Nursing 307 Week 1 Pediatrics: Infants, Toddlers, Preschoolers, School-Aged Children and Adolescents; Physical Assessment and Med Administrative ATI Chapter 1-10

I. Infants, Toddlers, Preschoolers, School-Aged Children and Adolescents a. Infants (2 days – 1 year) i. General Measurements 1. Head: 33-35 cm 2. Crown to rump length: 31-35 cm 3. Weight: 2,700 – 4,000 g (6-9lbs) a. Newborns will lose up to 10% of birth weight in the first 3-4 days b. Gain 1.5 lbs per month for the first 5 months c. Birth weight is doubled by age 5 mo. d. Tripled by age 12 mo 4. Length: head to heel 48 – 53cm ii. Physical Development 1. Fontanel a. Anterior: closes by 12-18 months b. Posterior: closes by 6-8 weeks 2. Milestones a. 3 months = head control b. 8 months = Sit alone 3. Dentition a. 6-8 teeth by end of year 1 b. Indications of teething: suckling, biting on fingers, drooling, irritable difficulty sleeping, mild fever, rub ears, decreased appetite c. NI: i. Nonpharm 1. Frozen teething rings 2. Ice cubes in wash cloths ii. Pharm 1. Topical anesthetics 2. Acetaminophen or ibuprofen when baby has trouble sleeping. Do not use >3 days iii. Cognitive Development 1. Piaget a. Sensorimotor Stage (Birth – 24 months) i. Tasks of this stage: 1. Separation- Infants lean to separate themselves from other objects in the environment 2. Object permanence- The process by which infants learn that an object still exists when it is out of view 3. Mental representation – The ability to recognize and use symbols ii. Infants progress from reflexive to simple repetitive to imitative activities b. Language i. Crying is first from of communication ii. Shows interest in environment by 3 months iii. Turns head to the sound of a rattle by 3 months iv. Begins speaking 2-3 word phrases v. Comprehends “no” by 9-10 months iv. Psychosocial Development 1. Erikson “Trust vs Mistrust” (birth to 1 year) a. Based on quality of caregiver b. Learns delayed gratification; if not met leads to mistrust 2. Social development a. Attachment is enhanced when parents are in good health, positive feeding experiences 3. Body-image changes a. Mouth is pleasure producer b. Hands and feet are play objects c. Smiling causes others to react v. Age- Appropriate Activities 1. Play should provide interpersonal contact 2. Short attention spans 3. Solitary play a. Rattles b. Teething toys c. Soft stuffed toys vi. Nutrition 1. Breastfeeding first 6 mo. 2. Solids introduced 4-6 months a. Start with iron fortified cereal b. Foods to be tried over 5-7 days c. Then try vegetables d. Last citrus fruits meats and eggs 3. Begin weaning off last 6 months vii. Screenings 1. H & H by 12 months viii. Sleep 1. Slep 14-15 hrs daily; 11 at night 2. 1-2 naps during day ix. Safety 1. NUMBER ONE CAUSE OF DEATH = CONGETINAL ABNORMALITES 2. Aspiration a. Hold infant for feedings, do not slump bottles 3. Bodily Harm 4. Burns a. Do not warm food in microwave b. Water below 49 C 5. Drowning 6. Falls 7. Poisoning 8. MVA 9. Suffocation