The public health nurse has received a referral to make a follow-up home visit to a 1-year-old recently diagnosed with failure to thrive (FTT). Which intervention is the priority nursing action for this child?

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FTT is generally defined as weight less than 80% of ideal for age and/or depressed weight for length, correcting for gestational age, sex, and special medical conditions. The underlying cause of FTT is inadequate dietary intake; contributing factors include a disturbance in feeding behavior and psychosocial factors. Observing the child feeding or when hungry will provide the nurse the opportunity to identify potential factors contributing to insufficient intake. The nurse can observe the type of food being offered, the quantity of food consumed, how the child is held or positioned while being fed, the amount of time for feeding, the parent's response to the child's cues, the tone of the feeding, and the interaction between the child and the parent. (Option A) As part of the home visit, the nurse will assess overall parenting skills. It is most important for the focus of the visit to be on the nutritional intake of the child and the feeding experience. (Option B) A 24-hour dietary intake is an assessment tool to obtain information regarding nutritional intake. However, because the child's intake would be reported by the parent, it may not be accurate and does not provide information about what takes place during the feeding itself. (Option C) This is an appropriate nursing action, but it provides no information about the factors contributing to the child's insufficient intake. Educational objective: FTT is generally defined as weight less than 80% of ideal for age and/or depressed weight for length, correcting for gestational age, sex, and special medical conditions. Observation of the child while being fed may provide information related to the cause of inadequate dietary intake, including disturbances in feeding behavior and psychosocial factors.

The Public Health Nurse Has Received a Referral to Make