CHAPTER 29: NURSING CARE OF A FAMILY WITH AN INFANT
HVGFT WEIGHT BODY SYSTEMS
Birth weight Cardiovascular system
o Double by 4 to 6 months o Heart rate
o Triple by 1 year Slows from 110 to 160 beats per minute to 100 to
First 6 months of infants 120 beats per minute by the end of the first year.
o Average weight gain = 2 lb per month o The heart continues to occupy a little over half the
Second 6 months width of the chest.
o Weight gain is approximately 1 lb per month. o Pulse rate may slow with inhalation (sinus
Average weight of 1-year-olds arrhythmia), but does not become marked until
o Males = 10 kg (22 1b) preschool age.
o Femals = 9.5 kg (21 lb) o The heart is becoming more efficient
LENGTH Decreasing pulse rate
An infant increases in length during the 1st year by 50%, or Slightly elevated blood pressure (from an average
grows from the average birth length of 20 in. to about 30 of 80/40 to 100/60 mm Hg).
in. (50.8 to 76.2 cm). o Prone to develop physiologic anemia at 2 to 3 months.
Infant growth during the early months o Hemoglobin in an infant
o Most apparent in the trunk Totally converted from fetal to adult hemoglobin at
Infant growth during the second half of the 1st year 5 to 6 months of age.
o Becomes more apparent as lengthening of the legs occurs. o Decrease in serum iron levels at 6 to 9 months.
End of the 1st year Respiratory system
o The child's legs may still appear disproportionately o Respiratory rate of an infant
short, however, and perhaps bowed. Slows from 30 to 60 breaths per minute to 20 to
Measure infants lying supine on a measuring board even if 30 breaths per minute by the end of the first year.
they are beginning to be able to stand for accuracy. o Upper respiratory infections occur more often and tend
to be more severe than in adults.
HEAD CIRCUMFERENCE
Gastrointestinal system
End of the 1st year o Gastrointestinal tract
o The brain already reaches two-thirds of its adult size. Immature in its ability to digest food
Head circumference increases rapidly during the infant and mechanically move it along at birth.
period to reflect this rapid brain growth. They mature gradually during the infant year.
Some infants' heads appear asymmetric until the 2nd half of Amylase
the first year, especially if they are always placed on their back - For digestion of complex carbohydrates
to sleep (as recommended), causing the skull bones to flatten - Decreased until approx. the 3rd month
in the back. Lipase
o Place infant on their back for sleep but spend - For digestion of saturated fat
"tummy time" daily with infant placed in a prone - Decreased during entire 1st year
position to prevent this flattening. Liver of an infant
o This early head distortion will gradually correct itself as o Immature
the child sleeps less and spends more time with the o Until age 3 or 4 months, an extrusion reflex (food placed
head in an erect position. on an infant's tongue is thrust forward and out of the
o Persistence of asymmetry = not receiving mouth) prevents some infants from eating effectively if
enough stimulation. they are offered solid food this early (not
BODY PROPORTION recommended).
By the end of the infant period, the lower jaw is o Newborns can drink from a cup as long as a
definitely prominent and remains that way throughout parent controls the fluid flow.
life. o An infant can independently drink from a cup by age 8
Chest circumference or 10 months.
o Generally, less than that of the head at birth by about Kidneys of an infant
2 cm. o Immature and not as efficient as eliminating body
o It is even with the head circumference in some infants wastes as in an adult.
as early as 6 months and in most by 12 months. Endocrine system
o The abdomen remains protuberant until the child o Particularly immature in response to pituitary
has been walking well into the toddler period. stimulation, such as adrenocorticotropic hormone, or
Cervical, thoracic, and lumbar vertebral curves insulin production from the pancreas.
o Develop as infants hold up their head, sit, and walk. Without these hormones functioning effectively,
Lengthening of lower extremities during the last 6 months an infant may not be able to respond to stress as
of infancy effectively as an adult may.
o Readies the child for walking and often is the final Immune system of an infant
growth that changes the appearance from "baby-like" to o Functional at least 2 months of age;
"toddler-like." o Can actively produce both immunoglobulin (Ig)G and
IgM antibodies by 1 year.
o The levels of other Igs (IgA, IgE, and IgD) are not
plentiful until preschool age.
, CHAPTER 29: NURSING CARE OF A FAMILY WITH AN INFANT
Ability to adjust to cold of their body, a major advance in muscle control.
o Matures by age 6 months.
By this age, an infant can shiver in response to
cold (which increases muscle activity and provides
warmth) and has developed additional adipose tissue to
serve as insulation.
o The amount of brown fat, which protected the newborn
from cold, decreases during the first year as subcutaneous fat
increases.
Extracellular fluid
o 35% of an infant's body weight (20% in adults)
Intracellular fluid
o 40% by the end of the first year (40% in adults)
o This proportional difference increases an infant's
susceptibility to dehydration from illnesses, such
as
diarrhea, because loss of extracellular fluid could result in loss
of over a third of an infant's body fluid.
TEETH
The first baby tooth (typically, a central incisor) usually
erupts at age 6 months, followed by a new tooth monthly
until all 20 deciduous (baby) teeth have erupted by age 2 to 3
years.
However, teething patterns can vary greatly among children.
o Some newborns (about one in 2,000) may be born with
teeth (natal teeth) or have teeth erupt in the first 4
weeks of life (neonatal teeth).
o The lower central incisors are the teeth most
frequently involved in this early growth.
They may be membranous and may be
reabsorbed (supernumerary or extra teeth).
If they are loosely attached, they are usually
removed before they loosen spontaneously and are
aspirated by the infant.
In most infants, natal or neonatal teeth are deciduous or
are fixed firmly.
o Should not be removed because no other teeth will
grow to replace them until the permanent teeth erupt at
age 6 or 7 years.
o Deciduous teeth are essential for allowing proper
growth of the dental arch.
MOTOR DEVELOPMENT
An average infant progresses through systematic motor
growth during the first year, strongly reflecting the principles of
cephalocaudal (head to toe) and gross-to-fine motor
development.
Control proceeds from head to trunk to lower extremities in
a progressive, predictable sequence.
To assess motor development, both gross motor
development (ability to accomplish large body movements)
and fine motor development, measured by observing or
testing prehensile
ability (ability to coordinate hand movements), are evaluated.
GROSS MOTOR DEVELOPMENT
VENTRAL SUSPENSION POSITION
Refers to an infant's appearance when held in midair on a
horizontal plane and supported by a hand under the
abdomen
In this position, the newborn allows the head to hang
down with little effort at control.
1 month – lift their head momentarily and then drop it again.
2 months – hold their head in the same plane as the rest
HVGFT WEIGHT BODY SYSTEMS
Birth weight Cardiovascular system
o Double by 4 to 6 months o Heart rate
o Triple by 1 year Slows from 110 to 160 beats per minute to 100 to
First 6 months of infants 120 beats per minute by the end of the first year.
o Average weight gain = 2 lb per month o The heart continues to occupy a little over half the
Second 6 months width of the chest.
o Weight gain is approximately 1 lb per month. o Pulse rate may slow with inhalation (sinus
Average weight of 1-year-olds arrhythmia), but does not become marked until
o Males = 10 kg (22 1b) preschool age.
o Femals = 9.5 kg (21 lb) o The heart is becoming more efficient
LENGTH Decreasing pulse rate
An infant increases in length during the 1st year by 50%, or Slightly elevated blood pressure (from an average
grows from the average birth length of 20 in. to about 30 of 80/40 to 100/60 mm Hg).
in. (50.8 to 76.2 cm). o Prone to develop physiologic anemia at 2 to 3 months.
Infant growth during the early months o Hemoglobin in an infant
o Most apparent in the trunk Totally converted from fetal to adult hemoglobin at
Infant growth during the second half of the 1st year 5 to 6 months of age.
o Becomes more apparent as lengthening of the legs occurs. o Decrease in serum iron levels at 6 to 9 months.
End of the 1st year Respiratory system
o The child's legs may still appear disproportionately o Respiratory rate of an infant
short, however, and perhaps bowed. Slows from 30 to 60 breaths per minute to 20 to
Measure infants lying supine on a measuring board even if 30 breaths per minute by the end of the first year.
they are beginning to be able to stand for accuracy. o Upper respiratory infections occur more often and tend
to be more severe than in adults.
HEAD CIRCUMFERENCE
Gastrointestinal system
End of the 1st year o Gastrointestinal tract
o The brain already reaches two-thirds of its adult size. Immature in its ability to digest food
Head circumference increases rapidly during the infant and mechanically move it along at birth.
period to reflect this rapid brain growth. They mature gradually during the infant year.
Some infants' heads appear asymmetric until the 2nd half of Amylase
the first year, especially if they are always placed on their back - For digestion of complex carbohydrates
to sleep (as recommended), causing the skull bones to flatten - Decreased until approx. the 3rd month
in the back. Lipase
o Place infant on their back for sleep but spend - For digestion of saturated fat
"tummy time" daily with infant placed in a prone - Decreased during entire 1st year
position to prevent this flattening. Liver of an infant
o This early head distortion will gradually correct itself as o Immature
the child sleeps less and spends more time with the o Until age 3 or 4 months, an extrusion reflex (food placed
head in an erect position. on an infant's tongue is thrust forward and out of the
o Persistence of asymmetry = not receiving mouth) prevents some infants from eating effectively if
enough stimulation. they are offered solid food this early (not
BODY PROPORTION recommended).
By the end of the infant period, the lower jaw is o Newborns can drink from a cup as long as a
definitely prominent and remains that way throughout parent controls the fluid flow.
life. o An infant can independently drink from a cup by age 8
Chest circumference or 10 months.
o Generally, less than that of the head at birth by about Kidneys of an infant
2 cm. o Immature and not as efficient as eliminating body
o It is even with the head circumference in some infants wastes as in an adult.
as early as 6 months and in most by 12 months. Endocrine system
o The abdomen remains protuberant until the child o Particularly immature in response to pituitary
has been walking well into the toddler period. stimulation, such as adrenocorticotropic hormone, or
Cervical, thoracic, and lumbar vertebral curves insulin production from the pancreas.
o Develop as infants hold up their head, sit, and walk. Without these hormones functioning effectively,
Lengthening of lower extremities during the last 6 months an infant may not be able to respond to stress as
of infancy effectively as an adult may.
o Readies the child for walking and often is the final Immune system of an infant
growth that changes the appearance from "baby-like" to o Functional at least 2 months of age;
"toddler-like." o Can actively produce both immunoglobulin (Ig)G and
IgM antibodies by 1 year.
o The levels of other Igs (IgA, IgE, and IgD) are not
plentiful until preschool age.
, CHAPTER 29: NURSING CARE OF A FAMILY WITH AN INFANT
Ability to adjust to cold of their body, a major advance in muscle control.
o Matures by age 6 months.
By this age, an infant can shiver in response to
cold (which increases muscle activity and provides
warmth) and has developed additional adipose tissue to
serve as insulation.
o The amount of brown fat, which protected the newborn
from cold, decreases during the first year as subcutaneous fat
increases.
Extracellular fluid
o 35% of an infant's body weight (20% in adults)
Intracellular fluid
o 40% by the end of the first year (40% in adults)
o This proportional difference increases an infant's
susceptibility to dehydration from illnesses, such
as
diarrhea, because loss of extracellular fluid could result in loss
of over a third of an infant's body fluid.
TEETH
The first baby tooth (typically, a central incisor) usually
erupts at age 6 months, followed by a new tooth monthly
until all 20 deciduous (baby) teeth have erupted by age 2 to 3
years.
However, teething patterns can vary greatly among children.
o Some newborns (about one in 2,000) may be born with
teeth (natal teeth) or have teeth erupt in the first 4
weeks of life (neonatal teeth).
o The lower central incisors are the teeth most
frequently involved in this early growth.
They may be membranous and may be
reabsorbed (supernumerary or extra teeth).
If they are loosely attached, they are usually
removed before they loosen spontaneously and are
aspirated by the infant.
In most infants, natal or neonatal teeth are deciduous or
are fixed firmly.
o Should not be removed because no other teeth will
grow to replace them until the permanent teeth erupt at
age 6 or 7 years.
o Deciduous teeth are essential for allowing proper
growth of the dental arch.
MOTOR DEVELOPMENT
An average infant progresses through systematic motor
growth during the first year, strongly reflecting the principles of
cephalocaudal (head to toe) and gross-to-fine motor
development.
Control proceeds from head to trunk to lower extremities in
a progressive, predictable sequence.
To assess motor development, both gross motor
development (ability to accomplish large body movements)
and fine motor development, measured by observing or
testing prehensile
ability (ability to coordinate hand movements), are evaluated.
GROSS MOTOR DEVELOPMENT
VENTRAL SUSPENSION POSITION
Refers to an infant's appearance when held in midair on a
horizontal plane and supported by a hand under the
abdomen
In this position, the newborn allows the head to hang
down with little effort at control.
1 month – lift their head momentarily and then drop it again.
2 months – hold their head in the same plane as the rest
