Pediatric Developmental Care Plan

Pediatric Developmental Care Plan Running Head: PEDIATRIC DEVELOPMENTAL PAPER Pediatric Developmental Paper Arlena Davis Subjective Clarissa is a 3 year old girl with upper respiratory infection. She has always lived with her parents and, grandmother in the same place. Her parents are mainly responsible for raising her since she was born. However, the child spends most of the time with her grandmother as the parents go to work. The caregiver described the child as calm, playful, hot tempered and shy. The grandmother spends more than 8 hours with the child as her parents go to work at 8.00am and come back at 5.00pm. The child wakes up at 8. 00 am and eats her meals with the grandmother. However, the child interacts with her parents during dinner and bedtime. The caregiver and the child interact well as the toddler shows affection by hugging. However, the caregiver identified the child’s upsetting behaviors including pushing people when she is angry. The caregiver disciplines the child when she misbehaved or went to dangerous places (Burns et al., 2013). Additionally, the parents worry about the child’s safety at home since she likes going to dangerous places. The grandmother finds it challenging to control the child’s movement since she is starting to learn about her surroundings. The parents also do not get adequate support from family members as they only rely on the child’s grandmother. However, they count on few friends for help since they have a large social network (Burns et al., 2013). The parents and the grandmother do not spend adequate time with friends, and thus the small social circle. The father is involved in the care giving role according to the grandmother and the mother. The father is helpful as he assists in feeding the child and playing with her. In addition, the mother did not have complications during pregnancy and the baby was not born premature. The baby was almost 3.2 kgs and 19 inches at birth. The parents take the child for healthcare at different facilities including emergency rooms an d walk-in clinics (Burns et al., 2013). The child has normal growth, appetite, bowel movement, urination and sleep patterns. However, the caregiver claims the child got sick often and she has to call her parents to take her to the hospital. Despite the sickness, the child has managed to learn new words and sounds. The child does not have visual and hearing (Burns et al., 2008). The child interacts well with other people, but the caregiver is worried about the Childs frequent sickness. The family has no major issues and concerns as there is one ill, alcoholic, using drugs or behaving strangely (Provence Apfel, 2001). The family has satisfactory housing and lives in a safe neighborhood. The family does not deal with fear of violence and no one owns a gun. Nonetheless, the family has financial problems and found it challenging to meet basic needs like paying rent and bills. Observation The child has had normal gross and motor development from 6 months up to now according to the caregiver (Provence Apfel, 2001). The child was able to sit alone, stand and grasp objects with the index and thumb finger according to the caregiver by 12 months. She could walk independently and scribble with crayon on paper. Additionally, she could build powers of cubes by the age of 18 months and squat and stand at 21 months. Also, she could jump off floor with two feet. She can hold crayon with thumb and finger and duplicate cross on the paper. The child has also had a normal social and emotional development as reported by the caregiver. The child was able to differentiate the main caregiver from other people and establish social contact by smiling by 6 months. She also played social games and enjoyed playing with dolls. She also showed affection to the caregiver and helped her with house chores and organizing things. Nevertheless, she expressed differ emotions including anger, anxiety and sadness by 12 months. She also found it challenging to cooperate while playing with other children. The child has no language development problems as she can speak and answer comprehension questions well. She has coping and self- development issues (Provence Apfel, 2001). She pushes away unwanted people, diet and objects. On the other hand, she can feed self with a spoon and drink from the cup without assistance. She also helps with dressing. Therefore, the child’s gross and fine motor development, language development and coping and self-help development are at age level. The child’s social and emotional development is below age level. Assessment Clarissa has a normal development in different areas including language, fine and gross motor, coping and self- help development (Provence Apfel, 2001). However, she has an abnormal social and emotional development. She is unable to manage her emotions when playing with other children, with the caregiver and other people. She expresses negative emotions including anger and sadness. She pushes away people, objects and foods she does not like. The caregiver and the child interact well as she shows affection to the caregiver by hugging. The child has a positive relationship with the family members including mother and father. Nonetheless, the frequent sickness may affect the child’s development as she has upper respiratory infection (Provence Apfel, 2001). The family seeks medical care from the emergency room or walk-in clinics when the child is sick. However, the family concerns include inadequate finances to meet basic needs and safety of the child at home. The child spends m ost of the time with the grandmother and she is unable to control and prevent the child from going to dangerous places. The family members have a small social network as they do not spend sufficient time with friends. They get financial and social support from the grandmother and few friends. The family has no history of alcoholism or fear of violence. Plan The following interventions will be implemented to address the concerns and issues raised by the caregiver and parents. Improving the safety at home is critical to prevent accidents. In this case, parents and the grandmother will be educated on the importance of safety at home to improve the child’s wellbeing. Dangerous substances including poisonous liquids should be stored far from the child to decrease accidents (Burns et al., 2008). The home should be redesigned to eliminate dangerous places and hence promote the child’s safety. Adaptations including fireguards and stair gates make the home safe. Further, providing medical care to the child is important to improve her health outcome and quality of life. Different medications will be administered to treat upper respiratory infections including Tylenol, Motrin, Benadryl and cough drugs. Additionally, social support interventions will be provided to improve the social wellbeing of the family. Social support interventio ns are important in increasing social networks or circles and enhancing physical and mental wellbeing (Burns et al., 2013). The parents and the grandmother will be able to share their concerns with friends and get necessary support. Lastly, the child should socialize with caregiver, peers and other adults to develop social and emotional skills. Adults should respond to the child’s signals in a reliable and predictable manner to enable her regulate emotions (Burns et al., 2013). Reference Burns, C. E., Dunn, A. M., Brady, M. A., Barber Starr, N., Blosser, C. G. (2013). Pediatric primary care. (5th ed.). Philadelphia, PA: Elsevier Saunders. Burns, C. E., Dunn, A.M., Brady, M.A., Starr, N. B., Blosser, C.G. (2008). Pediatric Primary Care-pageburst on vital source. Saunders: Elsevier Health Sciences Provence, S., Apfel, N. H. (2001).Infant-Toddler and Family Instrument. Baltimore, MD: Brookes Publishing

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Ashley Mitchell Professor Perniciaro LIT 2000 3 February 2014 Summary of H. Briscoe’s â€Å"The Scream† In H. Briscoe’s â€Å"The Scream,† a woman and her two daughters, Anna and Mary, are on vacation in the country of Spain. The story seems to take place fairly recently in this day and age. Throughout the account, we are taken on a journey, sometimes through Anna’s eyes, other times through the perspective of Mary’s and the mothers, through an amusement park on a blistering, sweaty day. But there is a twist at the end, and Mary is to blame. â€Å"The Scream† opens with the narrator providing a detailed account of the horrifically hot day in Spain, describing the heat as theoretical â€Å"missiles† and â€Å"rippling waves† (1). Anna, the eldest sister, adds to the horrific heat by mentioning that everything in the theme park was â€Å"manufactured - [with] angular, flat surfaces, and shiny polished metal,† which only added to the harshness of the sunlight (1). Additionally, the three, in an attempt to escape the overbearing heat and crowds, would risk forcing their ways in front of others in the drink line as well as the lines of shows that were labeled as â€Å"unmissable† in their eyes (1). Subsequently, the story kicks off with the mother proclaiming both Anna and Mary to carry a bag; Anna the second heaviest bag containing sunscreen and the camera, and Mary the smallest one, also referred to as a mini rucksack, which housed the money, keys, and other important items. Additionally, their mother carried a large food bag which is described as being filled to the brim. The three were seated on a bench next to a manmade lake when the mother began to walk away, resulting in Mary taking the mothers hand, and leaving Anna with no choice but to follow them to the ma... ...k down to see the rucksack slung over her sister’s shoulder. Anna stood in disbelief as Mary, wide-eyed and innocent looking, apologized for changing her mind about going on the rollercoaster, saying "It was just too scary after all" (11). Anna could no longer take the scorching heat and her sisters grinning face, and fell to the ground in a crashing fall. While the story originally focuses on the scenery and climate of the theme park, the focus shifts to that of the rollercoaster â€Å"The Scream!† rather quickly, as well as the manipulation that comes from Mary, and the mother, towards Anna. The twist at the end is relatively unexpected and pieces together the manipulations that Mary has been planning to use on Anna throughout the story. Work Cited Briscoe, H. "Short Stories: The Scream by H. Briscoe." Eastoftheweb.com. N.p., n.d. Web. 4 Feb. 2014.

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The biggest kopitiam restaurant linkage in Malaysiais Oldtown Berhad .Oldtown Berhad occupied in the manufacturing of beverages and manage a chain of cafà ©under the OLDTOWN WHITE COFFEE brand name. Oldtown using its formulated blendof coffees to served. Its major headquarters is in Ipoh, Perak, Malaysia. The served areas are Malaysia, Singapore, Indonesia and China. Its linkage of Oldtown cafà © outlets is sustain by two coffee manufacturing equipment,consist of three centralized food processing centers and bean roasting and processing facilities . Oldtown Berhad is a Public Limited Company. Oldtown Berhad has been created in 1999, with the purpose to output the quality white coffee to Malaysian family and food service industry. Mr Goh Ching Mun and Mr Tan Say Yap, the co-founders and administrator director of Oldtown begin the manufacturing and create their own 3-in-1 instant white coffee. 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They also extended their output line to involve different changes of their instant coffee mix and also extended their export markets to Hong Kong for their instant coffee mix. White cafà © received a HALAL certification from the Islamic Reeligious Department of Perak for the Group’s beverages in year 2002. This is their part of purpose, which is to generate beverages in accordance with the Islamic law. Oldtown Berhad have been achieve the goal that extended their nationwide retail allocation of their 3-in-1 instant coffee mix to cover East and West Malaysia through the main hypermarkets and supermarkets. Their own formulated blend of 3-in-1 instant milk tea  also smoothly commercialized for the retail market under the ‘OLDTOWN’ brand name in 2003. OldtownBerhad has been expand their manufacturing activities and they incorporated Gongga Food in 2003 and begin operations in 2004 to creating roasted coffee powder for the food service sector by using the ownership bean roasting process. Roasted coffee powder to traditional coffee shop in Ipoh and others states in Malaysia have been distributed by OldtownBerhad. ‘OLDTOWN’ is also marketed to the retail sector under ‘NANYANG’ brand in an addition to the food services sector. Oldtown Berhad has been penetrated the export markets for the 3-in-1 instant coffee to cover the United States,United Kingdom, Canada, Taiwan and Indonesia in 2004. Based on the traditional Ipoh coffee shop environment and the surrounding feeling under the ‘ OLDTOWN WHITE COFFEE’ brand name, Oldtown has been extended vertically into the food services sector by developing a chain of cafà © outlet in 2005. ‘OLDTOWN WHITE COFFEE’ brand in the food services industry is the part of Group’s plan of capitalizing and strengthen. With the same year, ‘OLDTOWN WHITE COFFEE’ cafà © outlets has been begin the operations in licensing,supply of beverages and food, others item and provision thread ministration service from Kopitiam Asia Pacific. Linkage of ‘OLDTOWN WHITE COFFEE’ have been extended to 137 cafà © outlets involved fully and partially owned and franchised in Malaysia since the first beginning of the first cafà © outlets in Ipoh in 2005 and at Singapore as at 31 October 2009. In 2005 and 2006, they have been fixed their subsidiaries name as Oldtown Kopitiam, Oldtown Kopitiam Kuala Lumpur, Oldtown Kopitiam Butterworth, Oldtown Kopitiam Cheras to focus on managing cafà © outlets in distinct areas and states within Malaysia. Besides, between 2005 and 2007 they also fixed the following subsidiaries as central food processing centre to sustain their cafà © business operations. Emperor’s Kitchen begin operation in 2005, Dynasty Confectionery and Esquire Chef started the operations in 2007. Gongga Food’s business also extended to ingratiate to the procurement of food items for ‘OLDTOWN WHITE COFFEE ‘ cafà © outlets in 2005. With the same year, HALAL certification from the Islamic Religious Department of Perak for the operation of its roasted coffee powder also received by Gongga Food. White Cafà © ,the subsidiary received a HACCP certification from BM TRADA Certification Ltd for the manufacturing and processing of beverages product  in the same year. In 2007, they incorporated Dynasty Kitchen as a allocation centre which begin operations. They also extended their export markets to China and Japan in 2006. Besides, they also incorporated Oldtown Berhad which concentrate on investment keeping and precaution of administration services according to its listing on the Main Market of Bursa Securities. Later, they also begin exporting to Philippines and Thailand during the same year. They also plan to extended their cafà © outlets business to Singapore. Soon, they have been incorporated Oldtown Singapore in 2007 to supply administration services, food and beverages items to cafà © outlets in Singapore. OTK Singapore begin operations in 2008 with the emission of their first ‘OLDTOWN WHITE COFFEE’ cafà © outlet in Singapore. Dynasty Confectionery and Esquire Chef, the subsidiaries, received HALAL certifications from the Islamic Religious Department of Perak for the processing of different food in 2008. Emperor’s Kitchen, the other food processing subsidiary received HALAL certification from IFRC ASIA. Even more confirm their adhesion to international food safety criterion, their subsidiary White Cafà © reach ISO 22000:2005 certification and ISO 9001:2000 from BM TRADA Certification in 2008 in extra to GMP Certification by the Department of Public Health, Ministry Health Malaysia with the same year. They also extended their product line to comprise 3-in-1 instant coffee mix with cane sugar in 2008. Gongga Food also received a HACCP Certification from BM TRADA Certification Ltd for the operation of roasted coffee powder in 2009. The vision of this company is to be Asian Pacific’s guiding white coffee producer supplying a high quality of goods or product to customers worldwide and locally.

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