Chapter 10
What can you put in a bottle and give to the infant at bedtime?
Give water in bottle at bedtime
Avoid giving milk or juice in bottle at bedtime because of the risk of dental caries. Best to omit bottle
Erikson’s Theory of Human Development- What age range is Initiative vs. Guilt?
Preschool years from 3 to 5
List two coomplications when infants are born early.
Premature babies are more likely to have chronic health issues, increased risk of SIDS, Infections, asthma and feeding problems
what is the pincer grasp?
Fine motor milestone of an infant being able to hold things between thumb and index finger which develops around 8-9 months
How can you compare the height of a two-year-old to that of his/her adult size?
At 2 years old a toddler is at about 50% of his/her adult size
Compared to an Adult how much food should a toddler eat?
-Serving size= ¼ of adult serving size
During pregnancy what should happen with your iron intake?
Iron is needed twice as much as in nonpregnant women because of the maternal blood cell volume and to supply needs to the developing fetus. Supplements of 30-60mg is recommended
Note: Iron deficiency anemia is common in pregnant women and impairs the fetus from receiving the oxygen that it needs
Erikson’s Theory of Human Development- What age range is Autonomy vs. Shame and Doubt?
Toddler years from 18 months to 3 years
Name two safe and two unsafe medications to take when you are pregnent
Safe Medications: Tylenol (PM, #3), Ambien, Unisom, Benadryl, Claritin, Mucinex, Zyrtec, Amoxicillin, Ampicillin, Pepcid, Zantac, Robitussin Cough Syrup-DM, Flu shot, hair color, mani/pedicures, etc.
Unsafe Medications: Ibuprofen, Tetracyclines
What are the appropriate toys for the different stages for a 2-month-old, 3-4 month old, and a 9-month-old?
2-month-old: colorful mobile with music
3-4 months: rattle
9-month-old: supervised time outside of the playpen
What is one way to implement good sleep habits for a toddler?
Schedules are helpful to avoid fatigue
Rituals help to develop a sense of security (e.g., reading a book, saying a prayer, brushing your teeth) helps them wind down
Night terrors- normal and less frequent as child develops, not fully awake, as a parent be sure to speak soothingly and do not wake up child
How can autonomy be promoted for a toddler?
Provide them with choices you are okay with
Allow them to explore, be supportive, and don't shame them when they do something incorrectly
What is Infantile Botulism?
illness of ingested toxins from a type of bacteria (clostridium botulinum)
Can occur from introduction to honey before the age of 1
Erikson’s Theory of Human Development- What age range is Trust vs. Mistrus?
Infancy from birth to 18 months
What are the complications when infants are born after 42 weeks?
There is a major concern of decreased placental function after 42 weeks; the baby will not receive the necessary nutrients due to decreases placental function
What is SIDS and name one risk factor.
Sudden Infant Death Syndrome: sudden death of infant under the age of 1 during sleep unexpectingly or unexplained
Risk factors: prone/ side sleeping positions, preterm birth and/or low birth weight, smoke exposure, soft bedding, bed sharing and not breast feeding.
Reduce risk by avoiding soft bedding or having object in crib and encourage supervised tummy time
What are the milk and juce recomendations for toddlers?
-Limit milk to 16-24 ounces (2-3 cups) per day
-Fruit juice should be limited because it contains high levels of natural sugar
-Both should be limited so that it will not decrease the amount of food the toddler will eat
What is the difference between infants birth weight to 5 months, 12 months and 2.5 years?
5 months - Double
12 months- Triple
2.5 years- Quadrupal
How can you reduce the risk of asphyxiation (choking) for infants and toddlers?
In infants avoid propping the baby bottle to avoid the risk of aspiration
In toddlers have them sit down and watch them and avoid giving them seeds, peanuts, or small items which can cause choking
Toddlers should be sitting at mealtime in order to prevent choking
Erikson’s Theory of Human Development- What age range is Industry vs. Inferiority ?
Middle school years from 6 to 11
What is Pica and what can a nurse do to help?
An eating disorder characterized by the ingestion of nonfood substance such as dirt, clay, laundry starch, ashes, plaster, raw rice, paint chips, coffee grounds, and ice . . . must occur over a period of at least 1 month
As a nurse, it is important to educate your patient on the importance of an adequate diet for the safety of her and the developing fetus. You also need to inform the patient of the dangers of practicing pica, how it can interfere with absorption, and give better alternatives for food.
What is the difference in elimination for an infant that is breastfed vs bottle-fed? (stool consistency, frequency, smell)
Breastfed stool - softer consistency, clean smell, initially several stools daily; progresses to once daily or over several days. More frequent bowel movements than bottle-fed babies.
Bottle-fed stool - Harder consistency, smellier. Similar to infant on solid food
What is the relationship between lead poisoning and iron-deficiency anemia
Lead causes anemia by impairing heme synthesis and increasing the rate of red blood cell destruction
Whats one way to prepare a preschool child for a new sibling?
Do your best to explain the pregnancy in an appropriate manner to the child, and make sure you answer the various questions they might have
Include the child when it comes to doing things for the baby; for example, decorating the nursery or picking out baby clothes
You could have the child attend your childbirth education classes with you or even encourage them to draw or make gifts for the baby.
If trying to reduce the risk of allergies to foods when should solids be introduced to infants?
4-6 months (preferably 6 months)
What would failure to successfully complete a stage of Eriksons Theory of Development do to someone?
It would leave a person confused along with possessing a tendency to act inappropriately for their age.
What are key points to establish bonding between infants and mothers and when should it be established?
holding the infant close, eye contact, and a nurturing attitude towards the baby.
Infant-mother bonding is encouraged immediately after birth.
Infant-mother bonding begins with the mother’s self-perception; a mother who is mentally and physically well will usually succeed in infant-mother bonding.
When should whole milk be introduced? When should solid foods be introduced to an infant?
Whole milk – after age 1
Solid foods – 4 to 6 months of age
Sequence of solids: cereal, fruits, vegetables, meats
1.Cereals – 4 to 6 months
2.Fruits & Vegetables – 5 to 7 months
3.Protein (cheese, meat, yogurt) – 6 to 8 months
Introduce one food at a time
List two foods that should not be in a toddlers diet. And two foods that should be given in a todlers diet.
-Avoid seeds, peanuts, small items that can cause choking
-Avoid overly spicy foods, and high fat foods
-Emphasize protein, veggies, fruit
-Give whole milk to toddlers
How much sleep does a toddler need?
12 hours of sleep a day, with one to two naps
During pregnancy what should happen with your sodium intake?
Sodium intake should remain the same- reducing sodium intake can lead to reduced plasma volume and cardiac output
Erikson’s Theory of Human Development- What age range is Identity vs. Confusion ?
Teen years from 12 to 18
Why is it important to practice cultural competence when it comes to pregnant women?
You need to be able to tailor your standard of care to accommodate for your patient’s beliefs so that the patient feels safe and respected within the hospital
Different cultures have different values, beliefs and practices. A woman’s cultural background can affect her needs and expectations during pregnancy and childbirth.
What are the car seat recommendations for an infant?
Rear-facing safety seat for infants to 20 lb in BACK seat (middle preferably)
Shield-type of “infant-only” seat to 30 lb
Correct seat for weight of child
Proper installation of safety seat
Rear-facing seat preferred before age 2 yrs.
What is one way to help your toddler when they are having a temper tantrum?
Provide a safe environment, if inside simply walk away from the child until the temper tantrum stops and they are ready to talk, if in a public space you may need to pull them outside to let them relax
try talking them through it by doing this you are promoting autonomy
What are two main dietary changes that can be made in order to reduce lead levels in the body?
-Diet: decrease fat intake, because lead is retained in fat.
-Increase vitamin C: orange juice, cantaloupe
-Increase calcium: dark leafy green vegetables (bok choy, collard greens, spinach, kale)
-Increase iron intake: meat, fish, poultry, vegetables, whole-grain cereals
-Limit milk intake (can cause iron deficient anemia) or dental caries
Can infants drink whole milk instead of breast milk or formula? Why or why not?
Infants should not be given whole milk instead of formula because of the high amounts of protein and sodium that could cause dehydration. Infants should not be given milk until after 1 year old.
What is Kohlberg’s Theory of Moral Development and what was it based off of?
Focuses on stages of moral development during school age, adolescent, and young adult years
Based on Paiget’s Theory of Cognitive Development. Emphasizes an ethic of justice and human rights.
When a mother is RH neg and the baby is RH positive the baby can die in utro. Maternal antibodies develop, cross the placental membranes, and destroy the cells of the fetus.
If there is Rh incompatibility between mother and baby RhoGAM is used to prevent death when is it administered?
28 weeks of gestation and then later after childbirth. This prevents the future response of Rh positive antibodies from attacking the fetus’ red blood cells.
This usually does not occur during first time pregnancies which is why women receive RhoGAM after childbirth; it is also common to receive the vaccine after a miscarriage or therapeutic abortion
When do you provide resources vs. report to CPS in monitoring signs and symptoms for child abuse?
s/s of child abuse could be bruising behind the arms (triceps) and behind thighs (not likely bruising from falls)
Report to CPS should be done if there is any suspicion of abuse occurring and neglect to child
Active manifestations of abuse can include, brain injuries, soft-tissue injuries, fractures of long bones and ribs, sexual abuse, bullying
Passive manefetations: poor nutrition (sever malnutrition), poor physical condition, emotional neglect, moral neglect, spiritual abuse
there are many hazards for accidental injury in toddlers, name three.
Structural hazards: “baby-proof” the home environment and provide appropriate supervision
Toy: inspect toys for risk of small removable parts, batteries, toxic paint, sharp edges
Drowning: highest risk ages 1-3; Danger-pools, tubs, toilets, pails of water
Burns: hot liquids, electrical cords, fireplaces
Motor vehicle injury: one of the leading causes of death 1-4yrs
Child safety seats
Pedestrian accident potential at home
Poisoning- great risks ages 1-2
Toddler mortality/morbidity rates increase in poverty
There are four ways to increase milk production for a mother breastfeeding. Name two of them.
Drinking 1 quart of fluids daily
Eating 500 to 800 kcal more per day (energy cost of milk production)
Eating 71g/ day of protein
breast-feeding infants more often and for longer periods of time (increases prolactin and oxytocin)