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Chapter 7
The Infant
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Objectives
Define the term infant.
State the developmental tasks of infancy.
Describe the physical development of infants from 1 month to 1 year of age.
Discuss milestones of motor development.
Understand five basic guidelines for physical activity for infants.
Discuss the development of language.
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Objectives (cont.)
Describe the theories of Piaget, Freud, and Erikson concerning infant development.
Define separation anxiety.
Discuss the development of attachment.
Describe the basic nutritional needs of infants from 1 month to 1 year of age.
List the immunization schedule for infants under 1 year of age.
State four safety precautions essential in infant care.
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Key Terms
autonomy
cephalocaudal
coping skill
defense mechanism
development
expressive
growth
infant
length
nonverbal language
norms
nursing caries
object permanence
ordinal position
personality
pincer action
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Key Terms (cont.)
preverbal
receptive
separation anxiety
sudden infant death syndrome (SIDS)
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Definitions
Infant
Growth
Development
Norms
Cephalocaudal
Length
Defense mechanisms
Coping skills
Ordinal position
Personality
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7. Critical Thinking Question 1
How should the nurse respond to a father who says his 12-month-old weighs 17 pounds?
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8. Developmental Tasks of Infancy
Include Trust versus Mistrust, Intelligence, Emotional Development, Attachment, Language Development, Motor Development, Physical Activity, Autonomy, Sleep Patterns, and Play.
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Trust Versus Mistrust
The first psychosocial crisis in infancy that must be resolved
Trust develops when infants learn that their basic needs will be met
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10. Understanding Cause and Effect
Discovered at an early age
A cry elicits a response from adults so the cry becomes a means of communication
En face position
Object permanence
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Memory
Infants can retain memory of a traumatic experience
General comforting may not be enough to achieve full emotional recovery
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12. Emotional Development
An infant will mimic the facial expression of the adult
Interaction between parent and infant is necessary in the first months of life and is important for later social development
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Attachment
Begins long before the infant is born, when the mother feels the fetus moving in the womb
Parents slowly develop an instinctive response to infants’ cues
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14. Critical Thinking Question 3
How should the nurse respond to the mother who says she lacks the energy to cope with her highly active 7-month-old? Give examples of possible assessments and interventions (i.e., maternal depression? anemia? illness? Mother may need treatment or ideas on how to provide more opportunities for active play; “mother’s day out”).
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Separation Anxiety
Begins at 6 months of age
Infant cries or protests when the parent leaves the room
By 18 months, memory development helps the child remember the parent's image and to trust that the parent will return after an absence
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Language Development
Verbal language is both expressive and receptive
Nonverbal language
There appears to be an innate ability to develop language skills
Preverbal stage of language development
First words between 10 and 13 months of age
See Figure 7-2.
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Motor Development
Closely related to the development of perception, emotion, and cognition
Many motor skills are dependent on the disappearance of newborn reflexes
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Physical Activity
Must be provided with a safe and stimulating environment to move and explore
Early motor competence and confidence can contribute to the enjoyment of physical activity throughout childhood and beyond
See Figure 7-3 and Box 7-1.
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Autonomy
Striving for independence starts early in infancy
Self-consoling behavior is an early form of independence
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Sleep Patterns
A maturing central nervous system combined with parental responses aids in the development of sleep patterns
The goal is to help infants develop self-regulatory skills so that they return to sleep without prompting
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21. Role of Play in Fostering Growth and Development
Piaget's sensorimotor theory of development is evident in the infant's play activities
According to Freud's theory of development, the infant is in an oral phase
By applying learned skills to environmental experiences, children learn about the world around them
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22. Critical Thinking Question 4
What would be your response to the mother who says she punishes her 8-month-old infant for “eating everything off the floor” and for “dropping food on the floor on purpose just to see me pick it up”?
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Health Maintenance
Tasks can include Nutrition, Teeth, Immunizations, and Accident Prevention.
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Nutrition
Proper nutritional intake is essential to support optimum development
The newborn has a rooting and sucking reflex
Introduction of foods before 6 months of age is not recommended
See Cultural Considerations: Breastfeeding (p. 107)
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25. Critical Thinking Question 5
What nursing care strategies could be implemented when working with a parent who gives the infant a bottle of formula every time the infant cries?
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26. Critical Thinking Question 6
How should the nurse respond to the mother who says she puts her infant to bed each night with a bottle of Kool-Aid?
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Teeth
Primary or baby teeth begin eruption at 5 to 7 months of age
Allow chewing of food
Nursing caries
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Immunizations
Well-child visits should be scheduled after birth before the newborn is discharged from the hospital
Growth, development, health, and nutrition of the infant should be checked every 2 months and appropriate immunizations scheduled
See Appendix A.
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Accident Prevention
Major cause of morbidity and mortality
First injury prevention activity for the newborn is the use of car seats
Safety Alert (p. 109)
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