Transcript King saud university College of nursing Master program NUR 543

King saud university
College of nursing
Master program
NUR 543
Child Development
Infant Development Stage
Done by : maha alonazi
Objective
At the end of this lecture the master student
able to :
-Know what is the infant period.
-Know physical & physiological growth in this
age .
-Discussed the health promotion component for
this age .
-Identify common health problem in this age .
Outline:
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-Infant period .
-Physical growth .
-Physiological growth .
-Motor development .
-Language development .
-Cognitive development .
-Emotional development .
-Social development .
-Promotion optimum health during infancy .
-Common health problem .
Infant period
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Infancy :it is a latine word means on speech
or speechlessness .
Infant period start from the end of first month
up to the first year of live .
Physical growth :
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-Weight :the infant well double his birth
weight by 4-5 month & triple by 10-12 month.
The infant weight well increased by :
Birth to 4 month
5 to 8 month
9 to 12 month
3/4 kg/month .
1/2 kg/month . }+ birth wt.
1/4 kg/month.
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Height :increased by 3cm/month in the first 3 month
then increased 2cm/month at age 4-6 month then 1.5
cm/month at age 6-12 month ( +birth length ) .
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Head circumference :increased 2cm/month in the
first 3 month then increased 0.5 cm/month at age 4-12
month ( + birth H.C ) .
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Chest circumference: it well be equal to the head
circumference by the end of the first year .
Physiological growth
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Pulse : 110-150 b/min.
Respiration :25-45 breath/min.
Blood pressure :100/70 -60/40 mmhg.
Senses :
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Visual :
2month
When on the back follow a moving object beyoud the midline of
vision .
3 month
-when on back turn eyes to a moving object light or dangling
object.
-turns head to look for voices & sounds .
4 month
-staring to rattle in his hand .
-follow moving object well with eyes.
-beginning hand-eye coordination .
5 month
-visual acuity 6/6.
9 month
-follow objects through transition from one place to another .
Taste : by age of 6 month
Motor development :
Age in
month
2month
Groos
- Hold head erect in mid position
-Turn from side to back
3 month
4 month
Fine
-holds a rattle briefly when
placed in his hand.
-Raises chest usually supported on forearm when -hold hands in front of face &
in prone position .
-hold head erect & steady.
stares at them .
-reaches for bright objects but
miss them.
-site with adequate support.
-rolls over from front to back.
-lift head & shoulders at 90 degree when in prone
-brings hands together in
midline & plays with fingers.
-grasps object held near hand
but can not pick it up when
dropped.
position & looks around.
–carry objects to mouth .
Age in
month
Groos
5 -hold back straight when pulled to a sitting
month position .
-balances head well when sitting .
-site with slight support.
6
month
-site alone briefly.
Fine
-grasps objects with whole
hand.
-hold one object while looking to
another.
-Transfer objects from one hand
to another .
-turns completely over
-hold own bottle .
7month
-site alone .
-imitates simple acts of others.
8month
9 month
-pulls himself to standing position with help.
-hand eye coordination is perfect .
-drink from cup with help
-raises to sitting position alone.
-crawls .
-holds own bottle with good
hand-mouth coordination
-move from prone to sitting position.
-creeps well.
-picks small objects up with
index finger & thumbs .
-walks holding on furniture (cruises ).
-remove covers from boxes.
-standing alone for variable length of time .
-site down from standing position alone .
-walks in few steps with help or alone .
-picks up small bits of food &
transfers to mouth .
-good pincer grasp .
-drinks from cup & eats from
spoon but still need some help.
10 month
11 month
12 month
Language development :
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2 month –coos respond to mother voice ah ,uh .
3 to 5 month –laugh loudly .
6 month –vocalizes
7to 8 month –vocalizes da ,ma,ba .
9 month –associates word with person mama ,dada
.
10 month – can say one word like no .
12 month – may speak two or more word beside
mama ,dada .
Emotional development :
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Infant express his felling through crying ,laughter and
body movement .
His emotion not stable where it is rapidly change from
crying to laughter and his love to the family member is
appear by age 10 month he express several
recognizable emotions like anger , anxiety ,pleasure and
this emotion well be more clear by age of 12 month .
Cognitive development :
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Infant learns through sensation and
movement. he learn that object continue to
exist even when they are out of sight .infant
develop primitive grasp of cause & effect
relationship but dose not learn to think which
is beyond his sensorimotor experience
Social development :
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by 2 Months
A newborn infant will often quickly learn her mother’s voice and
Smell and learn the crying brings attention.
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3 to 4 Months
He show more interested to family member play more actively with
a caregiver & smiling in response to smile of other
7 to 8 Months
At this stage show fear of stranger & response to his own name.
9 to 10 month
Play simple games with adult like = peak a poo & imitates
facial expression.
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12 months
At this age the infants begin to understand more clearly
the connection between the caregiver and the fulfillment
of his needs, when he is hurt or hungry he may turn to
his caregiver and fuss hoping that the caregiver will
respond. The infant may also begin to speak single
words and using simple non-verbal communication such
as shaking the head.
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Promoting optimum health during
infancy
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1- nutrition.
2- attachment .
3-immunization .
4-teeth eruption .
5-Play.
6-Safety measurement .
7-Hygiene .
8-Stranger anxiety.
9-Separation anxiety .
10-Fear .
: Nutrition
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Weaning is the process of introducing the baby to solids
food after being totally dependant on breast milk. Baby
weaning begins at age of 6month with the introduction of
various solid foods such as baby rice or vegetables.
solids weaning foods it should be smooth purees not
much thicker than milk. It should be given in addition to
breast milk or formula but gradually babies reduce their
milk intake and eat larger amounts of food. by age of one
year able to eating a well-balanced and varied diet that
is more or less the same as that of the rest of the family.
Principles of weaning :
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-start weaning when infant free from any disease (GI).
-food item is introduced at interval 4-7 days to allow
for identify allergies & to allow child to get to it .
-offer new food while child hungry .
-never force child to take a new food.
-start with non-sweetened food before sweetened to
reduce the tendency to develop desire for sweets
Things to be avoided :
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- food can cause chocking .
-food that produce allergy like fresh milk .
-artificial colors & flavors food .
-salted food .
-junk food as sweets .
-highly spiced & fatty food .
Attachment :
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Attachment and attachment behavior tend to
develop between the age of 6 months and
3years.
The infant become attached to adult who are
sensitive and responsive in social interaction
with the infant and who remain as consistent
caregivers for some time.
Immunization (vaccination ):
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A vaccine is an antigenic preparation used to
produce active immunity to a disease in order
to prevent or reduce the effects of infection.
visit
Vaccine
At Birth
BCG , Hep B
2 Months
IPV(DTP, Hep B, Hib, PCV)
4 Months
OPV(DTP, Hep B, Hib, PCV)
6 Months
OPV(DTP, Hep B, Hib, PCV)
9Months
Measles (mono)
12 Months
OPV, MMR, Varicella ,PCV
18 Months
OPV (DTP, Hib)Hepatitis A
24Months
Hepatitis A
4 - 6 years
OPV,DTP, (DT) ,MMR
Varicella
Dentition :
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Eruption of teeth started by 5-6 month it is
called milky teeth or primary teeth
It’s important to note that eruption times can
vary from child to child.
Teeth Eruption Timetable
Name of teeth
Upper jaw
Lower jaw
Central incisors
7-8 month
5-7 month
Lateral incisors
8-9 month
9-11 month
cuspids
16-20 month
16-20 month
First molare
14-16 month
10-14 month
Second molare
24-30 month
16-20 month
Play
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Play must provide interpersonal contact &
educational stimulation .
By 6 month to 1 year playing involved
sensorimotor skills & become mor sophisticated
& interdependent .
Safety measurements
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Falls : it is the most infant accident in the home.
-Never leave the baby alone on the table or high surface.
-Use gates or barriers to keep the baby away from
dangerous areas such as stairs
-The most safest place for the baby it is on the floor or the
crib .
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Choking
-Be sure to keep all small items that could cause the baby
to choke out of the baby’s reach.
-Never feed your baby hard pieces of food.
-Avoid toys with cords.
-Never put your baby’s pacifier on a cord .
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Drowning
Drowning is the second most common cause of
accidental death among children.
- Children under age four are especially at risk ,
it takes only 1 inch of water and a few moments
for a child to drown .
-do not leave baby alone in the bathtub.
Burns
-Do not smoke or drink hot liquids near to or
while carrying the baby .
-Protect the baby from direct sun .
-Keep electrical cords out of baby’s reach .
-Use safety caps on electrical sockets .
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Suffocation
-The safest position for sleeping babies is lying on
one side do not place the baby face down or on his
back .
-Never put the baby to sleep on a soft surface (e.g.,
pillow or water bed.)
Hygiene
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babies born in the winter are bathed less often due to cold .some study
advise bathing every day while others suggest fewer baths only 4 times
a week.
Wash the diaper area last during the bathing.
Remove diaper and wash bottom and genitals wash girls from front to
back toward the bottom & if boys have been circumcised clean area
gently unless a dressing is still covering the surgery.
After remove baby from the water wrap him in the towel & clean eyes,
ears, and nose with a cotton ball that's been dipped in water and
squeezed. Don't forget to wipe in folds of neck and ears.
Apply baby lotion if his skin is dry.
Make sure all areas especially genitals are completely dry before
putting on fresh clothing and a diaper.
Clean under the nail & cut as needed .
Fear
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As a child grows different fears may be noticed at
different times Some are very specific to the age such as
fear of falling for the 1year old. The bad experience
falling as the child begins to walk may affect future
attempts to walk .
Separation anxiety
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Infants typically begin to feel the fear of
separation between 7 and 8 months of age .
Infant separation anxiety tends to peak in the
toddler stage.
It is normal for infants to experience fear
when he separated from his parents.
Stranger anxiety
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The child who develops an attachment to a parent or
significant family member may show stronger anxiety
toward unknown people or even toward a grandparent
who is infrequently visited. This does not mean the child
doesn't like Grandma or Grandpa. It means the child
feels safe with some people and needs more time to
slowly accept others.
Stranger anxiety is normal for a developing child. around
7 to 8 months of age the child is learning that people are
different from his mother.
Most common health problem
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Major Health Problem .
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Minor Health Problem .
Major Health Problem
1-Dehydration.
2-Otitis media.
3-Infantile Rickets.
4-Malnutrition.
5-Febrile seizure.
Major Health Problem .
Dehydration: is defined as excessive loss of body fluid .
Common cause : vomiting ,diarrhea.
Dehydration is best avoided and treated by provide sufficient fluid .
Nursing management :
-correct cause of vomiting or diarrhea .
-correct cause of dehydration by parental fluid .
-in vomiting case place child on right side & elevate head of bed
after feeding.
-for both charting color ,amount ,odor .
-small frequent feeding are better tolerated then less frequent &
large feeding.
Infection
Ear infections( otitis media )
are a common problem in children Causes bacteria or
the common cold virus .
.
The treatment a seriuqer dna xelpmoc si:
ro/dna sdioretsocitroc ,scitoibitna fo noitanibmoc
.sebut fo tnemecalp
Nursing management:
-relieve pain.
-prevent complication or recurrence .
-educate family in care of child .
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Infantiale Rickets
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Infantile Rickets :It is a metabolic disorder of
infancy caused by vitamin D deficiency &
affecting the growing bones ,the skeletal
muscles & some times the nervous system .
 Treated by vitamin D .
 Nursing management:
-the back should be supported when he site up.
-should handled gently & turned frequently.
-prevent falls .
Malnutrition
Malnutrition : it is a term referring to poor or
inadequate nutrition .
For infant can happen during weaning process .
 Nursing management :
-provide diet high in quality of protein &
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carbohydrates.
-provide vitamin & minerals supplementation.
-Weight daily & record .
Febrile seizure
Febrile seizure: it is abnormal body movement due to
increased body temperature more then 38.9C .
Febrile seizures can occur in children ages 6 months to 5
years but are most common in toddlers ages .
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Nursing management :
-remain with child .
-loosen restrictive clothing.
-prevent child from hitting head .
-teach administration of medication .
- decrease body temperature to the normal range .
-provide emotional support to the child & family .
Minor problem
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Dipper rash.
Colic .
Constipation .
Dipper rash
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Diaper rash: is a common form of inflamed skin that appears as a
patchwork of bright red skin on the baby's bottom .
results from prolonged contact with urine or stool .the heat and moisture
make it easier for diaper rash to start and for germs to grow.
 Nursing management :
- Check the baby's diaper often and change it as soon as it's wet or soiled.
- Carefully clean the baby's bottom between diaper changes.
- Use warm water (not hot) with or without a very mild soap.
- Allow the baby's skin to dry completely before putting on another diaper.
- Use products that contain zinc oxide ointment or petroleum such as
Vaseline to protect the baby's skin from moisture.
Colic
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Colic : acute abdominal pain with intense spasmodic cramping. the
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infant appear abnormally irritable or cry for no reason.
The causes : Infants swallow air while feeding.
Nursing management :
-Feed the baby in an upright position .
-Teach mother with breastfeeding to make small changes in her diet
by to limit spicy foods, citrus fruits or caffeine .
- Teach mother to warming the formula to body temperature before
a feeding her baby.
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Constipation
The definition of constipation includes the following :
-Infrequent bowel movement 3times or fewer per a week.
-Difficulty during defecation.
-Sensation of incomplete bowel movement .
causes include:
-insufficient dietary fiber intake.
-inadequate fluid intake.
-decreased physical activity .
-side effects of medications .
cont
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Nursing management :
-increased fluid intake.
-Increased fiber intake.
-use of laxatives as doctor order.
-Used enema .