Paediatrics - fever, chickenpox, nappy rash, and colic

Question 1

What is a fever and what are the causes?

Answer 1

A fever is a body temperature above 38.0 degrees c.

Causes include viral/bacterial infection and vaccinations.

Question 2

Treatment Options

Answer 2

• Give your child plenty of fluids
• Do not try and cool down the child as a fever is a healthy response to infection
• Adjust clothes to surroundings so they do not overheat
• Simple analgesia can help
• paracetamol OR ibuprofen not both
• Paracetamol suspension
• Monitor for signs of dehydration and regularly check child

Question 3

MENINGITIS

Answer 3

Needs to be referred to A&E as soon as possible
Symptoms include:
-rash that does not disappear when pressed
-stiff neck
-photosensitivity
-headache
-extreme shivering
-strange breathing or difficulty breathing
-vomiting or not feeding
-irritable when picked up
-tense or bulging soft spot on head
-cold hands and feets

Question 4

What happens to the spots in chicken pox?

Answer 4

First stage- red, slightly raised lumps
Second stage- lumps develop into blisters
Third stage- blisters burst and crust over
Fourth stage- healing

After they crust over the blisters are no longer infectious
Child is infectious two days before spots appear up to crusting

Question 5

Treatment Options

Answer 5

-Simple Analgesia
Paracetamol, not ibuprofen as this can cause secondary skin complications
-Cooling gel - Care ViraSoothe
Spray approx 10cm away from skin and rub in
-Antihistamines to help with itching and make child sleepy

Question 6

Advice

Answer 6

Cut child’s nails as short as possible to stop itching
Put socks on child’s hands at night to stop itching at night
Keep child hydrated
Loose clothes
Bathe in school water and pat dry, not rub

Question 7

What are some of the causes of nappy rash?

Answer 7

Skin in contact with faeces and urine for long periods of time
Poor cleaning in nappy area
Detergents - from clothes or bathing
Alcohol/fragrance wipes
Friction

Question 8

What can happen when the skin is damaged?

Answer 8

When the skin barrier becomes compromised, colonisation of secondary infecting micro-organisms can occur

• candida albicans is fungal
• s. aureus is bacterial

Question 9

What are the symptoms?

Answer 9

• Rash in buttock area
• Skin unbroken

Weeping, blistering or crusting may indicate secondary candida infection
Red lesions may indicate secondary bacterial infection

Question 10

Describe some treatment options

Answer 10

• Better cleaning of the area, gently and from front to back
• Change nappies regularly
• Use water/fragrance free wipes
• Use barrier creams like sudocrem to protect the skin in nappy area from breakages
• No soaps, detergents, talc etc.
• Bathe daily but not more than once a day
• Dry gently after bath, pat rather than rub
• Be aware of infection signs
• Metanium rash ointment

For secondary infections

• candida - canesten
• bacterial - need GP prescription for cream

Question 11

What are the symptoms of colic?

Answer 11

Colic describes bouts of unexplained crying by young babies:

• difficult to comfort
• excessive crying
• grimacing/frowning
• clenched fists
• high pitched, piercing scream
• red faced
• knees drawn up to chest
• crying has been going on for a long time

Question 12

What are some things you can do to improve colic?

Answer 12

• holding the baby to soothe them during crying episodes
• sitting or holding upright during feeding
• changing teat if breastfeeding to help with flow rate
• burp baby after feeds
• gentle rocking (moses crib) or some background noise
• warm bath
• take it in turns with partner
• gentle stomach and back rubs