pediatric obesity Flashcards
how is apnea defined?
- cessation of breathing lasting longer than 20 seconds
- may be associated with cyanosis, pallor, hypotonia, and/or bradycardia
what are the three types of apnea?
obstructive
central
mixed
how is bradycardia defined for pediatric patients?
a HR slower than 80 bpm
-MRP/resident should be notified
what can cause apnea?
-infection, aspiration, cardiac problems, metabolic or endocrine disorders, neurologic conditions
how is obstructive sleep apnea characterized?
-repetitive episodes of partial/complete airway obstruction that occurs during sleep, usually associated with a reduction in blood oxygen saturation
what is the most common cause of obstructive sleep apnea?
- hypertrophy of adenoids and tonsils
- craniofacial abnormalities
what are symptoms of obstructive sleep apnea?
- loud snorting
- chest retractions during sleep in young children
- high blood pressure
- overweight
- irritability
- possible a change in behavior
why does blood pressure become high in those with obstructive sleep apnea?
-after long period of being apneic, BP may rise because of increased work for heart/body
what are some long-term implications of obstructive sleep apnea?
- stroke
- irregular heartbeat
- pulmonary and systemic hypertension
- cognitive impairment
what are some treatments for obstructive sleep apnea?
- weight loss
- side sleeping
- oral mouth devices
- c-pap
- bi-pap
- adenotonsilectomy
- O2 sat monitor
- may need oxygen or caffeine
why is caffeine used as a treatment for apnea in neonates?
Caffeine increases breathing frequency, decrease the number of apneic spells, and reduce partial tension of carbon dioxide (PCO2) and the need for (and duration of) mechanical ventilation.
Peripheral chemoreceptors, found in the carotid and aortic bodies and stimulated by chemical changes in blood composition, provide feed-forward control of respiration, which can thus terminate apnea and initiate normal breathing. These receptors are believed to be an important target for caffeine action
what are the two components of maturation?
timing and tempo
what is the formula for calculating body mass index?
BMI (kg/m^2) = weight (kg) / height^2 (m^2)
what are the classifications for BMI?
underweight <18.5
normal weight 18.5-24.9
overweight 25-29.9
obese >30
how is BMI calculated for children?
using growth charts and based on percentiles
overweight is 85th-95th percentile
obese is greater than 95th percentile
what age range counts as infant?
0-12 months
what age range counts as toddler?
1-3 years
what age range counts as preschool?
3-6 years
what age range counts as school age?
6-12 years
what age range counts as adolescence?
12-18 years
at what age does the average boy start their growth spurt?
14.1 years (initiation is 13.5)
at what age does the average girl start their growth spurt?
12.1 years (initiation 11.8 years)
how much do boys usually grow and gain during their adolescent growth spurt?
20 kg
20 cm
how much do girls usually grow and gain during their adolescent growth spurt?
16 kg
16 cm
what are some complications of childhood obesity?
- poor self-esteem
- eating disorders
- sleep apnea
- asthma
- exercise intolerance
- gallstones
- steatohepatitis
- slipped capital femoral epiphysis
- blount’s disease
- forearm fracture
- flat feed
- pseudotumor cerebri
- dyslipidemia
- hypertension
- coagulotherapy
- chronic inflammation
- endothelial dysfunction
- type 2 diabetes
- precocious puberty
- polycystic ovary syndrome (girls)
- hypogonadism (boys)
what are the long-term consequences of obesity in children
- high BP
- altered blood clotting
- strokes
- joint problems
- gallstones
- sleep apena
- type 2 diabetes
- CVD
- possibly cancer
how is fast food different in general than home prepared food?
- higher energy density
- poor micronutrients
- low fiber
- high in glycemic index
- excessive in portion size
how does screen time and sedentary activity affect children’s sleep?
every hour spent in sedentary activities delays bedtime by 3 minutes
the average children’s sleep duration has decreased 30-60 minutes
what are the sedentary behavior guidelines?
- no more than 2 hours of recreational screen time per day
- at least 60 minutes of moderate to vigorous physical activity daily
how long is it recommended children are exclusively breastfed?
6 months
what are some factors that contribute to obesity in children?
- early childhood development
- genetics
- infant feeding
- school, community, family
- inactivity
- diet/nutrition
- SES, food security`
how many young Canadians (2-17yrs) are overweight?
26%
8% are obese
1 in 3 school aged children
how high does Canada rank in childhood obesity out of the 34 OECD Countries?
11th
