The father of a toddler asks a nurse at a well-child clinic what to do when his child kicks and screams during temper tantrums.
Which of the following responses should the nurse make?

Choice A rationale

While the genitourinary system can be affected in individuals with Down syndrome, it is not the most commonly affected body system. Down syndrome is a genetic condition where a person is born with an extra chromosome. This can affect how their brain and body develop, leading to both physical and mental challenges.

Choice B rationale

The reproductive system is not the most commonly affected body system in individuals with Down syndrome. While individuals with Down syndrome can have reproductive health issues, these are not as common as issues with other body systems.

Choice C rationale

The gastrointestinal system can be affected in individuals with Down syndrome, but it is not the most commonly affected body system. Some individuals with Down syndrome may experience gastrointestinal issues such as constipation or gastroesophageal reflux disease.

Choice D rationale

The cardiovascular system is the most commonly affected body system in individuals with Down syndrome. Almost half of babies with Down syndrome have congenital heart disease (CHD), the most common type of congenital anomaly. CHD can lead to high blood pressure in the lungs, an inability of the heart to effectively and efficiently pump blood, and cyanosis (blue-tinted skin caused by reduced oxygen in the blood)3.

Choice A rationale

While rest is important for a child, suggesting that the child needs to rest does not address the parents’ concern about their child crying when they leave.

Choice B rationale

This is the correct answer. It is normal for an 8-month-old child to show signs of separation anxiety when their parents leave. This is a part of their normal development where they start to understand object permanence - the concept that things and people exist even when they’re out of sight. This can make them upset when their parents leave as they understand their parents are somewhere else, but they don’t know when they’ll return.

Choice C rationale

Notifying the provider about a normal developmental behavior is not necessary. It’s important for parents to understand that this behavior is a normal part of their child’s development.

Choice D rationale

While an overstimulating environment can cause distress in children, in this case, the child is upset because of their parents leaving, not because of the environment.