The clinic nurse assesses a 12-month-old infant and notes that the anterior fontanel remains slightly open. The infant's parent asks about the finding. What is the most appropriate response by the nurse?
The clinic nurse assesses a 12-month-old infant and notes that the anterior fontanel remains slightly open. The infant's parent asks about the finding. What is the most appropriate response by the nurse?
A. "I will contact the health care provider (HCP) immediately."
[6%]
B. "I need to examine your child further."
[7%]
C. "We will need to obtain an MRI on your child."
[1%]
D. "This is a normal finding on a child of this age."
[86%]
Statistics
Subject/Lesson
Subject
Child Health
Lesson
Growth & Development
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Techniques of Physical Assessment
Item Type
Item Type
Knowledge/Comprehension
Explanation
Choice D is correct. The anterior fontanel typically closes anywhere between 12 to 18 months of age. Therefore, an assessment finding demonstrating the anterior fontanel remaining slightly open is considered normal, which would necessitate no further action for this client. The nurse should reassure the infant's parents.
Choice A is incorrect. Notifying the health care provider (HCP) is unnecessary, as this is considered a normal assessment finding for a 12-month-old infant.
Choice B is incorrect. Additional assessments based solely on this finding are not necessary.
Choice C is incorrect. Ordering an MRI on this 12-month-old infant would be erroneous because an open anterior fontanel at 12 months of age is an expected finding, and placing unnecessary MRI orders is a waste of resources.
Learning Objective
Recognize that the anterior fontanel may close anywhere between 12 to 18 months of age.
Related Videos
4 Key Topics
Newborn Assessment
31.1 Immediate Newborn Evaluation
Infant Milestones
14.7 Infant Growth and Development
Additional Info
- Six fontanels (also commonly referred to as fontanelles) are present during infancy, with the most notable being the anterior and posterior fontanels.
- Typically, the posterior fontanel closes by two months of age, while the anterior fontanel fuses between 12 and 18 months.
- The purpose of fontanels is to facilitate the movement and molding of the newborn's cranium through the birth canal during labor.
- The primary cause of a sunken fontanel is due to dehydration.
- Conversely, a bulging fontanel occurs due to a rise in intracranial pressure, typically indicative of one or more of the following pathologies: hydrocephalus, hypoxemia, meningitis, trauma, or hemorrhage (of note, this is not an all-inclusive list).
