Case Scenario
Paul, a 5 year-old rescued street child was admitted in the charity ward of the hospital you are working to. He is suffering from severe malnutrition and some wounds in his legs and arms are left untreated. Upon attending to the patient, you learned that he is from the nearby city with no parents alive. His relatives are not interested of taking care of him. Immediately, you asked his name. As a five year-old kid, he is somewhat shy to answer several of your questions. But to the vital information that you need are given by his short, soft and hesitant responses.
After the preliminary recording of personal data and whereabouts, you immediately order a colleague to check on the medical files of the child in the hospital records shelves or in the nearby hospitals whom he is possibly admitted before. The colleague found out that Paul was born in your hospital as on March 18, 2000. According to the facts listed on the records, his mother passed away upon giving birth. He belongs to a poor family when his parents are still living.
1. Physical milestones
– As a street kid, Paul is too skinny and short. He definitely falls below the average weight and height of a normal five years old child. For some normal kids of his age, they are expected to be active and curious. They are generally playful and full of energy. It is believed that the first five years of a child is the most crucial and considered the formative years (‘). In the same article, a healthy child is in a perfect state not only in body but in mind. A child learns how to play independently, dress and undress (2001), talk, run, stand on one leg even as early as the age of 3 (1990). In relation to height and weight, a 5 year old child has the average of 109.0 cm and 18.2 kg. With the case of Paul, he is under the average height and weigh acceptable to his age.
2. Gross motor skills
“Gross motor skills are larger movements involving the arm, leg, or feet muscles or the entire body — things like crawling, running, and jumping are gross motor skills” (2005).
– Paul is not as active as a normal five years old child. He can run but easily gets exhausted. When tired, he barely moves his arms and limbs due to his malnourished condition. Accordingly, he just sits on street or park benches and waits for alms from by-passers. During meals, he often eats leftovers from rubbish.
3. Fine motor skills
According to (2005), “Fine motor skills are those smaller actions like picking things up between the thumb and finger or using the toes to wriggle into sand or the lips and tongue to taste and feel objects.”
– Though Paul is physically weak, he is still capable of thinking and speaking in his age. He can comprehend to questions from the people who interview him. He can move his hands in coordination with his eyes. He has a develop senses.
4. Language
Language as well as motor development is now at a level to give expression to imagination at the age of 4 to 5 (1999).
- Basing it to his age, Paul can speak well. However, he is shy and hesitant. He can pronounce works as a normal kid of his age but his soft shy voice is the only problem.
5. Social development for the particular age group
Paul is shy. Hence, he lacks self-confidence and self-esteem. His emotional health is poor. He is aloof to people and seems worried. Since he is a street child and no relatives taking care of him, his sense of security is low. This makes him troubled and uncomfortable. Referral may be the action of choice when a health professional believes that a patient has a personal problem and needs counseling. When the problem appears to be primarily related to something beyond the current treatment situation, or when it seems to be complex, the health professional may feel inadequate to deal with it (1999).
Nursing Suggestions
In developing gross motor skills, consider the long-term implications for development for its control, as well as fine motor coordination and eye-hand coordination basing it from the data taken in the environment of the patient.
Most importantly, healthy food should be given to Paul to make him as fit as a normal 5 years old kid. His wounds should be treated to alleviate the risk of infection. Exercise, sleep, and proper care and attention must be given to him. Further, as a street child, the responsibility of the nurses and/or doctors is to look for an institution that will cater to the needs of the child.
In social development, “Emotional relations established very early in life set the pattern of relations in later life” (‘). Paul must develop his emotional health because it is the basis of the child’s development of a sense of security, confidence and the ability to cope well with other people and with the world at large.
Meanwhile, it is vital to bear in mind that progression through the stages is a function of chronologic age, physical and emotional maturation, and the social environment. Different cultural contexts place different demands and expectations on individuals. Those presented here reflect a post-industrial society, and would not necessarily apply to a tribal society or that of a developing country. Thus, change occurs in the individual in several different areas simultaneously at each psychosocial stage throughout life.
Credit:ivythesis.typepad.com
0 comments:
Post a Comment