Health promotion

  • Health promotion
    • Sleep and Rest
      • To prevent sudden infant death syndrome (SIDS) – 90% of death occurs before 6 months of age – Parents should be advised to:
        • Be breastfed (if possible) 
        • Be put to sleep in a crib or other infant sleep location- not in a sofa, futon or adult bed 
        • Put to sleep on a firm surface, in the same room as caregivers but not sleeping with anyone else
        • Clothed in a sleep sack with no blanket 
        • Nothing soft placed in the crib 
        • Kept away from cigarette smoke 
        • Given a pacifier at the beginning of nap and bedtime 
        • Slats of crib should be no wider than 2 3/8 inches apart to avoid strangulation 
        • Sleep area should be placed away from blinds and curtain strings that can be wrapped around neck
    • Parent education
      • Diapers should be changed frequently to prevent diaper rash 
      • When bathing an infant: 
        • The baby should never be left alone or near water to prevent diaper rash 
        • All needed supplies should be collected before immersing baby in the water 
        • Bath water should be 105 degreed F to prevent burning 
        • Childproofing home should start at 4 months
    • Child abuse issues
      • Shaken baby syndrome (SBS) 
        • A serious syndrome that can result when an infant is violently shaken 
        • SBS can result in permanent damage including mental retardation and physical disability or death from bleeding brain
        • parents often misunderstand normal child behavior and should be taught 
        • If child abuse is suspected, the nurse must report the abuse
    • Immunizations



Hepatitis B (hep B)

2 Months

Diphtheria and tetanus toxoids and pertussis (DTap), rotavirus vaccine (RV), inactivated poliovirus (IPV), haemophilus influenzae type B (Hib), pneumococcal vaccine (PCV), and Hep B

4 Months

DTap, RV, IPV, Hib, PCV

6 Months

DTap, IPV (6 to 18 months), PCV, and Hep B (6 to 18 months)



6 to 12 Months

Seasonal influenza vacation yearly (the trivalent inactivated influenza vaccine is available as an intramuscular injection)

      • Communicating with parents about immunizations
        • Provide accurate and user-friendly information on vaccines (the necessity for each one, the disease each prevents, and potential adverse effects).
        • Realize that the parent is expressing concern for the child’s health.
        • Acknowledge the parent’s concerns in a genuine, empathetic manner.
        • Tailor the discussion to the needs of the parent.
        • Avoid judgmental or threatening language.
        • Be knowledgeable about the benefits of individual vaccines, the common adverse effects, and how to minimize those effects.
        • Give the parent the vaccine information statement (VIS) beforehand and be prepared to answer any questions that may arise.
        • Help the parent make an informed decision regarding the administration of each vaccine.
        • Be flexible and provide parents with options regarding the administration of multiple vaccines, especially in infants, who must receive multiple injections at 2, 4, and 6 months of age (i.e., allow parents to space the vaccinations at different visits to decrease the total number of injections at each visit; make provisions for office visits for immunization purposes only [does not incur a practitioner fee except for administration of vaccine], provided the child is healthy).
        • Involve the parent in minimizing the potential adverse effects of the vaccine (e.g., administering an appropriate dose of acetaminophen 45 minutes before administering the vaccine [as warranted]; applying EMLA [lidocaine-prilocaine] or LMX4 [4% lidocaine] to the injection sites before administration; following up to check on the child if untoward reactions have occurred in the past or parent is especially anxious about the child’s wellbeing).
        • Respect the parent’s ultimate wishes