NSG 222 Family Nursing Exam 4 (Peds) - Questions and Answers

NSG 222 Family Nursing Exam 4 (Peds) - Questions and Answers What type of reflexes are neonates born with? When do they disappear? Neonates are born with many reflexes called primitive reflexes. They are the Moro reflex, root, suck, asymmetric tonic neck, plantar and palmar grasp, step and Babinski reflexes. The Babinski reflex disappears at about age 1 year, the other reflexes diminish over the first few months of life What types of reflexes do Neonates develop? When the primitive reflexes diminish, the infant develops protective or postural response reflexes. They help with motor development and remain for life once established. They are the righting and parachute reactions. What development is expected in infants that are 3 months old? •Lifts head and neck when on abdomen •Grasps objects •Turns head side to side •Reflexes still present but palmar and plantar grasps disappearing (3-4 months) What development is expected of a 6 month old? •Moro reflex disappears around 6 months, startle at 4 months, tonic neck 4-6 months. •Birth weight double by 6 months •Rolls front to back around 5 months, back to front around 6 months •Reaches for and grasps object, puts them in mouth •Chews/teething, babbles •Sits when propped, can support some weight if held in standing position •Recognizes familiar objects, expresses displeasure if removed, developing object permanence What are developmental findings in a 9 month old? •Sits unsupported by 8 months, pulls to standing 8-9 months and crawls, responds to name •Transfers objects hand to hand, points to and picks them up, uses pincer grasp •Likes mirrors •Develops separation anxiety between 8-9 months, around 9 months also develops stranger anxiety What development is expected by age 1 year? •Birth weight tripled •Has 6-8 teeth •Knows name •Cruises or walks when 1 hand held •Places object in container •May have security object •Drink from cup and use spoon but prefers fingers What toys are appropriate for ages 1-4 months? •Age 1-4 months: mobile, mirrors, rattles, music/singing, high-contrast patterns in books What toys are appropriate for 4-7 months? 4-7 months: fabric/board books, music, toys that do things and are easy to hold, toys that float or squirt water, soft dills/animals What toys are appropriate for 6-12 months? 6-12 months: plastic cups, bowls or buckets, mirror, blocks, stacking toys, busy boxes, balls, dolls, toy phone, push-pull toys, board books with pictures What factors are important for infant nutrition? Infants should have breast milk or formula until age 6 months. Solid foods can be introduced around 6 months, introducing 1 new food a week. Continue breast milk or formula until age 1 year. Then the infant can be switched to whole milk. What is safety related to infant care? •Keep small objects or hard foods out of reach. Cover outlets, protect from falls, prevent poisoning from medications or household chemicals. Never leave unattended by water. Car seat should be rear facing throughout infancy and in the back seat. Crib should have firm mattress that fits snugly in crib What are some developmental concerns related to growth/development in the infant period? Colic Spitting up Thumb Sucking Teething Pain How to address Colic? (Infant developmental concerns) •inconsolable crying that lasts 3 hours or more. It happens more often in the evening and usually resolves around 3 months of age. Parents should develop stepwise approach to make sure the basic needs are met. When needs are met, they attempt to soothe by reducing stimulation, carrying, swings/vibration, pacifier (try 1 intervention at a time). How to address spitting up? (Infant developmental concerns) •normal after feedings. Encourage to burp frequently and keep upright (not in a seat) for 30 minutes after feeding. How to address thumb sucking/security? (Infant developmental concerns) •thumb sucking is a healthy, self-comforting activity. Pacifiers work but can be linked to increased incidence of otitis. If use pacifier, wean by age 2-3 or can negatively affect teeth. If have security object, wean after infancy. How to address teething pain? (Infant developmental concerns) •application of cold can be soothing, over-the-counter topical anesthetics may be helpful Piaget Infant Development •sensorimotor, uses senses to explore the world. Discusses separation anxiety, object permanence, ability to use symbols Erikson Infant Development •Trust vs mistrust, infant develops trust when needs met. Caregivers learn infant signals and responds to them to meet needs, signals include crying, cooing and facial expressions Freud Infant Development •oral stage, sexual urges gratified through mouth What type of discipline is appropriates in infants? •Setting limits for safety •Reward good behavior (Positive reinforcement) •Be consistent •Maintain routines What are expectations related to growth in toddlers? •Weight: gain 3-5 pounds a year •Height: grow about 3 inches per year, reach half of adult height by age 2. •Head circumference: grows 1 inch between ages 1 and 2, then half an inch per year until age 5 •Anterior fontanel should be closed by age 18 months Developmental Expectations by 15 months •Walks alone by 15 months, creeps up stairs, begins to run, uses cup, builds tower of 2 blocks Developmental Expectations by 18 months •kicks a ball, jumps in place with both feet, uses push-pull toys (toys they can manipulate), builds tower of 3-4 blocks