NANDA Issues and goal, not sure which one fits???

[bellie04]

I need to pick one nursing issue and Im not sure which one it should be?

The case study is about a child, the mother is concerned about developmental delays, child has no siblings, doesnt play with other kids, is shy,childcare workers noted lack of playing with other kids.

Im not asking for the strategies or rationales, but just which one of the NANDA issues fit. I keep thinking about the Impaired Social Interaction issue, but the Attachment, risk for impaired parent/child issue keeps entering my mind. The case study lists that the mother dosen't leave the kid all day, is not encouraging child to talk and child sits very close with mother (which i know that a 4yr old tends to do at first around strangers). But then i think that he wouldnt be playing at the daycare centre.... hence why I seem not to be able to decide on an issue.

Im torn between the two. (Or perhaps I have missed the mark completely??)

Any help would be appreciated.

[nurseprnRN, BSN, RN]

i think you could make a case for either; pick the one for which you have the most supporting data.

you might also take a look at the growth and development nursing diagnoses (domain 13) and see if your data support any of that. i'm also wondering if perhaps in domain 7, role relationships, you might look at readiness for enhanced parenting, risk for impaired parenting. i don't have all your assessment data, you have to go and look at the defining characteristics of each and see which one fits this patient/family situation best.

what do you think?

[guest042302019, BSN, RN]

Before I read the above post, I thought the same. I guess what comes to mind is developmental milestones. What has your patient met or hasn't met would be my consideration. What type of play does a 4 y/o have? Or, maybe this child is a "slow to warm up type." Remember those from psychology? Just my thoughts. If the mother never leaves the child's side, maybe she is somewhat smothering the patient somewhat. This is the Autonomy vs shame and doubt time frame-ish. But, there are cultural considerations as well. Maybe that's how it is in the family.