Ped Unit 1 Test

5 question converting pounds to Kg /2.2

Growth of child follows an orderly pattern starting with the head and moving downwards (cephalocaudal)

  • child is able to control head and neck before being able to control arms & legs

proceeds to the pattern proximodistal

  • growth starts in the center and progresses towards periphery or outside , following this pattern child can control movement of arms before being able control move on hands ( Gross motor develops first)

  • Ex; child is able to hold something in hand before being able to use fingers

Priority for homeless family? Give resources: medical and nutritional / provide information to the family about any assistance available:

Documentation: document adults with child at appt & who they are

Erikson - Psychosocial development : Each task person must master the central problem before moving on to the next one. Each task holds positive and negative outcomes and each of first 5 implies new development task for parents

  • 1: Trust vs Mistrust : child learns whether the world can be trusted to give love and concern pr only frustration , fear and despair. The infant who is fed on demand learns to trust that cries, communicating a need, will be answered

  • 2-3: Autonomy vs Shame

  • 4-6: Initiative vs Guilt

  • 7-12: Industry vs inferiority

  • 13-18: Identity vs Role confusion

Piaget- Intellectual Development

  • 1: Sensorimotor

  • 2-3:

  • 4-6: Preoperational phase

  • 7-12: Concrete operational phase

  • 13-18: Formal operational phase

What stage for abstract thinking and problem solving? Formal (age 12-15)

Kohlberg - Moral development

1 :Stage 0- what pleases me

2-3: Preconventional Level

  • Stage 1 — Avoid punishment — punishment and obedience orientation child determines right or wrong by physical consequences of a particular act. Child simply obeys the person in power with no understanding of the underlying moral principle

4-6: Preconventional level

  • stage 2 — Do what benefits me — (ages 4-7) child views a specific act as right if it satisfies their needs. Children follow the rules to benefit themselves “I’ll do something for you if you’ll do something for me” “ An eye for an eye”

7-12: Conventional Level

  • Stage 3 (7-10) avoid disapproval

  • Stage 4 (age 10-12)— do duty, obey laws

13-18: Post conventional level

  • Stage 5 (age 13) — maintain respect of others — (age 13-18) social contract orientation, culturally accepted values define personal standards and personal rights

  • Stage 6 (age 15)— implement personal principles

When has birth weight doubled? first 6 months, the infants birth weight doubles

  • To determine if an infant is reaching acceptable levels of developments, birth weight and height must be standard to which later measurement are compared

Posterior frontal (fontanelle) usually closed by the second or third month of life

First deciduous teeth usually the lower central incisors erupt

  • American Dental Association recommends first dental visit at 1 year

Normal HR? 90-190 bpm

Concern respiratory rate? anything over 60

Growth development:

10-12 weeks (2-3 months) : Posterior fontanel closes

16 weeks (4 months) : infant balances head/ shoulders & body for short periods

20 weeks (5 months): infant can roll over

24 weeks (6 months): Birth weight doubles; weight gain slows to 3-5 oz per week , Height slows to ½ inches per month , Tonic neck reflex disappears , sits alone in high chair, back erect, rolls over and back to abdomen

32 weeks (8 months): pincher grasp (use of thumb and index finger) , crawls around

40 weeks- 1 year (10-12 months): infant stands alone; begins to walk alone

8-12 weeks : supply infant with toys( loves surprise toys; peek-a-book , jack in the box) stay close to support in difficult situations; child is developing independence and temper tantrums

Extrusion (protrusion) reflex: infant knows only one way to take food , thrust the tongue forward as if to suck has effect of pushing solid foods out of infant mouth

  • complicant skill ; to take the edge off the hungry, annoyed infant give part formula before proceeding when learning to solid foods, as

  • this can help ease their transition and reduce frustration during feeding times.

  • foods are started in small amounts 1-2 tsp daily, enjoy their food smooth, thin , lukewarm and bland offer food one new food at a time, following 4-5 days to monitor for any potential allergic reactions and ensure the infant adjusts well to each new taste.

  • at 7 months of age infant may enjoy a teething biscuit or cookie to practive chewing and to offer comfort

Feed every 2-3 hours feeding

What age to introduce sippy cup? at age 5-6 months the infant who has watched other drink is ready to try a sippy cup

Routine Checkups: first year of life at least 6 visits are recommended

  • occur at 2 weeks, 2 months, 4 months, 6 months, 9 months, & 12 months

  • Immunization at birth given? Hep B

  • Side effects of immunization? low grade fever within 24 to 48 hours , local reaction such as tenderness, redness and swelling at the injection site treated symptomatically with acetaminophen. cool compression on injection site. Child may be fussy & eat less. Encourage to drink fluids and holding/ cuddling to comfort child. Call HCP if any concerns or symptoms don’t go away in 48 hrs

Preventing and treating Diaper rash

  • change diaper asap

  • wash bottom with lukewarm water

  • dry diaper area by patting

  • avoid using commercial baby wipes; fragrance free/ alcohol free

  • do not rub rash , cool wet cloth for 5 minutes over the area 3-4 a day

  • use ointment/paste , avoid powder

  • avoid fastening diaper too tightly

  • rinse baby’s clothes to eliminate soap or detergent residue

  • do not overdress

Tips for reinforcing family teaching

Falls

  • never leave child unattended

  • place gates where needed

  • raise crib rails make sure they are secured

Motor vehicles

  • place infant an approved car carrier

  • never leave unattended

Burns/ injuries

  • cover unused plus with plastic covers

  • keep electrical cords out of sight

  • remove tablecloths or dress scarves

  • pad sharp corners of low furniture

  • turn household hot water to safe temperature - 120 F

Poisoning

  • check toys for nontoxic material

  • move all toxic substance out of reach/ lock them up

  • remove any poisonous house plants

  • protect child for lead paint dust

  • place medication in locked cupboards

How to measure an infant: place child flat on an examining table measure child’s length by straightening the body and measuring top of the head to the bottom of the foot

Vitals Signs Newborn:

heart rate: 110-160 bpm

Respiratory rate: 30-60

axillary temp: 97.7-98.6

blood pressure 60-80/40-45

Moro reflex: startle reflex they extend arms and legs awy form body and to the side fingers to C shape

Notes: Infant are abdominal breathers

position infant in a supine position when sleeping

Apical pulse one minute at apex of the heart

Characteristics infants inhibit when hungry? reach for bottle , cry , cranky putting object in mouth

Whole milk needed for infant