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Ch 10: Health Promotion of the Infant and Family Ch 11: Health Problems of Infants. Laura Salisbury RN, MSN/Ed. Ch 10: Health Promotion. Biologic Development Birth weight, height Growth in spurts Fontanelles: when closed?
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Ch 10: Health Promotion of the Infant and FamilyCh 11: Health Problems of Infants Laura Salisbury RN, MSN/Ed.
Ch 10: Health Promotion • Biologic Development • Birth weight, height • Growth in spurts • Fontanelles: when closed? • Chest circumference equal to head circumference by end of the first year
Maturation of Systems • Respiratory • Cardiovascular changes • Hematopoietic changes • Digestive processes • Immune system • Thermoregulation • Body fluid • Renal system • Sensory • Fine motor development • Gross motor development
Psychosocial development • Trust vs. mistrust • Delayed gratification • Primary narcissism • Biting
Cognitive Development • Learning to separate • Object permanence • Use of symbols • Sensorimotor phase • Birth to 1 month: use of reflexes • 1-4 months: primary circular reactions • 4-8 months: Secondary circular reactions • Imitation and play • 8-12 months: fourth Sensorimotor phase: coordination of secondary schemas • Development of body image
Social Development • Attachment to parent • Able to discriminate mother • Reactive Attachment Disorder (RAD) • Separation anxiety: 4-8 months • Stranger fear • Language development • Play • Temperament
Concerns r/t normal growth and development • Separation and stranger fear • Child care • Limit setting/discipline • Thumb sucking/pacifiers • Teething • Shoes
Promoting Health During Infancy • Nutrition • First 6 months • Second 6 months • Starting solid foods • Weaning • Sleep and Activity • Typical sleep patterns • Typical activity patterns • Sleep problems (p348) • What about the “family bed”? • Dental Health • Cleaning of teeth • Fluoride
Promoting Health During Infancy • Immunizations • Hep A • Hep B • DTaP • Polio • MMR • Hib • Varicella • Pneumococcal • Influenza • Meningococcal • Know what each immunization is for and approximate schedule of administration(pg 352) • Typical reactions to immunizations • Precautions and contraindications
Promoting Health During Infancy • Injury Prevention • Aspiration of foreign objects: toys, food, pacifiers • Suffocation • Motor vehicle injuries: car seats • Falls • Poisoning • Burns • Drowning • Bodily damage
Ch 11: Health Problems of Infants • Pg 382
Nutritional Disorders • Vitamin imbalances • Vitamin D • Vitamin A and measles • Vitamin C • Overdoses: vitamin A and D • Complementary and alternative medicine • Mineral Imbalances • Iron • Zinc • Calcium
Nutritional Disorders • Vegetarian Diets • Types of vegetarians • Lacto-ovo • Lacto-vegetarians • Vegans • Macrobiotics • Semi-vegetarians • When is supplementing needed? • Vegetarians need to get complete proteins • Essential amino acids
Nutritional Disorders • Nursing care management • Know factors that affect iron absorption (box 11-1, p. 380) • Complete proteins and incomplete proteins • Protein-energy malnutrition (PEM) • Kwashiorkor • Marasmus • Management of PEM
Food Sensitivity • Food allergy • Food intolerance • Food hypersensitivity • Systemic • Gastrointestinal • Respiratory • Cutaneous • Atopy • Cow’s milk allergy • Lactose intolerance • (See “family-centered care” box on p. 388)
Feeding Difficulties • Regurgitation • Spitting up • GER/GERD • Reflux • Colic (paroxysmal abdominal pain) • Symptoms • Management
Feeding Difficulties • Growth failure (failure to thrive or FTT) • Organic failure to thrive • Nonorganic failure to thrive • Idiopathic failure to thrive • Evaluation • Management (See Nursing Care Guidelines box, p. 399)
Other Disorders • Positional Plagiocephaly • Symptoms • Management • Treatment
Disorders of Unknown Etiology • Sudden Infant Death Syndrome SIDS • Etiology • Management • Prevention • Assisting the family
Disorders of Unknown Etiology • Apnea of Infancy • Pauses of breathing >20 seconds • Many Causes • Can happen with or without ALTE
Disorders of Unknown Etiology • ALTE Apparent life-threatening event • Sometimes called near-miss SIDS • Infant found in state of apnea/cyanosis • May require significant interventions including CPR • May or may not have a history of apnea • Monitors can be used but can be very stressful for parents/family