1. Chapter 31 The Infant and Family
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2. Promoting Optimal Growth and Development
Biologic development
Proportional changes
5- to 7-oz weight gain per week
Doubling of birth weight by age 6 months
Tripling of birth weight by age 1 year
Height increases by 1 inch per month x 6 months
Growth in “spurts” rather than gradual pattern
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3. Maturation of Systems Slowing of respiratory rate
Slowing of heart rate
Hematopoietic changes
Head growth
Differentiation of the nervous system
Maturation of digestive processes
Maturation of immunologic system
Thermoregulation
Maturation of renal function
Increase in auditory acuity and perception
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4. Fine Motor Development
Grasping object: ages 2 to 3 months
Transferring object between hands: age 7 months
Pincer grasp: age 10 months
Removing objects from container: age 11 months
Building tower of two blocks: age 1 year
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5. Fine Motor Development (Cont.)
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6. Gross Motor Development
Head control
Rolling over
Age 5 months: abdomen to back
Age 6 months: back to abdomen
Sitting: age 7 months
Move from prone to sitting position: age 10 months
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7. Gross Motor Development (Cont.)
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8. Gross Motor Development (Cont.)
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9. Gross Motor Development (Cont.)
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10. Gross Motor Development (Cont.)
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11. Gross Motor Development (Cont.)
Locomotion
Cephalocaudal direction of development
Crawling: ages 6 to 7 months
Creeping: age 9 months
Walking with assistance: age 11 months
Walking alone: age 1 year
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12. Gross Motor Development (Cont.)
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13. Psychosocial Development
Developing a sense of trust (Erikson)
Infants trust that their comfort needs will be met
Feeding
Stimulation
Mistrust
Occurs when gratification of needs is delayed
Social modifications
Grasping
Biting
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14. Cognitive Development
Sensorimotor phase (Piaget)
Birth to age 1 month: use of reflexes
Ages 1 to 4 months: primary circular reactions
Ages 4 to 8 months: secondary circular reactions
Imitation
Play
Affect
Coordination of second schemas
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15. Development of Body Image
Concept of object permanence is acquired
Development of body image parallels sensory motor development
Anesthetic and tactile experiences are children’s first perceptions of their bodies
By end of first year, children recognize that they are distinct from parents
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16. Development of Body Image (Cont.)
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17. Development of Body Image (Cont.)
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18. Social Development Attachment Reactive attachment disorder (RAD)
Separation anxiety
Stranger fear
Language development
Play
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19. Social Development (Cont.)
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20. Temperament Infants’ behavioral style Strong biologic component
May be modified by the environment and family
Revised infant temperament questionnaire
Difficult
Intense
Less predictable
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21. Coping with Concerns Related to Normal Growth and Development
Fear of separation and strangers
Alternative child care arrangements
Setting limits and discipline
Thumb-sucking and use of a pacifier
Teething
Infant shoes
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22. Promoting Optimum Health During Infancy
Nutrition
First 6 months of life: human milk should be the only food
Second 6 months
Selection and preparation of solid foods
Introduction of solid foods
Weaning from breast or bottle
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23. Promoting Optimum Health During Infancy (Cont.)
Sleep and activity
Sleep patterns vary among infants
By ages 3-4 months, nocturnal sleep lasts 9-11 hours
Breastfed infants awakened more often
Napping
Infants are naturally active
Walkers, swings, and playpens are not necessary
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24. Promoting Optimum Health During Infancy (Cont.)
Dental health
Maternal dental health
Cleaning: begins when primary teeth erupt
Fluoride at 6 months
Prevention of dental caries
No bottle propping
No milk in bed
No fruit juices
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25. Promoting Optimum Health During Infancy (Cont.)
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26. Immunizations Schedule for immunizations
Recommendations for routine immunization
Hepatitis A and B viruses
Diphtheria
Tetanus
Pertussis
Polio
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27. Immunizations (Cont.)
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28. Immunizations (Cont.)
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29. Immunizations (Cont.) Routine immunizations Measles, mumps, rubella
Pneumococcus
Haemophilus influenzae B
Varicella (chickenpox)
Influenza
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30. Immunizations (Cont.) Recommendations for selected immunizations
Selected groups of children
Rotavirus and human papillomavirus
Reactions
Contraindications and precautions
Administration
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31. Immunizations (Cont.) Vaccine Adverse Event Reporting System (VAERS)
To report any adverse reactions after administration of any vaccine
Vaccine Information Statements (VIS)
Information statements that must be given to parents before administration of given vaccines
Updated information that must be given to parent/guardian of child being vaccinated
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32. Safety Promotion and Injury Prevention
Motor vehicle safety
Motor vehicle accidents: the leading cause of accidental death
Car seats: in the back seat of the car
Hyperthermia: can result from overdressing
Nurse’s role in injury prevention
Ensuring safety in the home
Teaching infant CPR
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33. Safety Promotion and Injury Prevention (Cont.)
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34. Special Health Problems
Colic (paroxysmal abdominal pain)
15%-40% of all infants
Therapeutic management
Failure to thrive (growth failure)
Diagnostic evaluation
Prognosis
Care management
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35. Special Health Problems (Cont.)
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36. Special Health Problems (Cont.)
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37. Special Health Problems (Cont.)
Sudden infant death syndrome (SIDS)
Risk factors for SIDS
Protective factors for SIDS
Infant risk factors
Care of the family after a sudden death
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38. Special Health Problems (Cont.)
Positional plagiocephaly
“Back to Sleep” since 1992
Front to play
Diagnostic evaluation
Therapeutic management
Care management
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39. Special Health Problems (Cont.)
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40. Special Health Problems (Cont.)
Apparent life-threatening event (ALTE)
Aborted or near-miss SIDS
Diagnostic evaluation of ALTEs
Therapeutic management
Theophylline/caffeine
Home apnea monitors
Family support
CPR training
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41. Special Health Problems (Cont.)
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42. Question
Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that Latasha recently began to suck her thumb. Which of the following is the best nursing intervention?
A. Recommend that the mother substitute a pacifier for Latasha’s thumb.
B. Assess Latasha for other signs of sensory deprivation.
C. Reassure the mother that thumbsucking is normal at this age.
D. Suggest that the mother breastfeed Latasha more often to satisfy sucking needs.
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