Case Study 2:
You see a 30-month-old named Brian for a well-child visit. His mother reports the following development:
· Physical: Walks independently, runs, able to climb stairs alternating feet, makes a tower of nine cubes, and is able to button his pants.
· Social: Follows one-step commands, uses one-word sentences, and has a vocabulary of approximately six words. He is resistant to nighttime and feeding routines, he has marked temper tantrums, and Mom states he does not calm when she tries to comfort him.
To prepare:
· Review this week’s media presentations, as well as “Developmental Management of Infants” and “Developmental Management of Toddlers and Preschoolers” in the Burns et al. text.
· Think about how physical, social, and cognitive development vary during infancy, toddlerhood, and the preschool years. Reflect on normal versus abnormal growth and development and consider the decision-making process of identifying and managing red flags of abnormal development.
· Select one of the three case studies provided. Reflect on the patient information included in the case study and consider any developmental red flags.
· Reflect on standardized screening tools, clinical guidelines, and management strategies that would be used to assess and manage the patient in your selected case study.
Required Readings
American Academy of Pediatrics. (2015). Immunization. Retrieved from http://www2.aap.org/immunization/
This website provides information related to vaccines and diseases. It also presents strategies for helping families make immunization-related decisions.
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017). Pediatric primary care (6th ed.). St. Louis, Missouri: Elsevier.
· Chapter 5, “Developmental Management of Infants” (pp. 61-79)
This chapter explores aspects of normal development of infants including milestones and identifies developmental red flags.
· Chapter 6, “Early Childhood” (pp. 80-100)
This chapter examines aspects of normal development of toddlers and preschoolers and identifies common developmental issues for patients in this age group.
· Chapter 10, “Nutrition” (pp. 166-185)
This chapter describes nutrition-related health problems in pediatric patients. It also provides guidelines for diagnosing and managing different types of nutrition disorders.
· Chapter 11, “Breastfeeding” (pp. 198-215)
This chapter examines the benefits, contraindications, and dynamics of breastfeeding. It also identifies common breastfeeding problems.
· Chapter 12, “Elimination Patterns” (pp. 216-232)
This chapter explores normal and abnormal patterns of bowel and urinary elimination. It also describes strategies for diagnosing and managing dysfunctional elimination syndrome.
· Chapter 14, “Sleep and Rest” (pp. 273-284)
This chapter provides strategies for the prevention and management of sleep problems in pediatric patients. It also identifies special considerations for children with chronic disorders.
· Chapter 17, “Role Relationships” (pp. 311-338)
This chapter explores circumstances that create role-relationship problems in family units such as violence, neglect, maltreatment, and physical and sexual abuse. It also presents strategies for assessing and managing families presenting with these circumstances.
Centers for Disease Control and Prevention. (2015). Vaccines & immunizations. Retrieved from http://www.cdc.gov/vaccines/
This website presents information related to immunizations including recommendations, requirements, preventable diseases, and side effects. It also provides updated policy statements regarding immunizations.
Hagan, J. F., Jr., Shaw, J. S., Duncan, P. M. (Eds.). (2017). Bright futures: Guidelines for health supervision of infants, children, and adolescents (4th ed.). Elk Grove Village, IL: American Academy of Pediatrics.
· Review: “Promoting Healthy Nutrition” (pp. 167-192)
This chapter examines the impact of environment and culture on patient behaviors related to food and nutrition. It also explores essential components of nutrition for children from preconception through adolescence.
· Review: “Promoting Physical Activity” (pp. 193-203)
This chapter describes physical activity as a growing problem. It also identifies strategies for promoting physical activity, including age-appropriate activities for infants, children, and adolescents.
· Review: “Promoting Safety and Injury Prevention” (pp. 235-256)
This chapter explores two categories of issues relating to safety and injury prevention and examines strategies for promoting safety among infants, children, and adolescents.
· “Infancy Visits” (pp. 303- 499)
This chapter examines the care of infants. It focuses on wellness visits from prenatal to 11 months, identifying specific health issues, common parental concerns, and anticipatory guidance for parents.
· “Early Childhood Visits” (pp. 501-647)
This chapter explores the care of children from ages one to four. It identifies issues related to their health, behavior, nutrition, and safety, as well as anticipatory guidance for family support.
