Health Problems of Early Childhood Flashcards
Sleep problems
-Prime time for sleep disturbances: Increasing autonomy, nighttime fears, inconsistent bedtime routines & lack of limit setting; Media use can contribute to this
-Nightmares and sleep terrors
-Media use
-Establish a bedtime routine: Make need a security item or a nightlight
-Cultural considerations: Co-sleeping
Skin disorders
-Contact dermatitis
-Disorders related to animal contact: Bug bites/stings; Pet/wild animal bites
-Human bites
Ingestion of injurious agents
-Children younger than age 6 years are at risk for injury
-Cosmetics and personal care products
-Cleaning products
-Plants
-Foreign bodies, toys, and miscellaneous substances
-Hydrocarbons (gasoline)
-Dietary supplements, herbals & homeopathic
-Heavy metal poisoning
-Most common is lead ingestion
-Mercury toxicity (less frequently)
Principles of emergency tx
-Poison control center: 800-222-1222
-Call 1st, initiating any interventions
-Assessment: assess/terminate the exposure/identify the poison/prevent poison absorption
-Gastric decontamination: induce vomiting (rare), absorb toxin (activated charcoal)
-Prevention of recurrence
Heavy metal poisoning
-Lead ingestion is most common
-Mercury toxicity occurs less frequently
-Brain damage, memory loss, trouble concentrating, HTN, muscle or joint pain, kidney damage, constipation, loss of appetite, stomach cramps
Lead poisoning etiology
-Peeling lead-based paint in older homes
-Microparticles of lead contaminate bare soil
-Food and water contamination
-Pottery and dishes; folk remedies
-Impoverished, urban area; older rental homes
-Can be inhaled or ingested
-Affects renal, hematologic & neurologic systems; developing brain &
nervous systems are especially vulnerable
-Relationship between lead & anemia
-Long-term effects –> behavioral & cognitive
Lead poisoning dx
-Rarely symptomatic but affects renal, neurologic, hematologic systems (bone marrow)
Anemia
-In venous blood sample the blood lead level is 10 μg/dl or
higher
-Screening for lead poisoning at age 1 and 2 years
-Chelation therapy
-Prognosis
-Calcium disodium edetate (EDTA)—IV or IM
-British antilewisite—IM (along w/EDTA)
-Succimer (DMSA)—Oral
Child maltreatment
-Neglect (MC): physical and emotional neglect, deprivation of food clothing, supervision, medical care and education
-Emotional neglect: lack of affection, attention and emotional nurturance
-Intentional physical abuse: abusive head trauma (AHT)
-Munchausen syndrome by proxy
-Sexual abuse
-Box 14.5
Abusive head trauma
-Shaken baby syndrome”, “Inflicted traumatic head injury,”
“Neuroinflicted brain injury”
-Intracranial bleeding (subdural and subarachnoid)
-Retinal hemorrhages
Fractures of ribs & long bones
-Most often there are no signs of external injury
-PredAHT –> prediction tool –> 6 clinical feature
Munchausen by proxy
-Caregiver exaggerates or fabricates signs and
symptoms of illness in a child (the proxy) to gain
attention or gratification
-Child may undergo needless and painful procedures
and treatments; in 10% of cases, they may be fatal to
the child
-Maltreatment may be physical, emotional, and
psychological
Factors predisposing to physical abuse
-Parental characteristics: Age, single parent, unrelated partner; Low self-esteem, poor parenting knowledge, poor role model
-Characteristics of the child: Age from newborn to 1 year; Physically disabled, hyperactive, premature
-Environmental characteristics: Social isolation, poor support systems; Chronic stress, poverty, substitute caregivers
Sexual abuse
-Defined as the use, persuasion, or coercion of any child to
engage in sexually explicit conduct or simulation of such
conduct for producing visual depiction of such conduct
-Rape or molestation
-Prostitution
-Incest with children
-Exhibitionism
-Child pornography or prostitution
-Pedophilia
Characteristics of abusers and victims
-Typical abuser is a man who the victim knows, but it may be ANYONE
-All socioeconomic backgrounds
-Adults in 80% of cases
-May be generational
