Stage 4 — Generate solutions. Which nursing actions are appropriate during Baby J's six-month well-child visit? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Appropriate actions: 1, 3, 5, and 6 Safe sleep begins supine in an empty approved sleep space, while an infant who rolls both ways may remain in a self-selected position (choice 1). Vaccination depends on the documented product series, intervals, season, health status, and current CDC notes (choice 3). Human milk or iron-fortified formula remains primary before 12 months, actual iron intake is verified, and human-milk-fed infants receive CBC and ferritin screening at 9 to 12 months under current AAP guidance (choice 5). Walker, stair, travel, and feeding hazards require specific changes (choice 6). Car-seat transition is not based on age 2 or leg appearance (choice 2). A milestone checklist is not a diagnostic screen, and routine validated general screening is scheduled at 9 months rather than required at every six-month visit (choice 4).
Wrong — choice 2 Rear-facing continues as long as possible until the child reaches the manufacturer's rear-facing height or weight limit. Crowded-looking legs and the second birthday are not automatic transition criteria.
Wrong — choice 4 Developmental surveillance occurs now, but the CDC milestone checklist is not a substitute for validated screening. Routine standardized screening occurs at 9, 18, and 30 months and whenever concern arises; vaccines are not withheld while waiting for an unnecessary screen.
Individualize routine care Vaccine products and iron screening both require history. Product-specific series and intervals determine vaccines; the primary nutrition source determines the updated iron-screening window.
Scenario (Stage 4 — Generate solutions)The nurse combines routine preventive care with concrete changes to the family's sleep, travel, feeding, and home environment.
Vaccine reconciliation — Verification of exact products, dose dates, intervals, contraindications, precautions, season, and health indications before selecting vaccines from the current schedule.
Primary milk source — Human milk or iron-fortified infant formula remains the main milk nutrition before 12 months; cow milk may not replace it as a beverage during infancy.
Developmentally prepared food — Food modified to a child's oral and motor ability in shape, size, and texture, served while the child is upright and directly supervised.