Well child Flashcards
Scheduled visits at
Birth 3-5 days (2-3 days after d/c) First year: 1,2,4,6,9,12 months old Then 15 and 18 months, 2 years after 2 years: yearly
Teaching for infants Bottlefeeding Skin care Bathing Fontanelle
Bottlefeeding q 2-3 hours at first then spreads out
Skin- johnsons
Bathing- no water until cord dries
Fontanelle- no harm if touched, anterior and posterior, allow overriding of sutures through canal and so brain can grow
ADLs *** - - - - Screenings
different than with adults
-nutrition (baby-BF/formula, toddler- want separate foods)
-sleep (through the night, naps, # hours, toddler/school age bedtime routine)
-elimination (i.e. potty training)
-development
Ht/wt, head circumference (birth to 2 years) vision hearing lead hematocrit
Age ranges Infant Toddler Preschool School age Adolescent
infant- birth to 1 toddler- 1 to 3 preschooler- 3-6 school age- 6-12 adolescent- 12-19
Weight at each visit
Birth weight regained by ____
6 months:
12 months:
regained by 2 weeks
6 months: weight doubles
12 months: weight triples
Head circumference
0-3 months
3-6 months
6-18 months
0-3 months increases 2 cm/month
3-6 months increases 1 cm/month
6-18 months increases 1 cm/month
Newborn
Development goes from ___ to ____ and ___ to ____
examples
Maturation and neurologic are _____
Order of maturation:
cephalo to caudal; proximal to distal
ie visual guidance before leg movement: hand mouth to foot mouth
maturation and neurologic are intertwined (if problem with development think about problem at birth)
motor then sensory vision auditory
Reflexes Rooting Moro Palmar TNR Plantar Parachute
rooting: stroke cheek turn head “sucking” integrated 4 months
moro: startle spread fingers and arms, integrated by 6
palmar: grab hand, integrated by 6
tonic neck reflex: fencing, integrated by 6 (when supposed to crawl)
plantar: standing toes curl under integrates 10 months (when supposed to walk)
parachute- ext arms legs when fall (does not integrate) starts around 8-9 months
Other reflexes
Step
Crawl
step integrated at 2
crawl around 7 months (right after tonic neck reflex when roll over)
Eye contact at
2 months
Infant nutrition
6 months: amount of formula
Start solids at: (how to start and why at this time?)
Start table foods at:
6 months: 24-32 oz no juice until 6-8 months
Start solids: 4-6 months (AAP recommends 6: at 4 months has normal tongue thrust capable of moving food around, try something for one week, vegetable before fruit)
Start table foods: 8 months of age (cheerios, gold fish, soft cooked vegetable)
Wean from bottle:
Introduce sippy cup: (when should you?)
Where to avoid sippy cup?
1 year
10-12 months introduce sippy cup but do not give in crib (ear infection, choking)
Infant sleeping Put on: Sleeps through the night around: If not sleeping through the night by \_\_\_\_ then \_\_\_\_\_\_ 2 naps daily up until \_\_\_\_
put infant: on back
sleeps through night: 2-3 months
if not sleeping through night by 6 months decrease afternoon nap
two naps daily up until 1 year
Infant elimination
describe
seedy, mustard like, 3-5 times a day
soft
breastfed: especially soft, mustard like until food is added
Infant developmental milestone
Gross motor Fine motor Personal/social Language Cognitive
gross: crawling (7 months), cruising, walking
fine: reaching, transferring (hand to hand), raking, pincer grasp, build tower
personal/social: regards face, smiles (eye contact- 2 months) stranger anxiety (7-9 months goes away back around 18 months), plays peek a boo (1 year)
language- alerts to bell (before leaving hospital), babbles, mama, baba, ball, dog
cognitive- responds to name, follows one step command (nine months) understand no
