The child I chose for this project is a five year old little girl who is in kindergarten. She is classified as the Preschooler (purpose) Initiative vs. Guilt under Erickson’s Stages of Psychosocial Development. She is very imaginative. She plays with dolls as though they are her little family and she is there mother. She likes to dress up as if she has created her own magical world. She looks up to her mother greatly. She wants to be just like her mom. If mom has her hair done with makeup on, she wants her hair and nails done as well. She initiates play and conversation very easily. She loves planning parties for her dolls and she enjoys playing games. The mother stated she will sometimes cheat during a game but feels so guilty she ends up telling on herself.
The child is current on all immunizations. She has received Hep B vaccine at birth and two months, three doses of DTap, RV, PCV, IPV from birth to six months. From ages 12-18 months she receives MMR, Varicella, Hep A. The child will receive DTap, MMR, IPV, and Varicella at six years old. Future immunizations she can look forward to are MMV, TDap, as well as the HPV vaccine if the mother chooses to have her daughter receive it. That vaccine will consist of a total of three one will be two months after initial dose and the last will be six months after initial dose. The child has met the expected developmental milestones of a normal five year old from my observation. The child was able to count to 100; she was also able to draw a person with six body parts as well as hair and accessories. She had no difficulty copying shapes and matching them with the correct color. She can print the Alphabet and spell her name. Spelling her name was not a expected developmental milestone for a five year old but she did it with no difficulties. Throughout this paper I will go more in detail on specific milestones for a five year old. A Nursing intervention appropriate for this child is to educate the parents on safety as the child yearns for more independence, nutritional information, and on the emotional changes of a child this age. Anticipatory guidance for the parent is that the five year old will begin feeling very independent at times and may want to do activities you usually do with them alone. If the activity is safe try allowing her some freedom to do so
Physical Assessment This child falls right above the 50th% on a growth chart for a five year old. A screening that can be done is iron deficiency screening just to make sure her iron levels are sufficient. Nutrition is very important at this age by helping the child grow physically but also developmentally. Most children at this age tend to want processed foods like hot dogs and chicken nuggets. Encourage the child to substitute apples or carrots in place of cookies or French fries. Make eating healthy appealing to you child by making it fun. Include her in meal preparations. For example give them a chef hat it will give them a sense of purpose and they will want to eat the masterpiece you and your child created. I observed nothing abnormal during my assessment.
Communication
The parent identified that the child can speak clearly, tell elaborate stories using full sentences with future and past tense words and describe the meaning of words and how they are used. The parent also stated the child can say her name and birthday, but still gets the numbers mixed up on her phone number and address. The parent believes the child has met all communication milestones. My observation matched the parents’ statements. The child engaged in a full conversation with me. She told me all about school and her monster high dolls and also told me what she was going to do at dance the following day. She had no difficulty describing the meaning and usage of words that were age appropriate. As far as screening recommendations, I would tell the parent to get visual and hearing screenings by six years of age. Being able to catch any abnormalities early will help the child progress successfully in learning and communication. I would educate the mother to continue to practice reading and writing and as the child excels in communication express the importance of not just communicating with unfamiliar people especially when the parent isn’t present.
Social/Emotional
The parent identifies the child has met all social and emotional milestones for the age of this child. From my observations the child is aware of her gender and the difference in boys and girls. When I was observing the child play with another child I seen she was very willing to play and very friendly. She taught her new friend how to play Connect Four with a lot of patience. She showed great concern for the other child. I also observed the child seems to meet and even exceed some of the milestones for a five year old. Most children at this age have a hard time following rules of a game especially if they lose; they tend to result to cheating so they can win. This child not only knew and accepted the rules, but was able to teach another child her age. She responds to other children with playful conversation and is very friendly. She interacts with adults very well by using manners if it’s an adult she knows her playful vivacious personality comes out. With strangers she tends to stick to her mom a little more until she wars up but will speak when spoken to. There is no specific screening tool for this set of milestones, but if the parent has any concerns it is best they contact their healthcare provider and get the proper referral. I Education I would give the parent is that the child is now really understanding the meanings of being angry, happy, sad etc. So encourage your child to express those feelings properly. This child looks up to her parent so as a parent the way you handle feelings in front of her child should be appropriate. The child will react the same way they seen the parent react.
Mobility
The parent identifies the child has met all mobility milestones. My observation matched the parents’ observation. The child was able to stand on one foot for longer than ten seconds. She did several somersaults in a row; she skipped with no difficulties up and down the sidewalk. A screening recommendation for this child is to have her parent annually take the child to the doctor for a well child checkup. They will assess developmental, physical growth, cognitive, and mobility to assure the child is where they need to be for their age. Education for this parent is to provide a nutritional diet high in protein. This child is actively growing. Dietary calcium and phosphorus is needed for the mineralization of the teeth. Assure the child receives eleven to twelve hours of sleep a night and allow the child to have sixty minutes of physical activity a day. These educational recommendations will help the child grow and develop in many ways. .