ATI: Infants

Question 1

Physical Development

Answer 1

• 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

Question 2

Reflexes

Answer 2

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

Question 3

Body Position

Answer 3

• flexed at rest

- movement should involve all 4 extremities equally, but can be sporadic

Question 4

Sleep

Answer 4

• sleep patterns can be reversed for several months (daytime sleeping and nighttime wakefulness)
• average 15 hours of sleep time each day

Question 5

Cognitive Development

Answer 5

• learn to respond to visual stimuli
• use cry as a form of communication
• cry patterns can change to reflect different needs

Question 6

Psychosocial Developement

Answer 6

-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

Question 7

Posterior Fontanelle Closes When?

Answer 7

by 2 to 3 months of age

Question 8

Anterior Fontanelle Closes When?

Answer 8

by 12 to 18 months of age

Question 9

Weight

Answer 9

• double by 4 to 6 months of age

- triple by 12 months of age

Question 10

Height

Answer 10

• 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

Question 11

Head Circumference

Answer 11

• 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

Question 12

Teeth

Answer 12

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

Question 13

Cognitive Development: Piaget

Answer 13

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

Question 14

Object Permanence

Answer 14

• develops at 9 months

- process of knowing that an object still exists when it is hidden from view

Question 15

Language Development

Answer 15

• 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

Question 16

Psychosocial Development: Eriskson’s

Answer 16

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

Question 17

When Does Attachment Begin?

Answer 17

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

Question 18

When Does Separation Recognition Begin?

Answer 18

• 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

Question 19

When Does Separation Anxiety Begin?

Answer 19

• develops between 4 to 8 months of age

- infants protest loudly when separated from parents, which can cause anxiety for parents

Question 20

When does stranger fear become evident?

Answer 20

between ages 6 to 8 months; when infants are less likely to accept strangers

Question 21

Self-Concept Development

Answer 21

by the end of the first year, infants distinguish themselves as separate from their parents

Question 22

Body-Image Changes

Answer 22

• discover that the mouth is a pleasure producer
• hands and feet are objects of play
• smiling makes others react

Question 23

Age-Appropriate Activities

Answer 23

-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

Question 24

Immunizations

Answer 24

• 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

Question 25

Breasfeeding

Answer 25

provides optimal nutrition during the first 12 months

Question 26

Feeding alternative to breastfeeding

Answer 26

-iron-fortified formula

Question 27

Cows Milk

Answer 27

-inadequate and not given before 1 year of age

Question 28

When Can Weaning from A Bottle or Breast Begin?

Answer 28

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

Question 29

When is Solid Foods Introduced

Answer 29

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

Question 30

How to Start new foods

Answer 30

- 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

Question 31

When are you allowed to give honey to infants?

Answer 31

until after 12 months | -it can cause infant botulism

Question 32

Appropriate finger foods to introduce at around 9 months

Answer 32

- ripe bananas - toast strips - graham crackers - cheese cubes - noodles - peeled chunks of apples, pears, and peaches

Question 33

When is Fluoridated water or supplemental fluoride available to use?

Answer 33

after 6 months to prevent against dental caries

Question 34

Prevent Aspiration

Answer 34

- 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)

Question 35

Prevent Bodily Harm

Answer 35

- 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

Question 36

Prevent Burns

Answer 36

- 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

Question 37

Prevent Drowning

Answer 37

-do not leave alone in bathtub

Question 38

Prevent Falls

Answer 38

- 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

Question 39

Prevent Poisoning

Answer 39

- 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

Question 40

Motor-Vehicle Injury Prevention

Answer 40

- 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

Question 41

Prevent Suffocation

Answer 41

- 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

Question 42

Gross Motor and Fine Motor Skills: 1 Month

Answer 42

Gross: -demonstrates head lag Fine: -has a strong grasp reflex

Question 43

Gross Motor and Fine Motor Skills: 2 Months

Answer 43

``` Gross: -lifts head off mattress when prone Fine: -holds hands in an open position -grasp reflex fading ```

Question 44

Gross Motor and Fine Motor Skills: 3 Months

Answer 44

``` Gross: -raises head and shoulders off mattress when prone -only slight head lag Fine: -no longer has grasp reflex -keeps hands loosely open ```

Question 45

Gross Motor and Fine Motor Skills: 4 Months

Answer 45

``` Gross: -rolls from back to side Fine: -grasps objects with both hands -places objects in mouth ```

Question 46

Gross Motor and Fine Motor Skills: 5 Months

Answer 46

Gross: -rolls from front to back Fine: -uses palmar grasp dominantly

Question 47

Gross Motor and Fine Motor Skills: 6 Months

Answer 47

Gross: -roll from back to front Fine: -hold bottle

Question 48

Gross Motor and Fine Motor Skills: 7 months

Answer 48

``` Gross: -bears full weight on feet -sits, leaning forward on both hands Fine: -moves objects from hand to hand ```

Question 49

Gross Motor and Fine Motor Skills: 8 Months

Answer 49

Gross: -sits unsupported Fine: -begins using pincer grasp

Question 50

Gross Motor and Fine Motor Skills: 9 Months

Answer 50

``` Gross: -pulls to a standing position Fine: -has a crude pincer grasp -dominant hand preference evident ```

Question 51

Gross Motor and Fine Motor Skills: 10 months

Answer 51

Gross: -changes from a prone to a sitting position Fine: -grasps rattle by its handle

Question 52

Gross Motor and Fine Motor Skills: 11 months

Answer 52

``` Gross: -cruises or walks while holding onto something Fine: -places objects into a container -neat pincer grasp ```

Question 53

Gross Motor and Fine Motor Skills: 12 months

Answer 53

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