Health Promotion Flashcards
Infants: Safety
Falls (do not leave infant unsecured in infant seat. Do not place on high surfaces. keep doors to stairways close or use gates)
Burns (check temp of bath water. cover electrical outlets. dont drink hot beverages while holding infant)
Motor vehicle crashes (use approved restraint system, properly buckled)
Drowning (Never leave infant along in a bath or water)
Poisoning (keep meds and cleaning products out of reach)
Choking (avoid foods and small toys that cause choking)
Suffocation (Position infant on back to sleep, do not place pillows/stuffies near head)
Strangulation (Slats of crib far enough apart)
Infant: Colic
Paroxysmal abdominal pain or cramping manifested by loud crying & drawing up legs to abdomen
Many theories of etiology
If no diagnosable cause, care is supportive
Medications may be recommended
Thorough, detailed history usually daily events is essential
- Provide rhythmic movement
- alternate positions
- reduce environment
- provide various tactile stimuli
- alter intake
Infant: teething
Age of tooth eruption varies considerably; Order of appearance quite regular & predictable
Signs of teething: drooling, increased finger-sucking, biting on hard objects, irritability, difficulty sleeping, refusal to eat, mild temp increase, ear rubbing
Treatment: cool teething rings; topical anesthetics, analgesics (acetaminophen, ibuprofen)
Infant: Diaper dermatitis
Change diaper as soon as the infant is wet or has a BM or minimally every 2 hours during day and once at night
Topical barrier creams. remove once or twice a day.
Observe for signs of infection.
Superabsorbent disposable diapers
Allow infant to lie or walk without a diaper during the day to let the skin air out
powders are not reccomended
Alcohol free baby wipes and let it dry
Infant: positional plagiocephaly
Increased since Back to Sleep campaign initiated
Oblique or asymmetrical head as a result of cranial molding during infancy
Flattening of posterior occiput with typical bald spot; mild facial asymmetry may develop
“tummy time”
Infant: SIDS/Safe sleep
SIDS: sudden death of an infant < 1 year that remains unexplained after a complete post-mortem examination, including an investigation of the death scene and review of the cast history
Some infants at increased risk (maternal smoking, bed sharing, sleep position)
- infants place on their backs to sleep, for every sleep, have reduced risk of SIDS
- preventing exposure to tobacco smoke, before & after birth, reduces the risk of SIDS
- safest place for an infant to sleep is in a crib, cradle, or bassinet that meets current Canadian regulations
- Infants who share a room with a parent or caregiver have lower risk of SIDS
- Breastfeeding provides a protective effect
Infant: limit setting/discipline
Begin with negative voice & stern eye contact
Time-out (playpen for infants, rather than a chair)
Behaviour is exploratory, not oppositional (provide safe alternatives)
Infants cry because a need is not being met
Infant: Thumb sucking/pacifier use
Sucking is the infant’s chief pleasure & may not be satisfied by breast or bottle-feeding
Research has not shown that pacifier use causes reduction in breastfeeding - complex # of factors
Strong evidence that pacifier use has a protective effect in SIDS prevention
Should explore further if pacifier is used to calm the child when other approaches would be more beneficial
CPS “pacifiers should not be routinely discouraged”
No need to restrict nonnutritive sucking of fingers or thumb in early childhood (malocclusion of teeth may occur if thumb sucking persists beyond 4 years)
Toddlers/Preschoolers: Nutrition
Toddler Appetite Slump
- lower growth rate results in lower needs
- advise parents to offer small amounts of high nutrition foods
- advice parents to avoid “food fights” give toddlers independence in feeding as much as possible
- advise parents to look at week’s intake and not just the day’s intake
Iron deficient Anemia
- advise parents to avoid excessive milk and juice
Bottle Mouth Syndrome or Early Childhood Caries
Toddlers should sit at a table or in a high-chair to eat, to minimize the chance of choking and to foster positive eating patterns
Toddlers/Preschoolers: Toilet training
Physical readiness (voluntary control of the sphincters - 18-24 mos. Ability to stay dry for 2 hours. regular bowel movements. Gross motor skills of sitting walking and squatting. Fine motor skills to be able to remove clothes)
Mental readiness (recognizes need to defecate or void. verbal or nonverbal communication skills to indicate when wet or needs to void or defecate. Cognitive skills to imitate behaviour and can follow directions)
Psychological readiness (wants to please parent. able to sit for 5-8 minutes without fussing. curious about adults - wants wet or soiled diapers changed)
Parental readiness (recognizes child’s level of readiness. Low stress time, willing to give the time)
Toddlers/Preschoolers: Tooth care
0-3 years: if at risk for tooth decay, brush teeth by adult with fluoridated toothpaste
if not at risk, brush with water only
RISKS
- non-fluoridated water
- visible defect; white chalky area on teeth
- regularly consumes sugar between meals
- special needs that make cooperation with toothbrushing a challenge
- brushes < 1x/day
- premature, with BW < 1500g
- parent has tooth decay
- visible plaque
Toddlers/Preschoolers: Injury prevention
Falls (supervise toddler closely.)
Poisoning (Keep medicines and other poisonous material locked away. child-resistant containers.)
Burns (keep pot handles turned inward on stove. do not burn fires without close supervision. instruct the child in the dangers of matches, lighters, and similar items. Stop, drop, and roll)
Drowning (supervise any child near water. teach child never to go into water without an adult.)
Motor-vehicle crashes (insist on care safety seat use for all trips. Preschooler: verify that the child is belted in properly before starting car. Booster seats should be in back sat. teach child never to go into the road.)
Preschool: Electrical injury (cover outlets. avoid use of cords if possible.)
Toddlers/Preschoolers: lead poisoning
Children and lead
Causes of lead poisoning (lead paint most common. ingest contaminated food, water, and soil.
Pathophysiology (interferes with normal cell function primarily the nervous system, blood cells, and kidneys)
Long-term effects
Prevention strategies
- identify environmental sources
- screening (questioning parents about the age and condition of their home. questioning parents about hobbies and occupations. Blood testing in areas at risk.
- avoid use of pottery or ceramic dishes that have not been fired
- test water of well source for lead
- make sure child does not have access to peeling paint or chewable surfaces with lead-based paint
- when remodeling older homes, avoid exposure of child to dust and paint
School-age: injury prevention
Motor vehicle/pedestrian/biking crashes (teach child safe outside play near streets. helmet use. biking safety rules. safe street crossing)
Firearms (teach child to never touch guns without parent present. guns kept unloaded and locked. ammunition stored in different location. trigger locks)
Burns (what to do in case of fire, or toxic substances touching skin or eyes)
Assault (provide telephone numbers, leave child alone for brief periods. teach not to accept rides from or talk to or open doors to strangers. teach child how to answer the phone)
School-age: enuresis
Primary or secondary
Diurnal or nocturnal
Genetic component
Supporting families
Management - behaviour and pharmacological
