Preventive Pediatric Health Care Flashcards
What is EINC?
Essential intrapartum and newborn care or unang yakap
4 core actions in EINC?
- 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
Unncecessary interventions in newborn care include?
- routine suctioning
- early bathing
- routine separation of mother
- foot printing
- application of various substances to the cord
- giving pre-lacteals or artificial milk
Recommended period of breastfeeding
- exclusive breastfeeding up to 6 months
- up to 2 years years and beyond after introduction of complementary foods
Minimum criteria for discharging newborns <48 hours
- 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
When should neonates discharged less than 48 hrs after delivery follow up?
Within the next 48 hrs
When is newborn screening done?
Immediately after 24 hrs from birth
What is the perfect first food for the newborn?
Colostrum
What must be initiated during the 1st 30 minutes to 1 hour after delivery of the infant
Latching-on and breastfeeding
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
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
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
NASAL SYMPTOMS:
- frequent sneezing
- rhinorhea
- itchiness
- nasal congestion
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
OCULAR SYMPTOMS
- bluish, brownish discoloration around both eyes
- puffiness under the eyes
- redness and tearing
- itchiness
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
SKIN SYMTPOMS
- dryness and itchiness
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
GASTROINTESTINAL SYMPTOMS
- itchiness of the roof of the mouth and throat
- colic
- vomiting
- stomach cramps
- diarrhea
- bloody stools
If a child is <2 years old, what will you measure?
Length
If a child is >2 years old, what will you measure?
Height
If a child is <2 years old and will not lie down, how will you measure the length?
Measure standing height and ADD 0.7 cm to convert it to length
If a child >2 years old and will not or cannot stand, how will you measure height?
Measure the length and subtract 0.7 cm to convert it to length
Is a reliable growth indicator even when the age is not known
Weight-for-length/height
Enable early detection and prevention of overweight and obesity problems
Body mass index (BMI)
When is BP measurement recommended annually for children?
> 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
Normotensive child?
1-13 years old: <90th percentile for age, gender and height
>13 years old: <120/80 mmHg
What to encourage in children with normal BP?
- healthy diet
- sleep
- physical work
Elevated BP in children
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
What to do for patients with elevated BP
- 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
Stage 1 hypertension is defined as?
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