Within this study Emma has expressed concern for her four year old daughter Lucy's development. In considering Lucy's development and aiding support and information to Emma, the following three subheadings will briefly outline the development of a four year old girl.
Firstly in regards to Lucy's physical development she is 105cm tall and weighs 15.5kgs, this is noted to be within the normal limits for a child of four years of age. As cited in NSW the normal weight of a four year old girls lies between 13 and 20.5kg, this too is further supported by Crisp J (2004) who notes that the average weight for a child of 4 years is 16.6kgs, also noting that preschoolers may grow up to 6-7.5cm a year with the elongation of legs contributing to a more slender appearing child.
The normal cognitive development for a four year girl encompasses the child becoming less egocentric (London et al 2011). Around fours years of age as stated by Crisp J (2004) the intuitive phase of pre-operational thought develops. It is at this stage where the child may demonstrate their ability to think in a more complex way by being able to classify objects according to size, shape and colour. In this stage egocentricity may persist, although it is noted that during this period it may begin to be replaced with social interaction( Crisp J 2004).
As Emma has stated Lucy's behaviour can be very energetic, oppositional and hard to control, it could be said that this factored into the norm as in this developmental stage the 4 year old may include repression as a coping strategy (London et al 2011). At this stage the child may have a surplus of energy which may lead them attempting activities that are beyond their limits. During times of stress children within this age group may develop dependent behaviours, sources of stress noted to trigger such behaviours include; insecurity, companionship, attention and fears (Crisp J 2004).
When completing an assessment of this particular case assessment tools may be used to further support and aid identification of issues and factors influencing Emma, these may include screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) which is considered a valuable and efficient way of identifying patients at risk for “perinatal” depression. With identification and a review of the factors that influence Emma's case, many issues arise that may see emma requiring ongoing support and referral. Such include, her lack of family support including the absence of her husband due to contract work, her unfamiliarity of the area and available services, her current pregnancy of 28weeks and the care of her four year old daughter, inclusive of eating habits and concern for development and Emma's unfamiliarity with the community and its available services (London et al 2011).
With Emma's initial presentation, a primary focus would be placed on establishing a trusting relationship, acknowledging her multiple concerns and obtaining family information that will be useful when planning nursing interventions that will promote family centred care and may improve this family's outcome. Emphasis would be placed on a full assessment and evaluation of her needs with the production of a care plan outlining Emma's needs including...