NORCET 3 - 2022 (Shift-1)
Child Health Nursing (Pediatrics)
Medium
A 6-month-old infant has developmental delays, his weight falls below the 5th percentile when plotted on a growth chart. A diagnosis of failure to thrive is made. What behaviours might indicate the possibility of maternal deprivation?
Appeared in: NORCET 3 - 2022 (Shift-1)
Explanation
- Infants experiencing maternal deprivation often exhibit emotional withdrawal and do not seek or respond to comfort when distressed.
- This lack of response to touch (e.g., not cuddling, stiffening) is a hallmark of a disturbed attachment.
- Feeding refusal is a primary symptom in nonorganic failure to thrive (also known as psychosocial FTT), directly leading to poor weight gain.
- These behaviors, combined with apathy and listlessness, are classic signs of reactive attachment disorder, which is strongly linked to neglect or deprivation.
Why Other Options Were Wrong
- Option A: This describes a securely attached infant who seeks comfort and physical closeness, which is the opposite of what is seen in maternal deprivation.
- Option C: Maintaining eye-to-eye contact is a positive sign of social engagement and a key developmental milestone in healthy infants.
- Option D: While being a 'finicky eater' can be a concern, being 'easily pacified' and 'cuddly' are strong indicators of a secure attachment and a responsive caregiving environment.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Behavioral indicators of maternal deprivation in an infant with failure to thrive to guide bedside assessment, documentation, and the next nursing action.
- Nurses are often the first to identify signs of FTT and potential neglect. Observing parent-child interactions during feeding and routine care is a critical assessment skill.
- Differentiating between organic (medical) and nonorganic (psychosocial) FTT is crucial, as the interventions are vastly different. Nonorganic FTT requires a focus on the caregiver-child relationship and social support systems.
- What if? If the infant had a confirmed congenital heart defect, the primary focus would shift to investigating organic FTT. The priority would be managing the medical condition and ensuring caloric intake meets the infant's increased metabolic demands, although psychosocial support would still be important.
How to Approach the Question
- First, identify the key concepts in the scenario: a 6-month-old infant with diagnosed 'failure to thrive' (FTT) and developmental delays.
- Next, understand the specific question being asked: What behaviors indicate 'maternal deprivation' as the possible cause?
- Recall or deduce the difference between signs of healthy infant attachment and signs of disturbed attachment or neglect.
- Evaluate each option. Healthy attachment behaviors include seeking comfort, cuddling, and making eye contact.
- Behaviors indicating deprivation include apathy, withdrawal, unresponsiveness to comfort, and feeding problems.
- Select the option that best describes these negative or avoidant behaviors, as they are most consistent with maternal deprivation.
Concept Tested & Keywords
- Concept Tested: Behavioral indicators of maternal deprivation in an infant with failure to thrive.
- Stem keywords: 6-month-old infant, developmental delays, failure to thrive, 5th percentile, maternal deprivation
- Lead-in keywords: behaviours might indicate
- Clinical cues: Weight below 5th percentile: A key diagnostic criterion for Failure to Thrive (FTT).
- Clinical cues: Developmental delays: Often co-occurs with FTT, especially nonorganic FTT, due to lack of stimulation and nutrition.
Question ID
QS3N09Dthx6iyZ0RMq-erG
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 535-537, 3175-3177
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 12238-12240
Practise the full NORCET 3 - 2022 (Shift-1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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