Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
NSG 309 peds
Ch 16 - Newborn/Infant Care
| Question | Answer |
|---|---|
| Newborn/Infant Developmental patterns | Age: Newborn - 12 months old - cephaloclaudal pattern (gain skills from head to toe) - proximodistal pattern (gain skills from trunk out to extremities) Gross motor skills before fine motor skills |
| Newborn/infant F/U Health assessment timeframe | -Newborn - 1 month - 2 months - 4 months - 9 months - 12 months |
| Physical exam for infants | - Assessment on caregiver's lap and explain everything to them - Auscultate first while quiet/sleeping and perform invasive procedures last - Assess for hip dysplasia - Respirations must be counted with exposed abdomen (care for body temp) |
| Fontanelles | Anterior (larger, close at 9-18 months) vs posterior (smaller, close at 2-3 months) |
| Physical Variations in Newborns/Infants | - Strabismus up to 6 months - Barrel chested (1:1 AP-transverse) - high HgbF (fetal Hgb) + anemia |
| Bone development in Newborns/Infants | - Fontanelles - incomplete bone ossification - benign metatarsus adductus (inward curving feet) |
| Skin variations in Newborns/Infants | - Possible acrocyanosis with decreased body temperature - Salmon patches - Mongolian spots |
| Newborn/Infant Primitive Reflexes | Present at birth and disappear over 1st year - sucking - rooting - Babinski (12-24 month duration) - Moro (startle) - stepping - palmar grasp - tonic neck (fencer) |
| NB/Infant reflex development | - Spinal cord myelination from NB -> 24 months age - Development of protective reflexes after disappearance of primitive reflexes |
| Cardiac and respiratory variation in infants/NB | - Irregular respirations w/ pauses, irregular HR - possible S3 sound and asymptomatic murmurs - diaphragmatic breathing |
| Meconium | Newborn's first stool, usually thick/green |
| Infant/Newborn stool quality | - breastfed - thinner consistency, seedy/yellow - formula fed - pastier consistency, darker color |
| Normal infant BMs | normal 1 BM every 1-2 days up to 10 BMs daily - consistency more important, not quantity (short bowels) - grunting not sign of constipation |
| FLACC scale | Face, Legs, Activity, Cry, Consolability 0-2 score 0-10 total score |
| NIPS scale | Neonatal Infant Pain Scale - facial expression, cry, breathing pattern, arms, legs, state of arousal - 0-1 scale for all criteria (*crying is 0-2*) - max score 7 (7-10 determines severity) |
| Physical growth in infants | 0-6 months: 1.5-2.5 cm in length/month 6-12 months: 1 cm in length/month 0-3 months: 20-30g/day Weight 2x by 4-6 months Weight 3x by 12 months Rapid head circumference gain up to 6 months, then slowed until 12 months |
| Infant developmental theories | Erikson: trust vs mistrust (psychosocial) - reliance of caregivers and needs met Piaget: sensorimotor (cognitive) - learn about world via sensations Freud: oral motor (psychosexual) - oral sensations for pleasure eg. sucking |
| Communications in Infants | communication via crying pitch variation based on needs - 2 months: cooing - 6 months: babbling - 9 months: copying sounds - 12 months: few words - by 12 months: use of simple gestures |
| Visual development in Infants | 20/400 vision at birth chromatic vision DLC released after 7 months of age |
| Sensory preferences in Infants | - high pitched voice - sweet taste > sour tastes - soft gentle touch |
| Cognitive development milestones in Infants | 2 mo - watch caregivers moving and focus on toy briefly 4 mo - open mouth on seeing breast/bottle when hungry 6 mo - put object in mouth/reach for toys; close mouth after eating 9 mo - development of object permanence 12 mo - able to put objects in container and look for hidden objects |
| Assess growth/development of premature infants | use adjusted/corrected age to determine expected outcome - Gestational age (time of birth since pregnancy) (40 weeks - GA) = prematurity in weeks Chronological age - (40 weeks - gestational age) = adjusted age eg: chronological age 12 weeks with gestational age 30 weeks (40 - 30) = 10 weeks premature 12 - 10 = 2 weeks old (adjusted age) |
| Infant temperaments | - Easy temperament (easily adaptable/happy) - Slow to warm up (medium fussiness with initial negative reaction) - Difficult temperament (need high activity level, commonly fussy/crying) parent based on temperament |
| Social determinants of health for infants | Risks: tobacco exposure, food/housing insecurity, parental substance abuse Protective factors: support network, positive family relationship, adequate childcare -Parent/infant relationships and daily routines - Home environment/parental knowledge (safety monitoring) |
| Sleep in infants | - Recommend sharing bed up to 6 months - Sudden infant death syndrome (SIDS) prevention techniques - Infants should sleep on back (SIDS prevention) - sleeps 16 hours daily |
| Play in infants | Activities: reading, singing, playing with age appropriate toys - Infants: engage in solitary play - Younger infants: toys for kicking/batting, unbreakable mirrors, contrasting patterns - Older infants: toys that make noise/light up, soft dolls, teething toys, board books, large blocks |
| Types of vaccines | Live attenuated Inactivated Toxoid Conjugate |
| Barriers to immunization | Lack of transportation Financial concern Safety concerns |
| Vaccination recommendations | Birth: HBV x 3, RSV x 1 2-6 months: - RS1 (x2) or RV5 (x3) - 2-6 mo - DTaP (x3) - 2-6 mo - Hib (x4) - 2-6 mo - PCV-15/20 - 2-6 mo IPV (x3) - 2-18 mo Influenza - annual after 6 mo |
| Infant nutrition | - Breastfeeding vs formula Hunger cues: rooting/sucking, crying and opening mouth, moving hands to mouth - Start solid food at 6+ months - tongue extrusion reflex goes away and able to sit in high chair with head control - Recommend start iron fortified cereal then add pureed foods (start slow for allergy) |
| Tongue extrusion reflex | stick tongue out when stroking chin/mouth prevents choking in infants and assist with feeding starts to disappear around 6 months |
| Infant oral health | First tooth @ 4 months Teething signs: fussy/irritable, increase salivation, low grade fever, difficulty sleeping - Frozen teething rings/topical analgesics - Wash gums with soft washcloth or infant toothbrush until tooth eruption - dental caries prevention with avoidance of refined sugars and propping bottles |
| Colic | Self limiting condition of increased fussiness and inconsolable crying - peak at 6 weeks of age and resolves by 3-6 months - worse in evening - no treatment for infant, caregiver need psychological and emotional support - encourage to lay infant in crib when frustrated |
| Brief Resolved Unexplained Events (BRUE) | S/S: cyanosis/pallor, irregular/slowed/absent breathing, hypertonia/hypotonia, altered level of responsiveness - lasts <60 seconds - need HCP evaluation - Elevated risk with <2 month age, Hx prematurity, Hx 1+ BRUE event - Signify possible underlying neurological condition |
| Diaper dermatitis | any skin breakdown in the diaper region S/S: erythamatous and excoriated skin (skin folds not affected), pain in area Tx: leave diapers off and allow skin to dry, commercial barriers - Notify HCP if signs of infection |
| Seborrhea | Aka "cradle cap" S/S: scaly scalp skin, erythema, not painful/itchy - Resolve by 12 months Tx: remove scales with soft brush, hydrocortisone cream if extends past scalp |
| Fevers | 100.4 F and up S/S: tachypnea/tachycardia, irritability - sign of illness/infection - use antipyretics in infants only if symptomatic and irritable - monitor for poor perfusion, hypo/hyperventilation use rectal thermometer for fever work up |
Created by:
sleepingbear