The Infant and Toddler NP03L006 ELO B / Version 2.0
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Questions and Answers

What does growth refer to in the context of an infant's development?

  • The consistency in emotional health
  • The change in ability to perform tasks
  • The development of motor skills over time
  • The increase in physical size that can be measured (correct)

    • What are growth charts primarily used for?

  • To assess emotional stability in children
  • To monitor cognitive advancements
  • To track physical growth and development over time (correct)
  • To diagnose mental health issues

    • Which developmental pattern describes growth from head to toe?

  • Distal to proximal
  • Proximodistal
  • Medial to lateral
  • Cephalocaudal (correct)

    • What might a significant difference between height and weight percentile levels indicate?

    <p>The child may be underweight or overweight</p> Signup and view all the answers

    What is a crucial nursing consideration in evaluating a child's growth and development?

    <p>Understanding standard milestones for development</p> Signup and view all the answers

    What characterizes maturation in children's development?

    <p>It is independent of environmental factors</p> Signup and view all the answers

    Which statement correctly describes the pattern of growth known as proximodistal?

    <p>Growth occurs from the midline to the periphery</p> Signup and view all the answers

    What percentage of their birth weight do infants typically lose within the first few days of life?

    <p>5% to 10%</p> Signup and view all the answers

    By what age should infants typically regain their birth weight?

    <p>10 to 12 days</p> Signup and view all the answers

    What is the expected birth weight growth by the time an infant is one year old?

    <p>Triples</p> Signup and view all the answers

    How often should infants be weighed during office visits?

    <p>At every visit</p> Signup and view all the answers

    What is a major consequence of inadequate dietary intake during infancy?

    <p>Permanent developmental deficits</p> Signup and view all the answers

    What is the typical sleep duration for neonates in a 24-hour period?

    <p>16-18 hours</p> Signup and view all the answers

    Which developmental reflex is expected to disappear around 3 months of age?

    <p>Grasp Reflex</p> Signup and view all the answers

    What vital need is essential for the emotional development of infants according to Erikson's theory?

    <p>Love and security</p> Signup and view all the answers

    Which stage must be mastered by infants to achieve trust according to Erikson's Stages of Development?

    <p>Trust vs. mistrust</p> Signup and view all the answers

    What is a common sign of parental bonding that should be observed during clinic visits by 4 to 6 months?

    <p>An obvious social smile</p> Signup and view all the answers

    What is the relationship between sleep patterns of neonates and self-soothing behaviors?

    <p>Self-soothing develops after parents stop soothing</p> Signup and view all the answers

    Which reflex indicates protective arm extension when an infant is suddenly dropped while prone, and typically appears by 7-9 months?

    <p>Parachute Reflex</p> Signup and view all the answers

    What physiological condition may occur due to infants having a higher body surface area compared to adults?

    <p>Higher caloric demands</p> Signup and view all the answers

    What is the significance of mother's immunity for infants during the first few months of life?

    <p>It protects against infections</p> Signup and view all the answers

    What should parents prioritize to assist infant development during the first year?

    <p>Interacting appropriately with the infant</p> Signup and view all the answers

    Which of the following is a recommended practice for infants to develop trust with their caregivers?

    <p>Picking them up when they cry</p> Signup and view all the answers

    How should infants be positioned during sleep for safety?

    <p>On their backs</p> Signup and view all the answers

    At what age should parents start introducing a flexible routine for their infant?

    <p>2 months</p> Signup and view all the answers

    What physical development milestone can typically be expected for a 3-month-old infant?

    <p>Staring at their hands</p> Signup and view all the answers

    Which best describes the sleeping pattern expected of a 2-month-old infant?

    <p>Sleeps from feeding to feeding</p> Signup and view all the answers

    What key behavior is expected from a 4-month-old infant?

    <p>Lifting head and shoulders when on the abdomen</p> Signup and view all the answers

    Which statement about teething is accurate for a 4-month-old infant?

    <p>Drooling is often observed as teething begins</p> Signup and view all the answers

    What is a common developmental milestone for a 1-month-old infant?

    <p>Making small throaty noises</p> Signup and view all the answers

    Why is sensory stimulation important during infancy?

    <p>It enhances thought processes and perceptual abilities</p> Signup and view all the answers

    What should be considered when choosing a pacifier for an infant?

    <p>Size and one-piece construction</p> Signup and view all the answers

    What is the purpose of using a stroller for an infant?

    <p>To help the infant engage with varied environments</p> Signup and view all the answers

    What is a common characteristic of colic in infants?

    <p>Irritable crying due to abdominal pain</p> Signup and view all the answers

    What should parents do to provide appropriate exercise for a 2-month-old infant?

    <p>Allow active play on a safe flat surface</p> Signup and view all the answers

    At what age should low-fat milk be introduced to a child's diet?

    <p>2 years</p> Signup and view all the answers

    Which response is most appropriate for a mother concerned about her 1-year-old infant's weight?

    <p>To suggest the infant will lose weight as they become active.</p> Signup and view all the answers

    What is the recommended action to prevent falls with infants?

    <p>Ensure crib rails are raised and securely locked.</p> Signup and view all the answers

    What should be the priority safety concern for the caregiver of a 4-month-old infant?

    <p>Raising and securing crib side rails.</p> Signup and view all the answers

    At what age is colic expected to generally resolve?

    <p>3 months</p> Signup and view all the answers

    Which preventive measure should be emphasized to protect crawling infants?

    <p>Lock cabinets containing poisons and cleaning supplies.</p> Signup and view all the answers

    Which parenting challenge is prominent during the toddler years?

    <p>Balancing safety with opportunities for independence.</p> Signup and view all the answers

    What is a common behavior of toddlers when trying to assert their independence?

    <p>Frequently testing boundaries by saying 'no'.</p> Signup and view all the answers

    What should caregivers consider when preparing foods to avoid infections?

    <p>Thoroughly wash fresh foods before preparation.</p> Signup and view all the answers

    What is a recommended practice during the infant feeding process?

    <p>Wash hands before preparing foods.</p> Signup and view all the answers

    What is a key developmental milestone for infants at 6 months of age?

    <p>Doubles birth weight</p> Signup and view all the answers

    Which behavior is characteristic of a 7-month-old infant?

    <p>Begins to crawl and transfer objects between hands</p> Signup and view all the answers

    How should caregivers introduce new foods to an infant at 8 months?

    <p>Add new foods slowly while observing for reactions</p> Signup and view all the answers

    What physical development is expected of a 9-month-old infant?

    <p>Creeps while keeping the trunk elevated</p> Signup and view all the answers

    What safety measure is essential for caregivers of a 10-month-old?

    <p>Know the phone number of the nearest poison control center</p> Signup and view all the answers

    At 11 months, what social behavior might an infant exhibit?

    <p>Shows impatience when held and enjoys playing with empty dishes</p> Signup and view all the answers

    What is a significant physical milestone for infants at 12 months old?

    <p>Drinks from a cup and uses a spoon with supervision</p> Signup and view all the answers

    Which behavior is an indication that an infant is ready for solid foods around 7 months?

    <p>Eagerly anticipates spoon feeding</p> Signup and view all the answers

    What activity serves as an appropriate form of exercise for an 8-month-old infant?

    <p>Using a jump chair and riding in a stroller</p> Signup and view all the answers

    What is a common practice for infants' sleep at 6 months old?

    <p>Takes several naps during the day</p> Signup and view all the answers

    What dietary addition is suggested for a 9-month-old?

    <p>Add meat and beans to their diet</p> Signup and view all the answers

    What commonly observed behavior occurs in a 7-month-old infant?

    <p>Easily shifts moods from crying to laughing</p> Signup and view all the answers

    What is a typical characteristic of social behavior in a 10-month-old infant?

    <p>Plays games like peek-a-boo and knows their name</p> Signup and view all the answers

    What is a common strategy for coping with an irritable infant?

    <p>Shield the infant's eyes from bright light.</p> Signup and view all the answers

    Which of the following factors is suggested as a potential cause of colic in infants?

    <p>Environmental factors and rapid feeding</p> Signup and view all the answers

    How should infants be positioned for sleep to reduce the risk of SIDS?

    <p>On their backs on a firm, flat mattress.</p> Signup and view all the answers

    What is an effective way to help a lethargic infant?

    <p>Talk in a calm voice and move slowly.</p> Signup and view all the answers

    What sleep pattern is most typical for newborns?

    <p>Sleeping at 2- to 4-hour intervals.</p> Signup and view all the answers

    What is a suggested technique for soothing a colicky infant?

    <p>Holding the infant face down and close to the body.</p> Signup and view all the answers

    Which of the following is important for developing positive sleep patterns in infants?

    <p>Synchronizing the infant's rhythm with family activities.</p> Signup and view all the answers

    Which of the following can indicate that an infant is becoming overwhelmed by stimulation?

    <p>They begin to cry and squirm.</p> Signup and view all the answers

    What is a key characteristic of colic in infants?

    <p>Periods of unexplained irritability and crying.</p> Signup and view all the answers

    What approach can help infants develop self-soothing behaviors?

    <p>Helping them learn to grasp a pacifier.</p> Signup and view all the answers

    What should parents avoid if their infant shows signs of becoming irritable?

    <p>Bright lights and loud noises.</p> Signup and view all the answers

    Which dietary addition is typically advised for infants as they grow?

    <p>Adding orange juice and well-cooked table foods.</p> Signup and view all the answers

    What common caregiver emotion can occur due to colicky infants?

    <p>Parental fatigue and guilt</p> Signup and view all the answers

    Which of the following statements is false regarding infant interaction?

    <p>Every infant progresses at the same rate.</p> Signup and view all the answers

    Which service is critical for identifying families at risk for issues such as child abuse?

    <p>Identification of families at risk</p> Signup and view all the answers

    What is the purpose of anticipating developmental changes in parent education?

    <p>Prepare parents for their child’s changing needs</p> Signup and view all the answers

    What is the recommended average weight for a 12-month-old infant who weighed 7 lbs 11 oz at birth?

    <p>23 lbs</p> Signup and view all the answers

    During the first week of life, how does a newborn's weight typically change?

    <p>Decreases about 5% to 10%</p> Signup and view all the answers

    Which of the following constitutes a developmental red flag for a 3-month-old infant?

    <p>The infant does not smile responsively</p> Signup and view all the answers

    Which statement reflects the importance of immunizations for children?

    <p>They can lead to serious illness if not administered.</p> Signup and view all the answers

    What aspect of play is most beneficial for an infant's emotional development?

    <p>Therapeutic play that fosters recovery</p> Signup and view all the answers

    Which of the following is NOT a recommended practice in parent education concerning diaper care?

    <p>Rinse off wipes thoroughly before use</p> Signup and view all the answers

    What guidance should a nurse provide to a mother concerned about spoiling her 2-month-old baby?

    <p>Explain that infants cannot be spoiled and emphasize trust</p> Signup and view all the answers

    How frequently should a child visit a healthcare setting during their first year?

    <p>At least five times at specific intervals</p> Signup and view all the answers

    What role does accurate record-keeping play in childhood healthcare?

    <p>It prevents confusion about immunization history</p> Signup and view all the answers

    During health assessments, which of the following is considered a critical service?

    <p>Health education and anticipatory guidance</p> Signup and view all the answers

    What should parents be educated about concerning the signs of developmental delay?

    <p>Identifying specific milestones to monitor</p> Signup and view all the answers

    Which immunization guideline stresses the necessity of timely vaccinations?

    <p>Timely immunizations prevent serious illness risks</p> Signup and view all the answers

    What is the average height increase for toddlers per year?

    <p>10 cm (4 inches)</p> Signup and view all the answers

    By what age is bowel and bladder control usually complete?

    <p>By 2 ½ to 3 years of age</p> Signup and view all the answers

    Which vital sign finding would be concerning for a 2-year-old child?

    <p>Respirations at 36 breaths/minute</p> Signup and view all the answers

    What behavior does a toddler exhibit that indicates testing their power?

    <p>Exhibiting negativism</p> Signup and view all the answers

    What age milestone is characterized by the child's ability to recognize sexual differences?

    <p>By 2 years of age</p> Signup and view all the answers

    Which of the following best describes how toddlers assimilate information?

    <p>Through trial and error plus repetition</p> Signup and view all the answers

    What common health issue is likely during the toddler period due to anatomical changes?

    <p>Tonsilitis and otitis media</p> Signup and view all the answers

    Which statement is true regarding toddler speech development?

    <p>Over 90% of speech should be understandable by age 3.</p> Signup and view all the answers

    What is one competitive advantage of myelination of the spinal cord by age 2?

    <p>Control of anal and urethral sphincters</p> Signup and view all the answers

    Which activity demonstrates a toddler's developing understanding of object permanence?

    <p>Finding a toy hidden under a blanket</p> Signup and view all the answers

    What should a nurse advise parents concerned about their toddler's speech development?

    <p>Discuss it with a healthcare provider during examinations.</p> Signup and view all the answers

    What developmental characteristic is common during toddlerhood related to ritualism?

    <p>Compulsive routines increase sense of security.</p> Signup and view all the answers

    Which statement is accurate regarding the emotional development of toddlers?

    <p>They can internally navigate conflicting emotions.</p> Signup and view all the answers

    What is the major component of cognitive development in toddlers?

    <p>Trial and error learning</p> Signup and view all the answers

    What is the main safety concern when selecting toys for infants?

    <p>Toys should avoid small or removable parts</p> Signup and view all the answers

    Which reflex helps infants find the nipple for feeding?

    <p>Rooting reflex</p> Signup and view all the answers

    At what age should solid foods typically be introduced to infants?

    <p>5 to 6 months</p> Signup and view all the answers

    What should be monitored periodically to assess an infant's nutritional adequacy?

    <p>Infant's weight, height, and head circumference</p> Signup and view all the answers

    Which of the following statements about breastfeeding is accurate?

    <p>Breastfeeding provides optimal nutrition for infants during the first year.</p> Signup and view all the answers

    What is a common sign that an infant is receiving adequate nutrition?

    <p>Infant has gained 4 to 7 ounces per week for the first 6 months</p> Signup and view all the answers

    What does the extrusion reflex do in infants?

    <p>Pushes food out of the mouth</p> Signup and view all the answers

    Which of the following toys is recommended for infants aged 6 to 9 months?

    <p>Peek-a-boo games</p> Signup and view all the answers

    What type of toys should be included in the playtime for infants to stimulate various senses?

    <p>Varied toys that stimulate vision, touch, hearing, and movement</p> Signup and view all the answers

    What is a potential consequence of a low-fat diet in infants under 2 years of age?

    <p>Compromised growth and development</p> Signup and view all the answers

    What dietary approach is recommended as infants transition to solid foods?

    <p>Introduce varieties of foods to find personal preferences</p> Signup and view all the answers

    Which indication suggests an overfeeding issue in infants?

    <p>Regurgitation and mild diarrhea</p> Signup and view all the answers

    How does the stomach of an infant develop during their first year?

    <p>It expands from 10ml to 200ml</p> Signup and view all the answers

    What is the recommended age for parents to start introducing solid foods to infants?

    <p>5 to 6 months</p> Signup and view all the answers

    Which formula is meant for infants with severe protein sensitivities?

    <p>Hydrolyzed formulas</p> Signup and view all the answers

    What is the primary reason that whole cow’s milk or goat’s milk is not recommended for infants under 1 year?

    <p>Difficult curd digestion</p> Signup and view all the answers

    When introducing high allergenic foods to infants, how should it be done?

    <p>One every four to seven days</p> Signup and view all the answers

    What is the significance of DHA and ARA in infant formula?

    <p>Enhance neurological functioning</p> Signup and view all the answers

    What should parents do concerning feeding their infant a complete bottle?

    <p>Avoid making the infant finish every last drop</p> Signup and view all the answers

    Which of the following is a safe practice for bottle feeding infants?

    <p>Refrigerate prepared bottles until use</p> Signup and view all the answers

    What condition might prevent a mother from breastfeeding her infant?

    <p>The mother has HIV</p> Signup and view all the answers

    How should new solid foods be introduced to prevent allergies?

    <p>Introduce one food every four to seven days</p> Signup and view all the answers

    What is the primary advantage of home-prepared baby foods?

    <p>Control over ingredients and lower cost</p> Signup and view all the answers

    Which behavior indicates an infant is ready to wean from breastfeeding?

    <p>Chewing on the nipple or bottle</p> Signup and view all the answers

    What is a common reason for using rice starch formulas?

    <p>Treat gastroesophageal reflux disease (GERD)</p> Signup and view all the answers

    What is the ideal first solid food for infants to minimize allergic reactions?

    <p>Rice cereal</p> Signup and view all the answers

    What is the purpose of using time-out as a discipline technique?

    <p>To allow the child to calm down and develop self-regulation</p> Signup and view all the answers

    What is an important aspect of setting limits for a toddler?

    <p>Including both praise for desired behavior and disapproval for undesired behavior</p> Signup and view all the answers

    Which of the following statements about corporal punishment is accurate?

    <p>It can have harmful long-term effects and should be avoided.</p> Signup and view all the answers

    What can contribute to a child’s fear of certain situations?

    <p>Being alone during fear-provoking experiences</p> Signup and view all the answers

    How should adults respond to a child's fear to foster self-esteem?

    <p>By respecting and understanding the child's feelings</p> Signup and view all the answers

    Which method is emphasized to improve a toddler's self-confidence?

    <p>Providing praise for positive behaviors</p> Signup and view all the answers

    What is the recommended timing for a time-out period for a 3-year-old?

    <p>3 minutes</p> Signup and view all the answers

    What is an essential guideline when communicating with toddlers?

    <p>Be at eye level to appear less overwhelming</p> Signup and view all the answers

    What characteristic of a toddler reflects a secure sense of independence?

    <p>Posture that indicates confidence</p> Signup and view all the answers

    Which of the following best characterizes effective discipline for toddlers?

    <p>Clear communication about acceptable and unacceptable behaviors</p> Signup and view all the answers

    What should be included in the daily care of toddlers?

    <p>A schedule that adapts to family and toddler needs</p> Signup and view all the answers

    Why is it important to respect children’s fears?

    <p>It protects their self-esteem and emotional well-being</p> Signup and view all the answers

    What kind of clothing is recommended for toddlers?

    <p>Simple and easy to put on and take off</p> Signup and view all the answers

    What can reinforce desired behavior in toddlers during parental interaction?

    <p>Offering praise for good behavior</p> Signup and view all the answers

    What is a key consideration for supervising toddlers during playtime?

    <p>Ensuring safety through constant supervision and hazard checks</p> Signup and view all the answers

    Which of the following play types is characterized by toddlers playing side by side but not engaging with one another?

    <p>Parallel play</p> Signup and view all the answers

    What is an essential role of nurses when caring for toddlers with special needs?

    <p>To assess and create a safe environment tailored to each child's requirements</p> Signup and view all the answers

    What is a common frustration that toddlers may experience during play?

    <p>Believing all toys are theirs leading to sharing difficulties</p> Signup and view all the answers

    Why is the use of high-priced toys discouraged in toddler development?

    <p>Toddlers often prefer simple, everyday objects for play.</p> Signup and view all the answers

    What is the significance of public announcements related to toy recalls?

    <p>They serve to inform parents about unsafe products to protect children.</p> Signup and view all the answers

    When comparing toddlers to preschoolers, what developmental difference is often observed?

    <p>Toddlers engage primarily in parallel play rather than group play.</p> Signup and view all the answers

    What is an important emotional development aspect for toddlers during play?

    <p>Recognizing their own egocentric perspective is beginning to shift.</p> Signup and view all the answers

    Which toy is generally recommended for toddlers to support their developmental milestones?

    <p>Push or pull toys that encourage walking and running</p> Signup and view all the answers

    What is an important factor in determining readiness for toilet independence in toddlers?

    <p>Voluntary control of anal and urethral sphincters</p> Signup and view all the answers

    Which of the following interventions can help with bladder training?

    <p>Restricting fluids before bedtime</p> Signup and view all the answers

    How should parents handle accidents during toilet training?

    <p>Accept the mishap and change the child’s clothes</p> Signup and view all the answers

    What is the recommended daily fluid intake from milk for toddlers?

    <p>720 mL (24 oz.)</p> Signup and view all the answers

    What is a sign that a child may be ready for bladder training?

    <p>Staying dry for about 2 hours at a time</p> Signup and view all the answers

    Which factor can contribute to picky eating in toddlers?

    <p>Strong preferences based on color, texture, and taste</p> Signup and view all the answers

    What strategy should be avoided to prevent issues during mealtime?

    <p>Forcing the child to eat all their food</p> Signup and view all the answers

    Which age group is at high risk for iron deficiency anemia?

    <p>Toddlers aged 1-3 years</p> Signup and view all the answers

    How long can most children expect to continue having occasional accidents during toilet training?

    <p>Until age 4</p> Signup and view all the answers

    Which dietary practice should be avoided to promote healthy eating in toddlers?

    <p>Offering candy, cake, and soda between meals</p> Signup and view all the answers

    What is an effective way to promote the acceptance of new foods in toddlers?

    <p>Gradual exposure to new smells and textures</p> Signup and view all the answers

    What is a recommended action to take just before meal times for toddlers?

    <p>Implement a quiet time to wind down</p> Signup and view all the answers

    What should be the size of serving portions for toddlers to prevent overwhelming them?

    <p>One tablespoon of solid food per year of age</p> Signup and view all the answers

    Which behavior could indicate a feeding disorder in a toddler?

    <p>Loss of weight for more than a month</p> Signup and view all the answers

    Which guideline is recommended for serving food to toddlers?

    <p>Offer one tablespoon of food for each year of the child's age</p> Signup and view all the answers

    What behavior indicates a child's readiness for toilet training?

    <p>Able to request to go to the bathroom</p> Signup and view all the answers

    What is a crucial characteristic of toddlers in daycare settings?

    <p>They have shorter attention spans than preschoolers</p> Signup and view all the answers

    Which food type is best suited for a toddler who is learning to self-feed?

    <p>Small pieces of finger foods</p> Signup and view all the answers

    When considering daycare options, which factor is least likely to influence parents' decisions?

    <p>Personal dietary preferences of the staff</p> Signup and view all the answers

    What is a common misconception about feeding toddlers?

    <p>Only healthy foods need to be introduced at every meal</p> Signup and view all the answers

    What is an important role for nurses in relation to injury prevention for toddlers?

    <p>Review safety measures with parents during check-ups</p> Signup and view all the answers

    Which statement regarding toddler behavior is true when assessing their development?

    <p>Curiosity can lead to increased safety risks at home</p> Signup and view all the answers

    Why is it important for parents to communicate about their child's behavior regarding potty training?

    <p>It allows the child to express needs related to bathroom use</p> Signup and view all the answers

    What is the effect of placing a half-asleep child on the potty chair?

    <p>It does little to aid in effective potty training</p> Signup and view all the answers

    During which ages is it vital for toddlers to be properly secured in a car seat?

    <p>Until they reach appropriate weight and height limits for seat belts</p> Signup and view all the answers

    Which best describes toddlers' typical play behavior?

    <p>They frequently participate in parallel play</p> Signup and view all the answers

    What is an appropriate action for parents to ensure their home is safe for toddlers?

    <p>Install safety locks and childproof caps on hazardous items</p> Signup and view all the answers

    Study Notes

    Infant Growth and Development

    • Infant development includes growth, which is increase in physical size, and development, which is increase in bodily function.
    • Maturation is independent of the environment, although timing may be affected by physical and psychological environments.
    • Growth charts are used to track the health of a child's growth and development.
    • Children in good health should follow a consistent growth pattern.
    • Growth charts measure length/height, weight, and head circumference by percentages.
    • Charts include a median value and percentile ranges.
    • A difference of one or more percentile levels between height and weight may suggest under/overweight, prompting further investigation
    • Infants lose 5-10% of their birth weight by 3-4 days of life, regain weight by 10-12 days, double birth weight by 5-6 months, and triple birth weight by 1 year
    • Newborns have 40% extracellular fluid, compared to 20% in adults; dehydration is a concern in infants due to their fluid demand
    • Infants gain 4-6 pounds per year after 1 year of age, until puberty.
    • Myelinization of the brain cortex begins at 8-9 months gestation and continues through adolescence.
    • Inadequate dietary intake, lack of caregiver interaction, or lack of environmental stimuli during infancy can result in permanent deficits.
    • Infants' metabolic rate is higher than in adults; requiring more vitamins, minerals, calories, and fluid.
    • Body Surface Area (BSA) is much higher in children than adults.
    • Infants have irregular and abdominal respirations, and their small airways are easily blocked by mucus.
    • Neonates have an increased need for cardiac output and higher oxygen consumption.
    • Infants develop an immune system through maternal immunity during the first 3 months of life; immunizations are crucial for maintaining and supporting a healthy immune system.
    • Kidney function is not mature until the end of the second year of life.
    • Sleep patterns vary with age, and cultural practices can influence these patterns.
    • Bone synthesis is greater than bone destruction in infants, and occurs at the epiphysis.
    • Vitamin A, D, sunlight, and fluorine, along with various growth hormones, are needed for appropriate bone growth and development.
    • Sleep-wake cycles, feeding preferences, and social interaction affect cognitive and emotional development throughout life.
    • The chief tasks of infants include establishment of effective feeding patterns, predictable sleep-wake cycles, and parental bonding and social interaction.
    • It is normal for infants to rely on parents to soothe them back to sleep when they awaken at night; however, parents should encourage infants to develop self-soothing behaviors.
    • Co-sleeping is highly discouraged due to the increased risk for Sudden Infant Death Syndrome (SIDS).
    • The use of pacifiers has been known to decrease SIDS.
    • Positive parental interaction with infant should be obvious by 4-6 months; if not, further follow-up is warranted.
    • Infants may show separation anxiety at 9 months.
    • Sucking brings comfort and relief from tension for infants.
    • Infants who are warm and comfortable associate food with love.
    • Infants will gradually suck on their hands, but as hand development occurs, they find more pleasure in grasping objects.
    • Infants should be fed via tube or IV with added attention and a pacifier to ensure sucking satisfaction.
    • Infants have a grasp reflex, which disappears around 3 months of age.
    • Prehension develops around 5-6 months of age.
    • The parachute reflex develops by 7-9 months of age.
    • The pincer grasp develops by 1 year of age.
    • The Moro reflex, or startle reflex, is present at birth.
    • Love and security are vital needs of infants.
    • Parents should pick up infants when they cry to build trust and decrease later crying episodes and aggressive behavior.
    • Early limits and discipline are essential for infant development.
    • Sensory stimulation is crucial for infant development.
    • Parents should integrate infants into different environments to provide stimulation.
    • Specific developmental guidelines and care considerations must be followed throughout the first year of life.
    • Solid foods should be introduced slowly to infants at the appropriate ages, with observation for reactions.
    • Safety precautions are necessary, including covering electrical outlets and keeping household cleaners and medicines out of reach.
    • Always supervise infants during bath time and be mindful of household objects and materials that may be harmful.
    • Check all toys for loose buttons and rough edges and remove any that may present a hazard.
    • Educate parents about the importance of routine physical examinations by a pediatrician.
    • Be aware of potential hazards and ensure the safety and well-being of infants.
    • Keep a close eye on growth and development progress, and address any concerns with a healthcare professional.
    • It is essential to provide infants with a safe, supportive, and stimulating environment to foster optimal physical, cognitive, and emotional development.

    Infant Development

    • Infants at 9 months old recognize “no-no”
    • Infants may take one long nap daily
    • Infants play with food and remove it from their mouth
    • Infants explore, imitate, and enjoy rhythmic music
    • Infants show emotions including fear, anger, and jealousy
    • Infants react to the emotions of adults

    Infant Care & Guidance

    • Infants should gradually be introduced to egg whites, fish, and orange juice
    • Infants enjoy placing objects into and removing objects from baskets, as well as placing objects on their head
    • Infants should be placed on their backs on a firm, flat mattress in a crib

    Coping with an Irritable Infant

    • Infants may become irritable due to excessive sensory stimulation
    • Create a calm environment with reduced light, sound, and movement
    • Swaddle infants snugly in a lightweight blanket to promote comfort
    • Respond to pre-cry cues calmly to prevent escalation

    Care of the Infant with Colic

    • Colic is characterized by periods of unexplained irritability and crying in a healthy infant
    • Colic is often caused by feeding too rapidly, swallowing air, formula intolerance, or environmental factors.
    • Support parents of colicky infants by providing periods of rest and "breaks" to prevent caregiver exhaustion

    Coping with the Lethargic Infant

    • Reduce environmental stimulation to promote comfort and relaxation

    Developing Positive Sleep Patterns

    • Synchronize the infant's circadian rhythm with the family routine to establish a predictable sleep pattern
    • Infants under 6 months rely on parents to soothe them back to sleep
    • Encourage self-soothing behaviors in infants after 6 months of age

    Infants with Special Needs

    • Early intervention is essential for infants with special needs
    • Refer infants with special needs to community agencies for follow-up care, including early childhood education programs, public school systems, psychologists, neurodevelopmental therapists, speech therapists, and social workers

    Illness Prevention

    • Infants should be seen by a healthcare provider at least five times during their first year for routine check-ups, immunizations, and developmental assessments
    • Parents should be educated on the importance of immunizations, diaper changing practices, and monitoring infant growth and development.

    Therapeutic Play for Infants

    • Play is essential for infant growth and development
    • Select safe toys that stimulate vision, touch, hearing, and movement
    • Therapeutic play utilizes play to aid in the recovery process

    Infant Nutrition

    • Infants require more calories, protein, minerals, vitamins, and fluids than adults
    • Breast milk is the ideal source of nutrition for infants under 6 months
    • Introduce solids between 5-6 months starting with rice cereal
    • Monitor weight, height, head circumference, and skinfold thickness to ensure adequate nutrition
    • Breastfed infants feed every 2-3 hours and bottle-fed infants feed every 3-4 hours

    Common Concerns of Parents About Feeding Infants

    • Ensure parents understand the signs of adequate nutrition
    • Assess parental knowledge, infant development, parent-child interaction, and cultural practices to identify potential nutrition barriers

    Breastfeeding vs Bottle-feeding

    • The American Academy of Pediatrics (AAP) recommends breastfeeding or iron-fortified formula for the first 12 months of life
    • Breastfeeding promotes parent-infant bonding, provides immunological benefits, and reduces allergic reactions.
    • Breast milk can be refrigerated for 48 hours or frozen for up to 9 months
    • Contraindications for breastfeeding include HIV, galactosemia, chemotherapy/radiation treatment, illicit drug use, or active/untreated TB

    Infant Formulas

    • Infant formulas are not an exact replacement for breast milk
    • Formulas are highly regulated in the US
    • Two primary milk proteins are found in infant formulas: whey and casein
      • Whey is easily digested and may cause protein intolerance in some infants
      • Casein digests more slowly and inhibits catabolic processes
    • DHA and ARA are added to formulas to aid in neurological function
    • Formulas contain 20-40 calories per ounce
    • Formulas may contain additional additives such as probiotics and prebiotics
      • Probiotics are live microorganisms that offer health benefits
      • Prebiotics are nondigestible food ingredients that promote Bifidobacterium growth.
      • Probiotics and prebiotics have been used to treat diarrhea
    • Rice starch formulas like Enfamil A.R. are used to treat GERD and reduce loose stools
    • Lactose-free formulas like Similac Sensitive use corn syrup instead of lactose as the carbohydrate source
    • Soy milk, such as Isomil, is used for infants with galactosemia
    • Hydrolyzed formulas, such as Alimentum or Nutramigen, are used for infants with severe sensitivities
    • Using the wrong formula on an infant is considered a medication error
    • Whole cow's milk or goat's milk is not recommended for infants under 1 year old
    • Low-fat milk is not recommended for children under 2 years old
    • Infants don't need to finish every drop in a bottle

    Safe Bottle Feeding

    • Wash hands before making a bottle
    • Wash bottles thoroughly between feedings
    • Never heat bottles in the microwave
    • Heat bottles by setting them in a warm container of water
    • Prepared bottles should be refrigerated until ready to use

    Introducing Solid Foods

    • Parents can start adding solid foods at about 5-6 months when the tongue extrusion reflex disappears and the GI tract is mature enough
    • Rice cereal is recommended as the first food as it is less allergenic
      • Can be diluted with breast milk or formula
      • Offer a small amount at first (1 teaspoon)
    • Add new foods slowly, one new food every 4-7 days
    • Avoid introducing new foods when the infant is ill
    • Orange juice should be avoided until 1 year old
    • Highly allergenic foods such as peanuts and strawberries can be introduced slowly before 11 months
    • Most fresh or frozen un-salted foods are appropriate for home-prepared baby foods
      • Use a blender or strainer to prepare, do not over blend as it breaks down nutritional value
    • Organic and natural foods do not contain additives and have been altered as little as possible during production
      • No substantial research indicates these foods are better than others
      • Encourage parents to read nutritional labels

    Weaning

    • Weaning is defined as substituting a cup for a bottle or breastfeeding
    • Signs of readiness to wean include an infant:
      • Eagerly looking forward to new tastes and textures found on a spoon
      • Chewing or "biting" at the nipple/bottle
    • Weaning is usually completed by 2 years old

    Development of Feeding Skills

    • 7 months: child reaches for spoon
    • 9 months: uses spoon independently and has a refined pincer grasp to pick up food
    • 2 years old: skilled at self-feeding and can rotate the wrist and elevate the elbow to keep food on the spoon

    Toddler General Characteristics

    • Toddler: children between 1 and 3 years old
    • By 1 year, they have generally tripled birth weight and gained control of their head, hands, and feet
    • Rapid growth and development slows down
    • Toddler period presents challenges for parents and child
    • Erikson's stage of autonomy vs. shame and doubt
      • Major parental responsibility:
        • Maintaining safety while allowing opportunities for social and physical independence
        • Maintaining a positive self-image and body image
    • Negativism: Testing their power by saying "no" frequently
      • Offering limited choices and using distraction helps
    • Self-control and socially acceptable outlets for aggression and anger are important for personality development
    • Ritualism: Toddlers increase security through compulsive routines
      • These rituals should be respected
    • Toddlers gain 1.8-2.7 kg (4-6 lbs) per year
      • Birth weight is quadrupled by 2.5 years old
    • Toddlers grow 10 cm (4 inches) per year
      • At 2 years, they are about half of their potential adult height
    • Brain growth decelerates, with only 2.5 cm increase in head circumference
    • Chest circumference continues to increase, appearing leaner due to exceeding abdominal circumference
    • Myelination of the spinal cord is largely complete by 2 years old
      • Control of anal and urethral sphincters
      • Bowel and bladder control is usually complete by 2.5-3 years old
    • Lymphatic tissues and adenoids enlarge, with shorter and straighter eustachian tubes
      • Tonsilitis, otitis media, and upper respiratory infections are common
    • Deciduous teeth eruption continues until completion at about 2.5 years old
    • Vital signs:
      • Blood pressure averages 90/56 mmHg
      • Respiration slows to 25 breaths per minute (abdominal)
      • Pulse slows to 70-110 beats per minute
    • Information is assimilated through trial and error and repetition
      • Alternatives methods are tried to accomplish goals
    • Separation anxiety: develops in infancy and continues throughout toddlerhood
      • Protest, despair, and detachment
      • Able to tolerate longer periods of separation from parents
    • Awareness of cause and effect develops
    • Spatial relationships develop
    • Object permanence: aware of items behind closed doors or in drawers
    • Internalizing standards of behavior
      • Saying "no-no" when tempted to touch a forbidden object
    • Copying words and roles of models
      • "Help Mommy clean," "Help Daddy shave"
    • By 2 years old, toddlers recognize sexual differences
    • Body image and self-esteem can be impaired if scolded in a way that makes them feel bad instead of their behavior being bad
    • The nurse needs to help parents develop skills to make toddlers feel loved even when their behavior is unacceptable

    Toddler Speech Development

    • Parallels cognitive growth
    • Comprehension exceeds verbalization
    • By 3 years of age, they have a vocabulary of about 900 words
    • Speech is more than 90% understandable
    • Toddlers repeat sounds and words to receive a positive response from others
      • Must have an appreciative audience to learn
      • Respond to tone of voice and facial expressions
    • Parents should discuss delayed speech with a healthcare provider during routine physical examinations
      • Many late talkers have no delays
    • Rule out lead poisoning and hearing deficits before screening for developmental issues
      • Screen for signs of autism

    Toddler Guidance and Discipline

    • The goal is to teach, not punish
      • Children seek approval, which increases self-confidence
    • Fear or physical aggression should not be part of discipline
      • Does not foster self-control and can lead to abuse
    • Teaching self-control with positive self-esteem is more desirable than obedience
    • Temper tantrums reflect uncontrolled anger reactions
      • Parental responses reinforce desired or undesired behavior
    • Limits should include both praise for desired behavior and disapproval for undesired behavior
    • Time-out is a period in a safe place that helps the child develop tolerance for delayed gratification and self-regulation
      • Should not begin until the child is calm
      • Timing is 1 minute per year of age
    • Fear: many children fear situations that aren't inherently dangerous, which deprives them of enjoyable activities
      • Statements like "be careful, don't fall" can lead to fear of taking risks
      • Physical and mental health of a child at the time affects fear response
      • Learned fear is difficult to eliminate
      • Clinging to possessions and rituals are self-consoling
      • Stress increases separation anxiety
      • Respect and understanding should be given to children who are afraid
      • Making fun of or shaming fear is detrimental to self-esteem
      • Children who don't seek their parent during stressful situations or turn to strangers for comfort need evaluation of the parent-child relationship
    • Corporal punishment, such as spanking:
      • Accepted in many cultures but is problematic
      • Time-out, limit setting, clear communication, and rewards are more effective noncorporal techniques
    • Communicate love and respect to the child, making it clear that the behavior is unacceptable
    • See Table 17.4 for behavior problems, normal expectations, and parental guidance

    Toddler Daily Care

    • Adults should be at the child's eye level when talking, especially when they are in a fear-provoking environment
    • A flexible schedule that meets the needs of the family but is consistent for the toddler is ideal
    • Toddler clothing should be simple, easy to put on and take off, and loose for freedom of movement
    • Sunburn protection is important, with thin layers of clothing and SPF 30 or higher
    • Shoes are mainly for protection
      • Should fit the shape of the foot, half an inch longer, and a quarter of an inch wider
      • Heel must fit securely
    • Posture: Toddlers with confidence and independence will have good posture
      • Slouching can indicate insecurity and lack of self-confidence### Toilet Independence
    • Voluntary control of anal and urethral sphincters begins around 18 to 24 months
    • Indicators of maturity include waking up dry in the morning or after naptime and being able to communicate when they need to urinate or defecate
    • Training pants or pull-ups allow children to be more aware of being wet
    • Bowel training should be attempted first as the toddler enjoys the "tinkle" in the potty
    • Bladder training begins when the child stays dry for about 2 hours
    • Most children continue to have occasional accidents until age 4
    • The parent(s) should accept accidents and merely change the child’s clothes
    • A recognizable signal word for defecation or urination should be used

    Nutrition

    • Toddlers need 100 calories/kg per day
    • Milk should be limited to 720mL (24oz.) per day
    • Children between 1 to 3 years old are at high risk for anemia
    • Avoid excess calories and large amounts of vitamins
    • Appetite fluctuates, and toddlers may have strong food preferences
    • Offer nutritious meals any time of the day, but should be avoided between meals
    • Serving sizes should be approximately 1 tablespoon of solid food per year of age
    • Offer varied choices with contrast in colors and textures
    • Chopped food should be in fine pieces to avoid choking
    • Quiet time should occur prior to mealtime
    • Do not force a child to eat if they refuse
    • Allow toddlers to use their favorite plate, spoon, and glass
    • Use unbreakable, colorful dishes
    • Eating utensils should be sized appropriately
    • Toddlers' brief attention spans may cause them to wander from the table or stand in the highchair

    Daycare

    • Many children are cared for outside the home setting
    • Daycare arrangements should meet families’ personal preferences, cultural perspectives, financial resources, and special needs
    • Frequent visits to the facility, ongoing communication, and conferences with staff are recommended
    • Toddlers engage in parallel play rather than group play
    • Toddlers need closer supervision than preschoolers

    Injury Prevention

    • Accidents are the leading cause of death and crippling in children
    • Nurses should review injury prevention at each clinic visit and demonstrate safety measures
    • Parents must understand normal behavior characteristics of toddlers that make them prone to injuries
    • Consumer education efforts by the federal government and private agencies attempt to regulate variables that cause injuries
    • Follow car safety guidelines, including rear-facing car seats for children up to 2 years old and booster seats for older children
    • All homes should have smoke and carbon monoxide detectors
    • Nurses play a significant role in educating parents on the importance of reducing incidents of disability and death

    Toys and Play

    • Toddlers prefer simple toys like pots and pans, water play, dancing, crayons, fingerpaint, and picture books
    • Tricycles, push or pull toys, and wind-up toys are all suitable for this age group
    • Toddlers engage in parallel play, playing next to peers but not with them
    • Cooperative play gradually develops during this age
    • It is important to calm and distract toddlers when they are frustrated rather than abruptly removing them from the play area.
    • Nurses should assess children with special needs for safety precautions and provide education on the use of safety items such as electric outlet covers, cabinet locks, drawer locks, and creation of a hazard-free environment.

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    This quiz evaluates key concepts related to the assessment of infant growth and development. It covers topics such as growth charts, developmental patterns, and important nursing considerations. Test your understanding of how to track and evaluate an infant's growth effectively.

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