13.5 Spotlight Application

The following spotlight application provides an example applying the nursing process to assessing and providing care to a school-aged child at a well-child check.

1. What assessment data should the nurse collect?

2. Based on the assessment data, what child-related nursing diagnosis applies?

Readiness for enhanced health self-management

3. Give examples of an appropriate overall goal and SMART outcome criteria for this child.

Overall goal: The client will practice healthy behaviors of exercise, nutrition, social activity, sleep, immunizations, dental care, and safety appropriate to their age.

Examples of outcome criteria:

• The client’s height and weight growth patterns are within the normal range based on his age.
• The client and/or his parents will report 60 minutes of physical activity per day after the teaching session.
• The client and/or his parents will report eating a well-balanced diet by the next well-child visit.
• The client and/or his parents will describe healthy interactions with peers after the teaching session.
• The client’s parents will report the client sleeping 9-12 hours per night by the next well-child visit.
• The client and his parents verbalize at least 3 safety rules for the child and family after the teaching session.
• The client and/or his parent will report an annual teeth cleaning and dental check-up by the next well-child visit.

4. What nursing interventions does the nurse plan to implement for Marcus and his parents?

• Complete screening tests appropriate to the client’s age.
• Assess height and weight growth trends across well-child visits.
• Recommend vaccine administration according to the CDC schedule for client’s age and prior vaccines
• Provide anticipatory guidance on the following teaching topics: Daily exercise, healthy nutrition, social activity, healthy sleep, use of safety equipment such as helmets and seatbelts, safe gun storage, healthy use of social media, annual dental care

5. How will the nurse evaluate if the interventions were effective?

The nurse will review the established outcome criteria described in question 3 and gather data to determine if they were met, partially met, or not met by the timeframes indicated.

6. If the child is appropriately progressing toward the overall goal and established outcome criteria, what should the nurse do next?

Plan on reevaluating progress at the next well-child visit.