58 terms

Potter/Perry Chapter 12

Conception through adolescence
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Prenatal Embryonic Stage
most vulnerable to noxious agents, fertilized ovum develops into an organism with basic structure of all the body's organs and systems
Embryo
during gestation, grows from a single cell to a complex physiological being
Pre-embryonic Stage
the first 14 days
Full Term
38 to 40 weeks, divided into trimesters
Embryonic Stage
lasts from day 15 to the 8th week
Fetal Stage
lasts from the end of the eighth week until birth
Placenta
begins development at the third week of the embryonic stage, produces essential hormones that help maintain pregnancy.
Fetus
unborn child
Apgar Score
-heart rate, respiratory effort, muscle tone, reflex irritability, and color are related to the overall status of the newborn.

-conducted 1-5 mins after birth and sometimes repeated until condition stabilizes.
Nursing Interventions at Birth
maintaining an open airway, stabilizing and maintaining body temperature, protect the newborn from infection
Attachment
feeling of closeness, close body contact, evolves over the first 24 months of life
Neonatal Period
first 28 days of life
Newborn Assessment
includes height, weight, head/chest circumference, temperature, pulse, respiration's, general appearance, body functions, sensory capabilities, reflexes, responsiveness
Newborn Average Weight
2700g-4000g(6-9 pounds)
Newborn Average Length
53 cm(19 to 21 inches)
Newborn Average Head Circumference
33-35 cm(13-14 inches)
Neonates
-loose up to 10% of birth weight in the first few days of life, primarily through fluid loss by respiration, urination, defecation, and low fluid intake.

-regain birth weight by the second week of life, gradual pattern of weight, height, and head circumference is evident
Normal Characteristics of Newborns
lanugo on skin and back, cyanosis of hands and feet for the first 24 hours, soft protuberant abdomen
Molding
overlapping of the soft skull bones, allows head to adjust to pelvis of the mother, the bones re-adjust within a few days allowing a rounded appearance of the head.
Fontanels
sutures of the soft skull bones

Anterior Fontanel- diamond shaped, "oft spot", towards front of head, closes at 12-18 months
Posterior Fontanel- triangle shaped, towards back of the head, closes at 2nd or 3rd month
Newborn Neurological Function
observe the newborns level of activity, alertness, irritability, responsiveness to stimuli, strength of reflexes
Newborn Normal Reflexes
blinking, startling, sucking, rooting, grasping, yawning, coughing, sneezing, palmer grasp, swallowing, plantar grasp, hiccoughing, and Babinski
Babinski Reflex
When the sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex up to about 2 years of age.
Tonic Neck Reflex
When the child's head is turned to the side, the limbs on that side will straighten and the opposite limbs will bend
SIDS
sudden infant death syndrome, babies should sleep on their backs, remove stuffed animals, and pillows from cribs
Inborn Errors of Metabolism
genetic disorders caused by the absence or deficiency of a substance, usually an enzyme, essential to cellular metabolism that results in abnormal protein, carbohydrate, or fat metabolism
Hearing Loss in Newborns
newborns should have a hearing screen before discharge,
Car Seats
all infants and toddlers should ride in a rear facing car seat until they are two. Nurses are responsible for providing car seat education before discharge.
Cribs and Sleep
crib mattresses should fit snugly, you should not use drop side cribs
Infancy
the period from one month to one year of age
Birth weight
doubles within 5 months
triples within 12 months
Cow's milk
cannot be used until 12 months, it can cause intestinal bleeding, anemia, and increased incidence of allergies.
Height increase during infancy
2.5 cm(1 inch) during each of the first 6 months and about 1.2 cm(1/2 inch) each months until 12 months
Moro Reflex
a normal reflex of young infants, startle reflex
Head lag
at birth infants can only momentarily hold their heads up, but by four months they have no problems
Language
by one year infants recognize their own names, can say three to five words, and understand almost 100 words
Two-Three Month Old Infants
begin to smile responsively instead of reflexively
Injury Prevention in Infants
the most common causes of injury are MVC, aspiration, suffocation, falls, or poisoning.
Child Maltreatment
includes intentional physical abuse or neglect, emotional abuse or neglect, and sexual abuse.
Warning Signs of Abuse in Children
physical evidence, previous injury, conflicting stories about injuries, injury blamed on sibling, injury inconsistent with history, injury inconsistent from developmental age, initial complaint not associated with injury, inappropriate response of the child, previous reports of abuse, frequent ED visits.
Breastfeeding
recommended for infant nutrition because breast milk contains the essential nutrients of protein, fats carbohydrates, and immunoglobins that bolster the ability to resist infection.
Solid foods
not recommended before 6 months
Infants- Total daily sleep
15 hours
Toddlerhood
ranges from the time children begin to walk independently until they walk and run with ease, 12-36 months
Toddlers
begin to put thoughts into words at about two years of age
Eating Habits in Toddlers
are determined in early childhood, limit milk intake to 2-3 cups per day.
Preschool Period
refers to the years between 3 and 5, vision screening should begin at this period
School Age Children
ages 6 to 18
Scoliosis
children should be evaluated at 12 years for a lateral curvature of the spine
Sexually Transmitted Infections
the consequences of should be taught to school age children at about 10 years of age.
Childhood Obesity
is a prominent health problem, increases risk for hypertension, diabetes, coronary heart disease, fatty liver disease, pulmonary complications, sleep apnea, musculoskeletal problems.
Adolescence
13 to 20 years old
Puberty
the point at which reproduction becomes possible
Adolescence- physical changes
1. Increased growth rate of skeleton, muscle, and viscera
2. Sex-specific changes such as changes in shoulder and hip width
3. Alteration in distribution of muscle and fat
4. Development of the reproductive system and secondary sex characteristics
Estrogen
hormone that stimulates ovarian cells
Testosterone
hormone that stimulates testicular cells
Menarche
the onset of menstration
Adolescents-Cause of Death
1. MVC
2. Homicide
3. Suicide
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