Peds Chapter 3: Infancy

Usually, the anterior fontanel remains open until ___ to ___ months of age to accommodate rapid brain growth. However, the fontanel may close as early as _________ of age, and this is not of concern in the infant with age-appropriate growth and development.

12 to 18; 9 months The increase in head circumference is indicative of brain growth.

The average pulse rate in the newborn is ______ to ________.

120- 140 bpm

Infants engage in what type of play?

Solitary play

An infant's individual normal behavior is referred to as the infant's ____________.

Temperament

The average pulse rate of a 1-year-old is _____

100 bpm

(T/F) Disappearance of the extrusion reflex is a sign that the infant is ready for solid food.

True. Rationale: The tongue extrusion reflex is necessary for reflexive sucking in early infancy. Disappearance of the reflex better allows for spoon-feeding of solids.

Mottling of the skin

a pink-and-white marbled appearance Mottling decreases over the first few months of life.

Persistence of _________ reflexes beyond the usual age of disappearance may indicate an abnormality of the neurologic system and should be investigated.

primitive

Appropriate presence and disappearance of __________ reflexes, as well as development of ___________ reflexes, are indicative of a healthy neurologic system.

primitive; protective

During the first few months of life, reflexive behavior is replaced with _______________.

purposeful action

During the ______ state, the infant's eyes are wide open, and the body is calm.

quiet alert

During the first few months of life, __________ behavior is replaced with purposeful action.

reflexive

Protective reflexes include the _______ and ________ reflexes.

righting; parachute

By _____ months of age, the infant's length has increased by 50%.

12

At what age can the infant recognize themselves in the mirror?

12 months Self-image is promoted through the use of mirrors. By 12 months of age, infants can recognize themselves in the mirror.

At what age is the infant able to use two or three recognizable words with meaning, recognize objects by name, and start to imitate animal sounds?

12 months The 12-month-old also babbles with inflection (this babbling has the rhythm and timing of spoken language, but few of the "words" make sense)

Stomach capacity of a newborn

0.5-1 ounce (15-30 mL) The stomach capacity is relatively small at birth, holding about one half to 1 ounce.

Most infants triple their birth weight by the time they are _____ old.

1 year

Head circumference increases about ___ cm from birth to 1 year of age.

10

At what age does the infant exhibit their first real smile?

2 months

Myelination of the spinal cord and nerves continues over the first _________.

2 years

Sucking reflex disappears

2-5 months

The normal RR at 12 months is?

20-30 breaths/min

The normal newborn's respiratory rate ranges from ____________ to _____________.

30 to 60

The average head circumference of the full-term newborn is ___ cm (___ in)

35; 13.5

Most infants double their birth weight by ______ months of age.

4-5

At what age are infants able to make simple vowel sounds, laughs aloud, performs "raspberries," and vocalizes in response to voices.

4-5 months

At what age can the infant respond to his or her own name and begin to respond to "no."?

4-5 months

Palmar grasp reflex disappears

4-6 months (**must disappear before voluntary grasping)

The average 12-month-old has how many teeth?

4-8 The average 12-month-old has four to eight teeth.

The step reflex disappears by age?

4-8 weeks

At what age should solid foods be introduced?

6 months

The newborn should wet how many diapers per day (when breastfed)?

6-8

Age that first tooth appears

6-8 months On average, the first primary teeth begin to erupt between the ages of 6 and 8 months. The lower central incisors are usually the first to appear, followed by the upper central incisors

Blood pressure steadily increases over the first 12 months of life, from an average of _____ in the newborn to ______ in the 12-month-old.

60/40 in newborn 100/50 in the 12-month-old

Newborns may lose 5% to 10% of their body weight over the first week of life. The average newborn then gains about 20 g to 30 g per day and regains his or her birth weight by _______ days of age.

7-10

Babbling begins at about

7-10 months At age 7 to 10 months, babbling begins and progresses to strings (e.g., mamama, dadada) without meaning

Object permanence is developed by what age?

8 months The concept of object permanence begins to develop between 4 and 7 months of age and is solidified by about 8 months of age (Piaget, 1969). If an object is hidden from the infant's sight, he or she will search for it in the last place it was seen, knowing it still exists. This development of object permanence is essential for the development of self-image. By age 12 months the infant knows he or she is separate from the parent or caregiver.

At what age may the infant develop stranger anxiety?

8 months The previously happy and very friendly infant may become clingy and whiny when approached by strangers or people not well known. Stranger anxiety is an indicator that the infant is recognizing himself or herself as separate from others.

Plantar grasp reflex disappears

9 months (**must disappear before taking steps)

At what age does the infant begin to attach meaning to "mama" and "dada" and start to imitate other speech sounds?

9-12 months

Moro reflex

AKA the "startle reflex" With sudden extension of the head, the arms abduct and move upward and the hands form a "C." Infant reflex where a baby will startle in response to a loud sound or sudden movement. Disappears: 4 months

Infants may experience physiologic ____________ at 2 or 3 months of age due to the shorter lifespan of HgbF.

Anemia

Rapid eye movements and irregular movements may be noticed when the infant is in which state of consciousness? A. Deep sleep B. Light sleep C. Drowsiness D. Active alert state

B. Light sleep Light sleep: Sleeping with eyes closed; rapid eye movements and irregular movements may be noticed. Deep sleep: Sleeping with eyes closed and no movement. Drowsiness: Eyes may close or be half-lidded; the infant may be dozing. Active alert state: The infant's eyes are open; body movements occur

Gross motor skills develop in a ________________ fashion.

Cephalocaudal

In which state of consciousness is it difficult to gain the infant's attention?

Crying Crying: The infant cries or screams and it is difficult to gain the infant's attention (p. 60)

(T/F) All primitive reflexes disappear over the first few months of life.

False Rationale: The Babinski reflex does not disappear until 12 months of age.

(T/F) Infant hearing develops over the first few months of life.

False. Rationale: Hearing should be intact at birth. Other senses develop over the first few months of life.

(T/F) An infant in deep sleep may startle to a noise and begin screaming.

False. Rationale: Infants typically move through several states ranging from deeply asleep, to wide awake and screaming. It is ordinarily a somewhat gradual process, rather than an abrupt, immediate change in state.

(T/F) The newborn's respiratory pattern is very regular in nature.

False. Rationale: Newborns display an irregular breathing pattern with periodic pauses.

(T/F) A benefit of formula is its greater iron concentration compared to breast milk.

False. Rationale: The iron available in breast milk is more bioavailable than the iron supplemented in formula.

In the infant, total body water is a greater percentage of weight than it is in the adult. Therefore, the infant is ______(MORE/LESS) susceptible to dehydration.

MORE In the infant, total body water is a greater percentage of weight than it is in the adult. Thus, the infant is more susceptible to dehydration

Neck righting reflex

Neck keeps head in upright position when body is tilted; log rolling of entire body to maintain alignment; infant in supine position and turn head to one side--> infant log rolls entire body. Appears at 4-6 months and persists Is a PROTECTIVE reflex (NOT primitive)

Adjusted age is determined by subtracting the number of weeks the infant was ______________ from the child's chronologic age.

Premature

______________ reflexes develop later in infancy and are gross motor responses related to equilibrium maintenance.

Protective

Parachute (forward) reflex

Protective extension with the arms when held up in the air and moved forward. The infant reflexively reaches forward to catch himself or herself. Appears at 6-7 months

Parachute (backward) reflex

Protective extension with the arms when tilted backward. Appears: 9-10 months

Parachute (sideways) reflex

Protective extension with the arms when tilted to the side in a supported sitting position. Appears at 6 months (when they can tripod sit)

Fine motor skills develop in a ________ fashion.

Proximodistal (Hand before fingers) Fine motor skills develop in a proximodistal fashion (from the center to the periphery)

Sucking reflex

Reflexive sucking when nipple or finger is placed in infant's mouth.

The newborn and young infant's skin is relatively ________(thinner/ thicker) than that of the adult, with the peripheral capillaries being closer to the surface.

Thinner This may cause increased absorption of topical medications.

Parachute (backward)

This is an example of what reflex?

Parachute (forward)

This is an example of what reflex?

Parachute (sideways)

This is an example of what reflex?

(T/F) The infant grows more quickly in length over the first 6 months, than during the second 6 months.

True

(T/F) Development is the sequential process by which infants and children gain various skills and functions.

True Development is the sequential process by which infants and children gain various skills and functions. Growth refers to an increase in physical size. Heredity influences growth and development by determining the child's potential, while environment contributes to the degree of achievement.

(T/F) Newborns may lose 5% to 10% of their body weight over the first week of life.

True Newborns may lose 5% to 10% of their body weight over the first week of life. The average newborn then gains about 20 g to 30 g per day and regains his or her birth weight by 7 to 10 days of age.

(T/F) Increased maternal bonding occurs with breastfeeding

True Rationale: Increased maternal-infant bonding is a benefit to both mothers and infants when breastfeeding.

(T/F) The head circumference increases more rapidly during the first 6 months than during the second 6 months.

True Similar to the weight and length, the head circumference increases rapidly during the first 6 months.

(T/F) Protective reflexes remain throughout life once they are established

True. Protective reflexes (also termed postural responses or reflexes) are gross motor responses related to maintenance of equilibrium. These responses are prerequisites for appropriate motor development and remain throughout life once they are established. The protective reflexes include the righting and parachute reactions.

(T/F) One stool every day or two is considered normal if the stool remains soft.

True. Rationale: Infants' stool patterns vary widely. Stool should not be hard, dry, difficult to pass, nor watery.

(T/F) The increase in head circumference is indicative of brain growth.

True. The brain undergoes tremendous growth during the first 2 years of life. By 6 months of age the infant's brain weighs half that of the adult brain. At age 12 months, the brain has grown considerably, weighing 2½ times what it did at birth

Asymmetric tonic neck reflex

While lying supine, extremities are extended on the side of the body to which the head is turned and opposite extremities are flexed (also called the "fencing" position). Stimulus: Fully rotate infant's head and hold for 5 seconds. Response: Extension of extremities on the face side, flexion of extremities on the skull side. Relevance: Promotes visual hand regard. Disappears: 4 months

Step reflex

With one foot on a flat surface, the infant puts the other foot down as if to "step." baby appears to take steps/walk or dance when held upright on a solid surface Disappears at 4-8 weeks

Children's play is so important to their development that it is considered the ______________ of children.

Work

Rooting reflex

a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple When infant's cheek is stroked, the infant turns to that side, searching with mouth. Disappears: 3 months

During the __________ state, the infant's eyes are open and body movements occur.

active alert

The ability to fuse two ocular images into one cerebral picture (_____________) begins to develop at 6 weeks of age and is well established by 4 months of age

binocularity

Acrocyanosis

blueness of the hands and feet Normal in the newborn Decreases over the first few days of life

__________ refers to an increase in functionality of various body systems or developmental skills.

maturation

Over the first year of life, an infant's involuntary movement progresses to ________ control

voluntary The infant experiences tremendous changes in the neurologic system over the first year of life. Critical brain growth and continued myelination of the spinal cord occur. Involuntary movement progresses to voluntary control, and immature vocalizations and crying progress to the ability to speak as a result of maturational changes of the neurologic system.