 Show Detailed Answer Key Growth and Development: Infants and Toddlers 1.A nurse is assessing a toddler at a well-child visit. At what point in the physical examination should the nurse examine the child's tympanic membrane? A. At the end Rationale:When examining a toddler, the nurse should follow a modified head-to-toe approach, starting at the head but deferring anything that the toddler is likely to view as invasive and traumatic to the very end. The toddler is likely to resist not only having the ears examined, but also anything that follows. B. At the beginning Rationale:The nurse should not examine the tympanic membranes first because the toddler is likely to view examination of the ear canal as invasive and traumatic. The toddler is likely to resist not only having the ears examined, but also anything that follows. C. Before examining the head and neck Rationale:The nurse should examine the head and neck before examining the tympanic membrane. D. Before auscultating the chest and abdomen Rationale:The nurse should auscultate the chest and abdomen before examining the tympanic membrane. 2.A nurse is caring for a 2-year-old child who is hospitalized and throws a tantrum when his parent leaves. Which of the following toys should the nurse provide to alleviate the child's stress? A. Set of building blocks Rationale:Although a set of building blocks is an age-appropriate toy for a 2-year-old child, it is not the most therapeutic toy. B. Toy hammer and pounding board Rationale:A toy hammer and pounding board helps the child to express the anger and frustration he feels about the parent leaving but lacks the verbal ability to express. C. Picture book about hospitals Rationale:Although a picture book is an age-appropriate toy for a 2-year-old child, it is not the most therapeutic toy. D. Stuffed animal Rationale:Although a stuffed animal is an age-appropriate toy for a 2-year-old child, it is not the most therapeutic toy. 3. A nurse is caring for an 18-month-old toddler who has been hospitalized for 10 days. After the toddler's mother leaves the room, the nurse observes the toddler sitting quietly in the corner of the crib, sucking her thumb. When Created on:06/02/2021Page 1 Use of Growth ChartsAn accurate record of a child’s overall pattern of growth is best determined by measurements over months or years. The Centers for Disease Control and Prevention (CDC) provides growth charts; a series of percentile curves for selected measurements, which are used to assess body size and monitor growth in infants, children, and adolescents in the United States (CDC, 2010). The CDC recommends that health care providers use the World Health Organization (WHO) growth standards to monitor growth for infants and children ages 0 to 2 years of age and the CDC growth charts for children age 2 years and older (CDC, 2010). The reason is that the data collected for the WHO growth charts represent infants and children who were breastfed during their first year of life; this is considered optimal nutrition and the standard to which all infants and children should be compared (Grummer-Strawn, Reinold, & Krebs, 2010). There are separate sets of growth charts for girls and boys. WHO growth charts for ages birth to age 2 years, plot length, weight, and head circumference measurements for age. They also plot the weight to length relationship, which can be used as an indicator of overweight or obesity in children. The CDC charts for ages 2 through 20 years, plot measurements of stature (height), weight, and BMI for age (www.cdc.gov/growthcharts). BMI is used primarily to screen for children who are overweight, though it may also be used to describe children who are underweight (CDC, 2010). Special growth charts for premature, very-low-birth-weight infants (<1500 g) and children with specific conditions that may affect size and growth (such as Down syndrome) are available, although most of these were developed from limited data (Kuczmarski, Ogden, Guo, et al., 2002; Rosenbloom, McGregor, Chen, et al., 2010). Plotting on a growth chart proceeds as follows: The exact age of the child is located on the chart’s horizontal axis. The corresponding measurement is noted on the chart’s vertical axis. The chart is marked where the two lines intersect. The percentile lines on these charts indicate the number of children whose measurements are expected to fall above and below the child’s measurement. Weight and height measurements above the 97th percentile or below the 3rd percentile on a standard growth chart may indicate a growth disturbance and need further investigation. Brain growth can be assessed by serial head circumference measurements (see Chapter 52). BMIs from the 85th to below the 95th percentile indicate a risk for being overweight; BMIs at or above the 95th percentile in children older than 2 years indicate overweight (CDC, 2010). Which of the following would the nurse expect to find in an 18What activity would the nurse expect to find in an 18-month-old? Toddlers continue to progress with motor skills. An 18-month-old should be able to climb stairs with assistance. A 24-month-old should be able to stand on his or her tiptoes and carry a large toy while walking.
Which condition is the 18Prolonged bottle-feeding (beyond 18 months of age) has been shown to increase a child's risk for iron deficiency—a condition that is common in children whose diet is primarily milk rather than a wide variety of healthy foods.
Which communication behavior would the nurse expect when assessing an 18What communication behavior should the nurse expect when assessing the 18-month-old toddler? A vocabulary consisting of 8 to 10 words with telegraphic speech is expected of an 18-month-old toddler.
Which developmental behaviors does an 18Your 18-month-old toddler is now walking and using basic words. At this age, children love to play and explore. They begin to show some independence and may play pretend and point at objects they want. They also begin to understand what things in the house are used for, such as a cup or spoon.
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Which assessment finding would the nurse consider abnormal for an 18-month-old child
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