid, this child should be having 6-8 servings of bread/cereal per day. Many 14 y/o would prefer fast food because of their busy and more independent lifestyle. Depending on the activity, a 14 y/o can intake approximately 1800-2500 calories per day.
a. My 14 y/o has not had much of an appetite since his hospitalization, but usually
eats 3 meals a day at home. He hates fruits and vegetables and only likes fast food.
A typical daily food intake includes…
Remember to include normal food and fluid intake(IV and PO), not just the food/fluid intake from the hospital. This is not his normal. Include # of calories and ml’s recommended per day and the approximate intake of calories and fluid per 24 hours.
Impression: Although it is normal…..
Continue the same outline. Remember 3 examples for each area of assessment
4. Gross motor skills and fine motor skills give (3 examples of each). Remember to question the child and/or parent in these areas. Some of these skills may not be evident in the hospital setting
5. Coping behaviors: How does a normal 3 month-old deal with displeasure? Crying, sucking, sleeping? A 10 y/o may regress, cry, withdraw, listen to music, and have a tantrum. Again, you need at-home and hospital examples. You can ask the child or mom. What makes a child worry? How do they handle this worry? What do they do?
6. Psychosocial/ Erickson… self-explanatory.
7. Teaching/Learning: This area is looking for ways that we teach this age. We would teach a
2 month-old by looking at them, changing the pitch in our voice, using black and white, movement and music. The 8 y/o can use games, competitions, computers, as well as demonstrations, pictures, and posters. Look at the age, decide what would be an appropriate thing to teach them (child, not parent for babies), and then how would you teach them.
8. Based on the assessment, describe a health promotion needed for this child at this level of growth and development
9. Describe one activity to enhance this child’s growth and d development (to achieve age-appropriate behavior, if the child is delayed, or to progress to the next stage if the child is currently age-appropriate.
10. Overall presentation