3A - physical, cognitive, social development during infancy

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Flashcards on 3A - physical, cognitive, social development during infancy , created by Elizabeth Then on 14/06/2018.
Elizabeth Then
Flashcards by Elizabeth Then, updated more than 1 year ago
Elizabeth Then
Created by Elizabeth Then almost 6 years ago
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Neonatal period First 28 days after birth, critical time for physiological adjustments
Effects of birth-Respiratory Sytem Foetus is hypoxic during birth increased CO2 A fetus passed through birth canal, forces lung fluid from alveoli to upper resp tract and out chest expands after birth drawing in air increased CO2 levels stimulate resp centre in medulla causing inspiration
Effects of birth circulatory system Cord clamped after birth pressures in left and right sides of the heart cause closure of connecting bv more blood to lungs oxygenation and increase pulmonary vascular resistance closes further blood vessel in heart
Resuscitation of new born most infants resuscitate themselves lung inflation struggle with first breath - need assistance ventilation provided with bag and mask
Agpar score score indicate level of support newborn needs score added overall performed at 1 and 5 minutes after birth 0-3 severe asphyxia 4-6 moderate asphyxia 7-10 good adaptation
Newborn assessment head to toe 4 modes: inspection, percussion, auscultation, observation general: measurements, skin, posture, body proportion, reflexes, movements, vitals, facial expression
Newborn reflexes primitive reflexes are sign of delay in maturation of CNS most disappear with maturation over first 3-4 months needed for: food, safety, transition, grasping
examples of primitive reflexes palmar grasp, moro reflex, rooting, sucking, tonic neck, blinking, stepping, walking
Newborn assessment toold physical: skin, ear, genitals, creases, breast, nipples, hair, oedema neurological: posture, flexion of arms, wrists, feet, legs behavioural characteristics: head lag, cry, colour
Brazalton neonatal behaviour assessment performed 24-36 hours of birth when clinical worried about neurological state assesses: neuro development, reflexes, reactions responses to stimulation/handling: tone, skin colour, able to follow object, consolability, resistant to cuddling and clinging low score- brain stress/damage moderate score- parent taught to interact with infant
neurological posture related to age developes cephalo-caudal direction less than 30 weeks no tone, extension of all limbs 30 weeks - some flexion, feet, knees 34 weeks - thighs, hips flexed 36 weeks - upper limbs flexed normal flexion indicates good muscle tone
New born neurological assessment abnormal movements tremors, jitters, convulsions, hyper-irritability, asymmetry of movement
Newborn neurological assessment alertness quiet sleep, semi-awake, alert and cooperative, fussing and uncooperative, crying, new borns sleep 16-17 hours of the dayy
Measuring physical growth length, height, head circumference, surface area, skin fold thickness, bone age
Assessing growth average birth weight is 3.3kg average length is 50 cm average head circumference is 35 cm
Growth patterns and differences appropriate for gestational age larger than gestational age smaller than gestational age - below 2500gm low birth weight - below 2500gm extremely low birth weight - below 1000gm
Patterns of sleep REM sleep decreases with age usually pattern gains 4-6 weeks should sleep more at night by 4 months of age
Types of sleep quiet - may suck, not REM active - may smile and fuss awake - drowsy, quiet alert, active alert, crying alert periods -can imitate movements and emotions
Brain growth Human brain at birth only 25% adult size develops neurones, dendrites, axon terminals
Birth to 6 months physical growth - doubles weight by 5-6 months, teeth may begin Fine motor ability - grasp objects, mouthing objects Gross motor - develops head control, standing supports much of own weight by 6 months sensory - alert to high pitched noises, turns head to look at voices
6 - 12 months physical - growth slower, triples by 1 year fine motor ability - bangs objects, may hold pencil gross motor - crawls, sits alone sensory - recognises own name, understand words such as no
Bonding after birth forming a connection is best between mother and baby encourage involvement
Attachment strong emotional bond infants develop attachment behaviour tendency of young to stay close
Infant communication birth to 2 months - coos, babbles 3-6 months - laughs, cries 6- 9 months - talking, increasing vowel sounds 9-12 months - understand no, says dada mama
crying 3 types rhythmic - steady pulsating- hunger, unhappy mad - shrill, turbulent - anger, frustration pain - long scream followed by silence
Types of play solitary - infancy parallel - toddlerhood associative - pre-schooler dramatic - pre -schooler cooperative - school age child
Play during infancy plays alone uses senses to grasp, touch, taste, manipulate
Toddlerhood rate of growth slows in second year displays independence and negativism pride in new accomplishments
Growth 1-3 years physical - anterior fontanel closes fine - throws ball, self dress gross - walks, runs, jumps sensory - can focus well
Teeth eruption regular sequence, varying timing, genetically determined
Toddler communication 1-3 years verbal and non-verbal imitates words, increasingly enjoys tallking, vocab of 1000 words in 3 year old, enjoys contact with others
Communicating with a toddler avoid telling toddlers about things too far in advance, allow to cry, use simple technology, comfort toddler
play during toddlerhood parallel play - social, play alongside others
Effects of hospitalisation - four idenfied categories seperation, pain and injury, immobility ad loss of control, change in routine reacts depends on: age, preparation, previous illness, support, health professionals
seperation anxiety protest - cries, screams despair - sad, lonely detachment - denail - interested and plays, responds to parents as strangers
Seperation anxiety protest phase - infants cries, scresm, attempts to escape
Seperation anxiety - protest phase - toddler agitated, resist caregiver,s increasing age, regression
seperation anxiety despair and detachment despair- occurs long term, withdrawn detachment - appears happy, interacts with strangers
Pain and bodily injury cognitive development - pre-operational concept of illness - external to child, cannot relate cause play is important in this to help them deal and express feelings and emotions
Immobility and loss of control altered routines and restrictions, decreased opportunities, help them release hospital is not a punishment
What can nurses do? family-centred care talk, honesty of pain, play is important, communication and language important, talk to level of child's understanding
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