1. Nina is the 5-year-old adopted daughter of Sarah and Tim Johnson. Nina is the Johnsons' only child. They adopted Nina before her first birthday. The Johnsons have brought Nina to the clinic today to discuss some concerns they have about her development. Nina is attending a public kindergarten. Since beginning school, the Johnsons have noticed that they are catching Nina lying more. They are concerned that this may be a result of attending school. In addition, they are concerned about her verbal development and note that her teacher reported that Nina seems to be stuttering or repeating the term "um" when speaking. She also has some difficulty with "sh" and "th" sounds. When the Johnsons try to discuss these issues with Nina she becomes "very emotional" and retreats to her room. (Learning Objectives 2 and 6)
a. What can the nurse teach the Johnsons about lying in preschool children?
b. What can the nurse teach the Johnsons regarding stuttering and speech development with Nina?
c. What can the nurse teach the Johnsons regarding emotional development in preschool children?
Growth and Development of the School-Age Child
2. Gina has come into the primary care center with her mother Kris for an 11-year-old wellness examination. As the nurse prepares Gina for her examination, Kris asks to speak to the nurse outside the examination room. Kris shares with the nurse her concerns about recent changes she has noticed in Gina. She explains that Gina's body is beginning to change and she has made a number of comments about her body image. Kris is concerned about Gina's self-esteem and emotional development. (Learning Objectives 1, 2, and 3)
a. What are some of the prepubescent changes school-age children experience that the nurse can share with Kris?
b. What are some of the issues regarding body image that the nurse can teach Kris about?
c. What can the nurse teach Kris regarding self-esteem in school-age children to address her concerns?
3. Don is a 10-year-old boy who is being seen by the school nurse today for a fall he experienced on the school's playground. Don's mother, Kandis, has arrived and expresses some concern regarding Don's recent behavior. She explains that he has engaged in more risk-taking behavior and has had more injuries lately. Kandis then asks the nurse what Don's weight is and asks her if she thinks Don is overweight. Don is 5'1" and weighs 130 lbs. His body mass index (BMI) is 24.5. (Learning Objectives 4, 5, and 6)
a. What can the nurse teach Kandis about promoting a safe lifestyle for Don?
b. What can the nurse teach Kandis regarding Don's weight and corresponding BMI?
c. What can the nurse teach Kandis regarding Don's nutritional needs, promoting nutritional healthy intake, and preventing overweight/obesity?