Chapter 31: The infant and family

Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake?

Be persistent through 10 to 15 minutes of food refusal

During a home visit, the parents report to the nurse that they are worried about their 3-year-old child's behavior. The child lacks discipline and writes on the walls. Which nursing advice would be helpful for the parents for limiting the child's behavior?

"Instruct the child to stand in play yard for some time."

A 4-month-old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention?

"When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall."

At what age should the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning?

10 months

The primary health care provider (PHP) prescribed HepB (Recombivax HB) vaccine for a child. Which question should the nurse ask the child's parents to ensure it is safe to administer the vaccine? "Does your child have a history of:

Being hypersensitive to yeast?"

The nurse is teaching nursing students about vaccine administration. Which statement made by the nursing student indicates effective learning?

A 16-mm (5/8-inch) length needle is used to administer the vaccine to newborns."

The nurse is educating a group of parents about the dental health for infants. Which statement made by the parent indicates effective learning?

A damp cloth can be used to wipe the child's teeth.

Which characteristic of fine motor skills does the nurse expect to find in a 5-month-old infant?

Able to grasp object voluntarily

The nurse is caring for an infant who has an iron deficiency. The primary health care provider (PHP) has prescribed oral iron supplements to the infant. What instruction should the nurse give to the infant's parents for the safe administration of the supplement?

Administer the medication in between meals

What are the primary goals in the nutritional management of children with failure to thrive (FTT)?

Allow for catch-up growth Correct nutritional deficiencies Achieve ideal weight for height Restore optimum body composition Educate the parents or primary caregivers on child's nutritional requirements

Which developmental changes are observed in a 5-month-old infant?

Birth weight has doubled. There are signs of tooth eruption.

The nurse advises the parents of a 2-year-old child to vaccinate their child with the influenza vaccine (inactivated influenza vaccine [IIV]). The child's parents ask the nurse, "My child had the same vaccine last year. Why does my child need another one?" Which response should the nurse give to the child's parent?

Different strains of influenza are used to manufacture the vaccine each year

which activities are indicative of the teething process in an infant?

Infant rubbing on the gums Infant biting on hard objects Increased sucking on fingers

A mother observes that her 7-month-old infant bears full weight on the feet when held in a standing position. What is the reason for this?

It indicates that the child's growth and development is normal.

An 8-month-old infant is able to pick up pieces of food. The parent is impressed with this skill and tells the nurse about it. What does the nurse tell to the infant's parent about this behavior?

It is a pincer grasp, which is expected at this age

The nurse is assessing a 5-month-old infant. Which behavior does the nurse observe in the infant?

Picking up a toy and putting it into the mouth

A 4-month-old infant is scheduled for heart surgery. Which nursing action is most appropriate to follow 2 hours before the surgery?

Place a pacifier in the infant's mouth to suck

The nurse is providing education to a parent of a 10-month-old infant receiving iron supplements. What will be included in the teaching?

Place iron toward the back side of the mouth with a dropper Caution parents not to switch to a low-iron-containing formula or milk

The nursing student asks the senior nurse, "Which are the suitable play items for an 8-month-old infant?" Which suitable play items does the nurse suggest to the nursing student?

Textured book Stuffed animal Hanging mobile

The nurse assesses that the infant has difficulty breathing, decreased heart rate, change in skin color, and an ill-looking appearance. What should be the first nursing intervention in this situation?

Rub the trunk gently to wake the child

The nurse is interviewing the parents of a 4-month-old male infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. They say he was "just fine" when they put him in his crib already asleep. The nurse should suspect his death was caused by:

Sudden infant death syndrome (SIDS)

Which fine motor activity does the nurse observe in a 6-month-old infant?

The infant can hold a milk bottle.

The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. What is the nurse's best reply?

There is no need to restrain nonnutritive sucking during infancy.

Transferring objects between both hands Which normal findings (age and developmentally appropriate) does the nurse find during the assessment of a 5-month-old child? .

Tooth eruption Babinski reflex Doubling of birth weight

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is breastfeeding exclusively. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant?

Vitamin D

The nurse is assessing a 4-month-old infant. Which reflex should the nurse expect to find in the infant?

drooling

Which normal finding does the nurse expect to find when assessing an 8-month-old infant?

eruption of the lower central incisors

which symptoms does the nurse expect to find in the teething infant?

irritability drooling

A parent of an 8-month-old infant tells the nurse that the baby cries and screams whenever he or she is left with the grandparents. The nurse's reply should be based on knowledge that:

it's normal

Which fine motor activity can be observed in a 4-month-old infant?

playing with a rattle

The parents of a 6-month-old infant report to the nurse that the infant is not sleeping properly and is refusing to eat solid foods. The infant is also biting on hard objects and sucking his fingers continuously. What should the nurse interpret from these symptoms?

the child shows signs of teething

While assessing an infant, the nurse notices a typical bald spot, a symmetric distortion of the skull, and torticollis. What should the nurse interpret from this assessment?

the infant has positional plagicephaly

Which fine motor activity is likely to be observed in a 7-month-old infant?

transferring objects between both hands

The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of:

trust

The nurse is teaching a group of parents about therapeutic management for preventing plagiocephaly in the infant. What instructions should the nurse give to the parents?

"Alternate the infant's head position." "Place the infant prone when awake." "Use a protective helmet for the infant."

The nursing student who is posted in the pediatric unit asks the nurse, "which behaviors would be expected in 8-month-old infants?" Which appropriate answers does the nurse state to the nursing student?

"Can play peek-a-boo." "Exhibits stranger anxiety." "Can stand by holding furniture."

A 6-month-old infant's parent asks the nurse, "What is the best alternative to breastfeeding?" What appropriate response should the nurse give to the infant's parents?

"Commercial iron-fortified formula is an alternative."

The nurse is educating a group of parents about safety promotion and injury prevention in the infant. Which statements made by a parent indicates effective teaching?

"Diaper pins should be kept away from the child." "The floor should be clean where the child crawls." "A smoke detector should be installed in the home."

The parents of a 7-month-old infant report to the nurse that the solid food they feed to the baby passes through the gastrointestinal tract unchanged. Which response of the nurse would help to relieve the parent's anxiety?

"It is a normal finding at this age."

The parent of a 12-month-old infant says to the nurse, "He pushes the teaspoon right out of my hand when I feed him. I can't let him feed himself; he makes too much of a mess." What is the nurse's best response?

"Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable."

The nurse should provide further teaching about sudden infant death syndrome (SIDS) prevention when hearing the mother of an 8-week-old make which statement?

"I only smoke in the kitchen." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."

As the nurse is assessing an infant, the nurse notices that the teeth are erupting and the infant's skin color is bluish. After assessing oxygenation, the nurse reviews the laboratory report and finds that the infant has methemoglobinemia. What would be the probable reason for this?

Application of topical anesthetics

Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. When teaching the parents about the infant's care, what is the most important information the nurse should include in the discharge teaching plan?

CPR (cardiopulmonary resuscitation)

The mother of a 3-month-old breastfed infant asks about giving her baby water because it is summer and very warm. What should the nurse recommend?

Fluids in addition to breast milk are not needed.

The most appropriate recommendation for relief of teething pain is to instruct the parents to do what?

Give child a cold teething ring to relieve inflammation

An infant's parent reports to the nurse that the infant is very irritable, has difficulty sleeping, and refuses to eat solid foods due to teething. What nursing interventions should the nurse include in the plan of care to make the infant comfortable?

Give ibuprofen (Advil) to the infant

Which activity of a 10-month-old infant indicates the development of object permanence?

Looking for a hidden object that the infant had seen earlier

The nurse has prepared feeding guidelines for an infant with failure to thrive (FTT). The nurse instructs the student nurse to feed the infant. Which guidelines should the nurse explain to the student nurse before feeding?

Provide a quiet, unstimulating atmosphere to the infant continue to talk to the infant while providing the feeding maintain a calm, even temperament throughout the meal

the exhausted parents of a 2-month-old infant with colic ask the nurse what is the best method to promote comfort and sleep for the infant. What is the nurse's initial action?

Take a thorough, detailed history of usual daily events

Cooper is an 8-year-old who is very excited about attending Lacrosse camp this summer. His mother has received registration forms along with a request for a physical examination and recommendations to have all immunizations up to date. The nurse is preparing the examination room for Cooper's visit and is responsible for administering the necessary boosters. Using the chart below, determine which catch-up doses Cooper will need. He is not considered high risk.

TdaP MMR Varicella Hepatitis B

The nurse is educating a group of mothers about expressing breast milk for feeding the infant. Which statement made by the parents indicates the need for further teaching?

The expressed breast milk should be heated in a microwave before feeding my baby.

Which activity does the nurse expect to observe in a 4-month-old infant?

The infant grasps an object by using both hands.

During the assessment of a 12-month-old infant, the nurse finds that the infant's head and chest circumference are equal, the length of the infant has increased by 50% since birth, and the weight is triple that of the birth weight. What does the nurse interpret from these findings?

The infant has normal development

The health care provider has prescribed a liquid iron supplement for an infant with iron deficiency. What advice does the nurse give to the parents to prevent the infant's teeth from staining from the liquid iron supplement?

Use a dropper toward the back of the mouth

The nurse is caring for a 2-month-old infant with the flu. The infant is crying due to colicky pain. The nurse tries to soothe the infant, but the infant continues to cry. What does the nurse do in this situation?

Walk with the infant's face down and with the body across a parent's arm

The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. what should the nurse recognize is true?

a developmental/neurologic evaluation is needed

A 3-month-old bottle-fed infant is allergic to cow's milk. What is the nurse's best option for a substitute?

casein hydrolysate milk formula.

The nurse is assessing a 12-month-old child during a well-child visit. The nurse notices that the child's birth weight has tripled, birth length is increased by 50%, head and chest circumference are equal, and the child has six deciduous teeth. What does the nurse conclude the child has from these findings?

normal development

The nurse is assessing a 9-month-old infant. Which type of play should the nurse suggest to the infant's parents?

peekaboo pat-a-cake