MOTHER, CHILD AND ADOLESCENT

(WELL CLIENTS)

NAME: LADIMER M. GUITORES COURSE/SECTION: BSN 2A

Problems in Infant

1. Birth Injuries
Sometimes, during the birth process, a baby may suffer a physical injury. It is called
birth injury or birth trauma. A birth injury could result from the use of the forceps while
getting the baby out of the birth canal. Most babies recover quickly from the trauma
of childbirth. Babies delivered normally may have a swelling on their scalp due to
vacuum; they may also get injured due to the use of forceps.

2. Jaundice
Jaundice is very common in newborns and infants. It occurs when there is an excess of
bilirubin in baby’s blood, which causes yellowish pigmentation of the skin. This is a fairly
common problem as many babies are born with neonatal jaundice. It occurs
because the baby’s liver is not mature enough to get rid of the excess bilirubin in the
blood. Neonatal jaundice normally resolves with time. In most cases, it should
disappear within 2 to 3 weeks of the baby’s birth. However, if it persists longer than 3
weeks, it could be a symptom of an underlying condition and parents should check
with their baby’s doctor.

3. Colic
Colic is very common in babies but that does not make it easier for parents to handle.
When a baby cries continuously for no apparent reason, especially in the evening, he
may have colic. The exact cause of colic is not known and some theories behind it
suggest that it could be because of gas, hormones that cause stomach pain,
overstimulation by light or sound, or a growing digestive system. Colic starts at 2 weeks
in full-term infants and should subside by the time the baby is 3 months of age.
However, if this condition persists, it could be because of intolerance to milk formula or
some other underlying condition. It is best to consult a doctor to get the condition
diagnosed.

4. Abdominal Distension
Abdominal distension can occur in newborns and healthy infants. One of the
prominent causes of abdominal distension in infants is swallowing of excess air. As a
parent, you need to observe the belly of your infant. Newborns have protruding and
soft bellies. If your baby’s belly feels hard and swollen when you touch it, it could be
because of gas or constipation. As the baby’s body begins to adjust to feeding, the
problem should get resolved. However, if a bluish tinge persists and much distension of
the abdomen is present, it could mean a serious underlying problem with the internal
organs.
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5. Bluish Skin and Apnea

Newborns tend to have bluish hands and feet. However, the blue colour fades in time
as the blood circulation improves in their bodies. But if you notice bluish tinge around
your baby’s mouth and it persists for long along with breathing difficulties, it could
mean that the baby’s heart and lungs are not functioning well. Your baby could have
apnea if his breathing stops for 15 to 20 seconds and he has bluish skin. Underlying
condition indicated is a heart problem that needs medical attention and intervention.

6. Vomiting
Sometimes babies vomit or spit the milk they feed – it is a common occurrence. This is
why mothers tend to burp their babies to prevent them from throwing up. After being
fed, however, if your baby throws up the milk and you notice a greenish colour in
vomit and he continues to vomit, then it could result in a serious problem. Infants can
get dehydrated very quickly and medical help and treatment may be needed.
Lactose and breast milk intolerance is also a fairly common problem that needs
medical support and monitoring. Frequent vomiting and spitting up of the milk could
be due to an underlying infection or digestive problems.

7. Coughing
If the flow of the milk is too fast, the baby might cough while being fed. Persistent
coughing and gagging while being fed could indicate a problem with the lungs or the
digestive system. Coughing at night continuously may indicate whooping cough or
respiratory problems. If your baby coughs while being fed or at night, you must take
him to a doctor at the earliest.

8. Respiratory Distress
This occurs when there is insufficient oxygen for the baby due to a blockage in his
nasal passage. The baby may have bluish skin because of the lack of oxygen. It takes
a few hours for the newborn baby to learn to breathe normally. Once normal
breathing is established, there should be no more bluish colouration. If wheezing,
grunting, and bluish colour persists, checking with a healthcare professional is a must.

9. Anaemia
Children of anaemic mothers are born anaemic. Anaemia is a condition in which red
blood cells are less than normal as per a child’s age. Anaemia is the lack of
haemoglobin, indicating that the level of oxygen in the blood is low and that the
blood is thick. Medical intervention is a must as untreated anaemia could prove to be
fatal.

10. Fever
Fever is an indication that the body is fighting an infection. However, high and
persistent fever above 101 degrees in newborns and infants can lead to seizures and
brain damage. If your baby has a high fever, you must take him to a doctor and get
the necessary medication.
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Problems in Toddler

1. Tooth Decay
Is the breakdown of tooth enamel. It can lead to holes in the teeth called cavities.
Is caused by bacteria in the mouth. These bacteria make a sticky substance called
plaque that can eat away at a tooth’s enamel. Poor oral hygiene can raise your
child’s risk for tooth decay.
2. Kicking and Biting
At age two or three, your otherwise angelic toddler may be showing signs of
aggression by biting and kicking all those in the range. He may be doing so to get
attract your attention. The key is not to respond to him every single time he does it as
this could then turn into a habit. However, like other similar habits, this one too will fade
away with time.

3. Temper Tantrums
Between the ages of one to three, your tiny tot is being exposed to a wide range of
emotions. He may not be able to express himself properly, although he can
understand all that you say. This can be frustrating for the child and leads to temper
tantrums. Crying out loud, screaming and throwing things around are the common
form of tantrums at such times.

4. Saying No
Your young child has probably made a recent discovery about the consequence of
saying the word “No”. Since he has often heard this word from you, he makes every
attempt to use it while responding to you. Not only does this word draw a reaction
from you but it also provides an alternative to your toddler.

5. Interrupting
Your child’s short-term memory hasn’t quite developed yet, which means that he will
want to say things before he forgets them. This can seem as interrupting, though it
does not make any sense to the toddler. At this age, he is unable to understand that
you have to manage and respond to various other people and situations. But he will
understand this concept after 4 years of age or so.

6. Lying
Your child may not be able to differentiate between reality and fantasy until he
reaches the age of 3 or 4 years. The concept of lying is still unknown to him, nor does
he understand what truth means. He has an active imagination at this age and he will
create imaginary creatures and people, deny drawing on the wall or spilling the milk.

7. Hair Pulling
Similar to kicking and biting, hair pulling too is a way of expressing his or her feelings
and creating a controlled environment around himself. Kids are keen to get a reaction
from their parents or siblings and hair pulling surely get them one. He could be pulling
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other’s hair to enjoy himself since he loves the reaction or it could also be an impulsive
control disorder if he is pulling his own hair.

8. Whining
Imagine this. Your child is dependent on you for all the important things in his life which
include eating, drinking, support and even getting cleaned after he poops. If he
wants to get your attention, he resorts to crying or whining. He feels that this way his
mother will give him all that he needs and this, then, becomes his standard behaviour.

9. Fear of Crowds
As a toddler, your child will probably become unruly and unmanageable when he is
surrounded by a large group of people. This could happen at the mall, a busy railway
station or a crowded party too.

10. Nail Biting

Biting of nails can become a habit with your child and he may even start doing it
unconsciously and at times even without a trigger. It becomes so common for him
that he may not be aware of doing it. This happens when the child is feeling bored or
is stressed. Follow this guide to deal with unhygienic habits in kids.

Problem in Preschool

1. Sore Throat
Sore throats are common in children and can be painful. However, a sore throat that
is caused by a virus does not need antibiotics. In those cases, no specific medicine is
required, and your child should get better in seven to ten days. In other cases, a sore
throat could be caused by an infection called streptococcal (strep throat).

2. Ear Pain
Ear pain is common in children and can have many causes—including ear infection
(otitis media), swimmer's ear (infection of the skin in the ear canal), pressure from a
cold or sinus infection, teeth pain radiating up the jaw to the ear, and others. . To tell
the difference, your pediatrician will need to examine your child's ear. In fact, an
in-office exam is still the best way for your pediatrician to make an accurate diagnosis.
If your child's ear pain is accompanied by a high fever, involves both ears, or if your
child has other signs of illness, your pediatrician may decide that an antibiotic is the
best treatment.

3. Urinary Tract Infection

Bladder infections, also called urinary tract infections or UTIs, occur when -bacteria
build up in the urinary tract. A UTI can be found in children from infancy through the
teen years and into adulthood. Symptoms of a UTI include pain or burning during
urination, the need to urinate frequently or urgently, bedwetting or accidents by a
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child who knows to use the toilet, abdominal pain, or side or back pain.

4. Skin Infection
In most children with skin infections, a skin test (culture or swab) may be needed to
determine the most-appropriate treatment. Tell your doctor if your child has a history
of MRSA, staph infection, or other resistant bacteria or if he or she has been exposed
to other family members or contacts with resistant bacteria.

5. Bronchitis
Chronic bronchitis is an infection of the larger, more central airways in the lungs and is
more often seen in adults. Often the word "bronchitis" is used to describe a chest virus
and does not require antibiotics.

6. Bronchiolitis
Bronchiolitis is common in infants and young children during the cold and flu season.
Your doctor may hear "wheezing" when your child breathes. Bronchiolitis is most often
caused by a virus, which does not require antibiotics. Instead, most treatment
recommendations are geared toward making your child comfortable with close
monitoring for any difficulty in breathing, eating, or signs of dehydration. Medicines
used for patients with asthma (such as albuterol or steroids) are not recommended for
most infants and young children with bronchiolitis. Children who were born
prematurely or have underlying health problems may need different treatment plans.

7. Pain
The best medicines for pain relief for children are acetaminophen or ibuprofen. Talk to
your pediatrician about how much to give your child, as it should be based on your
child's weight.

8. Common Cold
Colds are caused by viruses in the upper respiratory tract. Many young
children—especially those in child care—can get 6 to 8 colds per year. Symptoms of a
cold (including runny nose, congestion, and cough) may last for up to ten days.
Green mucus in the nose does not automatically mean that antibiotics are needed;
common colds never need antibiotics. However, if a sinus infection is suspected, your
doctor will carefully decide whether antibiotics are the best choice based on your
child's symptoms and a physical exam.

9. Bacterial Sinusitis
Bacterial sinusitis is caused by bacteria trapped in the sinuses. Sinusitis is suspected
when cold-like symptoms such as nasal discharge, daytime cough, or both last over
ten days without improvement.

Antibiotics may be needed if this condition is accompanied by thick yellow nasal

discharge and a fever for at least 3 or 4 days in a row.
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10. Cough
Coughs are usually caused by viruses and do not often require antibiotics. Cough
medicine is not recommended for children 4 years of age and younger, or for children
4 to 6 years of age unless advised by your doctor. Studies have consistently shown that
cough medicines do not work in the 4-years-and-younger age group and have the
potential for serious side effects. Cough medicines with narcotics—such as
codeine—should not be used in children.

Problems in School age

1. Chicken Pox
Chickenpox is a childhood disease that’s nearly been eradicated with the
introduction of the chickenpox vaccination in 1995. Prior to that time, four million kids
in the United States suffered every year from the disease. Cases have fallen
exponentially since the vaccine; however, unvaccinated kids are still susceptible to
the viral infection that causes itchy, fluid-filled blisters to rise on the skin. It is highly
contagious and uncomfortable.

2. Hand foot and mouth disease

Hand foot and mouth disease is a viral infection that kids in close proximity can pick up
from one another. A rash and sores appear in the mouth, on the hands, feet and even
on the buttocks. There’s nothing you can do to treat the disease though symptoms
can be treated if your child is uncomfortable. For instance, if the condition is
accompanied by a fever, ask your doctor about an over the counter medication that
will lower his fever. Dress the child in lightweight clothing and keep them cool.

3. Impetigo
is a skin infection that appears with reddish sores that will primarily surround the nose
and mouth. Hands and feet are also targets of impetigo that is characterized by
crusty sores, when the previous reddish sores crust over and burst. Impetigo is treated
with antibiotics and is highly contagious; Keep kids with impetigo home from school to
prevent spreading. Children are no longer contagious following twenty-four-hour
antibiotic treatments.

4. Poor nutrition
Do you know if – and what – your child is eating at school? Many parents don’t, says
Dr. Lisa Asta, a pediatrician in Walnut Creek, California, who often sees kids with
ailments like headaches that can be traced back to poor eating habits. “Nutrition
feeds into so much,” says Asta, including school performance. She recommends
learning about your children’s school meal program and what’s offered in after-care.
What and how you eat at home is important, too, adds Theodore, who suggests
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striving for regular family dinners, keeping only healthy snacks on hand, teaching your
kids about good food choices while bringing them on grocery trips and – most
importantly – modeling healthy eating at home.

5. Physical inactivity
Red rover, tag and other classic recess games are getting the boot at schools across
the country due to concerns about bullying, Asta says. The result: rule-laden,
structured exercise – think mind-numbing lap-running – during recess, if kids get recess
at all. “For many kids, that equates physical activity with just torture,” Asta says. To help
your kids develop a love of movement, try inviting them to join you for a run or a yoga
class, suggests Theodore, also a psychology professor at the College of William and
Mary. “A lot of parents say one of the things they like to do is engage in those activities
because it becomes a lifelong bond.”

6. Asthma
Asthma, which affects close to 9 percent of children, has been on the rise since the
early 1980s, according to the Asthma and Allergy Foundation of America. That’s
serious, since the condition is the top reason kids miss school, and it also compromises
their sleep, concentration, self-esteem and other areas of mental health, Theodore
says. “Overall, it diminishes their quality of life because it kind of alienates them,” she
says, noting that some psychological interventions like guided imagery and
mindfulness have been shown to improve symptoms. School nurses, too, can teach
students how to use an inhaler, avoid triggers and recognize when to visit a health
care provider, Mattey adds.

7. Poor social skills

If you can tweet, why talk? If you can send an emoji, why smile? If you can “like,” why
verbalize a compliment? “Children don’t have the same social skills that we did
growing up because they don’t need to,” Theodore says. That’s a detriment to their
mental health, since it can cause them to disengage from activities, alienate
themselves from (real) friends and even lead to situational depression and anxiety
when, say, they’re excluded from social events. To keep your kids’ people skills up to
snuff, initiate a no-technology rule at family dinners, Theodore suggests, and ask
everyone to share the “peaks and pits” of their days.

8. Stress
School psychologists see a lot of young perfectionists these days, Theodore says.
“They’ve gotta get the best grades, they have to be a Division 1 athlete,” she says.
Indeed, a 2014 survey from the American Psychological Association found that teens’
self-reported stress levels are higher than those of adults during the school year. That
type of pressure exacerbates all physical and psychological disorders, including
depression, Theodore says. One solution: simply spending quality time with your kids. “If
you have … parents who talk to you, model good eating behaviors and teach you
about coping skills and problem-solving skills," she says, "children will fare much better.”
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9. Concussions
Just because your son isn't a high school football star doesn't mean he's in the clear
when it comes to concussion risk. Young kids who tumble off the swing set or topple
from their bikes can also suffer traumatic brain injuries, which can manifest as difficulty
concentrating, headaches, light sensitivity, memory problems and more, Mattey says.
If you notice those symptoms or others such as changes in mood or sleep after a
knock to the head, encourage your child to rest and talk to his or her teachers about
lightening the workload if necessary, the American Academy of Pediatrics suggests. If
symptoms worsen,

10. Cyberbullying
Bullying is not a modern phenomenon, but its inability to be left at the schoolyard
when the dismissal bell rings is, Theodore says. One study from the Cyberbullying
Research Center, for example, found that more than one-third of 11- to 15-year-olds
have been cyberbullied. "We're seeing [mental health] issues magnetized because of
social media," Theodore says. To help your kids cope with this and other health issues,
first listen to and validate them, and then don't hesitate to reach out to school staff,
Mattey adds. "The school wants to work with your child," she says. "We want your kids
to succeed."

Problem in Adolescent

1. Injuries

Unintentional injuries are the leading cause of death and disability among
adolescents. In 2016, over 135 000 adolescents died as a result of road traffic
accidents. Many of those who died were “vulnerable road users”, including
pedestrians, cyclists or users of motorized two-wheelers. In many countries, road safety
laws need to be made more comprehensive, and enforcement of such laws needs to
be strengthened. Furthermore, young drivers need advice on driving safely, while laws
that prohibit driving under the influence of alcohol and drugs need to be strictly
enforced among all age groups. Blood alcohol levels should be set lower for young
drivers than for adults. Graduated licenses for novice drivers with zero-tolerance for
drink-driving are recommended.

2. Mental health

Depression is one of the leading causes of illness and disability among adolescents,
and suicide is the second leading cause of death in adolescents. Violence, poverty,
humiliation and feeling devalued can increase the risk of developing mental health
problems.
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Building life skills in children and adolescents and providing them with psychosocial
support in schools and other community settings can help promote good mental
health. Programmes to help strengthen the ties between adolescents and their
families are also important. If problems arise, they should be detected and managed
by competent and caring health workers.

3. Violence

Interpersonal violence is the third leading cause of death in adolescents, globally,

though its prominence varies substantially by world region. It causes nearly a third of
all adolescent male deaths in low- and middle-income countries of the WHO Region
of the Americas. Globally, nearly one in three adolescent girls aged 15 – 19 years (84
million) has been a victim of emotional, physical and/or sexual violence perpetrated
by their husband or partner.

4. HIV/AIDS

An estimated 2.1 million adolescents were living with HIV in 2016; the great majority in
the WHO African Region. Although the overall number of HIV-related deaths has been
decreasing since the peak in 2006, estimates suggest that this is not yet the case
among adolescents. This reflects the fact that most of today’s adolescents were born
before prevention of mother-to-child transmission of HIV by antiretroviral therapy
became widespread. However, a substantial proportion of HIV-positive adolescents
are unaware of their status, and many of those who are aware of their status do not
receive effective, long-term antiretroviral treatment.

5. Early pregnancy and childbirth

The leading cause of death for 15-19 year-old girls globally is complications from
pregnancy and childbirth. Some 11% of all births worldwide are to girls aged 15–19
years, and the vast majority of these births are in low- and middle-income countries.
The UN Population Division puts the global adolescent birth rate in 2018 at 44 births per
1000 girls this age – country rates range from 1 to over 200 births per 1000 girls (1). This
indicates a marked decrease since 1990. This decrease is reflected in a similar decline
in maternal mortality rates among 15–19 year olds.

6. Alcohol and drugs

Harmful drinking among adolescents is a major concern in many countries. It reduces

self-control and increases risky behaviours, such as unsafe sex or dangerous driving. It is
an underlying cause of injuries (including those due to road traffic accidents),
violence and premature deaths. It can also lead to health problems in later life and
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affects life expectancy. Setting a minimum age for buying and consuming alcohol
and regulating how alcoholic drinks are targeted at the younger market are among
the strategies for reducing harmful drinking.

7. Nutrition and micronutrient deficiencies

Iron deficiency anaemia was the second leading cause of years lost by adolescents
to death and disability in 2016. Iron and folic acid supplements are a solution that also
helps to promote health before adolescents become parents. Regular deworming in
areas where intestinal helminths such as hookworm are common is recommended to
prevent micronutrient (including iron) deficiencies.

8. Undernutrition and obesity

Many boys and girls in developing countries enter adolescence undernourished,

making them more vulnerable to disease and early death. At the other end of the
spectrum, the number of adolescents who are overweight or obese is increasing in
low-, middle- and high-income countries.

9. Physical activity

Physical activity provides fundamental health benefits for adolescents, including

improved cardiorespiratory and muscular fitness, bone health, maintenance of a
healthy body weight, and psychosocial benefits. WHO recommends for adolescents
to accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity
daily, which may include play, games, sports, but also activity for transportation (such
as cycling and walking), or physical education.

10. Tobacco use

The vast majority of people using tobacco today began doing so when they were
adolescents. Prohibiting the sale of tobacco products to minors (under 18 years) and
increasing the price of tobacco products through higher taxes, banning tobacco
advertising and ensuring smoke-free environments are crucial. Globally, at least 1 in 10
adolescents aged 13 to 15 years uses tobacco, although there are areas where this
figure is much higher. Cigarette smoking seems to be decreasing among younger
adolescents in some high-income countries.
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Nursing Care Plan in Infant with Jaundice

ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATION
Subjective;  Risk for Hyperbilirubine  After Independent;  Afte
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ang mata at related in the neonate of infant’s age. diagnosing of
balat ng baby to is an nursing underlying nursing
ko” as premat-u accumulation interve cause in interven
verbalized by rity. of serum ntions, connection tions,
the mother. bilirubin above the with the the
normal levels. patien appearanc patient
Objective: Onset of t skin e of skin
 Skin clinical is seen color  Assist with jaundice. color
appearin when serum will be phototherapy  To allow for was
g light to bilirubin levels normal treatment. utilization of normal.
bright are 5 to 7 . alternate
yellow. mg/100 dL. pathways
 Sclerae Physiologic  Have the for bilirubin.
appearin jaundice infant  To
g yellow. occurs 3 to 5 completely expose the
 Dark days after birth undressed. entire skin
amber and is an  Keep the  To
urine. increase in eyes and protect
 V/S taken unconjugated gonads them form
as follows: bilirubin levels covered. the
T: 36.4 that do not constant
P: 110 exceed 5 exposure to
R: 30 mg/100 dL/ high
day. intensity
 Develop light.
systematic  Ideally
schedule of every 2
turning the hours so
infant. that all the
surfaces are
Collaborative: exposed.
 Obtain
bilirubin lievel
as directed.  To have
baseline
data if the
therapeutic
 Administer regimen is
fluid as effective.
directed.  To ensure
adequate
hydration.