Health Promotion of the Infant - Adolescent

Question 1

How would you determine how many teeth an infant should have?

Answer 1

You get the age of child in months – 6 = number of teeth

Ex: 8 month old child – 6 = should have 2 teeth

Question 2

What are some child rearing approaches for children with intense temeraments?

Answer 2

Parents should not self-blame; establish and adhere to routines; remain calm during difficulty

Question 3

What are nightmares and when do they occur?

Answer 3

Nightmares: second half of night; scary or bad dream followed by awakening; often crying and able to recount the dream

Question 3

When school age children externalize stress they may display what behaviors?

Answer 3

Agression and delinquency

Question 4

Describe thumb sucking / pacifier use in infants, when does it peak, and what are some potential problems associated with it?

Answer 4

• Sucking is reflexive and pleasurable for infants
• Pacifier use controversial
• AAP: recommends use of pacifiers up to 6 months and wean second 6 months
• Pacifier use should not replace feeding
• Thumb sucking peaks 18-20 months, mostly when hungry, tired or feeling insecure
• Potential for malocclusion if thumb sucking > 4 years or when permanent teeth erupt
• Cultural variations

Question 5

When school age children internalize stress they may display what behaviors?

Answer 5

• May be Withdrawan
• Have delaying tactics
• Daydreaming a lot

Question 6

Define growth

Answer 6

It is an Increase in physical size

Question 6

How would you care for an infants primary teeth once they erupt?

Answer 6

• When primary teeth erupt: clean teeth and gums with damp cloth
• —Switch to soft-bristled toothbrush when more teeth erupt and routine established; use water instead of toothpaste
• —Begin fluoride at 6 months if not receiving fluoridated water
• —First dental visit by 1 year

Question 7

Describe the easy or flexible temerament style

Answer 7

The infant is happy, regular in sleeping and eating habits, adaptable, calm, not easily upset; even tempered

Question 8

Define development

Answer 8

A sequential process by which infants and children gain various skills and functions

Question 8

What is Telegraphic speech?

Answer 8

Speech that contains only the essential words to get the point across, common in toddlerhood.

Ex: instead of the toddler asking, “I am very hungry!”, the toddler would say, “I hungry”

Question 9

Define maturation

Answer 9

An Increase in functionality of various body systems or developmental skills

Question 11

Describe the nutritional needs of an infant druing the 1st 6 months of life

Answer 11

• Human milk is the best source of nutrition
  
  • Vitamin D 400IU/day for exclusively breastfed infants + iron supplements at 4-6 months
• Iron supplements not needed if taking iron-fortified cereal
• Commercial iron-fortified formula supplies all nutrients
• Not acceptable: whole, low-fat or skim milk for infants < 12 months
• Avoid honey (because of botulism), juices, carbonated beverages
• No water for infants. It takes of place in stomach of formula. > 6 months they can start taking in extra water

Question 14

What are some immunologic system changes seen in newborns?

Answer 14

• Newborns receive large amounts of maternal IgG for the first 3 months
  
  • This confers immunity for antigens to which the mother was previously exposed.
  • Infants synthesize their own IgG, reaching approximately 40% of adult levels at age 12 months.
• —IgM is produced in significant amounts after birth, reaching adult levels by 9-12 months.
• —IgA, IgD, IgE production increases gradually, maturing in early childhood.

Question 15

What are tanner stages?

Answer 15

They physical measures of the hormonal changes that are responsible for the dramatic changes in secondary sexual characteristics that occur during puberty

Question 16

What is the leading cause of fatal injury in children < 1 years old?

Answer 16

Aspiration is the #1 cause of fetal injury to children <1 years of age; so make sure you keep small objects out of the child’s reach!

NOTE: If the child is to eat hotdogs, make sure to have them cut into irregular pieces to prevent aspiration

Question 17

What is crawling?

Answer 17

moving forward with belly on the floor pulling with arms and pushing with legs

Question 18

What is creeping?

Answer 18

moving on hands and knees with stomach up; “on all 4’s” (by 9 months)

Question 19

Describe the intense / less predicable temperament style

Answer 19

The infant has constant activity; easily distracted; cries often loud and intense; difficult to sooth when fussy; light sleepers; require great deal of attention from parents

Question 19

What sre some stress responses to be investigated further by the nurse in school age children?

Answer 19

• Stomach pains or headache
• Sleep problems
• Bed-wetting
• Changes in eating habits
• Aggressive or stubborn behavior
• Reluctance to participate
• Regression to earlier behaviors (e.g., thumb sucking)

All of these indicate the child is stressed

Question 20

When a child has a question about sexuality, how should the parent respond?

Answer 20

Find out what the child knows and thinks

• Give correct and accurate information
• Answer only what is being asked

Answer honestly in a developmentally appropriate manner

• Use anatomically correct words
• Keep answers factual

Question 21

What is acrocyanosis?

Answer 21

• Cyanosis in the hands and feet, and this is normal in newborns
• You don’t want to see central cyanosis (in face and mouth)

Question 22

Describe the nutritional needs of an infant druing the 2nd 6 months of life

Answer 22

• Human milk or iron-fortified formula continue to be primary nutrition
  
  • As solid food consumption increases, the quantity of milk should decrease
• 4-6 months: physiologically and developmentally in a transition period to solid foods (they can start eating solid foods if ready)
• Iron-fortified rice cereal (mixed with breast milk or formula) first choice
• Introduce one solid food every 5-7 days; pureed vegetables and fruits
  
  • 1 tbsp per year of age (i.e. ½ tbsp at 6 months)
• Safety and digestibility: stay away from – nuts, small hard food (raw carrots), grapes are choking hazards

Question 23

What is the nurse’s role in childhood health promotion / health maintenance?

Answer 23

Assessment of the family/child:

• Make sure the child is getting age appropriate screening tests
• Conduct developmental surveillance
• Obtain a health history
• Conduct a physical exam
  *

Question 24

What is Adrenarche?

Answer 24

A period in which the child’s body is getting ready for puberty via hormones, starts around 6 years old

Question 26

What are some child rearing approaches for children with slow to warm temeraments?

Answer 26

They need gradual adapt to new situations, people without pressure from parents; watch for overstimulation

Question 27

What is the nurse’s role in sex education for the school age child?

Answer 27

• Treat sex as a normal part of growth and development
  
  • Make sure to answer questions using correct terminology
• Make sure the child knows how to differentiate between sex and sexuality
• Have open communication with the parents

Question 28

What is physiologic anemia for infants and what causes it?

Answer 28

• Maternal iron stores are transferred to the fetus during the last 3 months of gestation
• —At birth there are large amounts of fetal hemoglobin (HgbF)
• After birth the production of HgbF ceases resulting in physiologic anemia at 2-3 months
  
  • HgbF has short lifespan
  • HgbF ↓’s the production of erythropoietin
• Adult hemoglobin (HgbA) begin to increase during first 6 months & maternal iron stores are present until 5-6 months of age.
• —Premature infants do not receive maternal iron stores

Question 29

Describe the slow to warm or cautious temperament style

Answer 29

The infant is less active, fussy, withdraw to new situations but may become more comfortable with repeated exposure

Question 30

What are some child rearing approaches for children with easy/flexible temeraments?

Answer 30

Remind parents that child still needs parental time and attention even if undemanding

Question 31

What are the 4 stages of attachment, and when do they occur?

Answer 31

1. First few weeks: responds indiscriminately to anyone
2. 8-12 weeks: cry, smile, vocalize more to mother
3. 6 months: shows distinct preference for the mother
4. After 1 month of attachment to mother, infant begins attaching to other members of the family, most often father

Question 32

What are some symptoms of teething in infants, and what could be done about the discomfort?

Answer 32

• There is discomfort from inflammation as tooth breaks through periodontal membrane causing:
  
  • Drooling, ↑ finger sucking, biting on hard objects -> irritability, difficulty sleeping, mild fever, ↓ appetite
• The parents can use a frozen teething ring, ice cube wrapped in washcloth, topical anesthetic, OTC meds to reduce fever

Question 33

When should an infant begin getting fluoride supplementation?

Answer 33

The infant should begin getting water supplementated with fluoride at age 6 months if the child is not drinking adequate amounts of fluoridated water. Supplementation is not recommended before age 6 months regardless of whether the mother drinks fluoridated water.

Question 34

What are some effective communciation tips to use with school age children? There parents?

Answer 34

Ask child structured questions:

• School/physical activities
• Relationships
• Typical day

Ask parents open-ended and structured questions:

• Nutrition
• Physical activity
• Mental health status
• Body image/sexuality

Question 35

What are some risks that can lead to poor dental health in infants?

Answer 35

• propping milk bottle
• giving milk in bed
• fruit juice before 6 months

Question 36

What are night terrors and when do they occur?

Answer 36

shortly after falling asleep; screaming & thrashing; does not respond to parent’s soothing and has no memory of event