Fundamentals of Nursing: Chapter 12 Flashcards
First 28 days of life
Overlapping of the soft skull bones
Usually closes at 12-18 months. Located along the Coronal suture
Early cognitive development
Innate behavior, reflexes, and sensory functions
Sleep on their back
Usually closes by the end of the second or third month. Located along the Lambdoid suture
Sucking, crying, sleeping, and activity
Health promotion of the infant
Screenings, car seats, cribs
What is the Apgar score?
- Evaluation and rating of HR
- Muscle tone
- Reflex irritability
What is direct nursing care at birth?
- Maintaining a patent Airway
- Stabilizing/Maintaining Temperature
- Protecting from Infection
How do you encourage parent-child attachment after birth?
Close body contact, including breastfeeding, fosters bonding
What do you expect an infant to do at 1 month of life?
- Reflexive grasp
- No ability to sit upright
- Complete head lag persists
- Inborn reflexes predominant
What are the warning signs of abuse?
- Physical evidence of abuse or neglect, like previous injuries
- Conflicting stories about the event
- Injury blamed on a sibling or another party
- Injury inconsistent with story, like concussion and broken arm from falling off the bed
- Inconsistency with age, like a 6 month old burned by turning on hot water
- Initial complaint not associated with signs and symptoms (i.e. coming for a cold w/ evidence of trauma)
- Inappropriate response from child, especially older children. Like not wanting to be touched, looking at caregiver before answering questions
- Previous reports of abuse in family
- Frequent ER visits
What do you expect an infant to do between 10-12 months?
- Standing alone
- Walking while holding furniture
- Sitting down from a standing position
- Placing objects in containers
- Holding a crayon to mark a paper
What is the infancy period?
1 month to 1 year of age
How would you summarize height and weight changes through infancy?
- Birth weight doubles by 5 months, triples by 12 months
- Height increases by 1 in./month 1st 6 months, & about 1/2 in./month through 12 months
What can you expect an infant to be doing at 6 to 8 months?
- Sitting alone without support
- Standing while holding furniture
- Can move from a sitting to kneeling position
- Banging objects together
- Pulling a string to obtain an object
- Transferring objects from hand to hand
What can you expect an infant to be doing at 2 to 4 months?
- When prone, lifts head and chest and bears weight on forearms
- Sit up with support, with good head control
- Can turn from side to side
- Holds rattle for short periods
- Looks at and plays with fingers
- Able to bring objects from hand to mouth
What can you expect an infant to be doing at 4 to 6 months
- Turns from abdomen to back at 5 months and then back to abdomen at 6 months
- Can support much of own weight when pulled to stand
- No head lag when pulled to sit
- Grasps objects at will and can drop them to pick up another object
- Pulls feet to mouth to explore
- Can hold a baby bottle
What can you expect an infant to be doing at 8 to 10 months
- Crawling, pulling entire body along floor using arms
- Pulls self to standing or sitting
- Creeps on hands and knees
- Picking up small objects
- Using pincer grasp well
- Shows hand preference
What are the cognitive changes that occur in infants?
- Infants learn by experiencing and manipulating the environment
- Developing motor skills and increased mobility expand the environment, therefore expand knowledge
- Learn by experimentation and trial and error.
- 7 to 9 months learn 'object permanence'
How does an infant develop language? How would you help parents further develop their infant's language?
- They go from crying cooing and laughing, to imitation of sound, comprehending the meaning of simple commands, and repeating words with knowledge of their meaning.
- By the end of infancy, the child should be able to say 3 to 5 words, and understand almost 100.
- Encourage parents to name objects on which their infant's attention is focused.
What is separation and individualization?
Infants differentiate themselves from others as separate beings capable of acting on their own.
What does an infant get out of play?
Opportunity for development. Much of infant play is exploratory.
How do you prevent injuries with infants?
- Toddlers learn about objects by placing them in their mouths
- Lock up chemicals and hazardous materials
- Never leave the child alone in water.
- Properly restrain children in car seats
- Injury prevention is best accomplished by associating various injuries with the attainment of developmental milestones
At what age, and how, would you assess for child maltreatment?
Children at any age can experience maltreatment, but the youngest are the most vulnerable. A combination of signs and symptoms or a pattern of injury should arouse suspicion.
Why is breastfeeding recommended?
- Breastmilk contains the essential nutrients of protein, fats, carbohydrates, and immunoglobins that bolster the ability to resist infection
- The AAP and the US Department of Health and Human Services recommend human milk for the first year of life.
- If breastfeeding is not a possibility, use commercially prepared formula, not cows milk.
- Cows milk can cause intestinal bleeding, anemia, and increased incidence of allergies.
Why would infants take supplements?
Iron in formula is less readily absorbed than that in breast milk. Formula fed infants need iron-fortified formula throughout the first year.
What would you tell a parent who doesn't want to vaccinate their child?
Immunizations have produced a dramatic decline in infectious disease over the past 50 years, and it is the most important factor in health promotion during early childhood. Although minor side effects sometimes occur, serious reactions are rare. The parent would only have to monitor the child for local tenderness and low grade fever just after receiving a vaccination.
How does an infants sleep schedule change up to 6 months?
- Birth to 3 or 4 months: No sleep pattern established
- By 6 months, developing a nocturnal pattern, sleeping 9 to 11 hours at night.
- Total daily sleep averages 15 hours, and take one to two naps a day
What is a toddler?
A child between the age of 12 to 36 months. From the time they can walk independently, until they can walk and run with ease.
What fine motor capabilities can you expect out of a toddler?
- Start at scribbling spontaneously to drawing circles and crosses accurately.
- At 3 years can draw simple stick figures and stack small blocks.
What cognitive changes occur during the toddler stage?
- Increased ability to remember events
- Puts thoughts into words by 2 years
- Recognize they are separate beings from their mothers.
- Reasoning based on their own experience of an event
- Use symbols to represent objects, places, and people
How do toddlers use language?
- 18 months: use of 10 words
- 24 months: vocabulary up to 300 words, and able to speak 2 word sentences
- Understanding is much greater than spoken word
- 36 months: Begins use of simple sentences, some grammatical rules, and learn to use 5 or 6 new words each day
What are the psychosocial changes of a toddler?
- Sense of autonomy emerges
- Strive for independence by using their developing muscles to do everything for themselves and become the master of their bodily functions
What results from parental restrictions on toddlers?
Frustrated toddlers throw temper tantrums
How does a toddler play?
Children begin to discern the difference between past, present, and future, but can't yet comprehend cause and effect. Still remain strongly attached to parents, and usually show more exploration around parents. Toddlers practice 'parallel play', or playing beside another toddle, not with.