development, vaccs, blood spot, disability, blood gas, fluids, assessing febrile child Flashcards
4 areas
gross motor
fine motor and vision
speech, language and hearing
social
gross motor milestones
3-6 months rolls, sits supported 9 months pulls to a stand 12 months walks 2 years walks up steps 3 years jumps 4 years hops
fine motor and vision milestones
4 months grasps / reaches out for objects / uses both hands
8 months takes objects
12 months scribbles, develops pincer grip
18 months builds with blocks 2/3
3 years tower of blocks 8
fine motor and vision milestones - shapes that can be drawn at what ages
1 scribble 2 straight line 3 circle 3/4 cross 4 square 5 triangle
speech, language and hearing milestones
3 months laughs and squeals
9 months babbles, mama/dada
12 months single words
2 years two word sentences
3 years speech understandable
4 years knows colours, can count reasonably
5 years knows meaning of words (over/under)
social milestones
6 weeks smiles spontaneously 6 months finger feeds 9 months waves 'bye-bye' 12-18 months uses cutlery 2 years takes clothes off 3 years puts clothes on, plays with others 4 years dress no help
neonatal blood spot all 9 things
sickle cell anaemia CF congenital hypothyroidism phenylketonuria homocystinuria medium chain acyl CoA dehydrogenase deficiency isovaleric acidaemia glutaric aciduria type 1 maple syrup urine disease
neonatal blood spot inherited metabolic disorders
phenylketonuria PKU medium chain acyl CoA dehydrogenase deficiency MCADD maple syrup urine disease MSUD isovaleric acidaemia IVA glutaric aciduria type 1 GA1 homocystinuria HSU
neonatal blood spot non metabolic disorders
sickle cell anaemia
CF
congenital hypothyroidism
vaccinations at 8 weeks
diphtheria, hep B, haemophilus influenza type B, polio, pertussis, tetanus [6 in 1]
pneumococcal
rotavirus
meningitis B
vaccinations at 12 weeks
diphtheria, hep B, haemophilus influenza type B, polio, pertussis, tetanus [6 in 1]
rotavirus
vaccinations at 16 weeks
diphtheria, hep B, haemophilus influenza type B, polio, pertussis, tetanus [6 in 1]
pneumococcal
meningitis B
vaccinations at 1 year
haemophilus influenza type B, meningitis C [2 in 1]
measles, mumps, rubella [3 in 1]
pneumococcal
meningitis B
vaccinations at 3 years and 4 months
measles, mumps, rubella [3 in 1]
diphtheria, tetanus, pertussis, polio [4 in 1 pre school booster]
vaccinations at 12-13 years
human papilloma virus (to prevent cervical cancer)
vaccinations at 14 years
tetanus, diphtheria, polio [3 in 1]
meningitis ACWY
vaccination 2-10 years (every year)
flu vaccine (influenza)
whats WHODAS
WORLD HEALTH ORGANISATION
DISABILITY ASSESSMENT SCHEDULE
• A generic assessment instrument for health and disability
• Used across all diseases, including mental, neurological and addictive disorders
WHODAS 6 DOMAINS OF FUNCTIONING
- Cognition – understanding & communicating
- Mobility– moving & getting around
- Self-care– hygiene, dressing, eating & staying alone
- Social– interacting with other people
- Life activities– domestic responsibilities, leisure, work & school
- Participation– joining in community activities
quality of life definition
The degree to which a person enjoys the important
possibilities of his/her life.
• Being –who one is
• Belonging –how one fits into the environment
• Becoming –How to have purposeful activities in order to achieve ones goals
WHAT DETERMINES DISABILITY ?
BIOPSYCHOSOCIAL MODEL examples
bio - genetic vulnerabilities
psyc - self esteem
social - family circumstances
Primitive reflexes examples / when they diminish
moro - drop baby arms spread out
grasp - stroke palm, baby grasps
Galant - stroke spine, baby turns to that side
normally present in the term infant and diminish over the next 4 to 6 months of life.
Postural reflexes examples / when they diminish
positive support reflex, Landau, lateral propping and parachute emerge at 3 to 8 months of age.
pedigree signs
look up
respiratory acidosis features
pH - low
pCO2 - high
HCO3 - normal
Respiratory depression
Guillain-Barre
hyperventilation
respiratory acidosis with metabolic compensation
features
pH - low/normal
pCO2 - high
HCO3 - high
respiratory alkalosis features
pH - high
pCO2 - low
HCO3 - normal
Anxiety
Hypoxia
respiratory alkalosis with metabolic compensation
features
pH - high/normal
pCO2 - low
HCO3 - low
metabolic acidosis features
pH - low
pCO2 - normal
HCO3 - low
DKA
metabolic acidosis with respiratory compensation
features
pH - low/normal
pCO2 - low
HCO3 - low
metabolic alkalosis features
pH - high
pCO2 - normal
HCO3 - high
D+V
metabolic alkalosis with respiratory compensation
features
pH - high/normal
pCO2 - high
HCO3 - high
high base excess
A high base excess (> +2mmol/L) indicates that there is a higher than normal amount of HCO3- in the blood
may be due to a primary metabolic alkalosis or a compensated respiratory acidosis.
low base excess
A low base excess (< -2mmol/L) indicates that there is a lower than normal amount of HCO3- in the blood
suggesting either a primary metabolic acidosis or a compensated respiratory alkalosis.
anion gap
(positive anions k/na) + (negative anions hco3/cl)
normal 3-11
Mixed respiratory and metabolic acidosis features
pH - low
pCO2 - high
HCO3 - low
multi organ failure
Mixed respiratory and metabolic alkalosis features
pH - high
pCO2 - low
HCO3 - high
excess vomiting and diarrhoea
fluid calculations - estimate of weight
(age+4) x 2
fluid calculations - maintenance fluids
first 10kg - 100ml/kg
second 10kg - 50ml/kg
every other kg after - 20ml/kg
rate in ml/24hrs
fluid calculations - fluid deficit
Deficit(%) x 10 x Wt(kg)
fluid calculations - rate of rehydration
maintenance + fluid deficit
fluid bolus
in DKA
20 mls/kg 0.9% sodium chloride
10 mls/kg 0.9% sodium chloride
assessing febrile child traffic light categories
colour activity respiratory circulation and hydration other
assessing febrile child traffic light - colour
low, intermediate, high risk
low - normal
intermediate - pallor
high - pale, blue
assessing febrile child traffic light - activity
low, intermediate, high risk
low - smiles, responds normally
intermediate - decreased, no smile, not responding as normal
high - non responsive, dosnt wake
assessing febrile child traffic light - respiratory
low, intermediate, high risk
intermediate - nasal flaring, tachyponea RR>50 SATS O2 <95 in air
high - grunting , recessions, tachyponea RR>60
assessing febrile child traffic light - circulation and hydration
low, intermediate, high risk
intermediate - tachycardia, CRP>3, dry mucous membranes, reduced urine output
high - reduced skin turgor
assessing febrile child traffic light - other
low, intermediate, high risk
intermediate - temp >39, fever >5 days, rigors, swelling
high - buldging fontanelle, non blanching rash, neck stiffness, seizures
assessing dehydration
mild
moderate
severe
Mild (<5%)
• Thirst
• Dry lips
• Restlessness, irritability
Moderate (5-10%)
• Sunken eyes
• Reduced skin turgor
• Decreased urine output
Severe (>10%)
• Reduced consciousness
• Cold, mottled peripheries
• Anuria
fluid composition
0.9% sodium chloride + 5% glucose
