Assignment task:
Glyka
Case Scenario: Mr. Zee presents to the clinic with his son Eric for a 14-month well-child visit. He expresses concern that Eric is not walking yet. The APRN reviews Eric's past medical and birth history in the electronic medical record. Max was born at 34.5 weeks' gestation via emergency C-section and was discharged 2 weeks later.
- What fine motor and gross motor skills should the APRN expect a 15-month-old toddler to perform? Should Eric be able to perform those skills as well? Why or why not? Need Assignment Help?
Toddlers usually show different abilities in fine and gross motor skills when they reach 15 months of age. The gross motor abilities of children age 15 months should include independent walking along with stand-and-go movements without assistance for stability and the ability to climb onto furniture (Vandoni et al., 2024). The development of fine motor skills requires mastering the ability to grasp and hold objects between thumb and index finger as well as the ability to construct block towers and make pencil markings with crayons. Eric received his birth at week 34.5 placing him within the category of late preterm infant (Klupp et al., 2021). The developmental achievements of preterm infants normally align with those of full-term children but at a later time which spans up to three months. Eric should be near the point where he can achieve independent walking while his skill in stacking blocks and pincer grasp development should be starting to appear.
- What type of screening test(s) should the APRN utilize to assess Eric's current motor skills?
Standardized screening tools such as the Ages and Stages Questionnaires (ASQ) and Denver Developmental Screening Test (DDST) should be used by the APRN to evaluate Eric's motor abilities. These development measurement tools help healthcare providers assess how effective Eric has become at gross and fine motor skills combined with his communication abilities and social-emotional competencies (Kurbatfinski et al., 2024). Since Eric experienced prematurity at birth the APRN needs to consider correcting his age through prematurity adjustment while assessing his development.
- What type of anticipatory guidance and support should the APRN provide to monitor and encourage Eric's continued physical development?
The APRN needs to inform Mr. Zee that some preterm infants show delaying walking obstacles that remain within typical parameters for their condition. The APRN supports motor development through supervised tummy time and safe crawling territory as well as developing toys which help children grasp while stacking. It is necessary to perform routine check-ups that assess Eric's development. The prolonged duration of development delays would require an appointment with early intervention services together with pediatric physical therapy consultation (Dapp et al., 2021). Research from the American Academy of Pediatrics (AAP) promotes both preterm infant development screenings and personalized medical care. The APRN uses individualized guidance together with evaluation measures to confirm Eric meets his expected developmental benchmarks.
References:
Dapp, L. C., Gashaj, V., &Roebers, C. M. (2021). Physical activity and motor skills in children: A differentiated approach. Psychology of Sport and Exercise, 54, 101916.
Klupp, S., Möhring, W., Lemola, S., & Grob, A. (2021). Relations between fine motor skills and intelligence in typically developing children and children with attention deficit hyperactivity disorder. Research in developmental disabilities, 110, 103855.
Katherine
Case Scenario: Allen
Allen is a 14-year-old male who has come into the clinic for a complete physical exam. Two years ago, he was placed in foster care, but he has recently moved into his paternal grandfather's home. His grandfather is with him today. During the visit, you will perform an adolescent health history focusing on his current development and anticipatory guidance needed.
- Allen is in what phase of adolescence? Allen is in the early adolescence stage
- Summarize the physical, cognitive, and social/emotional challenges and anticipatory guidance to prepare Allen and his grandfather for this phase of adolescence.
During this stage of adolescence, individuals often feel confused and may experience fear or anxiety due to the rapid changes occurring in their bodies and minds. Physically, Allen may undergo a significant growth spurt, accompanied by a deepening voice and other puberty-related developments. He may also notice increased appetite and changes in sleep patterns as his body adjusts.
Allen might find himself daydreaming frequently, which is a normal part of brain development at this age. It's important for his grandfather to understand that daydreaming is not mere distraction but a way for Allen to process new thoughts, emotions, and aspirations. Additionally, he may set ambitious, idealistic goals that shift frequently as he explores different interests and future possibilities.
Socially and emotionally, Allen may start to prioritize friendships over family relationships, spending more time with peers as he seeks a sense of belonging and identity. This shift is natural but can sometimes create tension at home. He may also experience intense mood swings, ranging from excitement and happiness to sadness or frustration, as he navigates the emotional ups and downs of adolescence.
Furthermore, Allen may become highly self-conscious about his body, paying closer attention to his appearance, and comparing himself to others. As he adjusts to these physical changes, he may seek more privacy and enjoy spending time alone to reflect or simply decompress.
- What strategies should the APRN utilize to develop trust and establish confidentiality during Allen's history and physical exam?
To develop trust and ensure confidentiality during Allen's history and physical exam, the APRN should employ several key strategies. First, they should greet Allen warmly and engage in casual conversation to help him feel at ease before discussing sensitive topics. Maintaining eye contact, practicing active listening, and using a calm, respectful tone can further build rapport and demonstrate genuine care. It is essential to reassure both Allen and his grandfather that their conversations are confidential and private, with exceptions only for situations involving safety concerns. The APRN should also provide Allen with the opportunity to speak alone, creating a safe space where he feels comfortable discussing personal matters openly and honestly. Using open-ended questions allows Allen to express himself more freely, rather than feeling pressured to give simple yes or no answers. Additionally, the APRN should normalize the physical, emotional, and social changes he is experiencing, reassuring him that these transitions are a natural part of adolescence. Validating his emotions and offering guidance on how to navigate challenges-such as adjusting to his new home, managing peer relationships, and coping with mood swings-can help him feel supported and understood. By fostering a welcoming and judgment-free environment, the APRN can build a strong foundation of trust, empowering Allen to take an active role in his health and well-being.
Reference
Emmanuel, M. (2022, December 11). Tanner stages. StatPearls [Internet].
Maaks, D.L. G., Starr, N., & Gaylord, N. (2019). Burns' Pediatric Primary Care (7th ed.). Elsevier - Evolve.