CHILD HEALTH
Child Health Overview
Well-Child Visit •
Health professionals assess the child for: –
Current health status •
Progression of growth and development •
Need for immunizations •
Health professionals have opportunity to teach parents about –
child’s growth and development
Growth and Development
Growth •
Physical increase in the whole or any of its part –
Parameters of a child’s growth can be easily measured with –
accuracy through acquiring the following:
Weight •
Head circumference •
Length or height •
Dentition •
Growth and Development (continued)
Weight •
Important indicator of child’s nutritional status and general –
growth
Used to calculate medication dosages for children –
Should be measured at every visit –
Growth and Development (continued)
Head Circumference •
Related to intracranial volume –
Normal brain growth = expected rate of increase in head –
circumference
Abnormal lags or surges may indicate serious problems –
Growth and Development (continued)
Length or Height •
Compared with head circumference and weight measurement for –
overall indicator of physical growth
Measure infant from crown of head to heel –
Place child in recumbent position •
Standing height measurement for children 3 years or older –
Growth and Development (continued)
Dentition •
Refers to eruption of teeth and follows sequential pattern –
Eruption of primary teeth – 6-30 months –
Twenty primary teeth •
Eruption of permanent teeth - around 6 years of age –
Normally 32 permanent teeth •
Growth and Development (continued)
Development •
Increase in function and complexity that results through learning, –
maturation, and growth
Development screening tests are used as assessment tools –
Brazelton Neonatal Behavior Assessment Scale for Newborns •
Dubowitz for Newborns •
Denver II Developmental Screening Test for Infants and Young Children •
Growth and Development (continued)
Stages of Childhood Growth and Development •
Newborn – birth to 1 month –
Infancy – 1 month to 1 year –
Toddlerhood – 1 to 3 years –
Preschool Age – 3 to 6 years –
School Age – 6 to 12 years –
Adolescents – 12 to 18 years or 21 years –
Growth and Development Principles
Cephalocaudal •
Growth and development proceeds from head to toe –
Muscular control follows the spine downward •
Proximodistal •
Growth and development proceeds from the center outward or –
from the midline to the periphery
Growth and Development Principles (continued)
General to Specific •
Activities move from being generalized toward being more –
focused
Simple to Complex •
Language develops from simple to complex –
Growth Spurts •
Occur throughout childhood –
Alternate with periods of slow growth •
Immunizations
Immunization •
Process of creating immunity to a specific disease in an –
individual
Medication administered is a vaccine –
Suspension of infectious agents or some part of them •
Given to establish resistance to an infectious disease •
Immunity •
State of being immune to or protected from a disease, especially –
an infectious disease
Immunizations (continued)
Childhood Immunizations •
Administered to the well child according to specific schedule –
Recommended Childhood Immunizations –
Hepatitis B •
DTaP •
Hib •
Polio (IPV) •
MMR •
Varicella •
PCV •
COMMUNICABLE DISEASES
CHILD HEALTH
Communicable Diseases (continued)
Chicken Pox (Varicella) •
Viral disease of sudden onset with slight fever, successive –
eruptions of macules, papules, and vesicles on the skin, followed
by crusting over of the lesions with a granular scab
Itching may be severe •
Infectious agent: Varicella-Zoster virus –
Immunization: varicella vaccine –
Communicable Diseases (continued)
Diphtheria •
Serious infectious disease affecting the nose, pharynx, or larynx, –
usually resulting in sore throat, dysphonia, and fever
Infectious agent: Corynebacterium diphtheriae –
Immunization: one of the components of the DPT vaccine –
Communicable Diseases (continued)
Erythema Infectiosum (fifth disease) •
Viral disease characterized by a face that appears as “slapped –
cheeks,” a fiery red rash on the cheeks
Infectious agent: Human Parvovirus –
Communicable Diseases (continued)
Impetigo •
Contagious superficial skin infection characterized by serous –
vesicles and pustules filled with millions of staphylococcus or
streptococcus bacteria, usually forming on the face
Progresses to pruritic erosions and crusts with a honey-colored •
appearance
Highly contagious lesions •
Communicable Diseases (continued)
Mumps (Infectious Parotitis) •
Acute viral disease characterized by fever, swelling, and –
tenderness of one or more salivary glands, usually the parotid
glands
Infectious agent: Mumps virus –
Immunization: one of the components of the MMR vaccine –
Communicable Diseases (continued)
Pertussis (Whooping Cough) •
An acute upper respiratory infectious disease that occurs mainly –
in children and infants
Characterized by violent cough that consists of series of several short •
coughs, followed by a long drawn inspiration during which the typical
whoop is heard
Infectious agent: bacteria, Bordetella pertussis –
Immunization: one of the components of the DPT vaccine –
Communicable Diseases (continued)
Roseola Infantum •
Viral disease with a sudden onset of a high fever for 3 to 4 days –
during which time the child may experience mild coldlike
symptoms and slight irritability
Fever falls rapidly on the 3rd or 4th day and a maculopapular rash •
appears on the trunk
Rash expands to rest of body – fades in 24 hours •
Infectious agent: Herpes virus 6 –
Communicable Diseases (continued)
Rubella (German Measles, 3-Day Measles) •
Mild febrile infectious disease resembling both scarlet fever and –
measles
Characterized by a rash of both macules and papules that fades and •
disappears in 3 days
Koplik’s spots and photophobia are not present with Rubella •
Infectious agent: Rubella virus –
Immunization: One of the components of the MMR vaccine –
Communicable Diseases (continued)
Rubeola (“Red Measles”, 7-Day Measles) •
Acute, highly communicable viral disease that begins as an upper –
respiratory disorder, which is characterized by fever, sore throat,
cough, runny nose, sensitivity to light, and possible conjunctivitis
Typical red, blotchy rash appears 4 to 5 days after onset of symptoms – •
behind ears, on forehead or cheeks, progressing to extremities and trunk
– lasts about 5 days
Infectious agent: Measles virus –
Immunization: one of the components of the MMR vaccine –
Communicable Diseases (continued)
Scarlet Fever (Scarlatina) •
Acute, contagious disease characterized by sore throat, abrupt –
high fever, increased pulse, strawberry tongue, and pointlike
bright red rash on the body
Infectious agent: Group A beta-hemolytic streptococci –
PATHOLOGICAL CONDITIONS
CHILD HEALTH
Asthma
Pronounced •
(AZ-mah) –
Defined •
Paroxysmal dyspnea (severe attack of difficulty breathing) –
accompanied by wheezing caused by a spasm of the bronchial
tubes or by swelling of their mucous membrane
Asthma (continued)
Asthmatic Attack •
Starts suddenly with coughing and a sensation of tightness in the –
chest
Followed by slow, laborious, wheezy breathing –
Expiration is much more strenuous and prolonged than inspiration •
Patient may assume a “hunched forward” position in an attempt to get •
more air
Status Asthmaticus –
Severe asthma that is unresponsive to conventional therapy and lasts •
longer than 24 hours
Cleft Lip and Palate
Pronounced •
(CLEFT LIP and PAL-at) –
Defined •
Cleft Lip is a congenital defect in which there is an open space –
between the nasal cavity and the lip
Due to failure of soft tissue and bones in this area to fuse properly during •
embryonic development
Cleft Lip and Palate (continued)
Defined (continued) •
Cleft Palate is failure of the hard palate to fuse, resulting in a –
fissure in the middle of the palate
Newborn has difficulty with feeding and breathing as result of the •
abnormalities
Medical management and surgical intervention are necessary •
Coarctation of the Aorta
Pronounced •
(koh-ark-TAY-shun of the ay-OR-tah) –
Defined •
Congenital heart defect characterized by a localized narrowing of –
the aorta
Results in increased blood pressure in the upper extremities and •
decreased blood pressure in the lower extremities
Croup
Pronounced •
(CROOP) –
Defined •
Childhood disease characterized by a barking cough, suffocative –
and difficult breathing, stridor and laryngeal spasm
Stridor = high-pitched musical sound when breathing in •
Cryptorchidism
Pronounced •
(kript-OR-kid-izm) –
Defined •
Condition of undescended testicle(s); the absence of one or both –
testicles from the scrotum
Down Syndrome
Pronounced •
(DOWN SIN-drohm) –
Defined •
Congenital condition characterized by multiple defects and –
varying degrees of mental retardation
Also called trisomy 21 –
Down Syndrome (continued)
Clinical Manifestations •
Evident at Birth –
Low set ears •
Short broad appearance to the head •
Protruding tongue •
Short thick neck •
Simian line •
Transverse crease on palm •
Broad short feet and hands •
Poor or diminished muscle tone •
Hyperflexible joints •
Dwarfism
Pronounced •
(DWARF-izm) –
Defined •
Generalized growth retardation of the body due to the deficiency –
of the human growth hormone
Also known as congenital hypopituitarism or hypopituitarism –
Epispadias
Pronounced •
(ep-ih-SPAY-dee-as) –
Defined •
Congenital defect in which the urethra opens on the upper side –
of the penis at some pint near the glans
Epispadias (continued)
Erythroblastosis Fetalis
Pronounced •
(eh-rith-roh-blass-TOH-sis fee-TAL-iss) –
Defined •
Form of hemolytic anemia that occurs in neonates due to a –
maternal-fetal blood group incompatibility, involving the ABO
grouping or the Rh factors
Also known as hemolytic disease of the newborn (HDN) –
Esophageal Atresia
Pronounced •
(ee-soff-ah-JEE-al ah-TREE-zee-ah) –
Defined •
Congenital abnormality of the esophagus due to its ending –
before it reaches the stomach either as a blind pouch or as a
fistula connected to the trachea
Gigantism
Pronounced •
(JYE-gan-tizm) –
Defined •
Proportional overgrowth of the body’s tissue due to the –
hypersecretion of the human growth hormone before puberty
Child experiences accelerated abnormal growth chiefly in the long bones •
Hyaline Membrane Disease
Pronounced •
(HIGH-ah-lign MEM-brayn dih-ZEEZ) –
Defined •
Severe impairment of the function of respiration in the premature –
newborn
Also known as respiratory distress syndrome of the premature –
infant (RDS)
Hydrocele
Pronounced •
(HIGH-droh-seel) –
Defined •
Accumulation of fluid in any saclike cavity or duct, particularly the –
scrotal sac or along the spermatic cord
Hydrocephalus
Pronounced •
(high-droh-SEFF-ah-lus) –
Defined •
Congenital disorder in which there is an abnormal increase of –
cerebrospinal fluid in the brain that causes the ventricles of the
brain to dilate
Results in increased head circumference in the infant with open •
fontanels
Hypospadias
Pronounced •
(high-poh-SPAY-dee-as) –
Defined •
Congenital defect in which the urethra opens on the underside of –
the penis instead of at the end
Hypospadias (continued)
Intussusception
Pronounced •
(in-tuh-suh-SEP-shun) –
Defined •
Telescoping of a portion of proximal intestine into distal intestine –
usually in the ileocecal region causing an obstruction
Typically occurs in infants and young children •
Patent Ductus Arteriosus
Pronounced •
(PAY-tent DUK-tus ar-tee-ree-OH-suss) –
Defined •
Abnormal opening between the pulmonary artery and the aorta –
caused by failure of the fetal ductus arteriosus to close after birth
Defect seen primarily in premature infants •
Phimosis
Pronounced •
(fih-MOH-sis) –
Defined •
Tightness of the foreskin (prepuce) of the penis of the male –
infant that prevents it from being pulled back
The opening of the foreskin narrows due to the tightness and may cause •
some difficulty with urination
Reye’s Syndrome
Pronounced •
(RISE SIN-drohm) –
Defined •
A syndrome marked by severe edema of the brain and increased –
intracranial pressure, hypoglycemia, and fatty infiltration and
dysfunction of the liver
Symptoms may follow an acute viral infection, occurring in children •
below the age of 18, often with fatal results
Spina Bifida Occulta
Pronounced •
(SPY-nah BIH-fih-dah oh-KULL-tah) –
Defined •
A congenital defect of the central nervous system in which the –
back portion of one or more vertebrae is not closed
A dimpling over the area may occur •
Sudden Infant Death Syndrome (SIDS)
Pronounced •
(Sudden Infant Death SIN-drohm) –
Defined •
The completely unexpected and unexplained death of an –
apparently well, or virtually well, infant
Also known as “crib death” –
Most common cause of death between the second week and first year of •
life
Tay-sachs Disease
Pronounced •
(TAY-SACKS dih-ZEEZ) –
Defined •
Congenital disorder caused by altered lipid metabolism due to an –
enzyme deficiency
Tay-sachs Disease (continued)
Symptoms of Neurological Deterioration •
Occur around age of 6 months –
Progressive - due to accumulation of a specific type of lipid in the –
brain
Physical and mental retardation also occur •
Deafness, blindness with a cherry red spot on each retina, –
convulsions, and paralysis
Death occurs around the age of 2 to 4 years •
Tetralogy Of Fallot
Pronounced •
(teh-TRALL-oh-jee of fal-OH) –
Defined •
Congenital heart anomaly that consists of four defects: –
pulmonary stenosis; interventricular septal defect; dextroposition
of the aorta so it receives blood from both ventricles; hypertrophy
of the right ventricle
Babies are termed “blue babies” •
Tetralogy Of Fallot (continued)
Defects of Tetralogy of Fallot •
(1) Pulmonary stenosis –
Restricts flow of blood from heart to lungs •
(2) Interventricular septal defect –
Creates right-to-left shunt between ventricles •
Allows deoxygenated blood to communicate with oxygenated blood •
Tetralogy Of Fallot (continued)
Defects of Tetralogy of Fallot (continued) •
(3) Shifting of aorta to the right –
Aorta overrides the right ventricle •
Aorta communicates with interventricular septal defect •
Oxygen-poor blood passes more easily into aorta •
(4) Hypertrophy of right ventricle –
Occurs because of increased work required to pump blood through •
obstructed pulmonary artery
Transposition of the Great Vessels
Pronounced •
(trans-poh-SIH-shun of the great vessels) –
Defined •
Condition in which the two major arteries of the heart are –
reversed in position, resulting in two non-communicating
circulatory systems
Umbilical Hernia
Pronounced •
(um-BILL-ih-kahl HER-nee-ah) –
Defined •
An outward protrusion of the intestine through a weakness in the –
abdominal wall around the umbilicus
Umbilicus = navel or “belly button” •
DIAGNOSTIC TECHNIQUES AND PROCEDURES
CHILD HEALTH
Diagnostic Techniques and Procedures
Heel Puncture •
A method of obtaining a blood sample from a newborn or –
premature infant by making a shallow puncture of the lateral or
medial area of the plantar surface of the heel
Also called a “heel stick” –
Diagnostic Techniques and Procedures (continued)
Pediatric Urine Collection •
A pediatric urine collection bag is applied to the perineal area of –
the infant so urine can collect in the bag for a specimen
Skin must be completely dry for the bag to adhere •