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Health Promotion (Infants)
What has happened to the weight of an infant by 6 months?
it has doubled
What has happened to the infant's weight by 1 year?
it has tripled
How does the height increase during the first 6 months?
it increases by 1 inch per month
What happens to the birth length by 1 year?
it has increased by almost 50%
Where does the length increase mostly in infants?
in the trunk
When does the posterior fontanel close?
within 6 to 8 weeks
When does the anterior fontanel close?
12 to 18 months
What does the brain weight increase to by 1 year?
2 1/2 times
What is the chest circumference equal to by the end of the first year?
the head circumference
What is the increase in the heart by the end of the 1st year?
What is the often the rhythm of the heart rate in infants?
sinus arrhythmia (rate increases with inspiration and decrease with expiration)
What is a common blood change by in the first 2 to 3 months?
physiologic anemia (RBCs life is shortened)
When do the digestive functions begin?
by age 3 months (drooling begins)
How does gastric digestion occur in the stomach?
through the action of hydrochloric acid and rennin
How does rennin work?
causes the formation of curds so that milk can be digested
What is the most immature of all gastrointestinal organs throughout infancy?
When has the immunologic system reached adult levels?
by 9 months old
When does complete maturity of the kidney occur?
latter part of the second year
When does grasping occur in infancy?
in the first 2-3 months
What type of grasping occurs at first?
What position are the hands mostly in at 1 month and 3 months?
3 months= closed
When is the infant able to voluntarily grasp?
When are infants able to old their bottle, grasp their feet and pull them to their mouths,and feed themselves a cracker?
at 6 months
When are infants able to move items from one hand to another, use one hand for grasping, and hold a cube in both hands?
When does the infant develop a crude pincer grasp?
When does the infant develop a neat pincer grasp?
When is the infant able to pick up a raisin and other finger foods?
When can infants put objects into a container and like to remove them?
When do infants try to build a tower blocks but fail?
When can infants hold their head up?
When can infants hold their head and chest up, bearing weight on their forearms?
When is head control well established?
If a child displays head lag at 6 months....?
they should have an evaluation
When can a child roll from abdomen to back?
When can a child roll from back to abdomen?
When doe the parachute response occur?
at 7 months
What position is acceptable when an infant is awake and why?
enhances creeping, crawling, and turning over
Why should the head be placed on alternating sides before the infant is able to roll over?
to prevent positional plagiocephaly
When does the convex lumbar curve develop?
3-4 months when head control is established
When can an infant sit alone, leaning forward on their hands for support?
When can an infant sit up unsupported?
When can infants move from prone to sitting position?
When are infants able to bear all weight on their legs with assistance?
at 6-7 months
What is propelling forward with belly on the floor?
What is propelling forward with the belly off the floor and on knees?
When does crawling progress to creeping?
at 9 months
When can they pull themselves up on furniture?
at 9 months, but they can't move back down
When can infants walk by holding hands onto furniture with both hands?
When can infants walk with one hand?
What Erickson's stage are infants in?
trust vs. mistrust
What can the failure to learn delayed gratification lead to?
What are newborns primarily?
narcissistic ....total concern for oneself
What are the two social modalities that occur with infants?
grasping and biting
What are the first perceptions that an infant has of their body?
kinesthetic and tactile and they realize they are distinct from their parents
What social development does an infant have?
attachment and play
What are the 2 components of cognitive development required for attachment?
the ability to discriminate the mother from others
and the achievement of object permanence
When do infants begin to smile, cry, and vocalize more to their mother?
When do infants show distinct preference to their mother?
When do infants begin attaching to other members of the family?
1 month after mother
What is a psychologic and developmental problem that stems from maladaptive or absent attachment between infant and mother?
reactive attachment disorder
What are the 2 different patterns of RAD?
emotionally withdrawn inhibited pattern
When does infant become aware of the separateness of mother and child?
between 4-8 months, first progression through separation-individuation
When do infants begin to protest the departure of their mother?
in the second part of the 1st year
When infants anticipate the departure of their mother by watching her behaviors?
When does the fear of strangers and stranger anxiety become prominent?
between 6 and 8 months..cling to parents and cry
What is the infant's first means of communication?
What is a biologic sign that conveys a message of urgency and signals displeasure?
How much do infants cry in the 1st 3 weeks?
1-1.5 hours and increases by 6 weeks
What is it thought that the increase in crying represent?
discharge of energy and maturational changes
When do infants make the throaty sounds?
When do infants make the single vowel sounds, such as ah and eh?
When do infants add consonants and begin to coo?
by 3 to 4 months
When do infants combine syllables, such as dada?
When do infants understand the meaning of no?
How many words should infants know by the age of 1?
3-5 words with meaning
When can the games of peek-a-boo and pat-a-cake are played?
6 months -1 year...involves sensorimotor skills
Infants need to played?
What type of play do infants engage in?
What influences the interaction that occurs between the child and parents?
infant's temperament or behavioral style
What do difficult children respond better to?
structured environments and routines
What do highly distractible children respond to?
may require additional soothing measures
What may highly active children require?
What may slow to warm up child require?
gradual and preparation for new situations
What may the easy child require?
retraining because they develop new habits easily and parents may need reminders to feed or change
When do infants begin to warm up to strangers?
by the end of the 1st year
How should nurse approach infants?
talk softly, meet at eye level, maintain a safe distance, avoid sudden gestures, such as reaching for them
How can parents begin to separate from their infants?
talking to them as they leave the room, let them hear one's voice over the phone, use transitional objects
When does thumb sucking reach its peak?
What is the eruption of primary of deciduous teeth?
What is the formula for deciduous teeth?
age of child in months-6=number of teeth
What are some usual signs of teething?
drooling, swollen gums, increased finger sucking, difficulty sleeping, or biting on hard objects
What is the teething pain a result of?
inflammation, treat with cold soothing
What is the main reason for shoes?
protection during walking
What is a good shoe ?
1/2 thumb length between end of longest toe and shoe; roomy and square-toed socks; well-constructed athletic shoes or soft leather moccasins
What are signs that need to be larger?
curled toes when removed; redness or irritation of the skin on bottom of toes
What is the most desirable complete diet for the infant during the 1st 6 months?
human milk...or formula
What should all infants receive in the first 2 months of life?
vitamin D supplementation (200 IU)
What does vitamin D prevent?
rickets and vitamin D deficiency
If an infant is being exclusively breast fed, what should they receive after 4-6 months?
iron supplementation, use iron-fortified cereal
Do breast fed or bottle fed children require additional fluids?
no, can lead to water intoxification
How often should women pump to maintain supply?
every 3-4 hours
Can breast milk be microwaved?
When can infants receive cow's milk?
after 1 year
Are bottles recommended to be warmed in the microwave?
No because of uneven heating
What is the usual amount of ingested formula?
What can introducing foods before 6 months put an infant at risk for?
Are fruit juices recommended before 6 months?
What should be the primary source of diet during the second 6 months?
human milk and formula
What supplementation should begin during the 2nd 6 months?
When does the extrusion reflex disappear?
during the 2nd 6 months
How should new foods be introduced?
one at a time
What can vitamin C in fruit juices enhance?
the absorption of iron...mix juice with cereal
What juice is safer for GI system and better absorbed?
white grape juice
What is the recommended amount of juice daily?
4-6 ounces a day
What finger foods can be introduced at 6 months?
crackers or zwieback
What type foods can be introduced at 8-9 months?
cheese, firmly cooked veggies, raw fruit
When are well-cooked table foods served?
When should infant cereals be discontinued?
When should spoon feeding be attempted?
after ingestion of some milk
When is it best to introduce new foods?
during the first year because they are more likely to eat them
How many days should be between the intro of new foods?
the process of giving up one method, for another?
weaning.....breast or bottle for a cup
How should weaning be done?
gradual by replacing one session at a time , nighttime should be the last discontinued
What is the total amount of sleep for infants?
Who usually sleep for shorter periods of time?
breast fed babies
trouble either falling or staying asleep at night?
confusional arousals, sleep walking, sleep terrors, nightmares?
parasomnias (3-8 years)
involves letting the child cry for progressively longer times between brief parental interventions?
graduated extinction...increase intervals on successive nights
What is the 2 step approach of graduated extinction?
1. use GE during naps and @ bedtime
and if cried during night, use comforting measures
2. after partially trained, use GE at all times
What is the best way to prevent sleep problems?
establish bedtime rituals
How should teeth be cleaned in infants?
wipe with a damp cloth...water over toothpaste
When should infants see a dentist?
by 6 months of age
an essential mineral for building caries-resistant teeth?
How much fluoride should be used?
0.25 mg if intake is less than 0.3 ppm
What are the leading causes of injury?
falls, ingestion injuries, and burns
What are the 3 leading causes of death?
suffocation, car accidents, and drowning
What foods should be avoided to prevent aspiration?
hot dogs, candy, nuts, grapes, marshmallows, large amts of peanut butter
What baby product should be avoided because of fatal aspiration pneumonia?
When is a mattress to small for a bed?
when 3 adult finger widths can be put between
What is the recommended length of strings for infants?
shorter than 12 inches
How long should infants face the rear?
birth to 20 pounds or 1 year
What should be done to prevent slouching?
place padding between the infant's legs and crotch
Should padding be placed behind infant's back of under buttocks?
When should direct sunlight be avoided?
first 6 months
When does the infant assume flexed position wit pelvis high, but knees not under abdomen when prone (gross motor)?
age 1 month
When can infant turn head from side to side when prone, and lifts head momentarily (gross motor)?
age 1 month
When does the infant assume less flexed position when prone (gross motor)?
age 2 months (hips flat, legs extended, arms flexed, head to side)
When is there almost no head lag when pulled to sitting position, balances head in sitting position, and rolls from back to side?
age 4 months
When does the rooting, tonic neck, and moro reflexes disappear?
age 4 months
When does teeth eruption and chewing and biting occur/
age 6 months
When does the child actively hold a rattle but will not reach for it?
age 3 months
When does infant inspects and plays with hands, pulls clothing or blanket over face?
age 4 months
When is an infant able to grasp voluntarily?
When does infant use thumb and index finger crude pincer grasp?
When is infant able to fixate on moving object?
When is infant able to follow objects to periphery and locates sound by turning head?
When can infants fixate on very small objects?
When does the infant vocalization distinct from crying?
When does cooing, gurgling, and babbling being?
When does the infant begin to imitate sounds?
6 months..one syllabus utterances (mu, da, di)
When does the infant say dada and mama with meaning?
When does the infant demonstrate social smile in response to various stimuli?
When does an infant search for a dropped object?
When does an infant increase in the fear of strangers?
When does infant develop object permanence?
When does an infant search for an object even if it has not been hidden, but only searches where it has been seen?
age 11 months