PEDS T1 Chpt 10 Health Promotion of the Infant and Family

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How do infants biologically develop?

Cephalocaudalproximodistal Sequence

What does that ^^^ mean?

The grow from head to toe, center to periphery (how they obtain motor skills)

Infants shoud gain how much weight per week?

5-7 ounces

They should _____ their birth weight by 6 months.

double (Average = 16 lbs)

They will triple their birth weight by ....

1 year. (avg 21.5)

Breast-fed infants beyond 4-6 months ....

gain less weight.

Height increases by 1 inch per month for...

6 months

Growth is in _________ rather that a gradual pattern.

spurts

Resp rate slows in infants, goes from 35 to ___.

30

Why are infants predisposed to respiratory illness?

close proximity of trachea to the bronchi, short and straight eustachian tube, immunoglobulin A (IgA) is not produced

Heart rate slows:

Newborn: 100-180
1 week to 3 months: 100-220
3 months to 2 years: 80-150

They develop a _____ _________. HR increases with inspiration and decreases with expiration.

sinus arrhythmia

___ ________ is present the first 5 months causing physiologic anemia.

Fetal hemoglobin

Infant initially has mothers iron but it will diminish. Iron is need for...

Hgb formation

Digestive processes start at age...

3 months

Drooling is common because

swallowing reflex is not developed

Solid foods are

passes incompletely and not broken down well in feces

The liver conjugates _____ and secretes ____.

bilirubin, bile

The liver has a decreased capacity for ____________ and a high risk for _________.

gluconeogenesis, hypoglycemia

Thermoregulation gives infant ability to ______ and generate ____.

shiver, heat

Peripheral capillaries constrict in cold temperatures to conserve core body temp and avoid heat loss from _________.

evaporation

Infants gain insulation from...

increases adipose tissue

Infants ______ senses become the same as adults.

auditory

Visual accuity improves:

1 month: 20/120 (E on snellen chart)
4 months: 20/60
8 months: 20/30

Depth perception begins to develop by...

7-9 months and is fully mature by 2-3 years.

Fine motor development-
Grasping objects:
Hold bottle:
Transfer objects btwn hands:
Remove objects from container:
Build tower of 2 blocks:

2-3 months
6 months
7 months
10 months
11 months
12 months

***********

See page 326 for head control

Can roll over by...

5-6 months

Sit alone by...

7 months

Move from prone to sitting by...

10 months

Crawl by...

6-7 months

Creeping with belly off floor by...

9 months. Can also pull themselves up by holding onto furniture but cant get back down

Walk with assisstance by..

11 months. Walk alone by 12.

Erikson's psychosocial developement at 1 year:

Trust vs. Mistrust

What do infants trust?

their self, others, and the world; feeding, comfort, stimulation and caring needs; sense of self; physical comfort and security; feel empowered in unfamiliar and unknown situations

Mistrust is caused by...

failure to learn delayed gratification; too much or too little frustation; ability to control their environment- parents meet needs prior to infants signals, prolonged amount of time after infants signal leads to constant frustation causing them to mistrust others

Piagets Cognitive Development:

Sensorimotor phase
Imitation
Play
Affect

Reflex stage: birth - 1 month

sucking, rooting, grasping and crying

Primary circular reactions: 1-4 months

crying, nipple, parents voice

Secondary circular reactions: 4-8 months

shaking a rattle

Three achievements of cognitive development?

Separation- separate themselves from other obejcts and other people; Object permanence by 9-10 months; use of symbols

Development of body image: Realize that parts of their body are useful. Receive satisfaction when...

they smile and someone smiles back at them

First verbal communication =

crying

How lond do infants cry?

3 weeks: 1-1.5 hours a day
6 weeks: 2-4 hours a day
decreases at 12 weeks

By 1 year, they have ___-___ words with meaning. If this is delayed a _________ _________ should be completed.

3-5; hearing screening

When should solid foods be introduced?

4-6 months of age; infant cereal at 4-18 months; iron; introduce foods at intervals of 4-7 days to allow for identification of allergies; at 1 year can eat well cooked table food

How many teeth should infants have?

age of child in months - 6 = number of teeth they should have

Pertussis immunizations should be given to infants and adults. Added to _______.

tetanus

Varicella immunization should be give at ....

12-15 months, subcutaneous

An adverse reaction that can occur 2-23 days are a vaccination has been given:

Guillain-Barre

To ease pain of immunizations, be sure to use appropriate size needles. What can be given to reduce pain?

EMLA (lidocaine-prilocaine) 1 hour; Vapocoolant spray 15 seconds; Oral sucrose solution on pacifier for neonates

What is VAERS?

Vaccine Adverse Event Reporting System - to report any adverse reactions after administration of any vaccine

Injury Prevention: Aspirtaion of foreign objects-

food (hot dogs, popcorn, candy, nuts, and grapes), baby powder

Other common causes of injury:

MVA (backing up in driveway, 1-9 years old), falls, poisoning, burns, drowning

*********

Slide 39 for Passenger Restraint Laws

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Table 10-2

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