Chapter 23: Home Care of the Infant

Question 1

Plagiocephaly

Answer 1

Flattening of the head

Question 2

Colic

Answer 2

Irritable crying for no obvious reason in a healthy infant

Question 3

Cooing

Answer 3

Vowel sounds mad by the infant

Question 4

Extrusion reflex

Answer 4

Using the tongue to push out anything that touches it

Question 5

Miliaria

Answer 5

Prickly heat rash

Question 6

Seborrheic dermatitis

Answer 6

Cradle cap

Question 7

Sudden infant death syndrome (SIDS)

Answer 7

Abrupt and unexplained death of an apparently healthy infant.

Question 8

What teaching should you give prospective parents about an infant car safety seat for their newborn?

a. Use of harness:
b. Direction the seat should face:
c. Safest placement:
d. Use of seat belt with car seat:
e. Use in cars with air bags:

Answer 8

a. Use of harness: The harness should be easy to fasten with shoulder straps at or just below the shoulder level; the restraint clip should be at midchest or axillary level.
b. Direction the seat should face: The seat should face the rear of the vehicle until the child is 2 years old or at the highest weight or height recommended by the manufacturer.
c. Safest placement: The safest place is in the center of the back seat.
d. Use of seat belt with car seat: Secure the car seat with the automobile seat belt in the correct area.
e. Use in cars with air bags: Do not place car seat in from passenger seat, especially if the car has an air bag.

Question 9

What should the nurse teach parents about abusive head trauma (aka shaken baby syndrome)?

Answer 9

When someone shakes a baby, hemorrhage of the brain, fractures, and spinal cord or eye injury can result. Parents should never shake an infant and should seek help if they feel angry enough to do this.

Question 10

What should parents be taught about safety when the infant sleeps?

Answer 10

Position the infant on the back for sleep, not in a prone position. Do not place pillows or soft stuffed toys in the crib. The infant should not sleep with another person or on a soft surface.

Question 11

How can head flattening of the back of the head be prevented?

Answer 11

Placing the infant on the abdomen when awake and supervised and supine at alternating ends of the crib for sleep with help prevent flattening of the head. The infant should not spend prolonged time in infant or car seats where pressure is put on the back of the head.

Question 12

List basic teaching for these parent concerns.

a. Stools:
b. Smoking around infant:
c. Trimming nails:
d. Pacifiers:

Answer 12

a. Stools: Formula-fed infants usually pass one stool each day; breastfed infants may have one after each feeding or, when they are older, every 2 or 3 days. Stools should not be hard and dry nor should they be watery or leave a water ring on the diaper. Straining and redness in the face when passing stools are normal.
b. Smoking around infant: There should be no smoking inside the home or near the infant. Infants exposed to smoke have more respiratory infections and a higher incidence of SIDS.
c. Trimming nails: Cut nails strait across with a clipper or blunt-ended trimmer and then smooth with an emery board. They should not be cut too short. Cutting them while the infant sleeps may be easier.
d. Pacifiers: Discard any pacifier that is cracked, torn, sticky, or pulled away from its shield. Replace pacifiers every 1-2 months. Have several clean and ready to use. Never put a pacifier on a string around the neck, but clop it to clothing with a short band. Malocclusion is not a risk unless sucking continues beyond the time the secondary teeth appear.

Question 13

When should infants sleep through the night?

Answer 13

Infants sleep 5 hours at night by age 3-4 months. By 1 year they sleep about 1- hours at night. Teething and illness may cause night wakening, however.

Question 14

What are some aids for diaper rash?

Answer 14

Change diapers as soon as possible when wet or soiled; wash the area gently with soap and water; avoid disposable wipes with alcohol, perfume, or preservatives; expose the area to air; apply a thin layer of petrolatum or zinc oxide cream.

Question 15

Distinguish between spitting up and vomiting.

a. Spitting up:
b. Vomiting:

Answer 15

a. Spitting up: In spitting up, a small amount of milk is lost with the burp; it is not forcefully expelled.
b. Vomiting: Vomiting involves a large amount of milk, vomited with force. If it continues, the parents should report it to the health care provider.

Question 16

How would you answer a mother who wants to start feeding her 2-month-old infant rice cereal?

Answer 16

Use these facts when formulating your answer:

a. Early feeding of solids replaces milk, which is easily digested, with a food that is not taken or digested well.
b. The extrusion reflex makes feeding of solids difficult until the age of 4-6 months.
c. Early feeding will not help the infant sleep through the night.

Question 17

Approximately when should parents expect each of these developmental milestones?

a. Head control:
b. Social smile:
c. Cooing:

Answer 17

a. Head control: 3 months
b. Social smile: 1-3 months
c. Cooing: 1-4 months

Question 18

What are the purposes of well-baby check-ups?

Answer 18

Well-baby check ups assess growth and development, answer parent questions, identify abnormalities, allow infants to receive immunizations, and provide anticipatory parent guidance.

Question 19

When should parents seek immediate medical care for their infant?

Answer 19

If signs of dyspnea occur (sustained RR >60 bpm or <30 bpm, retractions, cyanosis, or extreme pallor) or the infant is hard to arouse, parents should see their pediatrician or visit an emergency department. Sudden respiratory distress in a well infant may indicate aspiration, and parents should summon paramedics.

Question 20

What precautions can parents take to reduce the risk of sudden infant death syndrome?

Answer 20

Avoid having the infant sleep in a prone position, overheating the infant, or letting the infant sleep with another person; provide a firm sleeping surface; allow no loose blankets, pillows, or stuffed toys in the infants bed; avoid smoking during or after pregnancy.