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Pediatrics > Exam 1 - Health Promotion of the Newborn and Infant PP > Flashcards

Exam 1 - Health Promotion of the Newborn and Infant PP Flashcards

1
Q

The neonate normally loses about 10% of birth weight by age 3 or 4 days.

A

Infant’s ability to fixate is greatest in 1st hour of life

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2
Q

Tracts that develop myelin first are the sensory and cerebellar tracts.

A

Touch is especially important and so is the most acute sense in the neonate.

All newborn senses are very acute, except for sight.

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3
Q

First reactivity period

A

30-60 minutes after delivery: alert, interested in environment
- Full-term infant may breast-feed

1-4 hours after delivery: sleepy and relatively calm
- All systems slow down, temperature falls

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4
Q

Second reactivity period

A

Occurs when infant wakes from first deep sleep

Lasts 2-5 hours: alert and responsive

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5
Q

Postpone erythromycin ointment immediately after birth. But must be given within two hours by law.

A

Ophthalmia neonatorum–
Chlamydia
Gonococcal conjunctivitis

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6
Q

Motor development is based on infant reflexes

A 
Rooting
Sucking
Doll’s eyes
Moro
Palmar
Step
Babinski
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7
Q

Nutrition

A

Breast milk or iron-fortified formula only for first 6 months of life

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8
Q

Promotion of 
Successful Breast-Feeding

A

Frequent and early breast-feeding (within first hour of life is important)

Promotion of skin-to-skin contact

Correct positioning of infant at breast

Feeding-on-demand schedule

Baby-Friendly hospital initiative

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9
Q

Breast Milk

A

Newborn has deficiency of pancreatic lipase for fat absorption, making cow’s milk indigestible

Breast milk contains enzymes – lipase

-This enables the high fat content of breast milk to be easily digested by the infant’s GI tract

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10
Q

Breast Milk

A

Breast milk contains vitamin D but may not have levels sufficient to prevent rickets

Recommendation is for breastfed infants to receive vitamin D supplementation if not receiving sunlight exposure

Formula fed infants do not need vitamin D supplementation

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11
Q

of wet diapers

A

1 for each day of life until day 5 or 6

5 or 6 per day until day 14

After that – 6 – 10 per day

Stools –

Bottle feeding: 1 stool every 2 – 3 days

Breast feeding: 2 or 3 per day

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12
Q

Sudden Infant Death Syndrome

A

Occurs during first year of life, peaks at 2 – 4 months

Occurs between midnight and 9am

Increased incidence in winter

Back-to-Sleep campaign

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13
Q

Colic

A

Inconsolable crying that lasts 3 hours or longer per day and for which there is no physical cause.

Usually resolves by 3 months

Frequent burping
Formula modification
Warmth to abdomen
Cuddling and closeness

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14
Q

1 week/2 week visit

A

Weight

Feeding, peeing, pooping

Discuss how the parents are feeling and how things are going in the home.

- Postpartum depression -- 
- Shaken baby syndrome

Assess attachment
Colic?

Never leave infant alone with pet or sibling

Warm formula in cup of warm water, never microwave

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15
Q

Neonatal Normal Vital Signs

A

Temp: 36.3oC – 37oC (97.3o – 98.6oF) axillary

Heart rate: 120 – 160

Resp rate: 30 – 60

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16
Q

1 – 3 month old – Physical

A

Rapid weight gain – 1.5 lb/mo (for 1st 6 mo)

Ht. – gain 1 inch/mo (for first 6 months)

Posterior fontanel closes at 2 months

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17
Q

2 month visit

A

By two months smiling spontaneously – social smile

Follows past midline

Loves looking at faces.
Imitate facial expressions.

Strabismus is normal in the young infant, but should not be present after about 3 months of age.

Turns head to sounds

Coos

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18
Q

Two month milestones 


A

Raises head and chest when lying on stomach and supports upper body with arms – called Head-up 450 


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19
Q

2 month visit immunizations

A

DTaP – Diphtheria, Tetanus, acellular Pertussis

Hib – Haemophilus influenzae type B

Rotavirus

IPV – Polio (inactivated poliovirus vaccine)

Pneumococcal

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20
Q

Age appropriate toys

A

Birth – 2 months: Mobiles – dark and light, black and white

2 – 4 months: rattles, cradle gym

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21
Q

3 month cause for concern

A

No response to loud noises

Does not try to find speaker’s face with his eyes

Does not coo, vocalize

Constant fisted hand

Stiff legs

Does not lift head when lying on stomach

Crosses eyes most of the time

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22
Q

4 – 6 mo – Motor

A

Sits with support

Discovers hands, begins reaching and grabbing

Brings hands to midline

Begin playing with rattles, squeaky toys, etc.

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23
Q

4 – 6 mo – Motor

A

Moro, tonic neck, and rooting reflexes disappear

Tonic neck reflex disappears. Infant turns over – abdomen to back at 5 mo; back to abdomen at 6mo

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24
Q

4 – 6 months– Motor

A

Tongue thrust diminishing

Teething begins – drooling

Putting weight on feet when held upright

Fine motor – Rakes objects

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25
Q

Sensory/Language ( 4 – 6 mo)

A

Ma-ma, Da-da vocalizations

Begins consonant sounds first, then vowel

Responds to rhythms

Tracks objects with eyes– 180 degrees

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26
Q

Social/Emotional ( 4 – 6 mo)

A

Smiles and laughs

Comforting habits such as thumb sucking begins

Demands attention by fussing
Smiles at mirror image

Has increased interest and attachment to parent

27
Q

Parent-Infant Attachment

A

Reciprocal cycle establishes trust and produces confidence in parents

28
Q

Age Appropriate Toys 4 – 6 months:

A

Bright colored, soft toys

Small enough to grasp

29
Q

Nutrition ( 4 – 6 mo)

A

Fetal iron stores – depleted by 4 months for term infant

By 2mo in preterm infant

Should continue BF or iron-fortified formula

Milk alternatives like rice milk are low in protein, calcium, vit D

30
Q

4 mo visit immunizations

A 
DTaP #2
Hib #2
Rotavirus #2
IPV #2
PCV (Pneumococcal) #2
31
Q

6 months – Physical

A

Double their birth weight

Weight gain slows to a pound a month

Length ½ inch a month

Teeth eruption

32
Q

6 months– Key milestones

A

Good head support – No head lag

Rolling in both directions

Bears weight on legs

Sitting with support– tripod sitting

Reaches for objects

33
Q

Nutrition

A

4 – 6 months begin solids

34
Q

Dental

A

First tooth about 6 months

Clean teeth with plain water and washcloth

{First tooth comes in at 6 months, and lose 1st tooth at 6 years}

Age of child in months minus 6 = # of teeth

35
Q

Dental

A

Routine fluoride supplementation is not recommended for infants younger than 6 months

Fluoride supplementation if there is not adequate fluoride in the water supply

36
Q

6 mo visit immunizations

A

Hepatitis B #3 (between 6 & 18 mo)

DTaP #3
Hib #3
Rotavirus #3
PCV #3

37
Q

Infants 7 - 9 months

A

Developing object permanence

Strong attachment behavior. Stranger anxiety. Develops attachment to blanket, teddy bear, etc.

Crawling

38
Q

Motor : 7 – 9 mo

A

Crawls vs Creeps

Fine motor – rake objects initially, progressing to crude pincer grasp

Feeds self cheerios

Transfers objects from hand to hand

39
Q

Motor: 7 – 9 mo

A

Goes from tripod sitting to sitting alone (about 8th month),

to pulling to stand

Stands while holding onto something

40
Q

Nutrition – Beginning to feed self

A

Raking to crude pincer grasp

Continue introducing foods slowly– soft mashed table foods

No egg white until after 1 year of age

41
Q

Foods NOT to feed a baby

A 
Honey 
Hot dogs
Grapes
Hard candies
Raw carrots
Popcorn
Nuts
Peanut butter
Cow’s milk of any kind before 1 year of age
42
Q

Sensory/Language 7 – 9 mo.

A

Babbles contentedly to self on waking

Responds to simple commands

Understands “no-no”

Depth perception developing

43
Q

Sensory/Language 7 – 9 mo.

A

Object permanence – Playing peek-a-boo is associated with development of object permanence

Identify causal relationships

Motor activity is necessary for cognitive development

44
Q

Age Appropriate Toys 6 – 9 months

A

Large toys with bright colors and moveable parts and noise makers

Pots and pans, nesting containers

45
Q

Physical – 10 – 12 months

A

Triple birth weight by 1 year of age

Head and chest circumference are equal

Length increases by 50% from birth length

Babinski reflex disappears

Lordosis evident during walking

46
Q

Fine Motor: 10 – 12mo

A

Neat Pincer grasp by 11 mo.

Feeding self with spoon

Wave bye-bye

47
Q

Sensory Language

A

Says “dada”, “mama” specifically

Responds to simple verbal requests
Knows own name

Uses simple gestures like shaking head for “no”

Says simple words to communicate needs – about 5 word vocabulary

48
Q

Nutrition

A

Wean from bottle to cup

Whole milk after 12 months

Eating 3 meals and snacks

No egg white until after 1 year of age

49
Q

Dental

A

Toothbrushing – Use a non-fluoride tooth paste until they are able to swish and spit

“Bottle-mouth” – caries in primary teeth from sleeping with bottle in mouth

50
Q

Age Appropriate Toys 9 – 12 months

A

Books with large pictures,

push-pull toys, teddy bears,

balls

51
Q

Causes for concern – 10 – 12 mo

A

Not crawling

Not pulling to stand

Says no single consonant sounds (da-da,ma-ma)

Does not use gestures

Does not respond to baby

games like “Pat-a-cake” or “Peek-a-boo”

52
Q

Poison prevention

A 
Most victims of poisoning are under 5 yr. age
Everything up and locked
Never store non-edible things in containers that are meant for edible things
Adult meds
Alcohol
Plants
Ashtrays
1-800-222-1222
53
Q

12 month visit

A

Lead screening
Hematocrit screening

4th dose of HIB and PCV 13

54
Q

Lead Blood Levels

A

Blood test done if infant is at risk at any time

Universal Lead Serum Test is done at 1 year and 2 years

55
Q

Lead Poisoning

A

The Blood Lead Level (BLL) for people living in the U.S. dropped from 12.8 mcg/dl in 1980 to 1.9 mcg/dl in 1999.

The level of concern for an elevated BLL has dropped from 80 mcg/dl in 1950 to 5 mcg/dl today.

56
Q

Lead poisoning – Nursing Interventions

A

Family education for preventing childhood exposure to lead

Wash toys and pacifiers frequently

Make sure that home exposure is not occurring from parental occupations or hobbies

Hot water dissolves lead, so use only cold water for consumption (drinking, cooking, making baby formula

57
Q

Lead poisoning – Nursing Interventions

A

Assist family to obtain sources of help for removing lead from the environment

Family education for preventing childhood exposure to lead

Do not vacuum hard-surfaced floors or windowsills or window wells in homes built before 1960, because this spreads dust

Wash and dry child’s hands and face frequently, especially before eating

58
Q

New immigrant communities have a higher risk of lead poisoning

A

Ayurvedic medicines from India

Eye makeup (surma) from India

Greta, Azarcon from Mexico (home remedies)

Day Tway from Thailand (digestive aid)

Ba-baw-san from China

59
Q

Car Seat

A

Continue rear facing car seat until child out-grows rear facing car seat by reaching the top height or weight limit allowed by your car seat’s manufacturer.

60
Q

Psychosocial Development
Erikson

Infancy 0 – 12 months

A

Trust vs. Mistrust

Require consistent, predictable, reliable care to accomplish this developmental task
Hope

61
Q

Hospitalization– Infant

Major fears:

A

Separation, strangers

Interventions:
Provide consistent caretaker
Attachment object

Minimize separation from parents and significant others

62
Q

Stages of Separation Anxiety

A

Stage 1 – Protest

Stage 2 – Despair- depressed signs

Stage 3 – Detachment- appears happy but is faking it

63
Q

Communication with Infants

A

Touch
Soft voice
Responsive to crying
Take turns in baby conversation

Develop from babbling & cooing to single word production

64
Q

Normal Infant Vital Signs

A

Temp: 36.5oC – 37.5oC (97.6o – 99.8oF) axillary

Heart Rate: 110 – 160
Respiratory Rate: 30 – 60

Pediatrics (24 decks)

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