Evaluate growth parameters, including height, weight, and head circumference.

Choice A rationale:

It is essential to evaluate growth parameters when assessing a child with Down syndrome for several reasons.

Children with Down syndrome often have growth-related concerns, including growth delays and potential issues with weight management.

By monitoring height, weight, and head circumference, the nurse can assess whether the child is following a growth curve that is appropriate for their age.

Deviations from normal growth patterns may indicate underlying health issues that need to be addressed.

Furthermore, assessing head circumference is important because changes in head size can be indicative of conditions such as hydrocephalus, which is more common in individuals with Down syndrome.

Choice B rationale:

Monitoring for speech and language delays is relevant when assessing children with Down syndrome, as they often experience communication challenges.

However, in the context of the presented case where low muscle tone and joint laxity are observed, focusing on growth parameters is more immediately relevant.

Speech and language delays can be assessed in a separate part of the assessment.

Choice C rationale:

Assessing for above-average motor skills development is not a priority in this scenario.

Children with Down syndrome typically experience low muscle tone, which can affect their motor skills development.

It is important to address the observed low muscle tone first before assessing motor skills.

Choice D rationale:

Screening for heart defects and gastrointestinal abnormalities is crucial in the overall care of a child with Down syndrome.

However, in the context of the initial assessment of low muscle tone and joint laxity, evaluating growth parameters is more directly related to the observed physical findings.

Heart defects and gastrointestinal abnormalities can be assessed as part of a comprehensive evaluation but are not the primary focus at this stage.