paediatrics 1 Flashcards
baby crying for more than 3 hours a day
drawing knees up to the abdomen
clenching of fists
may go red in face or flushed
some babies’ stomachs rumble
Colic
CAUSES
may be neurodevelopment stage
smoking during pregnancy
gut spasms
tiredness and tension
problems in under or over feeding
sensitivity
MANAGEMENT/TREATMENT
simeticone (reduce gas in gut)
lactase (breakdown of glucose)
gripe water(herbal)- (reduce gas in gut)
gentle motion (rock in cradle)
wrap in blanket
gently massage the baby’s tummy
use music
bathe in warm water
get the child to drink slower
patches of white or yellow greasy scales on scalp and face
small, dry flakes
not itchy or painful
does not bother baby
cradle cap
CAUSES
overactive sebaceous glands (excess of skin oil)
maternal hormones (hormones passed from the mother)
lack of regular hair washing
MANAGEMENT/TREATMENT
self limiting
If severe, consider topical imidazole cream (clotrimazole) or hydrocortisone 1% cream
gently wash the baby’s hair and scalp
lightly massage an emollient
gently brush your baby’s scalp with a soft brush
well-defined area of redness/brown
scattered papules over convex surfaces
may be skin erosion
child may be distressed, agitated or uncomfortable
nappy rash
CAUSES
acute inflammatory reaction of the skin in nappy area
prolonged skin contact with urine and faeces
friction between skin and nappy
use of certain wipes or products
MANAGEMENT/TREATMENT
barrier preparations:
dimeticone, zinc, caster oil, white soft paraffin ointment
For moderate-severe rash:
hydrocortisone 1% cream+ barrier preparation
Fungal nappy rash:
topical antifungal imidazole (clotrimazole,econazole)
Bacterial nappy rash:
oral antibiotic
flucloxacillin
clarithromycin (alternative for penicillin allergy))
Apply a barrier preparation every time during nappy change, will reduce the contact the baby’s skin has with urine and feaces
Avoid talcum powder (irritant effect)
pain
increased biting and chewing
drooling
gum-rubbing
sucking
irritability
ear-rubbing
facial rash
decreased appetite
teething
CAUSES
teeth emerge through the gums
most infants start teething around 6 months of age
MANAGEMENT/TREATMENT
paracetamol for pain relief
bonjela, soothing gel, dentinox (only recommended if practical measures have not worked)
gentle rubbing of the gum with a clean finger
allowing the infant to bite on a clean and cool object
cuddling and reassuring the child
wiping away excess saliva regularly
as soon as teeth erupt in the mouth brush them twice daily
intense perianal itching
threadworms look like thin, white cotton threads
severe cases may have diarrhoea
Threadworm- parasitic worm infection
CAUSES
lack of hygiene
ingesting eggs containing larvae (hands,clothing,towel, food and water)
airborne transmission (contaminated bedding)
MANAGEMENT/TREATMENT
Mebendazole (ovex or bermox):
first line treatment
inhibits worms uptake of glucose
100mg tablets or suspension (more than 2 years old)
all household members treated at the same time
aim to clear eggs from body and home and prevent eggs being swallowed
wash sleep wear, bed linen, towels, toys
vacuum home
cover food
wear close fitting underwear
shower every morning
wash hands and scrub under nails
short fingernails
wear gloves?
itchy scalp due to allergic response to saliva of lice
itch can persist after eradication
may experience itchy rash on the back of neck and behind ears
head-lice
CAUSES
direct head-to-head contact
spread from school and daycare centres
spread from household items
personal hygiene
MANAGEMENT/TREATMENT
Physical insecticides:
dimeticone 4% spray (hedrin)
dimeticone 92% spray (NYDA)
isopropyl myristate and cyclomethicone
isopropyl myristate and isopropyl alcohol
Chemical insecticides:
Malathion 0.5% aqueous liquid (Derbac-M)
Wet combing:
removes headlice without using lotion to kill them
no side effects
need to do this on every family member
takes 30 min-2 hours to do properly
50% cure rate due to lack of dedication
Treat all affected family members
Children being treated can attend school
