ATI: Infants Flashcards
Physical Development
- lose 5% to 10% body birth weight in first few days, but should regain it by the second week
- weight gain is about 5 to 7 oz per week in the first 6 months (should be doubled)
- measurements of crown-to-rump length, head-to-heel length, head circumference, and chest circumference are key indicators of appropriate growth
- head molding (overlapping of skull bones) present
- fontanelles are palpable
Reflexes
startling, sucking, rooting, grasping, yawning, coughing, plantar and palmar grasp, and Babinski
>confirm presence or absence of expected reflexes to monitor for appropriate neurological development
Body Position
- flexed at rest
- movement should involve all 4 extremities equally, but can be sporadic
Sleep
- sleep patterns can be reversed for several months (daytime sleeping and nighttime wakefulness)
- average 15 hours of sleep time each day
Cognitive Development
- learn to respond to visual stimuli
- use cry as a form of communication
- cry patterns can change to reflect different needs
Psychosocial Developement
-interactions with caregivers affect psychosocial development
>positive= promote nurturing and attachment
>negative= hinders appropriate attachment
-most newborns can mimic the smile of the caregiver by 2 weeks of life
Posterior Fontanelle Closes When?
by 2 to 3 months of age
Anterior Fontanelle Closes When?
by 12 to 18 months of age
Weight
- double by 4 to 6 months of age
- triple by 12 months of age
Height
- grow 2.5 cm (1 in) per month in the first 6 months
- grow 1.25 cm (0.5 in) per month until the end of the first year
Head Circumference
- increases 2 cm per month during first 3 months
- 1 cm per month from 4 to 6 months
- 0.5 cm per month from 6 to 12 months
Teeth
6 to 8 teeth erupt in the infants mouth by the end of the first year
- use cold teething rings, OTC teething gels, and acetaminophen or ibuprofen
- use a cool, wet washcloth to clean the teeth
- do not give infants a bottle when they are falling asleep; prolonged exposure to milk or juice can cause dental caries
Cognitive Development: Piaget
Sensorimotor Stage (birth to 2 years)
- separation is the sense of being distinct from other objects in the environment
- object permanence develops at 9 months of age
- recognition of symbols
Object Permanence
- develops at 9 months
- process of knowing that an object still exists when it is hidden from view
Language Development
- responds to noises
- vocalizes with “oohs” and “aahs”
- laughs and squeals
- turns head to the sound of a rattle
- begins to comprehend simple commands
- pronounces single-syllable words
- begins speaking two- and then three- word phrases
Psychosocial Development: Eriskson’s
Trust vs. Mistrust (Birth to 1 Year)
- infants trust that others will meet their feeding, comfort, stimulation, and caring needs
- infants reflexive behavior (attachment, separation recognition/anxiety, and stranger fear) influences their social development
When Does Attachment Begin?
infant begins to bond with their parents
- develops within the first month, but begins before birth
- process is optimal when parents are in good health, have positive feeding experiences, and receive adequate rest
When Does Separation Recognition Begin?
- occurs during the first year as infants recognize the boundaries between themselves and others
- learning how to respond to people in their environment is the next stage of development
- positive interaction with parents, siblings, and other caregivers help establish trust
When Does Separation Anxiety Begin?
- develops between 4 to 8 months of age
- infants protest loudly when separated from parents, which can cause anxiety for parents
When does stranger fear become evident?
between ages 6 to 8 months; when infants are less likely to accept strangers
Self-Concept Development
by the end of the first year, infants distinguish themselves as separate from their parents
Body-Image Changes
- discover that the mouth is a pleasure producer
- hands and feet are objects of play
- smiling makes others react
Age-Appropriate Activities
-have a short attention span
-do not interact with other children during play (solitary play)
>toys and activities that stimulate the senses and encourage development:
-rattles
-mobiles
-teething toys
-nesting toys
-playing pat-a-cake
-playing with balls
-reading books
Immunizations
- Birth: Hep B
- 2 months: Hep B, DTap, HIB, polio, PCV, rotavirus
- 4 months: DTap, HIB, Polio, PCV, rotavirus
- 6 months: Hep B, DTap, HIB, Polio, PCV, rotavirus, annual flu
- 12-18 months: DTap, HiB, PCV, MMR, Varicella, Hep A, annual flu
Breasfeeding
provides optimal nutrition during the first 12 months
Feeding alternative to breastfeeding
-iron-fortified formula
Cows Milk
-inadequate and not given before 1 year of age
When Can Weaning from A Bottle or Breast Begin?
when infants can drink from a cup (after 6 months)
- replace a single bottle- or breast feeding- with breast milk or formula in a cup
- every few days, replace another feeding with a cup
- replace the bedtime feeding last
When is Solid Foods Introduced
6 months
- readiness= voluntary control of the head and trunk and disappearance of the extrusion reflex (pushing food out of the mouth)
- introduced iron-fortified cereal first
- solid food is not a substitute for breast milk or formula until after 12 months
How to Start new foods
- one at a time over a 5 to 7 day period to observe for s/s of allergy or intolerance (fussiness, rash, vomiting, diarrhea, constipation)
- Vegetables, Fruits, and Meats follow; in that order
When are you allowed to give honey to infants?
until after 12 months
-it can cause infant botulism
Appropriate finger foods to introduce at around 9 months
- ripe bananas
- toast strips
- graham crackers
- cheese cubes
- noodles
- peeled chunks of apples, pears, and peaches
When is Fluoridated water or supplemental fluoride available to use?
after 6 months to prevent against dental caries
Prevent Aspiration
- avoid small objects (grapes, coins, and candy), which can become lodged in the throat
- provide age-appropriate toys
- check clothing for safety hazards (loose buttons)
Prevent Bodily Harm
- keep sharp objects out of reach
- keep infants away from heavy objects they can pull down
- do not leave infants alone with animals
- monitor for shaken baby syndrome
Prevent Burns
- check the temperature of bath water
- turn down the thermostat on the hot water heater to 120 degrees F or below
- have smoke detectors in the home and change their batteries regularly
- turn handles of pots and pans toward the back of the stove
- apply sunscreen when outdoors during daylight hours
- cover electrical outlets
Prevent Drowning
-do not leave alone in bathtub
Prevent Falls
- keep the crib mattress in the lowest position with the rails all the way up
- use restraints in infant seats
- place infants seat on the ground or floor, and do not leave them unattended or on elevated surfaces
- use safety gates across stairs
Prevent Poisoning
- avoid lead paint exposure
- keep toxins and plants out of reach
- keep safety locks on cabinets that contain cleaners and other household chemicals
- keep a poison control number handy or program it into the phone
- keep medications in childproof containers and out of reach
- have a carbon monoxide detector in the home
Motor-Vehicle Injury Prevention
- use an approved rear-facing car seat in the back seat, in the middle (away from air bags and side impact)
- should sit in a rear-facing position at least until age 2 or until they reach maximum height and weight for car seat
- convertible restraints should have a 5-point harness or T-shield
Prevent Suffocation
- keep balloons and plastic bags away from infants
- be sure the crib mattress is firm and fits tightly
- ensure crib slats are no farther apart than 6 cm (2.4 in)
- remove crib mobiles or crib gyms by 4 to 5 months of age
- do not use pillows in crib
- place infants on back for sleep
- keep toys that have small parts out of reach
- remove drawstrings from jackets and other clothing
Gross Motor and Fine Motor Skills: 1 Month
Gross:
-demonstrates head lag
Fine:
-has a strong grasp reflex
Gross Motor and Fine Motor Skills: 2 Months
Gross: -lifts head off mattress when prone Fine: -holds hands in an open position -grasp reflex fading
Gross Motor and Fine Motor Skills: 3 Months
Gross: -raises head and shoulders off mattress when prone -only slight head lag Fine: -no longer has grasp reflex -keeps hands loosely open
Gross Motor and Fine Motor Skills: 4 Months
Gross: -rolls from back to side Fine: -grasps objects with both hands -places objects in mouth
Gross Motor and Fine Motor Skills: 5 Months
Gross:
-rolls from front to back
Fine:
-uses palmar grasp dominantly
Gross Motor and Fine Motor Skills: 6 Months
Gross:
-roll from back to front
Fine:
-hold bottle
Gross Motor and Fine Motor Skills: 7 months
Gross: -bears full weight on feet -sits, leaning forward on both hands Fine: -moves objects from hand to hand
Gross Motor and Fine Motor Skills: 8 Months
Gross:
-sits unsupported
Fine:
-begins using pincer grasp
Gross Motor and Fine Motor Skills: 9 Months
Gross: -pulls to a standing position Fine: -has a crude pincer grasp -dominant hand preference evident
Gross Motor and Fine Motor Skills: 10 months
Gross:
-changes from a prone to a sitting position
Fine:
-grasps rattle by its handle
Gross Motor and Fine Motor Skills: 11 months
Gross: -cruises or walks while holding onto something Fine: -places objects into a container -neat pincer grasp
Gross Motor and Fine Motor Skills: 12 months
Gross:
-sits down from a standing position without assistance
-walks with one hand held
Fine:
-tries to build a two-block tower without success
-can turn pages in a book
