6-MONTH OLD CASE STUDY, Exams of Nursing

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6-MONTH OLD

CASE STUDY

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SUMMARY, HISTORY, SYMPTOMS  Patient Age : 6 months  Birth History: Born at 37 weeks gestation via cesarean section, cephalic presentation.  Neonatal Course : Unremarkable; newborn screening and hearing tests were normal.  Family History: Mother is a carrier of G6PD deficiency; father is also affected.

 Constipation following the transition to formula feeding (currently taking NAN Supreme

formula, 150 ml every 3–4 hours).

 Mild atopic dermatitis (eczema) localized

to the face.

SUMMARY, HISTORY, SYMPTOMS (CONT…)

 Vaccination Status:

 Vaccination is Up to date.

 He has received 6-month immunizations on

 They include:

 DTP-Hib-HepB-Pertussis-PolioTetanus

(hexavalent)

 Pneumococcal

 BCG

 Physical Examination:

 Stable vitals, alert and interactive, no abnormalities noted.

 Primitive reflexes present, tone https://www.healthychildren.org/English/safetyappropriate, and no

musculoskeletal or prevention/immunizations/Pages/Your-Babys-

neurological concerns. First-Vaccines.aspx

CLINICAL ISSUES  Functional Constipation:  Likely related to formula feeding (NAN Supreme)  Mild Atopic Dermatitis (Eczema):  Evident on the face.  Risk of developing G6PD Deficiency:

Atopic Dermatitis (Eczema)  Daily emollient use (fragrance-free, thick creams).  Avoid overbathing; use lukewarm water and mild soaps (Davari et al., 2020).  Monitor for flare-ups or signs of infection. G6PD Risk Education  Educate parents on oxidative stress (Al-Blewi et al., 2023).  Consider screening if future symptoms appear.  Provide emergency signs and when to seek help. VIABLE SOLUTIONS &

INTERVENTIONS (CONT…)

SIX-MONTHS GROSS AND FINE MOTOR SKILLS

• Gross Motor Skills :
  • Can sit with little or no support.
  • Rolls over in both directions (front to back, back to front).
  • Pushes up with arms when lying on tummy.
  • May start trying to rock back and forth on hands and knees (UNICEF, 2024)..
• Fine Motor Skills :
  • Reaches for and grasps objects with both hands (UNICEF, 2024)..
  • Transfers objects from one hand to the other.
  • Begins to use raking grasp to pick up smaller objects.

COMPREHENSIVE PATIENTCENTERED CARE- PLAN

Clinical Management

 Administer 6-month vaccinations.

 Monitor and manage functional constipation and

mild eczema.

 Maintain routine developmental surveillance.

Parental Education & Support.

 Teach signs of dehydration, red flags for

constipation.

 Skin care: Use of emollients, avoiding irritants.

 Address concerns with reassurance and clear guidance.  Tailor interventions to cultural preferences and parental confidence.  Encourage shared decision-making. REFERENCES Al Blewi, S. M., Alessa, R. A., Alzahrani, L. D., Kheder, O. M., Alissa, R. A., Alharbi, L. S., Alsanad, L. F., & Almuzaini, A. S. (2023).  Assessment of Parents’ Knowledge Regarding Pediatric Glucose-6-Phosphate Dehydrogenase Deficiency in Saudi Arabia. Cureus. https://doi.org/10.7759/cureus. Allen, P., Setya, A., & Lawrence, V. N. (2024, January 11). Pediatric Functional Constipation. PubMed; StatPearls Publishing.  https://www.ncbi.nlm.nih.gov/books/NBK537037/ Davari, D. R., Nieman, E. L., McShane, D. B., & Morrell, D. S. (2020). Current Perspectives on the Management of Infantile Atopic  Dermatitis. Journal of Asthma and Allergy , Volume 13 , 563–573. https://doi.org/10.2147/jaa.s Richardson, S. R., & O’Malley, G. F. (2019). Glucose 6 Phosphate Dehydrogenase (G6PD) Deficiency. Nih.gov; StatPearls  Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470315/ Liu, Q., Long, Q., & Garner, P. (2017). Growth monitoring and promotion (GMP) for children in low and middle income  countries. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd010102.pub Misirliyan, S. S., Boehning, A. P., & Shah, M. (2023). Development milestones. PubMed; StatPearls Publishing.  https://www.ncbi.nlm.nih.gov/books/NBK557518/ UNICEF. (2024). Your baby’s Developmental Milestones at 6 Months. Www.unicef.org.  https://www.unicef.org/parenting/child-development/your-babys-developmental-milestones-6-months 