Health Problems of the Infant

Question 1

Identify the symptoms and management of anaphylaxis.

Most common cause of anaphylaxis in children?
whats the first line of treatment?

Answer 1

Rapid onset of airway difficulties: dyspnea, wheezing, stridor, hypoxia

Evidence of shock—hypotension, syncope.

Food allergies are the most common cause of anaphylaxis in children.

Epinephrine is first-line treatment.
-EpiPen or EpiPen Junior depending on weight of the child.
(home, car, school)

Observe in Emergency Department (4-6 hours) after an anaphylactic reaction for biphasic response (anaphylactic response with no exposure to allergen).
–Medic Alert bracelet.

Question 2

Identify the etiology, presentation, and management of Atopic Dermatitis.

Answer 2

Chronic inflammatory skin condition that often develops in early childhood (60% begin during the first year of life)

-Hereditary tendency
-Scaly, pruritic (itchy)
Secondary infections (scratching)
-Sleep deprivation
-Academic performance

Question 3

Management of atopic dermatitis

Answer 3

Bathing and moisturizing is an important part of treatment.

-No bubble baths, shower gels, or hot water.

-Pat the skin dry after bathing (leaving slightly damp.)

-Hydrate the skin (e.g., Aquaphor, non-perfumed lotions)

-Relieve pruritus: Zyrtec (6 months), Benadryl (> 2 yr)

-Reduce inflammation (e.g., topical steroid -Triamcinolone)
Prevent and control secondary infection (keep hands clean and fingernails cut

Question 4

FTT

Answer 4

Failure to thrive is a lack of adequate weight gain in which the infant’s or child’s weight is below the 5th percentile on standard growth charts. Length WNL

**The first 3 years of life are a crucial brain development period in which adequate nutrition is vital for optimal growth and cognitive development.

Question 5

Failure to thrive symptoms

Answer 5

Weight < 5th percentile, length WNL

Decreased or lack of subcutaneous fat

Pale skin

Developmental delays

Question 6

Organic FTT

Answer 6

Inadequate caloric intake/incorrect formula preparation/cleft lip

Inadequate nutrient absorption—Cystic Fibrosis/Celiac disease

Increased metabolism-Hyperthyroidism/Congenital Heart Disease

Question 7

Nonorganic FTT

Answer 7

Abuse, neglect

Treatment is dependent upon the cause.

Question 8

Risk factors for SIDS (Sudden Infant Death Syndrome)

Answer 8

Low birth weight

Low Apgar scores

Siblings of two or more SIDS victims

Preterm infants experiencing apnea at time of discharge from hospital

Recent respiratory viral illness

Importance of immunizations (e.g., Pneumococcal (PCV), DTaP, Flu)

Question 9

Practices that may reduce the risk of SIDS

Answer 9

Avoid smoking during pregnancy and near infant

Breastfeeding-increases immunity

Supine sleeping position-Back to Sleep Program 1994

Avoid blankets, pillows, stuffed animals, bumpers

Room share without bed share (Avoid bed sharing)

Avoid overheating during sleep

Pacifier-requires forward positioning of the tongue - reduce the risk of oropharyngeal obstruction.