ATI health promotion of infant, toddler, preschool, school age, and adolescents

* posterior fontanel closes at...

2-3 months

* anterior fontanel closes at...

12-18 months

birth weight is _______ by 5 months and ________ by 12 months

-doubled

-tripled

infants grow _____ per month in first 6 months and their length increases by ______ by 12 months

-2.5cm (1in)

- 50%

first tooth usually erupts at age...

6-10 months; average age 8 months

teething pain management

- cold teething rings

- OTC teething gel

- acetaminophen up to 3 days

- ibuprofen up to 3 days

what age can a child take ibuprofen?

6 months

fine motor skill

gross motor skill of 1 month

-grasp reflex

-head lag

fine motor skill

gross motor skill 3 months

- no longer has grasp reflex, keeps hands loosely open

- raises head & shoulders off mattress when prone

fine motor skill

gross motor skill of 6mo

-holds bottle

- can roll back to front

fine motor skill

gross motor skill of 7mo

- moves object from hand to hand

- bears full weight on feet

fine motor skill

gross motor skill of 9mo

- crude pincer grasp, dominant hand preference evident

- pulls to standing position, creeps on hand & knees

fine motor skill

gross motor skill of 10mo

- grasps rattle by handle

- change from prone (flat) to sitting position

fine motor skill

gross motor skill of 11mo

-places objects in a container

- walks while holding onto something (cruises)

fine motor skill

gross motor skill 12mo

-tries to build a 2 block tower without success

- sits down from the standing position

Piaget stage for birth to 24mo

sensorimotor

3 important tasks during the sensorimotor stage

seperation, object permanence, mental representation

object permanence occurs at age...

9-10mo

expected language of infant...

-crying

- cooing

- responds to noise

- says 3-5 words and understands "no" by 1yr

Erikson stage for birth to 1yr

trust vs. mistrust

trust vs mistrust stage

the infant begins to learn delayed gratification. failure to learn delayed gratification leads to mistrust.

2 ways mistrust develops

- needs are consistently not met

- needs are continuously met before being vocalized by the

what play type do infant's have...

solitary

social development of an infant

includes attachment, separation/recognition anxiety, and stranger fear

play should provide...

interpersonal contact & educational stimulus

toys that stimulate senses and encourage development are...

brightly colored toys, rattles, pat-a-cake, blocks, books, rattles, teething toys, playing with balls, mirrors, soft stuffed toys

Car seat safety for infants

newborn infants should be placed in a federally approved car seat at a 45 degree angle to prevent slumping and airway, rear facing with safety belt

discharge teaching for parents of a newborn infant

their newborn will require a checkup within 72 hours of discharge; especially important for breastfed newborns to evaluate weight and hydration

what immunization should be received at birth?

Hep B

immunizations at 2 months

DTaP, RV, IPV, PCV, Hib

(DRIPH)

immunizations at 4 months

DTaP, RV, IVP, PCV, Hib

(DRIPH)

- same as 2 months

immunizations at 6 months

DRIPH and Hep B

what age can infant get the flu vaccine?

6-12mo

what is an acceptable alternative to breast milk?

iron-fortified formula

should infants be given cow's milk?

NO

other sources of fluid (juice, water) are not needed during first ______ months of age

4; can result in hyponatremia and water intoxication

what age are solids introduced?

4-6mo

indicators of readiness for solid foods are..

- interest in solid foods

- voluntary control of the head and trunk

- extrusion reflex goes away

why should new foods be introduced one at a time over 4-7 days?

- observe for signs of allergy or intolerance

(V/D, fussy, rash, constipation)

fruits and veggies are started first at ______. after both are tolerated meat can be added

6-8 mo

breast milk/formula should be ______ as solid food intake increases, but should remain the primary source of nutrition through _______.

- decreased

-1 year

appropriate finger foods at 9mo include...

bananas, toast strips, crackers, cheese, cheese cubes, noodles, firmly cooked vegetables, raw pieces of fruit (except grapes)

______ feedings are the last to be stopped

bed time

nocturnal sleep patterns established by...

3-4mo

infants sleep through the night and take two naps daily by the age of..

1yr

hot water thermostats should be set at or below...

120 degrees

infants & toddlers remain in REAR FACING car seat until the age of _______ or height recommendation of manufacturer

2yr

a nurse is assessing 12mo at well child visit. which finding should be reported?

A. closed anterior fontanel

B. eruption of 6 teeth

C. birth weight doubled

D. birth length increased by 50%

C. - it should be tripled by 1yr

a nurse is performing a developmental screening on 10mo. which motor skills should be performed?

A. grasp rattle by handle

B. try building 2 block tower

C. use crude pincer grasp

D. place objects into container

E. move object from hand to hand

A, C, E

a nurse is performing a well baby visit with a 4 month old. which of the following immunizations should be administered?

A. MMR

B. IPV

C. PCV

D. Varicella

E. RV

B, C, E

a nurse is providing education about introducing new foods to the parents of a 4mo. to best supply needed nutrients, the nurse should recommend that the parents introduce which of the following foods first?

A. stained yellow veggies

B. iron fortified cereal

C. pureed fruits

D. whole milk

B

a nurse is providing teaching about dental care and teething to the parent of 9mo. which statement indicates an understanding of the teaching?

A. I can give my baby frozen fluid filled teething rings to relieve discomfort

B. I should clean baby's teeth with cool, wet washcloth

C. I can give Advil for up to 5 days

D. I should dilute juice with water in the bottle my baby drinks while falling asleep

B- this is appropriate for cleaning infant teeth

(If the ring is fluid filled it will become cold and not stay frozen)

at 30mo a toddler should weight ______ their birth weight

4 times

toddlers grow about ______ per year

7.5cm (3in)

fine motor skill

gross motor skill for 15 mo

- uses cup well, builds two block tower

- walks without help, can creep up the stairs

fine motor skill

gross motor skill for 18 mo

-manages a spoon

- jumps up and down with both feet

fine motor skill

gross motor skill for 2y

- builds a tower of 6-7 blocks, turn pages 1 at a time

- walks up and down the stairs with both feet

fine motor skill

gross motor skill for 2.5y

- good hand- finger coordination, can draw a circle

- stands on one foot momentarily, jumps across the floor, takes a few steps on tiptoe

object permanence becomes full developed at age...

19-24mo

toddlers are in the preoperational phase and they do not understand _______________. But they can __________ to __________.

- other view points

- symbolize objects and people

- imitate

erikson stage for toddler

autonomy vs. shame and doubt

toddlers are..

egocentric

appropriate play activities for toddlers are....

- filling and emptying containers

- playing with blocks

-looking at books

-push-pull toys

-tossing balls

-large-piece puzzles

- finger paint

- thick crayons

temper tantrums result when....

toddler is frustrated with restrictions on their independence

providing __________ help toddlers work through their frustrations

consistent age appropriate expectations

2 things parents should demonstrate in toilet training

- patience

-consistency

physiologic anorexia can develop because....

toddlers are picky eaters and have decreased appetites

toddlers should have

24 to 28 oz of milk a day

juice consumption should be limited to....

4-6oz a day

toddlers should have ______ of fruit a day

1 cup

toddlers need _________ hours of sleep per day, including one nap

11-12hr

one way to promote good rest

maintaining a regular bed time

dental caries are more common in children that.....

go to bed with a bottle of juice/milk

____ is supplemented for children living in areas without adequate levels in drinking water

fluroride

children should have an established dental provider by age ____

1yr

how should a toddler over the age of 2yo sit in a car?

in a forward facing car seat in the backseat

a nurse is assessing a 2.5 yo toddler at a well child visit. which of the following should be reported to the dr?

A. height increased 3in in the past yr

B. head circumference exceeds chest circumference

C. anterior and posterior fontanels are closed

D. current weight is 4x birth weight

B.

a nurse is performing a development screening on an 18mo. which of the following should the toddler be able to perform?

A. build a tower of 6 blocks

B. throw a ball overhand

C. walk up and down the stairs

D. draw circles

E. use a spoon without rotation

B, E

a nurse is providing teaching about age appropriate activities to a parent of a 2yo. which of the following statements by the parent indicates a need for further teaching?

A. I send my child's favorite toy with when she will be napping at home.

B. putting large pieced puzzles together is one of my child's favorite activities

C. the soccer team my child will be playing on starts next week

D. my child likes to ride a straddle truck in the dining room while I am cooking

C- toddlers play by themselves but alongside other toddlers, the concept of a team is difficult for a toddler

a nurse is providing anticipatory guidance to parents of a toddler. which of the following should the nurse include?

A. develop food habits that will prevent dental caries

B. meeting caloric needs results in an increased appetite

C. expression of bedtime fears

D. behaviors associated with negativism and ritualism

E. Importance of annual screenings for phenylketonuria

A, C, D

preschooler age

3-6 years old

preschoolers height should grow _______ a year

6.2- 9cm

preschoolers weight should gain about ______ per year

2-3kg (4.5 to 6.5lb)

fine motor skills that preschool age should be able to do are...

- copying figures on paper, dressing independently

gross motor skills 3yo

-rides a tricycle

- stands on one foot for a few seconds

-jumps off bottom step

gross motor skills 4yo

- throws ball overhand

- skip and hops on one foot

-catches ball reliably

gross motor skill 5yo

- jump rope

- walks backward with heel to toe

-throws and catches a ball with ease

preschoolers go from egocentric to....

social awareness and the ability to understand other peoples viewpoints

variations in thinking at this age are....

- magical thinking

- animism

- centration

erikson stage for preschool

initiative vs. guilt

initiative vs. guilt

preschoolers become energetic learners, despite not having all the physcial abilities necessary to be successful at everything; gult can occur when preschools think they have misbehaved or unable to accomplish a task

to prevent guilt in preschoolers, guide preschools to attempt activities_______while setting limits is appropriate

within their capabilities

guilt may occur when....

they are unsuccessful at a task or believe they have misbehaved

during stress, insecurity, or illness preschoolers may....

regress to previous immature behaviors or develop bad habits lie bed wetting, nose picking, and thumb sucking

preschoolers begin comparing themselves with peers by age

5y

what can parents do to minimize stress during hospitalization?

bring favorite toys to hospital and provide appropriate play

age appropriate toys for preschoolers

- playing ball

- puzzles

-riding tricylces

- playing pretend and dress up

- role playing

- painting

-hand puppets

-reading books

-sand boxes

-skating

-computer games

-musical toys

- electronic games

immunizations for preschoolers include

4-6y= DTap, IPV, MMR, Varicella

(DIMV)

3-6y= flu vaccine

preschoolers consume _______ calories

1,200-1400 kcal/day- nutrition section says this

or 1,800- ati question says this

at what age do preschoolers become less picky and more willing to try new foods?

5yo