Certified Pediatric Nurse (CPN)

What should the nurse do if a 6-month-old's head circumference changes from the 25th percentile to the 75th percentile?

1. Immediately notify the physician as this may indicate increased ICP, a medical emergency

2. Reassure the mother that this is a period of growth and changes in HC are to be expected

3. Prepare mother for the placement of a helmet as safety is a concern

4. Measure infant head again to check for accuracy

The correct answer is: Measure infant head again to check for accuracy

Measuring the infant's head circumference again to check for accuracy is essential because variations in measurement techniques, positioning of the child, or even the child's state at the moment of measurement can lead to discrepancies. In pediatric nursing, head circumference is a critical indicator of growth and brain development, and it is important to ensure that the initial reading was precise before jumping to conclusions about potential medical issues. A measurement that shows a sudden change from the 25th percentile to the 75th percentile could be due to a measurement error rather than an actual significant change in the child's growth pattern. Once the accuracy of the measurement is confirmed, the nurse can then decide on the appropriate follow-up actions, which might include notifying the physician if the second measurement confirms a concerning increase, or addressing parental concerns based on accurate data.