Health Promotion and Maintenance
Health Promotion and Maintenance tests the PN's ability to teach health behaviors, identify risk, support normal growth and development, and apply screening and prevention.
Prevention and teaching
- Primary prevention prevents disease: immunizations, folic acid before and during pregnancy, seat belts, sunscreen, and safe sleep.
- Secondary prevention finds disease early: mammography, colonoscopy, blood pressure and glucose screening, and newborn screening.
- Tertiary prevention limits disability: cardiac rehabilitation, diabetes self-management, and physical therapy.
Worked example
A parent of a 6-month-old asks when to start solid foods. The PN explains readiness signs: good head control, sitting with support, interest in food, and fading extrusion reflex. Start iron-fortified cereal or pureed foods with a spoon, one new food at a time for several days, and no honey or cow's milk before 12 months. Reasoning: honey can contain botulism spores, and cow's milk is low in iron and has a high renal solute load. The PN documents the teaching and gives the family a written schedule.
Growth and development
Use developmental surveillance at every visit. Infant social smile appears around 2 months, sitting with support around 6 months, and walking with support around 12 months; these are ranges, not rigid deadlines. Anticipatory guidance should match the family's language, culture, and readiness.
Traps
Giving honey for infant cough; telling a breastfeeding parent to stop without a valid reason; treating a screening test as diagnostic; omitting a vaccine because of a mild cold; giving developmental advice that ignores prematurity-adjusted age.