(Pediatric Lecture 1) Chapter 16 - Care of the Newborn and Infant: Exam 1

Infant

newborn through 12 mo.

Infancy

28 days to 1 yr.

Cephalocaudal pattern

attainment of skills from head to toe

Proximodistal Pattern

attainment of skills from trunk out (can control arms before fingers, gross motor develops before fine)

Newborn Well Child Visits

Appts. at Newborn, 1, 2, 4, 6, 9, and 23 mo. (American Academy Pediatrics)

Newborn Well Child Visits - Info for Nurses

Involve caregivers

Assess infants on the caregiver's lap

Explain everything to caregivers during the assessment

Auscultate first, while the child is quiet and/or sleeping

Perform the most invasive procedures last

-assessing baby and family

-good rapport with caregivers

-developmental assessments (watching baby)

Anticipatory guidelines

preventative education/counseling focused in

nutrition

safety

environment

behaviors

screening/vaccines

Posterior Fontanelle

smaller, closes between 2 and 3 months

Anterior Fontanelle

larger, closes between 12 and 18 months

Strabismus for Infants

crossed eyes - normal finding until 6 mo. - comes from muscle weakness in eye -

- to inspect pull pinna of ear, pull it back and down

Barrel Chest for Infants

a condition characterized by increased anterior-posterior chest diameter caused by increased functional residual capacity due to air trapping from small airway collapse.

-normal finding for infants (1:1 ratio)

Diaphragmatic Breathing

main driver of respiration until 4 yo.. / look like belly breathers

Respiratory Assessment Findings - Infants

normal to be irregular respirations with occasional pauses / abnormal if pauses are too long , assess respirations for 1 min.

Acrocyanosis

Temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands and fingernails, feet and toenails. May last for a few hours and disappear with warming.

Heart Rate for Infants

80-160, younger the child, the faster it is

Cardiac Normal Findings - Infants

-presence of S3 is normal , listen PMI 4th intercostal space

-asymptomatic murmurs often present and normal

-common to hear murmurs when babies are running fevers

Musculoskeletal Normal Findings - Infancy

-incomplete bone ossification

(bone is formed but not ossified, aids in motor, higher risk for fractures)

-begnin metatarsus adductus is normal (curvature inward of the foot, have parents gently stretch out the foot)