Question

Community Case: Environmental Health: Lead Poisoning Case Part 1 A mother, Megan, brings her daughter, Eva, age 2 1/2, to the county health department Megan tells the health department nurse, Clara Jones, that Eva just doesn't seem to be doing things that other children her age in her apartment complex are doing and never seems to gain any weight. Clara asks for an example of what Eva can't do as well as other children her age. Megan states that Eva can't stack blocks and speaks limited words Questions for students 1 What are four specific growth and development milestones that Eva should be demonstrating at her age? Use the following site (or your pediatric textbook) as a reference: http://www.cdc.gov/ncbdddactearly/milestones/milestones 2yr html 2. What nursing assessments and risk factors are important to identify in a home environment?

Answer 1

The growth and developmental milestones that Eva should demonstrate at her age is described below.

Ø Physical milestone (Movement milestone) : This include activities such as beginning to run ,Carry toys ,kick and throw a ball etc.

Ø Cognitive milestone: Toddlers start to learn new thing during this phase as they develop problem solving skills (finding alternate methods to solve a problem by self) the activities during developed during this milestone is Pretending to be like other persons. For example acting like a super hero (batman) or any comic heroes. They will also develop skills to solve simple puzzles and can categorize their toys as per the size and color.

Ø Language Milestone: Toddler starts to speak 2 -4 words as sentences and can also follow simple instructions such as come here ,Eat etc. They also can repeat the words which we say(less complex).

Ø Social and Emotional milestone: Toddlers start to copy others particularly older adults and children, and will be very happy to play with other kids. This is the phase when they show more independent behavior and disobey more than before.

Important risk factors in a home environment.

Falls: As the child’s motor skills develop they may try to climb the stairs or to jump from the bed or anything than can be climbed and this is dangerous as it may cause serious injuries to the child. Parents have to monitor the child and not to leave them alone to prevent such accidents.

Firearm hazards: Child may play with the lighter or match stick as they feel more curious on these activities which in turn lead to burns or other critical injuries. Avoid keeping items such as match box, Kerosene stove or lighters out of the reach of child.

Poisoning: The Child may eat whatever they fell curious and this may lead to poisoning. Items such as lead batteries and even medicines have to be kept away from the reach of the child.

Proper parental supervision can avoid the child to face such hazards in home environment.

Nursing assessment

Ø The nurse should examine the home for any dangerous items such as firearms and should make sure to keep them away from the child. Also advice the parents about the hazards caused by it.

Ø Check if the doors are safely closed so that it prevents the child to travel to unknown places without the parent supervision.

Ø Educate the Parent to never leave the child alone during the bath as the child can drown quickly.

Ø Advice the parents to keep all the medicines and household products out of the sight of children so that incidents of poisoning and other hazards can be avoided.