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

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