Prenatal Period to 1 year Chapter 6. What are the two main factors that influence growth and...

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