G+D infant Flashcards
growth
chronological age
increase in physical size
development
continuous, orderly series of conditions that leads to activities and patters of behavior
measured by observation
patterns of G+D
predictable, universal and basic, individual differences
directional and sequential trends
directional trends
cephalocaudal
proximodistal
differentiation
sequential trends
stages, critical periods, positive and negative stimuli
prenatal period
geminal: conception - 2 wk
embryonic: 2 - 8 wk
fetal: 8 - 40 wk (birth)
infancy
neonatal: birth - birth - 28 days
infancy: 1 mo - 12 mo
early childhood
toddler: 1- 2 yrs
preschooler: 3 - 6 yr
middle childhood
6 - 12 yr
late childhood
prepubertal: 10 - 12 yrs
adolescences: 13 - 18 yrs
G+D importance
anticipatory guidance - predict child and prepare parents
healthy habits
gain understanding of reasons behind illness
weight
10% initial loss after birth because of hormone withdrawal, loss of ECF, poop and pee, limited food intake (small stomach)
rapid growth: about 1 oz/day until 6 mo, double weight by 6 mo, tripple by 1 yr
height
increase 1 inch/month until 6 mo
increase 50% by 1 year
head
0.5 inches/month for first 6 mo
closure of fontanels: 2, assess for intracranial pressure and hydration, posterior closes 6-8 wk, anterior closes 12 -18 mo for brain growth
respiratory
abd breathers, rate slows
heart
rate slows, paradoxical pattern increases with inspiration and decreases with expiration
blood pressure
fluctuate but generally systolic rises as LV pumps better
hemopoietic system
fetal hemoglobin till 5 mo - physiologic anemia
maternal iron stores diminish at 5 - 6 mo
digestive system
immature at birth, function ~3 mo
drooling common bc poor coordinated swallow reflex
amylase and lipase (4-6 mo)
solid food not well tolerated, not broken down
coordination of sucking, swallowing, and teeth eruption to prep for solid food (4-6 mo)
1st tooth eruption (5-6 mo)
taste: well developed, avoid bitter and sour for sweet
urination
kidneys immature and cant concentrate urine
proportion of fluids increases risk of dehydration
endocrine
e imbalance, fluid imbalance, glucose [], aa metabolism, stress
thermoregulation
shiver after first few months
adipose tissue
adjust to cold by 6 mo
need multiple layers
vision
birth - 1 mo: follow object to midline, 8 - 10”
2 mo: lift and look
3 mo: faces!, associate visual stimuli and event
4 mo: hand regard, follow past midline, recognize, follow parents
6 mo: directed reach, depth perception
10 mo: object permanence
hearing
discrimination to mothers voice at birth and familiar sounds to soothe
3-6 mo: localize sound, understand few words
6-12 mo: first meaningful word
12 mo: hear and follow simple command
motor development - gross
random, diffuse, uncoordinated; reflexes carry out bodily functions and responses to external stimuli
head control
1 mo: marked head lag
3 mo: hold up
4 -6 mo: well established head control
sitting
5 mo: roll from belly to back
6 mo: roll from back to belly, sit with support
7 mo: sit alone leaning forward on hands
8 mo: sit unsupported
10 mo: from prone or supine to sitting
locomotion
4 -6 mo: increasing coordination in arms - push backwards
6-7 mo: bear all of their weight on their legs
8 -10: crawl forward on belly
9 mo: stand holding furniture
11 mo: creep on hands and knees
10 -12 mo: cruise, sit down from upright
12 mo: walk well with one hand held - take 1st steps independently shortly after
fine motor development
1-3 mo: grasp reflex then voluntary
1 mo: hand mostly closed
3 mo: hands to midline, desire to grasp
5 mo: 2 handed, voluntary grasp
4 -6 mo: bring to mouth
6 mo: hold bottle, grasp feet
7 mo: transfer from hand to hand
8-9 mo: pincer grasp
11-12 mo: refined pincer grasp
motor development - 2 mo
hold head erect in mid position
turn form side back
motor development - 3 mo
hold head erect and steady
open or close hand loosely
hold object put in hand
motor development - 4 mo
sit with adequate support
may roll over front to back
hold head erect and steady while sitting
bring hands together at midline and play with fingers
grasp objects with both hands
motor development - 5 mo
balance head well when sitting
sit with slight support
pull feet to mouth when supine
grasp objects with whole hand
hold one object while looking at another
motor development - 6 mo
sit alone briefly
turn completely over
lift chest and upper abdomen when prone
hold own bottle
motor development - 7 mo
sit alone
hold cup
imitate simple acts of others
motor development - 8 mo
sit alone steadily
drink from cup with assistance
eat finger food than can be held in one hand
motor development - 9 mo
rise to sitting position alone
crawl (pull body while prone)
hold bottle with good hand mouth coordination
motor development - 10 mo
creeps well, walk with help, bring hands together
motor development - 11 mo
walk holding onto furniture, stand erect with minimal support
motor development - 12 mo
stand alone for variable length of time
sit down from standing position alone
walk in few steps with help or alone (hands at shoulder height for balance)
pick up small bits of food and transfer to mouth
kohlberg
preconventional morality obedience and punishment orientation: stage 1 because children do not speak as members of society, they see morality as external, they listen to the big people, they assume powerful authorities hand down fixed rule sets they must obey
erikson
trust vs mistrust
in sync with caregiver, cannot tolerate frustration, entirely dependent upon caregivers so the quality of care they receive is important to shape personality
piaget
sensorimotor
progress from simple reflex to simple repetitive acts
leanrs they are separate from others and objects
object permanence
begin to use symbols
intelligence takes form of motor actions: reflexive (birth - 1m), primary circular reactions ( 1-4 m), secondary circular reactions (4-8m), coordinaiton of secondary (9-12m)
sexuality
begin at birth from parental feedbakc (+ and accepting)
oral sensitivity, skin to skin, acceptance by parents
social development
attachment - depends on infants ability to discriminate mother from others and object permanence, parent- infant attachment is critical to mental health
crying brings attention, smile in response to others smile, stranger anxiety, responds socially to his name
social development - behaviors influencing attachment
different crying, smiling, vocalization, cry when mother leaves room, visual motor orientation (look more at mom), approach through locomotion, cling, explore away from mother and use her as base
social development timeline
1wk: preference for human face
6-8 wk: social smile
3 mo: excitement at new things
6 mo: very personable and interactive
7 mo: imitate actions and noises, show displeasure
8 mo: imitate sounds
9-10 mo: mouths understand simple commands and “on”
10 mo: play games (pat a cake and peekaboo)
12 mo: can be very interactive showing pleasure and displeasure, doing some things themselves
social development - prolonged separation
emotional deprivation during first 3 years
physical growth slower, more prone to infections and disease
stages: 1- protest, 2- despair, 3-detach
social development - reactive attachment disorder
occurs after maladaptive or absent attachment
child may refuse to make eye contacts, poor impulse control, destructive to self and others
may lead to antisocial
nursing intervention: warm, responsive, and interactive with infant during separation
stranger fear
6-7 mo - child-parent bond
separation anx
9-10 mo, peak 12 -15 mo, linger
sensory development
birth: hearing and touch well developed, sight not fully developed until 6 years
2m: smile, search and turn head to locate sounds
6 mo: has taste preference
7mo: respond to own name
12 mo: able to follow objects
1 yr: vocalize 4 words
emotional development
instable, rapid changes
affection for family
10 mo: express several beginning recognizable emotions (anger, sad, pleasure, jealous, anx, affection)
12 mo: clearly distinguishable emotions
stress and coping
loss of caregivers
loud noises
lights
sudden movement
sleep
first 4 mo: 16 - 20 hrs
5 mo: most sleep through night with 2 daytime naps
play (0-3 mo)
not differentiated, smile and squeal
play: 3-6 mo
show some discriminant interest
4 mo: laugh aloud
major focus: sensory stim, learn to distinguish self from env
solitary play: short, talk, sing, laugh, read, relationship is important
appropriate toys
play: 7-12 mo
have sensorimotor skills and discriminate between who they will play with
major focus: promote security, sensory stim, gross and fine motor stim, begin casual relationships, object permanence
more interactive
appropriate toys
type of toys not as important as the quality of interaction with the people they play with
language development - vocalization
cry 1-1.5 hrs/day up to 3 weeks; up to 2-4 hrs/day at 6 wk, then decrease
by end of year, will have specific cry for different needs and wants
vocalization at 5-6 wk
language development - timeline
2 mo: coo, cry is differentiated
3-4 mo: consonant sounds, laugh aloud
5-7 mo: vowel sounds
8 mo: imitating sounds, combine syllables
9-10 mo: understand simple commands and no
12 mo: can say 3-5 words with meaning besides mama and dada
hearing
BAER test at birth
ability to hear correlates with proper enunciation
always ask about hx of otitis media
early referral to asses effusion - infections can scar tympanic membrane
repeat hearing screening test
slp prn
red flags
unable to sit alone by 9 mo
unable to transfer objects from hand to hand by age 1
abnormal pincer grip or grasp by age 15 mo
unable to walk alone by 18 mo
failure to speak recognizable words by 2 yrs
patterns of temperament
the easy child
slow to warm up child
difficult child
concerns related to normal G+D
separation and stranger anx
spoiled child: not crying in early infancy, normal toddler negativism and tantrums, difficult temperament or attention deficit, or effects of extreme stress in home
need consistent clear guidelines and rules
setting limits
infant discipline (6-18 mo)
set limits to ensure safety
start with stern no, negative eye contact, removing child from unsafe situation
use gestures
