Laura Salisbury RN, MSN/Ed. Ch 10: Health Promotion of the Infant and Family Ch 11: Health Problems of Infants Laura Salisbury RN, MSN/Ed.

Ch 10: Health Promotion Biologic Development Birth weight, height Growth in spurts Fontanelles: when closed? Chest circumference equal to head circumference by end of the first year

Maturation of Systems Respiratory Cardiovascular changes Hematopoietic changes Digestive processes Immune system Thermoregulation Body fluid Renal system Sensory Fine motor development Gross motor development

Psychosocial development Trust vs. mistrust Delayed gratification Primary narcissism Biting

Cognitive Development Learning to separate Object permanence Use of symbols Sensorimotor phase Birth to 1 month: use of reflexes 1-4 months: primary circular reactions 4-8 months: Secondary circular reactions Imitation and play 8-12 months: fourth Sensorimotor phase: coordination of secondary schemas Development of body image

Social Development Attachment to parent Able to discriminate mother Reactive Attachment Disorder (RAD) Separation anxiety: 4-8 months Stranger fear Language development Play Temperament

Concerns r/t normal growth and development Separation and stranger fear Child care Limit setting/discipline Thumb sucking/pacifiers Teething Shoes

Promoting Health During Infancy Nutrition First 6 months Second 6 months Starting solid foods Weaning Sleep and Activity Typical sleep patterns Typical activity patterns Sleep problems (p348) What about the “family bed”? Dental Health Cleaning of teeth Fluoride

Promoting Health During Infancy Immunizations Hib Hep A Varicella Hep B Pneumococcal DTaP Influenza Polio MMR Meningococcal Know what each immunization is for and approximate schedule of administration(pg 352) Typical reactions to immunizations Precautions and contraindications

Promoting Health During Infancy

Promoting Health During Infancy Injury Prevention Aspiration of foreign objects: toys, food, pacifiers Suffocation Motor vehicle injuries: car seats Falls Poisoning Burns Drowning Bodily damage

Ch 11: Health Problems of Infants Pg 382

Nutritional Disorders Vitamin imbalances Vitamin D Vitamin A and measles Vitamin C Overdoses: vitamin A and D Complementary and alternative medicine Mineral Imbalances Iron Zinc Calcium

Nutritional Disorders Vegetarian Diets Types of vegetarians Lacto-ovo Lacto-vegetarians Vegans Macrobiotics Semi-vegetarians When is supplementing needed? Vegetarians need to get complete proteins Essential amino acids

Nutritional Disorders Nursing care management Know factors that affect iron absorption (box 11-1, p. 380) Complete proteins and incomplete proteins Protein-energy malnutrition (PEM) Kwashiorkor Marasmus Management of PEM

Food Sensitivity Food allergy Food intolerance Food hypersensitivity Systemic Gastrointestinal Respiratory Cutaneous Atopy Cow’s milk allergy Lactose intolerance (See “family-centered care” box on p. 388)

Feeding Difficulties Regurgitation GER/GERD Colic (paroxysmal Spitting up GER/GERD Reflux Colic (paroxysmal abdominal pain) Symptoms Management

Feeding Difficulties Growth failure (failure to thrive or FTT) Organic failure to thrive Nonorganic failure to thrive Idiopathic failure to thrive Evaluation Management (See Nursing Care Guidelines box, p. 399)

Other Disorders Positional Plagiocephaly Symptoms Management Treatment

Disorders of Unknown Etiology Sudden Infant Death Syndrome SIDS Etiology Management Prevention Assisting the family

Disorders of Unknown Etiology Apnea of Infancy Pauses of breathing >20 seconds Many Causes Can happen with or without ALTE

Disorders of Unknown Etiology ALTE Apparent life-threatening event Sometimes called near-miss SIDS Infant found in state of apnea/cyanosis May require significant interventions including CPR May or may not have a history of apnea Monitors can be used but can be very stressful for parents/family