Class 9. Health Promotion - Infants Flashcards
Limit Setting and Discipline
-begin with negative voice and stern eye contact
-time-out in playpen
-behaviour is exploratory, not oppositional
-provide safe alternatives
-infants cry because a need is not being met
PURPLE crying
P-peak of crying
U-unexpected
R-resists soothing
P-pain-like face
L-long lasting
E-evening
prevent shaken baby syndrome
Spoiled Child Syndrome
def: excessive self-centred and immature behaviour dt the failure of parents to enforce consistent, age-appropriate limits
-parents should feel comfortable living their infant without fear of spoiling them
-the earlier effective disciplinary methods are used, the easier it will be to continue these approches
Thumb Sucking & pacifier use
-sucking is infants’ main pleasure and may not be satisfied by breast/bottle feeding
-research has not shown that pacifier use causes reduction in bfing
-strong evidence that pacifier use has a protective effect in SIDS prevention
-no need to restrict nonnutritive sucking of fingers/thumb in early childhood
-malocclusion of teeth may occur if thumb sucking persists beyond 4 years
Teething
-age of tooth eruption varies
-order of appearance is regular and predictable
-first teeth- bottom middle at 6-10 mon
-signs of teething:
drooling
biting hard on objects
increased finger sucking
irritable
refusal to eat
mild temp increase
ear rubbing
diff sleeping
Tx:
cold teething rings
analgesics (aceta, ibuprofen)
topical anesthetics
Sleeping Problems
-usually a learned pattern or a developmental characteristic
-interventions offered only when pattern is disruptive to the family
-best prevention is to establish bedtime rituals that do not foster problematic patterns
Injury prevention
falls
burns
MVA
Drowning
Poisoning
Choking
Suffocation
Strangulation
Injury prevention
falls
burns
MVA
Drowning
Poisoning
Choking
Suffocation
Strangulation
Paroxysmal Abdominal Pain (Colic)
Paroxysmal abdominal pain or cramping manifested by loud crying and drawing up of legs to abdomen
no diagnosable cause, many etiologies
meds may be recommended
investigate detailed history of usual daily events
Failure to Thrive (FTT)
-based on growth parameters (height and weight) that:
-drop >2 percentiles from baseline
-are persistently below the 3-5th percentiles
-are <80th percentile of median weight for
height
-weight for length is most accurate indicator of undernutrition
-also called “growth faltering” or “pediatric undernutrition”
FTT Categories according to Pathophysiology
Inadequate caloric intake:
ex incorrect formula preparation, neglect, food fads, excessive juice consumption, poverty
Inadequate absorption:
ex CF, celiac disease, vitamin or mineral deficiencies
Increased metabolism:
ex. hyperthyroidism, congenital heart defects, immunodeficiency
Defective utilization:
ex. Triosomy18 or 21, congenital infection, metabolic storage diseases
FTT: Nursing Considerations
Early recognition, diagnosis, and intervention
Provide positive feeding environment
Teaching successful feeding strategies
Support child and family
FTT: Nutritional Management
goal: correct nutritional deficiencies and achieve ideal weight for height
-allow for catch-up growth
-restore optimum body composition
-educate parents about nutritional requirements and appropriate feeding methods
Diaper Dermatitis
factors in the development of diaper dermatitis:
-skin wetness
-increase in skin and diaper pH
-fecal enzymes
-chemical irritation
-mechanical irritation
-infection (Candida albicans)
Sudden Infant Death Syndrome (SIDS)
-sudden death <1 yr
-unexplained after a complete post-mortem exam, including investigation of the death scene and review of case hx
proposed etiology theories:
-bed sharing
-sleep position
-maternal smoking
-genetic predisposition
-brainstem abnormality in neurological regulation of cardiorespiratory control
-“triple threat” = underlying infant vulnerability + critical incidence + environmental stressor
