Nurse's Pocket Guide

delayed GROWTH AND DEVELOPMENT
Parents/Caregivers Will:
• Verbalize understanding of growth/developmental delay or
deviation and plan(s) for intervention.
• (Refer to ND risk for delayed Development for additonal
actions/interventions.)
Actions/Interventions
NURSING PRIORITY NO.1.To assess causative/contributing factors:
• Determine existing condition(s) contributing to growth/
developmental deviation, such as limited intellectual capacity,
physical disabilities, chronic illness, genetic anomalies, substance
use/abuse, multiple birth (e.g., twins)/minimal length of time
between pregnancies.
• Determine nature of parenting/caretaking activities (e.g.,
inadequate, inconsistent, unrealistic/insufficient expectations;
lack of stimulation, limit setting, responsiveness).
• Note severity/pervasiveness of situation (e.g., long-term physical/emotional
abuse versus situational disruption or inadequate
assistance during period of crisis or transition).
• Assess occurrence/frequency of significant stressful events,
losses, separation, and environmental changes (e.g., abandonment;
divorce; death of parent/sibling; aging; unemployment;
new job; moves; new baby/sibling; marriage; new stepparent).
• Determine presence of environmental risk factors (e.g., child
of parent(s) with active substance abuse issues, or who are
abusive, neglectful, or mentally disabled).
• Active-listen to SO’s concerns about client’s body size, ability
to communicate or perform desired/needed activites or participate
competitively (e.g., sports, body building).
• Determine use of drugs, which may affect body growth.
• Evaluate home/day care/hospital/institutional environment
to determine adequacy of care provided, including nourishing
meals, healthy sleep/rest time, stimulation, diversional
or play activities.
NURSING PRIORITY NO. 2.To determine degree of deviation from
norms:
• Identify present growth age/stage. Provides baseline for
identification of needs and effectiveness of therapies.
• Review expectations for current height/weight percentile.
Compares measurements to “standard” or normal range for
children of same age and gender to determine degree of
deviation.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
362 Cultural Collaborative Community/Home Care