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Preventive Pediatric Health Care Flashcards

1
Q

What is EINC?

A

Essential intrapartum and newborn care or unang yakap

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2
Q

4 core actions in EINC?

A
  • immediate and thorough drying of the newborn
  • early skin-to-skin contact betwen mother and newborn
  • properly-timed cord clamping and cutting
  • non-separation of newborn and mother for early breastfeeding
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3
Q

Unncecessary interventions in newborn care include?

A
  • routine suctioning
  • early bathing
  • routine separation of mother
  • foot printing
  • application of various substances to the cord
  • giving pre-lacteals or artificial milk
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4
Q

Recommended period of breastfeeding

A
  • exclusive breastfeeding up to 6 months

- up to 2 years years and beyond after introduction of complementary foods

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5
Q

Minimum criteria for discharging newborns <48 hours

A
  • uncomplicated ante/intra/postpartum course
  • NSD, term, AGA, singleton
  • stable VS during the preceding 12 hrs
  • 1 stool and urine; normal PE
  • documented proper latch, milk transfer, swallowing, infant satiety and absence of nipple discomfort
  • no significant jaundice in the 1st 24 hrs of life
  • educability and ability of the parents to care for the child
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6
Q

When should neonates discharged less than 48 hrs after delivery follow up?

A

Within the next 48 hrs

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7
Q

When is newborn screening done?

A

Immediately after 24 hrs from birth

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8
Q

What is the perfect first food for the newborn?

A

Colostrum

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9
Q

What must be initiated during the 1st 30 minutes to 1 hour after delivery of the infant

A

Latching-on and breastfeeding

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10
Q

Any child with a family history of atopy (asthma, atopic dermatitis, allergic rhinitis, drug/food allergy) who presents with recurrent / persistent symptoms of 1 or more of the following should be closely monitored, investigated, or referred to the subspecialist when warranted

A

RESPIRATORY:

  • chronic cough with or without wheezing
  • shortness of breath
  • chest tightness
  • trouble sleeping due to coughing
  • fatigue
  • problems with feeding or grunting during infancy
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11
Q

Any child with a family history of atopy (asthma, atopic dermatitis, allergic rhinitis, drug/food allergy) who presents with recurrent / persistent symptoms of 1 or more of the following should be closely monitored, investigated, or referred to the subspecialist when warranted

A

NASAL SYMPTOMS:

  • frequent sneezing
  • rhinorhea
  • itchiness
  • nasal congestion
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12
Q

Any child with a family history of atopy (asthma, atopic dermatitis, allergic rhinitis, drug/food allergy) who presents with recurrent / persistent symptoms of 1 or more of the following should be closely monitored, investigated, or referred to the subspecialist when warranted

A

OCULAR SYMPTOMS

  • bluish, brownish discoloration around both eyes
  • puffiness under the eyes
  • redness and tearing
  • itchiness
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13
Q

Any child with a family history of atopy (asthma, atopic dermatitis, allergic rhinitis, drug/food allergy) who presents with recurrent / persistent symptoms of 1 or more of the following should be closely monitored, investigated, or referred to the subspecialist when warranted

A

SKIN SYMTPOMS

- dryness and itchiness

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14
Q

Any child with a family history of atopy (asthma, atopic dermatitis, allergic rhinitis, drug/food allergy) who presents with recurrent / persistent symptoms of 1 or more of the following should be closely monitored, investigated, or referred to the subspecialist when warranted

A

GASTROINTESTINAL SYMPTOMS

  • itchiness of the roof of the mouth and throat
  • colic
  • vomiting
  • stomach cramps
  • diarrhea
  • bloody stools
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15
Q

If a child is <2 years old, what will you measure?

A

Length

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16
Q

If a child is >2 years old, what will you measure?

A

Height

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17
Q

If a child is <2 years old and will not lie down, how will you measure the length?

A

Measure standing height and ADD 0.7 cm to convert it to length

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18
Q

If a child >2 years old and will not or cannot stand, how will you measure height?

A

Measure the length and subtract 0.7 cm to convert it to length

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19
Q

Is a reliable growth indicator even when the age is not known

A

Weight-for-length/height

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20
Q

Enable early detection and prevention of overweight and obesity problems

A

Body mass index (BMI)

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21
Q

When is BP measurement recommended annually for children?

A

> 3 years old and adolescents

  • ill patients
  • obese
  • taking meds known to increase BP
  • with renal disease
  • history of aortic atch obstruction or coarctation or obesity
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22
Q

Normotensive child?

A

1-13 years old: <90th percentile for age, gender and height

>13 years old: <120/80 mmHg

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23
Q

What to encourage in children with normal BP?

A
  • healthy diet
  • sleep
  • physical work
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24
Q

Elevated BP in children

A

1-13 years old:
- >90th percentile to <95th percentile
- 120/80 mmHg to <95th percentile
(Whichever is lower)

> 13 years old: 120/80 to 129/80 mmHg

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25
Q

What to do for patients with elevated BP

A
  • counseling on physical activity and diet management
  • medical investigations for presence of factors that might need pharmacologic therapy (CKD, DM)
  • in doubt, refer to a subspecialist
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26
Q

Stage 1 hypertension is defined as?

A

1-13 years old:

  • > 95th percentile to <95th + 12 mmHg
  • 130/80 to 139/89 mmHg

> 13 years old: <130/80 mmHg to 139/89 mmHg

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27
Q

What is stage 2 hypertension

A

1-13 years old:

  • > 95th percentile + 12 mmHg
  • 140/90 mmHg

> 13 years old: >140/90 mmHg

28
Q

What is the newborn screening act?

A

Republic act 9288

- obligation to inform

29
Q

When should newborn screening be done?

A

Ideally done immediately after 24 hours of birth

30
Q

When should newborn screening be done for preterm (<37 weeks), LBW (<2000 g) and sick neonates receiving ICU care?

A

A sample may be taken immediately before 24 hours from birth if blood transfusion will be done otherwise a sample should be taken immediately after 24 hours from birth and a repeat screenjng should be collected at the 28th day of life

31
Q

What republic act is the neonatal hearing screening.

32
Q

Infants not born in the hospital should be screened within?

A
  • 1st 3 months after birth
33
Q

What to do if a newborn becomes positive for hearing loss screening?

A
  • Newborn shall undergo audiologic diagnostic evaluation

- appropriate follow-up, recall and referral for intervetion BEFORE THE AGE OF 6 MONTHS OLD

34
Q

The single most effective way of determining a child’s eye health

A

Non-invasive and simple eye and vision screening test

35
Q

Routine eye exam is recommended for early detection of?

A

Leukoria and strabismus

- the most presenting signs of retinoblastoma

36
Q

IRON SUPPLEMENTATION

- low birth weight

A
  • 15 mg elemental iron / 0.6 ml

- 0.3 ml OD at 2 months of age until 6 months when complementary foods are given

37
Q

IRON SUPPLEMENTATION

- 6-11 months

A
  • 15 ml elemental iron/0.6 ml

- 0.6 ml OD for 3 months

38
Q

IRON SUPPLEMENTATION

- children 1-5 years old

A
  • 30 mg elemental iron/5ml

- 1 tsp OD for 3 months or 30 mg once a week for 6 months

39
Q

IRON SUPPLEMENTATION

- 10-19 years

A
  • 60 mg elemental iron with 400 mcg folic acid

- 1 tablet OD

40
Q

VITAMIN A SUPPLEMENTATION

- 6-11 months

A
  • 100,000 I.U.

- 1 dose

41
Q

VITAMIN SUPPLEMENTATION

- 12-59 months

A
  • 200,000 IU

- 1 capsule every 6 months

42
Q

Zinc supplementation prevents what diseases?

A
  • pneumonia

- diarrhea

43
Q

Deworming is recommended in children?

A
  • 1-12 years old
44
Q

Dose of Albendazole

A

12 months to 23 months: 200 mg single dose every 6 months
24 months and above: 400 mg single dose every 6 months

  • taken on full stomach
45
Q

Dose of Mebendazole

A

12 months and above: 500 mg single dose every 6 months

  • taken on full stomach
46
Q

Deworming must not be done in children with?

A
  • severe malnutrition
  • high-grade fever
  • profuse diarrhea
  • abdominal pain
  • serious illness
  • previous hypersensitivity to antihelminthic drug
47
Q

In municipalities endemic for filiariasis, mass treatment with?

A

Diethylcarbamazine citrate (DEC) and Albendazole in children 2 years and above

48
Q

When is the First dental visit is recommended?

A
  • eruption of first tooth

- no later that 12 months of age

49
Q

Recommendation for physical activities for children and adolescent

A
  • 60 minutes daily or on most days
50
Q

Children are discouraged from prolong periods of sedentary activity

A
  • for periods greater that 2 hours per day
51
Q

Antichild abuse law

52
Q

CBC is done at least once between the following time intervals for those at risk

A
  • 6-24 months
  • 2-6 years
  • 10-19 years

> special attention to:

  • 6 months to <12 months
  • 12 to 23 months
  • actively menstruating female adolescents
  • fad dieters
53
Q

When is referral to an ophthalmologist for comprehensive eye examination warranted?

A
  • premature infants whose AOG meet the criteria for screening for retinopathy
  • with metabolic disorders
  • with medical conditions known to have associated eye problems
  • history of squinting, tilting, head turn
  • history of visual difficulties and learning problems
54
Q

Criteria for screening retinipathy

A
  • 32 weeks AOG or younger
  • 1500 g or lighter
  • > 32 or >1500 g but with stormy medical course in NICU
55
Q

Visual acuity of children

A

3 to <4 years old: 20/50
4 to <5 years old: 20/40
5 years and older: 20/30

56
Q

Test to check for presence of ocular misalignment

A

Cross over test

57
Q

Fluoride toothpast recommendation in children

58
Q

What is the purpose of LEA card?

A

Vision screening

59
Q

Presence of 1 or more decayed, missing, or filled tooth surfaces in any primary tooth in those <71 months of age

A

Early childhood caries

60
Q

Recommended use of fluoride toothpaste in children

61
Q

Recommended as a primary preventive measure for dental care

A

Twice daily use of fluoride-containing toothpaste

62
Q

Correct breastfeeding techniques

A
  • support the baby’s head and entire body throughout the feeding; head, back and hips should be facing the breast and aligned in a straight manner
  • maintain the position of the baby in such a way he is “face to face”, “chest to chest” and “tummy to tummy” with the mother
  • support the breast with the hand of the opposite arm in a C-hold position: thumb above, 4 fingers under the breast
  • stimulate the infant to open the mouth wide by stroking the corner of the baby’s lips; heck that the chin touches the breast and lower lips is turned outward
  • ensure that the baby grasps the entire nipple plus 1 imch of the surrounding areola
  • allow the baby to suck 15-30 minutes per nreast tp extract both foremilk and hindmilk
  • empty the breast around 8-10 times or more a day to ensure adequate milk supply
63
Q

Currently the recommended method for physiologic hearing screening

A 
Otoacoustic emissions (OAE)
Auditory brainstem response (ABR)
64
Q

Developmental surveillance and screening is done at?

A
  • done at every well child visit

- 9, 18, 30 months and yearly thereafter

65
Q

When should Moderate dental caries receive professional fluoride treatment?

A

At least evey 6 months

66
Q

Recommended breastmilk expression storage period

A 
Room temperature (<25): 4 hours
Room temperature (>25): 1 hour
Refrigerator (4): 8 days 
Freezer compartment 1 door refrigerator: 2 weeks 
Freezer compartment 2 door refrigerator: 3 months
Deep freezer with constant temperature: 6 months

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