Newborns and Infants Flashcards
What is the age range of a newborn?
Up to 28 days
What is the age range of an infant?
28 days to 12 months
During an assessment of newborns and infants, what percentage is subjective information?
80%
During an assessment of newborns and infants, what percentage is objective information?
20%
How often should preventative care wellness visits be?
For milestones (9 months)
When getting a health history of an infant, what do we need to know that would not necessarily apply to the health history of an adult?
Mother’s number of pregnancies, neonatal diseases of mom, medications taken by mom, alcohol and drug use of mom, etc.
What should happen within the first hour of birth?
Breastfeeding
Skin to Skin
Weight, length, and head circumference
Eye prophylaxis
Vitamin K
Pulse ox
Hep B
Newborn metabolic screening
Newborn hearing screening (first few days)
What does APGAR measure?
How to baby is transiting from the uterus to the world (adapting)
What does APGAR stand for?
Appearance
Pulse (HR)
Grimace (reflex irritability)
Activity (muscle tone)
Respirations
Is an APGAR of 8 good or bad?
Good
What APGAR score is concerning
7 or less
What timeframe is early preterm?
less than 32 weeks
What timeframe is preterm?
32 to 37 weeks
What timeframe is late preterm?
34 to 37 weeks
What timeframe is term?
37 to 41 weeks
What timeframe is post term?
After completion of week 42
What is there an increased risk of complications post term?
Placenta becomes less effective. Begins to age and does not perfuse well enough.
How do you determine disposition?
Are they consolable? crying? calm? sleepy?
What might be happening if the newborn/infant appears cyanotic during feeding?
Possibly heart issues
What is SIDS (sudden infant death syndrome)
Unexplained death, usually during sleep. Baby appears to be healthy. Less than 1 years old
What increases risk for SIDS
Put baby to sleep on side or stomach, smoking near baby, low birth rate/pre mature, overheating, baby sleeping on soft surface/comforter, family hx, maternal use of drugs/alcohol, male, nonwhite
What is included in breastfeeding assessment
Latch and milk transfer
Suck and swallow coordination
Maternal milk supply
weight gain and output
What is included in formula feeding
Tolerance of formula (GI upset)
Milk flow through nipple
Weight gain and output
At what point in gestation does the suck and swallow reflex develop?
34 to 35 weeks
What is the Denver Developmental Screening Tool?
Assess developmental progress
Motor development in 4 areas
What are the four areas for the Denver Developmental Screening Tool?
Gross motor skills
Fine motor & adaptive skills
Language
Personal/Social development
What is the M-CHAT and when do we use this?
Assessing for Autism at 18 to 24 months
At what age do babies coo?
2 months
What age do babies laugh and squeal?
4 months
At what age do babies sit alone/crawl?
8 months
At what age do babies say “dada/mama” and stand alone?
1 year
At what age do babies walk?
9 to 18 months
At what age do babies feed themselves?
18 months
At what age do babies have a 250 word vocabulary and run well?
2 years
What is the stepping reflex and when does it disappear?
Baby moves their leg up, disappears at 2 months
What is the moro reflex and when does it disappear?
Startle reflex (starfish), disappears at 3 months
What is the rooting reflex and when does it disappear?
When you touch their cheek, they turn that way, disappears at 3-4 months
What is the Palmar grasp reflex and when does it disappear?
Baby grip, disappears at 3-4 months
What is the tonic reflex and when does it disappear?
Fencing / Archery pose reflex, disappears at 4-6 months
What is the swimming/parachute reflex and when does it disappear?
When you got put the babies down, they put their arms and legs to smooth the landing, disappears at 4-6 months
What is the plantar grasp reflex and when does it disappear?
The curl their toes around your finger, disappears 8-10 months
What is the sucking reflex and when does it disappear?
If you tickle the roof of their mouth, their suck on the finger. Disappears at 10-12 months
What is the Babinski reflex and when does it disappear?
Disappears at 2 years, but if it prolongs it may indicate a neurological issue
What the flow of assessment?
clean to dirty OR quiet to dirty
Why is the weight and height of the baby important
Progression of growth
Why is the head circumference of the baby important
Hydrocephalis
Why is the birth chest circumference of the baby important?
To look at if everything is in alignment
What are fontanels?
They are the soft spots of the skull. It allows for movement of the skull during birth.
At what age does the posterior fontanel close?
2 to 3 months
At what age does the anterior fontanel close?
18 months
What happens if the fontanels close too early?
Misshapen head and brain damage
Why might the fontanel buldge?
It can be from the baby’s position laying down, crying hard, or vomiting. It changes back to flat once the event is over or the position is changed.
Caput Succedaneum
Posterior megamind. Reabsorbed after birth and is a normal finding.
Cephalohematoma
Small hump/bump on the side of the head. Collection of blood that is reabsorbed after birth. Normal.
The nurse is assessing the anterior fontanelle of a 4-month-old infant brought to the clinic for a well-child examination. What would the nurse expect to assess?
Closed fontanelles
Milia
Little white bumps/crusties around the baby’s face
Lanugo
Hairy baby
Vernix
Baby covering in “cream cheese” it’s a white/creamy biofilm to protect the baby
Congenital Dermal Melanocytosis
Also known as Mongolian spots. Seen in infant in african, hispanic, asian descent. Blue-grey spots that will disappear
Port-wine stain
Red “stain” on face. Blood vessels are too close the surface and has to be treat with laser therapy which can be started after the first few days of birth.
Strawberry hemangioma
Red bump that gets lighter and shrinks over time. Only concerning when it develops on the eyelid which may interfere with vision
Telangiectic Nevi
Fades on its own. Dilated blood vessel.
Cradle cap
Crusty oily patches of skin on the baby’s scalp
Sacral dimple
Small indentation of the lower back (usually benign unless there is a hair of a skin tag on it)
Congenital torticollis
Head position from utero. Can be resolved with stretch and physical therapy. Can affect milestones (lifting head, rolling, etc.)
Cafe au liat spots
A spot that looks like a birthmark. Resolves on its own.
A clinic nurse is assessing a 6-month-old infant prior to the administration of scheduled immunizations. The nurse should anticipate that the infant’s resting heart rate will be..
~ 110 beats/min
What is parallel play? What age group is this found in?
Toddlers play alongside, not with, others.
What is the most common form of play among toddlers?
Imitation is one of the most common forms of play
What is associative play? What age group is this found in?
Typical in preschoolers where they are interactive and cooperative with sharing
Give examples of associative play materials
dress-up clothes and dolls, housekeeping toys, play tents, puppets, and doctor and nurse kits
What is competitive play? What age group is this found in?
Play becomes more competitive and complex during the school-age period.
The nurse is performing an otoscopic examination of an infant’s ears. What action would the nurse do?
Pull down and back
When assessing the infant’s eyes, what finding would the nurse consider to be common but abnormal?
The infant’s sclerae have a yellowish tint.
When and where is cyanosis on a newborn expected versus unexpected?
It is normal for the hands and/or feet may appear blue (acrocyanosis). But central cyanosis is unexpected.
The newborn’s visual impressions are unfocused, and the ability to distinguish between colors is not developed until
8 months
At what age do teeth root in children?
6 years of age
