Health Promotion of Infants

Question 1

Physical Development - Head & Trunk

Answer 1

• Grow the fastest
• By 1yr: birth length incrs 50%
• Head incrs 33% in 1st yr

Question 2

Physical Development - Cranial Sutures

Answer 2

• Posterior Fontanel: closes at 6-8 wks
• Anterior Fontanel: closes by 12-18 months

Question 3

Physical Development - Weight

Answer 3

• Doubling of birth weight by 6 months
  > infants gain 5-6oz/wkly in 1st months
• Tripling of birth weight by 1yr old

Question 4

Physical Development - Fontanel Complications

looking at fontanel

Answer 4

• Sucken Fontanel: at risk for dehydration
• Swollen Fontanel: incrd ICP

Question 5

Maturation of Systems

CNS, resp, cardiac

Answer 5

• CNS: slow myelinization to gain control; over a couple yrs
• Respiratory: fast RR in newborns, nose to lungs very short, small nasal passages
• Cardiac: fast HR, small heart, murmurs common in newborns

Question 6

Maturation of Systems

GI, kidneys, immunity

Answer 6

• GI: not fully func until 4-6mnths; wait until solids then, newborns need to eat every few hrs
• Kidneys: can’t uptake water, hydration comes from food/breast milk/formula
• Immunity: comes from mom & vaccines

Question 7

Maturation of Systems

vision, hearing, thermoregulation

Answer 7

• Vision: very poor, need contrast
• Hearing: fully mature at birth
• Thermoregulation: not good for first couple mnths, burn “brown fat” for temp regulation

Question 8

Gross Motor Skills

1-4mnths

Answer 8

• 1 Month: demonstrates head lag
• 2 Months: lifts head off mattress when prone
• 3 Months: raises head & shoulders off mattress when prone, only slightly head lag
• 4 Months: rolls from back to side

Question 9

Fine Motor Skills

1-4months

Answer 9

• 1 Month: has strong grasp reflex
• 2 Months: holds hands in an open position, grasp reflex fading
• 3 Months: no longer has a grasp relfex, keeps hands loosely open
• 4 Months: grasps objects w/ both hands

Question 10

Gross Motor Skills

5-8months

Answer 10

• 5 Months: rolls from front to back
• 6 Months: rolls from back to front
• 7 Months: bears full weight on feet, sits leaning forward on both hands
• 8 Months: sits unsupported

Question 11

Fine Motor Skills

5-8months

Answer 11

• 5 Months: uses palmar grasp dominantly
• 6 Months: holds bottle
• 7 Months: moves objects from hand to hand
• 8 Months: begins using pincer grasp

Question 12

Gross Motor Skills

9-12months

Answer 12

• 9 Months: pulls to a standing position, creeps on hands & knees
• 10 Months: changes from a prone to a sitting position
• 11 Months: cruises or walks while holding onto something
• 12 Months: sits down from a standing position w/out assistance, walks w/ one hand held

Question 13

Fine Motor Skills

9-12 months

Answer 13

• 9 Months: has a crude pincer grasp, dominant hand preference evident
• 10 Months: grasps rattle by its handle
• 11 Months: places objects into a container, neat pincer grasp
• 12 Months: tries to build a two-block tower w/out success, can turn pages in a book

Question 14

Sensorimotor Phase

0-24 months

Answer 14

• Reflexive Stage: based on reflexes
  > sucking, rooting, grasping, crying
• Primary Circular Reactions Stage: grab w/ intention, won’t shake it yet
  > simple repetition; coordinating movements
  > reflexive behavior is replaced w/ voluntary acts
• Secondary Circular Reaction Stage: begin to manipulate
  > imitation of familiar behaviors
  > separation from envir’t
• Coordication of Secondary Schemas
  > intentional, goal-directed behavior
  > object permanence

Question 15

Trust v. Mistrust

erikson - psychosocial

Answer 15

• Infants trust tht their comfort needs will be met; wait for hunger ques
  > feeding, comfort, tactile stimulation
• Mistrust
  > occurs when gratification of needs is delayed
  > can occur from too much or too little frustration (control of envir’t)
• Task: attachment to primary caregiver
  > successful: trust! faith/hope in envir’t & future
  > unsuccessful: difficulties r/t ppl effectively, suspicion, fear of future
  Children who learn to trust caregivers in infancy will be more likely to form trusting relationships w/ others throughout course of their lives

Question 16

Social Development

Answer 16

• Human contact!
• Attachment
• Separation anxiety being around 4-8mnths
• Stranger fear begins around 6-8mnths
• Language Development:
  > 3-4 months: coos/babbles
  > 5-6 months: “talk back” (realization tht speech influences others)
  > 8-9 months: begin to understand simple commands like “wave bye-bye”
  > 10-12 months: says around 5 words
• if these are not getting met, check hearing first!

Question 17

Development of Body Image

Answer 17

• Concept of object permanence is acquired
• Development of body image parallels sensory motor development
• Anesthetic & tactile experiences are children’s 1st perceptions of their bodies
• By end of 1st yr, children recognize tht they are distinct from parents

Question 18

Age-Appropriate Play

Answer 18

• Solitary Play
  > primarily narcissistic & revolved around own body
  > by 3-6mnths; infants show more discriminant interest in stimuli & begin to play alone w/ rattle or soft toy
  > 6mnths-1yr; play involves sensorimotor skills

Question 19

Age-Appropriate Activities

Answer 19

• Games: peekaboo, patty cake
• Verbal repetition & imitation of gestures
• Although solitary play dominates, the child may choose w/ whom they prefer to interact
• Types of Toys:
  > rattles
  > soft, stuffed toys
  > blocks
  > mirrors
  > balls
  > nesting toys
  > books

Question 20

Health Promotion - Sleep/Rest

Answer 20

• Sleep patterns vary among infants
• 2 month olds need around 15hrs of sleep
• 12 month olds need around 13hrs of sleep
• By 3-4mnths, night sleep lasts 9-11hrs
• Infants are naturally active

Question 21

Health Promotion - Dental

Answer 21

• Cleaning: begins when primary teeth erupt
• 6-8 Months: teething
• Prevent dental caries
• No bottle propping
• No milk in bed
• No fruit juices

Question 22

Immunizations - Birth

Answer 22

• Hepatitis B
• 3 doses; begin at birth

Question 23

Immunizations - Two Months

Answer 23

• Rotavirus: 2 doses; beginning at 2mnths
• DTAP(diptheria, tetanus, acellular pertussis): 3 doses; beginning at 2 mnths
• Haemophilus influenza B: 3 doses, beginning at 2 mnths
• PCVB (pnuemococcal conjugate): 4 doses; beginning at 2mnths
• Polio: 3 doses; beginning at 2 months

Question 24

Immunizations - Six Months

Answer 24

Influenza: annually beginning at 6 months

Question 25

Immunizations - One Year

Answer 25

• MMR (measles, mumps, rubella): 2 doses; beginning at 1yr
• Varicella: 2 doses; beginning at 1yr
• Hepatitis A: 2 doses; beginning at 1yr

Question 26

Nutrition

Answer 26

• First 6 months of life: human milk/formula
• Supplements
  > vit D, iron (iron for BF babies)
• Second 6 months:
  > intro of solid foods
  > weaning fromo breast or bottle
  > no list: cows milk till after 1yr, honey, popcorn

Question 27

Injury Prevention

Answer 27

• Motor vehicle safety
  > 5 point harness, chest piece even w/ armpits
  > rear facing for first 2yrs
• Burns (electrical, water)
• Aspiration
• Falls
• Poison
• Bodily damage
• Drowning

Question 28

Nursing Role in Injury Prevention

Answer 28

• Ensuring safety in home
• Teaching infant CPR
• Anticipatory Guidance; care of families