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PEDS > newborn & infant development exam 1 > Flashcards

newborn & infant development exam 1 Flashcards

1
Q

When do fontanels close?

A

12-18 months anterior & 2-3 months posterior

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2
Q

Infant HR listen to

A

4th-5th intercostal space medial to L of midclavicular line = PMI

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3
Q

Parent-NB bonding 1st & 2nd step & Assessment

A

Nurses can positively influence the attachment of parent and child.
1st: recognize individual differences
2nd: enhance the infants development during wakeful Hrs

Assess: proximity, reciprocity and commitment and paternal engrossment fam-centered care involving siblings

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4
Q

Biologic development (1st 6 mo)

A

birth weight doubles
grows 1” per mo in length
head circumference increases 1/2” per mo
grasps as reflex, more with eyes, palmer grasp between 4-6 mo head control est.
tooth eruption begins
turns from abd to back at 6 mo

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5
Q

biologic development (7-12 mo)

A

birth weight triples by end of 1st yr
grows 1/2” per mo in length (mostly in trunk)
manipulates items: pulls to mouth, pincer grasp
head control > straightening of back > then sitting
sit alone by 7 mo and sit > explor from sitting at 8 mo

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6
Q

Psychosocial development

A

Erikson: Developing a Sense of Trust
-Acquiring trust while overcoming mistrust

Failure to learn “delayed gratification” leads to mistrust

Two oral-social stages: food intake (first 3-4 months) & grasping or biting possibly due to teething

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7
Q

Cognitive development

A

Separation: learn to separate themselves from others

Object permanence: realization object exists even if not visible (9-10 mos)

Mental representation: symbol allows infant to think of object without actually experiencing it

use of reflexes: sucking, rooting, crying, grasping

primary circular reactions: replacing reflexes with voluntary acts

secondary circular reactions: shaking or banging are done not just for the motion but for the sound (time and space)

Imitation: smiling to receive a smile

Play: pleasure at mastering a skill

Affect: manifestation of emotion and feeling, Develop sense of permanence, Critical to parent-child relationship, and Leads to stranger anxiety

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8
Q

the ability to know - piaget

A

cognition

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9
Q

birth to 24 mos, what phase is the infant in?

A

sensorimotor phase

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10
Q

Social development sequence and by when?

A

Regards faces (1 mo)
Smiles in response to other (2 mo)
Smiles at self in a mirror (4 mo)
Begins to fear strangers (6 mo)
Looks for a dropped object (6 mo)
Plays peek a boo (7 mo)
Responds to “ NO” (8 mo)
Waves goodbye (10 mo)
Plays pat a cake (10 mo)

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11
Q

age appropriate toys for the 1st yr

A

Rattles
Mobiles
Teething toys
Nesting toys
Playing with balls
Reading books

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12
Q

Fine motor sequence and expected age?

A

Brings hands together (3 mo)
Grasps rattle voluntarily (5 mo)
Plays with toes (5 mo)
Transfers hand-to-hand (7 mo)
Rakes finger food w/hand (7 mo)
Thumb-finger grasp (9 mo)
Compares two cubes (9 mo)
Nests objects (12 mo)
Turns pages of a book (12 mo)

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13
Q

Vocalization development

A

Can distinguish cry by 2month
Pleasure squeal by 3 months
Belly laugh by 4 months
May try to imitate sounds by 6 months
Dada by 7 months
Says Mama and Dada with meaning by 10 months
Should say 3-5 words by 12 months

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14
Q

What is colic?

A

vigorous crying & drawing legs to abdomen

most common < 3 months, can occur birth - 6 mos

paroxysmal abdominal pain or cramping

specific cause is rarely identified

onset usually late in afternoon

episodes last from 30 min to greater than 3 hours

between crying periods usually happy

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15
Q

How do you help colic?

A

Rule out organic causes
May try a different formula
Use of anti-spasmotics, sedatives , antihistamines or anti-fluctuents
Nursing mothers may need to change diet
Position changes
Caregiver support!!!!!

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16
Q

What do we know about teething?

A

deciduous (baby) teeth erupt between 6 -10 mos

age in months-6 = # of teeth (up to 2 years-of-age)

symptoms: irritability, difficulty sleeping, refuses to eat, drooling, chewing or biting

do not belittle beliefs & concerns or discourage home remedies unless harmful (repatterning)

firm & cold chewing objects, OTC analgesics, no aspirin

Acetaminophen

17
Q

What is the infant dosage for acetaminophen?

A

10 - 15 mg/kg per dose-max. 5 doses/day

18
Q

What is important to know about infant sleeping?

A

Co-sleeping may have cultural significance

AAP recommends:
baby sleep in close proximity in own bed, avoid soft bedding, smoking, overheating, prone position, baby sleeping on couch or armchair

newborn sleeps 16-20 hrs, awake 6 x to feed

1-3 month: 10-16 hrs in 30 min-3hr periods

3-6 month: 14 hrs, longer at night + 2-3 day naps

6-12 month: 12-14 hrs with 1-2 day naps

19
Q

What is important to know about daycare?

A

records available to public (including periodic evaluations of facility)

teacher qualifications

nurturing characteristics of workers

child-staff ratio

discipline policy

environmental safety precautions

provision of meals

20
Q

What is important to know about abuse?

A

Family violence within home

May occur across economic & educational backgrounds

Physical, sexual, emotional, neglect

Mandatory reporting laws require nurses to report suspected abuse (civil and criminal penalties)

At risk: under 3 yrs of age, &/or physically disabled – of unwanted pregnancy – trait making him vulnerable

Almost always-perpetrator felt child was different

21
Q

What is important to know about injury prevention?

A

suffocation: plastic, pillows, crib slats, bath tub

falls: rails up, carseat, gates on stairs

poisoning: lead, toxins & plants, lock cabinets, meds

burns: bath water, smoke, stove, cords, electrical sockets

motor vehicles: rear-facing carseat in backseat

abuse: give caregiver education & allow them to say they are tired/frustrated/at risk, give support

22
Q

Nutritional development (1-6 mo)

A

Support breastfeeding efforts

Vitamin D (200 IU/day)

Infants do not require additional fluids

Teach iron-fortified formula preparation (do not microwave)

Feed formula 6 x daily

Cereal – rice low allergy – 4-6 mos – iron fortified

23
Q

Nutrition development (6 mo)

A

Formula or breastmilk 4-5 x daily

Fruits & veggies: 6-8 mos

Meat, fish, poultry: 8-10 mos, commercial low protein, include organ meat high iron

Finger foods: 6-7 mos –teething cracker, fruit/veggie

Chopped table or junior foods: 9-12 mos

Introduce when hungry-one at a time

Spoon feed pushing food to back of tongue

24
Q

What is protein-energy malnutrition (PEM)?

A

chronic illnesses such as CF, renal dialysis, GI malabsorption, anorexia

25
Q

What is Kwashiorkor?

A

High starch diet, fed only rice beverage diet, parental ignorance, cow’s milk intolerance=muscle wasting, skin depigmentation, blindness due to Vit A deficiency

26
Q

What is food allergy/hypersensitivity or intolerance?

A

Cow’s milk, lactose, wheat, nuts (lactose intolerance use probiotics)

27
Q

What do you need to know about kids with feeding disorders?

A

Regurgitation vs spitting up

Failure to thrive
organic- physical cause
nonorganic FTT – unrelated to disease (usually social)
idiopathic FTT – unexplained by the usual organic/environmental etiologies

Factors leading to NFTT: poverty, beliefs, knowledge deficit, stress, resistance, or insufficiency

28
Q

What is failure to thrive?

A

in infants or children is manifested as inadequate growth resulting from inability to obtain or use calories required for growth.

It is usually described in an infant or child who falls below the 5th percentile for weight (and possibly for height) or has persistent weight loss.

29
Q

What do you need to know about feeding the child w/ FTT?

A

Consistent “primary” caregiver
Non-stimulating atmosphere
Maintain calm, even temperament
Talk to the child giving directions about eating
Be persistent
Maintain face-to-face posture
Introduce foods slowly
Follow the child’s rhythm
Develop structure

30
Q

What is sudden infant death syndrome?

A

SIDS
death of child under 1 yr with unexplained etiology after postmortem exam

unknown etiology

risks:
maternal smoking (12%)
co-sleeping
prone sleeping in soft bedding –overheating

infant was apparently healthy

not caused by suffocation –no identifiable cause

31
Q

SIDS risk factors?

A

Maternal health during pregnancy
Twins
Preemie
SGA
Persistent apnea
BPD (bronchopulmonary dysplasia)
Family history of SIDS
Environment

32
Q

What is apnea and what are the causes?

A

20 sec or more cessation breathing

causes: sepsis, seizures, neurologic disorders, upper or lower respiratory infection, GE reflux, hypoglycemia, metabolic problems

33
Q

What is apparent life threatening event (ALTE)?

A

possibly apnea, gagging, or coughing possibly requiring CPR

head injury (abusive), intentional suffocation, Munchausen by proxy, ½ the cases = no cause identified

34
Q

What is the management of apnea?

A

Depends on cause
CP monitor at home
Medications like theophylline or caffeine
CPR training for parents

PEDS (31 decks)

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