Infant Development Packet Flashcards
what is the neonate period
first 28 days of life
what is the newborn period
birth to 6 weeks of age
what is the infancy period
2nd month/6 weeks to 12 months
how should you conduct an infant assessment
-General Survey: “Across the Room Assessment”
-History first, touch later
-Observe BEHAVIOR
-Keep infant as warm as possible
-Do least invasive procedures first
-Leave orifices or procedures that invade body integrity to last!
-Use the “trusted lap” as exam surface
-Warm your hands and stethoscope
You are assessing an 8 month old infant. In
which order would you perform vital signs to
ensure obtaining the most accurate data? (Assume T = rectal temp)
a. BP, T, RR, HR
b. RR, HR, BP, T
c. HR, RR, BP, T
d. T, RR, HR, BP
b. RR, HR, BP, T
you want to go from quiet to active, or what’s going to disturb the child least to most
what are proportion changes in the infant
-Weight gain is 5 to 7 ounces per week
-Double the birth weight by age 6 months
-Triple the birth weight by age 1 year
-Height increases by 1 inch per month for 6 months
-Double the length by age 1 year
-Head circumference 1.5 cm/month first 6 months, then 0.5 cm/month between 6-12 months
-Growth occurs in spurts rather than in a gradual pattern
what ages should you use the growth chart
0-36 months
how do you measure an infant’s length
-Recumbent length until 2 yrs
-Head to heel method
-Measuring board for infants
-Plot on CDC gender-specific growth curve
-Look for trends (i.e., jumping/falling off percentile curve)
At birth, Mary weighed 3.5 kg and was 49 cm in length, which placed her in about the 50th percentile for weight and length.
How much would you expect Mary to weigh at her 6 month appointment?
a. 15.4 lbs
b. 7.5 kg
c. 10.5 kg
d. 10.5 lbs
a. 15.4 lbs
An infant’s weight doubles in the first 6 months. 3.5x2= 7kg (x2.2=15.4lbs)
Mary was at the 50th percentile at birth and is at the 10th percentile for weight at her 6 month appointment.
Is this cause for concern? How would you advise Mary’s mother?
a. Yes, Mary’s mother should be referred to a nutrition counselor.
b. Yes, the provider should review Mary’s diet and make recommendations.
c. No, children go up and down on the growth chart and this should just be monitored.
d. No, wait until Mary’s next appointment and see what happens.
b. Yes, the provider should review Mary’s diet and make recommendations.
The trend is what’s important, but the change in percentile shouldn’t be ignored (making C and D incorrect); however, it’s only one data point, so referral to a nutritionist is not warranted yet
when do the suture ridges become unpalpable
6 months
when does the posterior fontanel close
6-8 weeks
when does the anterior fontanel close
12-18 months
how do you measure head circumference
-Usually measured at regular intervals until 3 yrs
-Wrap tape above eye-brow, above ears & over occipital prominence
-Record to nearest .5cm
-Measure 3X, take largest
-Plot on growth chart
-Assess trends
A nurse is assessing a 6 month old infant. The nurse recognizes that the posterior fontanel usually closes at what age?
a. 6-8 weeks
b. 10-12 weeks
c. 4-6 months
d. 8-10 months
a. 6-8 weeks
posterior fontanel closes first, at 6-8 weeks
increased coordination of extremeties begins at what age
4 months
what age do infants start crawling
6-7 months
when do infants start creeping
9 months
what age to infants walk with assistance
11-12 months
what age do infants walk alone
12 months
During a routine health assessment, the nurse notes that the 8-month old infant has significant head lag. Which of the following is the nurse’s most appropriate action?
a. Teach parents appropriate exercises
b. Recheck head control at the next visit
c. Refer child for further evaluation
d. Refer child for further evaluation if anterior fontanel is also open
c. Refer child for further evaluation
8 months is very late for head control (4 months is the milestone), so referral for evaluation is warranted
what are the three important tasks of cognitive development
-separation
-object permanence
-mental representation
explain the development of body image
-Concept of object permanence
-By end of first year, child recognizes that he or she is distinct from the parents
-Increased interest in image
Which of the following behaviors indicates that an infant has developed object permanence?
a. Recognizes familiar face, such as mother
b. Recognizes familiar object, such as a bottle
c. Actively searches for a hidden object
d. Secures objects by pulling at them
c. Actively searches for a hidden object
active searching indicates that the infant recognizes something still exists even when out of sight
what is the first verbal communication
crying
when should infants start vocalization
6 weeks
when should infants start cooing, gurgle, laugh
3-4 months
when should infants imitate sounds
8 months
when do infants understand ‘no’ and follow commands
9-10 months
when should infants ascribe meaning to a word
10-11 months
how many words should infants be saying by 1 year of age
3-5 words
According to the “Talk With Me Baby” video, what is the best predictor of 3rd grade reading outcomes?
a. Parent income
b. Family socio-economic status
c. Parent education level
d. Number of words a child hears
d. Number of words a child hears
the number of words a child hears is the best predictor of 3rd grade reading outcomes
which stage of Erikson’s is a 1 year old infant in
trust VS mistrust
explain social development in infants
-Initially influenced by infant’s reflexive behaviors
-Includes attachment, separation, recognition/anxiety, and stranger fear
-Attachment with caregivers enhanced when infants and parents are in good health, feeding goes well and both receive adequate rest.
when do infants begin to have separation anxiety
4-8 months
when do infants get stranger anxiety
6-8 months
explain temperament in infants
-Influences the type of interaction that occurs between the child and parents
-Temperamental traits are real
-Important for both child and parent
-Best managed by accommodation, not confrontation
-Individualize care
what are parent concerns regarding normal growth and development
-Child-rearing practices related to temperament
-Separation and stranger fear
-Childcare arrangements
-Limit setting and discipline
-Thumb sucking and use of a pacifier
-Teething
A 4-month old was born at 35-weeks gestation. She seems to be developing normally, but her parents are concerned because she is a more “difficult” baby than their other child, who was term. The nurse should explain that:
a. Infants’ temperaments are part of their unique characteristics
b. Infants become less difficult if they are not kept on scheduled feedings and structured routines.
c. The infant’s behavior is suggestive of failure to bond completely with her parents.
d. The infant’s difficult temperament is the result of painful experiences in the neonatal period.
a. Infants’ temperaments are part of their unique characteristics
infant’s temperaments (even difficult ones!) are part of their unique characteristics
what is the role of the nurse with infants
-More than just giving info
-Views family/parents as competent, or capable of being competent
-Responds to needs identified by the parent
-Empowers parents to use knowledge about helping their child grow and flourish
-Identifies “teachable moments”
-Clarifies parental expectations
what are the big four parent concerns
-Development
-Nutrition/Feeding
-Elimination
-Sleep
what is the primary source of nutrition for the first year of life
breastmilk
what provides the complete diet for the first 6 months
breastmilk
are alternative fluids needed in the first 4 months of life
no
when are iron supplements recommended
after the first 4 months
what is weaning
Weaning from breast or bottle to cup after 1 year
What information should the nurse give a mother regarding the introduction of solid foods during infancy?
a. Solid foods should not be introduced until 8 to 10 moths, when the extrusion reflex begins to disappear.
b. Foods should be introduced one at a time, at intervals of 4 to 7 days.
c. Solid foods can be mixed in a bottle to make the transition easier for the infant.
d. Fruits and vegetables should be introduced to the diet first.
b. Foods should be introduced one at a time, at intervals of 4 to 7 days.
This is to detect allergies
what should you do during a nutrition physical assessment
-General survey
-Skin/hair/nails
-Dentition
-Anthropometric measures
-Weight
-Length
-Head circumference
-Weight/stature
-Percentile rank
what age should infants have their first dental appointment
6-12 months
how many hours of sleep should a 3-4 month old get
15 hours
what are common problems related to sleep
-Poorly organized sleep cycles
-Family stress and decreased coping
Which of the following is not true regarding tummy time? (Refer to healthychildren.org reference on slide 57)
a. Some babies don’t seem to like it
b. Parents should wait till the baby can lift her head to begin tummy time.
c. Tummy time can be done on the parent’s chest when the parent is lying down
d. Parents can place a toy just out of reach to encourage the baby to reach for it
a. Some babies don’t seem to like it
explain elimination in infancy
-Urine: Color/odor, Frequency, Hygiene (males and females)
-Stool: Frequency, Color/odor/consistency (breast vs bottle)
what does breast fed stool look like
-Golden yellow
-Often right after a feed
-Looser
-“Seedy”
what does formula fed stool look like
-“Peanut butter”
-Less frequent
-Soft, slightly firm
-Dark color if Fe in formula
how do you help diaper rash
-Use absorbent diapers
-Change as soon as soiled (urine and feces together = > pH)
-Dry to air
-Apply ointment as skin barrier
-Avoid over-washing
-Use non-soap cleanser
-Use non-irritant wipes (detergent and alchohol free)
-Use cornstarch, not talc
what are common health problems related to elimination
-Constipation: Alteration in frequency, consistency or ease of passing stool, More frequently seen in formula fed infants
-Diarrheal illnesses: Passage of loose or watery stools, increase in frequency of stools, Most often caused by viral infection, In US rota virus, Dehydration and electrolyte disturbance
You are the nurse in a well child clinic. A mother who has been exclusively breast feeding her 2 wk old infant since birth is worried because the baby is having four to five golden-yellow stools/day. There are no other findings. You would advise her that:
a. This stool description is normal for a breast fed infant
b. This is most likely a sign of GI infection
c. She should switch her infant to formula feeding
d. It’s time to add infant rice cereal to the infant’s diet
a. This stool description is normal for a breast fed infant
golden yellow stools are normal for a breast fed infant
what are recommended vaccines for infants
-Hepatitis A and hepatitis B
-Diphtheria, tetanus, pertussis (DTP)
-Polio (IPV)
-Rotovirus
-Measles, mumps, rubella (MMR)
-Varicella
-Haemophilus influenzae type B (HIB)
-Pneumococcal (PCV7)
-Influenza (annually)
what are contraindications/precautions for vaccine administration
-Severe febrile illness
-Immunocompromised child or household member
-Recently acquired passive immunity (blood transfusion, immunoglobulin, or maternal)
-Known allergic response
-Parental fears, misinformation, and questions
-Religious beliefs
what are typical injuries that you want to avoid in infants
-Aspiration of foreign objects
-Suffocation
-Motor vehicle injuries
-Falls
-Poisoning
-Burns
-Drowning
-Bodily harm
