Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2
Consider the following patient scenario:
A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).
Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.
Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2 SAMPLE 1
Some developmental markers the nurse can assess include social/emotional milestones, language/communication milestones, cognitive milestones, movement/physical development milestones. Also, paying attention to fine motors kills and Gross motor skill. These milestones are emphasized in the learning development of the child. For the assessment of a 9-month-old baby the expected milestones are as followed: (CDC,2023)
- Babies tend to be shy, clingy, and fearful of strangers.
- Shows facial expressions of being happy, sad, angry, and surprised.
- Reacts when parents leave the room (crying and looking for you).
- Starts to make different sounds.
- Lifts arms to show she want to be picked up.
- Look for objects that are out of sight.
- Bangs toys together.
Movement/physical development Milestones:
- Gets to a sitting position by herself.
- Can move things from one hand to another.
- Sits without support. (CDC, 2023)
Fine Motor Skills: (Green, 2022 p.9)
- Bring objects to the table.
- Feed herself finger foods.
Gross Motor Skills:
- Stands while holding onto a support.
- Makes stepping movements (Green,2022 p.9)
During the physical assessment the nurse should also assess the infant’s general appearance, nutritional status, hygiene, alertness, body posture and movements among other things. Assessing the well being of the infant is important to provide safe patient care. Understanding the developmental progression of an infant can help us gather the information needed to check if our patient is having any delays in physical growth, psychosocial development, or developmental milestones. An infant’s health promotion aims to reduce the developmental delays and their potentially lifetime implications (Green,2022 p.5) Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2.
For this 9-month-old baby, she is showing signs of slowed growth. The CDC growth chart helps us understand the baby’s growth. Providing education to the parents is important so they can be aware if the child is having any developmental issues. I would recommend the mother to first continue to care with the child’s pediatrician and work together to create a treatment plan. Providing early interventions can be beneficial to the baby. I would also recommend the family to interact with the baby with play time that includes promoting fine motor skills and gross motor skills. Providing evidence-based information is important so the family can have the most up-to-date information about the plan of care. Providing information that is easy to understand is also important to ensure that they are getting all the information needed.
Centers for Disease Control and Prevention. (2023a, June 6). Important milestones: Your baby by nine months. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html
Centers for Disease Control and Prevention. (2001, August 23). Growth charts – data table of infant length-for-age charts. Centers for Disease Control and Prevention. https://www.cdc.gov/growthcharts/html_charts/lenageinf.htm
Falkner, A., & Green, S. Z. (2022). Health Assessment: Foundation for Effective Practice (Second). Grand Canyon University.
Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2 sample 2
In the first 9-12 months of infancy, a lot of physical and psychological development happens to a baby. The development has a significant impact on their emotional and physical well-being throughout their life. A detailed nursing assessment will be critical in identifying any developmental delay and any other health promotion requirement (Green, 2022). A typical healthy nine months old baby should exhibit fine and gross motor skills like banging items on the floor or surfaces, sitting independently, crawling, transferring objects between hands, making stepping attempts, transitioning to standing position, and even exploring things (Green, 2022). At that age, an infant should be double or triple their birth weight and length between 10-12 inches (Mayo Clinic, 2022).
They need to be in a position to babble, laugh, imitate sounds and respond to verbal commands.
In reference to CDC growth chart, the child in question is in the 25th percentile for length and the 5th for weight. Therefore, it is critical to conduct a thorough evaluation of the infant’s nutritional requirements. For a proper physical development, it is recommended that the mother has to continue breastfeeding her while gradually incorporating solid foods rich in iron like small fruit portions, mashed egg yolk, vegetables crackers and even wheat toasts (AAP, 2012). Again, talking to the baby, encouraging tummy time, immunizing her and bonding with her is recommended. That would help her physical and psychological development.
These recommendations such as prevention of infants injury in promoting safety, nutritional and oral care, and adherence to immunization schedules are all based on evidence-based practice. For example, some safety promotional practices such as the avoidance of honey or corn syrups help in preventing the risk of botulism in these infants and the avoidance of some nuts also help prevent choking which are all through evidence-based research proven to help prevent diseases and sudden death of infants. Also eradication of various diseases through immunizations which is part of EBP can be seen and witnessed by all. Developmental monitoring and screening incorporate detailed examination of infants development via the use of evidence-based assessment tools which is relatively dependent on current and up to date research methods. Recommendations based on EBP helps in early identification of developmental delays and conditions thereby preventing and treating them in an early stage when identified (Green, 2022).
American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3).
Green, S. (2022). Health Assessment: Foundations for Effective Practice. Chapter 1. Health Assessment of the Infant. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/1.
Mayo Clinic. Infant and toddler health: Expert answers. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/infant-growth/faq-20058037.
Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2 sample 3
To begin the assessment of a 9-month-old girl, I would start by asking her mother if she has any concerns regarding her daughter’s health and development. Additionally, I would gather information about the infant’s gestational age at birth and her birth weight. It’s important to monitor the infant’s weight gain pattern, ensuring it is positive and not showing recent weight loss. My primary concern for this baby is the discrepancy between her length and head circumference, which falls at the 25th percentile, considered normal but on the lower side, and her weight, which is at the 5th percentile, indicating that she weighs less than 95% of babies her age. I would discuss the child’s diet with the mother and provide recommendations for an appropriate caloric intake (CDC, 2022).
In the assessment of the 9-month-old girl, as a nurse, I would also evaluate her motor skill milestones to gauge her developmental progress and offer guidance. At this age, a child should be able to perform various tasks, such as banging objects on a table, transferring objects from one hand to another, feeding themselves with finger foods, crawling, sitting without support, getting into a sitting position, pulling themselves to a standing position, standing while holding onto a support, making stepping movements, drinking from a cup with assistance, poking at objects with their finger, developing a finger-thumb pincer grasp to pick up objects, scribbling with a crayon or marker, and taking objects out of a container Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2. While some of these skills are not mandatory at 9 months, it’s important for the child to develop them by the age of 12 months (Grand Canyon University, 2022).
I would also assess the child’s language development. A 9-month-old should exhibit babbling, laughing, blowing bubbles, and be able to respond to simple verbal commands from others, like “no.” They may also imitate sounds, such as saying “mama” or “dada,” although they may not initially associate these sounds with their parents. For evaluating language development and other milestones, screening tools like the Denver Developmental Screening Test II, Infant Development Inventory, or Bayley Infant Neurodevelopmental Screener can be valuable. These tools help assess language, gross and fine motor skills, and psychosocial development based on evidence-based practice. If the infant shows any developmental delays on the screening, it’s crucial for the nurse to communicate with the infant’s primary practitioner or seek referral sources like early intervention services (Grand Canyon University, 2022).
CDC. (2022, December 12). Clinical growth charts. Centers for Disease Control and Prevention. https://www.cdc.gov/growthcharts/clinical_charts.htm
Grand Canyon University. (2022). Health Assessment: Foundations for Effective Practice. Health Assessment of the Infant. https://bibliu.com/app/#/view/books/1000000000584/epub/Imprint.html
Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2 sample 4
Developmental milestone markers to be looking for in a 9-month-old female infant can be determined by assessing their motor skills. At this age some fine motor skills should include transferring objects from one hand to another, feeding self finger foods, and poking at objects with finger (Green, 2022). A few Gross Motor skills should include crawling, beginning to sit without support, able to support weight on legs and may bounce (Green, 2022).
Language development is also a border line development to determine. Nine months is right on the cusp of 6-9 months, and the beginning of 9-12 month health assessment charts. Vocalization in infants from 6-9 months should include babbling, laughing, and blowing bubbles (Green, 2022). By 9-12 months the infant is responding to simple verbal commands, and imitating sounds like mama and dada (Green, 2022).
For Registered Nurses it is beneficial to incorporate simple play such as peekaboo to obtain a Health Assessment on a nine-month-old female infant. This is this age group who has a fear of strangers, stranger anxiety, and may cry if approached (Green, 2022). Keep in mind the child will most likely be held by the caregiver to have the appointment run smoothly, this is also a time to assess how caregiver and infant interact Developmental markers for a 9-month-old female infant – NRS-434VN Topic 1 DQ 2.
In this patient scenario a mother comes in with a 9-month-old female infant. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). The child’s weight is indicative of being malnourished which explains why the length and head circumference is only in the 25th percentile. Based on CDC guidelines backed up by Evidence Based Practice they talk about introducing other foods and drinks other than breast milk and infant formula (CDC, 2021). Including complementary foods are other foods and drinks such as infant cereal, fruits, vegetables, and meat or other protein (CDC, 2021). The Centers for Disease Control and Prevention include guides on when to start introducing solid foods to infants as it can be a daunting transition for parents. I would also address barriers to this transition as infants of this age are teething and will experience discomfort and pain.
Centers for Disease Control and Prevention. (2021, December 1). Foods and drinks for 6 to 24 month olds. Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/index.html
Green, Z. S. (2022). Health Assessment of the Infant. Health Assessment: Foundations for Effective Practice. Grand Canyon University. https://bibliu.com/app/#/view/books/1000000000584/epub/Chapter1.html#page_5