prenatal period to 1 year chapter 6. what are the two main factors that influence growth and...
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Prenatal Period to 1 year
Chapter 6
What are the two main factors that influence growth and
development?A. Stress and FamilyB. Environment and StressC. Environment and HeredityD. Heredity and Gender
Heredity: Zygote formation
• Sperm + ovum – Zygote –23 chromosomes
Heredity: Zygote formation
• Gender–X & Y
Chromosomes• Ovum –Always X
• Sperm –X or Y
Dominant & Recessive Genes
Dominant• Capable of expressing traits
over other genes
Recessive• Traits only appear if they
exist in pairs
Karyotyping: Eye ColorB = Brown b = blue
MOM
DADB b
B BB BbB BB Bb• MOM has brown
eyes but has recessive blue gene. • Bb
• Dad has brown eyes with no recessive gene. • BB
• All the kids would have brown eyes
Punnett Square
Karyotyping: Eye ColorB = Brown b = blue
MOM
DADB b
B BB Bbb Bb bb• MOM has brown
eyes but has recessive blue gene. • Bb
• Dad has brown eyes with a recessive blue gene. • Bb
• ¾ kids would have brown eyes.
Punnett Square
Karyotyping: Eye ColorB = Brown b = blue
MOM
DADb b
B Bb Bbb bb bb• MOM has blue
eyes• bb
• Dad has brown eyes with a recessive blue gene. • Bb
• ¾ kids would have brown eyes.
Punnett Square
Recessive disorders
• >700 recessive gene diseases– Sickle-cell disease– Tay-Sachs disease– Hemophilia
Environment
• “From the moment life begins, the environment begins to exercise its influence on the newly formed entity.”
For you personally, when does life begin?
A. ConceptionB. ImplantationC. When there is a heart beatD. When the fetus is viable if it was bornE. When the baby is born
Environment:Healthy Pregnancy
• Rest • Exercise
What is the best form of exercise for a pregnant women?
A. BicyclingB. WalkingC. SwimmingD. JoggingE. Kick-boxing
Teratogens
• Tobacco– i birth weight– Growth restrictions
Teratogens
• Alcohol– *1st trimester– Fetal Alcohol Syndrome
(FAS)– Miscarriages– Growth restriction– CNS damage
Teratogens
• Bacteria, viruses–Rubella
What is the estimated length of human pregnancy?
A. 28 weeksB. 38 weeksC. 40 weeksD. 42 weeksE. 48 weeks
Physical Characteristics
Neonate
• Apgar score–Activity–Pulse–Grimace–Appearance–Respiration
What is the highest score a neonate can get on a Apgar score?
A. 2B. 3C. 10D. 12E. 15
Head & Skull
• Head ¼ of total body length
Skull
• 6 bones• Separated by cartilage– Sutures
• Fontanels –Anterior–Posterior
Which fontanel is smaller?
A. AnteriorB. Posterior
When does the posterior fontanel “close” by?
A. 2 monthsB. 4 monthsC. 6 monthsD. 8 monthsE. 12 months or more
When does the anterior fontanel usually “close” by?
A. 6 monthsB. 12 monthsC. 18 monthsD. 2 yearsE. 3 years
What is the normal lengths of a full-term neonate?
A. 12 inchesB. 18 inchesC. 20 inchesD. 24 inchesE. 36 inches
How much does a normal infant grow in the first year?
A. ½ inch a monthB. 1 inch a month C. 1 ½ inch a monthD. 2 inch a monthE. 2 ½ inch a month
Normal Physiological Weight Loss. How much weight on average does a neonate loss in the first few days of
life?A. 5-10 % of birth weightB. 15-20% of birth weightC. 25 – 30% of birth weightD. There is no such thing as normal physiological
weight loss in a neonate
Skin
• Acrocyanosis• Pigmentation
Mongolian Spot
• Usually fads by…– Age 4 years
• 6 month old
Lanugo
Vernix Cascosa
Milia
Physiological Jaundice
What causes physiological jaundice?
A. High RBC count in newbornsB. Increased RBC destruction after birthC. High bilirubin levelsD. All of the aboveE. None of the above
Genitals
• Breasts–Swollen
• Scrotum–Large
Pseudomenstruation
• Blood-tinged vaginal discharge
What is the cause of most genital physiological anomalies in newborns?
A.High / elevated maternal hormone levels
B. High / elevated paternal hormone levels
C. High / elevated neonate hormone levels
Cryptorchidism
• Undescended testicle/s
Cryptorchidism
• h risk of – Testicular CA– Infertility
Genital
• Circumcision
What STD causes blindness in newborns?
A.SyphilisB. HIVC. GonorrheaD.ChlamydiaE. Herpes
Face
• Eye– Erythromycin– Silver nitrate
When do baby teeth start to come in?
A. 2 monthsB. 4 monthsC. 6 monthsD. 8 monthsE. 12 months
Deciduous teeth
Which teeth normally erupt first?
A. Two lower central incisors
B. Two upper central incisors
C. Two lower lateral incisors
D. Two upper lateral incisors
By age 12 months the baby will have 6-8 teeth
Abdomen
• Umbilical cord– Falls off
• When?• 10 days
– What should the baby not do / have until the umbilical cord “falls off”• No tub bath
Why do you have to “burp” the neonate?
• Cardiac sphincter– Under-developed
Bowel movement
• Meconium– Green-black
Bowel movement, Stool or Feces
Formula Fed• Pasty yellow or tan• Odor
Breastfed• Mustard seed color• Sweet odor
Why is a newborn not given cows milk (whole milk) to drink?
A. Cows milk does not have the necessary vitamins and minerals for a newborn human
B. Cows milk is too complex for a newborn to metabolize
C. Cows milk contains protozoans that are harmful to infants
D. What are you talking about – it’s OK to give a newborn cows milk.
Extremities
• Finger / foot prints
Gluteal fold asymmetry
• Is an indication of…– Congenital hip dysplasia
Neurological CharacteristicsProtective reflexes
• Blinking• Sneezing• Swallowing• Gag
Moro / Startle Reflex
• Sudden movement Extension & Abduction of extremities
• http://www.youtube.com/watch?v=PTz-iVI2mf4
Tonic Neck Reflex
• Turn head to one side extend arm and leg on that side
• http://www.youtube.com/watch?v=XMCw7IKN0xI
Rooting reflex
• Stroke cheek enfant turns toward that side and open mouth
Sucking Reflex
• Sucking movement when anything touches their lips
Babinski
• When sole is stroked
• hyper-extended of the toes
Palmar grasp
• Grasp anything placed in hand
Spinal Bifida
Vision
• Newborn– Primitive– Nystagmus
Vision
• An infant's vision isn't as sharp as an adults until children are about 3 years
Hearing
• 6 wks– Recognize mom and turn
to respond
• 1 year– ID sounds and source
Vital Signs - Newborn
• Temp– Initially
• low
• Pulse– 120 – 160 / min
• Resp– 30 – 60 / min
Gross motor skills
• 2 months– Control head
• 4 months– Sit w/ support
• 6 months – Roll
• 8 months– Sits alone
• 10 months– Creep
• 11 months– Pulls self up
• 12 months– walks
Fine motor skills
• Neonate– Grasp reflex
• 5 months– Purposeful reaching
• 6 months– Hold bottle
• 7 months– Hand preference– Pincer grasp
• 9– Cup– Spoon
• 12 months– Scribble– Tower – two blocks
Psychosocial Development: What theorist are we going to discuss?
A. FreudB. EriksonC. PaigetD. KohlbergE. Maslow
What stage of psychosocial development is a neonate?
A. Autonomy vs shame & doubtB. Trust vs mistrustC. Initiative vs guiltD. Industry vs inferiorityE. Identity vs role confusion
Parent-child relationship
Attachment Engrossment
Parent guidance / discipline
• 0-6 months– Distraction
• 6-12 months– Direct
Moral Development
• Neonate–No conscience–100% ID
Cognitive development: Who’s theory are we going to be applying?
A. FreudB. EriksonC. PaigetD. KohlbergE. Maslow
What stage of cognitive development is an infant?
A. PreoperationalB. Concrete operationalC. SensorimotorD. Formal operational
Communication: What “name” or word to baby’s say first (usually)
A. MaMaB. DaDa
Communication
• Birth– Crying
• 2 months– Smile
• 4-6 months– Babbling
• 8 months– Dada
• 10 months– Mama
• 12 months– 4-6 words
Nutrition
Breastfeeding• Colostrum– immunoglobulins
Bottle feeding
Sleep & Rest
Neonate• 20 hours/day
1 year• 12 hours / day
Play
• Non-symbolic• Solitary
Safety: Aspiration
Shaken Baby Syndrome
Burns
Drowning
• Bathtub never alone
Falls
Poisoning
MVA
• Read facing car seat • 12 months