Chapter 25: Growth and Development of the Newborn and Infant

The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents? Select all that apply. "I plan on encouraging my son to cook with me when he is old enough so that he will enjoy a variety of foods and learn how to cook too." "Food is so expensive. I can't afford for my child to leave any food on the plate." "I have tried at least 10 times with every green vegetable and I can't get my son to like them." "I try to eat healthy in front of my daughter so she will hopefully pick up good eating habits." "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up."

"Food is so expensive. I can't afford for my child to leave any food on the plate." "I have tried at least 10 times with every green vegetable and I can't get my son to like them." "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up." Encouraging children to eat everything on their plate can lead to overeating and obesity. Children may need to be exposed to new food at least 20 times before determining if they like it or not. Letting a child eat whatever he wants does not lead to good choices as the child matures.

The mother of a 11-month-old has come to the clinic with concerns. She reports to the nurse that her baby's "soft spot in the front" is now gone. The nurse assesses the infant and notes the fontanel (fontanelle) has closed. What response by the nurse is most appropriate? "The soft spot or fontanel has closed." "We will need to do additional neurological testing to make certain your infant is developing normally." "This closure of the fontanel (fontanelle) is very premature and warrants some further testing." "This may signal your baby's calcium levels are elevated."

"The soft spot or fontanel has closed." The anterior fontanel (fontanelle) traditionally closes between 12 and 18 months. In some infants, this may close sooner. This does not indicate there is any abnormality in the development of the infant.

The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother? "You could occasionally give your baby a bottle of water at bedtime." "Giving a bottle of milk when the infant goes to bed can lead to obesity." "Bottles given at bedtime can cause erosion of the enamel on the teeth." "Giving your baby a pacifier at bedtime will satisfy the need to suck."

"Bottles given at bedtime can cause erosion of the enamel on the teeth." The sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable and a pacifier will satisfy the sucking need, the most appropriate response is to warn of possible enamel erosion. Giving a bottle at bedtime is not a factor that leads to obesity.

The mother of a 6-week-old infant reports she doesn't know if her child recognizes her face yet. What response by the nurse is most appropriate? "Since about 4 weeks of age your child has been able to recognize those who are around him often." "Don't worry. He knows you are his mother." "Recognition of this type begins around 8 weeks of age." "Recognition of faces and voices will come with time."

"Since about 4 weeks of age your child has been able to recognize those who are around him often." At 1 month of age the infant can recognize by sight the people he or she knows best. Telling the child's mother that this will come with time is not correct as this developmental milestone has already occurred. Telling her not to worry minimizes her questions and concerns.

The postpartum nurse observes new mothers as they put their newborns in the bassinet to sleep. Which actions by the new mothers require further instruction from the nurse? Select all that apply. A mother states all of her children like sleeping on their abdomen and this newborn likes it too. A mother tells her husband to be sure to place the newborn on his back when putting the baby in the bassinet. A mother places the baby comforter her grandmother made over the newborn's body. A mother places her newborn on its side after falling asleep. A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off.

A mother states all of her children like sleeping on their abdomen and this newborn likes it too. A mother places the baby comforter her grandmother made over the newborn's body. A mother places her newborn on its side after falling asleep. A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off. Newborns and infants should be on their backs when sleeping in order to help prevent sudden infant death syndrome (SIDS). A firm mattress without pillows or comforters should also be used. The baby's bed should be placed away from air conditioner vents, open windows, and open heaters.

The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective? The parent places the child in time-out and explains the reason for the time-out The parent spanks the child while taking the child into another room away from the dog The parent allows the child to continue pulling at the dog and states, "If the dog bites her she will learn." The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog

The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog Providing a safe environment, redirection away from undesirable behaviors, and saying "no" in appropriate instances are effective forms of discipline for an infant's developmental level. Infants are at an increased risk for injury from spanking and do not understand the reason for the spanking. Infants do not understand time-outs or the reason for this type of discipline.

The English-speaking nurse is assessing a 12-month-old child with an English-speaking father and a Spanish-speaking mother. The child does not use words like "drink" "dog" or "ball." What is the nurse's priority intervention? asking the mother if the child uses Spanish words for those items referring the child to a developmental specialist to rule out developmental delay performing a developmental evaluation of the child encouraging the parents to speak only one language to the child

asking the mother if the child uses Spanish words for those items Infants in bilingual families may use some words from each language. Therefore, the priority intervention in this situation would be to ask the mother if the child uses Spanish words. There is not enough evidence to warrant performing a developmental evaluation or referring the child to a developmental specialist. Encouraging the parents to speak only one language to the child is unnecessary if the child is progressing with both.

The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response? when weaning is complete as soon as the first tooth erupts by 12 months of age as soon as the infant begins to eat fruit

as soon as the first tooth erupts Before tooth eruption occurs, parents should clean the infant's gums after feeding with a damp wash cloth. After the first tooth erupts, parents can use a soft bristle tooth brush. Dental hygiene should be part of the infant's everyday care. The American and Canadian Dental Associations recommend the first dental checkup to occur around 1 year of age. Infants should not go to bed with bottles or sippy cups to prevent dental caries.

The nurse is teaching the parents of a 9-month-old infant about proper dental care. Which statement by the parents most concerns the nurse? "We use a fluoridated toothpaste to brush our infant's teeth." "We prefer to use a cloth instead of a brush for cleaning the teeth and gums." "Our infant goes to sleep at night with a bottle of milk or juice." "We only brush our infant's teeth twice a day."

"Our infant goes to sleep at night with a bottle of milk or juice." The nurse will warn against putting the infant to bed with a bottle of milk or juice because this allows the sugar content of these fluids to pool around the infant's teeth at night, leading to early childhood caries (baby bottle syndrome). It is best to clean the teeth after every feeding, but brushing twice a day is sufficient. Using a cloth instead of a brush for cleaning teeth when they erupt will have minimal impact on the development of dental caries. The American Academy of Pediatrics recommends cleaning the teeth with fluoridated toothpaste. The amount should be limited to a smear or the size of a grain of rice until the child is able to spit (around 3 years of age).

A parent asks the nurse if the 2-month-old infant can have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which response? "Sure, if you feel your infant is ready to have bananas." "In 1 month you can try bananas if you think your infant is ready." "You can try bananas 2 or 3 months from now." "When did you feed your other child bananas?

"You can try bananas 2 or 3 months from now." The nurse will educate the parent to wait 2 to 3 months, because solid foods are not recommended for infants at 2 months of age. The age of 4 to 6 months is when it is recommended to introduce solid foods. In 1 month, the infant will be only 3 month of age. The other responses will not help the parent determine the appropriate answer.

A mother asks the nurse where the microwave is so that she can warm up breast milk to feed her baby. What is the best response by the nurse? "Make sure that you test the milk on your wrist before feeding." "You should warm the milk under warm water instead." "You should only give fresh breast milk to an infant." "Breast milk can be given cold, so there is no need to heat it."

"You should warm the milk under warm water instead." A microwave can heat unevenly and cause burns and therefore should never be used to heat breast milk or formula for an infant. In addition, it can change the immune properties of the breast milk.

The parent of 1-week-old infant voices concerns about the infant's weight loss since birth. At birth the infant weighed 7 lb (3.2 kg); the infant currently weighs 6 lb 5 oz (2.9 kg). Which response by the nurse is most appropriate? "Your infant has lost too much weight and may need to be hospitalized." "All infants lose a substantial amount of weight after birth." "Your infant has lost a bit more than the normal amount." "Your infant's weight loss is within the expected range."

"Your infant's weight loss is within the expected range." The normal newborn may lose up to 10% of birth weight. This infant has lost 9.1%. This degree of weight loss will likely not require hospitalization. Expressing to the parent that the infant may be hospitalized is rash and will most likely not occur.

The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months? 13 lb (5900 g) 15 lb 4 oz (6920 g) 10 lb 8 oz (4760 g) 19 lb 8 oz (8825 g)

19 lb 8 oz (8825 g) The average newborn weighs 7.5 lb (3400 g). The average newborn loses 10% of birth weight over the first week of life but regains it in about 10 to 14 days. Most infants double their birth weight by 4 to 6 months of age and triple their birth weight by the time they are 1 year old. If the newborn weighed 6 lb 8 oz (2,950 g) at birth and tripled that weight at 12 months, the infant should weigh 19 lb 8 oz (6.5 lb × 3 = 19.5 lb) or 8825 g.

The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit? 16 lb (7.2 kg) and 26 inches (65 cm) 28 pounds (12.7 kg) and 32 inches (80 cm) 24 pounds (10.8 kg) and 30 inches (75 cm) 20 lb (9.1 kg) and 28 inches (70 cm)

24 pounds (10.8 kg) and 30 inches (75 cm) By 1 year of age, the infant should have tripled his or her birth weight and grown 10 to 12 inches (25 to 30 cm). If this infant was 8 pounds (3.6 kg) at birth, at 1 year, this child should weigh 24 pounds (8 x 3 = 24) and grown to 30 to 32 inches (20 + 10 to 12 = 30 to 32 inches). Most of the growing occurs during the first 6 months with the infant's birth weight doubling and height increasing about 6 inches (15 cm). Growth slows slightly during the second 6 months but is still rapid.

What is the correct amount of wet diapers a mature infant should produce each day? An infant should have 9 to 10 wet diapers/day. An infant should have 3 to 5 wet diapers/day. An infant should have 6 to 8 wet diapers/day. An infant should have 1 to 2 wet diapers/day.

An infant should have 6 to 8 wet diapers/day. Urination occurs in the first 24 hours of life. A normal amount of urine is 200 to 300 ml/day as the infant matures. This amount is equal to 6 to 8 wet diapers/day. The infant should have an intake of between 140 to 160 ml/kg/day to be well hydrated and nourished. This amount of intake will produce the 6 to 8 diapers/day.

The nurse is assessing a 6-month-old infant in the clinic. Which characteristic represents normal language development for this age? Laughing out loud Producing noises when spoken to Cooing Babbling

Babbling Cooing begins in the first 4 weeks of life, productions of noises when spoken to and laughing out loud are seen later than 6 months of age. Infants begin to babble around 6 months of age.

When performing neurological reflexes on the infant, which primitive reflex will be present longest? Babinski step rooting Moro

Babinski Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski. Except for the Babinski, which disappears around 1 year of age, these primitive reflexes diminish over the first few months of life, giving way to protective reflexes

The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent? Bath time provides an opportunity for play Infants need a daily bath Soap lubricates and oils an infant's skin Never use soap on an infant's hair

Bath time provides an opportunity for play The work of children is play. Play provides a natural way for the infant to learn. In early infancy infants prefer their parents rather than toys. Parents can talk and sing to infants during feeding, bathing, and changing diapers. Infants do not need a daily bath as long as the diaper area is washed with diaper changes. Soap is actually drying to an infant's skin. Washing the hair with soap can help remove excess oil.

A new mother tells the nurse that she a bought car seat for her infant at a garage sale when she was pregnant but that a friend recently told her that she should buy a new one. Which instruction would the nurse give initially? Inspect the car seat for any cracks or damage. Check the expiration date on the car seat. Have the car seat installed by a professional. Clean all fabric that touches the infant.

Check the expiration date on the car seat. Initially, the nurse would instruct the client to check the car seat for an expiration date. Expiration dates are now placed on all car seats. The seat identifies when the seat was manufactured. Expiration dates allow for routine updates. If the expiration date had expired, the nurse would instruct the client to discard the car seat. The other options would be considered if the expiration date was in the future.

The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula? Iron Vitamin D Vitamin E Calcium

Iron Infants who are fed home-prepared formulas (based on evaporated milk) need supplemental vitamin C and iron. Evaporated milk has adequate amounts of vitamin D, which is unaffected by heat used in the preparation of formula. Calcium and vitamin E would not be a concern in this infant's formula.

The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability? Most infants sit steadily at 4 months; this infant is normal. Sitting ability and the age of first tooth eruption are correlated. Most infants do not sit steadily until 8 months; this infant is normal. Most infants sit steadily at 3 months; this infant is slightly delayed.

Most infants do not sit steadily until 8 months; this infant is normal. At 3 months of age the infant should be able to raise the head about 45 degrees when in the prone position. The infant does yet have the developmental skills for sitting. Most infants are unable to sit steadily until 8 months of age. Gross motor skill development does not correlate with tooth eruption. The nurse should reassure the parent that this infant is on tract developmentally.

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client? Baby Child Newborn Infant

Newborn A more accurate term for this child would be newborn rather than infant because the newborn or neonatal period of infancy is defined as the period from birth until 28 days of age. Infancy is the period of time up to 1 year old. Child and baby don't refer to the client's age accurately.

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention? Describe the capacity of a 5-week-old infant's stomach. Offer assurance that spitting up is normal. Observe the mother while she feeds and burps her infant. Recommend the mother offer smaller and more frequent feedings.

Observe the mother while she feeds and burps her infant. Assessing the mother's feeding and burping technique is the first nursing action needed. The mother may be overfeeding or inadequately burping the child. Recommending smaller and more frequent feedings would be determined by the assessment. Assuring the mother that some spitting up is normal and describing the capacity of the infant's stomach is helpful information but not the priority.

What feeding practice used by the parents of an 8-month-old should the nurse discourage? Including the infant at family meals in her high chair. Continuing to offer foods the child rejects. Placing all liquids given the child in a "no spill" sippy cup. Giving the child soft table food and finger foods.

Placing all liquids given the child in a "no spill" sippy cup. No-spill sippy cups promote sucking rather than teach cup drinking. Reserve these for times when avoiding spills is a must. The other feeding practices are age appropriate and safe. Soft table food and finger foods promote accepting new textures and self-feeding. Reoffering rejected food allows the child to accept it when ready. Including the infant at the family table provides for modeling of eating behaviors and socialization.

Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? Appropriately enunciate words when speaking to the infant. Respond promptly when the infant cries. Read age-appropriate books to the infant daily. Praise the infant when a new milestone is reached.

Respond promptly when the infant cries. The developmental task of the infant year, according to Erikson, is to gain a sense of trust. This can be accomplished by promptly meeting the infant's needs during the first year of life. If the infant does not learn to trust, mistrust will develop. Praising will help meet the future developmental tasks of the child. Reading books and appropriately enunciating words will aid in the infant's language development.

The nurse is conducting a physical examination of an 8-month-old infant. Which observation may be cause for concern about the infant's neurologic development? The infant displays an asymmetric tonic neck reflex (fencing reflex). The infant grasps a finger when it is placed in the palm. The infant's toes hyperextend when the bottom of the foot is stroked. The anterior fontanel (fontanelle) is open and easily palpated.

The infant displays an asymmetric tonic neck reflex (fencing reflex). The tonic neck reflex normally disappears by between 4 and 7 months, the palmar grasp reflex by between 3 and 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) between 12 and 24 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel (fontanelle), which remains open for brain growth, closes between 12 and 18 months of age.

The nurse in a community clinic is assessing a 2-month-old infant. The parent asks if the infant is developing normally. The nurse refers to which finding as suggestive of normal development in infants from birth to 2 months of age? The infant raises head and chest while on stomach. The infant stays seated in the tripod position. The infant transfers objects from one hand to the other. The infant laughs aloud and responds to name.

The infant raises head and chest while on stomach. Infants have gained some neck control and can independently raise head and chest by 2 months of age. Transferring objects from one hand to another is expected at 7 months of age. Laughing aloud and responding to his or her name is expected between 4 to 5 months of age. Sitting in the tripod position is not expected until 6 months of age.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? The child has a regular, scheduled bedtime. They sing to her before she goes to sleep. They put her to bed when she falls asleep. If she is safe, they lie her down and leave.

They put her to bed when she falls asleep. If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices.

A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: looking for a toy in her crib at the last place she saw it. smiling at herself in the mirror. pushing a spoon from her high chair tray to the floor. shaking a rattle to enjoy the sound.

looking for a toy in her crib at the last place she saw it. Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant's behaviors show use of her senses and motor activity but do not illustrate object permanence.

A parent calls the clinic nurse asking for a recommendation on comfort measures for the infant who is teething. What recommendation will the nurse make? warm compress hard candy teething ring ice chips

teething ring The nurse will recommend a teething ring that can be refrigerated. The parent also may rub the infant's gums with a cold, not warm, compress. Hard candy and ice chips pose a choking hazard for the infant.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines: the child weighs the expected amount for age. the weight assessment is blatantly inaccurate. the child weighs less than expected for age. the child weighs more than expected for age.

the child weighs less than expected for age. Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11250 g). The child is underweight for age.

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that: the best feeding schedule offers food every 4 to 6 hours. the newborn's stomach can hold between 0.5 oz and 1 oz. demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night. most newborns need to eat about 4 times per day.

the newborn's stomach can hold between 0.5 oz and 1 oz. The capacity of the normal newborn's stomach is between 0.5 oz and 1 oz. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1.5 to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.

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 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 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) 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.

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

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? 1 to 2 lower teeth 1 to 3 natal teeth 1 upper tooth no teeth

no teeth Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.

Parents of a newborn ask the nurse how to select a daycare facility that will limit the spread of germs for their newborn. Which response by the nurse is most useful? "Check if the facility allows older children to enter the newborn room, this can place your newborn at high risk." "Ask parents of current children at the facility how often their children are sick to get an estimate of exposure." "Ask staff if they perform regular handwashing between child interactions and diaper changes." "Ask the staff if they clean toys with a bleach cleaner at the end of each day."

"Ask staff if they perform regular handwashing between child interactions and diaper changes." The nurse discusses with the parents the importance of a safe, competent daycare provider. The parents should watch for proper hand hygiene, which is the best way to prevent the spread of bacteria and viruses. It is recommended to clean toys with a bleach solution at least once a day, but is best if they are cleaned properly between children. Exposing newborns to older children does increase the risk of infection; however, handwashing is priority. It is not probable to base practices at a facility on how often select children are sick. The children can be exposed to bacteria and viruses at any location.

The parents of an 8-month-old boy voice concern to the nurse that their child is not developing motor skills as he should. What question would be appropriate for the nurse to ask in determining if their fears are warranted? "Does he move a toy back and forth from one hand to the other when you give it to him?" "Does he place toys into a box or container and take them out?" "Is he able to drink with a cup by himself?" "Is he able to hold a pencil and scribble on paper?"

"Does he move a toy back and forth from one hand to the other when you give it to him?" Transferring an object from one hand to the other is expected at 7 months of age, so this would be expected of an 8-month-old. The other options are not expected until later months, so questioning the parents about these skills would not help in determining if he was at the motor skill developmental level that should be expected.

The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding? "I can expect my infant to become clingy around strangers within the next month." "I can expect my infant to laugh out loud within the next month." "I can expect my infant to be able to raise the head up when on the stomach within the next month." "I can expect my infant to be able to hold a rattle within the next month."

"I can expect my infant to be able to raise the head up when on the stomach within the next month." It is expected that a 3-month-old infant can raise the head to 45 degrees while laying on the stomach. Becoming clingy around strangers occurs in the infant around 6 to 8 months of age. The infant can begin to hold a rattle around 5 months of age. At 4 to 5 months, the infant will typically begin to laugh out loud.

A client who is breastfeeding asks the nurse if she can give the newborn a pacifier. Which nursing response is most appropriate? "This decision should be made by you and your partner based on your personal preferences." "I know a lot of people who breastfed and also gave their newborns a pacifier." "I will request the lactation consultant come talk to you about pacifier usage while breastfeeding." "It is recommended to wait until breastfeeding is well-established before introducing a pacifier."

"It is recommended to wait until breastfeeding is well-established before introducing a pacifier." It is recommended to wait to introduce a pacifier once breastfeeding is well-established, which can take about 1 month. This is to limit nipple confusion and promote an adequate milk supply. Stating other people have done this does not provide education to the client, nor does it address this specific client's situation. While the decision is up to the newborn's parents, this response does not address the client's concern. Requesting a lactation consultant come does not address the client at this moment. The nurse can provide education now, and also request the consultant for follow-up information.

The nurse goes in to check on a new mother to see how breastfeeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse? "Maybe you should watch the breastfeeding video again." "You are doing a wonderful job attempting to wake the baby." "That is not how you get him to eat." "You will never get him to eat all unwrapped like that."

"You are doing a wonderful job attempting to wake the baby." The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment.

A newborn requires skin care that includes bathing. Besides hygiene, what is another reason for bathing the newborn? Bathing is a time for bonding with the parents. Bathing can prevent infection. Bathing helps moisten the skin. Bathing is a great time to apply lotion.

Bathing is a time for bonding with the parents. The parents can use bath time for bonding with their newborn. This can be done with talking, cooing, and singing. Bath time should be slow-paced and nonstressful. Newborns prefer interacting with parents over toys and they love to watch people's faces. Bathing can help prevent infection, but it is a secondary response. Using soaps on the skin tends to dry the skin, not moisten it. After bathing, lotion can be applied. It is soothing to the baby and keeps the skin softened.

Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone? be able to turn over onto the back develop a fear of strangers insist on things being done the infant's way have many "blue" or moody periods

be able to turn over onto the back At four months of age, the infant is able to lift the head and look around. The infant can roll from prone to supine. When being pulled up, the head leads. The 4-month-old infant can make simple vowel sounds, laugh aloud, and vocalize in response to voices. A fear of strangers does not occur until the child is older; a 4-month-old infant has not developed emotionally to have "moody" periods and is dependent on parental care.

Which activity is most beneficial in the development of the newborn? laying on his back with a mobile overhead being sung to by his mother placement in an infant swing in a position to allow observation of the family's activities listening to classical music

being sung to by his mother Interaction between the newborn and his parents is the most beneficial activity. Later, toys and music may have a good influence but initially the parental interaction is best.

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. conclude the earlier assessments carried out fatigued the infant. consider this a normal response for the age. suggest more awake tummy time for the child.

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.

The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? "Increases in body size are referred to as growth." "Both growth and development are influenced by heredity." "Development refers to the increase in skills the child demonstrates as they grow and age." "Maturation refers to the child's increases in body size."

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

After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur? "I will place my infant on the back to sleep every night." "By keeping the room at a neutral temperature, I do not have to use blankets." "I have a crib in my room so that I can breastfeed my baby." "My husband gave the baby a special bear that I will place in the crib."

"My husband gave the baby a special bear that I will place in the crib." The nurse should reinforce that stuffed animals, blankets, pillows, and soft mattresses are suffocation hazards for infants.

The mother of an infant questions the nurse about her baby's teething. The nurse provides client education. Which statement by the mother indicates understanding of the information provided? "My baby's first tooth will likely appear between 5 and 6 months." "My baby will most likely have his upper middle teeth come in first." "The first teeth that will likely appear are the lower incisors." "By 1 year my baby should have about three teeth."

"The first teeth that will likely appear are the lower incisors." Teeth will begin erupting between 6 and 8 months. Traditionally, the first teeth to erupt will be the lower incisors, followed by the upper incisors. By the age of 12 months, the infant will have between 4 and 8 teeth, if progressing normally.

A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan? Keep all pots and pans in lower cabinets. Give warm bottles of formula to the baby. Lock all cabinets that contain cleaning supplies. Restrain the baby in a car seat.

Restrain the baby in a car seat. The client should restrain the baby in a car seat when driving. Infants are especially vulnerable to injuries resulting from falls from changing tables or being unrestrained in automobiles. Locking the cabinets and giving warm bottles of formula to the baby are secondary teachings.

The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply. The infant babbles. The infant is unable string together 2 word sentences. The infant seems disinterested in the surrounding environment. The infant has frequent episodes of crossed eyes. The infant does not pay attention to noises behind him.

The infant seems disinterested in the surrounding environment. The infant has frequent episodes of crossed eyes. The infant does not pay attention to noises behind him. Warning signs that may indicate problems with sensory development include the following: young infant does not respond to loud noises; child does not focus on a near object; infant does not start to make sounds or babble by 4 months of age; infant does not turn to locate sound at age 4 months; infant crosses eyes most of the time at age 6 months. Language development at this stage of development does not include stringing together 2-word sentences.

The nurse is reviewing the medical record of an infant who is being seen for the 12-month well-child visit. Which finding(s) is normal for this infant? Select all that apply. temperature 100.6°F (38.1°C) infant has moderate head lag heart rate 101 beats/min infant walks independently respiratory rate 28 breaths/min

infant walks independently heart rate 101 beats/min respiratory rate 28 breaths/min The respiratory rate slows from an average of 30 to 60 breaths/min in the newborn to about 20 to 30 breaths/min in the 12-month-old infant. As the cardiovascular system matures, the average pulse rate decreases from 120 to 140 beats/min in the newborn to about 100 beats/min in the 12-month-old infant. Walking independently often occurs at 12 months of age. Head lag should not be present in a 12-month-old infant (usually not present by 4 months of age). A temperature of 100.6°F (38.1°C) is abnormal and could indicate an infection.

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond? "Sure, you can do whatever you want, it is your baby." "The baby can sleep in your room in an infant crib, but not in an adult bed." "Sure you can, but make sure you use a soft mattress for support." "Bed sharing is okay, just make sure the infant is between two people."

"The baby can sleep in your room in an infant crib, but not in an adult bed." According to the 2016 recommendation by the American Academy of Pediatrics, infants should sleep in the same bedroom as the parents, but on a separate firm surface, such as a crib or bassinet, and never on a couch, armchair or adult bed, to decrease the risks of sleep-related deaths.

During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse? "Maybe she just knows your voice better than your mother's." "Babies really can't tell the difference between people at that age." "I'm not sure a 4-week-old infant can tell their mother from another woman's smell." "You may be right, since infants can sense their mother's smell as early as 7 days old."

"You may be right, since infants can sense their mother's smell as early as 7 days old." The sense of smell develops rapidly: the 7-day-old infant can differentiate the smell of his or her mother's breast milk from that of another woman and will preferentially turn toward the mother's smell.

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate? "Your baby's stomach is small and can only hold about 0.5 to 1 oz at birth." "It is too soon to determine a milk intolerance." "Babies do not each much." "You need to make certain to burp him more frequently."

"Your baby's stomach is small and can only hold about 0.5 to 1 oz at birth." At the time of birth, an infant's stomach can only hold 0.5 to 1 oz ounce. This will gradually increase. While it is true that the infant does not eat much, this does not meet the educational needs of the mother and is not the best response. Burping is a part of normal newborn feeding practices but is not the best response. There is no indication there is a milk intolerance from the information reported.

The nurse in a community clinic is caring for a 6-month-old infant and parent. Which nursing intervention is priority? encouraging a more frequent feeding schedule monitoring the infant's weight and height obtaining the infant's current feeding pattern recommending higher-calorie solid foods

monitoring the infant's weight and height Monitoring the infant's weight and height is the priority intervention. Ongoing assessments of growth are important so that too-rapid or inadequate growth can be identified early. With early identification, the cause can be diagnosed and the potential for further appropriate growth maximized. Encouraging a more frequent feeding schedule, obtaining the infant's current feeding pattern, and recommending higher-calorie solid foods are interventions that would be used should assessment show that the client's nutrition level does not meet body requirements.

A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse? "Delays are normal when a child is premature." "You should talk with the doctor about getting your son tested." "All children mature and develop at different rates so it is unwise to compare them in this way." "We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old."

"Delays are normal when a child is premature." When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. To determine adjusted age, subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age. Delays will not necessarily be resolved by the age of 6 months. While the mother should talk with the physician about concerns, this is not the best initial response by the nurse.