Children's health Flashcards
what is classed as premature?
less than 37 weeks
what are the survival rates at 24, 27 and 32 weeks ?
24= 45%
27= 80%
32= 100%
what are babies like if they’re born earlier?
- smaller, less well developed
what can premature birth be due to?
- smoking
- alcohol
- infection
- young mother
- multiple pregnancy
- poor maternal health
what problems can arise in a premature baby ?
immature systems:
- immunological
- respiratory
- GIT
- CNS
- associations with long term disability
how is growth and development tracked ?
- height and weight should follow trends
- should remain on the same centile
- if babies aren’t well there height and weight may drop off or an increase needs to be investigated
what else is tracked in growth and development ?
- known as milestones
- motor skills, speech, behaviour development
- health visitors and GP will monitor the development
- some babies may be slower or faster doesn’t mean problem
what Is the HCP?
- programme which aims fro children to get the best possible start up in life
- GPS, midwives and health visitors involved
- preconception to 24 yrs
what are the aims of HCP ?
- parent child bonding
- support parents to keep child safe and healthy
- prevent disease thru immunisation
- reduce childhood obesity healthy eating and physical activity
- promote oral health
- support resilience and positive maternal and family mental health
- support the development of healthy relationships and good sexual and reproductive health
- SCREENING and prevention diseases
- ensure children are ready for school at age 5
Nutrition from 0-12+ months ?
- 0-6 months= milk (breast/ formula) - on demand
- 6-9 months= weaning - purred food
- 7 months = finger food
- 9 month s= 3 meal and 3 snack times
- 12 months = chopped up food and cows milk
what is the let down reflex ?
- when baby sucks breast tiny nerves stimulated and sends messages to Brain
- hypothalamus = produces oxytocin
- pituatry gland = produces prolactin and releases hormones into bloodstream
- prolactin = hormone which causes the breast to produce milk
- oxytocin = causes the let down reflex causing breast to push milk out
what are the advantages of breast milk ?
- perfect nutrition
- no cost
- convenient
- IgA and macrophages = reduces risk of infection
- reduces risk of allergies
what are the disadvantages of breast milk?
- drug secretion
- can transmit HIV
- on demand feeding is tiring and sore
what is the purpose of screening ?
- identifying unrecognised disease
- improved outcomes (prognosis, quality of life )
- reduce cost of tx for diseases
when is screening beneficial ?
- works best when identifiable early or latent disease
- works best if disease treatable and prognosis is better with early treatment
- test must be acceptable for people one of the reasons why ppl dont get oral cancer screening is because they dont like the dentist
- if test cost more than treatment = not effective thus not used
when is screening done in children?
- preconception
- pregnancy for mother and child
what can pre conception screening detect ?
CF, huntingtons chorea, downs syndrome, heart kidney brain lung
what screening is done when baby is born ?
physical exam:
- head face mouth eyes eras (cleft lip)
- limbs hips
- genetialia
- reflexes (neurological development)
- heart
heal prick blood test :
- many things including
- Sickle cell disease
- CF
- congenital hypothyroidism
- phenylketonuria
what screening is done at school ?
height
weight
eye test
who are involved after midwives ?
- health visitor
- from baby to 5 yrs
- advice on safety and health of child
whos involved after 5 yrs?
- school nurse
- help in wellbeing, healthy lifestyle, support for vulnerable people, self care, health literacy
what is the APGAR score ?
what are vit k levels like in a newborn?
- low
- can lead to bleeding problems esp if in brain
- vit k injection or by mouth
how common is cleft lip and palate ?
1 in 700
when is CLP screened?
new born screening
and be identified in ante natal screening
- referred to MDT
what is epidemiology of Neo natal teeth ?
1 in 3000
sealer eruption of As
mandible more common than maxilla
may be loose
need removal as difficult when suckling
what is tongue tied ?
tight frenum
diffulcty feeding
franectomy MAY help
what Is jaundice ?
- transition of fetal haemoglobin which is designed to suck oxygen from mothers haemoglobin once born we dont need fetal haemoglobin as we start to produce own adult haem so all those red cells aren’t needed and body will break them down
- as theyre broken down liver gets overwhelmed an you can develop jaundice
- can cause problems with babies being sleepy, not developing and feeding
- phototherapy = breaks down fetal haem under skin
what does the paediatric consultation involve ?
assessment of :
- altered consciousness
- respiratory distress that may affect communication and observation
- growth nutrition
- motor skills
- social interaction
- speech understanding
- clothing hygiene
- bonding with parents
- any problems in pregnancy or birth?
- up today with vaccines and millstones
- family history eg for genetics diseases
- SH = housing (mould, damp can lead to asthma, employment, smoking, parental education)
what is global delay ?
- delay in language, motor skills and social skills
- can lead to significant intellectual disability
- delay in single area of milestone less worrying
what could developmental delays be due to ?
surgical sieve =
- genetics: downs
- prenatal: infection eg. rubella, injury: foetal alcohol syndrome
- peri natal : hypoxia, trauma
- post natal: infection (meningitis), injury (neglect)
- endocrine: hypothyroidism
- metabolic: phenylketonuria
- neurological: neural tube defect, hydrocephalus
- idiopathic: autism
what are the facial features of foetal alcohol syndrome ?
what ar the symptoms of foetal alcohol syndrome?
- intellectual impairment
- developmental delay
what is cereal palsy?
- permanent: non progressive injury to Brain
- presentation: determined by injury site
- variable severity, developing on extent of injury
- doesn’t always means association with intellcutal impairment
what does the pattern of cerebral palsy depend on?
part of brain affected
what is hemiplegic palsy ?
one half of brain affected so opposite side of body affected
what is diplegic palsy?
2 sides of brain affected so either legs or arms affected
what is quadriplegic palsy ?
arms and legs both affected
what is ataxic cerebral palsy ?
cerebral damage so affects control and movement
what is athetoid palsy ?
basal ganglia affected which is similar to parkisons
how do we diagnose cerebral palsy ?
- delay developmental milestones
- affects muscle tone and reflexes
how do we manage cerebral palsy ?
- irreversible permanent condition
- doesnt get worse
- MDT and physiotherapy, occupational therapy and surgery (maybe) involved
what are the Principles when it comes to acute fever in children ?
- safety first
- child may not be able to tell about symptoms
- systematic approach
what is an acute fever ?
greater than 37.5
if 39+ dangerous
if lower than 6 also dangerous
what are some other symptoms of acute fever ?
- looks unwell
- cough raised respiratory rate = maybe chest infection
- rash = non blanching rash = serious maybe sepsis
- altered conscious state
- any of above go a and e
what do we do if it doesn’t seem like acute fever?
- viral infections: measles mumps rubella chicken pox
- ostitis media
- tonsilitis
- UTI
- URTI
- dental infection
how do we work out dose?
BNF and weight
how serious are errors in dosage in kids?
- more dangerous in kids eg. NSAIDS salicylates, aspirin shouldn’t be given to under 16yrs
- need to be careful with bonjela as it contains salicylates
- can get Reyes syndrome: hepatitis and encephalopathy = rare but serious condition
why do we avoid prescribing tetracycline in children ?
can cause staining so we wait for permanent teeth
