Childrens Health Flashcards

0
Q

Define neonate , infant and child

A

Neonate- An infant less than four weeks old
Infant- from one month up to one year of age
Child- from 1-12 years of age

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1
Q

Where can you find the average/expected weight for specific age groups of the paediatric population

A

BNF for children

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3
Q

Outline when to refer a child (5)

A

1) symptoms lasting for long periods
2) recurring or worsening symptoms
3) failure to respond to medicines
4) severe pain
5) presence of danger symptoms

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4
Q

List the danger/red flag symptoms in children (9)

A

1) unexplained loss of appetite
2) unexplained weight loss
3) persistently raised temperature
4) abnormal drowsiness
5) loss of consciousness
6) difficulty breathing
7) cough with vomiting
8) blood in sputum etc
9) persistent night time cough

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5
Q

What medicine would you give for dental pain in children (2)

A

1) non-steroidal anti-inflammatory drugs (NSAID) - ibuprofen only licensed NSID in children
2) benzydamine spray/topical anaesthetics

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6
Q

Describe the treatment for headache in a child (2)

A

1) migraine - refer on initial presentation

2) migraine relief products licensed from age 10

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7
Q

Outline the analgesics which can be used to treat children (3)

A

1) paracetamol
- mild to moderate pain
- overdose dangerous

2) NSAIDs - ibuprofen ( take with or after food) TDS
- particularly useful in pain associated with fever and dental pain.
- cause gastric irritation
- watch asthmatics

Can use a combination in more severe pain
3) aspirin should not be given to children

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8
Q

Outline the management of a fever in children (3)

A

Raised temperature
Management:
1) cold drinks- encourage regular fluids
2) use paracetamol or ibuprofen
3) if child remains unwell alternate with paracetamol (record dose carefully)

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9
Q

Outline when to refer a fever in a child (9)

A

1) children under one year with fever
2) age one to five years 38 degrees and above
3) if temperature raises a over 39 degrees
4) if febrile convulsion (fits) have occurred
5) difficulty breathing
6) any signs of meningitis
7) fever lasting several days along with rash/ conjunctivitis/ other symptoms
8) failure to respond to treatment
9) stiff neck

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10
Q

What are febrile convulsions (4)

A

1) Febrile convulsions are seizures occurring in children aged 6 months to 6 years, associated with fever, without other underlying cause such as CNS infection or electrolyte imbalance.
febrile convulsions 6 months- 6 years
2) sudden rise in temperature rather than a persistently elevated temperature that is thought to cause convulsions
3) antipyretic agents do not prevent febrile convulsions and should not be used specifically for this purpose
4) refer

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11
Q

What are the symptoms of bacterial meningitis in children (8)

A

1) fever - cold hands and feet
2) refusing food or vomiting
3) fretful, dislike of being handled
4) pale blotchy skin
5) blank starting
6) drowsy
7) stiff neck
8) high pitched cry

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12
Q

What are headlice (8)

A

1) tiny whitish grey-brown insects that live in human hair
2) spread by head to head contact
3) all types of hair can be affected , regardless of length and condition
4) only effect humans and cannot be passed on to animals
5) nits = headlice eggs
6) females lay eggs which hatch after 7-10days
7) female life will then lay eggs after a further 7days
8) clings to hair and feeds on blood from hosts scalp

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13
Q

Outline the treatment of head-lice (8)

A

1) shampoos , lotions , sprays , wet combing
2) all affected persons treated at the same time
3) silicone based e.g dimethicone only kills eggs
4) insecticide e.g malathion, permethrin kill both lice and nits
5) refer younger than 6 months or children with skin conditions
7) only treat if lice have been confirmed and repeat treatment after 7 days
8) alcohol from product might trigger asthma

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14
Q

What is teething

A

1) teething pain may occur as a new tooth starts to break through the gum - will affect most children to some extent

We need to know: WHHAM
Who it’s for - from 3 months - 3 years
Symptoms - swollen red gums , red cheeks , excessive dribbling , fever, nappy rash , disturbed sleep / eating pattern

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15
Q

Describe the treatment for teething (5)

A

1) analgesics - paracetamol or ibuprofen liquid
2) topical gel - local anaesthetic lidocaine usually in combination with an antiseptic e.g. Cetalkonium chloride
3) homeopathic - teething granules
4) oral choline salicylate gels are contraindicated because of the risk of Reye’s syndrome
5) advice: teething ring , chewing on hard food - raw carrots , biscuits

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16
Q

What is oral thrush and what are the symptoms (4)

A

1) mild fungal infection affecting mouth and throat
2) sometimes called a yeast infection
3) cause by Candida albicans
4) symptoms: white patches in mouth is tongue that do not wipe off, sore red mouth or tongue , discomfort during feeding.

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17
Q

Outline the treatment for oral thrush (5)

A

1) miconazole oral gel - anti fungal
2) apply with clean finger or cotton bud
3) continue treatment for 2 days after symptoms have cleared
4) if breast feeding apply to nipples to avoid reinfection
5) advice- avoid reinfection by sterilising feeding equipment and dummies

18
Q

What is infant colic? (4)

A

1) exact cause unknown
2) problems with digestion
3) intolerance to lactose
4) trapped wind

19
Q

What are the symptoms of infant colic (3)

A

1) usually starts when the baby is 2-4weeks old
2) intense periods of crying - red faced from crying
3) a bay may pull up or stiffen their legs , as if in pain

20
Q

Outline the treatment for infant colic (6)

A

1) gripe mixtures
2) colic drops - simeticone disperses trapped wind
3) lactase - breaks down lactose
4) dill, caraway & ginger
5) antacids e.g sodium bicarbonate
6) advice: sit baby upright when feeding
- check the size of the hole in the teat for bottle- fed babies
- hold bottle so that the teat is full of milk, avoid sucking a lot of air
- burp the baby during and after feeding

21
Q

Describe the reasons to refer a baby suffering from infant colic (6)

A

1) baby is not feeding
2) if baby is vomiting or crying for several hours
3) there is diagnostic doubt ( e.g baby is not thriving)
4) crying is not starting to get better or is getting worse after 4 months of age
5) significant gastro-oesophageal reflux is suspected
6) unable to wean off treatment by the age of 6 months

22
Q

What is constipation and what are the symptoms (3)

A

1) characterised by infrequent bowel evacuations
2) hard and dry stools
3) difficult to pass

23
Q

Outline the treatment for constipation (8)

A

1) stool softeners e.g lactulose
2) bulk forming laxatives e.g. Ispaghula
3) stimulant laxatives e.g. Senna
4) glycerin suppositories
5) continue medication at maintenance dose for several weeks after regular bowel habit is established.
4) advice: increase fluid in the diet
- increase fibre in the diet - fruit and vegetables and bran
- encourage the child to go to the toilet regularly
6) exclude any underlying cause
7) staged approach to management
8) aim to establish a regular pattern

23
Q

What is the treatment for nausea and vomiting

A

Oral rehydration

24
Q

What is nausea and vomiting and list the common causes (2)

A

1) vomiting episodes in children with no other symptoms - often caused by primary condition in gastro- intestinal tract
2) common causes :
- gastro- enteritis
- respiratory condition
- problems with feeding
- meningitis
- overexcited/nervous

26
Q

Describe when you would refer a child who is suffering from nausea and vomiting (6)

A

1) systemically unwell with signs of infection or fever
2) frequent vomiting for >24-48 hours
3) frequent regurgitation, failure to thrive, feeding/swallowing difficulties
4) recurrent episodes of unexplained vomiting
5) vomit in blood - stained or looks like “coffee grounds”
6) warning signs- sunken eyes, wrinkly non-elastic skin, dry nappy , drowsiness

27
Q

What is nappy rash and what are the symptoms (5)

A

1) red rash found in the nappy area
2) glazed appearance if acute
3) red chapped skin in the nappy area
4) bacterial infection - yellow crust
5) fungal infection- skin appears shiny, rash surrounded by areas of red broken skin

28
Q

Outline the treatment for nappy rash (5)

A

1) barrier creams - dimethicone , white soft paraffin
2) antiseptics
3) astringents
4) antifungals e.g. Clotrimazole
5) advice :
- clean the bottom with warm water and cotton wool
- dry the nappy area thoroughly
- leave nappy off for as long as possible
- avoid using talc
- make sure the baby is drinking plenty of fluids

29
Q

What are threadworms and what are the symptoms? (2)

A

1) enteribius vermicularis - different from tape worm

2) white threadlike worms in stool

30
Q

Outline the treatment for threadworms (4)

A

1) mebendazole (ovex) from 2 years OTC
2) repeat after two weeks If infection persists- treat whole family
3) single dose
4) advice: hygiene measures
- keep nails short and clean
- careful washing and scrubbing of hand and nails before eating and after the toilet
- wash bed linen frequently , ideally every day
- wear underwear under nightwear to prevent scratching
- bathe or shower first thing in the morning
- eggs remain viable for up to 2 weeks
- damp dust surfaces and vacuum daily
- wear underwear to prevent eggs from falling onto sheets
- adult life cycle = 6 weeks therefore continue with these measures for at least 6 weeks after treatment

31
Q

When would you refer children suffering from threadworms (2)

A

1) fever , bed wetting, vaginal discharge

2) vomiting , diarrhoea , unexplained weight loss

32
Q

What is hayfever and what are the symptoms? (4)

A

1) pollen = allergen
2) lining of nose and eyes
3) pollen count and pollution
4) symptoms:
- sneezing, cough , itchy eyes/ nose and throat , watery and red eyes, runny or blocked nose
- normally for older children

33
Q

Outline the treatment for hayfever (5)

A

1) nasal sprays
2) antihistamines
3) eye drops
4) oral antihistamines - chlorphenamine liquid from 1 year , loratadine 2 years , cetrizine liquid 6 years
5) topical antihistamines e.g azelastine , corticosteroid nasal sprays 18+ only ,sodium cromoglycate mast cell stabiliser , eye drops adults and children

34
Q

Outline when you would refer a child suffering from Hayfever (6)

A

1) failed treatment
2) shortness of breath
3) wheezing
4) pain in the head, ear or sinuses
5) conjunctivitis with a purulent discharge
6) consider referring very young children e.g.

35
Q

Explain how you would administer medication to a child (5)

A

1) a medicine should not be mixed with large quantities of food
2) should not be mixed or administered in a baby’s bottle.
3) children under 5 generally need liquid formulations
4) sugar free medicines should be provided where possible
5) can disguise flavour

36
Q

Explain the advice you would give to parents about administering eye drops and eye ointment to children (2)

A

1) Eye drops:
- can wrap child/ baby in a blanket , older children can lie on bed
- in small children and babies, place the drop into the inner corner of the eye. This is easier when the eye is open, but the liquid will still drain on to the eye even with a closed eye if you can hold child’s head still for a few seconds

2) Eye ointment
- as above
- can successfully apply while a baby is sleeping

37
Q

Describe the information you would give to a parent about administering ear drops to children (3)

A

1) can wrap child/ baby tightly in a blanket
2) pull ear lobe backwards to open up ear canal
3) avoid touching ear with dropper

38
Q

Outline the information given to parents about administering nasal drops to children (4)

A

1) lay child across lap with head hanging down
2) wrap small babies/ young children in a blanket
3) to remove mucus from a baby’s nose tickle with cotton wool.
4) warm drops better tolerated. No more than 2-3 drops

39
Q

Describe the advice given to parents about administering suppositories to children (3)

A

1) lie child on side with knees pulled up
2) lubricate suppository and insert 2-4 cm into rectum
3) hold buttocks together for 5 minutes

40
Q

Outline the information you would give to parents about administering oral liquid to children (6)

A

1) ensure child is sitting or standing at not more than 45 degree angle to reduce the risk of choking
2) give medicine along side of mouth on inside of cheek
3) lift child’s chin
4) can mix unpleasant tasting medicines with more palatable foodstuffs
5) if mixed with something make sure child consumes whole amount
6) chilled medicine is often more acceptable

41
Q

Outline the advice given to parents about administering tablets to children (5)

A

1) place tablet or capsule on back of tongue
2) give them a drink from an adults cup/glass so tablet is swallowed along with the drink
3) sometimes can be mixed with food
4) crushing not recommended unless leaflet states that it is a safe practice
5) do not tilt head back