Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/87

Click to flip

87 Cards in this Set

  • Front
  • Back
How doe infants grow?
cephalcaudal
proximal to distal
Time frame for an INFANT
day 28-1year of age
Maturation of systems for infant
HEART-hr slows
LUNGS-still sm predisposed to Resp problems
HEMOPOIETIC->fetal heme physicologic anemia
DIGESTIVE-immature until 3mo
IMMUNE-materal IgG ist 3mo
THERMOREGULATION-<6mo no shivering >6mo can shiver
RENAL-immature, low GFR
HEARING-adult level
VISION-binocular vision 4mo, depth perception 7-9mo
Infant physical develpment
HR- 100-220 BPM
Abdominal respiration- 30
BP- 90/60
LENGTH WILL INCREASE BY 50% IN FIRST YEAR
WEIGHT TRIPLES AT 1 YEAR
Head/chest circumference=12mo
closure of posterior fontanel at 6-8wks
GROSS MOTOR DEVELOPMENT
head Lag
1mo-complete head lag
2mo-partial head lag
4mo-no head lag
GROSS MOTOR DEVELOPMENT
Rolling over
Abd-back at 5mo
back to abd 6mo
*newborns can roll by accident keep safe*
GROSS MOTOR DEVELOPMENT
Sitting
7 mo- can sit alone support self with hands
8 mo- can sit unsupported
10 mo- prone to sitting position
GROSS MOTOR DEVELOPMENT
Locomotion
6-7mo full wt-bearing
9mo- crawling to creepin on hands/knees
11 mo- walk holding onto furniture
12 mo- walk with one hand held
FINE MOTOR DEVELOPMENT
Crude pincer
8-10mo grasps object using palm. pincer graps is good indicator of neuromuscular maturity
FINE MOTOR DEVELOPMENT
Neat pincer
able to grasp small objects using forefinger/thumb 10-11mo
Erickson
Infant
TRUST VS MISTRUST
nn to provide comfort and security. quality of infant/parent relationship vital for developing trust
ERICKSOM
first social/oral stage
3-4mo. trust centered around food intake. child narsisitic. demonstrated by interactive behavior, crying and holding hand out. illict a response
ERICKSON
seocnd social/oral stage
active aggression. control over environment. develops first conflict ie when teething likes to bite mom but mom doesn't like to be bitten
Infant Piaget
Sensorimotor phase
birth-1 mo:reflex behaviors;sucking, rooting, crying, simple and repetitive task to illicit response. if parent responds builds trust
Infant Piaget
Circular reactions
1mo-2yr; simple and repetitive actions to illicit response done with DELIBRATE intent- begin to have seperation anxiety, object permenance-think of objects w/o experiencing them
OBJECT PERMANENCE
9-10 month of age. basic to development of self-image. have interst in own image. plays with own body parts. milestone!! Recognize this behavior and give + reinforcemtn
Social development
influenced intiially by reflexive behaviors
-attachment
-social smile 2mo
-laugh 4mo
-affection-12mo
-fear- new experiences,strangers
6mo begin to differentiate b/w caregiver and others
6-8mo stranger anxiety
health promotion/infant
injuries are a major cause of death in children 6-12 months of age.
do risk assessment, look at environment
teach preventive measures
health promotion/infant
Suffocaton
increased risk. watch out for plastic bags.
make sure crib matteress should fit properly
no pillows
crib slats 2 3/8" apart
baloons, beanbags and food such as hot dogs nut candy
health promotion/infant
aspiration
no powder unless put on hand first then spread
-never prop up a bottle
-pacifier all one piece
-toys w/ strings and cords
-mesh playpens risky
-bibs choking hazzard
-watch out for h2o even sm amts
-appliances
health promotion/infant
motor vehicle safety
should be restrained in a rear-facing car seat from birth to 20pd/1yr
-important to teach parent and also how to properly use
health promotion/infant
falls
never leave unattended on a raised surface with no guard rail. i.e. highchairs, changing tables, walkers, stairs, swings
health promotion/infant
posioning
Improper storage
ingestion
inhalation
make sure have safty latches, don't put cleaning labels in other bottles.
posion i.e. ointments, creams, batteries, lead paint, aerosol spray, smk
health promotion/infant
nursing care for posioning
-assess the victim
-terninate exposure
-identify the posion
-remove posion
-prevent further absorption(make sure poison control # available)
-lead poisoning
LEAD POISONING
chelating agents render lead nontoxic promotes excretion via the kidney
universal screening for all
if labs >10 continue to monitor
if >20 chelation therapy
careful as tx can cause renal necrosis-monitor kidneys closely
Assessment
communication
how does infant communicate? babbling and cooing to 3-5wrd by 1yr
Assessment
PLAY
needs to be played WITH, not by selfs.nn interaction with caregiver for development, infant can't initiate on own
birth-3mo; talk/sing
3-6mo; rattles, soft toys, swing w/ supervision
6-12mo sensory/motor, peekaboo, patty cake, squeeze toys, soft books
Assessment
nutrition
Breast Milk; most desirable complete diet for 1st 6mo
Formula: iron formulated, DON'T EXCEED 34OZ, risk for iron deficient anemia
when should whole milk be introduced
not until infant is one year. it is difficult to digest and hard on kidneys and predisposes to allergies, irritating to GI, can cause occult blood in stool
AAP RECOMMENDATIONS:NUTRITION
all infants should receive 200IU Vit D beginning at 2months of age
Iron supplementation for breast fed infants at 4-6 og age.
ASSESSMENT-NUTRITION
solids 4-6mo assess readiness, extrusion reflex?
food sequencing-cereal-fruit-veggies-meat
one new food q 4-7d
decrease quantity of milk as solids increase
what should you do prior to feeding cereal
breast or bottle feed
ASSESSMENT-DENTITION
FORMULA TO ASSESS NUMBER OF TEETH IN CHILD UNDER TWO
AGE IN MONTHS - 6 = #TEETH
ASSESSMENT-DENTITION
teething begins around 4mo
first tooth around 6mo
prevent nursing carries-no bottles in bed
fentle brushing with soft cloth/brush and no toothpaste
ASSESSMENT-SLEEP
by 3-4mo hope to have nocturnal sleep pattern
15h total sleep
breast fed babies may sleep less due to more freq feeding
by 12 mo 1-2 naps/day
USE OF A CRIB
place infant in crib awake vs. asleep. don't use as a playpen, graduated extinction(think ferber method)
ASSESSMENT-ACTIVITY
FORMAL exercise programs not recommended-may cause skeletal damage
Nursing Diagnosis
infant behavior disorgainzed
infant feeding pattern, ineffective
poisoning, risk for
growth and development, delayed
EDUCATIVE/SUPPORTIVE NURSING SYSTEM INFANT
teaching is on going
give nutrional guidence
limit setting-time out 1min/peryr old
thumbsucking/pacifier-normal developmental need if deprived of sucking infant may end up sucking tounge. <risk for teeth prob if stop by 4
HEALTH SCREENING FOR INFANT
at 2,4,6,9,12 months
-immunizations
-assess of G&D
-hearing/vision screening
-assess parent/child interaction
-risk assessment
-anticipatory guidence
WHAT IS THE DENVER DEVELOPMENTAL SCREENING TEST-DENVER II
examiner should be trained/certified
assess gross/fine motor skill, language, social ability, test behaviors such as attention span, interst, compliance, fear/anxiety
-Parent education-NOT and IQ test, if non-reassuring give referrals
TODDLER
AGE SPAN?
1-3 years
MATURATION OF SYSTMS
RESP-less predisposed to resp infections
THERMOREGULATION-stable
DIGESTIVE-18-24mo begin readiness for anal/urethral control, stomach growing
IMMUNE-phagocytes more efficent
RENAL-maturing, less risk for dehydration,>bladder size
SENSORY- 20/40, binocular vision, depth perception cont
PHYSICAL DEVELOPMENT ***
GAINS 4-6 LBS AND GROW 3"/YR
-BIRTH WT quadrupled by 2 1/2
-elongation of legs
-avg ht of 2yo-34", adult ht is times two
-head circumference slows
-ANT. FONTENEL CLOSE 12-18MO
-chest circumference>head
-HR 80-150
abd resp-25
-BP 100/58
-
GROSS MOTOR DEVELOPMENT
WALKING
12-18 walk alone/wide stance
18mo- trying to run
2yo-stairs up and down
2.5yo-jump using both feet
end 2nd yr-stand on 1 foot, walk tip-toe, climb stairs alternating feet
FINE MOTOR DEVELOPMENT
MANUAL DEXTERITY
15mo- drop sm object in container, build tower w/2cubes, scribble w/crayon
18mo- build tower 3-4 cubes, loves books cloth are good as can't turn pages easily
30mo- tower 8 cubes, hold crayon w/ finger vs. palm
loves to draw
DSCR of Toddler
develop sense of autonomy and independence
decrease egocentricity
ERICKSON
autonomy vs. shame and doubt
conflict b/w control and dependence
holding on/letting go
negativism
ritualism
Developmental tasks
acq. social skills
increase verbal communication
learn to delay gratification
gain control of body function
*toilet training*
decrease egocentricity
learn to tolerat seperation from mom
COGNITIVE DEVELOPMENT
PIAGET
CONTINUATION OF SENSORIMOTOR UNTIL 2
sensorimotor-learn by expiriment, develop spacial and causal realationships
by age 3 gender identity
ask why and how
PIAGET
PRECONCEPTUAL PHASE 2-4YR
pre-operational thought
ability to problem solve based on what seen/heard. NOT logical, poor recall
imitate behaviors, DOMESTIC MICMICARY, animitis-live qualities to inanimate obj
magical thinking
decrease egocentricity
HEALTH PROMOTION
ASPIRATION AND SUFFOCATION
similar risk for toddler as infant. but RISK HIGHER due to > mobility.
toys-no sm pieces/sharp edges
appliances
electric garage doors
food-SIT DOWN, no running
HEALTH PROMOTION
car saftey
front facing car seat until 60pd/8yrs
use boosters
HEALTH PROMOTION
FALLS?PREVENTION
High risk due to > mobility
If >35in in ht. should not sleep in crib,
top bunk >6yrs
HEALTH PROMOTION
poisoning
highest incidence is in 2yo
*nn supervision**able to open doors/cabinets etc...
have poison control # ready
Assessment
communication
say first and last name
2-3 word sentences,a bility to communicate increase
ASSESSMENT
PLAY
parallel paly: kids play side by side w/o interaction
toys: push/pull toys, trucks. balls, finger paints
MIMICARY/dress up
ASSESSMENT
NUTRITION
growth rate slows
needs: iron, Calcium. phosphorus
common for appitite fluxuations
feeding difficulties devellop
Assessing nutrional adequacy in toddlets
wt/ht
alert and energetic
shiny hair
absence of fatique, circles under the eyes
skin color
flat abd
erect posture
muscle tone
MM-firm moist, pink no swell
no mouth /tounge lesions
proper dentition/gd indictor
good appitite
reg. elimination
ASSESSMENT-DENTITION
AAP recomments dental exam by 6mo or 6mo after first tooth
plague removal-soft brush
flouride-supplement if not in h2o
low-cariogenic diet-low in sugar. if give best time right after meal
Assessment
activity and rest
high activity level
supervise outdoor play
increased risk for injury
sleep 12h/day
1nap/d until 2-3y
sleep problems r/t fear, seperation and darkness
Nursing dx for Toddler
poisoning, risk for
G&D, delayed physical and pyschosocial
injury, risk for
Nutriton counseling
serving size;1T per yr of age
provide finger food-no nuts, hot doges
food jags common-same thing QD and every meal
ritualism
rebellious behavior
serve nutrient dense food
provide freq nutrious snakes
ENCOURAGE AUTONOMY
Educative/supportive
what is the
BIG milestone
toilet training. myelinization of spinal cord complete by 18-24 mo. look for signs readiness(able to verbilize need, recog nn, willing to sit 5-10min)motivation to please caregiver
what is usually accomplished first, bowel or bladder
bowel
Educative/suportive
"temper tantrums" j
limit chance of NO answers, offer a choice. toddler is trying to seperate. Important for caregiver to maintain self-control and encourage self-esteem
How should a caregiver handle temper tantrums
better to ignore and stand by with support. try to prevent tantrum. BE CONSISTENT
partially compensatory
health screening for toddler
physical exam 15, 18, 24 and 36 mo
immunizations
ht/wt
vision/hearing
behavior and risk assessment
guidance
PRESCHOOLER
TIME FRAME
3-6 years of age
PHYSICAL DEVELOPMENT/PRESCHOOLER
physical growth slows/stabilizes
body systems mature
AVG. WT GAIN OF 5LBS/YR
increase of 2.5-3" in ht
20 primary teeth
bowel/bladder control(unless lots of conflict in toddler yrs or physiologic problem)
HR 70-110BPM
resp 23
BP 106/67
FINE MOTOR SKILLS
developed able to button, put on socks and dress etc..
GROSS MOTOR SKILLS
Can do it all! walk, run, jump, climb. good hand/eye coordination
very proud of self and abilities
ERICKSON
Initiative vs. guilt
learning and accomplishment preschooler takes the initiative. thought/action opposite than expected behavior
PIAGET
preoperation phase 2-4
intuitive thought stage 4-7**
decreased egocentricity, develops awarness of social norms, sees viewpoints of others. magical thinking. concept of time in relationship to event. ie when mom comes home it is dinner time
COGNITIVE DEVELOPMENT
3-4y influenced by cognitive ability, affected by environment. read to and stimulate. asks why! 4-5telegraphic speech(use only essential lang0progressess to adj/verb
5-6 use all parts of speech
MORAL DEVELOPMENT KOHLBERG
PRECONVENTIONAL/PREMORAL LEVEL
EMERGENCE OF CONSCIENCE
RELIES ON EXTERNAL CONTROL
CONCRETE SENSE OF JUSTICE Everything has to be fair.
wants to avoid punishment
no gratitude/loyalty but believe if nice to me i will nice to you
PRESCHOOL CHILD: DSCR
searching for independence from parents
needs to become part of group-preschool or play group important
nns to succeed in school-give lots of reinforcement
PLAY-promotes development
HEALTH PROMOTION PRESCHOOLER
Injury prevention- >risk
safety education-parents nn to be role model
NURSING ASSESSMENT PRESCHOOLER
socialization related to school-very social, eager to pls, learns group cooperation.
school refusal is common make sure to assess readiness
adq prepartion-talk about beofre started give time to adjust ok to bring transitional ite.
"sets tone for school-age period"
ASSESSMENT
NUTRITION
fads/preferences-not to the same degree as toddler
1800kcal/day fat <10% of cal
fluids important
ca+ enriched food/limit juices/
QUALITY VS. QUANTITY
ASSESSMENT
ACTIVITY/REST
12h/night
sleep disturbances-fears, nightmares, accept dreams as real. OK to lie down w/ child and comfort
sleep terrors-SLEEP REFUSALS ARE COMMON INSTILL RITUALS IE QUIET ACTIVITIES, READING, BATH BEFORE BED
what are sleep terrors
partial arousal from non-dreaming sleep, not rem sleep. lasts 5-10 mins. technically asleep
DO NOT WAKE
PLAY
ASSOSITIVE PLAY:love to use imagination, dress up, non-competitive, imaginary friends help in time of lonliness. like construction sets lg. blocks. promotes physical/social/cognitive develpment
Educative/supportive
sex education?
find out what child knows/thinks
be hones
one question/one answer
sexual curosity is normal
masturbation normal but should be private. may be doing b/c anxious or bored
Educative/supportive
limit setting and discipline
behavior modification
ignore the behavior
consequence/time out
CONSISTENCY
done to protect from danger and to teach socially accepted behavior
HEALTH SCREENING PRESCHOOLER
yearly physicals
immunizations
dental exam
assessment of G&D
hearing/vision
id risk factors
anticipatory guidance
HOSPITALIZATION AND PRESCHOOLER
may perceive hospitalization as the following: frightening b/c of magical thinking and egocentricity
seperation anxiety
regression to earlier behaviors is normal.
don't know which bodyparts essential (freak out bloody knee) invasive procedure scary even tympanic temps