Anterior fontanel in newborn closes between - - RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Child Health Nursing (Pediatrics)

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

The anterior fontanel is the largest of the fontanels, shaped like a diamond, located at the junction of the skull's sutures.
Its delayed closure is a normal physiological process that accommodates the rapid growth of the brain during the first year of life.
According to standard pediatric developmental milestones, the anterior fontanel typically ossifies (closes) between 12 and 18 months of age.

Option B: This is the typical timeframe for the closure of the posterior fontanel, not the anterior one.
Option C: This period is too early for the complete closure of the anterior fontanel. No major fontanel typically closes within this specific 6 to 9-month window.
Option D: While the closure process might begin as early as 9 months in some infants, this range does not represent the full, typical timeframe for complete ossification.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Normal infant developmental milestones: Anterior fontanel closure as background academic context rather than a clinical decision trigger.
Assessing the anterior fontanel is a key part of the newborn and infant physical examination. A sunken or depressed fontanel can be a sign of dehydration, while a tense or bulging fontanel can indicate increased intracranial pressure (ICP).
Nurses must educate parents about the normal feel of the fontanel (soft and flat) and to report any significant changes like bulging or sinking.
What if? If a 2-year-old child presents with a still-open anterior fontanel, this is considered delayed closure. The nurse should anticipate further investigation for underlying conditions such as congenital hypothyroidism, rickets, or Down syndrome.

How to Approach the Question

Identify the key anatomical structure in the question: 'Anterior fontanel'.
Recall the two main fontanels in a newborn skull: anterior and posterior.
Differentiate their key characteristics. The anterior fontanel is large, diamond-shaped, and closes late. The posterior fontanel is small, triangular, and closes early.
Access your knowledge of normal infant developmental timelines. The anterior fontanel's closure is a later milestone, timed to allow for brain growth.
Evaluate the given options. Eliminate the earliest timeframe (2-3 months) as this corresponds to the posterior fontanel. Select the range that accurately reflects the average completion of closure, which is around 18 months.

Concept Tested & Keywords

Concept Tested: Normal infant developmental milestones: Anterior fontanel closure.
Stem keywords: Anterior fontanel, newborn, closes
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

Qi4Cv6ig6RuQBAdJPXkQiV

E6 Comprehensive Textbook of Community Health NursingShyamala D part 1 (pp 26-389 of 389) p. 300-302

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1357-1359