NURSING IMPLICATIONS
Note presence or absence of age-appropriate responses during each
interaction with infant and parent; report and fully assess any signs of
developmental delay.
If visual fixation and following are not present by 4 months, refer for
evaluation of sight.
Observe parent–child interaction and note signs of minimal or absent
bonding that might require nursing intervention; report possible signs
of abuse.
Support infant–parent/caregiver bond by having caregiver serve as a
source of comfort for infant during procedures.
Avoid placing caregiver as participant in painful or distressing care
procedures.
Provide bottle, cup, then finger foods, as appropriate, to encourage pro-
gressive independence in feeding as ability to feed self increases.
Remove small objects from infant’s reach because curiosity places infant
in danger of blockages due to small objects being obtained and inserted,
swallowed, or inhaled.
Note and report respiratory distress or difficulty swallowing immedi-
ately because these may be a sign of obstructed airway or blocked
esophagus.
Keep infants dressed and covered to avoid exposure to drafts and cold
environment.
Exercise caution and close supervision as mobility increases to avoid
injury from falls and traffic accidents (upon return to home).
Monitor length and weight to detect malnutrition and plan diets with
adequate fat, carbohydrate and protein; watch for other signs of protein-
calorie deficiency (marasmus or kwashiorkor).
Remove all poisons from infant’s reach and teach family poison control
measures.EARLY CHILDHOOD (PRESCHOOL)
Marked by increasing self-sufficiency and preparation for school.
Age range:2 to 5 years (up to 6 years)Physical Milestones
Slower, more stable physical growth noted.
Weight gain of 5 pounds per year and 2- to 3-inch height gain may be
noted.
More slender body build than noted with toddler with erect posture.
Organ systems adapt to stress to a moderate degree.5(^18) Pediatric Nursing Demystified