Guideline 5

Guideline 5: Home Environment and Environmental Exposures Assessment 

Purpose 

On average, Americans spend 90% of their time indoors, so the quality of the home environment is critical to health. An evaluation of the home environment, including potential environmental exposures and safety risks, will augment the History and Physical assessment of the client. This additional knowledge will inform the development of a nursing care plan that supports the most appropriate interventions to promote a healthy pregnancy, optimal birth outcomes and child development, and a safe environment for infants to learn and grow. 

Because of their physiology, such as higher rates of oxygen consumption and cardiac output, pregnant people are uniquely vulnerable to environmental exposures. Because of rapid cell growth and division, the fetus is also particularly vulnerable to environmental exposures, which can impact organ development and increase the risk of preterm birth, stillbirth, and fetal growth restriction. Children also have unique risks to environmental exposures due to differences in exposure, metabolism and excretion, and longer post-exposure life span.  

Unintentional injuries are the leading cause of death for children in the U.S. According to the CDC, a child in the U.S. is treated in the emergency room due to injury approximately every four seconds, and many of these injuries occur in the home. Since 2017, the single leading cause of death for U.S. children under the age of 18 is firearms. Around 40% of American children live in homes with guns, so along with general safety measures, firearm safety is an essential component to keeping keeping kids safe in their homes.