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48 Cards in this Set
- Front
- Back
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Stages in the Prenatal Period
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Germinal
Embryonic Fetal |
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Germinal Stage
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Conception to 14 days
Rapid cell division |
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Embryonic Stage
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2nd to 8th week
Rapid cellular differentiation Vulnerable to noxious stimuli |
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Fetal Stage
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8th week to birth
Rapid growth and differentialtion of organs |
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Prenatal Nursing implications
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Early prenatal care
- stress reduction Complete Physical Nutrition - Vitamin supplements - Well balanced diet - WIC |
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Prenatal Safety Considerations
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Vulnerable to substances consumed by the mother
Alcohol Drugs - Teratogenic substances - OTC - Prescription - illegal the blood brain barrier is not very permeable but the placenta is, so pregnant women need to be careful what drugs they take. |
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Describe the neonate stage
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Birth to 1 month
Highest infant mortality rate in first 30 days Adjustment to extra-uterine life Energy working towards individual life |
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Assessments right after birth
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APGAR scores taken immediately after birth, 1min, 5 min, 10 min (10 is the highest, good if over 7)
Scored by nurses and/or doctors Assesses how child is adjusting to extrauterine life Physical assessment |
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Describe neonate
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Term 37-40 weeks (before 37 weeks preterm, after 40 weeks postterm)
Height (19-21 inches) Weight (5lbs 14 oz to 9lbs) Head circumference (32-37 cm) Heart rate (120 to 180 bpm) Respiratory rate (40 - 60min) Fontanels open anterior and posterior |
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Neonatal behaviors
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Sleep 20 to 24 hrs
Feed at breast every 2-3 hours Formula every 3-4 hours Voids 6 to 8 times a day Stools - meconium to transitional to yellow seddy |
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Neonate - pyschosocial development
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Bonding and attachment to caregiver
Feeding bottle or breast Crying, eliminating, sleeping |
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Advantages of breastfeeding
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Healthy people 2010
Increase to 75% of mother's breastfeeding Maternal benefits Human milk for human babies Increase bonding Composition adjusts to baby's needs Protection against disease |
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Advantages of Breastfeeding - Maternal Benefits
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Maternal benefits
- Aids uterine involution - convenience at low cost - Lessens risk of breast cancer |
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Advantages of breastfeeding - Protection against disease
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passive immunities
gastrointestinal infections less lowers risk of alleries |
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Neonate - Cognitive changes
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Piaget's sensorimotor development
Innate behavior Reflexes Vision 8 to 10 inches Prefer infant faces Black and White shapes Crying is a way to communicate |
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Neonate Health Risks
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Airway patency
Thermoregulation Prevention of infection Abduction Hearing screen |
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Which neonates are at high risk for infection?
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Premature babies - problems with thermoregulation
Too cold a body temp - hypoxia, acidosis If Mom has STDs |
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Infancy (1 to 12 months)
Biophysical Growth |
Infants born helpless and weak
Develop faster than ever will again Examined every 2 to 3 months Double birth weight by 6 months Triple birth weight by 1 year Height 1 inch in first 6 months and 1/2 inch next 6 months Brain 25% adult weight at birth Increases to 60% by 1 year of age |
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Infant (1 to 12 months)
Sensory Development |
Senses present, but not well defined
Vision becomes more acute Depth perception at 12 months of age improves Hearing more refined Sense of taste and touch more defined Prefers sweet |
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Infant (1 to 12 months)
Gross motor development |
Cephalocaudal and proximodistal development
At 3 months - hold head up At 6 months - rolls completely over At 9 months - sits independently, crawls At 12 months - pulls upright, cruises on furniture At 15 months - walks |
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Infancy (1 to 12 months)
Psychosocial - Language development |
Prelinguistic - no words
Cry is a way of communication At 2 months - uses voice to get attention Main focus of infant is getting needs met Need to bond to survive |
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Describe Freud's Oral Stage
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Mouth is chief source of pleasure
Activities involving mouth such as sucking, biting, and chewing Babies bring everything to mouth If all of the child's oral needs are met iwth consistency Successful completion of this stage allows the chiold to move to the next stage |
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If a child is deprived of oral needs being met, what happens?
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Unsuccessful mastery of this stage the person has an oral personality
Oral personality is someone who constantly needs to chew gum, smoke, and over-eat |
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Erickson - Trust versus Mistrust
(Infancy) |
-Sense of trust based on the child's needs being fulfilled by the parent
-Consistently with few caregivers -Infants learn to trust adults when they convey love and compassion -Keep routines, feeding, bathing consistent -If the child's needs are not met poor social development learns to mistrust |
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Piaget - Cognitive Development
Sensorimotor (birth to 2 years) Stage 1 (0-1 month) |
Use of reflexes
sucking and rooting, not a lot of thought |
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Piaget - Cognitive Development
Sensorimotor (birth to 2 years) Stage 2 (1-4 months) |
First habits and proimary circular reaction:
Baby does something accidentally leads to result (suck on thumb) baby tries to acheive result again |
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Piaget - Cognitive Development
Sensorimotor (Birth to 2 years) Stage 3 (4-8 months) |
Secondary circular reaction
Same as primary involves object (shaking of rattle), Repetition of an action involving an external object (moving a light switch to turn on a light repeatedly) |
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Piaget - Cognitive Development
- Sensorimotor (Birth to 2 years) Stage 4 (8-12 months) |
Coordination of secondary circular reactions
Baby intentionally performs an action with a goal crawls to get a toy |
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Piaget - Cogntive development
Sensorimotor Period (Birth to 2 years) |
Infants are aware of only what is immediately in front of them, what they are doing, physical interactions with the environment. Initially Reflexes (sucking and rooting), then does something accidentally (thumb in mouth) and takes pleasure in it, then tries to do it again. Generalize their activities into a wider range of situations and coordinate them into longer chains of behavior.
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Piaget Cognitive Development
Pre-operational Thought (2 to 6 or 7 years) |
Children acquire representational skills in the area of mental imagery, and especially language. Very self-oriented, egocentric point of view. Use representational skills only to view the world from their own perspective
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Piaget Cognitive Development
Concrete operations (6/7 to 11/12 years) |
Able to take another's point of view. Can understand concrete problems, not abstract problems.
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Piaget Cognitive Development
Formal operations (11/12 years to adult) |
Capable of thinking logically and abstractly. Can reason theoretically
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Object Permanence
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1-4 months - stares at last place an object was
4-8 months - doesn't know to search for an object 8-12 months - will search for hidden objects (toy hidden under a blanket) Also begins separation anxiety |
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Kolberg's moral development
(Infancy) |
Egocentric
No moral development |
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Up to 12 months #1 cause of death
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SIDs
twice as much as #2 (congenital abnormalities) #3 Injuries #4 Pneumonia and influenza #5 Homicide - Shaken baby syndrome |
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Infant health Promotion
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Prevent SIDS - back to bed
Injury prevention Car seats Child maltreament Aspiration Suffocation and drowning Falls Vaccines (immunologic system is not fully developed) Prevent tooth decay - no bottle to bed Encouraging sleeping through the night Electrical outlet safety plugs Provide stimulation |
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Introducing Solid Foods
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Introduce solid foods at 6 months
1 food at a time, every 3 days |
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Toddler (15 - 36 months)
Biophysical Development |
Rate of growth slows
2 1/2 years - 4 times birthweight Height - 3 inches per year Bow legs Brain - 75% adult size |
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Toddler (15-36 months)
Gross Motor Development |
Walks independently
Becomes more coordinated Striving for independence Feeds self |
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Toddler Psychosocial development
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Strive for independence
Master bodily functions Temper tantrums Firm, but consistent limits, socially acceptable behavior Extremely curious |
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Toddler Language Acquisition
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18 months - uses approximately 10 words
24 months - 300 words, strings 2 words together Favorite word is no Starts to sing songs |
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Erickson (Toddler)
Autonomy versus Shame and Doubt |
Socially toddlers are striving for independence
Remain strongly attached to their parents and fear separation Nervous to step out and explore but want to experience new things Positive resolution good self-control and esteem Negative resolution compulsive, self-restraining |
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Freud Anal Stage
(Toddler) |
Anus and rectum are areas of pleasure
Controlling and expelling feces provide sense of self control Holidng it in/letting it go Begin toilet talk and toilet training Must be physically mature, have sphincter control and able to communicate the need to go |
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Piaget - (Toddler)
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Still in Sensorimotor
Tertiary circular reaction - able to enter into an action at any given time, not just trial and error (Now they drop the spoon not just let it drop) Ability to think Shape boxes |
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Preconceptual Stage
(Piaget) |
Begins at 2 to pretend
Doll is a baby Object has to resemble Rituals and routines are comforting |
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Kolberg - Moral Development
Toddler |
Stage 1 - Preconventional
Child begins to understand morals if you do something wrong you will get punished The bully in the nursery grab the toy for sport Unable to put themselves in others' shoes 1 min/year for timeouts |
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Nursing Implications - Toddlers
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Health risks
Motor vehicle accidents Falls, drowning, burns, toxic ingestion Nurses who work with toddlers need to be aware of stranger anxiety Allow children to play with medical equipment |
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Health promotion - Toddlers
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Nutrition requirements slow
Picky eaters,need less milk (no more than 24 oz - milk anemia) Cut food up into small pieces Curiosity - be careful |
