NRS 434 Topic 2 Assignment Developmental Assessment and the School-Aged Child
NRS 434 Topic 2 Assignment Developmental Assessment and the School-Aged Child
Parents, educators, and health care providers optimize child development based on the information they have about a particular child. Since child development is multidimensional, the assessment should be broad and examine both typical and special needs as much as possible. A thorough evaluation should provide adequate information for supporting the child in all the deserved ways. This paper describes physical assessments and their modifications based on the needs of an eight-year-old girl while applying Piaget’s theory of development.
Physical assessments to obtain data vary with age. The modes of evaluation are also dynamic since the needs of five-year-old and twelve-year-old children differ profoundly. Also, their cooperation in the assessment is different. Growth charts are a reference point when physically observing a child. A health care provider can compare the details in a growth chart with the child’s visible state and make verifiable inferences. The observation method is also reliable. Here, a health care provider interacts with the child and makes deductions based on the child’s conduct. Standardized tests can also be used, although for children somewhat advanced in age and without special needs.
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Since the assessment approaches cannot be effective if used universally, modification is necessary to match the age and developmental stage. For instance, if a health care provider was assessing a child using a standardized test, the best way to engage a five-year-old is to read out the questions and write answers for them. In the case of observations, children can be placed in an environment where they can move around, play, and interact with peers as their behavior and visible health problems get recorded. Engaging parents and interpreters can also be considered modification since it eases collecting information and ensures that data is not collected and interpreted based on perceptions.
Health and developmental problems are typical in children. According to Moore et al. (2015), children’s developmental issues stem from the environment, access to health resources, and genetics, among other factors. Deborah, an eight-year-old girl, was born normally at thirty-eight weeks. She was not breastfed exclusively since her mother was supposed to travel back to Qatar due to job demands. As a result, the girl was left under the care of a nun as early as four months. Due to some inattention, Deborah was hospitalized for severe malnutrition when she was one-year-old, an issue thought to have contributed a lot to her developmental delays.
The typical development stages at her age include the concrete operational stage (ages 7 to 11) under Piaget’s stage of development. She is also in the industry vs. inferiority stage of Erikson’s stages of psychosocial development. At the concrete operational stage, the social world expands, and children begin to take pride in their accomplishments as they interact with peers (Börnert-Ringleb & Wilbert, 2018). Important events at this stage include attending school, growth in confidence, and a high rate of physical growth and cognition.
The most fitting theory in this scenario is Piaget’s stages of development. According to Piaget, children develop in four stages that follow each other: sensorimotor, preoperational, concrete operational and formal operational stages (Raeff, 2020). Deborah fits the concrete operational stage. To developmentally assess the child, the central focus should be their understanding of logic. Children are relatively good at using inductive reasoning in the concrete operational stage (Overton et al., 2015). They can understand reversibility and conservation. A suitable way of assessing whether Deborah has a developmental problem is cutting two candy bars of the same size into different pieces. One can be cut into two pieces and the other into four. The girl should know that both sizes are equal despite different pieces. I would offer explanations during the assessment through illustrations and active engagement. Active listening and engaging the child would help to gain cooperation. Potential findings include the child’s ability to apply inductive reasoning, awareness of external events, and expression of feelings.
In conclusion, the development assessment helps to obtain the necessary data about growth and development. It is a suitable reference of what needs to be done depending on the child’s physical, cognitive, and social-emotional needs. Deborah’s assessment can help identify mental and physical health problems and the interventions necessary depending on the severity of her problems. Active engagement is essential to ensure that the child cooperates to give as much information as possible.
Börnert-Ringleb, M., & Wilbert, J. (2018, May). The association of strategy use and concrete-operational thinking in primary school. In Frontiers in Education (Vol. 3, p. 38). Frontiers. https://doi.org/10.3389/feduc.2018.00038
Moore, T. G., McDonald, M., Carlon, L., & O’Rourke, K. (2015). Early childhood development and the social determinants of health inequities. Health promotion international, 30(suppl_2), ii102-ii115. https://doi.org/10.1093/heapro/dav031
Overton, W. F., Molenaar, P., & Lerner, R. M. (2015). Handbook of child psychology and developmental science: Theory and method, Vol. 1. John Wiley & Sons, Inc..
Raeff, C. (2020). Exploring the complexities of human action. Oxford University Press.
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For the middle-aged adult, exercise can reduce the risk of various health problems. Choose two at-risk health issues that regular physical exercise and activity can help prevent and manage. Discuss the prevalence of each of these health problems in society today. Describe measures that you would take as a nurse to assist clients with health promotion measures to incorporate exercise and physical activity into their lives. Include the kind of activities you would recommend, the amount of exercise, and the approach you would use to gain cooperation from the client. Support your response with evidence-based literature.
Middle- aged adults experience a variety of health concerns, varying from terminal illness to minor problems. Though our health is very important to us, the reality should be addressed with the individual early on in the diagnosis. Two health issues that can be improved with regular activity are hypertension and high cholesterol. According to Falkner, “Proper nutrition and physical activity are essential and lead to positive effects on overall health and help to prevent disease”…“ For instance, if the patient does not have access or financial means to join a gym, the nurse could help them develop a home workout regimen or a walking plan. The nurse should also provide proper nutrition recommendations such as those described on the Unites States Food and Drug Administration (USDA) website” (2018).
Hypertension is a pesky illness that may stay borderline for years, but the body can only tolerate the higher pressures within the blood vessels before it starts to damage vital organs and cause further health issues. The CDC conducted a study which showed “During 2015–2016, the prevalence of hypertension was 29.0% and increased with age: age group 18–39, 7.5%; 40–59, 33.2%; and 60 and over, 63.1%” (CDC, 2017). The fact is, these rates will continue to climb unless action is taken to reverse these illnesses. Increasing physical activity and exercise will allow these individuals to improve heart health, as well as become more aware of other health improvements. Along with changing your lifestyle, you should also encourage the individuals to monitor blood pressure daily, provide better dietary choices low in fats and salts, and also giving the individual the ability to still feel like they have options.
High Cholesterol is another illness that can be modified if lifestyle and dietary changes are made. According to the CDC, “Nearly 94 million U.S. adults age 20 or older have total cholesterol levels higher than 200 mg/dL. Twenty-eight million adults in the United States have total cholesterol levels higher than 240 mg/dL” (CDC, 2017). The goal for optimal cholesterol is anything less than 200 mg/dL. According to Heart, “Eat a heart-healthy diet. Focus on plant-based foods, including fruits, vegetables and whole grains. Limit saturated fats and trans fats. Monounsaturated fat, found in olive and canola oils, is a healthier option. Avocados, nuts and oily fish are other sources of healthy fat” (2021). They also suggest “Exercise regularly. With your doctor’s OK, work up to at least 30 minutes of moderate intensity exercise five times a week. Don’t smoke. If you smoke, find a way to quit” (Heart, 2021).
Centers for Disease Control and Prevention. (2017d). New CDC report: More than 100 million Americans
have diabetes or prediabetes. Retrieved from
My cholesterol guide. American Heart Association. https://www.heart.org/en/health-
topics/cholesterol/cholesterol-tools-and-resources. Accessed March 10, 2021.
The needs of the pediatric patient differ depending on age, as do the stages of
development and the expected assessment findings for each stage. In a 500-750-word
paper, examine the needs of a school-aged child between the ages of 5 and 12 years
old and discuss the following:
1. Compare the physical assessments among school-aged children. Describe how
you would modify assessment techniques to match the age and developmental
stage of the child.
2. Choose a child between the ages of 5 and 12 years old. Identify the age of the
child and describe the typical developmental stages of children that age.
3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain
how you would developmentally assess the child. Include how you would offer
explanations during the assessment, strategies you would use to gain
cooperation, and potential findings from the assessment.
You are required to cite a minimum of three peer-reviewed sources to complete this
assignment. Sources must be published within the last 5 years, appropriate for the
assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide,
located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to
the LopesWrite technical support articles is located in Class Resources if you need
Assessment is an important practice in nursing. Assessment provides data that nurses utilize in making their diagnoses and appropriate treatment plans for their patients. Assessment methods differ significantly based on the age group of a client. For example, it is anticipated that the physical assessment methods used for a pediatric patient differs significantly from that of an adult patient. Similarly, the assessment tools utilized to determine the care needs of the patients of different ages vary. Therefore, this paper explores the comparison of physical assessments used in school-aged children, their modification, and assessment of a child based on Piaget’s theory of development.
Comparison of Physical Assessment Among School-Aged Children
The assessment of school-aged children differs significantly from that of the toddlers, infants and the preschoolers. School-aged children have an enhanced understanding of the reality unlike infants, preschoolers, and toddlers that live in a world of fantasy. The thinking also differs among them as seen from the fact that school-aged children have developed logical thinking and comprehension of events. They also understand the consequences of their actions. School-aged children also have developed social skills from interacting with others in their societies. As a result, they have curiosity to learn new aspects in their lives and accomplish tasks for recognition. The children at the age group of 5-12 years can also express their health problems as well as their experience with them (Chiocca, 2019). Therefore, the appropriate modification of physical assessment techniques when working with them entails asking the children appropriate questions. It also entails involving the guardians or parents in the assessment process to obtain adequate data to inform the treatment plans. An additional modification entails beginning the assessment with areas that the children have a high level of awareness and moving to complex aspects of care (Tagher & Knapp, 2019).
Typical Assessment for a Child of a Specific Age
The selected case study involved a seven-year-old female patient brought to the clinic by her parents for assessment. The patient was brought for the annual normal checkup. She was born through caesarian surgery and with an Apgar score of 10. The immunization history is up-to-date with developments appropriate for her age. She does not have any history of surgeries or hospitalizations. The patient should demonstrate a number of cognitive, social, emotional and motor developmental milestones. She should have developed the desired cognitive abilities, as evidenced by her ability to describe her thoughts, feelings, and experiences and appreciate those of others. Further, she should be independent in forming friends and seeks acceptance from others. Finally, she should be able to perform physical activities such as sports and coordinate body activities effectively.
Developmental Assessment of a Child Using a Developmental Theory (Piaget)
Piaget’s theory of development can be applied in the above case study. According to Piaget, child’s development occurs gradually in four stages. The stages include sensory motor (birth to 2 years), preoperational (1.5-7 years), concrete operational (7-11 years), and formal operational (12-19 years). Based on the above, the child in the case study is in the concrete operational stage in Piaget’s model. Children in this stage are expected to have developed logical thinking. They have operational thought process characterized by their ability to relate abstract concepts with their experiences (Chiocca, 2019). Children in this stage also have the ability to express their feelings, emotions, and experiences. They also acknowledge the feelings and emotions of others. The focus of physical assessment when providing care to this client entails asking specific questions that they can answer to the best of their abilities and not her parents. The assessment should also focus on the exploration of issues relevant to the interests of the child. An example is asking questions related to the school, friends, her likes and dislikes. The nurse should provide information in simple language that is easy to understand for the children (Hockenberry et al., 2021). Since the visit by the client to the hospital was for regular assessment, it is anticipated that normal findings will be obtained.
The physical assessment of pediatric patients utilizes different approaches. The assessment depends largely on the developmental stage of the children. Nurses should demonstrate adaptability by being able to change the physical assessment approaches to suit the age group of their patients. In addition, theories of development such as Piaget’s should be used to inform the assessment findings.
Chiocca, E. M. (2019). Advanced Pediatric Assessment. New York, NY: Springer Publishing Company.
Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2021). Wong’s Essentials of Pediatric Nursing. Los Angeles, CA: Elsevier Health Sciences.
Tagher, G., & Knapp, L. (2019). Pediatric Nursing: A Case-Based Approach. Philadelphia, PA: Wolters Kluwer Health.
Great job Tanya! As you have mentioned, the same Head-to-Toe assessment is performed on both children and adults. However, the assessment may be conducted differently due to developmental stages and varying vital signs. It is important to consider the different stages of development when performing a child’s assessment. As you highlighted, toddlers and preschoolers may require a more playful approach, while school-aged children can follow directions but may still require the presence of their caregiver. Vital signs are different in pediatric patients than in adults, which requires healthcare providers to adapt their assessment techniques accordingly. As you have stated, blood pressure is typically lower than adults until around age 12, while the heart rate and respiratory rates are higher than adults. This information is important to consider when assessing a pediatric patient’s vital signs accurately. Your post also emphasizes the importance of talking with the child directly, as well as gathering information from their caregiver. This approach ensures that the healthcare provider receives all relevant information about the child’s health and well-being and can provide appropriate care.
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