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Pedi Exam 1 > Growth and Development of Infants > Flashcards

Growth and Development of Infants Flashcards

1
Q

Neonate Age

A

Birth to 1 month

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2
Q

Infancy period

A

1mo-12mo
Rapid motor, cognitive and social development
Establish trust in the world starting with caregiver

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3
Q

Psychosocial development of Infant 1mo-12mo

A

Erikson’s trust V mistrust
Acquire sense of trust of self, of other, of the world
Trust that feedings, comfort stimulation and caring needs will be met
Must overcome a sense of mistrust with emphasis on parents nurturing ability, visual and physical contact

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4
Q

Positive nurturing 1mo-12mo

A

Develop trust, optimism, confidence, and security

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5
Q

1mo-12mo Needs not met

A

Development of mistrust in world, feeling of insecurity

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6
Q

Piagets Sensory and Motor Phase Birth -24mo

A

Primitive reflexes are replaced by voluntary actions
Infants separate themselves from other objects and discriminate persons
Object permanence (9-10mo)

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7
Q

Infant Weight development

A

Rapid
By 6mo wt doubles birth weight (5-7 oz a week)
By 1 yr wt triples (average: 9.75kg or 21.5lb)

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8
Q

Average birth weight

A

7-8lb

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9
Q

Infant Height development

A

Increases 1 in monthly for first 6 mo

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10
Q

6mo Height average

A

25.5in

65cm

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11
Q

1yr Height average

A

29on

74cm

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12
Q

Infant Head Growth

A

Rapid

OFC: increases 1.5cm monthly for first 6mo, then 0.5cm monthly from 6-12 mo

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13
Q

OFC is measured…

A

Above the ears and eyebrows, on the widest part of the head

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14
Q

Average 6mo OFC

A

43cm

17in

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15
Q

Average 1yr OFC

A

46cm

18in

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16
Q

In hospital OFC measurement

A

Done routinely up to 3yr, and >3yr if child has brain problem (hydrocephalus, increased ICP)

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17
Q

Posterior Fontanel Closes

A

6-8week of age

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18
Q

Anterior Fontanel Closes

A

12-18mo

Average at 14 mo

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19
Q

Premature closure of fontanels

A

Craniosynostosis (inhibits perpendicular growth of skull and head is distorted, but brain growth is normal)

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20
Q

Anterior Fontanel Shape

A

Dimond

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21
Q

Posterior Fontanel Shape

A

Triangle

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22
Q

Documentation of normal fontanel

A

Soft and flat and open/closed

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23
Q

Sunken fontanel

A

Dehydration (notify provider)

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24
Q

Bulging fontanel

A

Bleeding in skull, fluid accumulation/overload from hydrocephalus, or infection (meningitis)

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25
Q

Growth chart used Birth - 2yr

A

WHO

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26
Q

Growth chart used 2-20yr

A

CDC

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27
Q

Infant Nutrition: Birth - 6mo

A

Human milk (preferred)

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28
Q

Human Milk

A

Most desired, complete diet for up to 6mo
Provides immunity to the infant (during last 3 months of pregnancy antibodies are provided to baby via passive immunity through the placenta– lasting a few weeks to months, longer if baby is breastfed)
Easily digested
>6mo can have significant health impact on children as they grow into adulthood

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29
Q

AAP&Nutrition recommends

A

Exclusively breastfeeding for 6mo
Continue for 1yr or longer as complementary foods are introduced
Prevents disease into adulthood

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30
Q

All infants should receive..

A

Vit D supplement of 400U/day beginning at hospital discharge

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31
Q

After 4 mo exclusively breastfed should receive

A

Iron supplement of 1mg/kg/day until iron containing foods can be introduced

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32
Q

Formula: Milk based

A

Preferred in full-term infant

Prepared with Cow milk with added veg oils, vitamines, minerals and iron

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33
Q

Formula: Soy based

A

For infants that are lactose intolerant and allergic to milk based formulas or casein protein in cow’s milk, or for those parents who wish for a vegetarian diet.
Made with soy protein and added veg oils and corn syrup and or sucrose

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34
Q

Special formula for Low birth weight infants

A

Low sodium formula

Predigested protein formula (for those who cannot break down casein or whey)

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35
Q

Feedings number/day

A

In general will decreased from 6 at 1 month to 4-5 at 6 months

36
Q

Total amount of formula ingested/day

A

32oz

37
Q

Amount of food infant should receive/day

A

Based on weight, age and if they are taking solid foods
Rule of thumb: infants under 6mo who haven’t started solid foods should be taking 2-2.5 oz/lb/day
Babies eat 3-4oz every 3-4 hr

38
Q

Introducing solid foods

A

Start at about 6mo (before that, the digestive tract isnt fully developed and cannot digest solid foods)

39
Q

Signs of readiness for Solid foods

A

Can sit in high chair and hold their head up
Can open their mouth when food comes their way
Can move food from a spoon into their throat and swallow appropriately

40
Q

Introduce 1st (solid food)

A

Iron fortified cereal (rice, barley, oatmeal, and high protein cereals)
Rice cereal is usually first

41
Q

Rice cereal

A

Easily digestible and low allergenic potential

DO NOT put in a bottle! Needs to be spoon fed

42
Q

Honey and infants

A

Avoid for first 12mo due to botulism

43
Q

Common sequence of introducing foods

A

Strained fruits, followed by veggies, then meats

44
Q

Introducing new foods

A

Feed small amount 1tsp-few tbsp in 4-7 day intervals

only introduce one food at a time to identify allergies

45
Q

Amount of solid food increased

A

Quantity of milk decreased to less than 1L/day to prevent overfeeding

46
Q

Gross motor: 1mo

A

Marked head lag
Can turn head from side to side when prone
(must hold/support baby head)

47
Q

Gross motor: 3mo

A

Can hold head up with slight head lag

48
Q

Gross motor: 4mo

A

Head lag is almost gone
Can roll from their back to their side
Important to put baby on their back to sleep (need to be aware of them rolling to side and belly to prevent SIDS)
🚩posteriorr fontanel not closed

49
Q

Gross motor: 5mo

A

Can roll from belly to back

50
Q

Gross motor: 6mo

A

Can sit in high chair (good head control) and roll from back to belly
🚩 any head lag at this age needs a neurologic evaluation

51
Q

Gross motor: 7mo

A

Can sit leaning forward on hands and bears weight on legs

52
Q

Gross motor: 9mo

A

Creeps on hand and knees and pulls themselves to standing position

53
Q

Gross motor: 10mo

A

Change from prone to sitting

54
Q

Important IV consideration when standing, creeping, crawling

A

dont put IV in feet because we dont want to limit their movement

55
Q

Gross motor: 11mo

A

Can cruise while holding furniture

56
Q

Gross motor: 12-14mo

A

Can stand alone and walks with one hand held

Most have taken at least one independent step by 14 mo

57
Q

Infant who doesnt pull to stand by 11-12 mo

A

🚩Needs to be evaluated for possible developmental dysplasia of the hip

58
Q

Fine motor includes

A

Using hands and fingers to grasp objects

59
Q

Grasping occurs between

A

2-3mo as a reflex and gradually becomes voluntary

Palmer grasp is replaced with Pincer grasp

60
Q

Fine motor: 3mo

A

Will hold a rattle if placed in their hand, will not reach for it

61
Q

Fine motor: 4 mo

A

plays with hands and can carry objects to mouth

❌ remove all small objects (anything that can fit down a toilet paper roll can be choked on)

62
Q

Fine motor: 5mo

A

able to voluntary grasp objects

63
Q

Fine motor: 6mo

A

Hold bottle, grasp their feet and pull to mouth and feed themselves a cracker

64
Q

Fine motor: 7mo

A

Can transfer objects from one hand to another, use one hand for grasping and hold a cube in each hand simultaneously

65
Q

Fine motor: 8-9 mo

A

Uses crude (not fully developed) pincer grasp, bangs blocks, explores movable parts

66
Q

Fine motor: 10mo

A

Can pick up a raisin and other finger foods

Can deliberately let go of objects and will offer it to someone

67
Q

Fine motor: 11-12mo

A

Places objects into a container and removes them

68
Q

2 mo Developmentally

A

Social smile in response to various stimuli
Follows midline
Vocalizes along with using facial and body expressions, distinct from crying
When prone, lifts head to 45 degree – tummy time is important

69
Q

2mo Physically: Skin

A

Infant acne may continue to 3mo, cradle cap, eczema is common

70
Q

2mo Physically: Head

A

Posterior fontanel should be closed

71
Q

2mo Physically: Eyes

A

Unequal movement

72
Q

2mo Physically: Neck

A

holds head 45 degree when prone, if on back turn head from side to side to prevent plagiocephaly or bald spot

73
Q

2mo Neurologically: Grasping reflex

A

Present when infant immediately closes fingers when and object placed in hand
Gone by 3-4 mo

74
Q

2mo Neurologically: Stepping reflex

A

Present when you hold the infant upright and touch foot to flat surface, they begin stepping
Gone by 2-4 mo

75
Q

2mo Neurologically: Sucking reflex

A

Present when the infants soft palate, lip, mouth cheek or chin is stimulated or stroked, will automatically begin sucking
Gone by 4-6mo

76
Q

2mo Neurologically: Rooting reflex

A

Present when the infants cheek is stroked, the baby will turn head in the direction of the stimulus, mouth open ready to suckle
Gone by 4mo

77
Q

4mo Developmentally

A 
Sit with support 
Rolls from back to side
Has almost no head lag when pulled to sit 
Grasp objects with both hands 
Regards hands. 
hands together
Laughs 
Bears weight on legs when held up
78
Q

4mo Physically/ Neurologically

A

Drooling begins
Moro and rooting reflexes are gone
Sucking, palmar grasp, plantar grasp and fading
Makes consonant sounds (like K or N)
Laughs out loud and show many expressions
Begins to show memory
Separation/Individuation begins, know that they are separate individual than their mother

79
Q

6mo Developmentally and Physically

A 
Feeds self with fingers 
Works for toys
Reaches for objects
Turns to rattle
Imitates speech sounds
Speaks single syllabus (like Ma, Da)
Teething my begin with eruption of 2 lower central incisors between 6-10 mo
80
Q

Quick guide to teeth coming in

A

Take child’s age in months and minus 6 equals how many teeth they should have

81
Q

6-8 mo

A

They begin to fear strangers. Stranger anxiety is prominent during this time
Talk softly and meet the child at eye level
Maintain safe distance
Avoid sudden intrusive gestures
Start with least invasive to most
Try to keep on moms lap, do assessment on mom first then baby

82
Q

9mo Developmentally and Physically

A 
Creeps on hands and knees 
Sits for prolonged time
Pulls self to standing position 
Stands holding furniture 
Responds to simple verbal commands
Understands "n-no"
Eruption of upper incisors begins between 8-12mo
83
Q

For pain with teething

A

Massage gums, give them ibuprofen or tylenol

Dont give hard, cold items to put in mouth- they damage the gums and cause bleeding

84
Q

12-14mo Developmentally and Physically

A 
Birth weight triples
Says 3-5 words besides "MaMa, DaDa"
Plays repetitive games 
Waves bye-bye
Indicates wants without crying 
Bangs 2 cubes together
Recognizes objects by name 
Stands alone for few seconds
May be walking on their own 
Has 6-8 deciduous teeth
85
Q

Common health consideration

A

Vaccine preventable diseases
Diaper rash
Eczema (have higher risk for development of asthma)
Teething
RSV (between November and April, Premature baby: talk about Synagis)
Jaundice
SIDS (dont lay baby on belly, prone only)
Abuse
FTT (failure to thrive)
Colic (remind parents to take slow deep breaths and a time out and tell them that this will get better with time)
Apnea of Prematurity (home monitor and protect from SIDS because these children are at greater risk for SIDS)
Flu

86
Q

Safety Considerations for infant: Risk for

A 
Suffocation (positioning is important)
Aspiration 
Falls
Bodily damage from sharp objects 
Poisoning from ingestion (store hazardous items in high places)
Motor vehicle accident (proper car seat)
87
Q

Car Seat recommendations

A

Children need to be in a rear facing seat until 2yr or until they reach the max height and weight for the seat
Once rear facing seat is outgrown: then use forward facing seat
Once forward facing seat is outgrown: then need to use a belt positioning booster seat until they have reached 4ft 9in and are between 8-12 yr

Pedi Exam 1 (18 decks)

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