The nurse is caring for a 12-month-old diagnosed with chronic lung disease, receiving supplemental oxygen with a portable oxygen tank. What developmental milestone is likely to be delayed?

Walking unaided 15 steps.

Holding a crayon.

Copying a circle.

Speaking 15 words.

Answer and Explanation

The Correct Answer is A

Choice A reason: Walking unaided is a significant gross motor milestone that may be delayed in a child with chronic lung disease due to decreased physical stamina and energy levels. These children may tire easily, making it more challenging to develop the strength and coordination needed to walk independently. The need for supplemental oxygen can further limit the child's mobility and opportunities for practicing walking.

Choice B reason: Holding a crayon is a fine motor skill that may not be as significantly affected by chronic lung disease. While any serious health condition can impact overall development, fine motor skills like holding a crayon can be practiced in less physically demanding ways, even if the child has reduced stamina.

Choice C reason: Copying a circle is a developmental milestone typically expected later, around 3 years old. At 12 months, a child is not expected to perform this task, so it is not relevant in this context for identifying a delay at this age.

Choice D reason: Speaking 15 words is a language milestone that can be affected by various factors. However, chronic lung disease more directly impacts physical stamina and gross motor skills rather than speech development. While any health issue can influence overall development, speech and language milestones might not be as immediately impacted by chronic lung disease.

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Correct Answer is A

Explanation

Choice A reason: Feeding the baby while lying in the bassinet can pose a significant risk of choking and improper feeding technique. Babies should be fed while being held in an upright or semi-upright position to ensure proper swallowing and to prevent aspiration of milk into their airways. This practice promotes bonding between the caregiver and the baby and supports the baby’s overall feeding development. Therefore, further teaching is required for parents who feed their baby while the baby is lying in the bassinet.

Choice B reason: Periodically pausing the feeding is actually a recommended practice as it allows the baby to burp and prevents overfeeding. It also gives the baby a break to catch their breath and reset their sucking pattern. This technique can reduce the risk of discomfort and gas. Hence, this behaviour does not require further teaching.

Choice C reason: Discarding the remaining milk after one hour is a proper practice because milk can spoil and become contaminated with bacteria, leading to potential health risks for the baby if consumed. It is important to ensure that the baby is fed with fresh milk to avoid any health issues. Therefore, this behaviour does not require further teaching.

Choice D reason: Holding the baby upright during feedings is a correct and recommended practice. This position helps to prevent ear infections, reduces the risk of choking, and promotes better digestion. It ensures that the milk flows steadily and safely into the baby's mouth, aiding in a more efficient feeding process. Thus, this behaviour does not require further teaching.

A. Immune globulin given as soon as possible after delivery B. Hepatitis B immune globulin and hepatitis B vaccine given within 12 hours of birth C. Hepatitis B immune globulin given within 20 hours after birth D. Hepatitis B vaccine given 24 hours after birth

Correct Answer is B

Explanation

Choice A reason: Administering immune globulin as soon as possible after delivery is a correct step but does not include the critical combination of both immune globulin and the hepatitis B vaccine, which provides optimal protection for the newborn against hepatitis B.

Choice B reason: The combination of hepatitis B immune globulin and hepatitis B vaccine given within 12 hours of birth is the most effective intervention for preventing hepatitis B transmission from the parent to the infant. This approach ensures immediate passive immunity through the immune globulin and active immunity through the vaccine, significantly reducing the risk of the newborn developing hepatitis B.

Choice C reason: Administering hepatitis B immune globulin within 20 hours after birth delays the initiation of protective measures compared to the 12-hour window. It is essential to provide both immune globulin and the vaccine as early as possible to maximize the protective effect against hepatitis B.

Choice D reason: Administering the hepatitis B vaccine 24 hours after birth is too late for immediate protection against the virus. The combination of immune globulin and vaccine should be provided within the first 12 hours to ensure the highest level of protection for the newborn. Delaying the vaccination could increase the risk of hepatitis B transmission and infection.

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The nurse is caring for a 12-month-old diagnosed with chronic lung disease, receiving supplemental oxygen with a portable oxygen tank. What developmental milestone is likely to be delayed?

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