Which toys would the nurse suggest to the parent of a 4 month old infant to help promote the childs growth?

Typical 4-month-old infants are expected to develop certain physical and mental skills. These skills are called milestones.

All children develop a little differently. If you are concerned about your child's development, talk to your child's health care provider.

PHYSICAL AND MOTOR SKILLS

The typical 4-month-old baby should:

• Slow in weight gain to about 20 grams (almost two thirds of an ounce) per day
• Weigh 2 times more than their birth weight
• Have almost no head droop while in a sitting position
• Be able to sit straight if propped up
• Raise head 90 degrees when placed on stomach
• Be able to roll from front to back
• Hold and let go of an object
• Play with a rattle when it's placed in their hands, but won't be able to pick it up if dropped
• Be able to grasp a rattle with both hands
• Be able to place objects in the mouth
• Sleep 9 to 10 hours at night with 2 naps during the day (total of 14 to 16 hours per day)

SENSORY AND COGNITIVE SKILLS

A 4-month-old baby is expected to:

• Have well-established close vision
• Increase eye contact with parents and others
• Have beginning hand-eye coordination
• Be able to coo
• Be able to laugh out loud
• Anticipate feeding when able to see a bottle (if bottle-fed)
• Begin to show memory
• Demand attention by fussing
• Recognize parent's voice or touch

PLAY

You can encourage development through play:

• Place the baby in front of a mirror.
• Provide bright-colored toys to hold.
• Repeat sounds the infant makes.
• Help the infant roll over.
• Use an infant swing at the park if the baby has head control.
• Play on the stomach (tummy time).

Normal childhood growth milestones - 4 months; Childhood growth milestones - 4 months; Growth milestones for children - 4 months; Well child - 4 months

American Academy of Pediatrics website. Recommendations for preventive pediatric health care. www.aap.org/en-us/Documents/periodicity_schedule.pdf. Updated March 2020. Accessed January 14, 2021.

Marcdante KJ, Kliegman RM. Normal development. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 7.

Onigbanjo MT, Feigelman S. The first year. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 22.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

A mother calls the pediatrician’s office because her infant is “colicky.” What is the most helpful measure the nurse can suggest to the mother?

Rock the fussy infant slowly and gently.
One technique the nurse can offer parents of a fussy infant is to rock the infant gently and slowly while being careful to avoid sudden movements.

When does the posterior fontanelle close?

2 to 3 months
The posterior fontanelle closes between 2 and 3 months of age.

At what age does an infant’s birth weight triple?

1 year
The infant usually triples his or her birth weight by about 12 months of age.

What is the earliest age at which an infant is able to sit steadily alone?

8 months
The infant can sit alone without support at about 8 months of age.

What is the earliest age at which the infant should be able to walk independently?

12 to 15 months
For the majority of children, the milestone of walking alone is achieved between 12 and 15 months.

The parent of a 3-month-old infant asks the nurse, “At what age do infants usually begin drinking from a cup?” What is the nurse’s most accurate response?

5 months
The infant can usually drink from a cup when it is offered at about 5 months.

What would the nurse expect a 4-month-old to be able to accomplish?

Lift head and shoulders.
Because development is cephalocaudal, of these choices, lifting the head and shoulders is the one that the infant learns to do first. The infant can usually sit with support at about 5 months of age and can sit alone at about 8 months.

What is an abnormal finding in an evaluation of growth and development for a 6-month-old infant?

Head lag present
The infant should be holding the head up well by 5 months of age. If head lag is present at 6 months, the child should undergo further evaluation.

A parent brings a 6-month-old infant to the pediatric clinic for her well-baby examination. Her birth weight was 8 pounds, 2 ounces. What will the nurse weighing the infant today would expect her weight to be?

At least 16 pounds
Birth weight is usually doubled by 6 months of age.

What will the nurse advise a parent to do when introducing solid foods?

Introduce each new food 4 to 7 days apart
Only one new food is offered in a 4- to 7-day period to determine tolerance.

The nurse is talking with a parent about tooth eruption. What teeth will the nurse explain are the first deciduous teeth to erupt?

Lower central incisors
The first teeth to erupt, usually at about 7 months, are the lower central incisors.

The nurse is assessing development in a 9-month-old infant. What would the nurse expect to observe?

Creeping along the floor
The 9-month-old tries to creep, has developed pincer movement, and can grasp a spoon without keeping food on it.

What statement made by a parent indicates correct understanding of infant feeding?

“I give the baby any new foods before he takes his bottle.”
New solid foods should be introduced before formula or breast milk to encourage the infant to try new foods.

A mother is concerned because her 10-month-old is lethargic. What is the best action the nurse can advise this mother to implement?

Handle the infant slowly and gently.
Some infants respond to stimulating environments by shutting down. Move and handle infants slowly and gently.

The nurse discusses child-proofing the home for safety with the mother of a 9-month-old. Which statement made by the mother would indicate an unsafe behavior?

“In the car, she rides in a front-facing car seat.”
A rear-facing infant car seat should be used for infants younger than 1 year of age

The nurse observes a 10-month-old infant using her index finger and thumb to pick up pieces of cereal. What does this behavior indicate the infant has developed?

The pincer grasp
By 1 year, the pincer-grasp coordination of index finger and thumb is well established.

A parent is concerned because her infant has a diaper rash. What is the best action the nurse would advise the parent to implement?

Apply a protective ointment on the area.
A protective ointment can be applied when the skin in the diaper area appears pink and irritated.

The mother of an infant born prematurely tells the nurse, “The baby is irritable. She cries during diaper changes and feedings. Can you make some suggestions about what I should do to soothe her?” What is the most appropriate recommendation to help this parent?

Wrap the infant snugly when you hold them.
A strategy that may be helpful is to swaddle the infant snugly in a light blanket with extremities flexed and hands near the face

What is the most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1-year-old?

Play with push-pull toys.
Push-pull toys are appropriate to promote sensorimotor stimulation for a 1-year-old child.

Which statement indicates the mother of an 8-month-old understands infant sleep patterns?

“I put the pacifier in the crib so that she can find it when she wakes up.”
The parent should assist the infant to develop self-soothing behaviors so that the infant can get back to sleep on her own.

How might the nurse demonstrate the parachute reflex with an infant?

Thrusting the infant downward into the crib
The infant, when thrust downward in a prone position, will protectively extend the arms.

Parents of a 6-month-old infant ask the nurse why it is necessary to offer iron-rich formula to their child. What is the correct response?

“The infant has exhausted maternal iron stores.”
Many pediatricians recommend iron-fortified formulas because maternal iron stores decrease by 6 months of age.

The nurse is assessing a 1-year-old infant in the pediatric office. What finding should the nurse report to the physician immediately?

Respiratory rate of 60 breaths per minute
Respirations of a 1-year-old should be 20 to 40 breaths per minute. Increased respiratory rate can lead to distress and should be reported immediately

A new mother is voicing concern she is breastfeeding her newborn too frequently. How often does the nurse instruct this mother she should expect her newborn to feed?

Every 2 to 3 hours
Breastfed infants may require feedings at 2- to 3-hour intervals because breast milk is more easily digested.

The nurse cautions that children who have unmet hunger needs will likely display which characteristic(s)? (Select all that apply.)

-Irritability
-Ineffective feeding patterns
-No predictable sleep-wake cycle
-Distrust

The nurse is preparing to outline principles of discipline for parents of an infant. What information should the nurse include? (Select all that apply.)

-Firmly say “No.”
-Distract the child to another activity.
-Remain consistent.

What should the teaching plan include about infant fall precautions? (Select all that apply.)

-Remove all unsteady furniture
-Keep crib rails up and in locked position.
-Steady infant with hand when on changing table.
-Keep infant seat on the floor.

The nurse is aware that the 7-month-old can signal feeding readiness by which action(s)? (Select all that apply.)

-Pulling spoon toward mouth
-Manipulating finger foods

The nurse is educating parents of a 2-month-old about immunizations. What immunizations against illness should their child receive? (Select all that apply.)

-Pertussis (whooping cough)
-Influenza
-Diptheria
-Tetanus
-Polio

What will the nurse take into consideration when educating parents regarding infant nutrition? (Select all that apply.)

-Cultural practices
-Parental knowledge
-Infant’s developmental level
-Parent-child interaction

Parents of an infant inform the nurse they are planning home preparation of solid foods. What directions should the nurse provide? (Select all that apply.)

-Puree food in electric blender.
-Add sugar sparingly.

The nurse explains that the second process of self-mobility an infant learns is seen at the age of 9 months, when the infant begins to ___________.

Creep
At 7 months the infant begins to crawl, using arms and dragging trunk and legs. At 9 months the infant begins to creep, holding his or her trunk above the floor. The next self-mobility activity is cruising, where the child walks from one piece of furniture to the next before it begins to walk independently.

The nurse cautions parents to place their infant in the ______________ position, rather than on his or her stomach, to reduce the risk of sudden infant death syndrome (SIDS).

Supine
The supine or side-lying position has been found to reduce possible aspiration and is believed to reduce the risk of SIDS.

______________ is characterized by periods of unexplained irritability and crying in a healthy, well-fed infant.

Colic
Colic is characterized by periods of unexplained irritability and crying in a healthy, well-fed infant.

What toys should a nurse suggest to the parent of a 4

Which toys would the nurse suggest to the parent of a 4 month infant to help promote the child's growth and development?

Which toy is appropriate for an infant?

Which of the following abilities would a nurse expect a 4