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Prenatal Period to 1 year
Chapter 6
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What are the two main factors that influence growth and development?
Stress and Family Environment and Stress Environment and Heredity Heredity and Gender
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Heredity: Zygote formation
Sperm + ovum Zygote 23 chromosomes
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Heredity: Zygote formation
Gender X & Y Chromosomes Ovum Always X Sperm X or Y
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Dominant & Recessive Genes
Capable of expressing traits over other genes Traits only appear if they exist in pairs
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Karyotyping: Eye Color B = Brown b = blue
MOM DAD B b BB Bb Karyotyping: Eye Color B = Brown b = blue MOM has brown eyes but has recessive blue gene. Bb Dad has brown eyes with no recessive gene. BB All the kids would have brown eyes The Punnett Square for eye color The Punnett Square is a visual representation of Mendelian inheritance. Punnett Square
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Karyotyping: Eye Color B = Brown b = blue
MOM DAD B b BB Bb bb Karyotyping: Eye Color B = Brown b = blue MOM has brown eyes but has recessive blue gene. Bb Dad has brown eyes with a recessive blue gene. ¾ kids would have brown eyes. Punnett Square
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Karyotyping: Eye Color B = Brown b = blue
MOM DAD b B Bb bb Karyotyping: Eye Color B = Brown b = blue MOM has blue eyes bb Dad has brown eyes with a recessive blue gene. Bb ¾ kids would have brown eyes. Punnett Square
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Recessive disorders >700 recessive gene diseases
Sickle-cell disease Tay-Sachs disease Hemophilia Tay–Sachs disease, it causes a relentless deterioration of mental and physical abilities that commences around six months of age and usually results in death by the age of four
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Environment “From the moment life begins, the environment begins to exercise its influence on the newly formed entity.”
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For you personally, when does life begin?
Conception Implantation When there is a heart beat When the fetus is viable if it was born When the baby is born
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Environment: Healthy Pregnancy
Rest Exercise
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What is the best form of exercise for a pregnant women?
Bicycling Walking Swimming Jogging Kick-boxing
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Teratogens Tobacco i birth weight Growth restrictions
Teratogens – chemical or physical substances that can adversely affect the unborn = bad for the baby
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Teratogens Alcohol *1st trimester Fetal Alcohol Syndrome (FAS)
Miscarriages Growth restriction CNS damage No alcohol while pregnant
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Teratogens Bacteria, viruses Rubella
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What is the estimated length of human pregnancy?
28 weeks 38 weeks 40 weeks 42 weeks 48 weeks
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Physical Characteristics
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Neonate Apgar score Activity Pulse Grimace Appearance Respiration
Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Activity, Pulse, Grimace, Appearance, and Respiration. The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby's condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth. Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2, with 2 being the best score: activity and muscle tone pulse (heart rate) grimace response (medically known as "reflex irritability") appearance (skin coloration) respiration (breathing rate and effort)
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What is the highest score a neonate can get on a Apgar score?
2 3 10 12 15
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Head & Skull Head ¼ of total body length
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Skull 6 bones Separated by cartilage Sutures Fontanels Anterior
Posterior
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Which fontanel is smaller?
Anterior Posterior
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When does the posterior fontanel “close” by?
2 months 4 months 6 months 8 months 12 months or more
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When does the anterior fontanel usually “close” by?
6 months 12 months 18 months 2 years 3 years
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What is the normal lengths of a full-term neonate?
12 inches 18 inches 20 inches 24 inches 36 inches
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How much does a normal infant grow in the first year?
½ inch a month 1 inch a month 1 ½ inch a month 2 inch a month 2 ½ inch a month
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Normal Physiological Weight Loss
Normal Physiological Weight Loss. How much weight on average does a neonate loss in the first few days of life? 5-10 % of birth weight 15-20% of birth weight 25 – 30% of birth weight There is no such thing as normal physiological weight loss in a neonate
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Skin Acrocyanosis Pigmentation Thin & pale
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Mongolian Spot Usually fads by… Age 4 years 6 month old
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Lanugo
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Vernix Cascosa
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Milia
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Physiological Jaundice
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What causes physiological jaundice?
High RBC count in newborns Increased RBC destruction after birth High bilirubin levels All of the above None of the above
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Genitals Breasts Swollen Scrotum Large
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Pseudomenstruation Blood-tinged vaginal discharge
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What is the cause of most genital physiological anomalies in newborns?
High / elevated maternal hormone levels High / elevated paternal hormone levels High / elevated neonate hormone levels
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Cryptorchidism Undescended testicle/s
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Cryptorchidism h risk of Testicular CA Infertility
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Genital Circumcision
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What STD causes blindness in newborns?
Syphilis HIV Gonorrhea Chlamydia Herpes
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Face Eye Erythromycin Silver nitrate
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When do baby teeth start to come in?
Deciduous teeth 2 months 4 months 6 months 8 months 12 months
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Which teeth normally erupt first?
Two lower central incisors Two upper central incisors Two lower lateral incisors Two upper lateral incisors
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By age 12 months the baby will have 6-8 teeth
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Abdomen Umbilical cord Falls off
When? 10 days What should the baby not do / have until the umbilical cord “falls off” No tub bath Neonate Lg and flabby
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Why do you have to “burp” the neonate?
Cardiac sphincter Under-developed
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Bowel movement Meconium Green-black Meconium Duration 1-2 days
Characteristics Green-black Tarry Odorless
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Bowel movement, Stool or Feces
Formula Fed Breastfed Pasty yellow or tan Odor Mustard seed color Sweet odor
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Why is a newborn not given cows milk (whole milk) to drink?
Cows milk does not have the necessary vitamins and minerals for a newborn human Cows milk is too complex for a newborn to metabolize Cows milk contains protozoans that are harmful to infants What are you talking about – it’s OK to give a newborn cows milk.
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Extremities Finger / foot prints
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Gluteal fold asymmetry
Is an indication of… Congenital hip dysplasia
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Neurological Characteristics Protective reflexes
Blinking Sneezing Swallowing Gag Newborns Reflexes Posture Movement Muscle tone
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Moro / Startle Reflex Sudden movement Extension & Abduction of extremities Disappears 3-4 months
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Tonic Neck Reflex Turn head to one side extend arm and leg on that side Disappears 5 months
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Rooting reflex Stroke cheek enfant turns toward that side and open mouth Disappears 4-6 months
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Sucking Reflex Sucking movement when anything touches their lips
Diminishes 6 months
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Babinski When sole is stroked hyper-extended of the toes Disappears
3 months
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Palmar grasp Grasp anything placed in hand Appears 6 wks Disappears
3 months
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Spinal Bifida
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Vision Newborn Primitive Nystagmus
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Vision An infant's vision isn't as sharp as an adults until children are about 3 years Optometrists, or "eye doctors", usually ask adults to read rows of letters in order to determine how well we can see, but how do they test an infant's vision? Although babies can not tell us what they see, they can choose to look (or not look) at interesting patterns with lots of contrast, like stripes or checkerboards. To determine how well babies can see, cognitive scientists show babies a plain gray image next to an image of a wide black and white stripe. Usually, babies will choose to look at the stripes. The fact that they show this preference means that babies can see the difference between the plain gray image and the black and white stripe. Once they've tried a very big stripe, the scientist can make the stripe narrower and narrower, each time placing it next to a plain gray image. At some point, the stripe will be so narrow that, to a baby, it will just look like a grey blur. At this point, the baby will look equally long at both images, because s/he can't tell the difference between them. When this happens, the scientist knows exactly how sharp the baby's vision is. For a newborn, only stripes bigger than 1/3 of an inch are preferred over plain grey. By three months, babies can see stripes bigger than 1/8th of an inch, and by six months, they're able to see 1/16th inch stripes. An adult can see a stripe that is only 1/80th of an inch across. An infant's vision isn't quite as sharp as an adults until children are about 3 years of age.
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Hearing 6 wks 1 year Recognize mom and turn to respond
ID sounds and source
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Vital Signs - Newborn Temp Pulse Resp Initially 120 – 160 / min
low Pulse 120 – 160 / min Resp 30 – 60 / min Temp- Initially low- Stabilized Axillary Pulse 120 – 160 / min Apical BP 64 / 40 Resp 30 – 60 / min Irregular apnea
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Gross motor skills 2 months 4 months 6 months 8 months 10 months
Control head 4 months Sit w/ support 6 months Roll 8 months Sits alone 10 months Creep 11 months Pulls self up 12 months walks Neonate Purposeless uncoordinated 2 months Control head 4 months Sit with support Roll belly to back 6 months Roll both ways 8 months Sits alone 10 months Laying to sitting Creep 11 months Pulls self up 12 months walks
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Fine motor skills Neonate 5 months 6 months 7 months 9 12 months
Grasp reflex 5 months Purposeful reaching 6 months Hold bottle 7 months Hand preference Pincer grasp 9 Cup Spoon 12 months Scribble Tower – two blocks
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Psychosocial Development: What theorist are we going to discuss?
Freud Erikson Paiget Kohlberg Maslow
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What stage of psychosocial development is a neonate?
Autonomy vs shame & doubt Trust vs mistrust Initiative vs guilt Industry vs inferiority Identity vs role confusion
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Parent-child relationship
Attachment Engrossment
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Parent guidance / discipline
0-6 months Distraction 6-12 months Direct More direct discipline
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Moral Development Neonate No conscience 100% ID
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Cognitive development: Who’s theory are we going to be applying?
Freud Erikson Paiget Kohlberg Maslow
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What stage of cognitive development is an infant?
Preoperational Concrete operational Sensorimotor Formal operational
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Communication: What “name” or word to baby’s say first (usually)
MaMa DaDa
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Communication Birth 2 months 4-6 months 8 months 10 months 12 months
Crying 2 months Smile 4-6 months Babbling 8 months Dada 10 months Mama 12 months 4-6 words
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Nutrition Breastfeeding Bottle feeding Colostrum immunoglobulins
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Sleep & Rest Neonate 1 year 20 hours/day 12 hours / day
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Play Non-symbolic Solitary
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Safety: Aspiration Avoid small objects
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Shaken Baby Syndrome
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Burns
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Drowning Bathtub never alone
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Falls Mattress lowest position firm Infant seat with restraint
Infant seat on the ground Safe gaits Slide Not accordion
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Poisoning Lead paint Plants Safety locks Medicine CO monitor
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MVA Read facing car seat 12 months
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