Management of Development

Sample Answer

Strategies that might be used by a pediatric primary care provider to incorporate developmental anticipatory guidance into the following sick visits:

1. An 18-month-old with an acute upper respiratory infection

The pediatric PCP should inform the caregiver of the expected length of illness. The PCP should enlighten the caregiver that symptoms of acute URI peak between 3-5 days and gradually improve. However, the cough can persist for almost two weeks. The child may have 6-12 colds per year, and they commonly have back-to-back URIs.

In addition, the caregiver should inform the caregiver that hand washing is the most effective way to prevent contracting URIs. The caregiver should bring the child for reevaluation if the fever persists or symptoms worsen.

2. A 4-year-old with stool withholding and constipation

The PCP should instruct the caregiver to schedule time for toileting about 5 to 10 minutes after meals, particularly breakfast and dinner. The caregiver can help the child use a footrest or toddler potty chair to stop the child from withholding stool (Tran & Sintusek, 2023). Besides, the caregiver can use a reward system like stickers when the child has a bowel movement.

3. A 9-year-old with chronic headaches

The PCP should encourage the caregiver and the child to incorporate migraine-healthy habits, like lifestyle modification. Encourage the child to identify headache triggers or aggravating factors. The PCP should advise the patient to avoid medication overuse. Do not use ibuprofen for more than 14 days or acetaminophen per month (Szperka, 2021). Encourage the children and the caregiver to maintain a headache diary to monitor their response to treatments.

4. A 15-year-old with dysmenorrhea.

The pediatric PCP should educate the adolescent patient about the typical puberty progression and the menstrual cycle development. The PCP should help the adolescent understand that menstruation is a normal part of development (Goss, 2023). She should be instructed on the use of feminine products. The PCP should educate the adolescent on what is considered normal menstrual flow so that the patient can differentiate between normal and abnormal menstruation (Goss, 2023).

Furthermore, the PCP should educate the patient on the importance of balanced, healthy nutrition and regular exercise in alleviating the severity of dysmenorrhea. Regular physical exercises should be emphasized as they reduce dysmenorrhea by improving pelvic circulation and stimulating the release of β-endorphins.

References

• Goss, G. L. (2023). Dysmenorrhea in Adolescents. The Journal for Nurse Practitioners, 19(8), 104710. https //doi.org/10.1016/j.nurpra.2023.104710
• Szperka, C. (2021). Headache in Children and Adolescents. Continuum (Minneapolis, Minn.), 27(3), 703–731. https //doi.org/10.1212/CON.0000000000000993
• Tran, D. L., & Sintusek, P. (2023). Functional constipation in children What physicians should know. World Journal of Gastroenterology, 29(8), 1261. https //doi.org/10.3748/wjg.v29.i8.1261