Prenatal Period to 1 year Chapter 6

What are the two main factors that influence growth and development? A.Stress and Family B.Environment and Stress C.Environment and Heredity D.Heredity and Gender

Heredity: Zygote formation Sperm & ovum – 23 chromosomes  – Zygote Gender – X & Y Chromosomes Ovum – Always X Sperm – X or Y

Dominant & Recessive Genes Dominant Capable of expressing traits over other genes Recessive Traits only appear if they exist in pairs

Recessive disorders >700 recessive gene diseases – Sickle-cell disease – Tay-Sachs disease – Hemophilia

Environment “From the moment life begins, the environment begins to exercise its influence on the newly formed entity.”

For you personally, when does life begin? A.Conception B.Implantation C.When there is a heart beat D.When the fetus is viable if it was born E.When the baby is born

Healthy Pregnancy Rest Exercise – Continue

What is the best form of exercise for a pregnant women? A.Bicycling B.Walking C.Swimming D.Jogging E.Kick-boxing

Teratogens Tobacco – Low birth rates – Growth restrictions

Teratogens Alcohol – *1 st trimester – Fetal Alcohol Syndrome (FAS) – Miscarriages – Growth restriction – CNS damage

Teratogens Bacteria, protozoan, viruses – Rubella Toxoplasmosis – Parasite – Eat well-cooked meat

Ova to Fetus Ovaries – Ova (pl) – Ovum (sing) Ovulation Sperm Conception/ Fertilization Zygote Implantation Embryo Fetus

What is the estimated length of human pregnancy? A.28 weeks B.38 weeks C.40 weeks D.42 weeks E.48 weeks

Stages of Labor & Delivery Stage 1 – Dilation Dilation Effacement Stage 2 – Expulsion After-brith – placenta

Fetal membranes Amniotic sac Amniotic fluid Placenta Umbilical cord – 2 arteries – 1 vein

Neonate 1 st breath Apgar score – 1 minute – 5 minutes

APGAR Activity Pulse Grimace Appearance Respiration activity and muscle tone pulse grimace response / reflex irritability") Appearance / skin coloration respiration

What is the highest score a neonate can get on a Apgar score? A.2 B.3 C.10 D.12 E.15

Head & Skull Head ¼ of total body length Ave circumference – inch – cm – 1 inch > chest

Skull 6 bones – 1 occipital – 1 frontal – 2 parietal – 2 temporal Separated by cartilage – Sutures Fontanels – Anterior – Posterior

Which fontanel is smaller? A.Anterior B.Posterior

When does the posterior fontanel “close” by? A.2 months B.4 months C.6 months D.8 months E.12 months or more

When does the anterior fontanel usually “close” by? A.6 months B.12 months C.18 months D.2 years E.3 years

What is the normal lengths of a full- term neonate? A.12 inches B.18 inches C.20 inches D.24 inches E.36 inches

How much does a normal infant grow in the first year? A.½ inch a month B.1 inch a month C.1 ½ inch a month D.2 inch a month E.2 ½ inch a month

Normal Physiological Weigh Loss. How much weight on average does a neonate loss in the first few days of life? A.5-10 % of birth weight B.15-20% of birth weight C.25 – 30% of birth weight D.There is no such thing as normal physiological weight loss in a neonate

Skin Thin & pale Acrocyanosis Pigmentation

Mongolian Spot Usually fads by… – Age 4 years 6 month old

Lanugo

Vernix Cascosa

Milia

Physiological Jaundice

Genitals Breasts – Swollen

Genitals Scrotum – Lg & edematous

What is the medical term for undescended testicles? No – this is not multiple choice! Turn to your neighbor and tell them the answer.

Cryptorchidism Undescended testicle/s

Cryptorchidism The testes develop in the abdominal cavity in early fetal life. By 14 to 17 weeks of intrauterine life they migrate to an opening in the body wall known as the inguinal canal. After 28 weeks they pass through the canal and by 35 to 40 weeks reach the scrotum.

Undescended testicles are fairly common in premature infants. They occur in about 3 - 4% of full-term infants. In most cases the testicles descend by the time the child is 9 months old.

Increased risk of – Testicular cancer – Infertility

Genital Urethra Circumcisions

Pseudomenstruation Blood-tinged vaginal discharge

Face Eyes swollen

Eye treatment – Erythromycin – Silver nitrate

When do baby teeth start to come in? A.2 months B.4 months C.6 months D.8 months E.12 months Deciduous teeth

Which teeth normally erupt first? A.Two lower central incisors B.Two upper central incisors C.Two lower lateral incisors D.Two upper lateral incisors

By age 12 months the baby will have 6- 8 teeth

Abdomen Neonate – Lg and flabby Umbilical cord – Cut – Clamped – Falls off – No tub bathing until…

Abdomen Digestion – Simple carbs Stomach can hole – Neonate 1-3 oz – 12 months 10 – 12 oz

Why do you have to “burp” the neonate? Cardiac sphincter

Bowel movement Stool Feces Meconium – Duration 1-2 days – Characteristics Green-black Tarry Odorless

Bowel movement, Stool or Feces Formula Fed Pasty yellow or tan Odor Breastfed Mustard seed color Sweet odor

Extremities Short Flexed Finger/sole prints Nurses – ROM – Gluteal folds

Gluteal fold assymetry

Neurological Characteristics Newborns – Reflexes – Posture – Movement – Muscle tone

Protective reflexes Blinking Sneezing Swallowing gag

Moro / Startle Reflex Sudden movement  Extension & Adduction of extremities Disappears – 3-4 months

Tonic Neck Reflex Turn head to one side  extend arm and leg on that side Disappears – 5 months

Rooting reflex Stroke cheek  enfant turns toward that side and open mouth Disappears – 4-6 months

Sucking Reflex Sucking movement when anything touches their lips Diminishes – 6 months

Babinski When sole is stroked  hyper-extened & fan out toes & big toe turns up Disappears – 3 months

Palmar grasp Grasp anything placed in hand Appears – 6 wks Disappears – 3 months

Spinal Bifida

Vision Newborn – Primative – Nystagmus 4 months – Binocular vision 6 months – 20/100 – Depth perception

Hearing 6 wks – Recognize mom and turn to respond 1 year – ID sounds and source

Touch Birth – Face – Hands and soles 1 yr – Withdrawal – Recognize source

Vital Signs - Newborn Temp – Initially low – Stabilized Axillary Pulse – 120 – 160 / min – Apical BP – 64 / 40 Resp – 30 – 60 / min – Irregular – apnea

Motor Development Neonate – Purposeless – uncoordinated

Gross motor skills 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

Fine motor skills Neonate – 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

Psychosocial Development: What theorist are we going to discuss? A.Freud B.Erikson C.Paiget D.Kohlberg E.Maslow

What stage of psychosocial development is a neonate? A.Autonomy B.Trust C.Initiative D.Industry E.Identity

Parent-child relationship AttachmentEngrossment

Parent guidance / discipline 0-6 months – Distraction 6-12 months – More direct discipline

Cognitive development: Who’s theory are we going to be applying? A.Freud B.Erikson C.Paiget D.Kohlberg E.Maslow

What stage of cognitive development is an infant? A.Preoperational B.Concrete operational C.Sensorimotor D.Formal operational

Moral Development Neonate – No conscience – !00% ID

Communication: What “name” or word to baby’s say first (usually) A.MaMa B.DaDa

Communication Birth – Crying 2 months – Smile – Coo 4-6 months – Babbling 8 months – Dada 10 months – Mama 12 months – 4-6 words

Nutrition

Sleep & Rest

Play

Safety: Aspiration Avoid small objects Age aprop toys

Baby harm Sharp objects Heavy objects Animals Shaken baby syndrome

Burns Check water temps Smoke detectors Handles of pans in Cover electrical outlets

Drowning Bathtub never alone

Falls Mattress lowest position – firm Infant seat with restraint Infant seat on the ground Safe gaits – Slide – Not accordion

Poisoning Lead paint Plants Safety locks Medicine CO monitor

MVA Read facing car seat 12 months