NRS-434VN – Developmental markers for a 9-month-old female infant

NRS-434VN – Developmental markers for a 9-month-old female infant

NRS-434VN – Developmental markers for a 9-month-old female infant Topic 1 DQ 2

Consider the following patient scenario:
A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). 
Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

According to the CDC for a nine month old infant, developmental milestones can be assessed and compared to other peers of the same age to indicate were the infant stands in accordance to growth charts. When a nurse assess the infant, they should keep in mind that the norm is for the infant to be “shy and fearful” with strangers. They also have many facial expressions at this age and looks towards a person when their name is called. Games such as peek a boo can cause the infant to laugh and giggle. At this time verbal communication is still very minimal. They have one worded sounds such as Mama. They may also indicated needs such as reaching for what they need. During this age they also start to explore physical things like hitting toys together over and over. Physically speaking, infants of nine months can sit up unsupported, and have items switched from one hand to another.

ORDER A CUSTOM-WRITTEN PAPER HERE

            The infant in the provided scenario describes them as being in the lower end of the growth chart that is provided per the CDC. Physically the weight, length and circumference are all lower than the expected readings. With all these details the nurse should provide education regarding the infants nutrition. According to the CDC, infants should be mostly consuming fruits and vegetables that have been pureed, at least for three meals a day. It is also important to note not to be giving infants things they can choke on such as nuts and uncut grapes. (Green,S 2022).
References
Centers for Disease Control and Prevention. (2023a, June 6). Important milestones: Your baby by nine months. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.htm
Green, Z. S. (2022). Health Assessment of the Infant. Health Assessment: Foundations for Effective Practice. Grand Canyon University. https://bibliu.com/app/#/view/books/1000000000584/epub/Chapter1.html#page_17

 
NRS-434VN – Developmental markers for a 9-month-old female infant post 2
A nurse should assess the following developmental milestones for a 9-month-old infant. (CDC, 2023).
Social/Emotional milestones: Is shy and fearful to strangers, shows several facial expressions, looks when you call her name, and smiles or laughs when you play peek-a-boo.
Language/Communication Milestones: Lifts arms up to be picked up, Makes a lot of different sounds like mama and baba.
Cognitive Milestones: Looks for objects when dropped out of sight (like his spoon or toy), bangs two things together.
Movement/Physical Development Milestones: Moves things from one hand to her other hand, sits without support, Uses fingers to “rake” food towards himself.
Our scenario already described about the 9 months old female infants that she is at the bottom of the chart as per CDC growth chart. This baby is unhealthy as her length, weight and head circumference is lesser than the other baby. Along with these measurements the nurse should perform the detail assessment of the baby. The first recommendations the nurse would give is about the nutritional status of the infant. Each baby develops in their own time and at their own pace. But as based on the above scenario, babies need three meals a day making puree from fresh fruits and vegetables. Foods with iron are especially important at this age. At this age, it is also important to lower the crib mattress. Safety is important. (Gordan S, 2022). These recommendations should be evidence based. The nutritious foods help in proper growth and development. Safety is important to prevent from accidents as at this age baby can crawl.
CDC,2023. Centers for Disease Control and Prevention. Important Milestones: Your Baby By Nine Months. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html.
Gordan S. 2022. Verywell family Your 9-Month-Old Baby’s Development and Milestones. https://www.verywellfamily.com/your-9-month-old-baby-development-and-milestones-4172786.

 
NRS-434VN – Developmental markers for a 9-month-old female infant discussion post 3

Pediatric care is important to provide developmentally appropriate care for the infants.  As a nurse, they should be monitoring the child’s growth and development and offering some level of support to the parents. “Health care providers also use the growth chart to compare development in children of the same age and gender. It’s been a standard in pediatrics since the 1970s and still today, plays a critical role in catching early signs of disease and preventing future health problems” (DiPietro,2020).     The length of this 9 month old  is in the 25th percentile which indicates normal growth for this age group, but the nurse needs to continuously monitor the length and height of the infant.  The infant’s weight is in the 5th percentile which needs to be monitored to make sure they are growing at a consistent rate.   I might give the mother some guidance on feeding and nutritional needs of an infant.  The head circumference is also at the 25th percentile which indicates normal brain development.   Again, the nurse would need to ensure that their head growth is increasing at an appropriate rate.   The health professional will need to give the parents certain activities that help promote cognitive development.  The nurse needs to examine the infant’s motor skills which includes reaching for things, sitting with support, or any signs of crawling or moving on their own.   These milestones should be in alignment with their infant’s age.
Other topics that should come up during the 9 month old check up should be the eating habits of the infant.  If the mother is breastfeeding or bottle-feeding, the nurse needs to suggest introducing solid foods if they haven’t already started.  The idea is to begin weaning the infant off the bottles or breastfeeding and eating solid food moving forward in the next few months. Infants at nine months begin moving more on their own.  “By 9 months, babies at this age are crawling and can raise themselves to stand, so safety in the home becomes an important issue as your baby’s curiosity (and mobility) grows” (Rattana-Umpa, Tanwatthanakul, & Santiboon, 2021).  Safety at home also becomes a topic for discussion with the parents since their child will be walking soon.   I believe for parents they want to find out if their child is developing both socially and cognitively at an appropriate rate.   The nurse can assess this by their response to their environment, recognizing familiar faces, and interactions with toys.  The nurse and parents will ask questions and observe how the infant responds to their parents, smiles from the infant, and how attached they are to the mother.  The nurse should provide guidance on the importance of bonding and parenting practices in relation to emotional development.  A final piece to look for is their speech and language development.  Even though it is still early at 9 months, at this stage you want to look for the infant’s response to sounds, any type of babbling, or communication from the infant.  It is important to give advice on talking and reading to their infant to help promote this development.
My recommendations to the mother based on evidence-based practices would be to ensure that the infant is receiving adequate nutrition. The parents should continue bottle feeding or breastfeeding along with providing solid foods.  The parents should also continue to make sure they are keeping up with the immunization schedule that is recommended vaccinations to prevent diseases.  These are based on the American Academy of Pediatrics recommendations and the World Health Organization.  The parents need to be given information on safe sleep practices to help prevent sudden infant death syndrome.   The recommendation of nurturing parenting practices need to be reinforced like talking and reading to the infant or playing with them with age-appropriate toys.   Of course, the parents need to be making observations on their milestones that they keep an eye out for.  If their child doesn’t do everything when they are supposed to, I would need to offer reassurance that not all children are the same or progress at the same exact rate.   If there are concerns, the nurse can provide early interventions about any developmental delays.  Regular follow-up with the pediatrician should be suggested to address the progress and concerns they may have.
DiPietro, G. (2020, October 22). What to know about the pediatric growth chart. Novant Health | Healthy Headlines. https://www.novanthealth.org/healthy-headlines/what-to-know-                               about-the-pediatric-growth-chart#:~:text=Pediatricians%20look%20for%20inconsistencies%20in,weight%2C%20length%20and%20head%20circumference.
Rattana-Umpa, N., Tanwatthanakul, J., & Santiboon, T. T. (2021). Associated indicator factors among inappropriate malfunctions’ development for the 9-month-old-baby.
 

NRS-434VN – Developmental markers for a 9-month-old female infant Response

The comprehensive assessment and guidance you’ve outlined for the 9-month-old infant align with the crucial aspects of pediatric care. In addition to monitoring growth and developmental milestones, addressing safety concerns, and encouraging parental involvement, it’s essential to emphasize the role of play in fostering cognitive and motor skills. Recommending age-appropriate toys and activities stimulating the infant’s senses and coordination can enhance their overall development. Furthermore, discussing the importance of tummy time for strengthening muscles and promoting motor skills can be beneficial. Regarding speech and language development, encouraging interactive activities like singing, imitating sounds, and responding to the infant’s babbles can contribute to language acquisition (National Institute on Deafness and Other Communication Disorders, 2018). Emphasizing the significance of creating a language-rich environment at home through talking and reading will positively impact the infant’s language skills. Additionally, reinforcing the importance of routine well-baby visits for ongoing assessment and timely interventions complements your evidence-based approach, ensuring the infant receives continuous, proactive healthcare.
References
National Institute on Deafness and Other Communication Disorders. (2018). Speech and language developmental milestones. NIDCD. https://www.nidcd.nih.gov/health/speech-and-language

NRS-434VN – Developmental markers for a 9-month-old female infant discussion post 4

 A nurse should assess a 9 months old female child for social milestone: where a infant  exhibits shyness and  fearfulness around new people, emotional milestone: where the infant has some facial expression of sad, happy and surprise, the infant is able to react to her name , cries at your departure from her presence, smiles and laughs, cognitive milestone; infant  produces noise with objects , looks out for missing things, movement and physical developmental milestone : the infant is able to sit , move objects from one hand to another, language and communication milestone: the infant is able to make different sounds with their mouth things like mamamama, bababababa, and is able to lift arm up to be picked (CDC 2023).
 
During assessment the nurse notes the general appearance of the infant , in this case the , the infant’s weight, length ans head circumference is below  the CDC growth chart according the details provided. Which an indication that the child has a retarded growth, it will be recommended to the mother to introduce some complimentary nutrition for example pureed fresh  fruit and vegetable to provide vitamin and minerals  in addition to breast milk and baby formula to give the infant more nutrient to enhance adequate growth according to age. I will recommend immunization in order to prevent childhood preventable diseases, i will recommend ensuring safety of the infant by not giving the child any nut as it has been noted to cause choking  and might lead to dead of an infant (Green,S 2022), i will recommend hand hygiene and general before handling infant to prevent infections in the infant. These recommendation are based on evidenced practice for example poor nutrition is linked to retarded growth and also immunization has helped in eradicating diseases or reduce the effect of some diseases for example polio was eradicated by immunization.
References
Centers for Disease Control and Prevention. (2023a, June 6). Important milestones: Your baby by nine months. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html
Green, Z. S. (2022). Health Assessment of the Infant. Health Assessment: Foundations for Effective Practice. Grand Canyon University. https://bibliu.com/app/#/view/books/1000000000584/epub/Chapter1.html#page_17  NRS-434VN – Developmental markers for a 9-month-old female infant