18.1 | Infancy

pulse and respiratory rates

the younger the child, the more rapid are the …

100 - 180 BPM

neonate heart rate during first 30 minutes of life

120 BPM

neonate heart rate settles to …

30 - 60 BPM

initial neonate respiratory rate at birth

30 - 40 BPM

infant respiratory rate after first few minutes of life

6 to 8 mL/kg

initial infant tidal volume

10 to 15 mL/kg

infant tidal volume by 12mo

60-90 SBP

average SBP at birth

87-105 SBP

average SBP at 12mo

3.0 - 3.5kg

normal birth weight

excretion of extracellular fluid

what causes an infant's weight to drop by 5-10% in the first week of life

second week

infants usually exceed their birth weight by the …

30g per day

infant growth rate during the 1st month of life

4-6mo

infant should be double their birth weight at …

9-12mo

infant should triple birth weight at …

25% of total body weight

infant's head is equal to …

ductus venosus

blood vessel connecting the umbilical vein and the inferior vena cava in the fetus

foramen ovale

opening in the interatrial septum of the fetal heart

ductus arteriosus

blood vessel connecting to the pulmonary artery and the aorta in the fetus

constrict

after birth, the ductus venosus and the ductus arteriosus…

blood pressure changes

closing of the foramen ovale

cconstriction of the ductus venosus results in …

blood can no longer bypass the lungs by moving from the pulmonary trunk directly into the aorta

constriction of the ductus arteriosus means …

increase in systemic vascular resistance

decrease in pulmonary vasculary resistance

cardiovascular duct constriction immediate causes …

strengthens

the left ventricle of the heart … throughout 1st year of life

forceful

due to lungs having been collapsed, the first breath an infant takes must be …

surfactant

chemical reducing surface tension that the lungs of a full-term infant continuously secrete

easier

after the first forceful breath, breathing becomes …

shorter, narrower, less stable, more easily obstructed

an infant's airway is … (compared to other life stages)

nose

until 4 weeks old, infants primarily breath through the …

nasal congestion

common complaint in infants less than 6mo

barotrauma

injury caused by a change in atmospheric pressure

fragile, prone to barotrauma

infant lung tissue is …

air moves only in the upper airway, never reaching the lungs

breathing becomes ineffective at rates higher than 60 BPM because …

rapid heat and fluid loss

rapid respiratory rates lead to …

less rigid

chest wall of the infant is … than an adult's

diaphragmatic breathing

infant ribs are positioned horizontally, causing …

abdomen rise and fall

when assessing infant breathing, observe …

less pressure, lower volume of air

when ventilating, an infant needs …

higher metabolic rate, higher oxygen consumption rate

compared to adults, infants have a …

specific gravity

the weight of a substance ompared with an equal amount of water

concentrated urine

a newborn's kidneys are not able to produce …

1.0

newborn kidneys excrete a relatively dilute fluid w/ a specific gravity that rarely exceeds …

dehydrated

newsborns can easily become … and develop water/electrolyte imbalance

naturally acquired passive immunities

fetuses acquire some of the mother's active immunities against pathogens and are said to have …

6mo-1y

a newborn's naturally acquired passive immunities can remain effective for …

antibodies

breast-fed babies receive … through the breast milk

sensation

… is present in all portions of the body at birth

localize it and isolate a response

as sensation is present in all portions of the body at birth, infants are able to feel pain but unable to …

motor and sensory development

infant … is most advanced in the cranial nerves at birth

Moro reflex

when startled, babies throw their arms wide, spreading their fingers and then grabbing instinctively with their arms and fingers

paralysis or weakness on one side of the body

an asymmetric Moro reflex can imply…

palmar grasp

placing a finger firmly in the infant's hand results in the infant closing its fist around it

rooting reflex

hungry infants turning their head to the right or the left when a hand or cloth touches their cheek

sucking reflex

sucking movement caused by stroking an infant's lips

fontanelles

allow for compression of the head during childbirth + rapid growth of the brain during early life

level with the surface of the skull OR slightly sunken

normal anterior fontanelle level

sunken anterior fontanelle

sign of dehydration in infants

16-18hrs daily

normal newborn sleep time

easily aroused

normal infant is … from sleep

growth plates located on each end of the long bones

developing infant's extremities grow in length from …

epiphyseal plates

secondary bone-forming centers separated by cartilage from larger bones

part of the larger bone

as each epiphysis grows, it becomes …

deposition of new bone on existing bone

bones grow in thickness by way of …

25% of the entire musculoskeletal system

muscle weight in infants

able to track objects with their eyes

recognize familiar faces

2mo baby development

move objets to their mouth w/ their hands

display primary emotions w/ distinct facial expressions

3mo baby development

drool without swallowing

begin to reach out to people

4mo baby development

sleeping through the night w/o waking for feeding

able to discriminate between family and strangers

5mo baby development

between 5-7mo

primary teeth begin to appear …

can sit upright in a high chair

begin to make one-syllable sounds

6mo infant development

fear of strangers

mood can quickly shift from crying to laughing

7mo infant development

begin to respond to “no”

can sit alone

can play “peek-a-boo”

8mo infant development

can respond to adult anger

begin to pull themselves up to a standing position

explore objects by mouthing, sucking, chewing, and biting them

9mo infant development

pay attention their name

crawl well

10mo infant development

attempt to walk w/o assistance

begin to show frustration w/ restrictions

11mo infant development

can walk with help

know their own name

12mo infant development

reciprocal socialization

interactions babies have w/ their families help them grow and change and help their families do the same

crying

newborn's only means of communication

secure attachment

infant's sense that their needs will be met by their caregivers

anxious resistant attachment

develops when infants are uncertain about whether their caregivers will be responsive or helpful when needed

children prone to separation anxiety

anxious resistant attachment leads to …

anxious avoidant attachment

occurs in infants who have no confidence they will be responded to helpfully when they seek care

trust vs mistrust

infant wants the world to be an orderly, predictable place where causes and effects can be anticipated

scaffolding

building on what is already known

easy child

infant w/ regular bodily functions, low/moderate reaction intensity, and acceptance of new situations

difficult child

infant w/ irregular body functions, intense reactions, and withdrawl from new situations

slow-to-warm-up child

infant w/ low intensity of reactions and a somewhat negative mood

protest

first stage of parental-separation reaction

despair

second stage of parental-separation reaction

detachment or withdrawal

third stage of parental-separation reaction