Social Health Flashcards
List three aspect of the social environment that is important on development
Physical Surroundings - affordable housing Community Resources: - availability and cohesion Social relationships
Describe the following:
Child neglect
Sexual abuse
Physical abuse
Child neglect: failure to provide for child’s basic physical, emotional, educational, or medical needs
Sexual abuse: activity with a child before age of legal consent (16) or beyond child’s comprehension
Physical abuse: injury inflicted on child
Discuss the risk factors for neglect
- parental substance abuse
- parental unemployment
- parental physical, cognitive, or psychiatric disbaility
- low maternal education
- violence at home
Discuss the presentation of child neglect
- failure to thrive
- developmental delay
- poor hygiene
- dental caries
Management: - CAS and provide resources and community services
Discuss the risk factors for child physical abuse
Parental: - young, single parent - low education level - substance abuse, psychiatric illness - stress Child: - age <3 - adopted - past medical history of abuse - medical conditions
Discuss the findings in abusive head injury
Triad of subdural hematoma, retinal bleeding, cerebral edema
- Associated features: skull fracture, cervical spin injury, rib fracture, long bone fracture
Presentation:
- altered LOC
- vomiting
- unstable vital signs
What are the typical presenting features of sexual abuse?
Sexualized behaviour - masturbation in excess and in public - coercing others to engage in sexual acts - sophisticated questions about sex - self insertion of foreign bodies into vagina Disclosure of sexual abuse Pregnancy or STD Non-Specific features - anxiety - enuresis
Discuss the HEEADDSS assessment for adolescents
Home - where do you live and if there have been any changes Education and Employment - In school or working - Enjoy school/work - How they are doing in these - Future aspirations or plans Activities - what much do they sleep - how much screen time - what sports/activities do they do Diet - regular meals - worried about weight Drugs - regular medication - do they smoke/drink/drugs Sexuality - have they had sexual experiences - guy, girl, both - how do they feel about sexual relationship - prevention Suicide and Depression - how is mood - feel as if want to hurt oneself - plan
Discuss the presentation and management of Behavioural sleep problems
- behavioural problem associated with bedtime refusal, delayed sleep onset, prolonged night awakening Cause - child maladaptive sleep problems: fall asleep under certain conditions and cannot self soothe - parental difficulty with limit setting Presentation - age is 0-5 years - bedtime resistance, delay and prolonged time to sleep onset and night time awakenings - daytime sleepiness and tiredness Screening (BEARS): - Bedtime probblems - Excessive daytime sleepiness - Awakenings during the night - Regularity and duration of sleep - Sleep-disordered breathing Management: - consistent bedtime routine - do not assist throughout the night
Discuss the presentation and management of temper tantrums
Presentation
- in 2-3 year olds
- are attention seeking behaviours in response to physical or emotional challenge
Management
- prevent: be firm in expectations and avoid triggers
- stop: ignore and distract
Discuss the presentation and management of enuresis
Presentation:
- <=5 year olds
- isolated nocturnal enuresis
Management
- education: void before bed, avoid high sugar and caffeine drinks, fluid intake in the morning mainly
- ensuresis alarms
- desmopressin for child >5 with enuresis
What are some bruise characteristics concerning for child abuse?
Age: Infants don’t normally bruise Number: >20 Size: less than 1cm, round Location: Extensor surface, forehead Pattern: positive or negative imprint of object
Discuss the differential diagnosis for bruising
Bleeding disorders: - von willebrand - hemophilia Neoplasm: - leukemia - neuroblastoma ITP HSP Connective tissue disorder - Ehlers-Danlos Congenital dermal melanocytes is
List some concerning features for abuse for burns
Uniform depth
Bilateral
Symmetric
