d4 pt 2

Question 1

urine output for children and PRBC

Answer 1

Minimum output:
- infant: 2 mL/kg/hour
- child:1 mL/kg/hr
- adolescent: 0.5 mL/kg/hour

Transfusion if significant blood loss
- 10cc/kg PRBC

Question 2

mild - moderate dehydration sx

Answer 2

5-10% loss
50 ml/kg/hr for <5 over 4 hrs
100 ml/kg/hr for 5-10 over 4 hours

sx.
Sunken eyes
sunken fontanelles
redced skin turger
poor urine output
dry mucous membranes
slowed capilary refll
moderate will have increased resp effort and depth
irritability

Question 3

severe dehydration

Answer 3

> 10%
20-30 ml/kg/hr IV and then ORT once stable

drowsy/ decreased LOC
sunken eyes
tachycardia
tachypnea
cool mottled skin
cool extremities

Question 4

types of insulin

Answer 4

Rapid acting
- Aspart
- gluisline
- lisopro

intermediate acting
- NPH
goes into
- grlargline
- detemir
- degludic

Question 5

HEEADSSS assessement

Answer 5

home
education
eating
activity
drugs
sexuality
suicide
safety

Question 6

child passanger safety

Answer 6

4 Stages of seating ;
1. Rear-facing seat
2. Forward-facing seat
3. BoosterSeat
4. Seatbelts
Need for legislation & enforcement

Question 7

preventing threats to breathing

Answer 7

Preventing threats to Breathing
– Food
– Cords
– Latex balloons
– Home Safety
Sleeping environment
– Legislation & standards for safe toys, child equipment

Question 8

injurty prevention child approach

Answer 8

1. establish particular ‘rules’ or patterns for approaching common situations
2. have child articulate risks and discuss how she or he can avoid them
3. provide opportunities for child to explore environment with his or her judgement
4. foster the child’s ability to appraise situations and know their own abilities & limits and to know what resources they have
5. modify the environment to reduce likelihood of exposure
6. Establish standards or legislation for safety
7. local policies to eliminate use of hazardous agents or to foster development of abilities

Question 9

Preventing Nutrient Deficiency

Answer 9

• Iron deficiency is the most common internationally
• Behavioural concerns
• Mental and motor development

intervention
* Pre and postnatal care
* Promotion of breastfeeding
* Fortification of cereals/grains & infant formula

Question 10

Preventing Neurotoxin Exposure (Alcohol)

Answer 10

Maternal alcohol consumption can lead to:
facial differences
- loss of neurons
- severe neurobehavioral impairment
- Impaired cognitive functioning
- Even at high doses, not all maternal alcohol use will lead to FAS
- Prevalence and preventability vs. inevitability
- Alcohol prevention programs

Question 11

Vaccinations

diptheria

Answer 11

• Diphtheria is a serious disease of the nose, throat and skin.
• It causes sore throat, fever and chills. It can be complicated by breathing problems, heart failure and nerve damage.
• Diphtheria kills about one out of every 10 people who get the disease.
• It is most often passed to others through coughing and sneezing.

Question 12

Vaccination

pertussis

Answer 12

• Pertussis, also called whooping cough, is a serious disease especially in children.
• Children who get this disease have spells of violent coughing. This cough can cause them to vomit or stop breathing for a short period of time.
• The cough can last for weeks and makes it hard for a child to eat, drink or even breathe.
• Pertussis can cause serious complications –> Pneumonia can occur in more than two out of 10 children with pertussis.
• Pertussis can also cause brain damage, seizures and death.
• These problems happen most often in babies.
• Pertussis spreads very easily from an infected person to others through coughing or sneezing.

Question 13

vacination

polio

Answer 13

• Polio is a serious disease that people can get from drinking water or eating food with the polio germ in it.
• It can also be spread from person to person. This disease can cause nerve damage and paralyse a person for life.
• It can paralyse muscles used for breathing, talking, eating and walking. It can also cause death.

Question 14

vaccination

Hib

Answer 14

• Hib does not cause influenza.
• Hib was the most common cause of bacterial meningitis in children two months to five years of age. Meningitis is a serious infection that can cause brain damage, learning and developmental problems, deafness and blindness.
• One out of 20 children with meningitis can die and serious disability (nerve damage, deafness) occurs in about 15 percent of cases.
• Also causes epiglottitis. This can make it difficult for the child to breathe –> Also can cause infection of the lungs (pneumonia) and bone and joint infections.

Question 15

vaccination

measels

Answer 15

• Measles can be a serious infection
• . It causes high fever, cough, rash, runny nose and watery eyes. Measles lasts for one to two weeks. Ear infections or pneumonia (lung infection) can happen in one out of every 10 children with measles.
• Measles can also be complicated by encephalitis, an infection of the brain, in about one out of every 1,000 children with measles.
• Measles can also make a pregnant woman have a miscarriage or give birth prematurely
• People can get measles from an infected person coughing or sneezing around them or simply talking to them.

Question 16

vaccinations

rubella

Answer 16

• Rubella is usually a mild illness in children; up to half of the infections with rubella occur without a rash.
• Rubella may cause fever, sore throat, swollen glands in the neck and a rash on the face and neck. Temporary aches and pains and swelling of the joints are common in adolescents and adults, especially females, with rubella infection.
• Rubella can be followed by chronic arthritis (inflamed joints). It can also cause temporary blood clotting problems and encephalitis. Rubella is very dangerous in pregnant women. If a woman gets rubella in the early part of a pregnancy, it is very likely that her baby will develop congenital rubella syndrome and be severely disabled or die.
• Rubella spreads by contact with an infected person through coughing, sneezing or talking to them.

Question 17

vaccines

mumps

Answer 17

• Mumps is a viral infection that is characterised by fever, headache and swelling of the cheek, jaw and neck.
• Mumps can cause very painful, swollen testicles in about one out of four teenage boys or adult men, and painful infection of the ovaries in one out of 20 women.
• Mumps infection during the first three months of pregnancy may increase the risk of miscarriage.
• Mumps can cause deafness in some people.
• People can get mumps from an infected person coughing or sneezing around them or simply talking to them via saliva

Question 18

working w vaccine hesitant parents

Answer 18

1. Understand the key role that sound vaccine advice from a health care provider can play in parental decision-making, and do not dismiss vaccine refusers from your practice
2. Use presumptive and motivational interviewing techniques to understand a parent’s specific vaccine concerns
3. Use simple, clear language to present evidence of disease risks and vaccine benefits, fairly and accurately
4. Address pain head on
5. Community protection (herd immunity) does not guarantee personal protection