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Pediatrics > Infant Growth And Development > Flashcards

Infant Growth And Development Flashcards

1
Q

Growth

A

Inc in physical size of a who or any parts; corresponds to chronological age

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2
Q

Development

A

Continuous, orderly series of conditions that lead to activities, new motives for activities, and eventual patterns of behavior; based on the oldest standard (ex: 15 months is the oldest age for walking)

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3
Q

Are patterns of growth and development universal and basic to all humans?

A

Yes

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4
Q

Cechalocaudal

A

Grows head first

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5
Q

Proximodistal

A

Grows trunk and center body first and extremities and digits last

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6
Q

Differentiation

A

Grows with gross motor control before fine motor control

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7
Q

Critical periods

A

Skill/body part must develop in this time for full development

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8
Q

Sequential trends

A

Stages, critical periods, positive and negative stimuli

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9
Q

Factors influencing development

A

Genetics, nutrition, prenatal and environmental factors, family and community, cultural factors

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10
Q

Prenatal Period

A

Germinal, embryonic, and fetal

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11
Q

Germinal stage

A

Conception to 2 weeks

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12
Q

Embryonic period

A

2 weeks to 8 weeks

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13
Q

Fetal period

A

8 weeks to 40 weeks (birth)

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14
Q

Neonatal

A

Birth to 28 days

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15
Q

Infancy

A

1 month to 12 months

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16
Q

Why do we need to learn G&D?

A

Anticipatory guidance—prepare parents for future, know what to expect at various stages, gain better understanding of reasons behind illness, enhance social development, community relationship, school and life achievement

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17
Q

Infancy weight

A

Lose up to 10% of initial birth weight in the first 2W but gain 1 oz/day until 6M; double weight by 6M, triple by 1 year

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18
Q

Baby head size and fontanelles

A

0.5 inches/month for first 6M; fontanelles are where plates on the skull come together—assess hydration and intracranial pressure; posterior closes at 6-8W, anterior closes 12-18M; needs to stay open for brain to grow

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19
Q

VS for babies

A

Respirations 30-60/min, HR 100 (sleep)—160 (cry), blood pressure avg 75/42 systolic 60-80, diastolic 40-50; temperature 90-99.5 rectal, auxiliary 97.6-98.6

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20
Q

***Hemopoietic system for infants

A

Fetal hemoglobin present for first 5 months (RBCs live shorter but can carry more oxygen), maternal iron stores diminish at 5-6 months

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21
Q

***GI system G&D for infants

A

digestive system immature (no enzymes) and don’t begin to function until 3 months; drool a lot bc poor swallow reflex; amylase (complex CHO) and lipase (fat) not fxn until 4-6 months; solid food not well tolerated, not broken down; coordination of suck and swallow develops around 4-6 months

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22
Q

***Body fluids for infants

A

Immature kidneys—can’t concentrate urine; total body fluid shift occurs from 75% water at birth primarily in ECF (make babies prone to dehydration)

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23
Q

***Endocrine system for infants

A

Immature; infants vulnerable to imbalances in fluid and electrolytes, glucose concentration, AA metabolism, stress; adipose tissue not initially present and thermoregulation (shiver) develops over first few months

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24
Q

Rooting reflex

A

Appears: birth
Disappears: 3-4M
Elicited by: head midline, stroke cheek
Response: infant opens mouth and turns head to stimulated side

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25
Q

Asymmetric tonic neck reflex

A

Appears: birth
Disappears: 4-6M
Elicited by: with baby supine, rotate head to one side, hold 15 sec
Response: arm and leg extend on facial side, arm and leg on other side flex

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26
Q

Palmer grasp

A

Appears: birth
Disappears: 3-6M
Elicited by: place finger into infant’s palm and press
Response: infant flexes fingers around the finger

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27
Q

Moro (startle) reflex

A

Appears: birth
Disappears: 4M
Elicited by: present loud noise or allow infant’s head to drop slightly
Response: arms spread and fingers extend and then flex, then arms come toward each other, may cry

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28
Q

Infant vision growth

A
  • Birth to 1M—follow object to midline, see 8-10 inches
  • 2M—lift and look—follow person around the room with eyes
  • 3M—interested in faces, begin to associate visual stimuli and event
  • 4M—hand regard—realize hand is there, follows past midline; recognize familiar objects, follow parents
  • 6M—directed reach—reach for bottle or person to pick them up; depth perception
  • 7M—transfer object from hand to hand
  • 10M—object permanence; can remember an object that is hidden from view
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29
Q

***Infant hearing

A
  • Discriminate mother’s voice at birth
  • 3-6M localizes sound; understand a few words (bye bye, so big, no no)
  • 6-12M say first meaningful word
  • 12M hears and follow simple command (no no)
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30
Q

Infant teeth and symptoms

A

First deciduous tooth emerges at 5-6M, may see low grade fever, fussy, swell

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31
Q

Infant taste

A

Well developed—bitter and sour taste resisted and sweet is accepted

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32
Q

Infant gross motor control

A

Newborn’s movements are random and uncoordinated; reflexes perform many bodily functions and responses to external stimuli
- 5M roll from belly to back
- 6M roll from back to belly and sit with support
- 7M sit alone leaning forward on hands (tripod)
- 8M infants sit UNSUPPORTED and unassisted
- 10M can go into sitting position from prone or supine

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33
Q

Infant head control

A

1M - marked head lag
By 3M - can hold head up
By 4-6M - well-established head control

34
Q

Tummy time

A

Lay infant on belly to get them to roll onto their back—very important; should always be supervised

35
Q

Infant gross locomotion

A

4-6M - inc coordination in arms, can push self backwards with arms
8-10M - can crawl forward on belly first
11M - able to creep on hands and knees (belly off floor)
6-7M - bear all their weight on legs
9M - can pull up on things (pull on furniture to stand but fall when let go)
10-12M - cruise (hold onto things to step)
12M - walks well with one hand held; step ind soon after
15M - WHEN MOST BABIES WALK WELL

36
Q

Walkers for babies

A

4 wheel things that you put the baby in to help them walk - NOT recommended bc puts spine in wrong position and can get them in bad spots

37
Q

Infancy fine motor development

A

1-3M - only reflexes that are replaces by voluntary grasps
1M - hand mostly closed
3M - desires to grasp—voluntary, not reflexive anymore; can bring hands to midline, can hold object put in hand
5M - two-handed voluntary, hold one object while looking at another, grasp object with whole hand
4-6M - intentionally bring things to mouth
6M - holds bottle, grasps feet
7M - can move things from hand to hand
8-9M - pincer grasp begins to develop
11-12M - refined pincer grasp (finger foods help develop)

38
Q

At 2 months infants can…

A
  • hold head erect in mid-position
  • turn from side back
39
Q

At 3 months infant can

A
  • hold head erect and steady
  • open or close hand loosely
  • hold object put in hand
  • desire to grasp
40
Q

At 4 months infant can…

A
  • sit with adequate support
  • may roll over front to back
  • hold head erect and steady while sitting
  • bring hands together in midline and play with fingers
  • grasp objects with both hands
41
Q

At 5 months infants can…

A
  • Balance head well when sitting
  • sit with slight support
  • pull feet up to mouth when supine
  • grasp objects with whole hand (Rt or Lt)
  • hold one object while looking
  • two-handed voluntary grasp
42
Q

At 6 months infant can…

A
  • sit alone briefly
  • turn over completely (abdomen to abdomen)
  • lift chest and upper abdomen when prone
  • hold own bottle
  • grasps own feet
43
Q

At 7 months infant can…

A
  • sit alone (tripod)
  • hold cup
  • imitate simple acts of others
  • can move things from hand to hand
44
Q

At 8M infants can…

A
  • Sit alone steadily
  • drink from cup with assistance
  • eat finger food that can be held in one hand
45
Q

At 9M infants can…

A
  • rise to sitting position alone
  • crawl (pull body while in prone position)
  • hold one bottle with good hand-mouth coordination
46
Q

At 10M infants can…

A
  • Creep well (hands and legs)
  • walk but with help
  • bring the hands together
47
Q

11M infants can…

A
  • Walk holding on furniture
  • stand erect with minimal support
48
Q

12M infants can…

A
  • stand alone for variable amounts of time
  • sit down from standing alone
  • walk in few steps with help or alone (hands held at shoulder height for balance)
  • pick up small bits of food to transfer to mouth
  • refined pincer grasp
49
Q

Kohlberg for infants

A

Preconventional—not much moral dev but learn authority is handed down by adult and listen based on reaction they get; morality is external and based on fixed rules

50
Q

Erikson for infants

A

Trust vs mistrust; must be in sync with caregiver; infants can’t tolerate frustration (don’t understand delayed gratification); bc an infant is entirely depending on caretakers, quality of care they receive plays role in shaping child’s personality

51
Q

Piaget for infants

A

Sensorimotor—progress from simple reflexes to simple repetitive acts; begin to use symbols; learn they are separate from others and objects; intelligence takes the form of motor actions
- Birth-1M - reflexive
- 1-4M - primary circular reactions (all about them—movements focused on their own body; awareness of own self, show interest in others)
- 4-8M - secondary circular reactions (interact with environment—cause and effect—kick makes sound or movement)
- 9-12M - coordination of secondary schema (responses are more complex, object permanence around 10-12M, can reach behind something to pick up an object)

52
Q

Infant sexuality

A

Begins at birth from parental feedback (positive and accepting from parents); heightened oral sensitivity, skin to skin contact

53
Q

Infant attachment

A

Depends on infant’s ability to discriminate mother from others and dev of object permanence; parent-infant attachment is critical to mental health (want to see baby cry when mom leaves—realize they care); learn that cry means attn, smile back, fear of strangers, responds to name

54
Q

Infant behaviors influencing attachment

A

Different crying, smiling, vocalization; crying when mother leaves room; visual-motor orientation (look at mom more); approach thru locomotion; clinging; exploring away from mom using her as a base

55
Q

First social smile

A

6-8 weeks—smile in response to a person not an item; learn thru imitation

56
Q

Infant social development timeline

A

1W - preference for human face
6-8W - social smile (smile at human, not bc toy or item)
3M - excitement at new things
4-6M - personable and interactive, not much stranger danger, happy
6-7M - stranger fear—result of parent bond; if infant goes to everyone, parent-baby might not have bonded well
7M - imitate actions and noises show displeasure when things not wanted
8M - imitate sounds (usually consonants; gibberish)
10M - understand simple commands and “on”
12M - v interactive showing pleasure and displeasure, doing some things themselves
9-12M - separation anxiety—fearful of parent leaving

57
Q

Infant effects of prolonged separation

A

Emotional deprivation during first 3Y of life, physical growth slower, more prone to disease and infection; stages are protest, despair, and depression

58
Q

Reactive attachment disorder

A

Occurs after absent or maladaptive attachment; child may refuse eye contact, poor impulse control, destructive to self and others; may become antisocial; nurses can be warm, responsive, interactive with infant

59
Q

Infant sensory development

A
  • birth—hearing and touch well-developed
  • 6Y—sight fully developed
  • 2M—smiles and turns head to locate sounds
  • 6M—taste preferences
  • 7M—responds to own name
  • 12M—able to follow objects
    -1Y—can vocalize 4 words
60
Q

Emotional development

A

Emotions unstable; affection and love for family members
- 10M—expresses beginning of recognizable emotions like anger, sadness, pleasure, jealousy, anxiety, affection
- 12M—clearly distinguishable emotions

61
Q

Infant stress and coping

A

Stresses by caregiver loss, loud noises, lights, sudden movement; don’t understand bodily harm so no fear of needles

62
Q

Infant sleep

A

First 4M, sleep 16-20h/day; by 5M, most infants sleep thru night with 2 daytime naps

63
Q

Infant play (3-6M)

A

Some discriminate interest, at 4M laughs aloud; sensory stimulation (rattles, crinkly books), learn to distinguish self from environment; solitary play for short periods but parents can talk, sing, laugh; appropriate toys are mobiles, mat with dangling things, exersaucer (baby in middle with things around but it doesn’t have wheels)

64
Q

Infant 7-12M play

A

Sensorimotor skills and discriminate btwn who /what they will play with; promote sense of security (push/pull toys, nesting toys); sense of security; gross and fine motor stimulation; beginning casual relationships; object permanence; infants more interactive

65
Q

Is interaction or toy more important?

A

Quality of interaction with people

66
Q

Infant crying development

A

Crying (1-1.5h/day, up to 3W, up to 2-4h/day ay 6W, then Dec); different cries for different needs and wants by end of first year; vocalization begins 5-6W

67
Q

Infant language development

A

2M coos, cry is differentiated
3-4M consonant sounds, laughs aloud
5-7M vowel sounds
8M imitating sounds, combining syllables
9-10M understand simple commands and no
12M say 3-5 words with meaning besides mama and dada

68
Q

Infant hearing

A

Pretty good from birth; BAER hearing test done at birth; ability to hear correlates with ability to enunciate well; ask about hx of otitis media (ear aid device); early referral to MD to assess for possible fluid in ears (effusion); repeat hearing screening test; SLP as needed

69
Q

Red flags in infant development

A
  • can’t sit alone by 9M
  • can’t transfer objects hand to hand by 1Y
  • abnormal pincer grip/grasp by 15M
  • can’t walk alone by 18M
  • can’t speak recognizable words by 2Y
70
Q

***Easy child temperament

A

Self-soothes, laid back, fun, transitions easily, happy; parents need to know they still need to interact and engage

71
Q

***Slow to warm up temperatment

A

Shy, take more time to warm up, may reject or withdraw from new situations; more cautious; parents must be patient, cautiously expose baby; gradually introduce baby to daycare/new situations

72
Q

***Difficult child temperament

A

May not sleep or be able to self soothe, may need constant physical activity, restless, easily distracted, may be very hungry in an angry way; demand lots of attention, need patience and reminder they did not cause this, address feelings of anxiety; consistency very important

73
Q

Nursing care for separation and stranger anxiety

A

Don’t force baby to go to someone they don’t know, be patient, don’t slip out/leave child (tell them you’re leaving and when you’ll be back)

74
Q

Spoiled child

A

Gets what they want when they want it; not confused with ADD or other situations; need consistent, clear guidelines and rules; need to be soothed and loved but need to have tantrums instead of giving in

75
Q

How to set limits for infants

A

Discipline begins 6-18M; set limits to ensure safety, start with strength “no” and negative eye contact, remove child from unsafe situation; use gestures

76
Q

Parachute reflex

A

Begins: 6-8M
Ends: Never
How to elicit: Suspend infant prone and lower quickly toward table
Response: infant should extend arm, hands, and fingers

77
Q

Babinski reflex

A

Begins: birth
Ends: 2 years
How to elicit: stoke the bottom of the sole of the foot going from the heel to the toes
Response: arms spread and fingers extend and then flex, then arms come toward each other; may cry

78
Q

Infancy height

A

Height inc 1 inch/month until 6M, inc height by 50% by 1Y; head grows 0.5 in/M for first 6M

79
Q

Baby hands at 1 month

A

Hand mostly closed

80
Q

When are reflexes replaced with voluntary grasps?

A

After 1-3 months

81
Q

When can babies intentionally bring things to their mouths?

A

4-6M

Pediatrics (26 decks)

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