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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.
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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
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Maturation of Systems Respiratory Cardiovascular changes
Hematopoietic changes Digestive processes Immune system Thermoregulation Body fluid Renal system Sensory Fine motor development Gross motor development
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Psychosocial development
Trust vs. mistrust Delayed gratification Primary narcissism Biting
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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
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Social Development Attachment to parent
Able to discriminate mother Reactive Attachment Disorder (RAD) Separation anxiety: 4-8 months Stranger fear Language development Play Temperament
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Concerns r/t normal growth and development
Separation and stranger fear Child care Limit setting/discipline Thumb sucking/pacifiers Teething Shoes
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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
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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
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Promoting Health During Infancy
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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
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Ch 11: Health Problems of Infants
Pg 382
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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
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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
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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
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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)
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Feeding Difficulties Regurgitation GER/GERD Colic (paroxysmal
Spitting up GER/GERD Reflux Colic (paroxysmal abdominal pain) Symptoms Management
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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)
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Other Disorders Positional Plagiocephaly Symptoms Management Treatment
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Disorders of Unknown Etiology
Sudden Infant Death Syndrome SIDS Etiology Management Prevention Assisting the family
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Disorders of Unknown Etiology
Apnea of Infancy Pauses of breathing >20 seconds Many Causes Can happen with or without ALTE
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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
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