ALLEAH JAYNE C.

ARELLANO BSN-N21

Individual Case Study

Nurses live by the statement: “Nurses are angles in a sickroom, caring for you from womb to tomb”. It is undeniable
that nurses are versatile individuals who do their best to give quality and effective care to everyone, no matter what the
age, life status, and health history. One of the various patients a nurse usually takes care of are the children. They help in
not only during delivery, but also aid the parents in making sure that all aspects of growth and development is satisfied,
for the sake of the child’s.
In addition, nurses value a child's growth and development for the following reasons: The nurse will be able to know
what to expect of a particular child at a given age, the nurse can be able to judge each child whether he/she is normal
for specific level of development, The nurse will be able to understands the need of a particular child, aid in planning
the total care of the child, and also help in monitoring the growth of the child. You see, growth is an increase in the size of
the whole body or any of its part. It can be measured in inches, centimeters, pounds or kilograms (Brainkart.com, 2016).
The nurse, along with the parents and physician will go hand-in-hand to make sure that the child will grow and develop
normally in order for that child to grow up as an effective adult.
With all that being said, my groupmates and I during our clinical rotation had the honor of interviewing a mother and
his toddler in order to evaluate the child’s growth and development. The experience felt so surreal due to the fact that it
was also a first time of ours to interview someone with the use of virtual tools like Google Meet. It only goes to show that in
nursing, versatility and adaptability is deemed and important trait to posses not only to rise the tides but also to make sure
that we will be able to foster to every health concern and individual has, no matter what ,medium, era or adversities
come our way.
ALLEAH JAYNE C. ARELLANO BSN-N21

What all that bieng said, in order to further present our case, I will be presenting the following information: Nursing
Health History and Physical Assessment, Developmental Milestone, Comparative Study, Nursing Care Plan, and lastly
Learning Outcome.

I. Nursing Health History and Physical Assessment

The following information are Baby Z’s health history and Physical Assessment:
Baby Z was born on September 23, 2016 and is a male individual. His type of delivery was spontaneous and was born
in Holy Child Hospital and during his birth, his mother was assisted by a midwife. During the first six months, he was mix fed
for every 3 to 4 hours. In addition, he has no allergies and loves to eat avocados. He was admitted for Previous illness
called Amoeba last January 20, 2020. He was admitted first at Santos then transferred to Holy Child Hospital severe
diarrhea, night sweats, and dehydration.
Interms of his growth and development, at 6 months he weighed approximately 7.6 kg; 9.4 kg when he was a year
old; 13 kg at two years old and lastly; 21 kg at five years old. His current Current height is 4 ft. In terms of Dentition his
age of onset of primary teeth was when he was 6 months old and currently his present no. of teeth are 10 teeth in the
Upper portions and 8 on the Lower portions. Now for his developmental milestone, at the following ages below, he was
able to do the following tasks:
 Smile:_2-3 mos.
 Hold head steady while in sitting position: 8-9 mos.
 Roll over: 7 mos.
 Sit with support: 8 mos.
 Sit unsupported: 11 mos
 Dress self: 5 yo.
 Stand with support: 13 mos.
 Stand and walk alone: 13 mos.
 Utter any first word with meaning: 1 yo.
 Talk in sentences: 2 yo.
 Toilet training at age: 2 yo.
ALLEAH JAYNE C. ARELLANO BSN-N21

Moving on to the Approach and attitude of the client and elimination pattern, Client Z prefers toilet than diaper after
acquiring toilet training. The client’s deficates 2 times per day usually in the evening. He urinates for 10 times per day
during the moring and does not bed wet.In terms of family history, there type of family is nuclear and and the only family
illnesses and congenital anomalies are: Hypertension and Diabetes. Both of Baby Z’s parents are healthy and are
employed, with decent income. In addition, the mother of the children is the one preparing the food for the family and
they live in a house with 4 rooms occupied by 5 individuals. They get their water supply from Butuan City water district
and they get their potable water from their very own water distilling station. You see, the family own a water distilling
business, hence supply for potable is safe and secured.

Their religion is The Members Church of God International (MCGI) and their cultural practices is taht theydoe snot
celebrate any Catholic holidays like Christmas and Easter. In terms of religious practices, they do not eat HALAL meats
and would go to church three times a week. In addition, their ethinicity is manobo and their family practices are the
following:
 Adult members get Vitamin C shots at least 3 times per month.
 Persons including family members are not allowed to kiss Zephaniah (5 months old) for sanitary/health purposes.
 Children are not allowed to go outside the house due to COVID-19 pandemic.
 Continuing incorporation of handwashing and brushing teeth (sometimes inconsistent).

II. Developmental Milestone

Developmental
Normal Actual Interpretation
Milestone
 Average weight  Baby Z is 21 kg and is 121.92 The client is showing evident
is 18.14 kg and height or 4 feet tall. growth sprout but is still
is 101.6 cm  Baby Z has 20/20 vision and considered to be within his
Physical Growth
 Has good 20/20 enjoys watching videos. normal BMI. The client also
vision  Baby Z usually sleeps for 6 seems to have healthy eyes
 Sleeping pattern to 7 hours and good vision. However, the
ALLEAH JAYNE C. ARELLANO BSN-N21

is healthy with 10 to  Baby Z does not wet the client’s sleeping schedule is
13 hours of sleep bed not normal and may affect the
everynight and does client’s growth if sleeping
not wet the bed pattern continues. This is
problematic and will
eventually be harmful for the
client---leading to sleep
deprivation. Studies have
linked sleep deprivation with
mood swings and reduced
cognitive function, including
concentration difficulties,
lower test scores and a drop in
overall school performance.
Poor sleep also is associated
with poor eating habits and
obesity.
 Able to jump in  The client is able to hold his The client can demonstrate
place balance for 10 seconds actions that requires strength,
 Move muscles to and more. balance and coordination.
make movements  The can sit and stand with
 Stands on one foot ease.
Gross Motor Skills for 10 seconds or  The client can walk and
longer and hold his run with ease and no
balance. longer wobbles when
 Is able to sit and executing said activities.
stand
 Is able to walk and
ALLEAH JAYNE C. ARELLANO BSN-N21

run with ease

 Make movements  Baby Z likes playing kinetic The client is able to illustrate
using the small sand and coins minor courses of action without
muscles in the hands  Can easily throw a ball with the assistance of others.
and wrists. little to no assisstance
 Manipulate small  Is able to eat on their own
objects. with little to no assisstance
 Eat on their own. and creates minimal to no
 Can be able to mess at all
throw a ball  Client is able to cut basic
Fine Motor Skills
overhand with great lines with assistance
body coordination.  Baby Z is able to draw
 Is able to cut out a basic lines, can trace and
picture with scissors connect lines as well.
with little to no
assisstance.
 Knows how to draw
and write

 Begin to use more  Baby Z greets everyone The client can easily verbalize
complex sentences during the interview with his wants, needs and concerns
and knows the basic enthusiasm. with ease. The client also
rules of grammar like  Knows how to properly use expereince minimal to no
Language/Speech
the use of “he” or “Ate”, “Kuya”, “Ma’am” stutters at all. The client’s
“she” pronouns and “Sir” pronounciation of words is also
 Can speak up for  Politely greets everyone clear and does not use
greetings and with a ecstatic “Good “baby-talks”. In addition, the
ALLEAH JAYNE C. ARELLANO BSN-N21

valediction morning” and “Hello” client is able to sing and recite

 Is able to state his first 
and last name with
ease
 Sing songs or poems
from memory like 
lullabies.
 Is able to tell stories
 Is able to tell stories that
Randomly sings lullabies or poems with little to no help
songs from memory and from his Mother. He also
seems happy when portrays excitement when he is
executing such act. spoken to.
Baby Z spontaneously sings
cocomelon, baby shark
and etc.
has occured or was told to
Baby Z

 Knows one or more  Is good with identifying The client seems to be paying
color colors close attention to his
 Imitation even if they  Baby Z is imitating his environment, which is typical
do not fully mother and ends up of someone his age.
understand it mimicking his mother’s Furthermore, it is common for a
 Understand words child of this age to be
commands  When Baby Z’s Mother confused, hence he follows
Cognitive  Follows simple told Baby Z to sit down, and imitates the adults and
Development instructions Baby Z obeyed diligently people who are older than him
 Can easily put 4 to 5  Baby Z seemed shy at more. Also, a child this age is
words together with first during th interview, but usually curious, hence, that
no assisstance eventually became child would usually ask various
 May begin to use comfortable and started questions in order to satisfy
vulgar words being utterly chatty. their curiousity. He' has no
 Knows how to count  Baby Z would trouble obeying rules and
occassionally spat out enjoys talking to other people.
ALLEAH JAYNE C. ARELLANO BSN-N21
curse words without
understanding the gravity
of his actions or his choices
of words.
 Can easily count from 1
to 20 and is able to recite
odd and even numbers
 Portrays basic  Baby Z illustrated how
emotions ecstatic and giddy he feels
 Experience, manage for his upcoming birthday.
and express  He inivted everyone
emotions present in the interview to
 Enjoys doing and his birthday with genuine
discovering new happiness in his eyes.
things.  Baby Z constantly asks his
Emotional
 Is more curious mother questions before
Development
 Talks about things and during the interview
that interest them  He verbalized that he
 Is more engaged in wanted jollibee when He
“make-believe-plays and the host will see each
” other soon
 The client often plays with
kinetic sand and coins and
plays
He also likes engaging himself
into conversations, even if he
was not part of it. With that
being said, the logical growth
is deemed normal. In addition,
a child at this age has not yet
fully grapsed the concept of
consequences. Hence, his
choice of words are usually
imitated or heard. He does not
fully understand it yet.
Being a child at this very age
and with the fact that he is
surrounded with people you
barely know at the very
beginning, it is human nature
to feel left out or afraid. It is
natural for a child to be shy
when facing foreign situations.
Give them ample time to
adjust and feel comfortable,
safe and secure before you
encourage them to get out of
his/her shell and make new
friends. However, in Baby Z’s
case, he was only shy for a
short period of time and then
became comfortable with his
ALLEAH JAYNE C. ARELLANO BSN-N21

“make-believe-plays” surroundings. Baby Z also is

great at expressing himself and
illustrates a good sense of
emotional development.

 Understand the idea  Greets everyone is the Baby Z seems to be

of sharing interview, including the comfortable with socializing
 Form and sustain clinical instructor with other people and would
positive relationship  Baby Z would often hug his speak to others with utter
 Explore and engage mother during the enthusiasm. It seems like he is
with the environment interview good at making friends and
 Gets along with  He would share to the class portrays good etiquette
people outside that his nails are clean around other people.
Social Development family  He bids goodbye and Hello However, despite him being
 Cooperates with utterly sociable, he seems to
other children be easily distracted, which is
 Would rather choose normal for a child his age.
toplay with other
children than by
themselves
 Easily distracted
ALLEAH JAYNE C. ARELLANO BSN-N21

III. Comparative Study

THEORY ACTUAL OBSERVATION INTERPRETATION

1. Sigmund Freud  Baby Z seems to me more attached  A child during this age has build up
(Psychosexual Theory. ) to his mother and often views his anger and resentment and does not
younger sister as competition really know how to effectively deal
The phallic stage towards his mother’s attention. with said emotions.
This is the third stage of  Saying bad words like “bwesit” and  Seeing how he is more attached
psychosexual development, during the interview, he would with his mother, brings that conotation
spanning the ages of three to mimic his mother in a playful that he regards his father and
six years, wherein the infant's manner. younger sister as competition towards
libido (desire) centers upon his mother’s attention. He is displaying
their genitalia as the Oedipus Complex and because of this
erogenous zone. The child sense of envy and not fully knowing
becomes aware of how to deal with this type of emotion,
anatomical sex differences, in order to cope with this anxiety, the
which sets in motion the son identifies with the father. This
conflict between erotic means the son adopts or internalizes
attraction, resentment, rivalry, the attitudes, characteristics and
jealousy and fear which Freud values that his father holds take for
called the Oedipus complex example personality, gender role,
(in boys) and the Electra masculine dad-type behaviors etc
complex (in girls). This is (McLeod, 2019).
resolved through the process  The Oedipus complex is
of identification, which involves successfully resolved when the boy
the child adopting the begins to identify with his father as an
characteristics of the same sex indirect way to have the mother
parent (McLeod, 2019). (McLeod, 2018). If oedipus complex is
ALLEAH JAYNE C. ARELLANO
2. Erik Erikson (Psychosocial 
Theory)
Initiative versus guilt
This is the third stage of Erik
Erikson’s theory of psychosocial
development. This stage
occurs during the preschool
years, between the ages of 3
and 5. During the initiative
versus guilt stage, children
begin to assert their power and
control over the world through
directing play and other social
interaction (Cherry, 2019).
BSN-N21
When Baby Z’s mother told him to 
sit down and he diligently
complide.
 Baby Z greets everyone in the
interview and is comfortable with 
chatting with the clinical insturctor
and the host.
 Baby Z invited everyone present in
the interview to his birthday with
great enthusiasm and excitement.
 When Baby Z would constantly ask
his mother questions during and
before the interview.
 He likes to engage himself with
“make-believe-plays”.
not resolved, the child will not grow
and develop normally and may lead
to underlining psychological problems
in the near future.
A child at this age is usually social and
likes to engage with conversations.
They enjoy other people’s company
and are very sociable at this age.
During this time, the child's main
characteristic is that he or she
interacts with other children at school
on a daily basis. Play is important at
this period because it allows
youngsters to practice their
interpersonal skills by initiating activities
(McLeod, 2018).
 At this age, the child is utterly curious
as well. They would ask various
questions in order to satisfy their
curiousity and they love discovering
new things.
ALLEAH JAYNE C. ARELLANO BSN-N21

3. Jean Piaget (Cognitive  Baby Z would occassionally spat  A child at this stage does not fully
Development) out curse words without grasp the idea of conscequences and
understanding the gravity of his know the gravity of their actions. They
The Preoperational Stage of actions or his choices of words. can process simple ideas but not fully
Cognitive Development  Likes to play with his kenitc sand understand it.
In Piaget's theory of cognitive and coins and would often play  A child at this stage enjoys
development, the “make-believe” with himeself or symbolic play. Hence, the kenitic sand
preoperational stage is the with a playmate or with his mother. and coin in an adults eyes may seem
second stage. This stage starts  Enjoys telling stories. like a mere choking harzard, but to the
at the age of two and lasts child, it could mean a lot to him and
until about the age of seven. his play time.
Children think in symbols  A child at this stage also enjoy
throughout this time, although conversing into story telling for it gives
they are not yet performing them the freedom to symbolically play
cognitive procedures. During while illustrating the picture he wants
this stage, the child's thinking is to paint.
pre (before) operations. This
implies that the youngster is
unable to reason, convert, mix,
or separate thoughts. The
child's development consists of
building experiences about
the world through adaptation
and working towards the
(concrete) stage when it can
use logical thought. During the
end of this stage children can
mentally represent events and
ALLEAH JAYNE C. ARELLANO BSN-N21

objects (the semiotic function),

and engage in symbolic play
(McLeod, 2018).

4. Lawrence Kohlberg (Moral  When Baby Z’s mother told him to  At this stage, a child has not yet
Development) settle down and sit, he obliged develop thier sense of morality and
diligently and without hesitation. independence. Hence, they base
Preconventional morality  He mimics his mother’s actionss and their morality on those they think are in
Preconventional morality is the words. authority like Baby Z’s mother.
first stage of moral  Their sense of morality is also
development, and lasts until copied by people of authority like his
approximately age 9. At the mother and other grown adults.
preconventional level children
don’t have a personal code of
morality, and instead moral
decisions are shaped by the
standards of adults and the
consequences of following or
breaking their rules (McLeod,
2013).
ALLEAH JAYNE C. ARELLANO BSN-N21

IV. Nursing Care Plan

PATIENT'S PROBLEM LIST
Problem Number Date Identified Nursing Problem
1. January 2020 Amoeba

2. Started at 2 years of age Addiction to sweets/Presence of Cavities

in left upper central incisor. Client is at risk
for infection in the tooth called a tooth
abscess.

3. Since birth Client Z excessively sweats when

exposed to normal temperature even in
short period of time. May be at risk for
Hyperhidrosis disorder.

4. Started at 2 years of age Irregular sleeping schedule and will be at

risk of sleep deprivation or insomnia.

5. Started at 2 years of age Exposed to cellular radiation before Bed

will lead to risk for unhealthy radiation
which may lead to the child being at risk
of ADHD.
ALLEAH JAYNE C. ARELLANO BSN-N21

Nursing Care Plan for Problem Number 1

Assessment Nursing Objective/ Nursing Itervention Rationale Evaluation

Diagnosis Evaluation
Criteria
Objective Excessive The patient will  Monitor  Provides The patient was
Cues: diarrhea can maintain consumption and information about able to maintain a
 Severe lead to a loss adequate fluid production, as overall fluid sufficient fluid
diarrhea. of fluid volume after 8 well as the quality balance,renal volume after 8
 Dehydratio volume, which hours of nursing and quantity of function,and hours of nursing
n can lead to care, as shown feces, and bowel disease interventions, as
 Vomiting dehydration by good skin calculate control,as well as shown by good
 Night (Amoeba). turgor and a insensible fluid guidelines for fluid skin turgor and
sweats balance in take losses. Measure replacement. balanced intake
and output. the specific  Hypotension and output.
Subjective gravity of your (including
Cues: urine and look for postural),
“Sakit kaayo foroliguria. tachycardia, and
akong tiyan!”  Assess vital fever can all be
signs( BP, signs of a fluid loss
pulse,temperatur reaction or
e). consequence.
 Observe for  Indicates excessive
excessively dry fluid loss or resultant
skin and mucous of dehydration.
membranes,decr  Indicator of overall
eased skin turgor, fluid and nutritional
slowed capillary status.
ALLEAH JAYNE C. ARELLANO BSN-N21

refill.  Colon is placed at

 Weigh daily. rest for healing and
 Maintain oral to decrease
restrictions, bed intestinal fluid
restvand losses.
avoidance of  Inadequate diet
exertion. and decreased
 Observe for overt absorption mayl
bleeding and test ead to vitamin K
stool daily for deficiency and
occult blood. defects in
 Note generalized coagulation,potent
muscle weakness iating risk for
orcardiac hemorrhage.
dysrhythmias.  Excessive intestinal
 Administerparent loss may lead to
eral fluids as electrolyte
indicated. imbalance.
 Administer  Maintenance of
medications bowel rest requires
alternative fluid
replacement to
correct losses.
 To reduces fluid
losses in the
intestine and to
prevent further
spread of the
ALLEAH JAYNE C. ARELLANO BSN-N21

bacteria.

Nursing Care Plan for Problem Number 4

Assessment Nursing Objective/ Nursing Itervention Rationale Evaluation

Diagnosis Evaluation
Criteria
Objective The client is at The patient will  Educate the  Having a heavy Restful
Cues: risk of sleep be able to take patient on meal right before appearance,
 Sleeps at 11 deprivation a 10 to 13 hour healthy food and night can cause verbalization of
pm in the and insomnia. sleeos everyday hydration intake, stomach distress feeling rested,
evening This can hinder without any such as the and delay the and improvement
and wakes his growth and disturbances. importance of onset of sleep. in sleep pattern all
up at 6 am development The client will avoiding large Caffeine-containin indicate that the
in the and may also reduce the meals, alcohol, g beverages such patient is getting
morning cause uses of cellular caffeine, or as coffee, tea, enough sleep.
 Takes a 3 underlining phones to play smoking before chocolate, and
hour nap problems in videos in order night. colas stimulate the
everyday. the long run. for the client to  Encourage neurological
 Watches sleep. daytime physical system. This may
videos in activities but make it difficult for
order to instruct the the patient to relax
feel sleepy. patient to avoid and fall asleep.
strenuous Alcohol causes
activities before drowsiness and
bedtime. may help you fall
ALLEAH JAYNE C. ARELLANO BSN-N21

 Instruct the asleep faster, but it

patient to follow interferes with REM
a consistent daily sleep.
schedule for rest  Therapeutic
and sleep. hobbies can help
 Remind the people relax and
patient to avoid sleep better.
taking a large Strenuous activities,
amount of fluids on the other hand,
before bedtime. might promote
 Inhibit the patient weariness and
from daytime insomnia.
naps unless  Consistent
needed. schedules facilitate
 Introduce regulation of the
relaxing activities circadian rhythm
such as warm and decrease the
bath, calm energy needed for
music, reading a adaptation to
book, and changes.
relaxation  This will refrain the
exercises before patient from going
bedtime. to the bathroom in
 Make a between sleep.
suggestion for a  Napping can
relaxing or cause sleep
sleeping setting. disruption;
nevertheless, older
ALLEAH JAYNE C. ARELLANO BSN-N21

patients benefit
from numerous
naps during the
day to
compensate for
their shorter nightly
sleep cycles.
 These activities
provide relaxation
and distraction to
prepare mind and
body for sleep.
 Many people
prefer to sleep in a
cool, dark, and
quiet atmosphere.
ALLEAH JAYNE C. ARELLANO BSN-N21

V. Learning Outcome

The activity has given me a clearer optic on how all aspects of growth and development is deemed important.
Before, I use to think that the only growth and development that needs great attention was the physical growth and
development of a child. I use to believe that as long as the child posses the normal cues of growth then everything is
deemed alright. However, human as we are, complexity and the sense of uniqueness is what makes us great. Hence,
physical growth and development is just the tip of the ice berg. With The acitivity and the lectures of various theorist, I
have come to the conclusion that growth and development has many factors and all of them need equal attention. The
activity has allowed me to gain more awareness and sensitivity towards the growth and development of a child and
how satisfaction of said growth and development cues can affect a child in the long run.

Furthermore, due to the activity, I have acquired a great sense of knowledge on how growth and development is
one of the various reasons why a individual is deemed physically and holistically healthy. I have also learned how to
effectively communicate with a child despite of his/her's short attention span. I have developed my patience when
dealing with children and also tapped in a child-like-spirit within me--- I cannot help but feel nostalgic of that feeling as
well. Moreover, I have also enhanced the skill of utilizing research findings in order to further understand my client and
their current situations. Lastly, With the given activities, I have acquired the knowledge on how to respond to a child
when he/she is on a tantrum and I now know how to capture the attention of a child without the need to scare them or
threaten them.

IUn conclusion, I have come to realized of how nursing is indeed both a science and an art. For you not only know the
sciences behind the growth and development of a child, but also learn the art of establish rapport and trust with your tiny
client. Nursing only goes to show how it is a science field with much dedication in order to better not only the health care
system but the lives of men, women, children and elderlies. Nursing comes with great responsibilities indeed, but all of it
will indeed be all worth it.
ALLEAH JAYNE C. ARELLANO BSN-N21

WORKS CITED:

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https://www.simplypsychology.org/Erik-Erikson.html
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 Stage 3 of Psychosocial Development. retrieved September 27, 2021. From
https://www.verywellmind.com/initiative-versus-guilt-2795737
 Mcleod, S. (2018). The Preoperational Stage of Cognitive Development. Retrieved September 27, 2021. From
https://www.simplypsychology.org/preoperational.html
 Mcleod, S. (2013). Kohlberg's Theory of Moral Development. Retrieved September 27, 2021. From
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 TLGuide (n.d). Learning objectives. Retrieved September 27, 2021. From
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