The nurse is conducting physical assessments for a group of children at a local wellness clinic. Which child requires further evaluation?

The nurse should include the following information in the teaching about home safety for a 10- month-old infant:

1. Keep plastic bags and plastic grocery bags in a secure place. Plastic bags pose a choking hazard for young children who can easily put them over their heads and suffocate.
2. Serve food in small pieces no larger than a cheerio. This reduces the risk of choking, as infants have limited chewing ability and can easily swallow large pieces of food whole.

E. Use plastic covers on all electrical outlets. This prevents the infant from sticking fingers or objects into the outlet, which could lead to electrical shock.

However, the following information is incorrect and should not be included:

C. Lower the crib rails to the lowest level. While lowering the crib rails might seem convenient, it actually increases the risk of the infant climbing out and potentially falling and injuring themselves. Crib rails should be kept at the highest level possible once the infant can sit up on their own.

D. Set the water heater to 65°C (149°F). This temperature is scalding hot and can cause severe burns in infants. The recommended safe water heater temperature is 120°F (48.9°C) or lower to prevent accidental scalding.

Therefore, the correct selections are A, B, and E. The nurse should emphasize the importance of creating a safe environment for the infant by keeping choking hazards out of reach, serving food in appropriate sizes, and preventing access to electrical outlets. Additionally, the nurse should educate parents about the safe water heater temperature to avoid scalding risks.

Choice A rationale

By 9 months, most babies have developed the fine motor skills necessary to pick up small objects, like crackers, with their thumb and forefinger. This is known as the pincer grasp. If a 9- month-old child is unable to do this, it could be a sign of a developmental delay.

Choice B rationale

It’s normal for babies at this age to have a short attention span. They often play with a toy for only a few minutes before moving on to something else. Therefore, this behavior is not typically a cause for concern.

Choice C rationale

The ability to crawl on all fours supported on hands and knees is a typical developmental milestone for a 9-month-old child. Therefore, this behavior is expected and does not indicate a developmental delay.

Choice D rationale

While some 9-month-old babies may be able to pull themselves to a standing position, not all babies develop this skill at the same time. Therefore, the inability to do this is not necessarily a cause for concern.