[NOISE] >> [INAUDIBLE] >> Well, Hello, good morning to you. My name is Jim. >> All right. >> And I’m your nurse for today. Stacy will be your nurse practitioner, but she just wants me to go over some simple things, just to ask you all about your son. Is that okay? >> Uh-huh. >> All right, well, let’s get started. Since your last visit, has there been any major illnesses, hospitalizations, changes, or stresses for your family or child? >> I was in a car accident a couple of months ago, and the pain is really bad, so I haven’t been to work for a couple of months, yeah. That’s about it. >> Okay, is your child taking a vitamin supplement? >> Yeah. >> Has your child ever had a reaction to a vaccine? >> No but he has all his shots, they’re all up to date. I make sure I track of that. >> Is your child still on a bottle? >> Yeah, like about he can [INAUDIBLE] at the hospital he has exciting ones, I just give him meds. And then he’s kind of keeps him occupied because it has like some kind of like mountain view or so I could catch them all day and then you don’t want to. >> Very well. Does your child sleep through the night? >> Sometimes he sleeps for 10 hours, and I have to get him up. I have to push and push and get him up, and it’s rough. I think, I feel like I need some Xanax. Because my anxiety just gets up and sometimes I can’t get him to sleep. So if he could get some Xanax or some Benadryl or something to put him to sleep, that would be great. >> Does your child drink or eat food prepared with tap water? >> Yeah. >> Do you have any questions or concerns about your child’s bowel movements? >> No. [INAUDIBLE] >> Okay, do you brush your child’s teeth with water every day? >> I brush it in the morning and at night. >> Does your child hear and see well? Is there a TV in your child’s bedroom? >> [INAUDIBLE] I have to say [INAUDIBLE] [LAUGH]. Okay I’m sorry, what was that? >> Yeah, is there a television in your child’s bedroom? >> Yeah, he watches TV every night. That’s how he goes to sleep. >> Do you play and read with your child every day? >> I’ve been trying to play with him, to make sure- [MUSIC] Things is he’s always on my phone. No, don’t do that. No, don’t touch my phone. He’s always on my phone. I try to like even like these puzzles, I got him these, and it’s like a jigsaw. And he loves cars, so I don’t understand why he can’t do it. And see, I’ll give him the puzzle, look, he don’t even know how to put it together. So that’s what we’re here today at the doctors office, to make sure everything right. >> Okay, we get some nice question. Do you have any concerns about tantrums or disciplining your child? >> No, I tell him no all the time. Like no, no, don’t touch that. See, he still touched it. No. >> How about choking? Do you know what to do if your child is choking? >> Do you always cook on the back burners of your stove? Okay, what about the pothead was he keep those pointed away? >> Yeah, he can’t get burnt, >> Okay. >> He can’t reach out there. >> If you have stairs in your home, do you have a safety gate at the bottom and the top of the stairs? >> Yeah, it’s at the bottom and top. We got it too at the basement doors, too, at the top and the bottom. >> Do you keep all medications, household cleaning products, poisons, in a cabinet and kind of out of reach from him? >> Yeah, but, so like sometimes I forget where I put my cigarettes. I have a cigarette and on the floor I’m gonna have one table here around because one time he grabbed a cigarette and he started chewing on it and I was okay because you [INAUDIBLE] he wants to get swallowed up and he almost swallowed it. I think he swallowed it I’m not really sure. I thought he was in control because I got that phone number in my phone. That’s what got me last time. So, yeah, we try to make sure we keep [INAUDIBLE] my cigarette. Sometimes I smoke in the living room, or the kitchen, or the bedroom. But I made sure that I don’t smoke in his bedroom. But I smoke everywhere else but just not in his bedroom, because that’s where he is. >> Okay. And you said you have the poison controls number in your phone. >> Yeah. >> Okay, so you get it readily available in your house, in other places as well too? >> Yeah, I got that. >> Do you place your baby in the car seat, facing backwards in the backseat? >> No, he faces forward, just like everybody else in the car. When I turn around, when I’m driving, I need to be able to see him. >> Do you watch your child at all times around water, like in a bathtub, pools, the ocean? >> Yeah, >> Does your child show affection by hugging or kissing you? >> Yeah, all the time, watch. Hey, bud, give mom a kiss. Give mom a kiss. Give mom a kiss. Give mom a kiss. [SOUND] Yeah, give mom a kiss. >> Yeah buddy. Does your child walk well? >> Yes. >> Does he say two to three words at a time? >> Yeah. [INAUDIBLE] >> What about things that you do? Does he imitate you or does he imitate activities? >> Yeah, he [INAUDIBLE] >> Does he try to feed himself with a spoon or fork? Does he follow simple directions? >> Yeah, he does. The phone ringing, hold on one second I probably. A text another. >> Okay I have a couple more questions for you. >> Okay. >> Then I’ll be out your way all right. >> All right, okay. >> Does your child listen to a story? >> Yeah, we love stories. I just have to read? >> Yeah. >> Watch. Read. Read. Yeah. Iguana baby. Turn the page. Turn the page. Good job. >> All right, big man, and final question, does your child indicate what he wants about pulling or tugging or groaning, pointing no draw some kind of action? >> Sometimes I get appointed was a male male or something, you know. He’ll be like [INAUDIBLE], so I’ll be [INAUDIBLE]. What’s the better. >> Okay, wow. >> [INAUDIBLE], stuff like that. You don’t throw that to my anxiety pills. Always throwing my pills away. They gave them to me after my car accident because my nerves was bad. Here, put that right there. Pills everywhere. Yeah, put it back in the, put them back where you got in from. >> Okay, well, that’s my phone press. That’s my final question. That’s all the info I need from you right now. Like I said, a follow on me Stacy will be right in and she’s gonna follow up everything else. Okay. All right, so she’ll be right in just a few minutes are thank you so much for your time.ript
Care of the Family and Child
Student’s Name:
| Category | SAFETY |
| Issue – Pertinent Negative
What did you see that was inappropriate? |
Mom’s response indicates that she allows her child to play around water like near a bathtub, a swimming pool, or an ocean. |
| Pertinent Positive
What did you see that was appropriate? |
Mom is aware that she should watch her child whenever he is playing around water. |
| Guidelines or Recommendations | Share resources that talk about drowning prevention with parents and caregivers. |
| Reference | American Academy of Pediatrics. (2021). Drowning prevention campaign toolkit. Drowning Prevention Campaign Toolkit (aap.org) |
| Professional/Ethical Communication by Nurse Practitioner to Parent
How will you provide non-judgmental and non-bias education regarding issue identified? Needs to be at least 3 sentences. Helpful Hints:
|
“It seems you allow your child to play around water like near a bathtub, a swimming pool, or an ocean. For a child aged 15 months, it is recommended that you stay within arm’s reach whenever your child is near water. Also, always read resources that talk about drowning prevention in order to keep your child safe near water.” |
| Category | TEMPER TANTRUMS AND DISCIPLINE |
| Issue – Pertinent Negative
What did you see that was inappropriate? |
Mom responded in a manner that it makes it difficult for the clinician to know whether she is concerned about her child’s tantrums and discipline or not. |
| Pertinent Positive
What did you see that was appropriate? |
Mom is aware that she should distract her child whenever he displays temper tantrums and engage in behaviors that show indiscipline. |
| Guidelines or Recommendations | Provide parental education on best practices such as staying calm and distracting the child by saying something or giving him or her playing objects such as toys. |
| Reference | American Academy of Pediatrics. (n.d.). Temper tantrums. https://publications.aap.org/patiented/article-abstract/doi/10.1542/peo_document396/81966/Temper-Tantrums?redirectedFrom=fulltext |
| Professional/Ethical Communication by Nurse Practitioner to Parent
How will you provide non-judgmental and non-bias education regarding issue identified? Needs to be at least 3 sentences. Helpful Hints:
|
“I see that you usually try to distract your child by saying ‘no, no, no’ whenever he displays temper tantrums and indiscipline. Temper tantrums are common in infants. I would advise that you replace your reactions with new ones such as giving her playing objects such as toys.” |
| Category | SLEEP ROUTINES |
| Issue – Pertinent Negative
What did you see that was inappropriate? |
Mom stated that her child sometimes sleeps for 10 hours and she has to get him up. She has to push to get the child up. |
| Pertinent Positive
What did you see that was appropriate? |
Mom’s awareness of the importance of sleep to her child’s health. |
| Guidelines or Recommendations | Educate the parent to allow the child to sleep 12 to 16 hours per 24 hours (including naps). This should be done regularly to enable the child to adapt to that particular routine. |
| Reference | Paruthi, S., Brooks, L. J., D’Ambrosio, C., Hall, W. A., Kotagal, S., Lloyd, R. M., Malow, B. A., Maski, K., Nichols, C., Quan, S. F., Rosen, C. L., Troester, M. M., & Wise, M. S. (2016). Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: Methodology and discussion. Journal of Clinical Sleep Medicine : JCSM : official publication of the American Academy of Sleep Medicine, 12(11), 1549–1561. https://doi.org/10.5664/jcsm.6288 |
| Professional/Ethical Communication by Nurse Practitioner to Parent
How will you provide non-judgmental and non-bias education regarding issue identified? Needs to be at least 3 sentences. Helpful Hints:
|
“You should not disturb your child during sleep. At the same time, you should not allow your child to sleep too much. Ensure that you create a sleep promoting environment for your child to avoid disturbance. Considering the child’s age, he should sleep for a maximum of 12-16 hours in a day. Maintain a bedtime routine for the child to adapt so that he can sleep and wake up without difficulties.” |
| Category | CAR SEAT SAFETY |
| Issue – Pertinent Negative
What did you see that was inappropriate? |
Mon stated that she places her child in the car seat facing forward. |
| Pertinent Positive
What did you see that was appropriate? |
Mom is aware that an infant should be placed at the back seat. |
| Guidelines or Recommendations | Advise the parent to always place her child in the back seat facing backwards. The rear-facing position must be maintained until the child reaches 4 years. |
| Reference | Durbin, D. R., Hoffman, B. D. (2018). Council on injury, violence, and poison prevention. Child Passenger Safety. Pediatrics, 142(5):e20182460. doi: 10.1542/peds.2018-2460. |
| Professional/Ethical Communication by Nurse Practitioner to Parent
How will you provide non-judgmental and non-bias education regarding issue identified? Needs to be at least 3 sentences. Helpful Hints:
|
“I see you place your child in the car facing forward just like everybody else in the car. It is advisable that child aged 15 months should be placed at the back seat facing backwards. This is the best way you can keep your child safe in the car.” |
| Category | HEALTHY TEETH |
| Issue – Pertinent Negative
What did you see that was inappropriate? |
Mom is not clear on what she uses to brush her child’s teeth. |
| Pertinent Positive
What did you see that was appropriate? |
Mom is aware that it is important to brush the child’ teeth twice a day: in the morning and at night. |
| Guidelines or Recommendations | Use a small-headed and soft toothbrush to brush the infant’s teeth. Use a very thin coating of fluoride toothpaste and water. Brush in the morning and when the child in going to bed at night. |
| Reference | Bright Futures. (2021). Guidelines for health supervision of infants, children, and adolescents. https://brightfutures.aap.org/Bright%20Futures%20Documents/BF4_OralHealth.pdf |
| Professional/Ethical Communication by Nurse Practitioner to Parent
How will you provide non-judgmental and non-bias education regarding issue identified? Needs to be at least 3 sentences. Helpful Hints:
|
“I am happy to learn that you brush your child’s teeth in the morning and at night. As you do so, remember that the child’s gums are still weak. Therefore, always use a small-headed and soft toothbrush to brush the infant’s teeth to avoid causing injury to the gums. Also, use a very thin coating of fluoride toothpaste and water. You should avoid feeding your baby on biscuits and sweets to help him have healthy teeth.” |