PEDS-101 Jersey College, School of Nursing – Christine is a 4-year-old female who comes to the clinic with her mother, Melanie Carson, for a well-visit checkup.

QUESTION

Christine is a 4-year-old female who comes to the clinic with her mother, Melanie Carson, for a well-visit checkup. After measuring Christine’s height and weight, the nurse plots this information on a standardized growth chart, finding both to be in the 25th percentile. The nurse also assesses Christine’s development and achievement of developmental milestones.

  1. Would the findings related to Christine’s height and weight be a cause for concern? What factors would the nurse need to consider when interpreting these findings?
  2. Using Erikson’s theory of psychosocial development, what behaviors would the nurse expect Christine to display?
  3. Based on Piaget’s theory, what behaviors would the nurse expect to assess?

ANSWER

 Assessing Growth, Development, and Psychosocial Behaviors in a 4-Year-Old Child: A Nursing Perspective

Introduction

This essay examines the case of Christine, a 4-year-old girl attending a well-visit checkup with her mother. The nurse measures Christine’s height and weight, which are found to be in the 25th percentile on a standardized growth chart. The essay addresses whether these findings should raise concern and discusses the factors that the nurse needs to consider when interpreting these measurements. Additionally, the essay explores the behaviors that the nurse would expect Christine to display based on Erikson’s theory of psychosocial development and Piaget’s theory of cognitive development.

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 Height and Weight Findings

Christine’s height and weight being in the 25th percentile on the growth chart may not necessarily be a cause for concern. Percentiles represent a range of normal growth, and falling within the 25th percentile means that Christine’s measurements are consistent with the average range for her age group. However, it is crucial for the nurse to consider several factors when interpreting these findings (Marchand, 2012). These factors include the child’s previous growth patterns, family history of growth and development, overall health status, and any potential signs of nutritional deficiencies or underlying medical conditions.

 Erikson’s Theory of Psychosocial Development

According to Erikson’s theory, at the age of 4, Christine would be in the stage of “Initiative vs. Guilt.” During this stage, children develop a sense of purpose and the ability to initiate activities. They explore their environment, engage in pretend play, and start taking more responsibility for their actions. The nurse would expect Christine to display behaviors such as increased curiosity, a desire for independence, imagination in play, and the development of a conscience regarding right and wrong.

Piaget’s Theory of Cognitive Development

Based on Piaget’s theory, the nurse would anticipate certain behaviors in Christine. At the age of 4, children typically fall into the preoperational stage. During this stage, they engage in symbolic play, use language more effectively, and demonstrate egocentric thinking (Green, 1991). The nurse would expect Christine to display behaviors such as imaginative play, improved language skills, the ability to ask questions and engage in conversations, and limited understanding of other people’s perspectives.

Conclusion

Assessing growth and development in children, such as Christine, requires a comprehensive understanding of various theories and factors. While Christine’s height and weight being in the 25th percentile may not raise immediate concerns, the nurse needs to consider individual factors to ensure appropriate growth and development (Rodziewicz, 2022). Additionally, understanding Erikson’s theory of psychosocial development helps the nurse identify expected behaviors related to initiative and guilt, while Piaget’s theory provides insights into cognitive behaviors during the preoperational stage. By utilizing these frameworks, healthcare professionals can monitor and support the holistic development of children, promoting their overall well-being.

References

Green, A. C. (1991). Application of Jean Piaget’s theory of human development for nursing children in an adult intensive therapy unit. Intensive Care Nursing, 7(4), 236–239. https://doi.org/10.1016/0266-612x(91)90049-w 

Marchand, V. (2012). The toddler who is falling off the growth chart. Paediatrics and Child Health, 17(8), 447–450. https://doi.org/10.1093/pch/17.8.447 

Rodziewicz, T. L. (2022, December 4). Medical Error Reduction and Prevention. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499956/ 

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