Week 10: Common Childhood Illnesses Flashcards
What is nasopharyngitis?
common cold
caused by viruses (influenza, RSV…)
What are the clinical manifestations of nasopharyngitis?
stuffy, runny nose
scratchy tickly throat
sneezing
watering eyes
low grade fever
sore throat
mild hacking cough
achy muscles/bones
NC: Nasopharyngitis
tx at home
promote comfort
educate on signs of complications
What is RSV (Respiratory Synctal Virus)?
common cause of bronchitis
high risk kids need tx for RSV once a month during RSV season (Nov-Apr)
spreads by touching (lives on hard surfaces for 6+hours)
tx is to relieve symptoms
antibiotics have no effect
What vaccine is givven to prevent severe RSV?
palivizumab
What is influenza?
flu
caused by orthomyxoviruses (TA/B/C)
What are the clinical manifestations of influenza?
fever/feverish chills
cough
sore throat
runny/stuffy nose
muscle/body aches
headaches
fatigue
NC: Influenza
rest
fluids (water)
mediction (tx of fever/aches)
How can you prevent influenza?
yearly vaccines (flu shot)
What are the types of flu vaccines available for children?
annual flu shot (6mo +)
- injectable influenza vaccine (IIV4), for young people 6mo+
- live attentuated influenxa vaccine (LAIV4), nasal spray for 2yrs-49yrs, non-pregnant ppl
What are emergency warning signs of the flu?
fast/troubled breathing
bluish lips/face
ribs pulling in with each breath
chest pain
severe muscle pain (child refuses to walk)
dehydration (no tears, dry mouth, no pee 8+hours)
not alert, not interacting when awake
seizures
fever: 104F+/ present in <12w kids
fever/ cough (imrpoves but then returns/worsens)
worsening of chronic medical conditions
What is Acute Otitis Media (AOD)?
inflammation in middle ear d/t cold/sore throat/respiratory infection
etiology/pathophysiology (when bacteria/virus infect and trap fluid behind eardrum, causing pain/bulging of ear drum)
Management of AOD?
pharmacological: antibiotics, pain-relief
surgical: placement of ear tubes (drainage + prevent buildup)
How can you prevent AOD?
pneumococcal 13-valent conjugate vaccine
Risk factors for AOD?
secondhand tobbaco smoke
preschool, daycare attendance
bottle feeding
pacifier use
allergies
esophageal reflex
siblings w/ ear infections
congential/autoimmune disease
chromosomal abnormalities
carniofacial abnormalities (cleft lip, down syndrome)
lower socioeconomic status (poor housing, diet, access to care)
NC: AOD
pain relief
facilitate drainage
prevent complications/reoccurence
education
- have child sit up/raise head on pillow, lie on unaffected side
- heat application
-diet, fluid intake - hygiene HH
-monitor hearing loss
What is bronchitis?
inflammation of the breathing tubes –> increased music production, narrowing airways
What is bronchitis caused by?
infections
physical/chemical agents (dust, allergens, fumes, tobbaco)
cold
S/S of Bronchitis?
cough
production of musuc (clear, white, yellow-grya, green, bloody streak-R)
fatigue
SOB
slight fever/chills
NC: Bronchitis
avoid exposure to second hand smoke
cough medicine
humidify air
medicine (fever, pain)
quit smoking
What medication should you avoid if you have bronchitis?
antihistamines
they dry up the secretions and cacan make the cough worse
What is Asthma?
chronic inflammatory disorder of airways; airways swell & narrow, produce extra muscus (broncial hyperresponsiveness). makes breathing difficult, triggering coughing, wheezing, SOB
What are triggers for asthma?
infections
allergies
exercise, weather
smoke, fumes, pollution
medicine (anti-inflammatory pain killers- ibuprofen, aspirin)
emotions (stress, laughter)
What are S/S of asthma?
SOB
chest tightness/pain
wheezing when exhaling
trouble sleeping
couching/wheezing worsened by infections
Medication Therapy for Asthma
1:bronchodilators
2;Anti-inflammatories (streoidal)
3:eukotrine modifiers
4: cromolyn sodium
-long tem control meds: singulair, flovent, advairm pulmicort, symbicort, QVAR
-quick relief: albuterol, ipratropium bromide, inhaler, corticosteriods, cromolyn sodium, levalbuterol, terbutaline, theophylline, leukotriene modifiers
NC: Asthma
acute ashtma care
long-term:
- avoid allergens
- relieve bronchospasm
- teaching adminsitration of meds
Outline the steps of using a puffer with a spacer
shake inhaler (3-4x)
remove caps
put inhaler into spacer
breath out away from spacer
bring spaver to mouth, put mouth piece between teeth
press inhaler once
breath in very slowly for a full breath (whistling means you are too fast)
hold breath for 10 secs then breathout
wait 30 secs between puffs and shake inhaler if need to repeat
Warning signs of respiratory complication in kids less than 3mo
trouble breathing
not eating/vomiting
fever (38.5+)
Warning signs of respiratory complication in kids of any age
rapid breathing, increased work
blue lips
coughing hard (choking/vomiting)
eyes dried with yellow pus after sleep
sleepier than usually (doesn’t play,feed, fussy, unable to be comforted)
What are some physiological pediatric GI differences?
mouth highly vascular
lower esophageal spincter muscle tone not developed until 1 mo
stomach capacity increases w/ age
intestinal growth spurts @ 1-3 yrs & 15-16yrs
less able to recieve and transform nutrients (immature system)
digestive enzyme are not plentiful/efficient
digestive capacity weak/impaired d/t diet or stressors
ingestion of incomplete chewing puts stress on GI + immune system
Types of Dehydration
isotonic: water + salt are lost in equal amounts
hypotonic: electrolyte deficit > water deficit
hypertonic: water deficit> electrolyte deficit
S/S of dehydration
dark coloured urine
increased urination
headache
fatigue
dry skin
decreased skin turgor
NC: Dehydration
oral fluid therapy, paraentral fluid therapy
treat underlying cause
What is the leading cause of illness in children under 5?
diarhea
What is chronic diarrhea?
increased stool frequency for 14+ days
NC: diarrhea
F/E
rehydrate
adequate diet
NC: Vomiting
detect + treat cause
prevent complications (dehydration)
provide fluids
antiemetic in some cases
the 4/2/1 method is used for _____
daily fluid requirements
What is a cleft lippalate?
facial malformation that occur during embryonic development
NC: Cleft Lip/Palate
surfical correction- pre/post operative care
How to breastfeed baby with cleft lip?
-breast tissue fiils the opening, seals off the mouth to create suction
- hold finger across cleft while baby feeds
- swallowing noises, weight gain = good feeding
- noisy feeding = improper suction
how to bottle feed with a cleft lip?
bottles/nipples with wider base
hold baby upright when starting feed
touch baby’s lower lip with nipple
when baby latches, point the nipple downwards
keep nipple in the centre of baby’s mouth
What is juvenile T1 DM?
autoimmune conditions
unknown cause
untreated= ketoacidosis
How do you dx T1 DM?
fasting blood sugar reading og 7.00mmol-11.00mmol at any time of the day
How do you manage T1 DM?
diet
exercise
insulin injections
monitoring
What is a group of disordered movement, muslcle tone & posture associated w/ acitvity limitations attributed to permanent injury to the brain
cerebral palsy
what condition is typically accompanied with CP?
epilepsy
Prenatal abnormalities assoc w/ CP
gross abnormalities of the brain
vascular occlusion
laminar degeneration
effects of LBW
anoxia
hypoxic infraction, hemmorhage
6 Attributes that need investigation assoc w/ CP
-early handedness in a child under 12mo
-stiffness/tightness in legs 6mo-12mo
-persistetnt fisting 4mo+
-persistant head lag 4m0+
-inability to sit w/o support in a child 9mo+
-asymmetry in posture movement
Management of CP
-rehab
-pharmacological (pain tx, botulinum toxin A injections- reduces overactivity)
- neurosurgical
- orthopedic
- denta hygiene
- NMES
Most common Congenital Heart Disease anomaly?
ventricular septal defect (VSD)
what is the major cause of death in first year of life?
CHD
What are defects that increased pulmonary blood flow?
1:atrial septal defect (ASD)
2:ventriculat septal defect (VSD)
3:patent ductus atreriosus (PDA)
- mixing of o2 + non-o2 blood
more blood on R side, less systemic blood flow
What are defects that decrease pulmonary blood flow?
tetralogy of fallot
- valve stenosis
- RV hypertrophy
- VSD (hole)
- override artery
tricuspid atresa
pressure increase r>l, desaturated blood in l side + systemic circulation
CHD: Homecare Plan
recovery: 6-8weeks
no activity that can = fall/blow to chest
child should not cry for too long (3-4w)
don’t pull/lift child from arms/armpit area
limit feeding to 30m, dd extra calories to formula
check for infection
CHD: The doctor should be contacted if ?
fever, n/v, chest-pain, redness, swelling, drainage, SOB, puffy eyes/face, blue-ish/gray skin, dizziness, fainting, heart palpitations, feeding issues, reduced appetite
CHD: Pre-OP Procedure
explain procedure
child fasting
identifcation bracelet
pain assessment
blood tests
clear fluids given
pt is clean
consent
CHD: Post-Op Procedure
oral fluids + light diet
urine passed post-op
IV fluids
I/O
antibiotics
VS, signs of infection
abnormal hemoglobin causing RBC to become hard and sticky, crescent shapes
sickle cell
what are the effects of sickle cell
the cells die early, always a reduced number of RBCs
clump up and clog blood flow in vessels –> pain, damage to nerves/organs. infection, acute chest syndrome, stroke
What level of hemoglobin indicates Sickle Cell & Sickle Cell Anemia?
9-14 & 6-9
S/S of Sickle Cell
painful episodes
hand-foot syndrome (swelling of fingers and toes)
acuse chest syndrome
anemia
avascular necrosis (death of bone tissue)
jaundice
priapism (pain in penis)
splenic sequestrian crises
infection
stroke
delayed grwoth
psycosocial issues
7 Goals of Tx for Sickle Cell?
1: mgt vasoocclusice crisis
2: mgt chronic pain
3: mgr chronic hemolytic anemia
4: prevention + tx of infections
5: mgt of complications + organ damage syndromes
6: prevention of stroke
7: detect + treat pulmonary hypertension
Treatment of Sickle Cell
hydorxyurea
penicillin/amoxicillin
immunization
transfusion
pain meds
hydration
comfort measures
