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

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Flashcards in Exam 1 - Health Promotion of the Newborn and Infant PP Deck (64)
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1

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

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

2

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

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


All newborn senses are very acute, except for sight.

3

First reactivity period

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

4

Second reactivity period

Occurs when infant wakes from first deep sleep

Lasts 2-5 hours: alert and responsive

5

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

Ophthalmia neonatorum–
Chlamydia
Gonococcal conjunctivitis

6

Motor development is based on infant reflexes

Rooting
Sucking
Doll’s eyes
Moro
Palmar
Step
Babinski

7

Nutrition

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

8

Promotion of 
Successful Breast-Feeding

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

9

Breast Milk

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

10

Breast Milk

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

11

# of wet diapers

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

12

Sudden Infant Death Syndrome

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

Occurs between midnight and 9am

Increased incidence in winter

Back-to-Sleep campaign

13

Colic

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

14

1 week/2 week visit

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

15

Neonatal Normal Vital Signs

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

Heart rate: 120 – 160

Resp rate: 30 -- 60

16

1 – 3 month old -- Physical

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

17

2 month visit

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

18

Two month milestones 


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


19

2 month visit immunizations

DTaP – Diphtheria, Tetanus, acellular Pertussis

Hib -- Haemophilus influenzae type B

Rotavirus

IPV – Polio (inactivated poliovirus vaccine)

Pneumococcal

20

Age appropriate toys

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

2 – 4 months: rattles, cradle gym

21

3 month cause for concern

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

22

4 – 6 mo -- Motor

Sits with support

Discovers hands, begins reaching and grabbing

Brings hands to midline

Begin playing with rattles, squeaky toys, etc.

23

4 – 6 mo -- Motor

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

24

4 – 6 months-- Motor

Tongue thrust diminishing

Teething begins – drooling

Putting weight on feet when held upright

Fine motor – Rakes objects

25

Sensory/Language ( 4 – 6 mo)

Ma-ma, Da-da vocalizations

Begins consonant sounds first, then vowel

Responds to rhythms

Tracks objects with eyes– 180 degrees

26

Social/Emotional ( 4 – 6 mo)

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

Parent-Infant Attachment

Reciprocal cycle establishes trust and produces confidence in parents

28

Age Appropriate Toys 4 – 6 months:


Bright colored, soft toys
Small enough to grasp

29

Nutrition ( 4 – 6 mo)

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

4 mo visit immunizations

DTaP #2
Hib #2
Rotavirus #2
IPV #2
PCV (Pneumococcal) #2