Newborns and infants- 7

Question 1

Vision: least-developed sense

Answer 1

infants are attracted to bright colors and black and white because of limited vision; objects appear two-dimensional with poor peripheral vision until 2 to 3 months of age

Question 2

Smell:

Answer 2

well-developed sense; especially recognizes smell of own mother

Question 3

Taste:

Answer 3

well-developed sense; sweet tastes are preferred

Question 4

Hearing:

Answer 4

can hear beginning in the womb and can identify mother’s voice; differentiates between male and female voices; hearing is critical for language development

Question 5

Touch:

Answer 5

Touch is extremely important for the newborn; gentle touch or massage is calming and pleasurable. Pain is a protective device; the infant responds by extending and retracting the extremities and crying.

Question 6

Soothing Odors

Answer 6

Studies have shown that biologically meaningful odors such as amniotic fluid, colostrum, and breast milk are soothing to infants, particularly when obtained from the infant’s own mother.

Question 7

Hearing Screening at Birth`

Answer 7

Any infant who does not pass the newborn hearing screening has the potential for a developmental emergency (AAP, 2016c). Initial newborn hearing screening occurs in the hospital setting by specially trained nursing staff with any necessary follow-up testing recommended in the pediatric medical home

Question 8

Language Acquisition

Answer 8

partly innate and partly learned process

language is learned through socialization within the family context.

favorable responses to speech encourage the infant to communicate.

Question 9

Discipline

Answer 9

discipline at this age should focus on setting limits for the child’s safety and well-being.

Question 10

discipline what to do

Answer 10

At 6 months of age, when the child is more mobile, use distraction to keep the child away from dangerous areas.

Temper tantrums are the infant’s way of expressing frustration, hunger, anger, illness, or fatigue.

Reward good behavior.

Remain calm, firm, and consistent.

Maintain a set routine.

Question 11

Corporal Punishment

Answer 11

such as spanking or hitting, has been found to have negative consequences and is less effective than other forms of discipline, such as the withdrawal of positive reinforcement

Question 12

Colic ( disappears by about 12 to 16 weeks of age)

Answer 12

great deal of intestinal gas, resulting in frequent crying

Paroxysms of irritability, fussing, or crying that start or stop without obvious cause

Crying is turbulent and dysphonic, with a higher pitch

Episodes last 3 hours or longer and occur 3 days a week for at least 2 weeks, peaking at 6 weeks of age

Infant thriving

Diagnosis of exclusion

Question 13

Care of the Infant With Colic

Answer 13

Swaddle infant.

Place in a safe area.

Remove yourself from the infant for a 10-minute break once the child is secured in a safe place.

Educate caregivers that colic is not a reflection of their caregiving skills.

Realize that it is a heightened time of stress for caregivers.

Simethicone drops have been prescribed to ease intestinal gas, but never give an infant an over-the-counter medication without consulting the child’s pediatrician.

Question 14

play

Answer 14

how infants learn about the world and themselves. Infants are primarily sensorimotor focused, so play should involve sensory stimulation. Infants explore the world with their mouths and imitate those around them.

Question 15

Breastfeeding and Zika

Answer 15

No cases of Zika virus transmission have been associated with breastfeeding.

The CDC and WHO recommend that the benefits of breastfeeding outweigh the risks of Zika virus transmission through breast milk

Question 16

breastfeeding

Answer 16

until the age of 6 months and to continue until the age of 2 years, with no supplementation of water, formula, or solids prior to this point

Question 17

Nutrition infants between 6 months and 1 year of age:

Answer 17

Sufficient protein is needed to support growth and development.

Fats are needed to provide calories and support brain development.

Carbohydrates are needed to provide energy.

Infants need 100 to 116 kcal/kg/day for basic growth and development.

Adequate fluid and electrolyte intake is necessary.

Fluids, mainly water, should total 120 to 150 mL/kg/day for infants.
Supplemental iron is not necessary for breastfed infants before 6 months of age.

All infants 6 months or older require iron supplementation. Iron can be supplied through lean red meats, fortified infant cereals, spinach, broccoli, green peas, or beans.

Do not feed cow’s milk until after 1 year of age.

Question 18

Nonnutritive Sucking

Answer 18

Nonnutritive sucking is a self-soothing or comforting measure used by infants.

imit the use of the pacifier as the infant gets older to prevent creating a habit

Question 19

Breastfeeding

Answer 19

Should begin within the first hour after birth during the initial period of reactivity

Infant should be fed on demand throughout the day and night

Reduces costs and preparation time

Promotes positive bonding between infant and mother

Decreases risk for obesity

Question 20

Stage one:

Answer 20

Colostrum, a yellowish fluid, is present in the first 2 to 3 days after birth and has higher concentrations of protein and lower levels of fat, carbohydrates, and calories than mature milk.

It contains large amounts of IgA and IgG, and assists in the passage of the infant’s first stool, known as meconium

Question 21

Stage two:

Answer 21

The milk transitions from colostrum to more mature milk at about 3 to 10 days after birth. It consists of increasing fat, carbohydrates, and calories

Question 22

Stage three

Answer 22

Mature milk begins 10 days after birth. This mature milk has approximately 23 calories per ounce and is composed of foremilk and hind milk.

Question 23

Foremilk

Answer 23

is produced and released at the beginning of the feeding; it has a higher water and lactose content and a lower fat content.

Question 24

The hind milk

Answer 24

released at the end of the feeding and has a higher fat content.

Question 25

letdown reflex

Answer 25

forces milk into the lactiferous ducts of the breast. The letdown reflex is responsible for milk ejection

Question 26

breastfeeding hormones

Answer 26

estrogen and progesterone are eliminated and prolactin becomes the predominant hormone Oxytocin produces the letdown reflex

Question 27

letdown reflex triggers

Answer 27

sexual stimulation, when hearing a baby cry, or when thinking of the infant

Question 28

letdown reflex inhibited

Answer 28

anxiety, stress, fatigue, and pain

Question 29

how long to breastfeed

Answer 29

feedings should last between 10 and 30 minutes recommended one year

Question 30

6 months of age

Answer 30

``` ready for solid foods some breastfeeding no fruit juice spoon not bottle baby rice cereal ```

Question 31

8 months

Answer 31

strained fruit, vegetables, and strained meats can be introduced. one food at a time single ingredient food

Question 32

Self-feeding

Answer 32

when infants can sit up alone hold their necks steady draw in their lips when food is introduced into the mouth keep the food in their mouths and not push it back out.

Question 33

1 year

Answer 33

double handed cup nighttime feeding is last when weening no cow milk til 1

Question 34

Avoiding Clostridium botulinum Contamination

Answer 34

infants younger than 1 year should never be given honey or corn syrup spores are found in improperly stored foods, home-canned foods, processed foods such as potato salad, restaurant-prepared foods, and bottled garlic

Question 35

newborns sleep

Answer 35

average 8 to 9 hours per day and 8 hours at night. substantial time in rapid eye movement (REM) sleep indicative of rapid brain growth

Question 36

3 months of age sleep

Answer 36

REM sleep decreases and non-REM sleep occurs

Question 37

Sudden infant death syndrome (SIDS)

Answer 37

leading cause of death from 1 month to 1 year of age, peaking between 2 and 4 months These are infant fatalities from an unknown cause and are not associated with infection, choking, vomiting, or abuse.

Question 38

Bumper Pads

Answer 38

bumper pads never be used in the cribs of infants.

Question 39

SLEEP PATTERNS THROUGH AGING

Answer 39

Infants’ increase in sleep patterns is tied to growth spurts Infants, like adults, progress through REM and non-REM sleep cycles.

Question 40

Infant Sleep and Parental Behavior

Answer 40

There are links between infant sleep and parental behaviors, cognitions, emotions, and relationships, as well as psychopathology. Parental behaviors are closely related to infant sleeping patterns

Question 41

Sucrose solution

Answer 41

provides analgesia for minor procedures.

Question 42

Circumcision

Answer 42

removal of the prepuce of the penis performed for religious, cultural, hygienic, or social reasons no medical reason done before discharge unless problem

Question 43

warning signs circumcision

Answer 43

Persistent bleeding or blood on diaper (more than quarter-sized) Increasing redness Fever Other signs of infection, such as increased swelling or discharge, or the presence of pus-filled blisters Not urinating normally within 12 hours after the circumcision

Question 44

Umbilical cord blood banking

Answer 44

fee-for-service option that stores cord blood obtained at the time of delivery to provide possible future reimplantation through the cryostorage of stem cells from the cord blood

Question 45

Pediatric Medical Hom

Answer 45

This model delivers “primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and cultural effective for every child”

Question 46

taking temp

Answer 46

no rectal take if fever suspected no mercury axillary

Question 47

Signs of Illness in the Newborn and Infant

Answer 47

Axillary temperature greater than 99.3°F or rectal temperature greater than 100.3°F Vomiting Decrease in the number of wet diapers Sunken or bulging fontanels Loss of appetite Foul odor or bleeding from the cord or circumcision Decreased level of consciousness; lethargy Increased irritability Blue or cool hands and feet Skin rash Drooling not associated with teething Refusal to lie down if 8 months of age or older

Question 48

sibiling rivalry education

Answer 48

- attend sibiling classes - include siblings in the supervised care of the infant as appropriate. - dont leave infant alone with young sibling - foster bonding - quality alone time w parent and sibling

Question 49

Milestone Concerns or Red Flags

Answer 49

No attempts by the infant to lift head when lying facedown No improvement in head control Does not respond to loud noises Extreme floppiness Lack of response to sounds or visual cues, such as loud noises or bright lights Inability to focus on a caregiver’s eyes Poor weight gain Does not crawl by 12 months

Question 50

Fostering Positive Parenting Skills

Answer 50

Talk to the infant. Respond to infant’s sounds by repeating and adding words. Read to the infant; this helps to develop and foster understanding of language and sounds. Sing to or play music for the infant. Praise the infant and give the infant attention. Spend time cuddling and holding the infant so that the infant feels cared for and secure. Play with the infant when he or she is alert and relaxed. Watch for signs of being tired or fussy so that the infant can take a break

Question 51

Pain in infants

Answer 51

- painful to adult=painful to infant - facial expressions such as bulged brow, eyes squeezed shut, open mouth, and quivering chin. - increased heart rate, respiratory rate, elevated systolic blood pressure, and decreased oxygen saturation. - depression of the immune system through the depletion of mature white blood cells because of heightened stress responses. - Gastric acid production increases. - Dilated pupils and sweating may be observed.

Question 52

Pain relief

Answer 52

should be intravenous or oral; if administering opioids, closely monitor respiratory rate and pulse oximetry Use EMLA cream or similar topical anesthetics when starting IVs

Question 53

Nonpharmacological Pain-Prevention Methods

Answer 53

``` Breastfeeding Nonnutritive sucking Kangaroo care Swaddling Limiting environmental stimuli Attention to behavioral cues ```

Question 54

Infant Massage

Answer 54

Stimulates organized sleep patterns Enhances growth May assist with colic in infants Promotes bonding with caregiver

Question 55

Music Therapy

Answer 55

improve sucking, weight gain, sleep, and recovery from painful procedures, especially in premature infants

Question 56

Respiratory syncytial virus (RSV)

Answer 56

acute infection limited to the lower respiratory tract and sometimes accompanied by fever in most healthy full-term infants

Question 57

Prematurity

Answer 57

primary reason for low birth weight and carries a high risk for developmental and motor delay.

Question 58

shaken baby syndrome

Answer 58

Most victims are infants younger than 1 year; the average age is between 3 and 8 months. Pay special attention when choosing a babysitter. Research suggests that teenage fathers are more likely to cause shaken baby syndrome. Contrecoup, injuries to the opposite side of the head, are common. Detached retinas may result. Permanent brain damage may result. Death may result.

Question 59

Warning signs of sexual abuse in infants include

Answer 59

Stained or bloody diapers Genital or rectal pain, swelling, redness, or discharge Bruises or other injuries in the genital or rectal area Difficulty eating or sleeping Excessive crying Withdrawing from others Failure to thrive

Question 60

Warning signs of physical abuse in infants include:

Answer 60

Unexplained or repeated injuries such as welts, bruises, burns, fractured skull, and broken bones, especially spiral fractures Injuries in the shape of an object (e.g., belt buckle, electrical cord, cigarette) Injuries that are unlikely given the age or ability of the child, such as broken bones in a child too young to walk or climb Disagreement or inconsistency in parent/caregiver explanation of the injury Unreasonable explanation of the injury Fearful or detached behavior by the infan

Question 61

An infant may be subject to emotional abuse in the presence of these warning signs:

Answer 61

Aggressive or withdrawn behavior Shying away from physical contact with parents or adults Basic needs of food, warmth, and cuddling not met

Question 62

Infant neglect may be indicated by:

Answer 62

Consistent failure to respond to the child’s need for stimulation Actively refusing to respond to the child’s needs Parents/caregivers expressing the fact that they are not going to spoil the baby or referring to the baby as evil Infant with malnourished appearance Obvious neglect of the child Failure to provide necessary medications for chronic condition Delays in calling for help or taking infant to the doctor