Ch 10: Health Promotion of the Infant and Family

Ch 11: Health Problems of Infants

Laura Salisbury RN, MSN/Ed.

Ch 10: Health PromotionBiologic Development

◦Birth weight, height◦Growth in spurts◦Fontanelles: when closed?◦Chest circumference equal to head

circumference by end of the first year

Maturation of SystemsRespiratoryCardiovascular changesHematopoietic changesDigestive processesImmune systemThermoregulationBody fluidRenal systemSensoryFine motor developmentGross motor development

Psychosocial development

◦Trust vs. mistrust◦Delayed gratification◦Primary narcissism◦Biting

Cognitive DevelopmentLearning to separateObject permanenceUse of symbolsSensorimotor 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 motherReactive Attachment Disorder

(RAD)Separation anxiety: 4-8 monthsStranger fearLanguage developmentPlayTemperament

Concerns r/t normal growth and development

Separation and stranger fearChild careLimit setting/disciplineThumb sucking/pacifiersTeethingShoes

Promoting Health During InfancyNutrition

◦ 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 InfancyImmunizations

◦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

Promoting Health During InfancyInjury 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 InfantsPg 382

Nutritional DisordersVitamin imbalances

Vitamin D Vitamin A and measles Vitamin C Overdoses: vitamin A and D

◦Complementary and alternative medicine

◦Mineral Imbalances Iron Zinc Calcium

Nutritional DisordersVegetarian Diets

Types of vegetarians Lacto-ovo Lacto-vegetarians Vegans Macrobiotics Semi-vegetarians

oWhen 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 DifficultiesRegurgitation

◦Spitting upGER/GERD

◦RefluxColic (paroxysmal

abdominal pain)◦Symptoms◦Management

Feeding DifficultiesGrowth 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 DisordersPositional Plagiocephaly

◦Symptoms◦Management◦Treatment

Disorders of Unknown Etiology Sudden Infant Death Syndrome

SIDS◦Etiology◦Management◦Prevention◦Assisting the family

Disorders of Unknown EtiologyApnea of InfancyPauses of breathing >20 secondsMany CausesCan happen with or

without ALTE

Disorders of Unknown EtiologyALTE 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