What age does WIC provide up to?
Age 5
What is the major contributer to infant death?
Low birth weight
Normal heart rate for an infant
120-160 BPM
Normal resp rate for an infant
30-60 breaths per min
Normal blood pressure for infant
74-100/50-70
Weight _at 6 mo and _ at one year
Doubles at 6 months
Triples at a year
Height at 6 months and one year for an infant (expected)
Increase about 6 inches in first 6 months
Increases about 50% by one year
Posterior fontanelle expected closing time
Closes by 6-8 weeks
Anterior fontanelle expected closing time
Closes by 12-18 months
Palmar grasp
Palmar = closing hand around someone’s finger for example goes away around 3-5 months
Pincer grasp
Using index finger and thumb to grasp
Well established after 1 year
At what age should a child be able to control head and neck/lift head
5-8 months
At what age can an infant sit with no assasit
8-12 months
At what age can an infant transfer an object from one hand the another
7 months
At what age can an infant crawl
5-8 months
What age does the infant smile and coo
Approx 2 months
What stage of ericksons is the infant in?
trust vs mistrust
developing a sense of trust in caregivers, themselves and the environment
What vaccines are recommended in the first 6 months?
Hep B doses 1 and 2 and 3
DTaP (Diphtheria, tetanus, and whooping cough (pertussis) doses 1 and 2 and 3
Hib (Haemophilus influenzae type b disease)
Polio (IPV) doses 1 and 2 and 3
PCV (Pneumococcal disease) doses 1 and 2 and 3
Rotavirus (RV) doses 1 and 2 and 3
Flu virus after 6 mon
what vaccine is sometimes given right after birth
Hepatitis B (1st dose)
At what age can an infant begin to drink cows milk
1 year
At what age can an infant have solids?
4-6 months
after extrusion reflex (pushing solids out of mouth) is mostly gone
How do you administer ear gtts to an infant?
Pull the ear down and back
Admin of liquid meds to an infant
syringe along the side of tongue and back of mouth
suck med out of empty nipple
Administering ear gtts to a child above 3
Pull ear up and back
What is the max volume to be given IM on an infant
1 mL MAX
Meningitis
inflammation of the meninges (membranes on brain and spinal cord)
organisms invade meninges via teeth, sinuses, tonsils, lungs, ear infections, skull fractures
S/S of meningitis
crying
nuchal rigidity (neck stiffness)
poor feeding
vomiting
bulging fontanelles
opisotolonos (arching of body)
petechiae
Brudzinski’s sign
assessment for meningitis
positive if pt cannot touch head to chest without extreme pain
Kerrin’s sign
assessment for meningitis
cannot move leg past 90 degree flexion without extreme pain
How is meningitis diagnosed/tx
Spinal tap
treated with antibiotics if bacterial, steroids and pain meds
ISOLATION
Nursing management for a patient with meningitis
NPO
isolation until 24 hrs of antibiotics
Low stimulation
Position changes
temp control of pt
Watch for s/s of increased ICP
no bright lights
spinal tap findings in someone with meningitis
pus
protein
high wbc
Complications of meningitis
SIADH in 60 %
deafness
What should you teach a parent regarding prevention of meningitis
vaccines!
meningitis vaccine
pneumonia vaccine
haemophilus influenzae (hib) vaccine
ALL help prevent
Bronchililits
caused by RSV
oxygen get trapped in lungs
can exhale but hard to inhale
S/S of bronchilitis/RSV
cough
shallow respirations
cyanosis
Nursing management for bronchilitis/RSV
isolation
oxygen
elevate HOB
push fluids
VS
clear secretions regularly
Cystic fibrosis
affects lungs, pancreas, liver
thick mucus obstructs all above
1st symptom is usually meconium ileus
Meconium ileus
absence of infants “first poop”
normally occurs before 24 hours after birth
Common in kids with CF
S/S of cystic fibrosis
meconium ileus
high levels of salt in tears, sweat
malnutrition but always hungry
atelectasis
emphysema
Pyloric stenosis
pylorus (bottom of stomach) narrows
food cannot get to intestines/out of stomach
S/S of pyloric stenosis
PROJECTILE vomiting
weight loss with no sign of other illness
dehydration
olive shaped mass in RUQ
Hirschsprung
partial/complete intestinal obstruction due to absence of nerve cells that create peristalsis
S/S of hirschsprung
persistent constipation
absence of first meconium poop
Intussusception
slipping of a portion of bowel
surgical emergency
S/S of intussusception
sudden onset severe abd pain
vomiting
jelly stools with blood and mucus
Infancy is considered
29 days to 1 year
Nutrition for infants
Breast milk q2-3 hours
formula q4
(about 1-2 months)
400 IU of vitamin D/day important
When do teeth come in?
Anywhere from 5-17 months
How do you measure head circumference
mesure just above eyebrows, just below the crown on the back of the head
When does a fear of strangers develop
5-8 months
Babies under 1 month breathe how
Only through their noses
Checkups should occur at what ages
2 wks, 2 months, 4 months, 6 months, 9 months, 12 months
Do you need to wait to give an infant a vaccine if she has a cold
No, do not need to wait even if there is a low grade fever
Contraindications to vaccines
very ill
chronic diseases
chemo
long term steroids
How to feed baby with a g button
Provide a pacifier and attention + warmth when feeding through g tube to act as similar to breastfeeding
What is the rooting reflex
Helps baby find the nipple
By what age has the child mastered spoon feeding
2 years
Normal weight gain in first 6 months and # of wet diapers per day
4-7 oz per week
6 wet diapers per day
What food is often introduced first and why
rice cereal
smaller chance of allergens
How should new foods be introduced?
New food one at a time, with 4-7 days before trying something else
do not introduce new foods while the baby is ill
When can juice be offered?
9 months
dilute at first, then gradually increase to 3-4 ounces per day
How many teeth does the 1 year old have
Approx. 6
Colic usually disappears by what age
3 months
Toddler pulse rate
90-140
School age child pulse rate
75-100
Preschool pulse rate
80-110
Toddler respirations
24-40
What is the last vital sign to take on a child
Temperature
What is ELMA cream and how long must it be on for?
Numbing cream used for injections and other procedures on children
60 minutes wait until cream is working
Head circumference is measured on __
All children under 36 months
and children with neurological defects