Altered Growth and Development

Altered
Growth and Development

(_)Actual (_)
Potential

Related
To:
[Check
those that apply]
(_)
Acute illness
(_) Prolonged pain
(_) Chronic illness

(_) Prolonged bedrest
(_) Neglect/isolation

(_)
Traction or casts
(_) Separation from significant other
(_) Parental knowledge deficit

(_) Other:_____________________________
____________________________________
____________________________________

 

As
evidenced by:
[Check
those that apply]
Major:

(
Must be
present
)
(_)
__________________________________

_____________________________________
_____________________________________

Minor:

(
May be
present
)
(_)
__________________________________
_____________________________________
_____________________________________

 

Date &
Sign.
Plan and Outcome
[Check
those that apply]
Target

Date:

Nursing Interventions
[Check
those that apply]
Date
Achieved:
  The
child/patient will:

(_) Demonstrate an increase in personal,
social, language, cognition, or motor activities
appropriate to age group.

Specify Behaviors:

  (_)
Assess present level of personal, social, cognitive and
motor development.

(_) Assess etiological factors for
alteration in growth and development.

(_) On admission,
evaluate height and weight.

(_) Daily weights
at___ a.m./p.m. using the same scale.

(_) Provide
opportunities for child to meet age related developmental
tasks such as:

  1. _____________
  2. _____________
  3. _____________
  4. _____________
  5. _____________

(_) Teach parents
appropriate developmental tasks and parental guidance
information such as:

  1. ______________
  2. ______________
  3. ______________
  4. ______________
  5. ______________

(_)
Other:________________

________________________
________________________
________________________

 

 

__________________________
Patient/Significant other signature

 

__________________________
RN signature