Pediatrics Power Point Infancy

7/31/2019 Pediatrics Power Point Infancy

1/214

Pediatric

Nursing


2/214

GENERAL PRINCIPLESDefinition of Terms

Growth: increase in size of a structure.

Development: increased complexity inthought, skill, & function.

Maturation: physiologically determinedpattern for growth & development.

Cephalocaudal: head-to-toe progression ofgrowth.

Proximodistal: trunk-to-periphery

progression of growth


3/214

Rates of Development

Infancy & Adolescence:fast growthperiods

Toddler, preschool, school-age: slow

growth periods Fetal period & Infancy: head &

neurologic tissue grow the fastest

Toddler & Preschool periods: trunkgrows more rapidly than other tissues

School-age: limbs grow most

Adolescence: trunk grows faster


4/214

Child Development TheoristsSigmund Freud (Psychosexual Theory)


5/214

Erik Erikson(Psychosocial Theory)


6/214

Lawrence Kohlberg

(Moral Development Theory)


7/214

Jean Piaget(Cognitive Theory)


8/214

Unit I

Health Promotion

of the Newborn

and Family

(birth-1 year)


9/214


10/214

1. PROMOTINGOPTIMAL

GROWTH &

DEVELOPMENTIN INFANCY


11/214

1.1Biologic Development

A.Proportional Changes

B.Sensory Changes

C.Maturation of Systems

D.Neurological Reflexesthat Appear duringInfancy


12/214


13/214

A. Proportional Changes

Weight (gain 1.5 lbs/month until 6months; triples at 1 year)

Height (cephalocaudalproximodistal)

Head Circumference (inc. by 2cm/month from birth to 3 months)

Heart (55% of the chest width)


14/214

B. Sensory Changes

Eyes(birth)

Presence of Dolls eye reflex

Tear glands are not yet able to fxn.(4 wks) Can watch intently when parent

speaks to infantTear glands begin to function


15/214

(6-12 wks) Binocularity (fixation of 2 ocular

images into 1 cerebral picture) Disappearance of Dolls eye reflex

(20-28 wks) Develops color preference for yellow

& red

Prefers more complex visual stimuli


16/214

(28-44 wks)

Depth perception develops Lack of binocular vision indicatesstrabismus (lack of ocular muscle

development)(44-52 wks)

Visual loss is developing ifstrabismus is present


17/214

Ears(birth)

Responds to loud noise by startle orMoro reflex

Responds to human voices morerapidly than to any other sounds

Quieting effect from low-pitched

sounds such as lullaby, metronome,or heartbeat


18/214

(24-32 wks)

Responds to own name

(40-50 wks)

Knows several words such as

no and names of familymembers

Knows to control & adjust

response to sound such aslistening for the sound to occuragain


19/214

C. Maturation of Systems

Respiratory system

Ears

Immune system

Cardiovascular system

Blood (presence of HgbF until5th month)


20/214

GIT

- Liver- Reflexes such as:

Sucking (nutritive &nonnutritive)

Swallowing ( Santmyerswallow)


21/214


22/214


23/214

Metabolism ( ACTH):

mineralocorticoids and

glucocorticiods) less tolerance for stress

Kidneys immaturity predisposesinfants to dehydration

Skin40% ECF in baby to 20% in

adultsPredisposes infants to

dehydration


24/214

D. NeurologicReflexes that

appear during

infancy


25/214

Newborn Reflexes

reflex actions originating in thecentral nervous system that areexhibited by normal infants but not in

neurologically intact adults natural physical responses a baby

has that helps him or her to survive

outside of the womb
http://en.wikipedia.org/wiki/Reflex_actionhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Reflex_action


26/214

generally subside within a few

months as the baby grows andmatures

reflexes help pediatriciansidentify if a baby is growing andmaturing as he or she should be.
http://www.mamashealth.com/pregnancy/ped.asphttp://www.mamashealth.com/pregnancy/ped.asp


27/214

Reflex Stimulation Response

Duration

M

OR

O

Sudden

move;

loud noise

Startles;throwsout arms,

legs thenpullsthem

towardbody

Disappearsat three tofourmonths


28/214
http://en.wikipedia.org/wiki/File:Moro.jpg


29/214
http://en.wikipedia.org/wiki/File:Moro.jpg


30/214

Reflex Stimulation Response Duration

R

O

O

TI

NG

Cheek

stroked or

side of

mouthtouched

Turns

toward

source,

opensmouthand

sucks

Disappearsat three tofour months
http://en.wikipedia.org/wiki/File:Rooting.jpg


31/214
http://en.wikipedia.org/wiki/File:Rooting.jpg


32/214

Rooting Reflex


33/214


Duration

SU

C

K

I

NG

Mouthtouched

by object

Suckson

objectDisappearsat three tofourmonths


34/214


35/214

Sucking Reflex


36/214


Duration

Toni

cneck

Placed

on back

Makesfists andturns

head tothe right

Disappearsat twomonths


37/214


38/214


39/214

Reflex Stimulation Respon

se

Duration

G

R

A

S

P

Palmstouched

Graspstightly

Weakensat three

months;disappears

at 1 year


40/214


41/214


42/214


43/214


Duration

ST

E

P

P

I

N

G

Infantheldupright

with feettouching

ground

Movesfeet asif to

walk Disappearsat three tofour months


44/214


45/214

Reflex Stimulation

Response

Duration

Babin-ski

Sole of

foot

stroked

Fans

out toes

andtwistsfoot in

Disappears

at nine

months to1 year


46/214

Babinski

Reflex


47/214

Reflex Stimulation Response Duration

Para-

chute

Thrust

forward invertical

position

Extends

handsand

fingersforward

Appears at

seven toninemonths


48/214


49/214
http://en.wikipedia.org/wiki/File:Galant.jpg


50/214
http://en.wikipedia.org/wiki/File:Galant.jpg


51/214


52/214

Why should nursesbe familiar with the

different infantile

reflexes?


53/214

Reflexes help

identify if a baby

is growing andmaturing

normally.


54/214

ExerciseIdentify the

following Infant

reflexes


55/214


56/214

The

Sucking

Reflex
http://en.wikipedia.org/wiki/File:Tonic.jpg


57/214
http://en.wikipedia.org/wiki/File:Tonic.jpghttp://en.wikipedia.org/wiki/File:Tonic.jpg


58/214

The Tonic

Neck Reflex


59/214


60/214

The

BabinskiReflex


61/214


62/214

The

Parachute

Reflex
http://en.wikipedia.org/wiki/File:Grasp.jpg


63/214
http://en.wikipedia.org/wiki/File:Grasp.jpg


64/214

The Palmar

GraspReflex
http://en.wikipedia.org/wiki/File:Stepping.jpg


65/214
http://en.wikipedia.org/wiki/File:Stepping.jpghttp://en.wikipedia.org/wiki/File:Stepping.jpg


66/214

The

SteppingReflex


67/214


68/214

The

Parachute

Reflex


69/214

Additional

Reflex

L b i h Ri h i


70/214

Labyrinth Righting

- infant raises head

- appears at 2months; strongest at

10 months


71/214

Fi M t D l t


72/214

Fine Motor Development

- includes the use ofhands & fingers

a.Crude Pincer Grasp (8-10 months)

b.Pincer Grasp (11 months)


73/214


74/214

Gross Motor


75/214

Gross Motor

Development-Developmental

maturation in posture,head balance, sitting,crawling, standing,

and walking

A H d C t l


76/214

A.Head Control

- head lag at 1 month- partial head lag at 2

months- no head lag at 4

months


77/214

B R lli O


78/214

B. Rolling Over

-Ability to willfully turn overfrom abdomen to back (5

months)- turn over from back to

abdomen (6 months)

C Sitting


79/214

C. Sitting

-sit alone with hands forsupport(7 months)

- sit while unsupported(8 months)

- prone to sitting position(10 months)


80/214


81/214

D C li


82/214

D. Crawling- Most infants start

crawling at 9 months


83/214

E Standing


84/214

E. Standing- With support ;both hands

held (11 months)

- With one hand held (12months)


85/214

Absence indicatespossible

developmental

hip dysplasia.

How to calculate the


86/214

How to calculate the

Motor Quotient:Motor Age

MQ = Chronological Age X 100

>85=Normal;


87/214

1.2 Psychosocial

Development Developing a sense of trust

(Erikson); trust of self, ofothers, & of the world

Overcoming ORALstage (Freud)

Erikson's Freudian life stage / basic maladaptati


88/214

psychoso

cial crisis

stages

psycho-

sexual

stages/agerange

relationships /

issuesvirtue

(potential

positiveoutcomes

from each

crisis)

on /

malignancy

(negativeoutcomes

from

unhelpful

experience)

1. Trust v

Mistrust

Oral

(0-1 yrs.

Old)

infant/mother /

feeding and

beingcomforted,

teething,

sleeping

Hope and

Drive

Sensory

Distortion /

Withdrawal

Infants needs:


89/214

Infant s needs:

a. Feeding/Foodb. Comfortc. Stimulation

d. Care

These needs must be


90/214

These needs must be

met in order to instilltrust in the infant which

allows a feeling of

physical comfort &security.


91/214

Trust assists infantsin experiencing

unfamiliar situations

with minimum fear.

Th i f t & t


92/214

The infant & parent

mustjointly satisfy

their needs for mutualregulation of

frustration.


93/214

What is the possible


94/214

What is the possible

outcome if bothparent and infant fail

to achieve a

satisfying

relationship?


95/214

Mistrust is the

eventualoutcome.

How can nurses


96/214

How can nurseshelp parents to

instill trust to

their babies?

B f di th b b


97/214

By feeding the baby on

demand, not too late or

too early, & providingthe baby comfort &

stimulation.


98/214

Wh t if th


99/214

What if theparents are

not available

to the baby?

Someone should


100/214

Someone should

substitute as a

caregiver who iswarm, loving,

responsible, &

interactive


101/214


102/214


103/214

The fathers emotionalattachment to the infant

is important in themothers well-being

2 oral social stages:


104/214

2 oral-social stages:

Stage 1- (3-4 mos.)crying as primary

means for attention- (>4 mos.)

grasping & reaching to parents


105/214

Tactile stimulation is


106/214

Tactile stimulation is

important in

acquiring totalquality of

interpersonal

relationship


107/214


108/214

Stage 2


109/214

Stage 2

- (6 mos.) biting occurs- During breastfeeding,

biting upsets the motherbut also relieves teething

discomfort

How can


110/214

How can

you helpthe mothersolve the

conflict?

By weaning the


111/214

By weaning the

baby

Begin bottle-feedingor use of

pacifiers


112/214


113/214

1.3 Cognitive


114/214

g

Development-Sensorimotor Phase

(Piaget)- Explains how we are

able to know

Stage Characterized by


115/214

Senso-rimotor(Birth-2

yrs)

Differentiates self fromobjectsRecognizes self as

agent of action andbegins to act

intentionallyAchieves object

permanence SensorimotorSt /


116/214

Stage/

Age CharacteristicBehaviorStage 1

ReflexiveStage

(0-1month)

Simple reflexactivity such asgrasping,

sucking Stage 2 Reflexive


117/214

PrimaryCircularReactions(1-4months)

behaviors occurin stereotypedrepetition such asopening andclosing fingersrepetitively.

Stage 3S d

Repetition of


118/214

Secondary

CircularReactions

(4-8months)

actions to produceinterestingconsequences suchas pulling a string toset it into motion orshaking a rattle tomake a noise.


119/214

Stage 4C

Responses become


120/214

Coordin

ation ofSecond

aryReactio

ns(8-12

months)

coordinated intocomplex sequences.Actions are"intentional" ex.infant reachesbehinda screen to obtain ahidden object.


121/214

1.4 Development of


122/214

p

Body Image Learn about their body throughkinesthetic and tactileexperiences

Learn that body parts areuseful by bringing objects to

mouth


123/214

Mouth is the primary


124/214

area of pleasureHands are thesecondary area of

pleasure


125/214


126/214


127/214


128/214

1.5 Social Development


129/214

psocializing agents:

1. Attachment

2. Language

Development3. Play

1 Attachment


130/214

1.Attachment Physical contact with humans;

Critical to optimum child

development Attachment of parent and child

begins beforebirth


131/214

At 6 months,infants show a

distinct preference

to the mother.


132/214

What are the


133/214

What are the

effects of

prolonged

parental

ti ?

Physical & mentalt d ti


134/214

retardation

Inability to form trusting

relationships Language impairment

Deficiency in abstractthinkingAND

Reactive AttachmentDi d


135/214

Disorder

Not cuddly with parents

Fails to make eye contactwith parents

Destructive to self &others

Maltreatedand orphaned childrenare the usual victims


136/214

are the usual victims

Signs of the disorder can be seenas before the age of 5

Without interventions, the childwill fail to develop a conscience &suffer from antisocial personalitydisorder leading to criminalacts

What should be


137/214

What should be

done when

parental

separationoccurs?

Help should be given


138/214

Help should be givento provide a suitable

substitute parent tominimize physiologic

and behavioral effects.

Separation


139/214

p

Anxiety

Separation Anxiety


140/214

Begins at 4-8 months as childdevelops awareness of self &mother as separate beings.

By 11 months, they cananticipate her departure by

watching her behavior & beginto protest before she

leaves


141/214


142/214


143/214


144/214

Stranger


145/214

StrangerAnxiety

Begins at 6-8 monthswhen child develops fear

of strangers.


146/214


147/214

2. Language


148/214

2. Language

Development Crying is the first means ofcommunication; means for

social contact

Crying as a means to be feed,changed or held


149/214

(5-6 weeks) beginning ofli ti


150/214

vocalization

(10-11 months) begins to

ascribe meaning to words Can vocalize up to 4 words

during infancy

3.PLAY


151/214

Important for psychosocial growth

Play in infants is narcissistic &revolves around their body (solitary

play). The quality of interpersonal

interaction is moreimportant than any toy.

Enjoys peek-a-boo at 10-12 months


152/214

Solitary Play


153/214


154/214

TEMPERAMENT

1.6 TEMPERAMENT


155/214

Behavioral style of an infant Influences the type of interaction

between the infant & parents. Parents should accept & deal

with the behavior to avoidcreating conflict.

The


156/214

TheDIFFICULT

Infant

Responds toscheduledf di &


157/214

Responds to scheduled feding &

structured care givingHave higher IQ if born in richfamilies

feeding &

structured caregiving

Sleeps less

With high activitylevel; needsconstant watching

Have higher IQ ifborn in richfamilies


158/214

The Slow to

Warm Up/ShyInfant

Demonstratesmore strangerf


159/214

fear

Requiresgradual &

frequentpreparation fornew situationsand people


160/214

The

EASYInfant


161/214


162/214

Parents need to


163/214

be reminded tofeed the child

who sleepslonger & cries

rarely.

Provide the parents with


164/214

background informationregarding their childs

temperament to help themcopewith their childs

behavior & give them ideason how to rear the child.

GROWTH &


165/214

DEVELOPMENTTABLE DURING

INFANCY(pp. 516-521)


166/214

A.Separation Anxiety &Stranger Fear


167/214

Stranger Fear

- normal developmental

behavior- child should not beperceived as antisocial


168/214

What areeffective ways toreduce stranger

fear in infants?

B.Spoiled Child Syndrome- the ff. are NOT signs of spoiling:


169/214

the ff. are NOT signs of spoiling:

crying in infancy, negativism &tantrums, persistent exploration

in toddlers, ADHD, etc.-indulging children, combined with

clear limits & expectations,does not cause spoiling

C. Limit Setting & Discipline

Babies cry because they have a need to


170/214

- Babies cry because they have a need to

be met, not to irritate the parents(irritable babies usually are victims of

Shaken Baby Syndrome).

- Giving attention to a crying baby is notspoiling

- A crying baby whose needs areimmediately met are better adjustable &does not cry too often later on.

D. Alternative Child CareArrangement


171/214

E. Thumb Sucking & Use of Pacifiers- Helps infant in coping with stress

- Normal & healthy unless when it extends to

preschool years (4-6 yrs.).- Malocclusion occurs when sucking extends 4-

6 yrs. or when teeth erupts.

- Benefits of nonnutritive sucking: increase wt.gain, decrease hospital stay,improve pain mgt


172/214

Louis VuittonPacifier


173/214

Pacifier

F.TeethingOccurs at 6 months


174/214

- Occurs at 6 months

# of teeth= age in months-6Ex.12 months 6 = 6 teeth


175/214

Teething causes stress &


176/214

g

pain to the child.

What health teaching can yougive to the family?

- Give ice cubes, frozenpacifier or washcloth to the


177/214

child to numb the pain- When teething interferes

with feeding, giveacetaminophen or

ibuprofen for no more than3 days


178/214

G. Infant Shoes


179/214

- Buy flexible shoes toprevent impeding the

development of supportivemuscles.


180/214


181/214

2. PROMOTINGOPTIMAL

HEALTH DURING

INFANCY

2.1 Nutrition(0-6 months)


182/214

( )

- Breastmilk- Whole milk is best given after 1 year.

- No honey due to risk of botulism

- No nuts or egg whites until12 mos.

- No solid food; can cause allergy, vomiting,

or diarrhea

(6 monthsonwards)

Weaning


183/214

- Weaning- Give foodrich in Iron,vit. A,Calcium, &

othervitamins &minerals.


184/214

- Givesugary

drinksin cups,not

bottles.


185/214

Introduce the infant todifferent kinds of food but

DONT OVERFEED


186/214

DON T OVERFEED

the child.


187/214


188/214

2.2 Sleep & Activity Total daily sleep is approximately 15 hours


189/214

y p pp y

Family teaching to PREVENT sleepproblems:

- Place infants awake on their crib while

lulling them to sleep.

- Use the crib for sleeping only, not as

playpen; avoid hanging toys over the bed. Most infants are normally active

2.3 Dental Health


190/214

Avoid giving milk bottle in bed. Avoid giving fruit juices in bottle.

Once tooth erupts, cleaning shouldbegin.

Wipe tooth/teeth with clean damp

cloth.

2.4 Immunizations


191/214

AGE VACCINE DOSE DURATION

Birth BCG 1 ---

Birth Hepatitis B 3 1 month

6 wks DPT 3 1 month

6 wks OPV 3 1 month

9 mos. Measles 1 ---

CONTRAINDICATIONS FORIMMUNIZATION


192/214

Minor illnesses (cough, fever, diarrhea)are NOT contraindicated to immunization.

Severe allergic reaction

Anaphylactic reaction

Immunosuppression


193/214

Is immunization

important? Why?

2.5 Preventing


194/214

Injuries


195/214

Injury is the leading

cause of death inchildren ages 6-12

months.

Causes of Injury Aspiration of Foreign Objects (pacifiers, toys,

powder, liquids, candy, nuts)


196/214

p , q , y, )

Suffocation & Drowning (blankets, plastic bags,cords, bucket of water, pools)

Falls (beds, stairs, buildings, furniture)

Poisoning (cleaning chemicals, drugs, smallbatteries, paints, insecticides)

Burns (hot water, sunburns, electrical wires)

Motor Vehicles (improper restraint within the vehicle,riding on the lap)

Bodily Damage (sharp objects, forks,toothpick, diaper pins)


197/214


198/214


199/214

A Cabinet Stopper


200/214

A Cabinet Stopper


201/214


202/214


203/214


204/214


205/214

An Outlet Cover


206/214


207/214


208/214

Prepare for weaning/introduction of solidfood.

Prepare parents for childs stranger


209/214

anxiety/separation anxiety. Encourage use of negative voice & eye

contact rather than physical punishment as

means for discipline. Encourage showing most attention when

infant is behaving well, rather than wheninfant is crying.

Encourage parents to leave child with

suitable caregiver to allow for some free time

DEVELOPMENTALTASKS


210/214

Psychosocial Tasks Cries to express needs or displeasure

Smiles indiscriminately Comforted through sucking

Vocalization at 1-4 months (squeals, coos,

laughs) Imitates sounds at 5-6 months

Social smile at 2 months

Cognitive Tasks


211/214

Reflexive behavior only Repetitive actions

Begins to understanding objectpermanence

Fears

Separation anxiety


212/214

Pain (can be distracted withtalking, sucking, toys,

opportunities)

Play

Solitary play

TOYS to GIVE


213/214

Brightly colored objects , differentsizes & textures to hold on &squeeze

Hang mobiles within 8-10 inchesof infants face

Rattles, musical toys

Thank You For Listening.


214/214

Date post:	05-Apr-2018
Category:	Documents
Upload:	duna-bil-pacana-sumugat
View:	219 times
Download:	0 times

Pediatrics Power Point Infancy

Documents