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Key points
Background
AssessmentHistory
Examination
Growth charts
Growth chart interpretationIn the first few months of life, a healthy baby who is gaining weight may cross and track along a lower centile than that of their birth weight. Children with isolated less than 3rd percentile weight-for-age, but with typical neurodevelopmental progress and no red flags on clinical assessment may still be within normal limits of growth
A drop in percentiles may be observed when switching from WHO to CDC charts
ManagementA multi-disciplinary team approach is highly recommended. Professionals may include:
For an otherwise healthy and normally developing child with no suggestive features on history or examination, no investigations are necessary at first. Investigations to consider:All ages:
In children older than 12 months:
Other:
Treatment
Consider consultation with local paediatric team when
Consider transfer when
For emergency advice and paediatric or neonatal ICU transfers, see Retrieval Services. Consider discharge whenA clear individualised plan is in place thatclearly outlines the following:
Follow up
Parent informationGrowth charts Additional notesAverage growth The rate of weight gain per week is variable The table below is a guide to the expected average weight gain per week (it is not the minimally acceptable weight gain)
Growth charts for Down syndrome and Turner syndrome are available at: More information on how to interpret child growth can be found at: Last updated March 2021 Which assessment finding would the nurse expect in an infant diagnosed with pyloric stenosis?Classically, the infant with pyloric stenosis has nonbilious vomiting or regurgitation, which may become projectile (in as many as 70% of cases), after which the infant is still hungry. Jaundice. The infant may develop jaundice, which is corrected upon correction of the disease. Dehydration and malnutrition.
When feeding a child with pyloric stenosis what interventions will the nurse perform?Gradually, the amount and intervals of feeding should increase. It is recommended that feedings occur every 4-6 hours, and these feedings should include glucose, water, or electrolyte solution. The infant should be fed slowly, burped frequently and the infant should be handled minimally after feedings.
Which positioning would the nurse use for a newborn with a diagnosis of tracheoesophageal fistula?Semi-Fowlers. Option A: To prevent aspiration of stomach contents, the nurse should place the client in semi-Fowler's position. Option B: Supine position may increase the risk for aspiration.
Which is the priority need that must be included in the nursing care for a child with pneumonia?Initial priorities in children with pneumonia include the identification and treatment of respiratory distress, hypoxemia, and hypercarbia. Grunting, flaring, severe tachypnea, and retractions should prompt immediate respiratory support.
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