The nurse is providing education about age-appropriate activities to the parents of a 7-year-old child. Which of the following statements indicates a need for further teaching?

Choice A rationale

Catching a bounced ball is a skill that typically develops around the age of 21. However, it’s not uncommon for 1-year-olds to start practicing this skill, especially if they show interest and are physically ready.

Choice B rationale

Jumping rope is a complex activity that requires advanced motor skills, coordination, and timing. These skills are usually not fully developed in a 1-year-old child. Therefore, purchasing a jumping rope for a 1-year-old child indicates a need for further teaching as it is not an age- appropriate activity.

Choice C rationale

Riding a tricycle is a skill that children typically start to develop around the age of 31. However, there are tricycles designed for younger children that come with push handles for parents. If the parents are referring to this type of tricycle and they are always present to supervise and assist, it could be an appropriate activity.

Choice D rationale

Running and playing chase can be great activities for a 1-year-old child. Around this age, many children start to walk independently and may even start to run. Playing chase can help them develop their gross motor skills and is a fun way for them to stay active.

Choice A rationale

Restlessness, bilateral wheezes, and poor feeding are concerning symptoms in a child. Restlessness can indicate discomfort or distress. Bilateral wheezes can suggest an airway obstruction or inflammation, often seen in conditions like asthma. Poor feeding can be a sign of general illness or specific conditions like gastrointestinal disorders. However, these symptoms, while concerning, are not as immediately threatening as the symptoms described in choice D12.

Choice B rationale

Sitting up, coarse breath sounds, coughing, and restlessness are also concerning symptoms. Coarse breath sounds and coughing can indicate a respiratory infection or other lung condition. Restlessness can again indicate discomfort or distress. However, these symptoms are not as immediately threatening as the symptoms described in choice D12.

Choice C rationale

Not eating well and increased respiratory effort are signs of potential illness. Not eating well can lead to malnutrition and weakened immunity, making the child more susceptible to infections and slowing recovery. Increased respiratory effort can be a sign of respiratory distress, which could be due to conditions like pneumonia or asthma. However, these symptoms are not as immediately threatening as the symptoms described in choice D12.

Choice D rationale

A toddler in the tripod position (sitting up and leaning forward, using the arms to support the upper body), with diminished breath sounds and grunting, is showing signs of severe respiratory distress. The tripod position is often used instinctively to maximize airway patency and ease breathing. Diminished breath sounds can indicate significant airway obstruction or lung disease. Grunting is a sign of increased work of breathing and is often seen in conditions like pneumonia or severe asthma. These symptoms together suggest that the child may be in respiratory failure, which is a life-threatening emergency requiring immediate medical attention.