A nurse is assessing an 11-month-old infant and notes that the infant's height and weight are at the 5th percentile on the growth chart
Family history reveals that the infant's two siblings are at the 50th percentile for height and at the 75th percentile for weight. Psychosocial history reveals that the parents are separated and are planning to divorce. Which of these nursing diagnoses takes priority?
1. Alteration in Growth Pattern Related to Parental Anxiety
2. Alteration in Growth Pattern Secondary to Familial Short Stature
3. Nutritional Intake: Excessive Secondary to Maternal Feeding Patterns
4. At Risk for Constitutional Growth Delay Related to Decreased Appetite
Correct Answer: 1
Rationale: The scenario reveals parental anxiety due to marital problems. The most appropriate nursing diagnosis is alteration in growth patterns related to parental anxiety. There is no data that indicates familial short stature. Since height and weight are at the 5th percentile, there is no indication of increased nutritional intake. This infant is not at risk for constitutional growth delay.
You might also like to view...
The physiology instructor explains to the students that some substances increase actual learning. What is one of these substances?
A) Oxytocin B) Acetylcholine C) Serotonin D) Dopamine
Implementations that are appropriate in the care plan for a visually impaired person include:
1. leaving the bed in the highest position. 2. keeping the door closed. 3. announcing your presence when you enter and leave the room. 4. leaving the radio on all the time to help the patient know the time of day.
According to cognitive theory, the treatment for the depressed client is focused on the client's:
a. way of thinking about him- or herself and the world b. psychobiological and spiritual profile c. understanding of the origins of feelings d. sense of control over life's events
An appropriate nursing diagnosis for a patient who manifests a psychological problem through frequent expressions of unfounded or excessive guilt or shame, states that he is unable to deal with situations, and has a hesitation to try new things would be:
a. Hopelessness b. Powerlessness c. Ineffective coping d. Chronic low self-esteem