questionnaire was completed at her 4 months well child exam and no red flags were indicated. At this age, infants should begin to smile spontaneously, begin to babble, babble with expression and imitate sound, cry in different ways to show hunger, pain, sleepiness, responds to affection, reaches for toy with one hand, lets caregiver know if happy or sad, watchesface intently, focuses on ones face, recognizes familiar faces from a far, hold head erect, push down with legs when standing on hard surface, roll from tummy to back and push up on elbows when on stomach (“Important Milestones: Your Baby By Four Months,” 2019). Present Developmental: Based on Jean Piget’s developmental theory, at this stage until two years of age infants and toddles are in the sensorimotor stage of development. During this stage of development, infants and toddlers are learning about the world around them using the key senses. They learn object permanence, spatial relationships, causality, use of instruments, andcombination of objects during this developmental stage (Burns, Starr, Dunn, Blosser, & Brady, 2017). In reference to Erikson’spsychosocial stage of development, she falls in the category of Trust versus Mistrust. This stage lasts from birth to approximately 18 months of age and is when infants and toddlers are learning whether they can trust the world around them (Knight, 2017). For example, when children cry their parents tend to their needs. During this office visit with this infant, she cried when I started to examine her, but her mother came to the table and talked to her as I was examining her letting her knowshe was right there. This calmed the infant down and soothed her. This not only shows she trusts her mother but also helps establish a trusting relationship with the infant and provider because as time goes on her mother’s trust in the provider will be shown to the infant as she gets older. Lab and/or Diagnostic Tests: N/ADIAGNOSISInstructions:1.Acute Serous Otitis Media- H65.0Acute otitis media (AOM) is one of the most common infections seen among the pediatric population. Ear infections typically occur after respiratory related illnesses because of inflammation in the mucous membranes that often causes issues in the draining of the eustachian tube. The increase of fluid causes a change in pressure which causes the typical symptoms commonly seen in infants and children with ear infections including fussiness, fever, decreased appetite, and pulling at ears due to pain (Pelton, 2018). 2.Herpangina- B08.5Herpangina is a febrile viral illness caused by enterovirus (same as hand, foot, and mouth). Although typically seen during the summer months, herpangina can also be seen throughout the year. Affecting primarily infants, adolescents, and young adults, symptoms may vary depending on age group. Typical symptoms include fevers ranging from 101 to104 degrees Fahrenheit, malaise, sore throat, and pain with swallowing. Because infants are unable to voice pain with swallowing or sore throat, often symptoms of decreased appetite and refusal to nurse, suck a bottle, or pacifier will
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