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95 terms

Health Promotion of Infant and Family

STUDY
PLAY
Define infancy
Period of birth to 12 months
Which Erikson phase applies to infancy?
Trust vs. Mistrust (birth to 1 yr)
Which Piaget phase applies to infancy?
Sensorimotor phase (birth to 24 mths)
When does solitary or one-sided play emerge?
6-12 months
At what age does child start imitating sounds?
8 months
At what age does child associate meaning to sounds?
9-10 months
Interventions for difficult temperament
routine and structure
Interventions for highly distractible temperament
soothing measures, swing
Interventions for high activity temperament
extra safety precautions
interventions for easy child temperament
reminders to be vigilant with feeding schedules
when should head lag disappear by?
6 months
when does teething begin?
6 months
when does object permanence begin?
6 months
when can child stand with furniture support?
9 months
when does crude pincer grasp emerge?
9 months
when can child sit without support?
9 months
how many words can 12 month old say?
5
when can child walk with one-handed support?
12 months
What does the Denver II (DDST-II) assess?
four sectors of development:
- personal/social
- fine motor/adaptive
- language
- gross motor
What does the Bayley Scale of Infant Development test?
-gross motor
- fine motor
- language
-cognitive development
accomplished through play tasks
when is Bayley Scale used?
0-3 yrs
What is the Ages and Stages tool?
a survey for parents to fill out (lengthy)
What supplements does an infant receiving breastmilk need?
-Vitamin D
-Iron
What does iron supplement cause in infants?
dark stool
How much Vit D should infants take?
400 IU
What may happen if infants receive water in addition to breastmilk?
water intoxication
FTT
hyponatremia
how long does refrigerated breast milk last?
5 days
how long does frozen breast milk last?
12 months
What supplement is needed for formula-fed babies?
fluoride
What can too much fluoride cause?
tooth discoloration in children
Fruit juice is not recommended before:
6 months
Cows milk is not recommended before:
12 months
How many bottles does a formula-fed baby need?
1 month - 6
6 months - 4-5
Average volume of feed for formula-fed babies
32 ounces
introducing cow's milk too early can cause:
an allergy
Why wait until 6 months to introduce solids?
-GI tract able to handle more complex nutrients
- teeth start to erupt
- extrusion reflex disappears
- swallowing is more coordinated
-head control present
-pincer grasp present
-improved hand/eye coordination
Foods that should not be introduced too early due to risk of allergy:
peanuts
eggs
fish
seafood
What is the first food that should be introduced to infants?
Iron-fortified cereal or rice cereal
Describe how new foods should be introduced
one at a time, wait 4-5 days between foods
How long should infant cereal be continued?
until 18 months
how much fruit juice should babies receive?
not more than 4-6 ounces a day
benefit of fruit juice
vitamine C helps absorb iron
serving size of infant cereal
3 Tbsp
S&Sxs of teething
drooling
swollen gums
increase in finger sucking
biting hard objects
What symptoms require medical examination?
fever >100.4
vomiting
diarrhea
what may happen if pacifier usage is continued after 4-6 yrs?
malocclusion
when does oral hygiene begin?
with first tooth
what type of oral hygiene can be used before six months?
damp washcloth
when should baby get first dental exam?
at 6 months
Infant FOC is how much greater than chest circumference?
2-3 cm
Signs of a food sensitivity in an infant
systemic: anaphylaxis
GI: abd pain, vomiting, diarrhea, cramping
Rsp: cough, wheezing, rhinitis, infiltrates
Cutaneous: urticaria, rash
infants: restlessness, irritability, listlessness, unresponsiveness, urticaria
if high risk of hereditary food allergy, exclusively breast feed until:
12 months
Colic affects what percent of infants?
5-30%
S&Sxs of colic
loud crying, drawing legs up to abd
last longer than 3 hrs, 3 days a week at more than 3 months of age
Causes of colic
too rapid feeding
overeating
swallowing excessive air
improper feeding technique
emotional stress
milk allergy
Paroxysmal Abdominal Pain
Colic
drugs that may assist with colic
antihistimines
zimethicone drops
sedatives
Failure to Thrive (FTT)
inadequate growth/inability to obtain or use calories required for growth (less than 5th percentile)
organic FTT
physical causes with absorption, cardiac issues, GERD, lead, anemia, occult blood, parasite
non-organic FTT
environmental, psychosocial
S&Sxs of FTT
withdrawn
no fear of strangers
avoidance of eye contact
stiff or flaccid
minimal smiling
(poor attachment)
nursing care for FTT
set up a consistent, soothing feeding routine
consistent caregiver
unstimulating environment
be persistent
Erythema Toxicum Neonatorum
Newborn Rash
Describe Newborn Rash
benign
begins in first 2 days of life
firm lesions 1-2mm, pale yellow or white papules or pustules on an erythematous base
no systemic manifestations
lasts 5-7 days
How is candidiasis contracted in infancy?
vaginal delivery
poor handwashing
contaminated source (hands, bottle, nipple)
Types of candidiasis
diaper dermatitis
oral (thrush)
normal sleep in 3-4 months
9-11 hours at night, 15 hrs a day
Sudden Infant Death Syndrome
under 1 yr
(95% before 6 months)
risk factors with SIDS
maternal smoking
male sex
pacifier usage
bedding
overheating
co-bedding
positional plagiocephaly
oblique or nonsymmetrical head shape from cranial molding
management of positional plagiocephaly
tummy time, alternate head position when lying
helmut can be used if necessary
normal number of diapers in an infant
6-8 in a 24 hour period
meconium
black tarry first stools (4-5 days)
differentiate breastfeeding and formula stool
formula stool -- less frequent
breastfed - yellow, seedy
S&Sxs of dehydration in infants
dry mucous membranes
fewer wet diapers
lack of tears
dry skin
sunken fontanels
vital changes indicate late-stage
S&Sx of constipation in infants
pellet-like stool
infant strains with stooling
Causes of diarrhea in infants
intestinal infection
food allergy
pain relief for infants and immunizations
sucrose on a pacifier (or breastfeeding)
EMLA (requires 60 mins)
distraction
IM injections in infants: equipment
1" needle
25 gauge
90 degrees
SubQ injections in infants: equipment
5/8" needly
25-30 gauge
injected at 45 degrees
sites for injections in infants
vastus lateralis or ventrogluteal
written information for immunization documentation
completed consent
expiration date
lot number
manufacturer
site, route, tolerance of patient
name/address/title of person administering
VIS date (vaccine information statement)
leading cause of death in infants
injury
most common injuries in infants
suffocation, MVAs, drownings
trauma and falls is more common in which age group and why?
under 7-9months due to poor depth perception
how long should rear-facing seat be used?
until 1 year and 20 lbs
Water heater should be set at what temp to prevent burns?
120 degrees
When does Moro reflex disappear?
5-6 months
When does rooting reflex disappear?
3-4 months
When does suck reflex develop?
Around 36th week of pregnancy
when does palmar grasp reflex disappear?
2-3 months
when does stepping reflex disappear?
2-3 months
when does Babinski reflex disappear?
2 years
Tonic Neck reflex
When baby's head is turned to one side while lying on her back, the same arm will extend and the opposite arm will bend (fencing reflex)
when does the tonic neck reflex disappear?
6-7 months