Ch. 25 growth and development of the newborn and infant

6m.o. gross motor skills?

Tripod sits p. 968

After 1yr stomach accomadates how many meals?

3 full meals and several snacks per day p. 965

9-12m.o. communication style?

Infant attaches meaning to mama and dada starting to imitate sounds p. 972

Warning signs that indicate issues w/ language learning?

Infant does not make sounds by 4m, does not laugh or squeal by 6m, does not babble by 8m, does not use single words w/ meaning by 12m p. 973

Solitary play?

Infant does not play or share w/ others around them p. 975

Babinski disappears?

12m p. 964

PrepU Which client will the nurse assess first after receiving 0700 shift report? A 6-month-old infant with a respiratory rate of 44 breaths/minute A 1-month-old infant with positive Moro and root reflexes A 12-month-old infant with a blood pressure of 60/40 mm Hg A 1-day-old newborn who just passed a black, sticky stool

A 12-month-old infant with a blood pressure of 60/40 mm Hg The nurse will first assess the 12-month-old infant with a blood pressure of 60/40 mm Hg. This is the expected blood pressure in an infant; however, by 12 months of age the blood pressure should rise to around 100/60 mm Hg. The normal respiratory rate of an infant is 30 to 60 breaths/minute. It is expected for a 1-month-old infant to still have Moro and rooting reflexes. These should diminish over the first few months of life. Stools are dark green to black and sticky for the first few days of life. Chapter 25: Growth and Development of the Newborn and Infant - Page 925

Why does AAP not recommend infant walkers?

Infant walker may tip over, baby may fall out, infant may fall down stairs, infants can access things like hot stoves p. 976

Education on pain and inflammation for teething?

Application of cold, infant chewable cold teething ring, washcloth wrapped in an icecube, OTC numbing gels (Orajel) to be placed on gums and not lips and occasional acetaminophen or ibuprofen p. 986

Warning signs that indicate development issues?

Arms and legs are stiff or floppy, child cannot support head at 3-4m, child reaches w/ one hand, child cannot sit w/ assistance at 6m, child does not crawl by 12m, cannot stand supported by 12m p. 969

7-10m.o. communication style?

Babbling, strings of sounds w/ no meaning p. 972

9m.o. fine motor skills?

Bangs objects together p. 972

4m.o. fine motor skills?

Bats at objects p. 972

How to clean infants teeth?

Before teeth eruption parents should clean gums w/ damp washcloth After teeth has erupted soft cloth can still be used then eventually a small soft bristle toothbrush Do not use toothpaste p. 983

Colic appears and disappears when?

Begin as early as 2weeks and resolves by 3m p. 984

PrepU The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which ability should appear at this age? Cruises around furniture Uses two or three words with meaning Feeds self with spoon (but spills) Sits from standing position

Cruises around furniture At 10 months, this ability appears and is practiced often in preparation for later independent walking. All the rest of the skills take an additional 2 months to develop and appear around age 1 year. Chapter 25: Growth and Development of the Newborn and Infant - Page 935

According to Erikson, trust vs. mistrust, birth to 1yr, what activities need to be done?

Caergivers respond to infants basic needs by feeding, changing diapers, cleaning, touching, holding, talking to infant p. 967

Educate mother on what during oxytocin release?

Causes uterine contractions, warn mother of afterpains from breast feeding p. 978

Warning signs for social issues when developing?

Child does not smile at 3m, refuses to cuddle, does not seem to enjoy people, no interest in peek-a-boo at 8m p. 973

Foods likely to cause an allergic reaction?

Citrus, strawberries, wheat, cows milk, egg whites, and peanut butter p. 982

Breastmilk transition?

Colostrum 2-4d, transitional milk then mature milk by 10th day p. 978

9m.o. gross motor skills?

Crawls, abdomen off floor p. 968

How are fine motor skills developed?

In a proximodistal fashion (from center to periphery) p. 969

Colic?

Inconsolable crying that lasts for 3hrs or longer per day w/ no physical cause p. 984

Maturation definition?

Increase in functionality of various body systems or developmental skills p. 960

Growth definition in book?

Increase in physical size p. 960

Primary are also called?

Deciduous teeth p. 965

Gross motor skills develop where and are related to what large muscles?

Develop in the cephalocaudal fashion from head to tail and the large muscles involved are head control, rolling, sitting, and walking p. 968

4-7m communication style?

Distinguish emotions, squealing, yelling, around 6m p. 972

Warning signs that may indicate problems w/ sensory development?

Does not respond to loud noises, does not focus on near objects, does not make sounds or babble by 4m, does not turn to locate sound at 4m, crosses eyes most of the time at 6m p. 970

Newborn weight doubles and triples by when?

Doubles by 4months, and triples by 1 yr p. 960

When are maternal iron stores transferred to the infant?

During last 3m of gestation, newborn has 0.3-0.5g of iron stores available p. 967

Anticipatory guidance?

Education on what to expect in the next phase of development p. 974

Neck righting?

Neck keeps head in upright position when body is tilted p. 964

Development definition in book?

Sequential process where infants and children gain various skills and functions p. 960

prepu The nurse is assessing an infant at the 6-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3600 g) and was 20 in (50.8 cm) in length. Which finding is consistent with the normal infant growth and development? weight of 14 lb (6400 g) and length of 24 in (61.0 cm) weight of 16 lb (7300 g) and length of 26 in (66.0 cm) weight of 18 lb (8200 g) and length of 28 in (71.1 cm) weight of 20 lb (9100 g) and length of 30 in (76.2 cm)

weight of 16 lb (7300 g) and length of 26 in (66.0 cm) The average newborn weighs 7.5 lb (3400 kg) at birth. Most infants double their birth weight at 4 to 5 months and will triple by the time they are 1 year old. If this infant was 8 lb (3600 kg) at birth, then it is most likely now 16 lb (7300 g). The average newborn is 20 in (50 cm) long at birth. They grow more quickly in length over the first 6 months, than during the second 6 months. By 12 months of age, the infant's length has increase by 50%. At 1 year, this infant will most likely be 30 in (76.2 cm) in length; however, since most of the growth occurs in the first 6 months, it is possible for the infant to grow an additional 6 in (15 cm) during that time. Chapter 25: Growth and Development of the Newborn and Infant - Page 924

Bottle weaning is at what age?

12-15m p. 983

When does an infant usually recognize themselves in the mirror?

12m p. 968

When is an infant capable of feeding themselves w/ spoon or cup?

12m p. 969

When does first molars develop?

13-19m p. 965

Fluid nutritional requirements for a newborn?

140-160mL/kg/day p. 977

When does cuspids usually develop?

16-22m p. 965

Education on engorgement?

-Apply warm compresses -Hot shower before feeding p. 980

Inadequate milk supply education?

-Decrease maternal stress -Encourage adequate maternal diet and fluid intake -Instruct working mothers to pump p. 980

Education on preventing sore nipples?

-Encourage appropriate latch on -Expose nipples to air between feedings -Allow breast milk to dry on nipples -Use aloe vera or vitamin E to help heal sore nipples -Use medical grade lanolin or preservative-free lanolin (Lansinoh) p. 980

Education on poor sucking?

-Feed on cue, not on a schedule -Encourage sleepy infant by stroking feet, undressing and rubbing head p. 980

Maternal benefits of breastfeeding?

-Increased bonding -Lessens maternal blood loss in postpartum period -Decreased risk of ovarian and premenopausal breast cancer -Reduced incidence of pregnancy-induced, long-term obesity -Possible delay of return of ovulation in some women -Always ready, no mixing -Economic advantage p. 978

Benefits of breastfeeding for infant?

-Increased bonding w/ mother -Immunologic protection -Breast milk has anti-infective properties -Decreased incidence and severity of diarrhea -Decreased chance of asthma, otitis media, bacterial meningitis, botulism, UTI -Possible enhancement of cognitive development -Lessens likelihood of obesity p. 978

Four substages in sensorimotor stage from birth to 1yr in Jean Piagets theory?

-Reflexes -Primary circular reaction -Secondary circular reaction -Coordination of secondary schemes p. 968

Educating on preventing choking?

-Use only toys recommended 0-12yr -Avoid stuffed animals w/ eyes or buttons that can be dislodged by persistent infant -Keep floor clean from small items such as paperclips, coins, pins Avoid feeding popcorn, nuts, carrot slices, grapes, hot dog pieces p. 976

6 states of consciousness for normal newborn?

1. Deep sleep: Sleeping w/ eyes closed, no movement 2: Light sleep: Sleeping w/ eyes closed, rapid eye movements and irregular movements 3. Drowsiness: Eyes my close or be half lidded, infant may be dozing 4. Quiet alert state: Infants eyes wide open and body is calm 5. Active alert state: Infants eyes open, body movements occur 6. Crying: Infant cries/screams and its difficult to get attention p. 960

Fluid nutritional requirements for an infant?

100mL/kg/day for first 10kg 50mL/kg/day for next 10kg p. 977

Calorie nutritional requirements for a newborn?

105-108kcal/kg/day p. 977

Calorie nutritional requirements for infant?

108kcal/kg 1-6m 98kcal/kg 6-12m p. 977

When does infant recognize well known sounds?

1m p. 970

How many times should infant be burped per feeding?

2-3x p. 980

Best time to wean from pacifier?

2-3yrs p. 985

Infants require how many exposures to a new food before it is accepted?

20 exposures p. 982

Newborns sleep how often?

20hrs/day on and off waking up frequently to feed p. 983

First real smile is predicted by what age?

2m p.973

IgG is first passed to newborn through placenta to last the first?

3-6m p. 967

Newborn weight avg, amount lost in a week, then when is it regained, how much is added a day?

3.400kg (7.5lb) at birth, 30g/day, loses 10% over first week the regained by 10-14days p. 960

ECF (lymph, interstitial, blood plasma) and ICF accounts for how much of body weight?

35% for ECF, 40% for ICF p. 965

Head circumference avg and increases by how much in 1yr?

35cm, increases 10cm in 1yr p. 960

Age that rooting disappears?

3m p. 962

Palmer grasp disappears?

4-6m p. 962

Patty cake and peek-a-boo is predicted to be played at what age?

6-8m p. 973

When should a cup be introduced?

6-8m p. 982

Distance between crib slates?

6cm (2 3/8 in) (no wider than a soda can) p. 976

3m.o. sleep how much?

7-8h w/ out waking per night p. 983

12m.o. sleep how often?

8-12h per night and take two naps per day p. 983

Stranger anxiety develops by what age?

8m p. 973

PrepU The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. What should be included in the teaching plan? Select all that apply. Advising the mother this behavior is a form of self-comfort Assuring the mother this behavior won't cause malocclusion Informing the mother that thumb sucking occurs more often during periods of stress Telling the mother this behavior usually decreases by 6 to 9 months of age

Advising the mother this behavior is a form of self-comfort Assuring the mother this behavior won't cause malocclusion Informing the mother that thumb sucking occurs more often during periods of stress Telling the mother this behavior usually decreases by 6 to 9 months of age All are accurate and should help the mother better understand and accept the behavior. Chapter 25: Growth and Development of the Newborn and Infant - Page 951

Sensorimotor stage timeframe?

Birth to 2 yrs p. 968

Hindmilk?

Breast milk received near the end of a feeding; contains higher fat content than foremilk. p. 978

Appropriate toys for 1-4m.o.?

Bright mobile Unbreakable mirror Rattles Singing by parent or caregiver High contrast patterns in books or images p. 975

Education on avoiding spitting up?

Burp baby 2-3x, keep baby in upright position for 30min, do not lay infant in prone position, avoid bouncing or car seats due to compression on stomach p. 985

First dental appt recommended?

By 1 yr p. 983

IgG is self synthesized when?

By 12m p. 967

Assessing readiness for solid food?

Extrusion reflex is absent and infant can sit up (usually around 4-6m) p. 981-982

Toys for 4-7m.o.?

Fabric or board books Different types of music Easy to hold toys that do things (makes noise) Floating, squirting bath toys Soft dolls or animals p. 975

12m.o. fine motor skills?

Feeds self w/ cup and spoon, makes simple mark on paper, pokes w/ index finger p. 972

Is there teeth upon birth? How long do they take to develop?

Few upon birth which is rare, most newborns have no teeth, may develop in first 28d p. 965

10m.o. fine motor skills?

Fine pincer grasp, puts objects into container and takes them out p. 972

Small amounts of saliva is present for how long?

First 3m p. 965

Foremilk?

First milk in feeding, collects in lactiferous sinuses, where small tubules serve as a reservoir for milk located behind nipples where let down reflex is responsible p. 978

1m.o. fine motor skills?

Fists mostly clenched, involuntary hand movements p. 972

Newborn period of infancy?

From birth to 28days of age p. 960

Infancy period?

From birth until 1 yr p. 960

What parts of the liver are mature during first year of life?

Gluconeogenesis, vitamin storage, protein metabolism p. 965

8m.o. fine motor skills?

Gross pincer grasp (rakes) p. 972

How does small intestine grow?

Grows to 270cm long and grows to adult size within first few years of life p. 965

Newborns take in how much at first then how much within the next few days, then 6months?

Half-oz to 1oz per feeding working up to 2-3oz in first few days 6-10x per day, by 6 months babies feed 4-5x per day taking 6-8oz per feeding p. 980

Education on normal crying behavior in infants?

Healthy infants cry 3hrs/day 3-7x per week. Normal crying increases when infant is 6weeks old and diminishes by 12 weeks p. 984

Physiologic anemia at 2-3m is due to what?

HgbF production nearly ceases as HgbA is steadily produced throughout first 6m p. 967

3m.o. fine motor skills?

Holds hand in front of face, hands open p. 972

Foods to avoid during infancy?

Honey, egg yolks and meats until 10m, excessive amounts of fruit juice, peanuts, popcorn, raw carrot chunks or other small foods, grapes, hot dog slices p. 982

Education on washing bottles and nipples?

Hot soapy water, rinse well or dishwasher p. 981

Education for mother worrying about not eating enough?

If infant has at least 6 diapers a day and is gaining weight theyre fine p. 980

When should spitting up be a concern to go to doctor?

Infant vomits 1/3 of most feedings, chokes when vomiting, experiences forceful emesis p. 985

Water safety tips?

Infants can drown in small amounts of water, aquatics program does not improve chances of drowning, bathroom door should be kept closed, toilet lid should be kept down p. 976

What foods are good to start out w/?

Iron-fortified rice cereal mixed w/ small amount of breast milk or formula, foods that are pureed, then by 8m texture can be eaten for example cheerios, soft green bean pieces, soft peas, then strained or mashed meats by 12m p. 982

1m.o. gross motor skills?

Lift/turn head to side in prone position, head lag when pulled to sit, rounded back in sitting p. 968

4m.o. gross motor skills?

Lifts head, looks around, rolls from prone to supine, head leads body when pulled to sit p. 968

Do lower or upper incisors develop first?

Lower within 8-12m p. 965

Appropriate toys from a newborn to 1m.o.?

Mobile w/ contrasting colors or patterns Unbreakable mirror Soft music via tape or music box Soft/brightly colored toys p. 975

Protective reflexes?

Neck righting, parachute (sideways), parachute (forward), parachute (backwards) p. 964

Cribs should be free of what to prevent suffocation?

No pillows, comforters, stuffed animals, soft items, do not place crib by window p. 976

11m.o. fine motor skills?

Offers objects to others and releases them p. 972

Spitting up occurs usually due to what?

Overfeeding or baby is not burping properly p. 985

Toys for 8-12m.o.?

Plastic cups, bowls, buckets Unbreakable mirror Building blocks Stacking toys Busy boxes w/ buttons and knobs that do things Balls Dolls Board books w/ large pictures Toy telephone Push-pull toys (older infant) p. 975

Gastric digestion occurs as a result of?

Presence of HCL and rennin p. 965

Parachute (backward)?

Proective extension w/ arms when tilted backward p. 964

After delivery of placenta, how does milk begin to produce?

Progesterone drops, prolactin is released from anterior pituitary, prolactin stimulates production of acinar or alveolar cells of the breast, when infant sucks the nervous impluses stimulates milk p. 978

Parachute (sideways)

Protective extension w/ arms when tilted to the side in a supported sitting position p. 964

Technique to stop infant from feeding on nipple to avoid pulling infant off at breast and causing pain/dryness/cracking at nipple?

Put finger in babies mouth p. 978

PrepU The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look? Shifts a toy to his left hand and reaches for another. Picks up an object using his thumb and fingertips. Puts down a little ball to pick up a stuffed toy. Enjoys hitting a plastic bowl with a large spoon.

Puts down a little ball to pick up a stuffed toy. At 6 months of age, the child is able to put down one toy to pick up another. He will be able to shift a toy to his left hand to reach for another with his right hand by 7 months. He will pick up an object with his thumb and fingertips at 8 months, and he will enjoy hitting a plastic bowl with a large spoon at 9 months. Chapter 25: Growth and Development of the Newborn and Infant - Page 941-942

6m.o. fine motor skills?

Releases object in hand to take another p. 972

5m.o. gross motor skills?

Rolls from supine to prone and back again, sits upright when supported p. 968

Primitive reflexes?

Root, sucking, moro, asymmetric tonic neck, palmer grasp, plantar grasp, babinski, step p. 964

Infant car seats should be placed where until what age?

Should face the rear of car, secured tightly in center of back seat, should never be placed in front seat w/ air bag until infant is 12m.o. and weighs 9kg p. 976

4-5m how much communication does infant do?

Simple vowel sounds, laughs, performs "rasberries", vocalizes in response to voices, responds to name and "no" p. 972

7m.o. gross motor skills?

Sits alone w/ use of hands for support p. 968

12m.o. gross motor skills?

Sits from standing position, walks independently p. 968

8m.o. gross motor skills?

Sits unsupported p. 968

Which milestone would the nurse expect an infant to accomplish by 8 months of age? Sitting without support Creeping on all fours Pulling self to a standing position Being able to sit from a standing position

Sitting without support Physical development of infants occurs in a cephalocaudal fashion. That means they must learn to control and lift their heads first. This is followed by the ability to turn over. Once this occurs the remainder of development occurs quickly. Most infants are able to sit unsupported by 8 months. They are able to creep at 9 months and pull to a standing position by 10 months. At 12 months the infant is able to sit from a standing position and is learning to walk. Chapter 25: Growth and Development of the Newborn and Infant - Page 932

PrepU The nurse is assessing a 12-week-old infant in the clinic at a well-baby visit. Which assessment finding does the nurse predict to assess in this healthy infant? Able to sit up and roll over Smiles at significant others Grasps objects and brings them to the mouth Bears weight on legs when held in standing position

Smiles at significant others By 12 weeks of age the infant smiles at their mother and significant others. The other choices are seen in the infant who is about 20 weeks of age. Chapter 25: Growth and Development of the Newborn and Infant - Page 937

How to determine premature infants adjusted age?

Subtract number of weeks that infant was premature at from infants chronologic age. Ex: 6m.o born at 28weeks gestation was born 12 weeks early (3m), so subtract 3 from 6m to get adjusted age of 3m, therefor expected to achieve developmental milestones of a 3m.o. rather than 6m.o. p. 960

After mixing concentrate or powdered formula how long can it be stored for?

Tightly closed 48h p. 981

7m.o. fine motor skills?

Transfers object from one hand to the other p. 972

Enzymes in duodenum?

Trypsin is in sufficient amounts, amylase and lipase is deficient and do not reach adult levels until 5m p. 965

Fruit juice is recommended to be given when?

Until 6m and limited to 2-4oz/day p. 982

What teeth appear within 8-12m?

Upper and lower incisors p. 965

12m.o. communication style?

Uses 2-3 words w/ meaning, recognizes objects by name, imitates animal sounds p. 972

How is oxytocin released during breast feeding?

When baby sucks, oxytocin is released from post. pit. p 978

When should infant stool be a concern?

When it is red, white, black, mucus like, frequent or watery, frothy or foul smelling, hard/dry, formed, pellet like, baby is vomiting p. 965

PrepU Which assessment findings if noted in a 4-month-old infant would the nurse recognize as normal growth and development? holds head up when prone, bears partial weight on legs, reflexes are fading follows object past midline with eyes, keeps hands fisted, rolls over rolls over, grasp reflex fading, cooing sound uses palmer grasp, starts to make vowel sounds, reaches out

holds head up when prone, bears partial weight on legs, reflexes are fading At 4 months of age, the infant should be able to hold the head up when prone and bear partial weight on the legs; newborn reflexes are beginning to fade. The nurse should recognize these changes as normal growth and development. Chapter 25: Growth and Development of the Newborn and Infant - Page 932

PrepU The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:

refer the infant for developmental and/or neurologic evaluation. There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem. Chapter 25: Growth and Development of the Newborn and Infant - Page 932

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:

should have disappeared. This primitive (not protective) reflex should be present at birth and disappear around age 4 months. Chapter 25: Growth and Development of the Newborn and Infant - Page 925

5m.o. fine motor skills?

Grasps rattle p. 972

PrepU The nurse is interacting with several parents of infants. Which parent statement would alert the nurse to refer the infant for further evaluation by the health care provider? "My 2-week-old infant seems to prefer looking at designs that are black and white." "My 9-month-old infant is beginning to track objects when we show her favorite objects." "My 1-month-old infant's eyes occasionally cross and wander when looking at me." "My 3-month-old infant does not seem to be able to see things at a distance."

"My 9-month-old infant is beginning to track objects when we show her favorite objects." Infants should be tracking objects by 7 months of age, so an older infant who is just "beginning to track objects" would warrant further evaluation. The newborn shows preference for items with contrast, such as black and white stripes so this is a normal finding. The newborn's eyes may cross and wander and this is a normal finding for this age. Distance vision develops by 7 months of age, so a younger child would not be expected to have developed distance vision yet. Chapter 25: Growth and Development of the Newborn and Infant - Page 933

When does sucking disappear?

2-5m p. 962

RR in 12m.o. newborn?

20-30 w/ irregular and periodic pauses p. 961

When does second molars develop?

25-33m p. 965

Neck righting appears when?

4-6m p. 964

Avg amount of teeth by 12m?

4-8 teeth p. 965

Stepping disappears?

4-8w p. 964

Asymmetric tonic neck?

4m p. 962

When does moro disappear?

4m p. 962

How much does infant weight incrase by 1 yr?

50% p. 960

Newborn height avg at birth?

50cm (20in) p. 960

Parachute (forward) appears?

6-7m p. 964

First primary teeth develop when?

6-8m p. 965

Iron stores are available for how long?

6-9m but will become depleted throughout life and supplement is needed for first 15y of life p. 967

BP avg on newborn, then 1 y.o.?

60/40 at first then increases to 100/50 by 12m.o. p. 961

Parachute (sideways) appearance?

6m p. 964

Object permanence develops when?

7-8m p. 968

Newborn smell and taste?

7d.o. can smell differences of breast milk p. 970

RR takes how long until it reaches maturity?

7yrs p. 961

Newborns have how many stools a day?

8-10 or as few as 1-2 p. 965

Parachute (backward) appears?

9-10m p. 964

Lateral incisors occur within how long?

9-13m p. 965

Plantar grasp disappears?

9m p. 962

IgM production reaches maturity when?

9m p. 967

Newborn eyesight?

Nearsighted, 20-38cm (8-15in), can recognize sight of people by 1m, ability to fuse two ocular images into one cerebral picture (binocularity) begins to develop at 6w and well established by 4m, full color appears by 7m along w/ being able to track objects p. 970

Stomach capacity?

One-half to one oz p. 965

Mottling decreases over how long?

Over first few months of life p. 966

Parachute (forward)?

Protective extension w/ arms when held up in the air and moved forward, the infant reflexively reaches forward to catch themselve p. 964

10m.o. gross motor skills?

Pulls to stand Cruises p. 968

2m.o. gross motor skills?

Raises head and chest, holds position, improves head control p. 968

3m.o. gross motor skills?

Raises head to 45degree in prone, slight head lag in pull to sit p. 968

PrepU A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. What has the girl demonstrated? Secondary circular reaction Primary circular reaction Object permanence Binocular vision

Secondary circular reaction By the third month of life, a child enters a cognitive stage identified by Piaget as primary circular reaction. During this time, the infant explores objects by grasping them with the hands or by mouthing them. Infants appear to be unaware of what actions they can cause or what actions occur independently, however. At about 6 months of age infants pass into a stage Piaget called secondary circular reaction. Now when infants reach for an object, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again. By 10 months, infants discover object permanence. Infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when the follow moving objects with their eyes, although not past the midline. Chapter 25: Growth and Development of the Newborn and Infant - Page 931

The nurse is assessing the neurological status of a 10-month-old infant. Which finding(s) does the nurse determine to be abnormal when performing this assessment? Select all that apply. The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked. The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth. The infant reflexively grasps when the nurse touches the palm. The infant fans and extends the toes when the nurse strokes along the lateral aspect of the sole and across the plantar surface of the foot. With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C".

The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked. The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth. The infant reflexively grasps when the nurse touches the palm. With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C". The primitive reflexes (root, suck, palmar grasp, moro) should be absent by 10 months of age. A positive Babinski sign normally persists until 12 months of age so the presence of this sign would be considered a normal finding in the 10-month-old. Chapter 25: Growth and Development of the Newborn and Infant - Page 926