1.

Make a health teaching plan for infants, toddlers, preschoolers, schoolers, and adolescents based on the following: GENERAL HEALTH TEACHING 1. INFANT a. NUTRITION SPECIFIC HEALTH TEACHING ( 5 or more for each item) a. First 6 months 1. Feed only breast milk or formula for first year. 2. Always hold infant when feeding and never propping bottle when feeding. 3. Limit water intake to 1 oz to 1 oz at a time. 4. Avoid use of honey or corn syrup. 5. Allow non-nutritive sucking 6. Introduce solid foods without added salt or sugar and ironfortified cereal, one food at a time. 7. Avoid use of juice or sweetened drinks. 8. Feed from a spoon only. b. Second 6 months 1. Introduce finger foods and cup when infant is able to sit up. 2. Have infant join family at mealtimes. 3. Allow self-feeding, with observation to prevent choking. 4. Offer fluids after solids. 5. Introduce limited amounts of diluted juice in a cup. 6. Avoid sugary desserts and soda. 7. Offer 3 meals and healthy snacks. 8. Begin to wean from bottle and begin table foods. 9. Avoid fruit drinks and flavored milk. 10. Allow infant to feed self with spoon. c. Selection and Preparation of Solid Foods/Quantities & Types of Food 1. Calorie allowances can be gradually reduced during the year from a level of 120 per kilogram of body weight at birth to approximately 100 per kilogram of

2.

3.

4.

5.

body weight at the end of the first year to prevent babies from becoming overweight. The first food generally given to infants is infant cereal fortified with B vitamins and iron. Initially, cereal should be mixed with enough fluid to make the mixture fairly liquid. As an infant adjusts to eating food from a spoon, parents can gradually thicken it. Adding sugar to cereal is unnecessary. Extra sugar in the diet can lead to diarrhea in young infants and beginning caries in older infants. Usually, it is offered twice a day, morning and evening. Once the child has taken rice cereal for 1 week, parents can try another kind. Some parents mix cereal with an infant's formula and give it to the child from a bottle. Caution parents to avoid this practice because (a) it is necessary to cut a larger hole in the bottle nipple for the cereal and milk mixture to flow freely, and there is a danger an infant may aspirate if the hole cut is too big; (b) there is a real danger of aspiration if the parent then uses that nipple for formula without cereal added; and (c) it denies the child the opportunity of learning to eat from a spoon and experiencing different food tastes and textures. Simply cook a vegetable and then blend or strain it so it does not have to be chewed. Caution parents not to add butter or salt to the preparation, because infants have difficulty digesting fats until almost the end of the first year, and the added salt is unnecessary. Additional sugar is also unnecessary. By filling icecube trays with the blended

vegetables, parents can make a 1weeksupply and defrost a cube at a time. An ice cube is approximately 1 oz, or one-fourth the size of a jar of baby food. 6. Fruits can be given in addition to cereal for breakfast and dinner. Raw mashed banana is easy to prepare with just a fork; peaches are easily prepared in a blender. 7. Parents can grind a portion of the meat they have prepared for their own meal so it is tender, or they can use commercially prepared products. Beef and pork have more iron than chicken, so encourage parents to offer these more frequently than chicken. When meat is added to an infant's diet, it is usually added as part of the evening meal in place of cereal. 8. Eggs may be prepared by hard boiling (then adding a little formula or breast milk to the mashed yolk to make it more liquid) or purchased as commercial baby food. Soft-boiling or poaching is not usually recommended, because salmonella, the chief offending microorganism that may be in eggs, may not be killed by these methods. Also, thorough cooking makes protein easier to digest. 9. Encourage parents to establish a three-meal-a-day pattern, if that is the family's lifestyle, and to have an infant join the family at the table. 10. If hot dogs are offered, caution parents to cut them into small bite size portions; otherwise, they can be aspirated. As infants begin teething, they enjoy dried bread, teething biscuits, or zwieback. d. Introduction of Solid foods 1. Teach parents to offer new foods

one at a time and allow a child to eat that item for about 1 week before introducing another new food. This system helps parents to detect possible food allergy. 2. It is best for the first solid food feeding if an infant is held in the parent's arms as if for bottlefeeding or breast-feeding. This reduces the newness of the experience and minimizes the amount of stress associated with it. 3. The first food generally given to infants is infant cereal fortified with B vitamins and iron at around 5-6 months of age because it aids in preventing iron-deficiency anemia; the least allergenic type of food; and an easily digested food. 4. Because their iron content is generally higher than that of fruits, vegetables are usually the second food added to the diet (at approximately 7 months of age). This is also a good source of vitamin A; adds new texture and flavors to diet. 5. Fruit is usually offered 1 month after beginning vegetables (at approximately age 8 months). It is a best source of vitamin C, good source of vitamin A; and adds new texture and flavors to diet. 6. Meat is usually introduced at 9 months. They are a good source of protein, iron, and B vitamins. 7. Egg yolks are offered by 10 months of age and are a good source of iron. e. Weaning 1. The sucking reflex begins to diminish in intensity between ages 6 and 9 months, which makes this the time to consider weaning. 2. To wean from formula or breast milk, the mother chooses one feeding a day and then begins

f.

offering fluid by the new method at that feeding. She should choose a time of day that is not an infant's fussy period; other than that, the time is immaterial. 3. After 3 days to 1 week, when an infant has become acclimated to the one change, the mother changes a second feeding. 4. Should an illness such as an upper respiratory infection occur or should the child have teething discomfort, there will be setbacks, so no set number of weeks should be prescribed to complete weaning. 5. Infants usually need more fluid during hot weather than cold weather because of increased perspiration. This may make it more difficult to begin weaning during the summer. Self-feeding 1. At approximately 6 months of age, infants become interested in handling a spoon and beginning to feed them. Their coordination, unfortunately, has not developed enough for them to use a spoon without a great deal of spilling, so they are much more adept at feeding themselves with their fingers. 2. Parents concerned with neatness can spread newspapers, a plastic tablecloth, or a towel on the floor around a highchair to catch most of the dropped food, and then let the child practice. 3. When an infant becomes fatigued or frustrated by attempts at selffeeding, a parent can then quietly help without making an issue of it. 4. Parents who insist on continuing to spoon-feed past the time an infant wants to feed him or herself can cause an infant to balk at eating. 5. If a parent gives an infant a spoon,

b. SLEEP AND ACTIVITY

the child can poke at a cereal dish with it while the parent continues to offer him or her bites from a second spoon. 6. When infants no longer attempt to feed themselves at a meal but merely begin to play with their food by squeezing it through their fingers or dabbing it in their hair, it is time to end the meal. This behavior indicates that they have had enough. Sleep Problems 1. Suggests to the parent to delay bedtime by 1 hour 2. shorten an afternoon sleep period 3. Do not respond immediately to infants at night so they can have time to fall back to sleep on their own 4. Provide soft toys or music to allow infants to play quietly alone during this wakeful time. 5. Reassuring parents that infants take varying lengths of time to adjust to night sleeping is helpful in assuring them their child is normal. 6. Suggesting parents to use the time they are awake at night (e.g., solve a problem at work, watch the late show, plan a shopping list) may help them view the situation as a constructive time rather than a problem.

c. DENTAL HEALTH a. Oral Hygiene 1. Teach parents to ask about the presence of fluoride in the drinking water in their community and help them to determine what, if any, supplementation is necessary. 2. Breast-fed infants do not receive a great deal of fluoride from breast milk, so it may be recommended they be given fluoride drops once a day.

3. Teach parents to begin brushing even before teeth erupt by rubbing a soft washcloth over the gum pads. This eliminates plaque and reduces the presence of bacteria, creating a clean environment for the arrival of the first teeth. 4. Once teeth erupt, all surfaces should be brushed with a soft brush or wash cloth once or twice a day. 5. Children lack the coordination to brush effectively until they are school-age, so parents must be responsible for this activity well past infancy. 6. Toothpaste is not necessary for an infant, because it is the scrubbing that removes the plaque. b. Diet 1. Advise parents never to put their baby to bed with a bottle. 2. If parents insist a bottle is necessary to allow a baby to fall asleep, encourage them to fill it with water and use a nipple with a smaller hole to prevent the baby from receiving a large amount of fluid. 3. If the baby refuses to drink anything but milk, the parents might dilute the milk with water more and more each night until the bottle is down to water only. 4. When solid food is introduced, a bottle of water can be substituted for formula at one feeding. 5. Encourage parents to learn more about balanced nutrition and to provide this for their entire family. d. INJURY PREVENTION a. Aspiration of Foreign Objects 1. Be certain any objects that an infant can grasp and bring to the

mouth is either safe to eat or too big to fit in the mouth. 2. Do not feed infant foods such as popcorn or peanuts, because these are easily aspirated. 3. Store baby product such as powder out of infant reach; powder is high risk for aspiration. 4. Inspect toys and pacifiers for small parts that could be aspirated if broken off. 5. Do not make home made pacifiers. b. Suffocation 1. Allow no plastic bags within infants reach. 2. Do not pillow in a crib. 3. Store unused appliances such as refrigerators or stoves with the doors removed. 4. Buy a crib that is approved for safety (spacing of rails is not over 2 3/6 in diameter [6 cm] apart) 5. Remove constricting clothing such as a bib from neck at bedtime. c. Motor Vehicle injuries/Car Safety 1. For protection while in automobiles, infant should be transported in car seats. Look at the label to be sure the seat meets federal guidelines. 2. Never transport unless infant is buckled into an infant car seat in the back seat of the car. 3. Be aware of the proper technique for placing an infant in a car seat. 4. Do not be destructed by an infant while driving. 5. Do not leave an infant unattended in a parked car (can become dehydrated form excess heat, move gear shift, or be abducted) d. Falls 1. Do not leave infant on an unprotected surface, such as bed or couch, even if the child is in an infant seat. 2. Place a gate at the top and

bottom of stairways. 3. Do not allow infant to walk with a sharp object in the hands or mouth (it could pierce the throat in a fall). 4. Raise crib rails and make sure they are locked before walking away from crib. 5. Do not leave a child unattended in a high chair. 6. Avoid using an infant walker. e. Poisoning 1. Never present a medication as a candy. 2. Buy medication in containers with safety caps; put away immediately after use. 3. Never take medication in front of infants. 4. Place all medications and poisons in locked cabinets or overhead shelves. 5. Never leave medication in a pocket or handbag. 6. Use no lead-based in any area of the home. 7. Hang plants or set in high surface. 8. Post telephone number of the poison control center by the telephone. f. Burns 1. Do not smoke drink hot liquid while holding or caring for infant. 2. Buy flame-retardant clothing for infant. 3. Use a sunscreen on a child over 6 months when out in direct or indirect sunlight; limit the childs sun exposure to less than 30 min at a time. 4. Turn handles of pan toward back of the stoves. 5. Keep a screen on front of a fireplace or heater. 6. Monitor infant carefully near candles. Do not leave infant unsupervised near hot-water faucets.

7. No not allow infant to blow out matches (dont teach infant that fire is fun). 8. Keep electric wires and cords out of reach; cover electrical outlets with safety plugs. g. Drowning/Bathing and Swimming Safety 1. Caution parents never to leave an infant unattended in a tub, even when propped up out of the water or sitting in a bath ring or bath seat. 2. Normal wiggling can easily cause the baby to slip down under the water. 3. If their child is enrolled in one of the swim programs, dont be overconfident about the infant's ability to operate safely in water. 4. Because children can dog-paddle momentarily in a swimming pool does not mean they can sustain that position for any length of time in a bathtub or pool and may cause children to lose their instinctive fear of water and so be in more danger when around water than children who are still naturally more cautious. 5. Such programs may also spread microorganisms because infants this age are not yet toilet-trained h. Bodily Damage 1. Know the whereabouts of infant at all times. 2. Be aware that the frequency of accidents is increased when patents are under stress. Take special precautions at these times. 3. Choose baby sitters carefully and explain and enforce all precautions when sitters are in charge. 4. Do not allow an infant to approach a strange dog. 5. Supervise play with family pets.

2. TODDLER a. NUTRITION a. Nutritional Counseling 1. Teach parents to place a small amount of food on a plate and allow the child to eat it and ask for more rather than serve a large portion the child cannot finish. One tablespoonful of each food served is a good start. 2. Also, cleaning a plate gives the child a feeling of independent functioning, whereas leaving food uneaten may suggest to a child that parents expected something more. 3. It is important to educate parents while the child is still an infant that this decline in food intake will occur so they will not be concerned when it happens. 4. Allowing self-feeding is a major way to strengthen independence in a toddler. 5. Offering finger foods and allowing a choice between two types of food helps promote independence while exposing children to varied 6. Nutritious finger foods that toddlers enjoy include pieces of chicken, slices of banana, pieces of cheese, and crackers. 7. Children ages 1 to 3 years should consume 1,300 kcal daily. 8. Protein and carbohydrate needs are often easily met during the toddler period; diets high in sugar should be avoided. 9. Fats should generally not be restricted for children under 2 years old; however, children over 2 years old should consume no more than 30% of total daily calories from fat. 10. Adequate calcium and phosphorus

b. SLEEP AND ACTIVITY

intake is important for bone mineralization. Milk should be whole milk until age 2 years, after which 2% milk can be introduced 11. A vegetarian diet can be easily designed for a toddler who prefers finger foods, because many vegetables, fruits, and grains (e.g., pieces of oranges, peaches, raisins, chickpeas, tomatoes, and crackers) are easily eaten this way. The use of fortified soy milk prevents fluid, protein, B12, and calcium deficiencies. a. Sleep Problems

c. DENTAL HEALTH

d. DRESSING AND BATHING

a. Regular Dental Examination/Tooth Care b. Removal of Plaques c. Fluoride d. Diet a. Guidelines

e. INJURY PREVENTION/TODDLER SAFETY

a. Motor Vehicle injuries 1. Maintain child in car seat; do not be distracted from safe driving by a child in a car. 2. Do not allow child to play outside unsupervised. 3. Do not allow child to operate electronic garage doors. 4. Supervise toddler who is too young to be left alone in a tricycle. 5. Teach safety with pedaling toys (look before crossing driveways; do not cross streets) but do not expect that toddler will obey these rules at all times (in other words, stay close by). b. Drowning 1. c. Burns 1. Buy flame0retardant clothing. 2. Cook on the back burners of stove

if possible and turn handles of pots toward back of stove to prevent toddler from reaching up and pulling them down. 3. Keep screen in front of fire place or heater. 4. Monitor toddlers carefully when they are near lit candles. 5. Do not leave toddlers unsupervised near hot-water faucets. 6. d. e. f. g. 3. PRESCHOOL Poisoning/Lead Screening Falls Aspiration and Suffocation Bodily Damage

a. NUTRITION

a. Promoting Nutritional Health b. Diet a. Sleep Problems b. Exercise a. Care of Teeth

b. SLEEP AND ACTIVITY

c. DENTAL HEALTH

d. DRESSING

a. Guidelines

b. HYGIENE

a. Guidelines

c. INJURY PREVENTION/PRESCHOOLER SAFETY 4. SCHOOLER

a. Keeping Children Safe, Strong, and Free b. Motor Vehicle and Bicycle Safety

a. NUTRITION

a. Establishing Healthy Eating Patterns b. Diet a. Guidelines

c. SLEEP AND REST

d. EXERCISE AND ACTIVITY

e. DENTAL HEALTH

a. b. c. a. b.

Sports Acquisition of Skills Exercise Dental Problems Care of Teeth

f.

DRESS

a. Hygiene

g. INJURY PREVENTION

a. Promoting School-age Safety

5. ADOLESCENT

a. NUTRITION

a. Eating habits and behavior b. Diet a. Guidelines

b. SLEEP AND REST

c. EXERCISE AND ACTIVITY

a.Guidelines

b. DENTAL HEALTH

a. Care of Teeth

b. PERSONAL CARE

a. Dress and Hygiene

b. STRESS REDUCTION

a. Guidelines

c. SEXUALITY EDUCATION AND GUIDANCE d. INJURY PREVENTION

a. Guidelines

a. Adolescent Safety

NOTE: HAVE AT LEAST 2 BOOK REFERENCES (PILLITTERI AND WONGS PEDIATRIC NURSING); USE APA STYLE TO BE PASSED ON AUG. 15, 2013. ENCODE IN A LONG BOND PAPER, PLACE IN A FOLDER WITH FASTENER.

2. CREATE A HEALTH TEACHING PLAN FOR AN EXPECTANT MOTHER. MUST BE MORE THAN 5 SPECIFIC HEALTH TEACHING GENERAL HEALTH TEACHING 1. EXERCISE 2. NUTRITION 3. SLEEP AND REST 4. HYGIENE 5. TRAVEL SPECIFIC HEALTH TEACHING