General child's health Flashcards
Are cardiac arrests more serious in children or adults
Children
Tends to be end point of prolonged problem (not acute problems like MI).
Associated with greater acidosis, circulatory impairment, end organ damage.
Until what age are anterior fontanelles in babies palpable
Up to 18 months
Until what age are posterior fontanelles in babies palpable
2-3 months
General exam: What 3 things must always be examined for in a child’s HANDS
- Capillary refill time
- Temperature
- Clubbing
Which areas must pulse be felt from if a child is under 1yo
Brachial pulse
Femoral pulse
What is the commonest cause of hypertension in children
Kidney dysfunction (usually from UTI)
Causes of clubbing in children
" Cyanotic congenital heart disease " Lung conditions (including cystic fibrosis) " Ulcerative colitis " Bronchiectasis " Infective endocarditis " Neoplasm (tumours) " GI conditions: IBD, biliary atresia, Coeliac's, malnutrition " Others: TB, thyrotoxicosis
General exam: What 3 things must always be examined for in a child’s THROAT
- Tonsils
- Dehydration
- Central cyanosis
How long must one wait before deciding that there are no abdominal sounds
3min
How often would abdominal sounds be in normal, non-sluggish bowels
At least 3 abdominal sounds per minute
Which is the first bedside observation to be affected in an unwell child
Respi rate
Which is the last observation bedside to be affected in an unwell child (would indicate child is very sick)
Blood pressure
Minimum time period in between giving live vaccines
6 weeks (3 months to be safe)
Otherwise second live vaccine will ruin the effects of the first live vaccine.
Common complication of forceps delivery
Clavicle fracture
How is the vaccination schedule in a premature baby adjusted
Based on number of weeks from day they were born.
NOT based on corrected age
Maintenance fluids for children
- 100ml /kg for first 10kg
- 50ml /kg for next 10kg
- 20ml /kg for everything else
(Tip: divide by 24 for hourly rate before rounding off to easiest amount to give)
How much of what fluid to give shocked child
20ml /kg 0.9% NaCl
When might you give less fluid in a shocked child
10ml/kg
For renal failure/ cardiac disease
For trauma (high risk of thrombus, fat embolus)
Glucose requirements for hypoglycaemic child
5ml/kg 10% dextrose
What 5 symptoms should always be asked in any child’s history
- fever
- rash
- feeding changes
- lethargy
- wet, dirty nappies
What allergies must be specifically asked about in a child
- drug allergy
- skin allergy
- food allergy
What should be asked about in child’s social history
- BINDS
- smokers in house
- social service involvement
At what age would a UTI in a child be concerning (and warrant further investigations)
<1yo
How much milk does a child normally drink
150ml/kg a day
Definition of PROM
Rom >18h
Risks of neonatal infection at birth
- PROM
- Mum GBS positive (check if adequate a/b coverage)
- Maternal fever
What questions to ask in history to assess how well child is
Wet nappies per day
If child is waking to feed
List the TORCH infections
Toxoplasmosis Other: VZV, Syphilis Rubella CMV HSV
Clinical signs of TORCH infections
- Fever
- Jaundice
- Anaemia
- Purpura, petichiae
- Hepatosplenomegaly
Expected rate of baby weight gain in first 6 months
Should have x2 birth weight (by 3-6 months)
140-200g a week
Expected rate of baby weight gain by 1 year
Should have x3 birth weight
90-140g a week
