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Pharmacy Professionalism & practice > RTS - Paediatric Health > Flashcards

RTS - Paediatric Health Flashcards

1
Q

what is oral thrush?

A

mild fungal infection affecting the mouth and throat - Candida albicans.
White patches in mouth that don’t wipe off,
red sore mouth and discomfort when eating, and drooling

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2
Q

oral thrush treatments &directions

A

antifungals- Miconadazole - daktarin (brand) - oral gel, P med, for babies aged 4 months or above
Apply with a clean finger or cotton wool bud 2-4 times daily
Continue treatment for 7 days after the symptoms clear

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3
Q

lifestyle advice for oral thrush

A

To avoid re infection - sterilise bottles, feeding equipment, sterilise toys they put in mouth

  • wash hands thoroughly after changing nappy
  • advice to new parents- sometimes it clears up by itself and may not need treatment - it is a MILD infection
  • Are they asthmatic? if so check inhaler technique
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4
Q

what is pyrexia / fever?

A

raised body temperature above the normal range of 36.5 - 37.5
Can be due to post immunisation, RTI or UTI infection, chicken pox
- Excess sweating, chills, headache

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5
Q

how is body temperature measured?

A

thermometer under armpit, tongue, ear

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6
Q

what are the red flag referral signs for pyrexia?

A 
temperature of >38 if under 3 months, or >39 if 2-6 months
breathlessness
persistent vomiting
rash
seizures
signs of meningitis/sepsis/pneumonia 
treatment failure 
fever >5 days 
crying 
refusal to feed
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7
Q

treatment for pyrexia

A
  • drink cool clear fluids, fruit juices, if breastfed continue as normal
  • Keep cool 18 degrees and use light blanket and gage the environment they are in
  • Antipyretics - para and Ibu
  • Monitor temperature regularly
  • No cold flannel
  • Look out for warning signs
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8
Q

what are febrile convulsions?

A

seizures in young children when they have a fever.
Ranges from 6 months -6 years
Simple febrile - rapid rise int empire lasting <5 mins - If known and <5 mins. - GP
Complex febrile - last >15 mins and recur - 999 (and if its the first time)

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9
Q

treatments for pain in children? and referral points

A

Ibuprofen - only licensed NSAID for children - >3 months OTC. (caution in asthmatic)
Paracetamol - >2 months
Can use combination, do not use aspirin

REFER: if severe, recurring, treatment failed and if they are abnormally drowsy, loss of consciousness, hard to breath

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10
Q

What is teething?

A

new tooth breaking through the gums - 3 months to 3 years (typically 6 months old).
Swollen gums, red cheeks, dribbling, fever, tendency to chew, irritable

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11
Q

Treatments for teething

A
  1. analgesics
  2. Topical gels e.g Bonjela (the children one NOT adult)
  3. Homeopathic that target immune system- not in prescription but an option
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12
Q

why can’t the adult version of bonjela gel be used in teething?

A

The oral choline salicylate it contraindicated in the adults - it contains salicylate which lead to Reyes syndrome in children. (same as aspirin)

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13
Q

Lifestyle advice for teething

A
  • teething rings (some can be cooled)
  • Raw fruit and veg to Chew IF they have started weaning
  • Hardened bread but not sugary rusks
  • cool sugar free drinks
  • Keep them occupied
  • Wipe chin and face often to ensure they don’t get a teething rash
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14
Q

what Is infant colic?

Causes

A

intense periods of crying lasting hours.
Baby may pull up or stiffen legs
Usually starts 2-4 weeks old
CAUSES: maybe problems with digestion, intolerance to lactose, trapped wind

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15
Q

treatment for colic

A
  1. gripe water mixtures - of dill, caraway, fennel & ginger
    antacids (e.g sodium carbonate), must be alcohol free
  2. colic drops - simeticone (infacol), and Dimeticone (dentinox - disperses trapped wind)
  3. Enzyme lactase - colief - breaks down lactose
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16
Q

lifestyle advice for colic

A
  • sit baby upright when feeding
  • Check the size of the teat on bottle - shouldn’t be too big as air will get in (if bottle fed)
  • hold the bottle so the teat is full of milk so avoids sucking air in
  • Burp them during and after feed
  • Baby massage
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17
Q

Referral symptoms for colic?

A 
weak, high pitched continuous cry for several hours
breathing issues
seizures 
vomiting green fluid 
Not feeding 
treatment failure
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18
Q

What is nappy rash?

A

inflammation of the skin in the nappy area - red and raw and white or red pimples which spread out to the folds of the skin
- Sore an itchy when area is wiped and baby unsettled

CAUSES: reaction of skin to urine and faeces mainly. but could be due to - eczema, psoriasis, fungal infections, allergies

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19
Q

treatments for nappy rash

A
  1. Barrier creams - Dimethicone & white soft paraffin,
    or - titanium dioxide/peroxide, titanium salicylate, - Brand = metanium ointment
  2. Antiseptics - cetirimide
  3. Astringents - zinc oxide e.g sudocrem
  4. antifungals - clotrimazole cream - canister 1% cream if fungal is suspected or other treatments failed
20
Q

what warning should be given when using barrier creams (white soft paraffin) for nappy rash?

A

White soft paraffin is flammable

21
Q

lifestyle advice for nappy rash

A
  • change nappy frequently
  • clean bum with warm water and cotton wool not wipes
  • Dry area thoroughly
  • leave nappy off for as long aspossible
  • avoid talcum powder
  • drink plenty of fluids
  • dress them in loose fitting bottoms
22
Q

what is threadworm?

A

happens in children >2 years.
White threadlike worms in the stool, itchy bottom
easily spread

23
Q

treatments for threadworm

A

MEBENDAZOLE - Ovex brand.
Tablet or suspension - from 2 years OTC.
- Single dose, repeat after 2 weeks if infection persists
- treat the WHOLE family (except preg/BF)
Must also use strict hygiene measures.

24
Q

lifestyle advice for threadworm

A

Keep nails short and clean

  • Careful washing & scrubbing of hands and nails after toilet and before eating
  • wash bed linen daily
  • Shower first thing in morning
  • Wear underwear or mittens to stop scratching
  • dust damp surfaces, vacuum daily
  • discourage nail biting, finger sucking
25
Q

referral points for threadworm

A 
<2 years 
signs of secondary bacterial infection
doubts about diagnosis 
fever, bedwetting, discharge
vomiting, dioarrhoea, weight loss 
recent travel abroad
26
Q

What is constipation?
Symptoms
causes

A

difficulty or strain passing stools, pass less often than normal and stools are hard, large and pellet like

Also have tummy ache, poor appetite, irritability, restlessness, nausea

Causes:
(a) idiopathic - common and can be due to anything, diet, stool holding, emotions, random

(b) underlying disease - uncommon, e.g could be due to hypothyroidism, CF, side effects of medication

27
Q

treatments for constipation children

A
  1. lactulose - osmotic laxative, stool softeners - 1 year (MACROGOLS)
  2. Ispaghula husk - bulk forming laxative >6 years old
  3. Senna syrup >12 years, Macrogols (POM)
  4. Glycerin suppositories - Lubricant and irritant, osmotic laxative
    - 1g <12 years
    - 2 g >12 years

continue treatment at the maintenance dose for several weeks after regular habit is established

28
Q

lifestyle advice for constipation

A

increase fluid and fibre intake (fruit, veg, bran)
Change milk if there is a possible intolerant to cows milk protein
encourage to go toilet regularly

29
Q

referral for constipation

A 
severe abdominal pain
rectal bleeding or blood stain stool
vomiting
severe pain on defacation 
persistence despite treatments
30
Q

Nausea and vomiting, and treatments

A

Vomiting episodes caused by e.g gastroenteritis, respiratory condition, feeding, meningitis, emotion

Treatment - oral rehydration - boiled and cooled drinking water, and correct volume dilution
regular sipping
if don’t use - throw away after an hour, but if keep in fridge - throw after 24 hours

31
Q

referral for vomiting

A 
signs of infection &amp; ever
frequently >24=48 hours
Feeding and swallowing difficulties 
Unexplained vomiting frequently
It is blood stained or looks like coffee grounds

WARNING signs - sunken eyes, wrinkly non elastic skin, dry nappy, drowsiness

32
Q

what are head lice?

A

insects that live in human hair (white/grey brown), spread via head to head contact and all types of hair.
Clings on hair and feeds on blood
(schools may have outbreaks)

33
Q

Head lice treatment cannot be used when a child has what medical condition?

A

Eczema (using E45) - ingredient that makes it flare up and there is alcohol (same with asthma)

34
Q

treatments for head lice

A

(a) INSECTICIDES
1. Dimeticone (silicone based) - shampoo sprays etc, suffocate lice by blocking resp system- Hedrin, once, nydra

  1. Isopropyl myristate and cyclomethicon - dissolve and disperse waxy coating = dehydration - full marks solution
  2. Octane-1,2 diol - dissolve waxy coating - dehydrate then - Hedrin Protect & go
    (b) use a lice comb
35
Q

3 types of insecticides for head lice

A
  1. dimeticone
  2. isopropyl myristate and cyclomethicon
  3. Octane-1,2 diol
36
Q

what is wet combing? (headlice)

A

Use a fine tooth comb and comb them out - break their legs so they fall out. Also detection- can comb them out

  • Use conditioner
  • Stops the cycle of laying eggs and hatching
37
Q

referral for head lice

A

severe skin or scalp conditions
children <6 months
suspected scalp infection

38
Q

wat is bacterial meningitis?

A

Symptoms such as stiff neck, photophobia, fontanelle, unresponsive
NON blanching rash (tumbler test)

39
Q

what are the general points for children medicine administration?

A
  • shouldn’t be mixed with large amount of food
  • Not to mixed or administered in a milk bottle
  • Children under 5 should have liquid prep
  • Sugar free provided where posoible
40
Q

how does a parent administer eye drops/ointment to child?

A

wrap in blanket / lay down - place drop into inner corner of eye. Better with eye open but still drains if eye is closed if keep head still

41
Q

how does a parent administer ear drops to child?

A

wrap tightly in blanket,

pull ear lobe backwards to open up ear canal, avoid touching ear with dropper

42
Q

how does a parent administer nasal drops to child?

A

lay across lap with head hanging down. wrap small in blanket)
To remove mucus from nose, tickle with cotton wool
warm drops are better tolerated and no more than 2-3 drops

43
Q

how are suppositories administered

A

lay children with knees pulled up
lubricate supp & insert 2-4 cm into rectum
hold buttocks together for 5 mins

44
Q

administering liquids - how is a spoon used?

A

Ensure child no more than 45 degree angle to reduce risk of choking.
Shakebottle
Pour onto the spoon according to dosage and give water to wash down
Don’t use household spoon - 5ml med spoon

45
Q

how is a syringe used?

A

Insert syringe into the bottle adapter, turn bottle upside down and pull plunger until the medicine reaches the volume required
Turn and move,
insert into mouth into the side slowly

46
Q

what other counselling points must be remembered in administration?

A

Length of supply
expiry date
for them to always wash hands

Pharmacy Professionalism & practice (25 decks)

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