“Growth and Development Of A

Child”
(Individual Case Study)

Mojeca Christy C. Galla

Level 2, SN

Ms.Nathalie C. Fat
Supervising Clinical Instructor
 Introduction

Preschool is a planned educational program for children in the years before a child

commences school. Children are usually aged between 3 and 5 years. Preschool may take

place in a range of settings including a purpose built building, in a community setting, a

school, as part of a long day care center or a mobile or visiting service.

Growth and development occur across the life stages and focuses on the physical,

intellectual, emotional and social changes that humans go through.

Growth, predominately concentrates on the physical changes that take place across

different parts of the body. Growth is measured using a range of intervals such as height and

weight. Centile charts are used to measure changes in growth. Different centile charts are

used to measure the height and weight of boys and girls because of the difference in growth

patterns, for example, boys tend to be heavier and taller. Development, refers to the orders

of sequence that humans follow and mainly focuses on the attainment of skills and abilities.

Children usually progress in a natural, predictable sequence from one developmental

milestone to the next. But each child grows and gains skills at his or her own pace. Some

children may be advanced in one area, such as language, but behind in another, such as

sensory and motor development. Milestones usually are categorized into five major areas:

physical growth, cognitive development, emotional and social development, language

development, and sensory and motor development.

 Nursing Health History

Nursing health history is a holistic assessment of all factors that influence a

patient's health status, including social, cultural, familial, economic, and any other aspect of

the patient's life and well-being.

The utilization of Gordon's 11 Functional Health Patterns will aid in investigating the

health-related behaviours our client usually engages and in determining the development of

care and appropriate treatment to be rendered. The gathered information about the patient

were all from the patient's record and verbalization of identified person. In providing the

patient's privacy and maintaining confidentiality, we will hide the patient's identity with a

pseudonym of Patient Y.

Demographic Profile

Patient Y is a 4-year-old Filipino female and currently residing at Brgy. Curva Santiago

Agusan Del Norte, together with her parents and sibling. Pt. Y is the oldest among her 1

sibling. Pt. y is a Roman catholic by faith. Patient Y weight 37 lbs and a height of 156 inches.

Family History

The patient’s grandmother has high blood pressure and diabetes aside from her

grandmother there we’re no other history of illness or disease from the family.

Gordon’s 11 Functional Health Patterns

A. Health Perception – Health management pattern

Patient Y has no history of any illness or such diseases as verbalized by her mother

‘’kalooy sa Ginoo mam wala paman pod na sya nasakit ug grabe ug nadala sa hospital or

naadmit’’ Patient Y as stated by her mother, only goes to the hospital for check-up annually

and only drinks medicine when having cough or runny nose. In addidtion, upon asking if the

pt. is experiencing a mild condition like fever how will you manage it? The mother response

“Patumaron ra namo among bata mam ug paracetamol kada 4 ka oras kay mao man pod na

ingon sa iyang doctor. The mother also claimed that they are using herbal “ gagamit pod mig

mga herbal mam sama sa lagundi, ug kanang kamungay pag pagkasakit akong bata.

B. Nutritional and Metabolic pattern

Upon the interview it was observed that the pt. loves to eat unhealthy foods such as

junk foods and barely eats healthy food like vegetables and fruits and it was confirmed by

the pt.’s mother. “Hilig kaayog mga junk foods kana siya mam.” Mag lisod mig pakaon sa iya

ug mga gulay ug prutas pero ganahan na siyag gatas ug makhurot pod siya 8 ka bason a

tubig a day, musobra pa gani mam. However, pt. loves to drink milks and drink 8 glasses of

water a day.

C. Elimination Pattern

Patient Y has no difficulty in defecating. According to her mother, the patient has a

normal defecation, that she defecates once a day upon asking the color the mother said it is

a yellow color” Kada adlaw na siya malibang mam, kausa sa isa kaadlaw. Yellow ang color

mam tapos dli man pod tubol” as verbalized by the mother. IN in terms of pt. urination, there

is no problem at all. She can urinate with ease and without any pain and. As verbalized by

her mother ‘’wala man pod siyay reklamo na sakit pag mo ihi”. Upon asking about the color

and urine and the number of urination per day the mother answeres “ wala jud ko kabalo

maam if kabila siya mangihi sa usa ka adlaw kay siya naman gid moadto sa CR unya sa iyang

ihi sa color pod mam pabag.o- bag.o, sahay dl pod nako mabantayan.

D. Activity-Exercise Pattern
 One of the activities by the pt. is playing. “ hilig kaayo na siyag duha mam bisan unsa

nalang jud, motungko bisan aha magkinatkatkatkat. Mao nang ginabantayan na nako pod

mam everytime na magduha basi man gid mahulog ug basi mainjury ba”, as verbalized by

the mother. Her mother is worried about the child due to the child plays like climbing in the

stair. In addition most of the day after fishing her task “gadula na dayon na sila sa iyang

manghud after sa iyang module.

E. Cognitive – Perceptual Pattern

Patient Y has a good standing to her school. She can able do all her task with the helps

of his mother in school even though it is modular. But some times according to her mother

the child has difficulty in focusing in doing her task because often the time she plays with toy

and with her sister. “Okay man mam iyang pag skwela bisan paman modular da. Makahimo

gihapon siya sa iyang mga gipanghatag na mga activity sa iya pero ako jud na siya ginatuload

pariah anang pag sulat sa iyang pangalan ug mga tracing traing sa mga letter ug number.

Pero lge mam ang problema kay maglisod man siyag focus tungod sad ula, tungod sguro mam

kay naa ra sa balay ba”. As verbalized by the mother. In addition, the mother said “makabalo

na pod na siya mobilang mam ug mo identify ug mga butang ug uban pa. In addition, “Pero

sometimes mam kay akong masakpan akong bat aba murag naa siyay kadula pero wala man,

iya pod ginatudloan. Usahay kay mokatawa nalang ngani ko mam.” The child manifesting an

imaginary friend which accordingly at his stage imaginary friend is normal.

F. Sleep-Rest Pattern

According to the patient’s mother ‘’mo mata an siya mam alas otso sa buntag tapos

matulog alas noybe sa gabii’’ as verbalized by the mother. All in all, the pt. 6 hours of sleep.

The child also takes her nap at every afternoon and spend 1 to 2 hours of sleep. “

ginapakatulog man na nako sila sa hapon mam pagkahuman ug maniudto” as verbalized by

the mother

G. Self-perception and Self-concept pattern

Pt’s Y most of the time is the one who choose her outfit of the. “ kanang mam siya

raman ga pili sa iyang isuot sa kada adlaw, kay if ako mam mo ana man siya na pangit daw”
as verbalized by the mother. At this stage the child can able to determine the outfit that she

is about to dress up.

Role relationship Pattern

Patient Y has a closed relationship toward her family member “lambing kaayo na siya

sa amoa mam, kabalo ba siya mahanap sa among kiliti especially pagnakabalo na siya sa

nasuko na mi sa iya. In addition, the child also becomea good siter toward her sibling she

can play and share her favorate toy toward her sibling. “sa iyang manghud mam, buotan

kaayo na siya nag pag ka ate kay dli man niya ginaaway iyang manghud mam,

magkasinabtanay na sila ug ginapahulam pod niyang mga dulan niya sa iyang manghud

everytime na magdula sila” as verbalized by the mother.

I. Sexuality- Reproductive pattern

Patient Y is able to identify now her gender as her mother said “ kabalo naman na siya

mam kabalo unsay buhatonon sa mga bae, kabalo nag ani siya mo determine sa sinina na

iyang suoton. Siya man naga pili sa iyang sina ganahan siyag mga girly kaayo na sinina ug

kanang mga colorful kaayo mam”. At this stage the child is now know what are the things

common for their gender and that they are aware if the cloths that they are choosing

J. Coping and Stress tolerance

Upon interview the patient’s mother stated ‘’mag duwa ranas iyang igsoon mam or

saiyang mga duwaan pag magsige na siyag hilak2 or pag makasab.an siya’’. Playing with her

sibling is one of the child ways to enjoy. Few of the things that only make the child cry is

when her mother get anger to her.

K. Value-Belief Pattern

Since, the family is a catholic believer, they thought their child the common practice

and value of their religion. of According to the patient’s mother, they always attend mass

virtually due to the current situation every Sunday and always does praying together before

sleeping, in addition the family also teaches their children to be thankful by praying before

they eat. As verbalized by the mother “karon mam tungod aning virus sa TV nalang mi

gapanguta ug ug misa every Sunday, pero tong wala pa ang pandemic ginadala namo sila sa
church. Amo pod silang ginatudloaan ug gina.ingnan na mag pray before matulog ug kaon.

Nalipay pod ko mam kay magtimaan man sila.”

 Physical Assessment

Physical assessment is an organized, systemic process of collecting objective data based on health history and head-to-toe examination. The physical assessment is
the first step in the nursing process. It provides the foundation of the nursing care planning which the nurse’s observations play an integral part in the assessment,
intervention, and evaluation phases. The techniques used in assessment include inspection, palpation, percussion and auscultation. While in the abdomen, it has a different
sequence of the assessment which is inspection, auscultation, percussion and palpation to ensure a reliable result.

Inspection- is the visual examination of the client. This includes the observation of the color, size, location, movement, symmetry, odors and sounds as you as sess
each of the body system.

Palpation- is the use of the hand to touch for the purpose of determining temperature, moisture, shape, position, texture, consistency and movement. This can have
two types: light palpation and deep palpation.

Percussion- is the striking of the body surface with short, sharp strikes in order to produce palpable vibration and characteristics sounds.

Auscultation- is the listening to sounds produced inside the body. This includes breath sounds, heart sounds, vascular sounds, and bowel sounds with a stethoscope.

Patient T was assessed last September 16, 2021

Legend: Black- NORMAL Red: ABNORMAL

Body Parts Inspection Palpation Percussion Auscultation

Scalp and Hair -Black in color -Dry and brittle hair strand

-No nodules or masses have

been palpated on the scalp.

Head -Normal cephalic or -Smooth and firm head

round head noted without nodules or presence
of masses.

Skin -Skin complexion is -Skin turgor snaps rapidly

medium to brown back to it’s normal position.
skin

Eyes & Visual

Acuity
 Eyes -Sunken eyes -There were no masses and
Pupil Equally Round tenderness were noted over
Reactive to Light and the lacrimal gland and
Accommodation nasolacrimal gland
(PERRLA)
 -Without tenderness, pain and
masses palpated

 Eyebrows -Constricts when

assess with penlight

 Eyelashes
-Eyebrows were
evenly distributed
and symmetrically
aligned.
-Eyelashes were
equally distributed
and curled out
  Eyelids -Eyelid’s skin was
intact on both right
and left, and close
symmetrically with
15-20 bilateral
blinks/minute

 Bulbar -Has no tenderness and

Conjunctiva edema
-no drainage noted

Ears -The auricles align -The auricles were firm and

with the corner of pinna recoils after it is folded
each eye. within 2 seconds without
pain noted.
 - The pinna is aligned
with the outer -When palpating for the
canthus. texture, the auricles were
mobile, firm, and not tender.

Nose & Sinuses

 Nose -Color is the same as -Without tenderness
the rest of the face;
the nasal structure is
smooth and
symmetric and the
client reports no
tenderness.

-Nasal flaring noted

 Sinuses -Facial sinuses were not

tender upon palpation
Mouth

 Mouth -Patient was able to

move his tongue in
either ways.

-Symmetrical, pink
and smooth lips were
noted upon inspection

Neck
 Neck -Muscle equal in size -Without visible or palpable
Muscle lumps or masses.
-No difficulty of
swallowing
(dysphagia)
Thorax and lungs -Chest was -No tenderness and masses
symmetrical.
were felt upon palpation.
-Rhythmic effortless
respiration noted.

Heart and Central - The jugular vein was -Correct palpable at correct
vessels not distended nor pulse noted.
visible upon
inspection
Breast and Axilla -No lesions -Smooth in texture

-No tenderness and nodules

palpated
Upper - Skin was darker on
Extremities the outside part of the
extremities; those
that were exposed to
sunlight and lighter
on the inside part
 those that were not
exposed to sunlight

Lower - Skin was darker on

Extremities the outside part of the
extremities; those
that were exposed to
sunlight and lighter
on the inside part
those that were not
exposed to sunlight.

Nails -Clean nails noted -Capillary refill returns

within 2 seconds

Genitourinary -The color of the

urine is amber yellow

Anus and Rectum

ASSESSMENT INSPECTION AUSCULTATION PERCUSSION PALPATION

Abdomen -Abdominal
contour is
rounded, and
has symmetric
movements
with no
vascular
patterns noted.

Developmental Milestone

Developmental Normal Actual Interpretation

Milestone
Gross Motor *Hop, Swings, *Student/Child was Motor skills are also connected not only with academic achievement but also with
Climb and may able to hop, swing and physical activity in future lifestyle.
skip jump
(Rechtik, 2019)

Fine Motor *Enjoys drawing *Draws a lot In Basics of Fine Motor Skills, you’ll learn which skills are important for fine motor
during free time development, plus what fine motor development looks like in children at all age
levels.

(Greutman, 2017)

Language *Correctly name *Name different colors Children learn by absorbing information through daily interactions and experiences
atleast 5 colors not only with us, but with other adults, family members, other kids, and the world.

(Gavin, 2019)
Play *Plays *Enjoys playing card When a child starts to interact with others during play, but there is not a large
board/card games amount of interaction at this stage. A child might be doing an activity related to the
games with pictures kids around him.
(flashcards)
(Journal of Abnormal and SocialPsychology)
 Comparative Study

Theory Normal Actual Interpretation

Sigmund Freud Focuses on genitals. Play with his Child competes with other children for attention of an individual.
Psychosexual Theory Discovers other male
differences of males classmates due to (Pillisteri. 2010)
and females. gender
Development of differences.
unconscious sexual
feelings, fear of
punishment for
feelings.
Erik Erickson Copy adults; takes Child initiates Ephasized doing activities all by themeselves.
Psychosopsycial Theory initiative in play time to play with
situations. classmates. (Liu, 2016)
Initiative vs. Guilt Interested in
If frustrated, may doing his tasks
easily experience and seatworks.
guilt.
Jean Piaget Cognitive Expand vocabulary, Can relate to Development of intellectual abilities occurs in a series of relatively distinct stages and
Thoery think according to others. that a child's way of thinking and viewing the world is different at different stages.
individual
experiences. Star
relating with peers
and others.
Lawrence Kohlberg Moral development Child accept and Preschoolers who received consistent harsh
Moral Development proceeds in a linear, believe the discipline had
step-wise fashion; person. less
i.e., moral sophisticated
development moral criterion
proceeds gradually judgments than
from one stage to their less consistently
the next, in a or harshly disciplined
predictable, peers.
ordered sequence. Results demonstrate the importance
of social contexts in preschoolers' developing
moral judgments.

(Ball, 2017)
 Patient’s Problem List

Problem No. Date Identified Date

Nursing Problem
Implemented

September 16, Risk for fall related to

1 September 17, 2021
2021 activity

Risk for injury related September 17, 2021

September 16,
2 to environmental
2021
factor

Impaired Skin
Integrity r/t
September 16,
3 mechanical factors September 17, 2021
2021
such as trauma:
injury

Risk for Infection r/t

September 16, Inadequate primary
4 September 17, 2021
2021 defenses such as
trauma to skin

Fear r/t unfamiliarity

September 16,
5 with environmental September 17, 2021
2021
experience(s)
 NURSING CARE PLAN NO. 1

Cues Nursing Diagnosis Planning Nursing Intervention Rationale Evaluation

Subjective Cues:“hilig Risk for fall related Short Term Independent: Short Term
kaayo na siyag duha to pt. age and 1. Assess for circumstances 1. Using standard assessment
mam bisan unsa activity Within 4 hours of associated to increase the level of tools, the level of risk and After 4 hours of nursing
nalang jud, motungko nursing intervention fall subsequent fall precautions can interventions the patient SO
bisan aha the pt. SO will be able be determined. was able to be able to relate
magkinatkatkatkat. to relate the intent to the intent to use safety
Mao nang use safety measures to 2. Assess the pt. environment 2. trip hazard can increase the measures to prevent falls.
ginabantayan na nako prevent falls. risk of the pt. falling
pod mam everytime Long Term
na magduha basi man Long Term
gid mahulog ug basi After 3 day of nursing
mainjury ba”. As Within 3 day of nursing 3. Select a highchair with a wide interventions, the patient the
verbalized by the interventions caregiver 3. discuss to the SO the Use base that makes tipping less pt. SO was able to implement
mother will be able to preinstalled safety straps on a likely. Don't leave a child strategies to increase safety
implement strategies changing table or highchair unattended on a changing table and prevent falls in the
Objective Cues: to increase safety and or in a highchair. home.
 Always playing as prevent falls in the
observed home. 5 the SO encourage Install safety
 Goes up and down gates at the top and bottom of 5. Put doorknob covers on
to the stair staircases. doors that lead to staircases,
 Start to learn how such as basement doors. Install
to bike lower stair rails that are easier
for younger children to reach.
Don't leave clutter on stairs
6. educate the SO to seek out
playgrounds with shock- 6. Falls on cement, packed dirt
and turf are more likely to
absorbing surfaces, such as wood result in injuries. Steer your
chips, mulch, rubber or sand. child to age-appropriate
activities to help prevent falls
from equipment.

7. Encourage to always have

your 7. When using skates, a scooter
child wear a helmet while biking, or a skateboard, your child
inline skating, skateboarding or should wear guards for the
riding scooters wrists, elbows and knees.

8. Encourage the SO to provide a 8. For the child to become

notorious and a healthy food healthy and support her growth
their children such as fruits and and development
vegetable
9. to promote a safety measure
9. Advice the SO to ensure that and support to the pt. doing
the floor is free of objects that
can cause the pt. to slip or fall
10. to keep the child free from
10. Discuss to the pt. SO the bacteria and for the child
important of and to maintain cleanliness
hygiene to their child such as
taking a bath, washing hands
often and changing cloths
 NURSING CARE PLAN NO. 2

Cues Nursing Diagnosis Planning Nursing Intervention Rationale Evaluation

Subjective Cues: :“hilig kaayo Risk for injury Short Term Independent: Short Term
na siyag duha mam bisan unsa related to physical 1. Assess general status of the 1. This is to determine the
nalang jud, motungko bisan environment Within 8 hours the pt. is free patient. patient’s condition that may After 8 hours of nursing
aha magkinatkatkatkat. Mao from any injury cause injury. interventions the patient was
nang ginabantayan na nako free from any injury
pod mam everytime na Long Term 2. Assess mood coping abilities, 2 Mood coping abilities and
magduha basi man gid personality style that may style of personality aid to Goal not met.
mahulog ug basi mainjury ba”. Within 3 days of nursing result in carelessness. determine the patient’s level
As verbalized by the mother intervention the pt. SO is able of cooperation. Long Term
to implement intervention
given the prevent injury 3. Check on home environment 3. Patients experiencing After day of nursing
Objective Cues: for threats to safety: clutter, impaired mobility, impaired interventions, the patient SO
 improper storage of chemicals, visual acuity, and neurological was able to implement
slippery floors, scatter rugs, dysfunction, intervention given the prevent
unstable stairs and stairwells, including dementia and other injury
blocked entries, dim lighting, cognitive functional deficits,
extension cords across are at risk for injury from Goal Met.
pathways, hazardous electrical common hazards.
or gas connections, unsafe
heating devices, inappropriate
oxygen placement, high beds
without rails, extremely hot
water, pets, and pet excrement.
4. Ask family or significant 4. This is to prevent the
others to be with the patient to patient from accidentally
prevent him or her from falling or pulling out tubes.
accidentally falling or pulling
out tubes.

5. Eliminate or drop all possible 5 This is to prevent the patient

hazards in the room such as from any unpleasant
razors, medications, and experience due to dangerous
matches. objects.

6. Avoid extreme hot and cold 6. Patients with decreased

around patients at risk for cognition or sensory deficits
injury (e.g., heating pads, hot cannot discriminate extremes
water for baths/showers). in temperature.

7. Educate patients SO about 7. Patient’s knowledge about

safety ambulation at home, his or her condition is vital to
including the use of safety safety
measures such as
handrails in bathroom.

8. Encourage the SO to provide 8. For the child to become

a notorious and a healthy food healthy and support her
their children such as fruits and growth and development
vegetable
9. to promote a safety
9. Advice the SO to ensure measure and support to the
that the floor is free of objects pt. doing
that can cause the pt. to slip or
fall
 10. to keep the child free from
10. Discuss to the pt. SO the bacteria and for the child
important of and to maintain cleanliness
hygiene to their child such as
taking a bath, washing hands
often and changing cloths
References

Rechtik, Zdenek. (2019). Assesment of Gross Motor Skills as a Part of Child's Physical

Readiness. v6 n11a p127-132 Nov 2018. 6 pp.

Greutman, Heather. (2017). Basics-Fine-Motor-Skills. Create Space Independent Publishing

Platform.

Gavin, Mary. L. (2019). Communication and your 2-to 4- year-Old. Kids health. Org.

Parten MB Social Participation among Preschool Children. Journal of Abnormal and Social

Psychology. Pp. 243-269.

Introduction to Growth and Development. Retrieved September 20, 2021 from

https://www.tutor2u.net/hsc/reference/introduction-to-growth-development.