NURSING 346

One

CASE
Mikheil and Sophia have brought in their first-born child Michelle, for her
newborn wellness examination. Michelle is 3 days old. Vaginal delivery at 38
weeks gestation.
Pregnancy and delivery unremarkable.
Family is from Jordan but have been in the US for 8 years. They plan to travel
back to Jordan as soon as Michelle is ready to travel.
The nurse explains the process of health supervision to the parents, and explains
that this includes developmental surveillance and screening; injury and disease
prevention; and health promotion. Mikheil and Sophia state that they are not
aware of these principals and request further explanation.
1. What are the principals of health supervision
2. What is developmental surveillance and screening, and what are some of the
factors that may place Michelle at risk for developmental problems?
3. What are some of the various types of screening the nurse may perform on
Michelle?

HEALTH AND HEALTH

SUPERVISION
Principals of Health Supervision
Proactive in regards to services
Optimizes optimal functioning
Ensures pediatric client is growing and developing appropriately
Health promotion
Prevention of injury and illness through appropriate interventions

MEDICAL HOME

HEALTH PARTNERSHIPS
Many benefits:
What does this mean?

Mutual goal setting

Marshalling of resources
Development of optimal health
practices

HEALTH SUPERVISION
Issues that must be given consideration
Culture
Community
Chronically ill child
Adoption and foster care

HEALTH SUPERVISION
What is covered in the psychosocial assessments?
Insurance
Transportation
Financial
Coping
Home to school

HEALTH SUPERVISION
Three components
Developmental surveillance and screening
Prevention of illness and injury
Health promotion

HEALTH SUPERVISION
Health supervision visit
History and physical
Developmental and behavioral assessment
Age appropriate vision and hearing
Risk screening
Immunizations
Health promotion

DEVELOPMENTAL SURVEILLANCE
What are the goals?
Note and address parent concerns
Obtain a developmental history
Good assessment and observation
Referrals as indicated

SCREENINGS
Risk Assessment
Universal screening
Selective screening

SCREENINGS
Not always universal
Metabolic
Hearing
Vision
Iron-deficiency anemia
Lead
Hypertension
hyperlipidemia

IMMUNIZATIONS
Immunity
Vaccines
Immunizations
Schedule
Risks and barriers
Nursing responsibility

ANTICIPATORY GUIDANCE
PROMOTE
Oral health
Weight
Activity
Hygiene
Sun protection